Browsing by Author "Şakar Coşkun A."
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Item Occupational asthma in welders and painters(Ankara University, 2010) Temel O.; Şakar Coşkun A.; Yaman N.; Sarioǧlu N.; Alkaç Ç.; Konyar I.; Özgen Alpaydin A.; Çelik P.; Cengiz Özyurt B.; Keskin E.; Yorgancioǧlu A.We aimed to investigate the frequency of occupational asthma (OA) and the factors associated with OA development in a bicycle factory, subsequently after the diagnosis of OA in three workers at the same department. Forty one welders, 23 painters and 46 controls (office workers), a total number of 110 cases were included in the study. Turkish Thoracic Society Occupational and Environmental Diseases Evaluation Questionnaire and physical examination, chest-X ray, pulmonary function tests were performed as needed. Peak expiratory flow (PEF) follow-up was done in welders and painters. Cases having symptoms related with work and ≥ 20% PEF variability were diagnosed as OA. Wheezing were more frequent in welders and painters than the control group, although there wasn't a statisticall significance. Dyspnea, cough and sputum production were more frequent in welders and painters with respect to controls (p< 0.05). Nine (22%) welder, 4 (18%) painter were diagnosed as OA. Working duration of welders and painters with OA (72, 156 months, respectively) were longer than the welders and painters without OA (45, 76 months, respectively), but it did not have any statistically significance. We suggest that working in welding and painting departments may cause respiratory symptoms and OA.Item Clinical presentations and diagnostic work-up in sarcoidosis: A series of Turkish cases (clinics and diagnosis of sarcoidosis); [Sarkoidozlu olgularda klinik görünüm ve tanısal yaklaşım: Türk olgu serisi (sarkoidoz kliniǧi ve tanı yaklaşımları)](Ankara University, 2011) Kiter G.; Müsellim B.; Çetinkaya E.; Türker H.; Kunt Uzaslan A.E.; Yentürk E.; Uzun O.; Saǧlam L.; Özdemir Kumbasar O.; Çelik G.; Okumuş G.; Arbak P.M.; Altiay G.; Tabak L.; Şakar Coşkun A.; Erturan S.; Türktaş H.; Yalniz E.; Akkoçlu A.; Öǧüş C.; Doǧan O.T.; Özkan M.; Özkan S.; Uzel F.I.; Öngen G.Sarcoidosis is an idiopathic granulomatous disease. It usually affects the lung. The diagnosis may be problematic since the known causes of granulomatous inflammation must be excluded. This multicenter study aimed to evaluate the clinical presentations and diagnostic approaches of sarcoidosis. The study protocol was sent via internet, and the participants were asked to send the information (clinical, radiological and diagnostic) on newly diagnosed sarcoidosis cases. 293 patients were enrolled within two years. Pulmonary symptoms were found in 73.3% of the patients, and cough was the most common one (53.2%), followed by dyspnea (40.3%). Constitutional symptoms were occured in half of the patients. The most common one was fatigue (38.6%). The most common physical sign was eritema nodosum (17.1%). The most common chest radiograhical sign was bilateral hilar lymphadenomegaly (78.8%). Staging according to chest X-ray has revealed that most of the patients were in Stage I and Stage II (51.9% and 31.7%, respectively). Sarcoidosis was confirmed histopathologically in 265 (90.4%) patients. Although one-third of the bronchoscopy was revealed normal, mucosal hyperemi (19.8%) and external compression of the bronchial wall (16.8%) were common abnormal findings. The 100% success rate was obtained in mediastinoscopy among the frequently used sampling methods. Transbronchial biopsy was the most frequently used method with 48.8% success rate. Considering sarcoidosis with its most common and also rare findings in the differential diagnosis, organizing the related procedures according to the possibly effected areas, and the expertise of the team would favor multimodality diagnosis.Item Level of smoking of 3rd and 4th grade students studying health and related factors: Follow-up study; [Saǧlık eǧitimi alan 3 ve 4. sınıf öǧrencilerinde sigara kullanımı ve etkileyen faktörler: Izlem araştırması](Ankara University, 2011) Göktalay T.; Cengiz Özyurt B.; Şakar Coşkun A.; Çelik P.The levels of smoking of 1st and 2nd year students at Faculty of Medicine and Manisa School of Health at Celal Bayar University were investigated in 2006-2007. This study is carried out in order to see if there is a change in the same students' level of smoking while they are in 3rd and 4th year. In addition, the study aimed to examine the factors affecting the level of use and attitudes towards the law effectuated in July 19, 2009. This is a follow-up study with 80.42% return rate. A 26-item structured questionnaire was administered. The participants filled out the questionnaires under supervision of the researchers in their classrooms. The University Institutional Review Board approved the study. The total of participants (263) of the follow-up study included 189 female and 74 male. The rate of experimenting with smoking was 49% with the mean age of 15.7 (SD= 4.01 years). The mean age of experimenting with smoking was the earliest on male students studying at faculty of medicine. The level of smoking was found to be the most on females, studying at faculty of medicine and staying at the dormitory, with smoking parents (p< 0.05). The most important reason to begin smoking was curiosity (55.2%) while bad breath and yellowing of teeth were the reasons to quit (91.7%). 83.3% of the students thought that the law will be effective on quit smoking. The level of both experimenting and use of smoking has been increased over time. It is suggested that medical students' awareness about the danger of smoking should be raised at earlier grades. In addition, lectures should be offered to students at School of Health and they should be encouraged to unite in order to fight with smoking.Item Serum and pleural fluid N-Terminal-Pro-B-Type natriuretic peptide concentrations in the differential diagnosis of pleural effusions; [Plevral efüzyonların ayırıcı tanısında serum ve plevral sıvı n-terminal-pro-B-tip natriüretik peptid konsantrasyonunun yeri](Ankara University, 2011) Yorgancioǧlu A.; Özgen Alpaydin A.; Yaman N.; Taneli F.; Bayturan O.; Şakar Coşkun A.; Çelik P.Currently, new biomarkers like N-Terminal-Pro-B-Type natriuretic peptide (NT-proBNP) have been used in the differential diagnosis of pleural effusions. In our study, we aimed to investigate the diagnostic value of NT-proBNP, especially in cardiac originated pleural effusions. Forty-five patients with pleural effusions were included in the study. NT-proBNP levels and biochemical markers involved in the Light's criteria were analyzed in pleural fluid and serums of the patients. Pleural fluid culture, AFB smear, cytology were performed where they were indicated according to the clinical evaluation. In patients, to whom cardiac pathology was considered to be; cardiological evaluation and echocardiography were also done. Thirtyeight pleural effusions were exudative and, 7 were transudative according to the Light's criteria. Final diagnosis were malignant effusion in 13, infection (tuberculosis/pneumonia) in 10, congestive heart failure in 21, and other conditions related with pleural effusion in 1 of the patients. Median (25th to 75th percentiles) NT-proBNP levels of serum and pleural fluid due to congestive heart failure (CHF) were 4747 pg/mL (931-15754) and 4827 pg/mL (1290-12.430) while median NTproBNP levels of serum and pleural fluid related with non-cardiac reasons were 183 pg/mL (138-444) and 245 pg/mL (187-556) respectively. NT-proBNP levels of serum and pleural fluid were significantly high in CHF (p< 0.001 for both). When four groups were compared serum and pleural fluid NT-proBNP levels were highest in the CHF group which was followed by malignancy, infection and others (p< 0.001 for both). Fourteen of 21 patients who were accepted to have congestive heart failure as the final diagnosis by a cardiological evaluation had an exudative pleural fluid according to the Light's criteria. Serum and pleural fluid NT-proBNP levels were higher in transudates and this reached statistically significance for pleural fluid (p= 0.009). We suggest that measurement of pleural fluid NT-proBNP is a smart approach and pleural fluid NTproBNP can reflect cardiac origin of effusions better than serum NT-proBNP and Light's criteria.Item Is the diagnosis of asthma different in elderly?; [Yaşlılarda astım tanısı farklı mıdır?](Ankara University, 2012) Yorgancioǧlu A.; Şakar Coşkun A.Asthma is mis-diagnosed, under-diagnosed and under-treated in older populations but has a high mortality rate. The physiological changes due to aging of lung, the co-morbid situations and poly pharmacy may change the typical presentation of asthma in older people and cause diagnostic difficulties. But it therefore should be diagnosed properly by taking of all differential situations especially chronic obstructive pulmonary disease into consideration since the appropriate management of the disease will alter the morbidity and mortality.Item A health survey in the workers of municipality; [Belediye çalışanlarında akciǧer saǧlıǧı taraması](Ankara University, 2013) Göktalay T.; Şakar Coşkun A.; Havlucu Y.; Akdemir S.E.; Datli U.; Gümeli F.; Yorgancioǧlu A.Introduction: Internal and external air pollution that is gradually increasing due to urbanization and industrialization has a negative impact on the lung health. A health survey has been applied to evaluate the respiratory symptoms, respiration functions and smoking habits of the workers of Izmir Konak Municipality whom have been reported to have a high rate of smoking habit and be affected by the external air pollution due to their being working in the field by the Municipality's doctor. Materials and Methods: Questionnaire that are composed of the topics of work anamnesis, environmental anamnesis, curriculum vitae, symptoms (coughing, sputum, wheezing, dyspnea, hemoptysis) and smoking have been executed to 301 workers by face to face interview and their chest X-rays have been reviewed. Results: Dyspnea on exertion, sputum in the morning, wheezing and morning cough have been the most frequently observed complaints (respectively 37.2%, 32.2%, 27.9% and 24.9%). Sanitary workers have reported sputum in the morning more while maintenance shop workers have reported wheezing more (p values respectively 0.009, 0.008). No significance has been observed while the workers are evaluated one by one regarding to their work groups. No significant difference was identified between the addiction of smoking and nicotin addiction or pulmonary function test and chest X-rays (p> 0.05) but active smoking was much more seen in drivers (p= 0.047). Conclusion: Although working on the hazardous work branch does not institute a sharp distinction, it becomes significant to trace and lead the workers in order to obtain their lung health protection in long term. Informing and influencing the workers about the harms of smoking and the ways to quit has been the most considerable acquisition of this survey.Item Clinical characteristics and outcome of healthcare associated pneumonia in Turkey; [Türkiye’de sağlık bakımı ile ilişkili pnömoni olgularının klinik özellikleri ve sonuçları](Ankara University, 2016) Gündüz C.; Taşbakan M.S.; Sayiner A.; Çıllı A.; Kilinç O.; Şakar Coşkun A.Introduction: Pneumonia in cases with preceding hospitalization, hemodialysis, intravenous therapy, wound care, or chemotherapy within the prior 30 days and residence in nursing homes are defined as healthcare associated pneumonia (HCAP). The aim of this study was to compare the demographic and laboratory data, isolated causative agents and prognosis of patients with communityacquired pneumonia (CAP) and HCAP in a large population in Turkey. Materials and Methods: The data of 785 cases (average age 65.3 ± 16.4, 530 male) registered to Turkish Thoracic Society Respiratory Infections Study Group CAP database (TURCAP) were examined. The demographic data, clinical history, pneumonia severity scores (PSI), laboratory and radiologic findings of the CAP and HCAP patients were compared. Results: Out of 785 cases, 207 (26.4%) were diagnosed with HCAP and 578 (73.6%) with CAP. Among HCAP cases, 140/207 (67.6%) had preceding hospitalization in the last 90 days, 28/207 (13.5%) were on a hemodialysis program during the previous 30 days and 22/207 (10.6%) were staying in nursing homes. Patients with HCAP more frequently had comorbidities (93.2% vs. 81.6%; p= 0.001) and higher PSI scores (103.9 ± 37.2 vs. 94.6 ± 35.4; p= 0.002) compared to patients with CAP. A causative microorganism was isolated in only 12.1% (70/578) of CAP and 14.5% (30/207) of HCAP patients. The length of stay in hospital was higher in HCAP than CAP (8.6 ± 5.5 vs. 7.5 ± 6.1 days, p= 0.03); however the rates of treatment failure, intensive care unit admission and mortality were similar. Conclusion: In comparison to CAP, HCAP patients tend to have more severe disease, despite have no difference in mortality. The current criteria for HCAP do not predict worse clinical outcomes. Further work is required to define local risk factors for multidrug resistant pathogens. © 2016, Ankara University. All rights reserved.Item Factors affecting treatment success in community-acquired pneumonia(Turkiye Klinikleri Journal of Medical Sciences, 2016) Gündüz C.; Taşbakan M.S.; Sayiner A.; Çilli A.; Kilinç O.; Şakar Coşkun A.Background/aim: Treatment failure in hospitalized patients with community-acquired pneumonia is a major cause of mortality. The aim of this study was to evaluate the factors affecting treatment success in community-acquired pneumonia. Materials and methods: A total of 537 patients (mean age: 66.1 ± 15.8 years, 365 males) registered to the Turkish Thoracic Society Pneumonia Database were analyzed. Of these, clinical improvement or cure, defined as treatment success, was achieved in 477, whereas 60 patients had treatment failure and/or died. Results: Lower numbers of neutrophils (5989.9 ± 6237.3 vs. 8495.6 ± 7279.5/mm3), higher blood urea levels (66.1 ± 42.1 vs. 51.2 ± 38.2 mg/dL), higher Pneumonia Severity Index (PSI) scores (123.3 ± 42.6 vs. 96.3 ± 32.9), higher CURB-65 scores (2.7 ± 1.2 vs. 2.2 ± 0.9), lower PaO2/FiO2 ratios (216.3 ± 86.8 vs. 269.9 ± 65.6), and the presence of multilobar (33.3% vs. 16.4%) and bilateral (41.7% vs. 18.9%) radiologic infiltrates were related to treatment failure. The PSI score and PaO2/FiO2 ratio were independent parameters affecting treatment results in multivariate linear regression analysis (P < 0.001). Conclusion: The risk of treatment failure is high in patients with severe pneumonia and with respiratory failure. Effective treatment and close monitoring are required for these cases. © TÜBİTAK.Item Evaluation of physians, patients, relatives and society of opinions on the told lung cancer diagnosis; [Hekimlerin, hasta yakınlarının ve toplumun akciğer kanseri tanısının söylenmesine ilişkin görüşlerinin değerlendirilmesi](Ankara University, 2017) Datli U.; Çelik P.; Havlucu Y.; Göktalay T.; Şakar Coşkun A.; Yorgancioğlu A.A.Introduction: In our country, this is usually done by patient relatives. In this study, we aimed to investigate the thought of doctors who done the diagnosis, doctors who arrange the treatment, first degree relatives of patients with lung cancer, and population as a control. Materials and Methods: 310 subjects (100 doctors, 110 first degree realtives of patients, and 100 subjects as a control) were included to the study. The mean age was 39.77 ± 11.44 years and there was 170 females. 46% of doctors were giving cancer treatment (chemotheraphy/radiotheraphy). Results: 84.5% of subjects were answered the question (Do you want to know the diagnosis of lung cancer if you are lung cancer?) as "yes" and the answers were not different between groups (p> 0.05). 72 of doctors were giving information about diagnosis of patients. This ratio was 89.1% in doctors who arrange lung cancer treatment whereas it was 57.4% in doctors who do not arrange cancer treatment. The percent age of learning of diagnosis of lung cancer throughout the time in doctors, population, and patient's relatives were 19%, 34%, and 59% respectively (p< 0.05). Information about quality of life was more important in relatives of patients (87%) than population (65%) and doctors (63%) (p< 0.05). Quality of life was more important for doctors who arrange lung cancer treatment (76.7)% than doctors who did not (48.8%) (p< 0.05). Patients who were more children wanted to stay with their family at end stage of disease (p< 0.05). Conclusion: According to this study we think that doctors should say the diagnosis of lung cancer in the form of they understand, inform the patients and relatives about treatment, and quality of life and this can increase patient trust to doctor and compliance of patients to the treatment. © 2017, Ankara University. All rights reserved.Item Antibiotic treatment outcomes in community-acquired pneumonia(Turkiye Klinikleri Journal of Medical Sciences, 2018) Çilli A.; Sayiner A.; Çelenk B.; Şakar Coşkun A.; Kilinç O.; Hazar A.; Aktaş Samur A.; Taşbakan S.; Waterer G.W.; Havlucu Y.; Kiliç Ö.; Tokgöz F.; Bilge U.Background/aim: The optimal empiric antibiotic regimen for patients with community-acquired pneumonia (CAP) remains unclear. This study aimed to evaluate the clinical cure rate, mortality, and length of stay among patients hospitalized with community-acquired pneumonia in nonintensive care unit (ICU) wards and treated with a β-lactam, β-lactam and macrolide combination, or a fluoroquinolone. Materials and methods: This prospective cohort study was performed using standardized web-based database sheets from January 2009 to September 2013 in nine tertiary care hospitals in Turkey. Results: Six hundred and twenty-one consecutive patients were enrolled. A pathogen was identified in 78 (12.6%) patients. The most frequently isolated bacteria were S. pneumoniae (21.8%) and P. aeruginosa (19.2%). The clinical cure rate and length of stay were not different among patients treated with β-lactam, β-lactam and macrolide combination, and fluoroquinolone. Forty-seven patients (9.2%) died during the hospitalization period. There was no difference in survival among the three treatment groups. Conclusion: In patients admitted to non-ICU hospital wards for CAP, there was no difference in clinical outcomes between β-lactam, β-lactam and macrolide combination, and fluoroquinolone regimens. © TÜBİTAK.Item The validity and reliability of the turkish version of the leicester cough questionnaire in COPD patients(Turkiye Klinikleri Journal of Medical Sciences, 2018) Kurhan F.; Göktalay T.; Havlucu Y.; Sari S.; Yorgancioğlu A.; Çelik P.; Şakar Coşkun A.Background/aim: The reliability and validity of the Turkish version of the Leicester Cough Questionnaire (LCQ) have been evaluated before. This study aimed to validate the Turkish version of the LCQ in chronic obstructive pulmonary disease (COPD) patients with cough. Materials and methods: COPD (GOLD B, C, D) patients over age 40 (n = 75) and healthy volunteers as a control group (n = 75) were included. A sociodemographic data form, the LCQ, the Short Form-36 (SF-36) quality of life questionnaire, and the World Health Organization Quality of Life Brief Form for Turkish people were completed. The internal reliability of the LCQ was determined using the Cronbach alpha coefficient (>0.6) and its repeatability by the intraclass consistency coefficient (P < 0.05) was accepted as significant. Results: For internal consistency, Cronbach alpha coefficients of all subscales of the LCQ, physical, psychological, and social, were found as 0.72, 0.86, and 0.83, respectively, with 0.92 for the total index. There was significant internal consistency for all subscales and the total index (Cronbach alpha coefficients of >0.6). In test–retest reliability, the correlation coefficient ranged between 0.71 and 0.80 for each question and was calculated as r = 0.89 for total LCQ score (P < 0.001). Conclusion: The Turkish version of the LCQ has been found to have acceptable reliability and validity for use in Turkish COPD patients with chronic cough. © TÜBİTAK.