Browsing by Author "Akgun, M"

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    Research Publications from the ATS MECOR Program in Turkiye
    Karakurt, Z; Yilmaz, O; Arikan, H; Ay, P; Demir, C; Gurkan, CG; Akgun, M; Buist, S
    Background: The American Thoracic Society (ATS) Methods in Epidemiologic, Clinical, and Operations Research (MECOR) Program aims to build research capacity in low and middle-income countries. MECOR has three levels, during which students learn to develop a research protocol and write a manuscript. MECOR Turkiye has been offered every year since 2008.Objective: The aim of this paper is to report the number and impact of published articles generated from research questions developed by students in levels 1, 2, and 3 of the ATS MECOR Program in Turkiye between 2008 and 2018.Methods: We collected the research questions developed in all levels of the ATS MECOR Program in Turkiye between 2008 and 2018. We searched Google Scholar, PubMed, Web of Science, and ResearchGate in April 2022 to see how many of these research questions were published as articles and, if published, in which journals.Results: Of the 176 research questions collected, 49 had been developed in level 1, 82 had been developed in level 2, and 45 had been developed in level 3. Of those 176 research questions, 55 (31.3%) generated articles that were accepted for publication. The frequency of published articles based on MECOR-developed research questions increased linearly as the course level in which they were developed increased (18.4% in level 1, 30% in level 2, 46.7% in level 3; P = 0.012; linear-by-linear association, P = 0.003). The median time from the development of the research question to publication was three years overall and did not differ significantly among the course levels (P = 0.36). Of the research questions developed, 43 were published in Science Citation Index or Science Citation Index Expanded-indexed journals.Conclusion: Acceptance of an article for publication is one way to measure the impact of the ATS MECOR Program. Our data describe significant research output among our participants, which increases with their length of participation in the program.
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    Publication Results of the Methods in Epidemiological Clinical and Operations Research (MECOR) Program in Turkey
    Karakurt, Z; Yilmaz, O; Arikan, H; Ay, P; Demir, C; Gurkan, CG; Akgun, M; Buist, S
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    The validation of the Turkish version of Asthma Control Test (vol 22, pg 1773, 2013)
    Uysal, MA; Mungan, D; Yorgancioglu, A; Yildiz, F; Akgun, M; Gemicioglu, B; Turktas, H; Ozkan, G; Yilmaz, I; Incioglu, M; Boyaci, H; Atis, S; Yalcin, A; Bayram, NG; Deveci, F; Pulur, D; Ozgur, ES; Dursun, B; Bulbul, Y; Sulu, E; Yilmaz, V
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    Asthma control test administered by web-based text messaging (short message service-SMS): Is it comparable with paper form?
    Uysal, MA; Mungan, D; Yorgancioglu, A; Yildiz, F; Akgun, M; Gemicioglu, B; Ozkan, G; Yilmaz, I; Incioglu, M; Boyaci, H; Atis, S; Yalcin, A; Bayram, NG; Deveci, F; Pulur, D; Özgür, ES; Dursun, B; Bülbül, Y; Sulu, E; Yilmaz, V; Turktas, H
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    Asthma control test via text messaging: could it be a tool for evaluating asthma control?
    Uysal, MA; Mungan, D; Yorgancioglu, A; Yildiz, F; Akgun, M; Gemicioglu, B; Turktas, H
    Introduction: Originally, the Asthma Control Test (ACT) was designed for English-speaking patients using a paper-and-pencil format. The Turkish version of the ACT was recently validated. This article compares the paper-and-pencil and web-based texting formats of the Turkish version of the ACT and evaluates the compatibility of these ACT scores with GINA-based physician assessments of asthma control. Methods: This multicentre prospective study included 431 asthma patients from outpatient clinics in Turkey. The patients were randomized into a paper-and-pencil group (n = 220) and a text messaging group (n = 211). Patients completed the ACT at Visit 1, after 10 +/- 2 days, and at 5 +/- 1 week to demonstrate the reliability and responsiveness of the test. At each visit, physicians assessed patients' asthma control levels. Results: The ACT administered via texting showed an internal consistency of 0.82. For the texting group, we found a significant correlation between the ACT and physician assessments at Visit 1 (r = 0.60, p < 0.001). The AUC was 0.87, with a sensitivity of 78.0% and a specificity of 77.5% for a score of <= 19 for screening uncontrolled asthma in the texting group. Conclusion: When the Turkish version of the ACT was administered via either the paper-and-pencil or text messaging test, scores were closely associated with physician assessments of asthma control.
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    A multicenter randomized trial for the effectiveness of structured discharge and follow-up protocol on readmission rate in COPD patients receiving LTOT/NIV: one-year interim analysis.
    Ergan, B; Goktalay, T; Ergun, P; Yilmaz, D; Ocakli, B; Gurgun, A; Demirci, N; Elverisli, F; Ucar, EY; Durmaz, A; Dilektasli, AG; Aksoy, E; Elmas, F; Kokturk, N; Aytekin, F; Akgun, M; Ozyilmaz, E; Cetinoglu, ED; Tuncay, EA; Tasbakan, S; Balbay, O; Demir, AU; Ergun, R; Savci, S; Karakurt, Z; Ekinci, B; Gemicioglu, B; Yorgancioglu, A
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    Absenteeism and Delay to Work Due to Sleep Disorders in the Turkish Adult Population: A Questionnaire-Based National Survey
    Firat, H; Yuceege, M; Kiran, S; Akgun, M; Demir, AU; Aksu, M; Ardic, S; Karadeniz, D; Ucar, ZZ; Sevim, S; Itil, O; Yilmaz, H
    Sleep problems may have negative effects on work-life balance, overall health, and safety. We aimed to investigate the association between sleep disorders and absenteeism and delay to work (being late or tardy) among the working adult population. The study was conducted by using data from a large survey of working adults who participated in the Turkish Adult Population Epidemiology of Sleep Study (TAPES) managed by Turkish Sleep Medicine Society (TSMS). Secondary analyses was employed to examine absenteeism and delay to work and their associations with sleep problems, including sleepiness by Epworth Sleepiness Scale (ESS), parasomnias, sleep apnea (by Berlin Questionnaire), sleep quality (by Pittsburgh Sleep Quality Index), and restless leg. History of any absenteeism and delay to work was observed in 276 (18%) and 443 (29%) out of 1,533 working adults, respectively. In the multivariate analyses, absenteeism was associated with younger age, female gender and poor sleep quality, while delay to work was associated with younger age, poor sleep quality, parasomnia, and sleepiness. In the presence of absenteeism and delay to work, sleep disorders including sleepiness, poor sleep quality, and parasomnia should be considered. Such evaluation may improve worker well-being and provide some additional benefits in terms of increasing productivity and lowering work-related costs.
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    The validation of the Turkish version of Asthma Control Test
    Uysal, MA; Mungan, D; Yorgancioglu, A; Yildiz, F; Akgun, M; Gemicioglu, B; Turktas, H
    Current guidelines focus more on levels of asthma control than on severity of asthma. The original version of the Asthma Control Test (ACT), a self-administered instrument to determine asthma control levels, was designed for English-speaking patients. More recently, the ACT has been translated into many languages and has been validated for many cultures, but this is the first study to evaluate the Turkish version. We aimed to evaluate the reliability, validity, and responsiveness of the Turkish version of the ACT among outpatients with asthma. This multicenter prospective study included 220 asthma patients in outpatient clinics in Turkey. The ACT was completed at admission (Visit 1), after 10 +/- A 2 days (Visit 2), and at 5 +/- A 1 weeks (Visit 3). At each visit, physicians assessed patients' asthma control levels. The Turkish version of the ACT showed an internal consistency reliability of 0.84 (Cronbach's alpha). Test-retest reliability was 0.85 in stable patients. There was a significant correlation between the ACT and physicians' assessments at admission (r = 0.68, p < 0.001). The AUC was 0.91, with a sensitivity of 89.06 % and a specificity of 78.26 % for a score of a parts per thousand currency sign19 for screening uncontrolled asthma. A minimally important difference of three points on the ACT was consistent with the GINA physician assessment scores between the baseline and the follow-up visits. The Turkish version of the ACT is a valid and reliable tool for assessing asthma control in patients in outpatient settings. The test may facilitate the designation of asthma patients' symptoms as either controlled or uncontrolled.
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    The predictors of COVID-19 mortality in a nationwide cohort of Turkish patients
    Kokturk, N; Babayigit, C; Kul, S; Cetinkaya, PD; Nayci, SA; Baris, SA; Karcioglu, O; Aysert, P; Irmak, I; Yuksel, AA; Sekibag, Y; Toprak, OB; Azak, E; Mulamahmutoglu, S; Cuhadaroglu, C; Demirel, A; Kerget, B; Ketencioglu, BB; Ozger, HS; Ozkan, G; Yuce, ZT; Ergan, B; Oguz, VA; Kilinc, O; Ercelik, M; Ciftci, TU; Alici, O; Temel, EN; Ataoglu, O; Aydin, A; Bahcetepe, DC; Gullu, YT; Fakili, F; Deveci, F; Kose, N; Tor, MM; Gunluoglu, G; Altin, S; Turgut, T; Tuna, T; Ozturk, O; Dikensoy, O; Gulhan, PY; Basyigit, I; Boyaci, H; Oguzulgen, IK; Borekci, S; Gemicioglu, B; Bayraktar, F; Elbek, O; Hanta, I; Okur, HK; Sagcan, G; Uzun, O; Akgun, M; Altinisik, G; Dursun, B; Edis, EC; Gulhan, E; Eyuboglu, FO; Gultekin, O; Havlucu, Y; Ozkan, M; Sakar, A; Sayiner, A; Kalyoncu, AF; Itil, O; Bayram, H
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    What should be the appropriate minimal duration for patient examination and evaluation in pulmonary outpatient clinics?
    Musellim, B; Borekci, S; Uzan, G; Sak, ZHA; Ozdemir, SK; Altinisik, G; Altunbey, SA; Sen, N; Kilinc, O; Yorgancioglu, A; Yilmaz, N; Ulasli, SS; Salepci, B; Ocakli, B; Sokullu, ZGE; Uzun, O; Kurtulus, S; Uslu, S; Saritas, E; Genc, S; Annakkaya, AN; Aydin, O; Bilgin, C; Turk, M; Ozmen, I; Tasbakan, MS; Halis, AN; Bahcecioglu, SN; Dabak, G; Isik, SR; Ozturk, AB; Akgun, M; Pihtili, A; Ozkan, G; Balbay, EG; Okumus, G; Onen, ZP; Yasayancan, N; Uysal, FE; Hanta, I; Kaya, Z; Turker, H; Berkesoglu, C; Celik, P; Cetinkaya, PD; Gundogus, B; Ongen, G; Tuncay, E; Erboy, F
    INTRODUCTION: Patient examinations performed in a limited time period may lead to impairment in patient and physician relationship, defective and erroneous diagnosis, inappropriate prescriptions, less common use of preventive medicine practices, poor patient satisfaction, and increased violent acts against health-care staff. OBJECTIVE: This study aimed to determine the appropriate minimal duration of patient examination in the pulmonary practice. METHODS: A total of 49 researchers from ten different study groups of the Turkish Thoracic Society participated in the study. The researchers were asked to examine patients in an almost ideal manner, without time constraint under available conditions. RESULTS: A total of 1680 patient examinations were reviewed. The mean duration of patient examination in ideal conditions was determined to be 20.4 +/- 9.6 min. Among all steps of patient examination, the longest time was spent for taking medical history. The total time spent for patient examination was statistically significantly longer in the university hospitals than in the governmental hospitals and training and research hospitals (P < 0.001). Among different patient categories, the patients with a chronic disorder presenting for the first time and were referred from primary or secondary to tertiary care for further evaluation have required the longest time for patient examination. CONCLUSION: According to our study, the appropriate minimal duration for patient examination is 20 min. It has been observed that in university hospitals and in patients with chronic pulmonary diseases, this duration has been increased to above 25 min. The durations in clinical practice should be planned accordingly.
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    The predictors of COVID-19 mortality in a nationwide cohort of Turkish patients
    Kokturk, N; Babayigit, C; Kul, S; Cetinkaya, PD; Nayci, SA; Baris, SA; Karcioglu, O; Aysert, P; Irmak, I; Yuksel, AA; Sekibag, Y; Toprak, OB; Azak, E; Mulamahmutoglu, S; Cuhadaroglu, C; Demirel, A; Kerget, B; Ketencioglu, BB; Ozger, HS; Ozkan, G; Ture, Z; Ergan, B; Oguz, VA; Kilinc, O; Ercelik, M; Ciftci, TU; Alici, O; Temel, EN; Ataoglu, O; Aydin, A; Bahcetepe, DC; Gullu, YT; Fakili, F; Deveci, F; Kose, N; Tor, MM; Gunluoglu, G; Altin, S; Turgut, T; Tuna, T; Ozturk, O; Dikensoy, O; Gulhan, PY; Basyigit, I; Boyaci, H; Oguzulgen, IK; Borekci, S; Gemicioglu, B; Bayraktar, F; Elbek, O; Hanta, I; Okur, HK; Sagcan, G; Uzun, O; Akgun, M; Altinisik, G; Dursun, B; Edis, EC; Gulhan, E; Eyuboglu, FO; Gultekin, O; Havlucu, Y; Ozkan, M; Coskun, AS; Sayiner, A; Kalyoncu, AF; Itil, O; Bayram, H
    The COVID-19-related death rate varies between countries and is affected by various risk factors. This multi-center registry study was designed to evaluate the mortality rate and the related risk factors in Turkey. We retrospectively evaluated 1500 adults with COVID-19 from 26 centers who were hospitalized between March 11 and July 31, 2020. In the study group, 1041 and 459 cases were diagnosed as definite and highly probable cases, respectively. There were 993 PCR-positive cases (66.2%). Among all cases, 1144 (76.3%) were diagnosed with non-severe pneumonia, whereas 212 (14.1%) had severe pneumonia. Death occurred in 67 patients, corresponding to a mortality rate of 4.5% (95% CI:3.5-5.6). The univariate analysis demonstrated that various factors, including male sex, age >= 65 years and the presence of dyspnea or confusion, malignity, chronic obstructive lung disease, interstitial lung disease, immunosuppressive conditions, severe pneumonia, multiorgan dysfunction, and sepsis, were positively associated with mortality. Favipiravir, hydroxychloroquine and azithromycin were not associated with survival. Following multivariate analysis, male sex, severe pneumonia, multiorgan dysfunction, malignancy, sepsis and interstitial lung diseases were found to be independent risk factors for mortality. Among the biomarkers, procalcitonin levels on the 3rd-5th days of admission showed the strongest associations with mortality (OR: 6.18; 1.6-23.93). This study demonstrated that the mortality rate in hospitalized patients in the early phase of the COVID-19 pandemic was a serious threat and that those patients with male sex, severe pneumonia, multiorgan dysfunction, malignancy, sepsis and interstitial lung diseases were at increased risk of mortality; therefore, such patients should be closely monitored.
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    Importance of Inhaler Device Use Status in the Control of Asthma in Adults: The Asthma Inhaler Treatment Study
    Yildiz, F; Erbagci, A; Demirel, YS; Akcali, SD; Ekici, A; Dursunoglu, N; Ediger, D; Erdinc, M; Cemri, SC; Kalyoncu, AF; Guclu, SZ; Aktogu, S; Gurler, BB; Bayram, M; Akgun, M; Mirici, A; Akyildiz, L; Celik, P; Guven, AO; Camsari, G; Ozseker, F; Cimen, F; Kurutepe, M; Senyigit, A; Bektas, Y; Ozbudak, O; Saylan, B; Baslilar, S; Polatli, M; Cagatay, T; Kalkan, S; Ozer, A
    BACKGROUND: Proper education and training in correct inhalation technique has been reported to have a substantial role in the achievement of optimal therapeutic benefit and asthma control. The present study was designed to evaluate inhaler technique and the role of education in relation to asthma control among patients with persistent asthma in Turkey. METHODS: A total of 572 patients with persistent asthma (mean +/- SD age 42.7 +/- 12.2 y, 76% females) were included in this non-interventional, observational, registry study conducted across Turkey. Data on the effective and correct use of inhaler devices were collected via the Ease of Use for the Inhaler Device Questionnaire to patients and physicians. RESULTS: Asthma control (overall 61.5% at baseline, and increased to 87.3% during follow-up) was better, with significant improvement in technique and decrease in basic errors to the range 0-1, regardless of the inhaler type. Overall, the most common basic error associated with inhalation maneuvers was failure to exhale before inhaling through the device (18.9%). There was concordance between the patients and physicians in the ratio of correct inhaler technique only for spray-type inhalers. CONCLUSIONS: Close follow-up with repeated checking of the patient's inhaler technique and correction of errors each time by a physician seem to be associated with a significant decrease in the percent of patients who make basic errors in inhalation maneuvers and device-independent errors, and with better control of persistent asthma.
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    The association of antiviral drugs with COVID-19 morbidity: The retrospective analysis of a nationwide COVID-19 cohort
    Babayigit, C; Kokturk, N; Kul, S; Cetinkaya, PD; Nayci, SA; Baris, SA; Karcioglu, O; Aysert, P; Irmak, I; Yuksel, AA; Sekibag, Y; Toprak, OB; Azak, E; Mulamahmutoglu, S; Cuhadaroglu, C; Demirel, A; Kerget, B; Ketencioglu, BB; Ozger, HS; Ozkan, G; Ture, Z; Ergan, B; Oguz, VA; Kilinc, O; Ercelik, M; Ciftci, TU; Alici, O; Temel, EN; Ataoglu, O; Aydin, A; Bahcetepe, DC; Gullu, YT; Fakili, F; Deveci, F; Kose, N; Tor, MM; Gunluoglu, G; Altin, S; Turgut, T; Tuna, T; Ozturk, O; Dikensoy, O; Gulhan, PY; Basyigit, I; Boyaci, H; Oguzulgen, IK; Borekci, S; Gemicioglu, B; Bayraktar, F; Elbek, O; Hanta, I; Okur, HK; Sagcan, G; Uzun, O; Akgun, M; Altinisik, G; Dursun, B; Edis, EC; Gulhan, E; Eyuboglu, FO; Gultekin, O; Havlucu, Y; Ozkan, M; Coskun, A; Sayiner, A; Kalyoncu, AF; Itil, O; Bayram, H
    Background and objectivesAlthough several repurposed antiviral drugs have been used for the treatment of COVID-19, only a few such as remdesivir and molnupiravir have shown promising effects. The objectives of our study were to investigate the association of repurposed antiviral drugs with COVID-19 morbidity. MethodsPatients admitted to 26 different hospitals located in 16 different provinces between March 11-July 18, 2020, were enrolled. Case definition was based on WHO criteria. Patients were managed according to the guidelines by Scientific Board of Ministry of Health of Turkey. Primary outcomes were length of hospitalization, intensive care unit (ICU) requirement, and intubation. ResultsWe retrospectively evaluated 1,472 COVID-19 adult patients; 57.1% were men (mean age = 51.9 +/- 17.7years). A total of 210 (14.3%) had severe pneumonia, 115 (7.8%) were admitted to ICUs, and 69 (4.7%) were intubated during hospitalization. The median (interquartile range) of duration of hospitalization, including ICU admission, was 7 (5-12) days. Favipiravir (n = 328), lopinavir/ritonavir (n = 55), and oseltamivir (n = 761) were administered as antiviral agents, and hydroxychloroquine (HCQ, n = 1,382) and azithromycin (n = 738) were used for their immunomodulatory activity. Lopinavir/ritonavir (beta [95% CI]: 4.71 [2.31-7.11]; p = 0.001), favipiravir (beta [95% CI]: 3.55 [2.56-4.55]; p = 0.001) and HCQ (beta [95% CI]: 0.84 [0.02-1.67]; p = 0.046) were associated with increased risk of lengthy hospital stays. Furthermore, favipiravir was associated with increased risks of ICU admission (OR [95% CI]: 3.02 [1.70-5.35]; p = 0.001) and invasive mechanical ventilation requirement (OR [95% CI]: 2.94 [1.28-6.75]; p = 0.011). ConclusionOur findings demonstrated that antiviral drugs including lopinavir, ritonavir, and favipiravir were associated with negative clinical outcomes such as increased risks for lengthy hospital stay, ICU admission, and invasive mechanical ventilation requirement. Therefore, repurposing such agents without proven clinical evidence might not be the best approach for COVID-19 treatment.