Browsing by Author "Celik, P"

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    Omalizumab in patients with severe persistent asthma in real life setting in Manisa, Turkey
    Havlucu, Y; Yorgancioglu, A; Kurhan, F; Özdemir, L; Coskun, S; Goktalay, T; Yilmaz, O; Celik, P
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    Drug-resistant pulmonary tuberculosis in western Turkey: prevalence, clinical characteristics and treatment outcome
    Surucuoglu, S; Ozkutuk, N; Celik, P; Gazi, H; Dinc, G; Kurutepe, S; Koroglu, G; Havlucu, Y; Tuncay, G
    BACKGROUND: Although high antituberculosis (anti-TB) drug resistance rates have been reported in Turkey, the clinical characteristics and implications for the outcome of anti-TB treatment have not been fully investigated. We determined the prevalence of anti-TB drug resistance and examined demographic data, clinical characteristics and treatment outcome in relation to patterns of resistance. METHODS: From the TB case registry of a university hospital and the two largest dispensaries in Manisa city, we identified all pulmonary TB cases with a culture-proven definitive diagnosis and antimicrobial susceptibility results for a 7-year period. We collected and analyzed demographic and clinical data and information on treatment outcome for those cases in relationship to anti-TB drug resistance. RESULTS: Of 355 M. tuberculosis strains, 71.5% were susceptible to streptomycin, isoniazid, rifampicin and ethambutol. Any drug resistance and multi-drug resistance (MDR) rates were 21.1% and 7.3% and were higher in males (53% and 9%, respectively) than in females (22% and 1%, respectively). Drug resistance was significantly higher in old cases (acquired drug resistance) vs new cases (primary drug resistance), and was associated with treatment failure (P<0.001). The prevalence of MDR was significantly higher in the old cases (22.4%) than in the new cases (4.4%) (P<0.001). Symptoms, radiographic findings, associated diseases, and sputum smear positivity were unrelated to the development of resistance. The prevalence of any drug resistance and MDR was significantly higher in those with treatment failure than in patients with treatment success. CONCLUSION: High resistance rates, particularly for acquired MDR, indicate a need for improvement in the TB control programme in our region.
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    Patient education in asthma
    Yorgancioglu, A; Celik, P; Topcu, F
    The day and night symptoms, medical therapy requirements, PEFR monitorizing : hospital admisssions, pulmonary function parameters and the seventy of disease of 80 asthmatics were compared before and after an education program which was repeated 3 times with a 4 month interval in groups of 20 people in order to evaluate the impact of education. The mean age of 63 female, 17 male patients was 40.52 +/- 10.89 (18-70). Day and night symptom scores were significantly decreased (p < 0.05). Self-recording of PEFR values was increased from 22.7% to 66.7% (p<0.05). Mean PEF% was changed from 65.59 +/- 24.32 (20-129) to 78.91 +/- 22.15 (31-144) and FEV1% pred. from 70.35 +/- 20.71 to 80.55 +/- 22.05 (p = 0.0000). Mild intermittan, mild, moderate and severe persistan groups were changed from 25.3% to 70.3%, 27.8% to 18.9%, 26.6% to 2.7% and 20.3% to 8.1% respectively (p < 0.05). These results strongly suggest the importance of education on management in asthma.
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    Relation between COPD assessment testCAT™ and functional parameters and quality of life in COPD patients
    Erkan, S; Yorgancioglu, A; Havlucu, Y; Ozdemir, L; Goktalay, T; Sakar, A; Celik, P
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    Short-term effects of montelukast in stable patients with moderate to severe COPD
    Celik, P; Sakar, A; Havlucu, Y; Yuksel, H; Turkdogan, P; Yorgancioglu, A
    This study aims to investigate the possibility of additional value of leukotriene receptor antagonist (LTA) on dyspnea score, arterial blood gases (ABG), pulmonary function tests (PFTs), and quality of life (St. George QoL) in chronic obstructive pulmonary disease (COPD) patients. In this randomized, prospective, single-blind, and controlled study, 117 non-reversible COPD patients defined by global initiative for chronic obstructive lung disease (GOLD) criteria were randomized to receive ipratropium bromide, formoterol and montelukast (n:58, montelukast group) or ipratropium bromide and formoterol (n:59, control group) after a 2-week run-in period. There was no significant demographic difference between the two groups (P > 0.05). Baseline ABG, PFT, visual analoque scores r(VAS), and QoL scores were obtained and at first month and second month, PFT, VAS, and QoL scores were repeated and ABG was obtained at second month and the values were compared with baseline values. As the result of the comparision, there was significant increase in vital capacity, FVC, FEV1, VAS, and PaO2 parameters (P < 0.05), and a significant decrease in the QoL scores (P < 0.05) in the montelukast group. These parameters did not show any difference in the control group (P > 0.05). Sputum samples that could be obtained in 24 of the COPD patients were evaluated and in the montelukast group, there was a decrease in neutrophitic activity after treatment (n:13) (P <= 0.059). These results suggest that LTA that is used additionally in routine treatment protocol can produce additive improvement on PFr, dyspnea score and especially QoL in patients with stable COPD and for these reasons, LTA may be taken into account when there is need for an additional anti-inflammatory treatment in COPD patients. (c) 2004 Elsevier Ltd. All rights reserved.
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    Pulmonary hypertension in patients with chronic renal failure
    Havlucu, Y; Kursat, S; Ekmekci, C; Celik, P; Serter, S; Bayturan, O; Dinc, G
    Background: Many etiologies causing pulmonary hypertension (PH) have been reported, and one of the background disease seen with patients with PH is chronic renal failure (CRF); however, the pathogenesis of PH in this group of patients is not explained satisfactorily. Objectives: The aims of this study were to evaluate the incidence of unexplained PH among patients with CRF and to suggest possible etiologic factors. Methods: Two hundred and eleven patients with CRF were evaluated and the ones who have comorbid conditions that cause PH were excluded. Pulmonary arterial pressure (PAP) and cardiac functions were evaluated by Doppler echocardiography. Arteriovenous fistula (AVF) flow was measured by Doppler sonography. The patients were followed for at least 6 months. Results: Forty-eight CRF patients (20 males, 28 females) were included: 23 were predialysis patients, and 25 patients received hemodialysis via AVF. Patients were followed for 7.5 +/- 1.01 months. Systolic PAP>35 mm Hg was found in 56% (14/25) of patients receiving hemodialysis (36.8 +/- 10.7 mm Hg) and in 39.1% (9/23) of predialysis patients ( 29.5 +/- 9.5 mm Hg). The parathyroid hormone level, cardiac output values and CRF duration were found to be increased in patients with elevated systolic PAP (p < 0.05). AVF flow and AVF duration were positively correlated with systolic PAP in patients receiving hemodialysis (p < 0.05). There was a negative correlation between systolic PAP and residual urine volume (p < 0.05). AVF compression in hemodialysis patients decreased systolic PAP from 36.8 +/- 10.7 to 32.8 +/- 10.5 mm Hg. Systolic PAP values were increased at the end of the study in the predialysis group, whereas they were decreased at the end of the follow-up in the hemodialysis group (36.9 +/- 10.5 and 32.04 +/- 10.5 mm Hg, respectively). Conclusions: This study demonstrates a high incidence of PH among patients with CRF.CRF duration, AVF flow, parathyroid hormone level and cardiac output may be involved in the pathogenesis of PH. The effective hemodialysis and dry weight reduction decreased systolic PAP values. Copyright (c) 2007 S. Karger AG, Basel
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    Relation Between Quality of Life and Morbidity and Mortality in COPD Patients: Two-Year Follow-Up Study
    Yorgancioglu, A; Havlucu, Y; Celik, P; Dinc, G; Saka, A
    Quality of life (QoL) is being recognized as an important outcome when evaluating chronic obstructive pulmonary disease (COPD) patients. This study aims at identifying the relation between QoL parameters and mortality and morbidity in COPD patients by using the St. George Respiratory Questionnaire (SGRQ). In this prospective study, 251 COPD patients as defined by American Thoracic Society (ATS) criteria were included. A total of 218 patients (86.85%) were male and mean age was 65.55 years. A pulmonary function test (PFT) and SGRQ were performed at the beginning, first, and second years. During a two-year follow-up, the first exacerbation day, the number of exacerbations and intubations, the number and duration of hospitalizations, hospitalizations in an intensive care unit, and exitus day were recorded. When the correlation between FEV1, SGRQ scores, and these parameters was investigated, there was significant correlation between these parameters, and this correlation was more significant in SGRQ scores than FEV1 (Pearson correlation test). The activity score of SGRQ was found to be more useful than other scores (Cox regression analysis). Not only PFT but also QoL questionnaires are useful in determining the prognosis of COPD. QoL questionnaires provide a valid and standardized estimate of the overall impact of COPD, and can complement spirometric measurements of baseline assessment of patients in routine practice.
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    Lumbar stiffness but not thoracic radiographic changes relate to alteration of lung function tests in ankylosing spondylitis
    Cerrahoglu, L; Unlu, Z; Can, M; Goktan, C; Celik, P
    Involvement of the costovertebral (CV) and costotransverse (CT) as well as the sacroiliac (SI) joints is known to occur in patients with ankylosing spondylitis (AS). The functional significance of these changes is not clear. We have performed clinical and radiological evaluations and assessed the effect of joint involvement on pulmonary function. We detected radiologic evidence of involvement of the CV joint in 80% of patients and of the CT joint in 60%. We found a direct relation between the severity of CV, CT and SI joint affliction, and the severity of CV and SI joints were related to time of evolution of the disease. Pulmonary function tests revealed neither restrictive nor obstructive defects. No relation was found between pulmonary function and CV and CT joint affliction. Patients with stiffer spines had a tendency to have pulmonary function tests within the lower limit of the normal range. In patients with AS diaphragmatic breathing might compensate the chest respiration to some extent.
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    Reliability and validity of a Turkish version of Leicester cough questionnaire
    Gonen, NA; Havlucu, Y; Yorgancioglu, A; Goktalay, T; Coskun, AS; Celik, P
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    The prevalence of asthma and allergic symptoms in Manisa, Turkey (A western city from a country bridging Asia and Europe)
    Sakar, A; Yorgancioglu, A; Dinc, G; Yuksel, H; Celik, P; Dagyildizi, L; Coskun, E; Kaya, E; Ozyurt, B; Ozcan, C
    The aim of this study was to determine the prevalence of asthma and allergic symptoms in Manisa city center, Turkey, to evaluate the determinants effective on those values, and to review the prevalence rates reported from different parts of the country. Data were collected from 610 households and complete interviews were conducted with 1,336 adults over 18 years of age by using European Community Respiratory Health Survey-ECRHS questionnaire. The prevalences of current asthma, cumulative asthma and asthma-like symptoms were found in 1.2, 1.0 and 25.0%, respectively, of the 20-44 years age group and the prevalences of allergic rhinitis, allergic dermatitis and family atopy were found in 14.5, 10.9, and 15.2%, respectively, in all age group. Wheezing with breathlessness, wheezing without cold, woken up with shortness of breath and woken up with cold were reported by 9.1%, 6.9%, 6% and 16.1% of the study population, respectively. Gender, age, active or passive smoking, family atopy and home condition effect on prevalence of asthma and allergic symptoms. In this study prevalence of asthma correlated with the studies reporting low prevalence rates of Turkey.
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    Relationship between BODE index, quality of life and inflammatory cytokines in COPD patients
    Sarioglu, N; Alpaydin, AO; Coskun, AS; Celik, P; Ozyurt, BC; Yorgancioglu, A
    Background and aims: Recently a multidimensional grading system based on the body mass index (B), degree of airflow obstruction (O), dyspnea (D) and exercise capacity (E) - the BODE index - has begun to be used increasingly for the evaluation of chronic obstructive pulmonary disease (COPD) patients. The aim of our study was to investigate the relationship between the BODE index and disease duration, annual exacerbation and hospitalization rates, health related quality of life and systemic inflammatory markers like C-reactive protein (CRP), tumor necrosis factor (TNF)-alpha and interleukin (IL)-8. Materials and methods: In 88 stable COPD patients we evaluated the body-mass index, pulmonary function tests, Modified Medical Research Council dyspnea scale and six-minute walk test (6MWT). BODE scores were determined. Disease duration, number of exacerbations and hospitalization in the previous year were recorded. We also performed arterial blood gases analysis, administered the St. George's Respiratory Questionnaire (SGRQ) and measured serum levels of CRP, TNF-alpha, IL-8. Results: According to BODE score 52% of patients were BODE 1, 21% BODE 2, 15% BODE 3 and 12% were BODE 4. There was a significant relationship between BODE index and COPD stage as classified according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) (p < 0.001). Correlations between BODE score and disease duration (p = 0.011), number of exacerbations (p < 0.001) and hospitalizations (p < 0.001) in the last year were also observed. SGRQ symptom, activity, emotion scores and total scores were found to be significantly correlated to BODE (p < 0.001). Serum CRP levels and BODE were also correlated (p = 0.014); however, no correlation was found between serum levels of TNF-alpha and IL-8 and BODE. Conclusions: As the BODE index shows a strong correlation with various prognostic and follow up parameters of COPD and systemic inflammation, its use should be considered for the evaluation of COPD patients.
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    Does asthma control as assessed by the asthma control test reflect airway inflammation?
    Bora, M; Alpaydin, AO; Yorgancioglu, A; Akkas, G; Isisag, A; Coskun, AS; Celik, P
    Background and aims: The treatment of asthmatic patients is particularly focused on the control of symptoms as well as functional and inflammatory parameters. In our study, we investigated the relationship between the asthma control test (ACT) which evaluates symptoms and airway inflammation and functional parameters. Materials and methods: Stable asthmatic patients admitted to our pulmonary outpatient clinic were enrolled in the study consecutively and underwent the ACT, pulmonary function tests and methacholine bronchial provocation test (MBPT). Additionally, fractional exhaled nitric oxide level (FeNO) and induced sputum cell distribution were assessed. All these parameters were re-evaluated at the third month after adjusting medications of the patients according to baseline ACT scores. Results: Of the 101 patients screened, we analyzed 83 who proceeded to the follow up visit. At the baseline visit, 8 were totally controlled, 36 partially controlled and 39 uncontrolled according to ACT. At the follow up visit, 10 were totally controlled, 39 partially controlled and 34 uncontrolled. Comparison of the two visits in terms of all parameters revealed significant reductions only in the percentages of patients with MBPT positivity (p = 0.029) and FeNO levels > 20 ppb (p = 0.025) at follow up. The percentages of patients with FeNO > 20 ppb, MBPT positivity, induced sputum eosinophilia or induced sputum neutrophilia did not show significant differences between totally controlled, partially controlled and uncontrolled groups at both baseline and follow up visits. Conclusion: Although the ACT scores did not show significant correlations with the airway inflammation parameters tested in this study, a marked reduction in the percentage of patients with MBPT positivity and FeNO > 20 ppb at follow up may suggest the importance of the control concept in the management of asthma.
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    Evaluation of Thyroid Function Tests In Chronic Obstructive Pulmonary Disease
    Kaya, E; Coskun, E; Celik, P; Sakar, A; Yorgancioglu, A; Özyurt, B
    Abnormal thyroid function test (TFT) levels were reported in chronic obstructive pulmonary disease (COPD) patients. We aimed to investigate the relationship between COPD and TFT in our study. Ninety three stable COPD patients and 17 healthy adults as a control group were evaluated. Physical examination, pulmonary function tests, and arterial blood gas analysis were performed in COPD patients. To evaluate the thyroid functions, fT3, fT4, TSH levels were measured. Mean age was 65,8 +/- 9,0 for the COPD group consisting of 9 (% 10) female and 84 (% 90) male, and 44,6 +/- 9,2 for the control group. When COPD and control groups were compared, TSH levels were found to be lower in the COPD group (p= 0.03). There is no relationship between age and TFT levels. In the COPD group, there was a negative correlation between fT4 and PEF (r=-0,21); and a positive correlation between sT4 and pH (r= 0,27). In conclusion, TFT levels are considered to be affected in COPD which is a systemic disorder, thyroid hormone levels decreased in severe COPD, and TFT levels low in all COPD patients, and correlations between TFT and some PFT levels are suggested.
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    Does one year change in quality of life predict the mortality in patients with chronic obstructive pulmonary disease? - Prospective cohort study
    Havlucu, Y; Yorganatoglu, A; Coskun, AS; Celik, P
    Background: Subjects with chronic obstructive pulmonary disease (COPD) present increased mortality and poor health-related quality of life (HRQoL) as compared with the general population. The objective of this study was to evaluate whether an improvement in QoL. after 1 year of proper management is a predictor of survival in a cohort of patients followed up for 10 years. Methods: In this prospective study, 306 COPD patients were assessed for eligibility between January 2003 and September 2003. Thirty-five patients were excluded due to failure to meet inclusion criteria or declining to participate and 20 patients were also excluded subsequently because they could not complete the questionnaire. Two hundred and fifty one patients were assessed at the beginning. St. George Respiratory Questionnaire (SGRQ) and pulmonary function test (PFT) were performed at the initial visit and the end of the first year. Mortality information was obtained from hospital records and direct family interviews. Results: A comparison between respiratory diseases mortality according to baseline paramaters reveals that age and presence of cardiac comorbidity indicates a higher risk of death and associated with worse QoL. After a cox regression analysis, the relative risk of death of any cause related to baseline QoL score was 1.042 (95% CI: 1.028-1.057), and 1.030 (95% CI: 1.011-1.050) for respiratory cause mortality. However, the relative risk of death when there was a deterioration in QoL, after one year of follow up was 1.175 (95% CI: 1.130-1.221) for all-cause mortality and 1.214 (95% CI: 1.151-1.280) for respiratory cause mortality. Conclusions: A QoL. worsening in the initial year of follow up more strongly predicts 10-year mortality of any cause and for respiratory diseases than the baseline assessment alone predicts, among patients with COPD.
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    Epidemiological changes of patients with lung cancer over Years
    Havlucu, Y; Celik, P; Durmaz, F; Coskun, AS; Goktalay, T; Yorgancioglu, A
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    Asthma control with omalizumab treatment in severe allergic asthma and severe non-allergic asthma patients
    Havlucu, Y; Yorgancioglu, A; Kurhan, F; Goktalay, T; Coskun, AS; Celik, P
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    Factors affecting the interval from diagnosis to treatment in patients with lung cancer
    Yaman, N; Ozgen, A; Celik, P; Ozyurt, BC; Nese, N; Coskun, AS; Yorgancioglu, A
    Aims and background. We aimed to investigate the factors affecting the interval from the beginning of the symptoms until diagnosis and treatment in patients with lung cancer. Methods. Records of 119 lung cancer patients diagnosed in our pulmonary diseases clinic between 2004 and 2006 were evaluated retrospectively. Demographic data, histopathological tumor type, TNM stage, ECOG performance status, presence of endobronchial lesions, and radiological localization of the tumor were determined. Intervals from the first symptom to contacting a doctor, to diagnosis and to treatment were calculated. The interval from first admission to a clinic and referral to a chest physician was also calculated. Results. Of 119 patients, 74% were diagnosed as non-small cell and 26% were as small cell lung cancer. Forty-eight percent of the patients were at stage 3B and 36% were at stage 4. ECOG performance status was 0 in 6%, 1 in 52%, 2 in 36%, 3 in 3%, and 4 in 2%. Endobronchial lesions were observed in 50% of the patients, and the lesions had a central radiological localization in 59%. Fifty-four percent of the patients presented to a chest physician first. Patients who first presented to an internal medicine clinic were referred to our pulmonary disease clinic significantly later than those who presented to other clinics (P = 0.005). The median period from the beginning of the symptoms until contacting a doctor was 35 days (range, 1-387), until diagnosis was 49 days (range, 12-396), and until beginning the treatment was 57 (range, 9-397) days. The presence of endobronchial lesions, radiological localization, TNM stage and ECOG performance status were not found to be related to the intervals from the first symptom to presentation to a doctor, to diagnosis or to the beginning of the treatment. Conclusions. Lung cancer patients consult a doctor after a relatively long symptomatic period. Patient delays may be shortened by increasing the awareness of patients about lung cancer symptoms. Diagnostic procedures should be performed more rapidly to shorten doctor delays.