Oğuz Köktürk

Gazi University, Engüri, Ankara, Turkey

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Publications (20)12.95 Total impact

  • Oğuz Köktürk · Ayşe Baha · Asiye Kanbay ·
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    ABSTRACT: Upper airway resistance syndrome (UARS) is characterized by repeated number of arousals at night, and excessive daytime sleepiness or somnolence (EDS). It is often missed in classical polysomnographic diagnostic approaches and misdiagnosed as simple snoring or idiopathic hypersomnia, thereby is often left untreated. We propose that positive airway pressure (PAP), which has shown to be effective against UARS, can be used as a diagnostic tool as well. The study designed to test whether patients with high titration pressures can be diagnosed for UARS, and whether this pressure can be used as the treatment pressure in UARS. This study is a retrospective cohort study. The patients with the following selection criteria: apnea hypopnea index (AHI) < 5, respiratory effort related arousal (RERA) index > 20, excessive daytime sleepiness or somnolence (EDS) without nocturnal oxygen desaturation levels were included to the study. After diagnostic polysomnography (PSG), PAP titrarion was applied to diagnose and treatment. Fourteen (%46.7) of the patients were male, 16 (%53.3) were female, with a mean age of 46.4 ± 9.9 and mean body mass index (BMI) of 26 ± 3.3. The patiens had a mean Epworth sleepiness scale 15.3 ± 3.9, mean AHI: 2.3 ± 1.4 and average RERA: 26.1 ± 4.9. The mean CPAP titration pressure was 7.1 ± 1.1 cmH2O. In the light of current findings, during PAP titration patients required high pressures is the evidence of increased upper airway resistance in UARS. Using the from therapy to diagnosis protocol, the PAP protocol determines the individual therapeutic pressures needed by patients. Following up the clinical outcomes of these patients under the PAP treatment, and including a larger cohort will contribute greatly to treating this syndrome, defined as one of the "unresolved problems in years".
    Tuberkuloz ve toraks 03/2015; 63(1):31-36. DOI:10.5578/tt.8799
  • Handan Inönü Köseoğlu · Asiye Kanbay · Oğuz Köktürk ·
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    ABSTRACT: Interstitial lung diseases (ILD), are a group of diseases which can involve pulmonary interstitium, small airways, and vessels, and diffusely affect pulmonary parenchyma as a consequence development of inflammation, and fibrosis leading to respiratory failure, and finally death. Obstructive sleep apnea syndrome (OSAS) is a disorder which courses with its systemic outcomes, and increasing morbidity, and mortality when accompanied with other respiratory system diseases. Concomitancy of OSAS with other lung diseases including chronic obstructive pulmonary disease, asthma, ILD, cystic fibrosis is termed as ''overlap syndrome''. Because of characteristic feature of OSAS ie. recurrent oxygen desaturations during night hours, ILD-OSAS concomitancy accelerates progression of underlying lung disease. Therefore, in cases with ILD, early diagnosis, and treatment of comorbid OSAS conveys vital importance in that this approach improves quality of life of the patients, and slows down progression of the disease. In this review ILD-OSAS concomitancy will be analyzed from its various aspects.
    Tuberkuloz ve toraks 09/2014; 62(3):231-5. DOI:10.5578/tt.7885
  • Handan Inönü Köseoğlu · Asiye Kanbay · Oğuz Köktürk ·
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    ABSTRACT: Central sleep-apnea syndrome (CSAS) is a disease state characterized by respiratory arrest as a result of decrease or lack of respiratory drive originating from respiratory center. Although it is seen in less than 5% of the casses who consult to the sleep disorders center, incidence of CSAS increases in the presence of congestive heart and/or renal failure, and central nervous system abnormalities. Treatment of CSAS which has been analyzed under six headings in the last version of International Classification of Sleep Disorders (ICSD-2), differs among each type of CSAS. In this review, our aim is to analyze treatment alternatives for CSAS in the light of currently updated information.
    Tuberkuloz ve toraks 03/2014; 62(1):68-78. DOI:10.5578/tt.6810
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    ABSTRACT: Background: Mucopolysaccharidoses (MPS) are a group of inherited lysosomal storage disorders caused by the deficiency of hydrolases involved in the degradative pathway of glycosaminoglycans. In MPS, upper airway obstruction may result from multiple causative factors which may impact severely upon morbidity and mortality. Methods: We evaluated upper airway obstructive disease and related clinical findings through home sleep study in 19 patients (11 with MPS VI, 4 with MPS I, 4 with MPS II) with MPS followed at Gazi University Pediatric Metabolic Unit. Patients underwent home-based sleep measurements, and sleep respiratory problems were asked in a detailed clinical history. Measurements of apnea, apnea-hypopnea index (AHI), hypopnea index, oxygen desaturation index, and minimal oxygen saturation were obtained through home sleep study. Results: For 19 children, the disorder was normal in 1, mild (AHI=1.5-5/h) in 5, moderate (AHI=5-10/h) in 2, and severe (AHI>10/h) in 11. The prevalence of OSA was 94.7 % (18/19) in patients with MPS. Snoring, witnessed apnea, pectus carinatum, and macroglossia were the main clinical findings. Echocardiograms showed evidence of pulmonary hypertension in 13 patients. Conclusion: Home sleep study is a quick and accessible screening test to determine the abnormalities of breathing during sleep and enables clinicians to take necessary action for patients with severe manifestations.
    Sleep And Breathing 05/2013; 18(1). DOI:10.1007/s11325-013-0862-z · 2.48 Impact Factor
  • nazlı sinanoğlu · tansu ulukavak çiftçi · Oğuz Köktürk ·

    Türk Toraks Derneği; 04/2011
  • Nazlı Sinanoğlu · Tansu Ulukavak Çiftçi · Oğuz Köktürk ·

    Turkish Thoracic Society 14th Annual Symposia; 04/2011
  • Handan Inönü · Oğuz Köktürk ·
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    ABSTRACT: Sleep disorders are common in patients with end-stage renal disease. Daytime sleepiness, restless legs syndrome, periodic limb movement disorder, insomnia, sleep apnea syndrome are the most disturbances. Usually, sleep-related complaints are attributed to uremia because of similar symptoms, and this may cause to delayed diagnosis. Sleep disorders are negative effect on quality of life and compliance to treatment of patients as well as cause increased mortality and morbidity. Therefore, sleep disorders should be evaluated as a different clinical entity in patients with chronic kidney failure or receiving renal replacement therapy. In this article, we aimed to review of etiology, pathogenesis and treatment of common sleep disorders in end-stage renal failure in sight of related literature information.
    Tuberkuloz ve toraks 10/2010; 58(4):450-4.
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    Handan İnönü · Tansu Ulukavak Çiftçi · Oğuz Köktürk ·
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    ABSTRACT: Aim: Complex sleep apnea syndrome (CompSAS) is characterized by the onset of central apneas or a Cheyne-Stokes breathing pattern in some patients with obstructive sleep apnea syndrome (OSAS) who were treated with continuous positive airway pressure (CPAP). The etiology of CompSAS is unclear, but derangement of respiratory control has been proposed. We sough.: to compare clinical and polysomnography (PSG) features of patients with CompSAS and OSAS. Materials and methods: Records of PSG were evaluated in a total of 270 patients, retrospectively. CPAP titration was prescribed in patients with an apnea-hypopnea index (AHI) of >= 15. Patients who developed a central AHI of >= 5 following titration PSG were diagnosed with CompSAS. Results: There were 71 patients with OSAS and 12 with CompSAS. The mean ages and body mass indexes (BMIs) were similar between the 2 groups. The incidences of diagnostic AHI, congestive heart failure (CHF), and chronic renal failure (CRF) were higher in patients with CompSAS. The average and minimum oxygen saturation levels were lower in patients with CompSAS and those with diagnostic PSGs. Conclusion: According to our results, lower oxygen saturation may cause instability of respiratory control in these patients and may be responsible for the pathophysiology of CompSAS.
    Turkish Journal of Medical Sciences 10/2010; 40(5). DOI:10.3906/sag-0904-14 · 0.50 Impact Factor
  • Vesile Sepici · Aliye Tosun · Oğuz Köktürk ·
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    ABSTRACT: Fibromyalgia syndrome (FMS) is characterized by chronic widespread musculoskeletal pain, stiffness and tenderness at multiple points. Sleep disturbances are common in FMS and patients usually complain about nonrestorative sleep. Obstructive sleep apnea syndrome (OSAS) is characterized by repetitive pharyngeal collapse during sleep. Recurrent arousals from sleep occurs to restore pharyngeal patency in OSAS and this results in increased sympathetic activity and fragmentation of sleep. Sleep disturbances may lead to musculoskeletal pain and some studies suggest a relation between OSAS and FMS. Since OSAS is strongly associated with increased risk of myocardial infarction, cerebrovascular accidents and congestive heart failure, its diagnosis and treatment are of particular importance. Herein we present a female patient with diagnosis of FMS for 10 years who had complaints of morning fatigue, restless sleep, sleepiness during day and snoring besides musculoskeletal symptoms. Severe OSAS was diagnosed after polysomnographic analysis and FMS symptoms were totally improved with nasal continuous positive airway pressure treatment.
    Rheumatology International 12/2007; 28(1):69-71. DOI:10.1007/s00296-007-0375-9 · 1.52 Impact Factor
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    ABSTRACT: To evaluate the right ventricular function in patients with obstructive sleep apnea syndrome (OSAS) independent from systemic hypertension (HT) and to determine the association between OSAS severity and right ventricular dysfunction. The study population included 77 consecutive subjects; 20 of these patients had OSAS, 20 of them had HT, but did not have OSAS, 16 patients, who constituted the study group, had both disorders, and 21 subjects without any of these two disorders represented the control group. Right ventricular function was assessed by echocardiography: standard two-dimensional, M-Mode, and conventional Doppler as well as tissue Doppler imaging. None of the patients had a previous history of cardiac disease. The diagnosis of OSAS was based on an apnea- hipopnea index of 5 or higher in polysomnography. Tricuspid inflow velocities and tissue Doppler derived tricuspid annular diastolic velocities were significantly different in the patient groups (OSAS, HT, OSAS + HT) compared to the control group. Tricuspid annular plane systolic excursion (TAPSE) (18.3 +/- 3.2, 18.4 +/- 2.5, 20.1 +/- 2.1, and 20.7 +/- 2.5 mm, respectively, P = 0.024) and peak systolic myocardial velocity at tricuspid lateral annulus (S-vel) (12.2 +/- 1.5, 10.9 +/- 0.9, 11.2 +/- 1.1, and 13.1 +/- 2.1 cm/s, respectively, P < 0.001) were significantly lower in patient groups compared to those of the study group. Tissue Doppler derived myocardial performance index (MPI) of the right ventricle was significantly impaired in the patient groups compared to the control group (0.34 +/- 0.06, 0.44 +/- 0.06, 0.45 +/- 0.07, and 0.41 +/- 0.06, respectively, P < 0.001). With regard to these right ventricular functional parameters, there was no significant difference between OSAS and the other patient groups (HT and OSAS + HT). There were significant correlations both between OSAS severity and the right ventricular functions, and between diastolic and systolic parameters of the right ventricle (r = -0.45, P < 0.05). Both right ventricular systolic and diastolic functions are impaired in patients having OSAS with or without HT. Right ventricular MPI was found to be the parameter most closely related with OSAS severity and the right ventricular subclinical dysfunction.
    The International Journal of Cardiovascular Imaging 09/2007; 23(4):469-77. DOI:10.1007/s10554-006-9168-6 · 1.81 Impact Factor
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    ABSTRACT: We sought to evaluate aortic function and its relationship with left ventricular (LV) function in patients with obstructive sleep apnea syndrome (OSAS), with or without systemic hypertension. A total of 29 patients with OSAS, 28 patients with systemic hypertension without OSAS, and 19 patients having both disorders were chosen as a study group, and 29 participants without these two disorders were taken as the control group; none of the patients had a history of cardiac disease. All of them underwent echocardiography and polysomnography. Aortic strain and distensibility were calculated from the aortic diameters measured by echocardiography and blood pressure obtained by cuff-sphygmomanometer. Cardiac functions were determined using echocardiography comprising standard 2-dimensional and conventional Doppler and Doppler tissue imaging. Aortic strain (mean +/- SD; 6.1 +/- 2.7% vs 6.4 +/- 2.4%, 4.7 +/- 1.8%, and 13.7 +/- 4.5%, P < .001, respectively) and distensibility (mean +/- SD 2.8 +/- 1.6 vs 2.5 +/- 0.9, 1.7 +/- 0.7, and 6.2 +/- 3.2 10(-6) cm(2) dyn(-1)P < .001, respectively) were significantly decreased in the patient groups (OSAS, hypertensive, and OSAS and hypertensive) compared with the control group. LV long-axis and diastolic functions were also impaired in the study group. There were good correlations between the aortic stiffness and LV function parameters. In a multivariate analysis, aortic strain was the parameter found to be most strongly associated both with the Doppler tissue imaging mean peak early/late diastolic velocity ratio and the LV mitral lateral annular plane systolic excursion. Aortic stiffness parameters (aortic strain and distensibility), LV systolic long-axis function indicators (mitral lateral annular plane systolic excursion, peak systolic myocardial velocity at lateral annulus, peak systolic myocardial velocity at septal annulus), and Doppler tissue imaging-derived LV diastolic indices were found abnormal in patients with OSAS, hypertension, or both. Thus, subclinical cardiac dysfunction has been found in patients with OSAS independent from the systemic hypertension.
    Journal of the American Society of Echocardiography: official publication of the American Society of Echocardiography 04/2007; 20(4):366-72. DOI:10.1016/j.echo.2006.09.005 · 4.06 Impact Factor
  • Oğuz Köktürk · Tansu Ulukavak Ciftci · Hikmet Firat · Serap Firat ·
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    ABSTRACT: The first diagnostic step in pleural effusions is the separation of transudates from exudates. We aimed in present study to investigate the value of HDL/LDL ratio for distinguishing between pleural exudates and transudates. Pleural fluids (PF)from 121 patients, including 28 transudates and 93 exudates were analyzed. The levels of cholesterol, HDL cholesterol and LDL cholesterol in PF were measured. The HDL/LDL ratio was calculated. HDL/LDL ratio found significantly higher in transudates than exudates (p= 0.001). Receiver operating characteristic (ROC) curves were generated and the cut off points determined to the highest level of accuracy and precision. The HDL/LDL ratio was to maximize sensitivity over specificity in the diagnosis of a transudative effusion. The usefulness of HDL/LDL ratio for identifying transudates was evaluated in terms of sensitivity and specificity. The value of pleural HDL/LDL ratio that best differentiated between transudates and exudates was 0.6 (sensitivity 89%, and specificity of 79%). Measurement of HDL and LDL in PF and calculating of HDL/LDL ratio can be proposed to aid for differentiation between pleural exudates and transudates with advantage of not requiring serum levels.
    Tuberkuloz ve toraks 02/2005; 53(1):34-9.
  • İzci B · Fırat H · Ardıç S · Köktürk O · Gelir E · Altınörs M. ·

    Tuberkuloz ve toraks 01/2004; 52:224-230.
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    ABSTRACT: Turkish version of functional outcomes of sleep questionnaire (FOSQ.tr) was examined for its psychometric properties in patients with obstructive sleep apnoea hypopnoea syndrome (OSAHS). The FOSQ was translated into Turkish using a forward-backward translation. For the psychometric evaluation, 73 consecutive patients were selected along with 73 control subjects. Internal consistency, test-retest reliability, concurrent and discriminant validity were investigated. Values of Cronbach's alpha for the total FOSQ.tr (alpha= 0.92) and its sub-scales (alpha= 0.76-0.80) suggest that the questionnaire was consistent internally. Test-retest reliability of the FOSQ.tr was significant for the total score (r= 0.7) and the sub-scales apart from social outcome (r= 0.5 to 0.8, all p< 0.01). FOSQ.tr correlated moderately with Epworth sleepiness scale (ESS), with coefficients ranging from r= -0.5 to -0.62, (all p< 0.05) for the sub-scales, and r= -0.64 (p< 0.01) for total score. Discriminant analysis showed that FOSQ.tr could significantly distinguish the patients from normal subjects (p< 0.03). The psychometric properties of the FOSQ.tr suggest that it is a valid and reliable instrument for the assessment of the impact of disorders of excessive sleepiness on daily behaviour.
    Tuberkuloz ve toraks 01/2004; 52(3):224-30.
  • Oğuz Köktürk · Bülent Ciftçi ·
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    ABSTRACT: The term overlap syndrome (OVS) in sleep disorders is used to describe the association of obstructive sleep apnea syndrome (OSAS) with one of the following disorders: chronic obstructive pulmonary disease (COPD), asthma, cystic fibrosis and interstitial lung diseases. Because OSAS and COPD are seen together frequently, the term of OVS is often used for OSAS associated with COPD. In both OSAS and COPD, some abnormalities on the level of oxygen saturation occur during sleep. These abnormalities are much more serious in the OVS. Oxygen desaturation destroys the architecture of sleep and leads to the complications due to hypoxemia, which are normally seen in the late stage of each disease, occur in early stage. In this review, interaction of sleep and some of the lung diseases was discussed.
    Tuberkuloz ve toraks 02/2003; 51(3):333-48.
  • Oğuz Köktürk · Tansu Ulukavak Ciftçi ·
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    ABSTRACT: Central sleep apnea syndrome (CSAS) is a disorder characterized by repeated apneic events during sleep with no associated ventilatory effort. CSAS is classified as either hypercapnic or non-hypercapnic. In the hypercapnic form of CSAS, increases in PaCO(2) generally result from reductions in ventilation or outright apneas due to an underlying depression of respiratory drive. Hypercapnic CSAS is common in central hypoventilation syndromes which may be primary (idiopathic) or secondary to other disorders that cause damage to the respiratory center. Non-hypercapnic CSAS is not associated with either a primary reduction in respiratory drive or respiratory muscle weakness. Non-hypercapnic CSAS can be a primary disorder or can occur secondary to high altitude, other medical illnesses such as congestive heart failure and central nervous system disease.
    Tuberkuloz ve toraks 02/2003; 51(3):349-60.
  • Oğuz Köktürk · Selma Firat Güven ·
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    ABSTRACT: Upper Airway Resistance Syndrome (UARS) is characterized with daytime sleepiness and cardiovascular disturbances, because of the repetitive increase of upper airway resistance leading to arousals. UARS, can easily be overlooked because the conventional polysonographic measurements are not sensitive enough to diagnose this syndrome, therefore the prevalence and morbidity of this syndrome is not known. Measuring the increased inspiratory effort by an esophageal balloon during the rising upper airway resistance is the gold standard technique for the diagnosis. Treatment of UARS is similar with Obstructive Sleep Apnea Syndrome (OSAS). In this article the clinical picture, diagnosis, and management of the UARS is reviewed.
    Tuberkuloz ve toraks 02/2003; 51(2):216-26.
  • Oğuz Köktürk · Tansu Ulukavak Ciftçi ·

    Tuberkuloz ve toraks 02/2003; 51(1):107-16.
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    ABSTRACT: Urinothorax is a rare complication of blunt renal trauma, ureteral instrumentation or ureteral surgery. A leakage from the urinary tract causes urinoma, a retroperitoneal collection of fluid, which can lead to urinothorax. We report a patient with solitary kidney who underwent extracorporeal shock wave lithotripsy (ESWL) for nephrolithiasis. Four days after ESWL, she had right-sided pleural effusion which demonstrated as urinothorax. Urinoma occurring after ESWL, as in our case, is a situation that has not been reported before as a cause of urinothorax. Urinothorax should be taken into consideration in patients with pleural effusion who recently underwent ESWL.
    Respiration 02/2002; 69(3):273-4. DOI:10.1159/000063633 · 2.59 Impact Factor

  • 01/2000; DOI:10.1501/Kriz_0000000159