Browsing by Author "Bilun Gemicioglu"

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    Turkish Thoracic Society asthma management and prevention guideline: key points
    (2011) Arzu YORGANCIOĞLU; Bilun Gemicioglu; İ. Kıvılcım OĞUZÜLGEN; VESİLE DİLŞAD MUNGAN; ADİLE BERNA DURSUN; Fusun Yildiz
    Astım, dünyada ve ülkemizde patogenez, tanı ve tedavisinde tüm ilerlemelere rağmen morbiditesi ve maliyeti yüksek bir hastalıktır. Doğru tanı ve tedavi ile kontrol altına alınabilen bir hastalık olmasına rağmen dünyada ve ülkemizde belirlenen düşük kontrol oranları sadece hastalığın değişken seyrine ve hastaların psikososyal kronik hastalık davranışına bağlanamaz. Bu bağlamda, Türk Toraks Derneği de en son 2000 yılında yayınladığı “Astım Tanı ve Tedavi Rehberi”ni güncelleme kararı almıştır. Ülkemizin verileri toplanmış, konu ile ilgili eğitimcilerden oluşturulan yazarlar tarafından kanıta dayalı bilgiler derlenerek hazırlanmış ve Türk Toraks Derneği Astım ve Allerji Çalışma Grubu tarafından son şekli verilerek, danışman kişi ve kurumlara sunulmuştur. Haziran 2009 tarihinde Türk Toraks Derneği “Astım Tanı ve Tedavi Rehberi” Türkçe olarak yayınlanmıştır. Bu derlemede ulusal rehberin temel özellikleri ve diğerlerinden farkları İngilizce olarak sunulmaktadır.
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    Ağır astım tedavisi: Uzman görüşü
    (2014) Gülfem ELİK; Fusun Yildiz; Arzu YORGANCIOĞLU; Sevim Bavbek; Dilşad Mungan; MEHMET POLATLI; İPEK KIVILCIM OĞUZÜLGEN; haluk turktas; Nurhayat YILDIRIM; Tunçalp DEMİR; SEVGI BEHIYE SARYAL; Bilun Gemicioglu; ELIF SEN; Esen KIYAN; Abdullah Sayiner; Hakan Gunen
    Ağır astım tüm astımlı hasta popülasyonunun yakla ş ık %10'unuo lu şturur. Astım kontro lünün sorun o ldu ğu b u grup h asta larda acilservis b a şvuru ları, h astane yatışları, iş- güç kayıpları yü kse k oran larda görülür. Dolayısıyla tedavi maliyetleri çok yüksektir ve tümastım maliyetinin %50'si bu grup için h arcanmaktadır. Genellikle yüksek doz in h aler steroid ve uzun etkili beta-2 agonist kombinas-yonu ile kontrol altına alınamayan bu grup h astalarda farklı tedavi seçenekleri denenmektedir. Bu kısa raporda güncel literatür veri-leri derlenerek stan dart tedaviye dirençli a ğır astımlı h astalarda tedavi seçenekleri ülkemiz koşulları da göz önüne alınarak tartışılmışve gün lük klinik pratik için önerilerde bulunulmuştur.
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    KOAH ve astımda atak
    (2015) VESİLE DİLŞAD MUNGAN; Gülfem E. ÇELİK; Sevim Bavbek; MEHMET POLATLI; arzu yorgancıoglu; İPEK KIVILCIM OĞUZÜLGEN; Nurhayat YILDIRIM; Tunçalp DEMİR; Fusun Yildiz; SEVGI BEHIYE SARYAL; Bilun Gemicioglu; Esen KIYAN; Abdullah Sayiner; ELIF SEN; HALUK ŞABAN TÜRKTAŞ; Hakan Gunen
    Kronik obstrüktif akciğer hastalığı (KOAH) ve astım, ataklarla seyreden hava yollarının hastalıklarıdır. Ataklar her iki hastalıkta da hastalığın doğal seyrini etkilemektedir. KOAH atakları infeksiyonlar ve infeksiyon dışı nedenlere bağlı olarak gelişebilir. İnfeksiyon dışınedenler; başlıca çevresel faktörler (iç ve dış ortam hava kirliliği, mevsimsel değişiklikler), kardiyovasküler hastalıklar, astım-KOAHoverlap sendrom varlığı, KOAH-obstrüktif uyku apne overlap sendrom varlığı, pulmoner emboli, gastro-özefageal reflü, anksiyetedepresyon, pulmoner hipertansiyon olması gibi diğer faktörlerdir. Astım atakları, tetikleyen etkenlere maruziyet, viral infeksiyonlar, tedavinin hasta veya hekim tarafından aksatılması veya yetersiz verilmesi ile ortaya çıkar. Sigaranın bırakılması, infeksiyonların önlenmesi, uzun etkili antikolinerjik, uzun etkili β2 agonist, inhaler kortikosteroidler, fosfodiesteraz-4 inhibitörleri, mukolitikler, profilaktik antibiyotikler KOAH akut ataklarının önlenmesinde etkili olabilir. Astımda tetikleyen allerjen, viral infeksiyonlardan korunma, mesleki ajanlar, çevre kirliliğinden sakınma, komorbit hastalıkların tedavisi ile atak oranlarında azalmalar sağlanabilmektedir. Etkin tedaviler verilmesi; inhaler steroidler ve kombine tedaviler atakların önlenmesinde en etkin tedavi ajanlarıdır. Hasta eğitimi ve hasta ile işbirliği; etkin bir tedavi verilerek hastaya düzgün tedavisinin kullanımının gereği, inhaler tekniği öğretilmeli ve eline yazılı eylem planı verilerek yakınmaları başlayınca yapması gerekenler yazılarak aktarılmalıdır. KOAH ve astım atak tedavisinin temeli yoğun bir bronkodilatör tedavidir. Buna paralel olarak, atakta yangıya yönelik steroid tedavileri de, hastanın durumuna göre, devreye sokulur. Ayrıca atağa neden olan soruna (infeksiyon, hava kirliliği, emboli vb.) özgül tedavi ve uygulanmalıdır.
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    Attitude and Practice Toward Use of Cigarettes and Electronic Cigarettes Among Pregnant Women: A Questionnaire-Based Survey
    (2022) PINAR ÇELİK; FUSUN TOPÇU; Fusun Yildiz; nursel turkoglu selcuk; Yelda Varol; Gulru Polat; Eylem Tunçay; Hilal Altınöz; Özlem Erçen Diken; tijen atacag; arzu yorgancıoglu; Serir Özkan; Elif YILDIRIM; Serap Akcalı duru; tülin sevim; Bilun Gemicioglu; ipek ozmen; Birsen Ocaklı; Yaşam Kemal Akpak; NESE DURSUNOGLU; Derya Kilic; Pinar Yildiz Gulhan; pelin duru cetinkaya; Elif Yelda Ozgun Niksarlioglu; Esra Uzaslan; Nurdan Kokturk
    OBJECTIVE: This study aimed to evaluate attitude and practice toward use of regular tobacco cigarettes and electronic cigarettes among pregnant women. MATERIAL AND METHODS: A total of 1123 pregnant women participated on a voluntary basis in this questionnaire survey. Maternal charac- teristics, cigarette consumption parameters, and personal opinions regarding the adverse effects of smoking during pregnancy were evaluated. RESULTS: Active smokers composed 12.4% (9.4%: regular tobacco cigarettes, 3.0%: electronic cigarettes) of the study population. Smoking during the current pregnancy, particularly via regular tobacco cigarettes, was more likely for women with smoking during previ- ous pregnancies (56.0% vs. 7.8%, P < .001), previous history of low birth weight infant delivery (16.1% vs. 8.6%, P = .013), premature delivery (16.7% vs. 7.0%, P < .001), and stillbirth (22.8% vs. 11.7%, P = .002). The presence versus absence of smoking during preg- nancy was associated with a lower likelihood of being a housewife (70.5% vs. 80.5%, P = .010) and a higher likelihood of having an actively smoking mother (25.9% vs. 11.2%, P < .001) or partner (65.7% vs. 46.9%, P < .001). Regular tobacco cigarette users considered electronic cigarettes to have a higher risk of adverse impacts (11.1% vs. 2.9%, P = .012), while electronic cigarette users considered regular cigarettes to have a higher risk of nicotine exposure (55.9% vs. 13.0%, P < .001). CONCLUSION: Our findings indicate being employed, having an actively smoking mother or partner, as well as smoking in previous pregnancies, to be the risk factors for increased likelihood of smoking during pregnancy.
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    Stepwise Approach in Asthma Revisited 2023: Expert Panel Opinion of Turkish Guideline of Asthma Diagnosis and Management Group
    (2023) SEÇIL KEPIL ÖZDEMIR; Gülfem Çelik; omur aydin; Ebru Damadoglu; ayse baccioglu; Sevim Bavbek; Dane Ediger; Ferda Oner Erkekol; Bilun Gemicioglu; Rana Işık; AYSE FÜSUN KALPAKLIOGLU; Ali Fuat Kalyoncu; GÜL KARAKAYA; Metin KEREN; Dilşad Mungan; I.Kivilcim Oguzulgen; Fusun Yildiz; Insu Yilmaz; arzu yorgancıoglu
    Introduction of inhaled corticosteroids (ICS) has been the cornerstone of the long-term management of asthma. ICSs either alone or in combination with long-acting beta-2 agonists have been shown to be associated with favorable asthma outcomes. However, asthma con- trol is still reported to be below expectations all around the world. Research in the last decades focusing on the use of ICS/formoterol both as maintenance and as needed (maintenance and reliever therapy approach) showed improved asthma outcomes. As a result of recent developments, Turkish Asthma Guidelines group aimed to revise asthma treatment recommendations. In general, we recommend physi- cians to consider the risk factors for poor asthma outcomes, patients’ compliance and expectations and then to determine “a personalized treatment plan.” Importantly, the use of short-acting beta-2 agonists alone as a symptom reliever in asthma patients not using regular ICS is no longer recommended. In stepwise treatment approach, we primarily recommend to use ICS-based controllers and initiate ICS as soon as possible. We define 2 different treatment tracks in stepwise approaches as maintenance and reliever therapy or fixed-dose therapy and equally recommend each track depending on the patient’s risks as well as decision of physicians in a personalized manner. For both tracks, a strong recommendation was made in favor of using add-on treatments before initiating phenotype-specific treatment in step 5. A strong recommendation was also made in favor of using biologic agents and/or aspirin treatment after desensitization in severe asthma when indicated.
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    Asthma-chronic obstructive pulmonary disease overlap: Results from a national-multicenter study
    (2024) SEVGI BEHIYE SARYAL; Fusun Yildiz; arzu yorgancıoglu; Gülfem Çelik; omur aydin; tuncalp demir; Bilun Gemicioglu; Esen Kıyan; Dilşad Mungan; I.Kivilcim Oguzulgen; MEHMET POLATLI; Ozlem GOKSEL; Abdullah Sayiner; ATİLLA HALİL ELHAN; oznur yıldız; Ilknur Basyigit; YAVUZ HAVLUCU; Gulfer Okumus; Murat Türk; ELIF SEN; Sermin Borekci; Nurhayat Yıldırım
    Asthma-chronic obstructive pulmonary disease overlap: Results from a national-multicenter study Introduction: Patients with asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) have a greater disease burden than those with COPD or asthma alone. In this study, it was aimed to determine the prevalence, risk factors, and clinical features of ACO because there are limited national data in Türkiye. Materials and Methods: The study was conducted in a cross-sectional design in nine tertiary-care hospitals. The patients followed with a diagnosis of asth- ma or COPD for at least one year were enrolled in the study. The frequency of ACO and the characteristics of the patients were evaluated in the asthma and COPD groups. Results: The study included 408 subjects (F/M= 205/203, mean age= 56.24 ± 11.85 years). The overall prevalence of ACO in both groups was 20.8% (n= 85). The frequency was higher in the COPD group than in the asthma group (n= 55; 33.3% vs. n= 22; 9.8%), respectively (p= 0.001). Patients with ACO had similarities to patients with COPD in terms of advanced age, sex, smoking, exposure to biomass during childhood, being born in rural areas, and radio- logic features. Characteristics such as a history of childhood asthma and allergic rhinitis, presence of chronic sinusitis, NSAID hypersensitivity, atopy, and high eosinophil counts were similar to those of patients with asthma (p< 0.001). The annual decline in FEV 1 was more prominent in the ACO group (mean= -250 mL) than in the asthma (mean change= -60 mL) and COPD (mean change= -230 mL) groups (p= 0.003). Conclusion: This study showed that ACO was common among patients with asthma and COPD in tertiary care clinics in our country. ACO should be considered in patients with asthma and COPD who exhibit the abovemen- tioned symptoms.
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    Elderly and aged asthma have different characteristics: results of a multicenter study
    (2024) Ebru Damadoglu; OZGE OZTURK AKTAS; Bilun Gemicioglu; nafiye yılmaz; fulsen bozkus; VEHBİ AYHAN; AYSE FÜSUN KALPAKLIOGLU; Ferda Oner Erkekol; YAVUZ HAVLUCU; FUAT EREL; omur aydin; Aydanur Ekici; ayse baccioglu; SERAP ARGUN BARIS; Gözde Köycü Buhari; Berrin Ceyhan; Ozlem GOKSEL; mehmet köse; Adile Berna Dursun; Fusun Yildiz; arzu yorgancıoglu; Rana Işık; Dane Ediger; I.Kivilcim Oguzulgen; ahmet demir; GÜL KARAKAYA; Ali Fuat Kalyoncu
    Background/ aim: Characteristics of asthma in the elderly population is not well-known. The aim of the present study was to evaluate asthma in the elderly population, to compare disease characteristics between patients diagnosed <60 (aged asthma) and ≥60 (elderly asthma) years of age. Materials and methods: The study was a prospective, multicenter, cross-sectional type. A questionnaire was filled out to patients 60 years of age and over, that have been followed for asthma for at least 3 months. Asthma Control Test (ACT), eight-item Morisky Medication Adherence Scale (MMAS-8) was filled out, inhaler device technique was assessed. Results: A total of 399 patients were included from 17 tertiary care centers across the country. Mean age was 67.11 years and 331 (83%) were female. The age at asthma diagnosis was ≥60 in 146 (36.6%) patients. Patients diagnosed ≥60 years were older (p < 0.001), had higher education level (p < 0.001), more commonly had first-degree relative with asthma (p = 0.038), asthma related comorbidities (p = 0.009) and accompanying rhinitis/rhinosinusitis (p = 0.005), had better asthma control (p = 0.001), were using less controller medications (p = 0.014). Inhaler technique was correct in 37% of the patients with no difference in between the groups. Treatment compliance was better in elderly asthma patients (p < 0.001). In the multivariate logistic regression analysis, having well-controlled asthma (odds ratio = 1.61, CI = 1.04–2.51), and high medication adherence rate (odds ratio = 2.43, CI = 1.48–4.0) were associated with being in the elderly asthma group. Conclusion: The characteristics of asthma are different among patients aged 60 years and over which seems to be related to onset age of asthma. In our cohort, the elderly asthma patients had higher education level, and treatment adherence and asthma control was better. Patients diagnosed ≥60 years of age did not have more severe disease.