Browsing by Author "Coskun A.S."

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    Factors affecting the interval from diagnosis to treatment in patients with lung cancer
    (Il Pensiero Scientifico Editore s.r.l., 2009) Yaman N.; Ozgen A.; Celik P.; Ozyurt B.C.; Nese N.; Coskun A.S.; 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.
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    Relationship between BODE index, quality of life and inflammatory cytokines in COPD patients
    (BioMed Central, 2010) Sarioglu N.; Alpaydin A.O.; Coskun A.S.; Celik P.; Ozyurt B.C.; 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)-α 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-α, 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-α 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?
    (BioMed Central Ltd., 2011) Bora M.; Alpaydin A.O.; Yorgancioglu A.; Akkas G.; Isisag A.; Coskun A.S.; 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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    Asthma control test and asthma quality of life questionnaire association in adults
    (2012) Alpaydin A.O.; Bora M.; Yorgancioglu A.; Coskun A.S.; Celik P.
    Asthma control and quality of life are expected to be correlated. We aimed to evaluate the association of asthma control test (ACT) with asthma quality of life questionnaire (AQLQ) and guideline based control assessment. We also aimed to investigate the impact of therapy adjustment according to ACT score on AQLQ A total of 101 asthmatic patients were included. ACT, AQLQ and Global Initiative for Asthma (GINA) based control assessments were performed. Based on ACT, treatment was adjusted by stepping down in controlled and stepping up in uncontrolled/partly controlled patients. In some controlled/partly controlled patients, no therapy adjustment was done. After 3-months the same parameters were reevaluated. We found a statistically significant association between ACT and AQLQ, a one point increase in ACT was associated with a 0.129 point increase in AQLQ. ACT scores increased significantly in the step-up group; however AQLQ total scores were not affected after therapy adjustment. We found that ACT was concordant with GINA recommended control classification in the first (kappa=0.511, 7.718) and third months (kappa=0.599, 7.912) (P <0.001 for both). We determined an association between ACT and AQLQ. ACT was also found fairly concordant with GINA. However, treatment adjustment according to ACT was not found satisfactory in terms of quality of life. Copyright© 2012, Iranian Journal of Allergy, Asthma and Immunology. All rights reserved.
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    Mannose binding lectin (MBL) gene polymorphism and relationship between serum MBL concentrations in COPD patients; [KOAH hastalarında mannoz baǧlayan lektin (MBL) gen polimorfizmi ve serum MBL derişimi arasındaki ilişki]
    (Turkish Biochemistry Society, 2012) Ulutas G.S.; Taneli F.; Alpaydin A.O.; Cetinkaya C.; Ulman C.; Guvenc Y.; Dinc G.; Coskun A.S.
    Aim: We aimed to assess mannose-binding lectin (MBL) gene polymorphisms and serum MBL concentrations in a sample of Turkish chronic obstructive pulmonary disease (COPD) patients as well as in cigarette smokers. Furthermore, we looked for the possible correlations of serum MBL concentrations with pulmonary function tests. Materials and methods: Forty COPD patients and 40 healthy volunteers were included. The subjects were thereafter divided into 2 groups according to smoking status. Circulating MBL concentrations were assessed by ELISA and MBL gene polymorphisms were assessed by real time PCR method. Spirometry was performed to all subjects except healthy nonsmokers. Results: In the whole study population MBL gene frequencies were found 82.5%(66/80) for A/B genotype, 15%(12/80) for D/D genotype and 2.5%(2/80) for B/B genotype. Circulating MBL concentrations were found 2103±1311 ng/ml and 2324±1001 ng/ml in smoker and nonsmoker COPD patients, respectively, whereas they were 1746±1142 ng/ml in smoker and 2040±879 ng/ml in nonsmoker controls. No statistical difference was found between the study groups for serum MBL concentrations. Serum MBL concentration correlated positively with cigarette smoking (r=0.280, p=0.030) and negatively with pulmonary functions (FEV1 (r=- 0.246, p=0.058). Conclusion: To our knowledge, no previous study has been performed in healthy Turkish population to detect the MBL gene polymorphisms. A/B genotype was the most frequent MBL variant in our study population; however serum MBL concentrations were not found compatible with MBL deficiency. We believe these results need further investigation which includes larger series to evaluate whether serum MBL concentration is a risk factor for COPD. © TurkJBiochem.com.
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    Effect of smoke-free legislation on smoking cessation rates in teachers in Manisa, Turkey
    (2013) Coskun A.S.; Goktalay T.; Havlucu Y.; Dinc G.
    Objective:This study investigated the attitudes of Turkish adults towards the ban on smoking in public areas and compared annual smoking cessation rates before (pre-2009) and after (post-2009) the ban became law, using data from a survey of teachers.Methods:A self-reported questionnaire was used to collect data from teachers in Manisa, Turkey. Annual smoking rates were calculated. Joinpoint regression analysis was used to identify when a significant change occurred in the annual smoking cessation rate.Results:Questionnaire response rate was 79.6% (579/727); 47.8% (277) of respondents were male. Smoking prevalence among men and women was 32.7% and 24.7%, respectively, and 97.3% of nonsmokers and 75.5% of current everyday smokers supported the law changes. Results of the Joinpoint analysis showed no significant change in annual smoking cessation rate between 2001-2002 and 2006-2007; but there were significant reductions in smoking rates between 2007-2008 and 2010-2011.Conclusions:Teachers in Turkey have a positive attitude to the law on smoking. The smoking cessation rate in teachers was significantly increased by changes in legislation. © The Author(s) 2013.
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    Does high-frequency chest wall oscillation therapy have any impact on the infective exacerbations of chronic obstructive pulmonary disease? A randomized controlled single-blind study
    (2013) Goktalay T.; Akdemir S.E.; Alpaydin A.O.; Coskun A.S.; Celik P.; Yorgancioglu A.
    Objective: To investigate the impact of high-frequency chest wall oscillation in chronic obstructive pulmonary disease patients with infective exacerbation. Design: Clinical randomized controlled trial. Setting: Patients received high-frequency chest wall oscillation therapy at the Department of Pulmonology. Subjects: Stage III-IV chronic obstructive pulmonary disease patients hospitalized with acute infective exacerbation who had received high-frequency chest wall oscillation therapy were studied. Interventions: Patients were randomized into two groups, which were classified as I and II. All patients have been treated with bronchodilators, antibiotics, if necessary oxygen and patient education, as part of acute chronic obstructive pulmonary disease exacerbation protocol. Group II patients received additional high-frequency chest wall oscillation therapy. Main measures: Body mass index (B), forced expiratory volume in the first second (O), modified Medical Research Council dyspnea scale (D) and 6-minute walking test (E) (BODE) index, forced expiratory volume in the first second, dyspnea, exercise capacity, oxygenation parameters and hospitalization of duration were recorded at baseline and at three-days and five-days follow-up. Results: From April 2009 to July 2011, a total of 99 patients were assessed for eligibility, 50 patients were enrolled and randomized into two groups. A total of 50 (100%) patients (25 in Group I and 25 in Group II) were followed up for five days. Application of high-frequency chest wall oscillation therapy resulted in no significant advantage in all outcomes (p > 0.05). Mean (SD) baseline BODE index value in Group I was 7.72 (1.76), in Group II was 7.72(1.89) (p = 0.55). On the fifth-day assessment, mean (SD) BODE index value in Group I was 7.24 (1.83), in group II was 6.44 (2.46) (p = 0.18). © The Author(s) 2013.
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    Metabolic syndrome and carotid intima-media thickness in chronic obstructive pulmonary disease
    (BioMed Central Ltd., 2013) Alpaydin A.O.; Arslan I.K.; Serter S.; Coskun A.S.; Celik P.; Taneli F.; Yorgancioglu A.
    Background: The aim of this study is to investigate the prevalence of metabolic syndrome (MetS), carotid intima media thickness (IMT), and serum C-reactive protein (CRP) levels in patients with chronic obstructive pulmonary disease (COPD), and the possible relationships among them. Methods: Fifty stable COPD patients and 40 healthy controls were included in the study. The participants were further divided into four groups according to their smoking status. Pulmonary function tests were performed in COPD patients. Anthropometric measurements and blood chemistry analysis, serum CRP levels and carotid intimamedia thickness (IMT) measurements were performed in all the study population. Results: Prevalence of metabolic syndrome was 43% in COPD patients and 30% in the control group (p = 0.173). FEV1% and FEV 1/FVC were higher in COPD patients with MetS (p = 0.001 and p = 0.014, respectively) compared to those without MetS. Prevalence of MetS was significantly different among the COPD patients with different stages (p = 0.017) with the highest value in stage 2 (59%). Carotid IMT was significantly higher in COPD patients than in control group (1.07 ± 0.25 mm and 0.86 ± 0.18 mm, respectively; p < 0.001). Serum CRP levels were not different in COPD patients and controls, however they were higher in individuals with MetS compared to those without MetS regardless of COPD presence (p = 0.02). Conclusions: Early markers of atherogenesis, in terms of carotid IMT, were found to be higher in COPD patients than in healthy controls. MetS prevalence was observed to decrease as the severity of airflow obstruction increased. Therefore, screening COPD patients for these cardiovascular risk factors would be a novel approach even in absence of symptoms. © 2013 Ozgen Alpaydin et al.
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    Varenicline disrupts prepulse inhibition only in high-inhibitory rats
    (Elsevier Inc., 2014) Goktalay T.; Buyukuysal S.; Uslu G.; Coskun A.S.; Yorgancioglu A.; Kayir H.; Uzbay T.; Goktalay G.
    Varenicline, a widely used smoking cessation drug, has partial agonistic activity at α4β2 nicotinic receptors, and full agonistic activity at α7 nicotinic receptors. Thus it may interact with cognitive processes and may alleviate some of the cognitive disturbances observed in psychotic illnesses such as schizophrenia. We aimed to test the effects of varenicline on sensorimotor gating functioning, which is crucial for normal cognitive processes, especially for the integration of sensory and cognitive information processing and the execution of appropriate motor responses. Prepulse inhibition (PPI) of the acoustic startle reflex was used to test the sensorimotor gating functioning. First, the effects of varenicline and nicotine on rats having high or low baseline PPI levels were evaluated; then, varenicline was applied prior to apomorphine (0.5. mg/kg), and MK-801 (0.15. mg/kg), which are used as comparative models of PPI disruption. Varenicline (0.5-3. mg/kg) did not change PPI when given alone in naïve animals. When rats were selected according to their baseline PPI values, varenicline (1. mg/kg) significantly decreased PPI in high-inhibitory (HI) but not in low-inhibitory (LI) rats. Nicotine (1. mg/kg; tartrate salt) produced a similar activity in LI and HI groups. In combination experiments, varenicline did not reverse either apomorphine or the MK-801-induced disruption of PPI. These results demonstrate that the effects of both varenicline and nicotine on sensorimotor gating are influenced by the baseline PPI levels. Moreover, varenicline has no effect on apomorphine or the MK-801-induced disruption of PPI. © 2014 Elsevier Inc.
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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
    (AME Publishing Company, 2019) Havlucu Y.; Yorgancıoglu A.; Coskun A.S.; Celık 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. © Journal of Thoracic Disease. All rights reserved.
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    The effect of inhaled corticosteroids in the outcomes of community-acquired pneumonia: ICCAP study (TURKCAP Database)
    (Blackwell Publishing Ltd, 2020) Baha A.; Kokturk N.; Bahcecioglu S.N.; Yapar D.; Aksakal N.; Gündüz C.; Tasbakan S.; Sayiner A.; Coskun A.S.; Durmaz F.; Cilli A.; Celenk B.; Kılınc O.; Salman S.; Hazar A.; Tokgoz F.
    Objective: We aimed to investigate the effect of inhaled corticosteroids (ICS) in the outcomes of community-acquired pneumonia (CAP), as well as to determine if ICS usage is exist among the risk factors for mortality in those patients. Materials and Methods: In this retrospective cross-sectional multicentre study, 1069 hospitalised CAP patients were investigated using CAP Database of Turkish Thoracic Society (TURKCAP Database). The patients were divided into two groups, depending on their ICS use. The data were analysed by appropriate statistical methods. Results: 172 (75.8%) of the 227 patients who were on ICS had COPD and 37 (16.3%) had asthma. There were fewer patients with fever among ICS-users compared to non-ICS users (P = 0.013), and less muscle pain (P = 0.015) and fewer GIS symptoms (P = 0.022). No statistically significant difference was found between ICS use/ type of ICS and the duration of hospitalisation (P = 0.286). The multivariate regression analysis showed that patients using ICS had lower body temperature and, less crackles/bronchial sound. In the multivariate logistic regression model lung cancer (OR: 6.75), glucose (OR: 1.01) and CURB-65 (OR: 1.72) were significantly associated with mortality in the CAP patients. ICS usage were not found to be associated with mortality. Conclusion: The use of ICS by the patients with CAP admitted to the hospital is not independently related with any radiological pattern, hospitalisation duration and mortality. ICS usage may diminish fever response and may suppress the findings of crackles and/or bronchial sounds. This needs further confirmation. © 2020 John Wiley & Sons Ltd