Publications by authors named "Aydanur Ekici"

44 Publications

Chronic CT features in PE patients with co-existing DVT.

Am J Emerg Med 2021 Mar 14;46:126-131. Epub 2021 Mar 14.

Departments of Pulmonary Diseases, Kirikkale University Faculty of Medicine, Kirikkale, Turkey.

Objective: Clinical features may be different in patients with PE without co-existing DVT compared to those with PE with co-existing DVT. This prospective study aims to investigate the different clinical features between patients with isolated pulmonary embolism (PE) and those with PE associated with deep venous thrombosis.

Method: This is a prospective study conducted in 107 consecutive patients diagnosed with acute PE in the emergency department or other departments of Kırıkkale University Hospital. The diagnosis of PE was confirmed by computed tomography pulmonary angiography (CTPA), which was ordered on the basis of symptoms and findings. Bilateral lower extremity compression ultrasound with standard 7.5 MHz linear array probe was applied to all patients. According to compression ultrasound results, the patients were divided into two classes as with and without deep venous thrombosis. Embolism in the main or lobar pulmonary arteries were classified as central, and those found only in segmental or subsegmental arteries were classified as peripheral. Laboratory parameters and Oxygen saturation were assessed on admission.

Results: 67 of 107 (62.6%) patients with PE were isolated pulmonary embolism, and 40 (37.4%) were PE + DVT. Patients with PE with co-existing DVT have wider pulmonary artery, higher d-dimer and pro BNP level, and lower saturation than those with isolated pulmonary embolism. Central pulmonary embolism is more common in patients with deep vein thrombus than those without it. (87.5% (35/40) vs 32.8% (22/67),p = 0.001). 38.6% of central pulmonary embolism occur without deep vein thrombosis of the lower extremities. Patients with PE with co-existing DVT have 42.5% mosaic perfusion pattern,70% chronic infarct appearance such as linear band, pleural nodüle, %15.0 thickened, small arteries and, %12.5 shrunken complete artery occlusion, suggesting the chronic background.

Conclusion: PE patients with co-existing DVT are clinically more serious than those who do not have a DVT. An acute picture may be present in the chronic background in a significant proportion of patients with PE with co-existing DVT. In the presence of deep vein thrombosis, pulmonary embolism is usually central, but more than one-third of central pulmonary emboli occur without lower extremity deep vein thrombosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ajem.2021.03.031DOI Listing
March 2021

[Mortality prediction ability of phycians in intensive care units of Turkey (MOPAP)].

Tuberk Toraks 2020 Sep;68(3):205-217

Clinic of Chest Diseases, Hakkari State Hospital, Hakkari, Turkey.

Introduction: Intensive care physicians are increasingly involved in decision making about the prognosis of intensive care unit ICU patients. With this study; we aimed to evaluate the power of clinician foresight at prediction of mortality in patient at triage to intensive care and patient follow-up.

Materials And Methods: This study was conducted in ICUs located in various geographical regions of Turkey between January 1, 2017-April 30, 2017.The clinical research was planned as observational, multicenter, cross-sectional.

Result: A total of 1169 intubated patients were followed in 37 different ICU. At the beginning of the follow-up we asked the physician who will follow the patient in the ICU to give a score for the probability of survival of the patients. Scoring included a total of 6 scores from 0 to 5, with the "0" the worst probability "5" being the best. According to this distribution, only 1 (0.9%) of 113 patients who were given 0 points survived. Three (6.1%) of 49 with the best score of 5 died. Survival rates were significantly different in each score group (r: -0.488; p<0.001). After the combined mortality estimation scores based on the clinical observations of the physicians (0 and 1 point score was combined as non-survive, 4 and 5 score was combined as survived) 320 of the 545 patients were estimated to be dead and 225 were predicted survival. Sensitivity and spesifity of scoring system to predict mortality was 91.56% (95% CI: 87.96-94.37), 76.89% (95% CI: 70.82-82.23) respectively.

Conclusions: In this study, we concluded that the physicians who follow the patients in the ICU can predict the poor prognosis at the time of admission and the high mortality rate. The physician's opinion on mortality estimation should be considered in intensive care mortality scoring in addition to other laboratory and clinical parameters.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5578/tt.70135DOI Listing
September 2020

Pulmonary embolism in obesity-hypoventilation syndrome.

Clin Respir J 2020 Nov 13;14(11):1099-1104. Epub 2020 Aug 13.

Department of Pulmonary Diseases, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey.

Introduction: Obesity-hypoventilation syndrome occurs with alveolar hypoventilation during sleeping and daytime. Obesity may be a risk factor for venous thromboembolism. However, the venous thromboembolism in the obesity-hypoventilation syndrome is not well characterized.

Objective: This case series aimed to investigate the presence and clinical features of venous thromboembolism in patients with the obesity-hypoventilation syndrome.

Methods: Data of eight case reports were collected. Ages ranged from 36 to 73 years.

Results: All patients had mosaic perfusion and enlarged main pulmonary artery, two had signs of infarction and mostly segmental and subsegmental filling defects. On the basis of this information some conclusions can be drawn carefully.

Conclusion: Present cases indicate that pulmonary embolism are also very common in patients with obesity-hypoventilation syndrome, anticoagulant therapy is at least as important as the treatment of the current disease. Clinicians will frequently be faced with patients with obesity-hypoventilation syndrome suspected of PE.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/crj.13241DOI Listing
November 2020

Therapeutic Treatment with Abdominal Adipose Mesenchymal Cells Does Not Prevent Elastase-Induced Emphysema in Rats.

Turk Thorac J 2020 Jan 1;21(1):14-20. Epub 2020 Jan 1.

Clinic of Biochemistry, Yenimahalle State Hospital, Ankara, Turkey.

Objectives: Emphysema and chronic bronchitis have different pathophysiologies but both are significant components of chronic obstructive lung disease (COPD). The levels of Matrix metalloproteinase (MMP)-9 in the bronchoalveloar lavage fluid (BALF) and in serum indicate the presence of emphysema. Intratracheal administration of elastase has been used to create a rat model of emphysema. Adipose tissue-derived mesenchymal stem cells (MSC) have been postulated to prevent or reverse emphysema, however, this has not been examined in the rat model of elastase-induced emphysema.

Materials And Methods: In this study, 31 Wistar albino rats aged 6-8 weeks and weighing 250-300 g were assessed. On day 1, the animals were treated intratracheally with 0.5 mL saline (control group, n=10), i.e., 0.5 mL saline solution containing 0.1 IU porcine pancreatic elastase (PPE) (Elastase group, n=12) or PPE plus MSC (Elastase-MSC group, n=9) was adminstered per animal. MSCs suspended in serum were injected via the caudal vein on day 21. At least 10 cells were injected. All animals were sacrificed on day 42 and the emphysema index (EI) was calculated, along with measuring the BALF and serum MMP-9 concentrations.

Results: Porcine pancreatic elastase induced a significant degree of emphysema in the PPE groups as compared to the control group, which was determined by the EI index (p=0.008). This was not reversed by MSC treatment. The EI remained significantly low in comprison with the controls (p=0.001) and measured no different from the Elastase-treated animals. There was no statistically significant difference between the BALF and serum MMP-9 levels between the control and treatment groups.

Conclusion: Our findings suggest that therapeutic treatment with adipose tissue-derived MSC in rats has no effect on emphysema or on MMP9 expression, which is a known marker of emphysema.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5152/TurkThoracJ.2019.180136DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7020897PMC
January 2020

[Determination of anthropometric measurements in obstructive sleep apnea syndrome in Turkish population].

Tuberk Toraks 2019 Dec;67(4):248-257

Clinic of Chest Diseases, Bursa Medical Park Hospital, Bursa, Turkey.

Introduction: In this study, we aimed to determine the values of anthropometric measurements and rates used in the evaluation of obstructive sleep apnea syndrome (OSAS) in our country.

Materials And Methods: Twenty accredited sleep centers in thirteen provinces participated in this multicenter prospective study. OSAS symptoms and polysomnographic examination and apnea-hypopnea index (AHI) ≥ 5 cases OSAS study group; patients with AHI < 5 and STOP-Bang < 2 were included as control group. Demographic characteristics (age, sex, body mass index-BMI) and anthropometric measurements (neck, waist and hip circumference, waist/hip ratio) of the subjects were recorded.

Result: The study included 2684 patients (81.3% OSAS) with a mean age of 50.50 ± 0.21 years from 20 centers. The cases were taken from six geographical regions of the country (Mediterranean, Eastern Anatolia, Aegean, Central Anatolia, Black Sea and Marmara Region). Demographic characteristics and anthropometric measurements; age, neck, waist, hip circumference and waist/ hip ratios and BMI characteristics when compared with the control group; when compared according to regions, age, neck, waist, hip circumference and waist/hip ratios were found to be statistically different (p< 0.001, p< 0.001, p< 0.05, respectively). When compared by sex, age, neck and hip circumference, waist/hip ratio, height, weight and BMI characteristics were statistically different (p< 0.001, respectively). Neck circumference and waist/hip ratio were respectively 42.58 ± 0.10 cm, 0.99 ± 0.002, 39.24 ± 0.16 cm, 0.93 ± 0.004 were found in women.

Conclusions: The neck circumference was lower than the standard value in men, but higher in women. The waist/hip ratio was above the ideal measurements in both men and women. In this context, the determination of the country values will allow the identification of patients with the possibility of OSAS and referral to sleep centers for polysomnography.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5578/tt.68595DOI Listing
December 2019

Troublesome cough as the sole manifestation of pulmonary embolism.

Respir Med Case Rep 2019 25;28:100861. Epub 2019 May 25.

Departments of Pulmonary Diseases, Kirikkale University Faculty of Medicine, Kirikkale, Turkey.

Early diagnosis and effective treatment to reduce mortality is the basis of pulmonary embolism. However, the diagnosis can be easily overlooked due to nonspecific clinical presentation. We present 9 cases of pulmonary embolism manifested by a symptom suggestive of an irritating cough due to viral upper respiratory tract infection (patients with no risk factors for PE). Pulmonary embolism should be considered in cases of irritating cough that does not respond to inhaler treatment, d-dimer positive and normal chest X-ray.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.rmcr.2019.100861DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6554364PMC
May 2019

Immunization status in chronic obstructive pulmonary disease: A multicenter study from Turkey.

Ann Thorac Med 2019 Jan-Mar;14(1):75-82

Chest Disease Clinic, Afyon State Hospital, Afyon, Turkey.

Objective: The purpose of this study is to detect the prevalence and the factors associated with influenza and pneumococcal vaccination and outcomes of vaccination during 2013-2014 season in patients with chronic obstructive pulmonary disease (COPD) in Turkey.

Methods: This was a multicenter retrospective cohort study performed in 53 different centers in Turkey.

Results: During the study period, 4968 patients were included. COPD was staged as GOLD 1-2-3-4 in 9.0%, 42.8%, 35.0%, and 13.2% of the patients, respectively. Influenza vaccination rate in the previous year was 37.9%; and pneumococcus vaccination rate, at least once during in a life time, was 13.3%. Patients with older age, higher level of education, more severe COPD, and comorbidities, ex-smokers, and patients residing in urban areas had higher rates of influenza vaccination. Multivariate logistic regression analysis showed that advanced age, higher education levels, presence of comorbidities, higher COPD stages, and exacerbation rates were associated with both influenza and pneumococcal vaccination. The number of annual physician/outpatient visits and hospitalizations due to COPD exacerbation was 2.73 ± 2.85 and 0.92 ± 1.58 per year, respectively. Patients with older age, lower education levels, more severe COPD, comorbid diseases, and lower body mass index and patients who are male and are residing in rural areas and vaccinated for influenza had significantly higher rates of COPD exacerbation.

Conclusions: The rates of influenza and pneumococcal vaccination in COPD patients were quite low, and the number of annual physician/outpatient visits and hospitalizations due to COPD exacerbation was high in Turkey. Advanced age, higher education levels, comorbidities, and higher COPD stages were associated with both influenza and pneumococcal vaccination.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/atm.ATM_145_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6341858PMC
February 2019

Prospective cross-sectional multicenter study on domiciliary noninvasive ventilation in stable hypercapnic COPD patients.

Int J Chron Obstruct Pulmon Dis 2018 10;13:2367-2374. Epub 2018 Aug 10.

Department of Pulmonology, Sureyyapasa Chest Disease and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.

Background: Domiciliary noninvasive ventilation (NIV) use in stable hypercarbic COPD is becoming increasingly widespread. However, treatment compliance criteria and factors related to compliance remain to be defined.

Methods: This research was designed as a prospective, cross-sectional, multicenter real-life study. Chronic hypercapnic COPD patients who were using domiciliary NIV for at least 1 year and being followed up in 19 centers across Turkey were included in the study. The patients who used NIV regularly, night or daytime and ≥5 hours/d, were classified as "high-compliance group," and patients who used NIV irregularly and <5 hours/d as "low-compliance group."

Results: Two hundred and sixty-six patients with a mean age of 64.5±10.3 years were enrolled, of whom 75.2% were males. They were using domiciliary NIV for 2.8±2 years. Spontaneous time mode (<0.001) and night use (<0.001) were more frequent in the high-compliance group (n=163). Also, mean inspiratory positive airway pressure values of the high-compliance group were significantly higher than the low-compliance group (n=103; <0.001). Cardiac failure (=0.049) and obesity (=0.01) were significantly more frequent in the high-compliance group. There were no difference between 2 groups regarding hospitalization, emergency department and intensive care unit admissions within the last year, as well as modified Medical Research Council dyspnea and COPD Assessment Test scores. With regard to NIV-related side effects, only conjunctivitis was observed more frequently in the high-compliance group (=0.002).

Conclusion: Determination of the patients who have better compliance to domiciliary NIV in COPD may increase the success and effectiveness of treatment. This highly comprehensive study on this topic possesses importance as it suggests that patient and ventilator characteristics may be related to treatment compliance.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2147/COPD.S164384DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6089109PMC
January 2019

Psychological characteristics of patients with asthma.

Clin Respir J 2018 Jan 27;12(1):113-118. Epub 2016 May 27.

Faculty of Medicine, Department of Pulmonary Diseases, Kirikkale University, Kirikkale, Turkey.

Introduction: Psychological distress of patients with asthma may be reduced when they learned to live with their illness. Asthma can change the psychological and personality characteristics. We aim to investigate the psychological and personality characteristics of patients with asthma using MMPI (Minnesota Multiphasic Personality Inventory).

Methods: Thirty-three adult patients with asthma (23 female and 10 male) and 20 healthy controls (14 females and 6 males) were enrolled in this study. Psychometric evaluation was made with the Turkish version of the MMPI. The patients were separated into two groups according to the duration of symptoms (recent-onset asthma < 10 years, long-standing asthma ≥10 years).

Results: Patients with asthma compared with control group had significantly higher the rate of clinical elevation on depression, hysteria, psychasthenia and social introversion. Patients with recent-onset asthma compared with long-standing asthma have significantly higher the rate of clinical elevation on depression, hysteria, psychopathic deviate, psychasthenia and social introversion. MMPI mean t score in patients with recent-onset asthma was higher than patients with long-standing asthma. MMPI mean t score in patients with asthma was negatively associated with the symptom duration in multivariate model.

Conclusions: Patients with asthma have relatively more inactivity, anergia, guilt, pessimism, nonspecific physical complaints, irrational fears and introvert. Patients with long-standing asthma have less psychological distress, suggesting that learned to cope with his illness.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/crj.12494DOI Listing
January 2018

Factors Influencing Cognitive Function in Subjects With COPD.

Respir Care 2016 Aug 1;61(8):1044-50. Epub 2016 Mar 1.

Department of Pulmonary Diseases, Kırıkkale University Faculty of Medicine, Kırıkkale, Turkey.

Background: The aim of this study was to assess the association between cognitive function and age, pulmonary function, comorbidity index, and the 6-min walk distance in subjects with COPD as well as to compare the Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) in terms of their ability to identify cognitive dysfunction in subjects with COPD.

Methods: A total of 52 individuals with stable COPD were included in this study. Cognitive function was assessed using MMSE and MoCA. Age, body mass index, the Modified Cumulative Illness Rating Scale, 6-min walk distance, arterial blood gases, and pulmonary function tests were assessed and recorded.

Results: The range and SD of scores in subjects with COPD were larger with MoCA than with MMSE. MMSE and MoCA scores are associated with 6-min walk distance and comorbidity index in subjects with COPD. General cognitive function measured by MoCA was negatively correlated with the comorbidity index but was positively associated with 6-min walk distance in subjects with COPD after controlling for possible confounding factors in the multivariate model. However, general cognitive function measured by MMSE was not correlated with the comorbidity index and 6-min walk distance in subjects with COPD, after controlling for possible confounding factors in the multivariate model.

Conclusions: MoCA may be a more reliable screening test than MMSE in detecting cognitive impairment in subjects with COPD. The addition of cognitive tests on assessment of subjects with COPD can provide further benefit.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4187/respcare.04403DOI Listing
August 2016

Low Cognitive Ability in Subjects With Bronchiectasis.

Respir Care 2015 Nov 28;60(11):1610-5. Epub 2015 Jul 28.

Department of Pulmonary Diseases.

Background: Bronchiectasis may change cognitive function. The mechanism responsible for cognitive dysfunction in COPD may be neuronal damage caused by hypoxia. Cognitive function in patients with bronchiectasis is also likely to be affected by similar mechanisms. The goal of this study was to determine the frequency and determinants of low cognitive ability in subjects with stable bronchiectasis.

Methods: Thirty subjects with stable bronchiectasis and 25 healthy volunteers underwent a cognitive ability assessment using the Wechsler Adult Intelligence Scale. Bronchiectasis was diagnosed by high-resolution computed tomography of the chest. Age, body mass index, the Hospital Anxiety and Depression Scale, and pulmonary function were assessed. Perceived intensity of dyspnea after exercise (after climbing 3 flights of stairs) was estimated using a modified Borg scale.

Results: Mean scores on the verbal and performance tests and full-scale IQ scores were significantly lower in subjects with bronchiectasis than in healthy volunteers. Low cognitive ability in subjects with bronchiectasis was associated with higher depression scores, lower oxygen saturation, and poor lung function after adjusting for potential confounders in multivariate analysis. Borg scores after exercise in subjects with bronchiectasis and low cognitive ability were higher than those in subjects with bronchiectasis and high cognitive ability, despite similar PaO2 and FEV1 in both groups.

Conclusions: Low cognitive ability in subjects with bronchiectasis may be associated with reduced lung function, more serious hypoxemia, and higher depressive symptoms. Subjects with bronchiectasis and low cognitive ability feel more intense dyspnea than do those with high cognitive ability.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4187/respcare.03905DOI Listing
November 2015

Quality of Life and Bronchial Hyper-Responsiveness in Subjects With Bronchiectasis: Validation of the Seattle Obstructive Lung Disease Questionnaire in Bronchiectasis.

Respir Care 2015 Nov 21;60(11):1616-23. Epub 2015 Jul 21.

Department of Pulmonary Diseases, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey.

Background: Bronchiectasis can adversely affect quality of life. However, the tests examining quality of life in bronchiectasis are not sufficient. We examined the validity of a measure designed for COPD, the Seattle Obstructive Lung Disease Questionnaire (SOLQ), in bronchiectasis. In addition, we aimed to compare the quality of life of subjects with bronchiectasis and bronchial hyper-responsiveness with that of those without to identify the effective factors.

Methods: We studied 78 subjects with clinically stable bronchiectasis and 41 healthy controls matched for age and sex. Subjects were assessed by the SOLQ. A detailed history, physical examination, the Medical Outcomes Study 36-Item Short Form questionnaire, the Hospital Anxiety and Depression Scale, and spirometric measurements were obtained.

Results: Cronbach α coefficients, which reflected internal consistency, were >0.70 for all SOLQ components except for treatment satisfaction. SOLQ component scores correlated with all of the component scores of the Medical Outcomes Study 36-Item Short Form questionnaire and the Hospital Anxiety and Depression Scale, confirming their concurrent validity. All SOLQ scores correlated positively with percent-of-predicted FEV1, whereas the physical function, treatment satisfaction, and emotional function correlated negatively with the exacerbation frequency in Pearson analysis. Emotional and physical functions were positively associated with percent-of-predicted FEV1 in linear regression analysis. Compared with subjects without bronchial hyper-responsiveness, those with bronchial hyper-responsiveness had lower FEV1/FVC and more exacerbations/y. Compared with bronchiectasis subjects without bronchial hyper-responsiveness, those with bronchial hyper-responsiveness had significantly lower SOLQ, physical function, and coping skills scores but not emotional function and treatment satisfaction.

Conclusions: The SOLQ is a valid instrument for determining quality of life in subjects with bronchiectasis. Subjects with bronchiectasis and bronchial hyper-responsiveness had a poorer quality of life, lower baseline spirometric values, and more frequent exacerbations, suggesting more severe disease.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4187/respcare.03906DOI Listing
November 2015

Factors Associated With Quality of Life in Subjects With Stable COPD.

Respir Care 2015 Nov 7;60(11):1585-91. Epub 2015 Jul 7.

Department of Pulmonary Medicine, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey.

Background: The purpose of this study was to assess the impact of bronchiectasis, anxiety and depression, and parameters of disease severity on health-related quality of life (HRQOL) in subjects with COPD.

Methods: Sixty-two subjects with stable COPD were selected for the study. The presence of bronchiectasis in all subjects with COPD was investigated by high-resolution computed tomography. Pulmonary function tests were performed. Dyspnea was assessed using the Modified Medical Research Council (MMRC) dyspnea scale. Psychological disorders were investigated using the Hospital Anxiety and Depression Scale (HADS), and the HRQOL was examined using the St George Respiratory Questionnaire (SGRQ).

Results: High-resolution computed tomography revealed that 44 of 62 (70.9%) subjects with COPD had bronchiectasis. There were no differences in pulmonary function tests, symptoms, activities, impact, SGRQ total scores, and HADS scores between COPD subjects with and without bronchiectasis. Pearson correlation analyses showed that there was no significant association between the presence of bronchiectasis, bronchial wall thickness, or severity of bronchial dilatation and all subscales of the SGRQ or HADS scores. Additionally, HADS scores showed significant positive association with all subscales of the SGRQ in all subjects. In linear regression analysis, a statistically significant relationship was found between the SGRQ total score and percent-of-predicted FEV1, percent-of-predicted diffusing capacity of the lung for carbon monoxide, MMRC score, and anxiety score, but the SGRQ total score was not associated with age, body mass index, total number of hospitalizations, PaO2 , or depression score.

Conclusions: The presence of bronchiectasis in subjects with COPD does not impact HRQOL and psychological disorders. However, disease severity, dyspnea levels, and anxiety scores predict poor HRQOL.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4187/respcare.03904DOI Listing
November 2015

Microalbuminuria in obstructive sleep apnea syndrome.

Sleep Breath 2015 Dec 17;19(4):1191-7. Epub 2015 Mar 17.

Department of Biochemistry, Faculty of Medicine, University of Kirikkale, Kirikkale, Turkey.

Objectives: Microalbuminuria is an important risk factor for cardiovascular diseases. Microalbuminuria may be seen due to intermittent hypoxemia in patients with obstructive sleep apnea syndrome (OSAS). In this study, we investigated the prevalence and relationship of microalbuminuria with clinical and physiological parameters in patients with OSAS.

Method: Ninety-eight patients with OSAS and 26 nonapneic snoring subjects upon polysomnography were included in this study. The urinary albumin-to-creatinine ratio (UACR) was calculated according to a previously described formula. The severity index of chronic diseases was evaluated by using the modified cumulative illness rating scale (MCIRS). Insulin resistance (IR) method was analyzed by homeostasis assessment model (HOMA-IR). Subjective sleepiness was assessed using the Epworth sleepiness scale (ESS).

Results: Body mass index (BMI), MCIRS, and UACR were higher in patients with OSAS than nonapneic snoring subjects. In linear regression model, there was a negative relationship between UACR and minimal O2, and there was a significantly positive relationship between UACR and desaturation index.

Conclusion: Microalbuminuria may be seen in patients with OSAS, depending on the severity of disease and hypoxemia. Microalbuminuria in patients with OSAS should be examined in regular periods for risk of cardiovascular morbidity or mortality.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11325-015-1136-8DOI Listing
December 2015

Assessment of patients' preferences regarding the characteristics associated with the treatment of chronic obstructive pulmonary disease.

Int J Chron Obstruct Pulmon Dis 2014 16;9:363-8. Epub 2014 Apr 16.

Department of Pulmonary Medicine, Faculty of Medicine, University of Kırıkkale, Kırıkkale, Turkey.

Objective: Patient preferences regarding characteristics associated with the treatment of chronic obstructive pulmonary disease (COPD) must be determined to increase the compatibility between the patients and the treatments, but as yet no studies have been performed regarding these characteristics. Here, we evaluate the preferred characteristics associated with the treatment of patients with COPD.

Method: The expectations of patients receiving copd therapy were assessed in six categories: time allocated by the physician to listen to patients' complaints, treatment to be applied, estimated adverse effect frequency concerning the therapy, ability of patients to visit the same physician each time, integral approach of the physician to the treatment of the patient, and therapy cost. These groups were divided into categories of therapy indicating 25 alternative treatment methods, using conjoint analysis. Patients were sorted to the 25 types of treatment with regard to their preferences.

Results: The major expectation of conjoint analysis associated with the treatment of COPD patients is for the therapy to allow the patients to completely recover from their complaints. The order preferred by patients of other treatment expectations is from sufficient time to be allowed by the physician to listen to the patient, to no cost for the treatment, to minimum adverse effects resulting from the treatment, to each follow-up to be performed by the same physician, and to the physician performing an assessment of the patient's well-being, rather than examining only the areas of complaint.

Conclusion: The major expectation of COPD patients regarding treatment was to completely recover with the help of the therapy. Considering the expectations of the patient may help improve the compatibility of the patient with the treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2147/COPD.S56229DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3998864PMC
August 2014

Case of round pneumonia: pulmonary infarct and a rare situation that is similar with the lung cancer.

Clin Respir J 2015 Oct 15;9(4):512-5. Epub 2014 May 15.

Faculty of Medicine, Department of Pulmonary Medicine, University of Kirikkale, Kirikkale, Turkey.

Background And Aims: Round pneumonia (RP) is a rare radiological presentation of a subtype of lobar pneumonia that arises because of a developmental defect in connective tissues (pores of Köhn and channels of Lambert). The round appearance on chest X-ray (CXR) is thought to occur from an infectious process that spreads from small peripheral alveoli centrifugally through interalveolar channels via the pores of Kohn and the canals of Lambert. This explains the nonsegmental distribution and shape of RP. The pathogenesis of RP is unknown. An alternative theory holds that RP in children occurs because of underdeveloped pores of Kohn and the absence of canals of Lambert, limiting the spread of the organism and resulting in a focal, round mass seen on radiographs. As a result of this developmental defect, dissemination of infection remains in a limited area. While this is a well-known entity in childhood, it has been described infrequently in adults. Lesions of RP are not necessarily round; oval lesions can also be seen. It is a radiological subtype of the pneumonia subtype and presents as a solitary nodule or a mass lesion in CXR.

Methods: We presented two cases of RP. One mimicked and was mistaken for pulmonary infarction because of triangular pleural-based density and the other mimicked pulmonary malignancy because of a homogeneous triangular opacity based on the pleura on the posteroanterior radiography and computed tomography.

Conclusion: These cases were presented because of RP's importance, and RP should be considered a part of differential diagnosis of pulmonary infarct and lung tumor.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/crj.12137DOI Listing
October 2015

Bronchial hyperresponsiveness in patients with obstructive sleep apnea syndrome.

Tuberk Toraks 2013 ;61(3):221-6

Department of Chest Diseases, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey.

Introduction: The relationship between obstructive sleep apnea syndrome (OSAS) and bronchial hyperresponsiveness (BHR) is not well known. In this study, we investigated the association between BHR and disease severity in patients with OSAS.

Materials And Methods: Fourty seven (37 male/10 female) OSAS patients admitted with polysomnography enrolled to the study. Histamine bronchial challenge test was performed and body mass index (BMI, kg/m2) was calculated. Presence of BHR was diagnosed as positivity of bronchial provocative test (BPT) (PD values ≤ 16 mg/mL). Patients were questioned with Epworth sleepiness scale (ESS).

Results: Histamine bronchial challenge test was positive in 21 of 47 patients. There were significant negative correlations between PD 20 value and AHI (r= -0.47, p= 0.03), BMI (r= -0.45, p= 0.03), and ESS score (r= -0.45, p= 0.03) in the patients with BHR. In addition, AHI (p= 0.03), BMI (p= 0.02), ESS scores (p= 0.03) were higher in patients with BHR (21 patients) than in patients not having BHR (26 patients). Significant negative relation was found between PD 20 value and AHI (b=-0.45, p= 0.03) and significant positive relation was found between presence of BHR and AHI (p= 0.04), BMI (p= 0.03) independently of age and sex in multiple regression analysis.

Conclusion: BHR is common in patients with OSAS. As severity of OSAS increased, severity of BHR increased. In addition, obesity may trigger presence of BHR in patients with OSAS.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5578/tt.5791DOI Listing
March 2015

Microalbuminuria in chronic obstructive pulmonary disease.

COPD 2013 Apr;10(2):186-92

Department of Pulmonary Medicine, University of Kirikkale, Faculty of Medicine, Kirikkale, Turkey.

Background: Microalbuminuria is an important risk factor for cardiovascular diseases. Microalbuminuria may be seen due to hypoxemia in patients with chronic obstructive pulmonary disease (COPD).

Objectives: In this study, we investigated prevalence and relationship of microalbuminuria with clinical and physiological parameters in patients with COPD.

Method: During the research, 66 consecutive patients with COPD and 40 cases smokers with normal spirometry were included. The urinary albumin creatinin ratio (UACR) was calculated according to previously described formula. The presence of microalbuminuria was defined as UACR being ≥20 in men and ≥30 in women. The severity index of chronic diseases was evaluated by using MCIRS.

Results: The rate of presence of microalbuminuria and UACR were higher in patients with COPD than smokers with normal spirometry. Pearson correlation analysis showed a significant inverse relationship between UACR and PaO2, FEV1%, FVC%. On the other hand, there was a positive relationship between UACR and BODE index. There was a significant relationship between the presence of microalbuminuria with PaO2 and BODE index. In the linear regression model, there was a negative relationship between UARC and PaO2 yet there was a significantly positive relationship between UARC and MCIRS score, BODE index. In the logistic regression model, the presence of microalbuminuria showed significant associations with PaO2, BODE index.

Conclusion: Microalbuminuria may be seen in patients with COPD, depending on the severity of disease and hypoxemia. Microalbuminuria in patients with severe COPD should be examined in regular periods for risk of cardiovascular morbidity or mortality.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3109/15412555.2012.735292DOI Listing
April 2013

Attention deficit/hyperactivity disorder in adults with sleep apnea.

J Clin Psychol Med Settings 2013 Jun;20(2):234-9

Department of Psychiatry Diseases, Kirikkale University Faculty of Medicine, Kirikkale, Turkey.

AAttention deficit hyperactivity disorder (ADHD) is a common childhood illness. In some patients, this illness may persist into adulthood and an association between ADHD and Obstructive Sleep Apnea (OSA) has been found in childhood. However, it is unclear how OSA and ADHD coincide in adulthood. Therefore, to explore the relationship between OSA and adult ADHD the current investigation utilized a clinically-based cross-sectional survey. Subjects consisted of 81 treatment-naïve OSA patients and 32 controls. Measures included each patient completed a questionnaire regarding sleep, Adult ADHD scale. Clinical information, body mass index, 36-item Short Form Health Survey (SF-36), Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scale, and polysomnography.The subjects with Apnea-Hypopnea Index (AHI) ≥ 5 events/h were defined as patients with OSA. The control group was accepted as individuals with AHI > 0 events/h. The prevalence of adult ADHD was not different between the patients with OSA and the control group [(7.4 % (6/75) vs. 6.3 % (2/30), p = 0.8, respectively]. OSA patients with ADHD, as compared with those without, had higher anxiety scores and poorer physical component scores of quality of life and higher ESS scores. ADHD scores in patients with OSA were associated with anxiety and depression scores and SF36 physical and mental component scores in bivariate analyses. Thus, in our sample ADHD was not a frequent illness in adult patients with OSA. However, in patients with OSA and ADHD higher levels of anxiety and daytime sleepiness and poorer quality of life was found.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10880-012-9331-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3676641PMC
June 2013

Effects of long-term low-level solvent exposure on cognitive function.

Clin Invest Med 2012 Aug 4;35(4):E190-205. Epub 2012 Aug 4.

Departmentof Public Health, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey.

Purpose: The effects of long-term low-level exposures to solvents on cognitive function were investigated.

Methods: A total of 389 workers at a gun factory, those exposed to solvents (n = 193) and those that were not exposed to solvents during work (n = 196), were included. All the workers were given a questionnaire. Cognitive function was evaluated by Mini-mental Status Examination (MMSE) and psychological status was assessed by Hospital Anxiety and Depression (HAD) Scale.

Results: No differences were found in the MMSE and HAD scores between solvent-exposed workers and control workers (p > 0.05). In the workers who had used a mask for a longer time, orientation scores were lower. Daytime sleepiness was related to lower recall scores. Left-handed workers had higher total HAD scores than right-handed workers.

Conclusions: Long-term low-level exposure to solvents did not affect cognitive function in the workers, according to their MMSE scores. Duration of solvent exposure was also not related to MMSE Scores. Short sleep duration and daytime sleepiness may negatively affect cognitive function.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.25011/cim.v35i4.17148DOI Listing
August 2012

Prevalence of self-reported asthma in urban and rural areas of Turkey.

J Asthma 2012 Jun 16;49(5):522-6. Epub 2012 Apr 16.

Department of Pulmonary Medicine, Kirikkale University Faculty of Medicine, Kirikkale, Turkey.

Background And Purpose: The risk factors for asthma in rural and urban population of Turkey are not well known. In this study we examined the effects of risk factors on the prevalence of asthma in adults living in rural and urban areas using data from a representative sample.

Methods: Parents and grandparents of students from 20 randomly selected primary schools in urban and rural areas of Kirikkale, Turkey, were asked about respiratory diseases using the respiratory questionnaire, which were returned to us by their children.

Results: Out of 13,225 parents and grandparents of primary school students 12,270 returned the questionnaires, for an overall response rate of 92.7%. The prevalence of asthma was more common in adults living in rural areas than in urban areas (10.8% vs. 6.2%, p < .0001, respectively). Asthma was more prevalent in women exposed to biomass smoke than those who were not exposed to it in rural areas (14.8% vs. 6.6%, p = .0001, respectively). Frequent childhood respiratory infections were more common in adults living in rural areas than in urban areas (18.2% vs. 10.9%, p < .0001, respectively). Exposure to biomass smoke and frequent childhood respiratory infections were associated with an increased risk of asthma, after adjusting for possible confounding factors in the logistic model for rural subjects. Chronic rhinitis (p = .0001) and frequent childhood respiratory infections (p = .0001) were associated with an increased risk of asthma, after adjusting for possible confounding factors in the logistic model for urban subjects.

Conclusions: The prevalence of asthma in adults living in the rural areas of the Kirikkale Region in Central Turkey was significantly higher than that in the urban population. Exposure to biomass smoke and childhood respiratory infections were more common in adults living in rural areas. The higher rate of asthma in adults living in rural areas may be due to a higher frequency of childhood respiratory infections and exposure to biomass smoke.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3109/02770903.2012.677893DOI Listing
June 2012

Quality of life and metabolic disorders in patients with obstructive sleep apnea.

Clin Invest Med 2012 Apr 1;35(2):E105-13. Epub 2012 Apr 1.

Department of Pulmonary Medicine, Faculty of Medicine, University of Kirikkale, Kirikkale, Turkey.

Purpose: Quality of life (QoL) may be poor in patients with sleep apnea depending on multifactorial reasons. In this observational study, we examined the factors determining QoL in patients with obstructive sleep apnea (OSA) and nonapneic snoring subjects.

Methods: Complete assessments were obtained on 111 subjects who diagnosed OSA and 18 nonapneic snoring subjects. Fasting blood samples of all of subjects were taken to determine insulin resistance (IR) and oral glucose tolerance tests were performed to diagnose disorders of glucose metabolism (DGM). Quality of life, with short form (SF)-36, and excessive daytime sleepiness, with epwort sleepness scale (ESS), were evaluated.

Results: The mean age of the patients with OSA was higher than that of the nonapneic snoring subjects (48.4 ± 9.6 years and 43.0 ± 11.8 years, respectively; p=0.03). BMI was also significantly higher in the patients with OSA than in the nonapneic snorers (31.0 ± 4.5 and 27.1 ± 4.0, respectively; p=0.001). The mental health component in the patients with OSA was slightly but not significantly lower than the nonapneic snoring subjects (p=0.05). A negative correlation among most domains of quality of life with scores of ESS, body mass index (BMI), presence of hypertension (HT) and DGM was found. Only physicial functioning was negatively correlated with apnea hypopnea index (AHI). In linear regression analysis, there were negative associations among physical functioning with BMI, presence of HT and DGM while there was no association between physicial functioning and AHI. In addition, there were negative correlations between mental health component with BMI and presence of HT in the multivariate analysis. Obese patients with OSA had lower physicial and mental components compared with nonobese patients with OSA.

Conclusion: The impact of OSA on quality of life can be attributed to excessive daytime sleepiness. Obesity and metabolic disorders in patients with OSA may also negatively affect the quality of life.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.25011/cim.v35i2.16294DOI Listing
April 2012

Personality profiles in patients with obstructive sleep apnea.

Sleep Breath 2013 Mar 25;17(1):305-10. Epub 2012 Mar 25.

Department of Pulmonary Diseases, Kirikkale University Faculty of Medicine, Kirikkale, Turkey.

Objective: The Minnesota Multiphasic Personality Inventory (MMPI) responses between snorers and obstructive sleep apnea (OSA) may be different. Thus, we compared the MMPI responses between snorers and OSA.

Design: A clinical-based cross-sectional survey.

Participants: This is a survey of 94 treatment-naive sleep-disordered breathing (SDB) subjects.

Method: Clinical information, body mass index (BMI), 36-item Short Form Health Survey, the Turkish version of the MMPI, Epworth sleepiness scale (ESS), fatigue scale, attention-deficit scale, and polysomnography were collected. All patients with OSA and snorers was accepted as individuals with SDB (AHI > 0 events/h). The threshold of five apnea and hypopnea per hour of sleep was chosen to define both OSA and snorers. Disability profile is consisting of four or more MMPI clinical scale elevations.

Results: OSA patients compared to snorers have significantly higher absolute scores on hypochondriasis (Hs) (65.0 ± 12.0 vs 58.4 ± 7.9, p = 0.01, respectively). OSA patients compared to snorers have significantly higher rate of clinical elevation on both psychopathic deviance (13.0 vs 0 %, p = 0.03, respectively) and Hs (26.1 vs 3.3 %, p = 0.01, respectively). People with disability profile has lower the quality of life, a higher score for inattention, a higher fatigue scores, and higher sleepiness scores. The quality of life and attention deficit and daytime sleepiness scores were associated with total MMPI absolute score in individuals with SDB in bivariate analyses.

Conclusion: Present study indicated that patients with OSAS compared to snorers displayed significantly more hyopchondriasis and psychopathic deviance personality characteristics. The daytime functions in individuals with sleep-disordered breathing may be influenced by the severity of psychopathology.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11325-012-0691-5DOI Listing
March 2013

Affect status and perception of exacerbation in patients with asthma.

Allergy Asthma Proc 2010 Nov-Dec;31(6):106-10

Department of Pulmonary Diseases, Kirikkale University Faculty of Medicine, Kirikkale, Turkey.

Exacerbations occur commonly in patients with asthma but factors affecting perception of dyspnea during exacerbation are not well known. This investigation was designed to determine the effects of negative mood on perception of dyspnea during exacerbation. A total of 47 patient aged 28-78 years (mean age, 52.5 years) admitted with acute asthma had recordings of blood gas pressure, negative mood score, forced expiratory volume in 1 second (FEV(1)), and dyspnea score at admission and at the 72nd hour. Perceived intensity of dyspnea was estimated using a modified Borg scale. The negative mood was assessed with an overall of six mood adjectives (nervous-anxious, sad-blue, and tired-drowsy). High negative mood score was defined as the score above the cutoff point (median score, >7). Borg sore of patients with a high negative mood score was higher than that of patients with a low negative mood score (6.3 ± 2.5 versus 4.4 ± 2.4; p = 0.01). The high Borg sore of asthmatic patients with high negative mood persisted even at the 72nd hour (1.6 ± 0.9 versus 1.0 ± 0.7; p = 0.01). FEV(1) values of both groups at admission were similar. The negative mood score (beta = 0.68; p = 0.0001) and initial FEV(1) (beta = -0.42; p = 0.01) were the important determinants of Borg score at admission in all patients with multivariate analysis but not arterial oxygen pressure, arterial carbon dioxide pressure, asthma duration, and female sex. This study indicated that emotional factors, as well as the level of airways obstruction, predicted the magnitude of dyspnea at exacerbation of asthmatic patients. Thus, the emotional factors should be taken into account in the treatment of dyspnea at exacerbation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2500/aap.2010.31.3408DOI Listing
November 2011

Effects of septoplasty on pulmonary function tests in patients with nasal septal deviation.

J Otolaryngol Head Neck Surg 2010 Apr;39(2):196-202

Department of Pulmonary Medicine, University of Kirikkale, Faculty of Medicine, Kirikkale, Turkey.

Objective: To investigate the effects of septoplasty on pulmonary function tests (PFTs) and bronchial hyperresponsiveness (BHR) in patients who had no previous pulmonary diseases.

Design: Prospective, controlled clinical trial.

Patients: Fourteen patients with nasal septal deviation (NSD) and 20 controls were enrolled in the study.

Main Outcome Measures: All patients were evaluated with anterior rhinoscopy, nasal endoscopy, acoustic rhinometry (AR), visual analogue scale (VAS), PFTs, and bronchoprovocation test (BPT) on the day before surgery and 8 to 12 weeks after surgery.

Results: The postoperative values of forced expiratory volume in 1 second, forced vital capacity, and peak expiratory flow percentages were higher than preoperative ones, and these results were statistically significant (p = .007, p = .04, and p = .007, respectively). Nine patients had preoperative BHR, and three of them had negative BPT postoperatively. When compared with the preoperative values, there was a borderline decrease in the rate of BHR in six patients. There were significant improvements in the symptoms of left and right nasal congestion, headache, postnasal drip, and olfactory function after surgery. We found important improvement in the values of AR at right minimal cross-sectional area 1 (p = .02), left distance 1 (p = .04), and left distance 2 (p = .04) postoperatively.

Conclusion: An improvement in both nasal symptoms and PFT values was seen after surgical treatment for NSD. We concluded that septoplasty may be considered as having favourable effects on BHR.
View Article and Find Full Text PDF

Download full-text PDF

Source
April 2010

Effects of timolol and latanoprost on respiratory and cardiovascular status in elderly patients with glaucoma.

J Ocul Pharmacol Ther 2009 Oct;25(5):463-6

Department of Ophthalmology, Kirikkale University, School of Medicine, Ankara, Turkey.

Purpose: To investigate the respiratory and cardiovascular effects of switching therapy from topical timolol 0.5% to latanoprost 0.005% in elderly patients with glaucoma.

Methods: Twenty-five patients with primary open-angle glaucoma (POAG) who were treated with topical timolol 0.5% were included in the study. The beta-blocker treatment was ended due to insufficient intraocular pressure (IOP) and systemic or local side effects. The treatment then switched to latanoprost in these patients. All recruited patients underwent a full ocular, cardiovascular, and respiratory examination including spirometry, pulse rate, and blood pressure. All measurements were made 1 day before the beta-blocker treatment was ended and 30 days after the latanoprost treatment was started.

Results: Timolol treatment was associated with numerically but not statistically significant lowered pulse rates, systemic blood pressure, diastolic blood pressure, and reductions in the spirometry measurements. The change to latanoprost treatment was associated with numerical improvement in mean values of spirometric test results. There were no significant differences in changes in mean values of spirometry, pulse rate, or blood pressure. Histamine challenge test was determined to be positive in 16 of 25 patients for timolol, of whom 10 were positive for latanoprost. This was statistically significant (P < 0.05).

Conclusions: Although all the results presented were statistically insignificant, switching to latanoprost treatment may offer some advantages in respiratory and cardiovascular function for elderly people with glaucoma over beta-blocker drugs. Spirometry and the measurement of pulse rate and blood pressure are advised in all patients receiving topical beta-blocker therapy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1089/jop.2008.0137DOI Listing
October 2009

Five annual observations of respiratory findings in gun factory workers exposed to solvents.

J Occup Environ Med 2007 Aug;49(8):909-12

Department of Public Health, Medical Faculty, Kinkkale University, Turkey.

Objective: We investigated whether long-term, low-level exposures to solvents had adverse longitudinal effects on pulmonary functions.

Methods: The study was performed on 1091 workers 5 years ago and then on 697 workers 5 years later. Chronic respiratory symptoms were recorded using a questionnaire on respiratory symptoms.

Results: The annual decrease in forced expiratory volume in 1 second in the workers exposed to solvents was not significantly different from that of the unexposed workers (69.7 +/- 89.9 vs 75.8 +/- 87.6 mL/yr, P = 0.5, respectively). In 453 workers who were exposed to solvents 5 years ago, the prevalence rate of asthma was 1.1%. Five years later, it was 3.6% in 193 workers from the same group. The difference was statistically significant (P = 0.03).

Conclusions: Longitudinally, the chronic exposure to low doses of solvents does not adversely affect the pulmonary functions, whereas it increases the asthma prevalence.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/JOM.0b013e318124a8f3DOI Listing
August 2007

Risk factors and correlates of snoring and observed apnea.

Sleep Med 2008 Mar 19;9(3):290-6. Epub 2007 Jul 19.

Department of Pulmonary Medicine, Kirikkale University, Faculty of Medicine, Kirikkale, Turkey.

Background And Purpose: Risk factors and correlates of snoring and observed apnea in the population are not well known. This study aimed to assess risk factors and correlates of snoring and observed apnea.

Methods: Parents and grandparents of students from 20 randomly selected primary schools in urban and rural areas of Kirikkale, Turkey were asked about respiratory diseases, psychological distress and sleep-related disorders, using the Respiratory Questionnaire, Hospital Anxiety and Depression (HAD) scale and Sleep Questionnaire, respectively, which were returned by their children.

Results: Out of 13,225 parents and grandparents of primary school students 12,270 returned the questionnaires, for an overall response rate of 92.7%. Snoring and the observed apnea were more prevalent among subjects from rural than those from urban areas (52.6% vs. 46.6%, odds ratio (OR): 1.2, p<0.001 and 16.2% vs. 10.1%, OR: 1.7, p<0.001, respectively). Exposure to biomass smoke and smoking were associated with an increased risk of snoring and observed apnea, after adjusting for gender, age, body mass index, income and education in the multivariate linear model. In all subjects, increases in performance ability, daytime sleepiness, psychological distress and dyspnea scores observed in categories indicating increases in snoring intensity and observed apnea frequency constituted a trend but did always not reach statistical significance. Lastly, prevalence of traffic accidents, falling asleep at the wheel and morning headaches increased with the increments of snoring intensity and apnea frequency.

Conclusions: Exposure to biomass smoke in rural areas may account for the higher prevalence of snoring and observed apnea. Snoring intensity and observed apnea frequency may increase prevalence of traffic accidents along with many unfavorable symptoms.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.sleep.2007.04.018DOI Listing
March 2008

Chronic airway diseases in adult life and childhood infections.

Respiration 2008 15;75(1):55-9. Epub 2007 May 15.

Department of Pulmonary Medicine, Kirikkale University Faculty of Medicine, Kirikkale, Turkey.

Background: Respiratory disorders in childhood may predispose to pulmonary disease in late adult life.

Objectives: The aim of this study was to evaluate the relationship between their effects in adult life and the characteristics of the respiratory system in childhood.

Methods: A total of 10,224 parents and grandparents of students from 14 randomly selected primary schools in the city center were asked to answer questionnaires given to their children. 9,853 of 10,224 persons (the overall response rate was 96.3%) were eligible for analysis. In the questionnaire subjects were asked about respiratory system-related symptoms and characteristics.

Results: Chronic cough [14.3 vs. 4.7%, OR 3.4 (2.6-4.4), p < 0.001], chronic bronchitis [35.3 vs. 11.8%, OR 4.0 (3.4-4.8), p < 0.001] and asthma [34.2 vs. 5.1%, OR 9.6 (8.0-11.5), p < 0.001] in the childhood respiratory infection group were more common than in the control group. Childhood respiratory infections were associated with an increased risk of asthma (OR 5.6, p < 0.001), chronic bronchitis (OR 2.3, p < 0.001) and chronic cough (OR 1.5, p < 0.001), after adjusting for possible confounding factors. In addition, the presence of dampness or visible mould, wall-to-wall carpets, pets at home and parents' smoking during childhood were associated with an increased risk of frequent childhood respiratory infections.

Conclusion: These results indicated that frequent respiratory infections during childhood might play an important role in the occurrence of chronic airway diseases in adult life. The removing of risk factors for frequent childhood respiratory infections may reduce the subsequent risk of chronic airway disease in late adult life.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000102952DOI Listing
February 2008

Female sexual and hormonal status in patients with bronchial asthma: relationship with respiratory function tests and psychological and somatic status.

Urology 2007 Mar;69(3):421-5

Department of Urology, University of Kirikkale Faculty of Medicine, Kirikkale, Turkey.

Objectives: To assess the relationship among the sexual, hormonal, physical, and psychological status of women with bronchial asthma (BA) compared with that of healthy volunteers.

Methods: Thirty-eight women with BA were enrolled in the study. The patients were asked to complete the Female Sexual Function Index, General Health Questionnaire, and Medical Outcomes Study Short Form 36-item Health Survey (SF-36). Using the answers on the SF-36, the mental and physical component summary scores were calculated. A total of 20 healthy women were enrolled in the study as the control group. The same questionnaires were given to this group as well. Statistical analysis was performed using the Mann-Whitney U test and Pearson correlation tests.

Results: At the end of the study, statistically significant differences were observed for all questionnaire scores (P <0.05). The most common female sexual dysfunction was diminished arousal (n = 30, 78.9%) in women with BA. In the correlation analysis, the total Female Sexual Function Index score had a statistically significant and positive correlation with the mental component summary score (r = 0.503, P = 0.001) and a negative correlation with the General Health Questionnaire score (r = -0.380, P = 0.020).

Conclusions: The results of our study have shown that BA, as a chronic medical condition, can be a cause of female sexual dysfunction with mental and psychiatric mechanisms.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.urology.2006.12.001DOI Listing
March 2007