Browsing by Author "Yorgancioǧlu A."
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Item Pulmonary function parameters in patients with diabetes mellitus(2002) Özmen B.; Çelik P.; Yorgancioǧlu A.; Özmen D.; Çok G.[No abstract available]Item Unusual foreign body aspiration; [Nadir görülen bir yabanci cisim aspirasyonu](2006) Çelik P.; Kaya E.; Şakar A.; Yorgancioǧlu A.Tracheobronchial foreign body aspiration in adults is rare when compared to children. In this case report, 76 years old female patient who aspirated a screw of tracheostomy canula which was taken out by fiberoptic bronchoscopy (FOB) was presented. This case showed us that education of patients about stoma care is important. The FOB can be used safely to get foreign body from distal airways.Item Lung involvement in inflammatory bowel diseases [3](King Faisal Specialist Hospital and Research Centre, 2006) Sarioǧlu N.; Türkel N.; Şakar A.; Ćelik P.; Saruç M.; Demir M.A.; Göktan C.; Kirmaz C.; Yüceyar H.; Yorgancioǧlu A.[No abstract available]Item Thorax perfusion CT in non-small cell lung cancer(2007) Ovali G.Y.; Sakar A.; Göktan C.; Çelik P.; Yorgancioǧlu A.; Nese N.; Pabuscu Y.Objectives: We aimed to determine the perfusion differences according to the histological type, stage, volume and prognoses in the non-small cell carcinoma by thorax perfusion CT. Materials and methods: Twenty-four non-small cell carcinoma patients were included in the study. Thorax perfusion CT was done to evaluate the tumors in terms of perfusion parameters: blood flow (BF) and time to peak (TTP) values. Results: The total blood flow of the tumor in squamous cell carcinoma was significantly higher than adenocarcinoma (p = 0.031). There was no statistical difference between the perfusion parameters and other parameters. Conclusions: Perfusion CT may help us in evaluating non-small cell carcinomas. © 2007 Elsevier Ltd. All rights reserved.Item Effect of severity of asthma on quality of life(2007) Şakar A.; Yorgancioǧlu A.; Aydemir Ö.; Sepit L.; Çelik P.This study is aimed to evaluate the health related quality of life (HRQL) in asthmatics and the probable association between HRQL and disease severity and also other demographic factors by using a generic scale, SF-36 questionnaire. One-hundred and two asthmatics were enrolled. The scores of the 8 domains of SF-36 questionnaire were evaluated according to age, gender, status of education and compared with the severity of asthma. The mean age of 84 (83%) female and 18 (17%) male patients was 42.86 ± 11.15. Fifty-two of them was well educated (51%) and 50 was poorly educated (49%). Atopy ratio was 81%. Mild intermittent, mild persistent and moderate-severe persistent groups were 27 (26%), 46 (45%) and 29 (29%) respectively. Female gender were worse in physical functioning (p= 0.000), physical role difficulties (p= 0.0049), vitality (p= 0.045) and social functioning (p= 0.025). Poorly educated group were worse in physical functioning (p= 0.001), physical role difficulties (p= 0.039), vitality (p= 0.045), emotional role difficulties (p= 0.046), general health (p= 0.030) and mental health (p= 0.044). Mental health was worse in the presence of atopy (p= 0.035). Physical functioning was better in mild intermittent group than moderate and severe persistent group (p= 0.024). General health was better in mild intermittent group than mild persistent group (p= 0.018), moderate and severe persistent group (p= 0.015). Vitality and emotional role difficulties was better in mild intermittent than mild persistent group (p= 0.042, p= 0.007). The HRQL scores and severity of asthma is well correlated like other objective parameters. So one of the primary goals in management of asthma should also improve QOL as well as functional parameters.Item Allergic rhinitis and its impact on asthma update (ARIA 2008): The Turkish perspective(2008) Kalayci Ö.; Yorgancioǧlu A.; Kalyoncu A.F.; Khaltaev N.; Bousquet J.Allergic rhinitis is a symptomatic disorder of the nose induced after allergen exposure due to an IgE-mediated inflammation of the membranes lining the nose. According to its definition in 1929, "The three cardinal symptoms in nasal reactions occurring in allergy are sneezing, nasal obstruction and mucous discharge." Allergic rhinitis is a global health problem. Patients from all countries, ethnic groups, and ages suffer from allergic rhinitis. Allergic rhinitis causes major illness and disability worldwide. It affects social life, sleep, school and work. The economic impact of allergic rhinitis is substantial; however, rhinitis is still underdiagnosed and undertreated.Item Sensitivity of cough with capsaicin in smokers; [Sigara içenlerde kapsaisin ile öksürük duyarliliǧi](2008) Yildirim Ç.A.; Çelik P.; Havlucu Y.; Coşkun E.; Yorgancioǧlu A.; Şakar A.; Dinç G.In this study, effect of long term smoking on sensitivity of cough reflex was investigated. Healthy, current smoker male and female was evaluated by capsaicin cough challenge test and they were compared with healthy, non-smoker persons with similar age and gender, prospectively. In current smokers, there were 50 male and 39 female, in non-smoker control group, there were 20 male and 21 female. Mean and log C5 dosage in current smoker and non-smoker groups and mean and log C5 dosage in current smoker according to gender were calculated by using Mann-Whitney U-test. Results of capsaicin cough challenge test in current and non-smoker groups were evaluated by using Pearson Chi-Square test and Fisher's Exact test. In current smokers comparison of results of capsaicin cough challenge test with smoking history (age with first smoking, duration, pocket year and smoking per day) was evaluated by using Mann-Whitney U-test. Mean C5 and mean log C5 dosage were found decreased in current smokers when they were compared to control group (p< 0.00). In current smoker group mean C5 and mean log C5 dosage were found decreased in male (p< 0.002). When the results of capsaicin cough challenge test were compared between current smoker and control groups, sensitivity of cough reflex in concentration with 0.49, 0.98, 1.95, 3.9, 7.8, 15.6 μM was significantly decreased in current smoker group. Also there was a significant correlation between concentration with 0.98, 1.95, 3.9, 7.8, 15.6, 31.2 μM, and duration of smoking and pocket year of smoking. Also there was a correlation between concentration with 15.6, 31.2, 62.5, 125 μM and smoking per day. This results were correlated with hypothesis about inhibition of C-fibers with nicotin or decrease of C-fibers' sensitivity due to induction of neuropeptide wasting.Item Allergic rhinitis and its impact on asthma update (ARIA 2008) the Turkish perspective; [Allerjik rinit ve astim üzerine etkisi güncelleme (ARIA 2008) Türkiye deneyimi](2008) Yorgancioǧlu A.; Kalayci Ö.; Kalyoncu A.F.; Khaltaev N.; Bousquet J.In this article, it is aimed to summarize the newly updated and published version of "Allergic Rhinitis and its Impact on Asthma (ARIA) 2008" and add the recent Turkish epidemiological data on it.Item Three atypical pulmonary hydatidosis lesions mimicking bronchial cancer from Turkey(2009) Kilinç O.; Döşkaya M.; Ayşin S.; Yorgancioǧlu A.; Halilçolar Ḧ.; Caner A.; Gürüz Y.Hydatid disease is endemic in Turkey. Echinococcus granulosus causes cystic echinococcosis mostly in the liver and lung. Although pulmonary hydatid cysts can be diagnosed by clinical and radiological findings, atypical or complicated lung lesions may be misdiagnosed. In the present study, three cases with hemoptysis and atypical lung lesions were diagnosed and treated as lung cancer or tuberculosis based on the clinical and laboratory findings along with the imaging data and fiberoptic bronchoscopy evaluation. Eventually, pathological examination of the bronchoscopic biopsy material confirmed the definitive diagnosis as pulmonary hydatidosis. The three patients presented herein emphasize the importance of considering pulmonary hydatid disease in the definitive diagnosis of atypical lung lesions such as bronchial carcinoma in echinococcosis endemic areas.Item The effect of nicotine among active, passive smoker health personnel; [Saǧlik çalişanlarinda, aktif ve pasif sigara i̇çicilerde nikotin etkilenim düzeyleri](2009) Temel O.; Coşkun A.Ş.; Gök Ş.; Çelik P.; Yorgancioǧlu A.Objective: It is aimed to evaluate the effect of environmental tobacco smoke among active and passive smoker and non-smoker health staff. Material and Method: 209 volunteers were included; age, gender, occupation and smoking habits were recorded. Exhaled air carbon monoxide (CO), urinary cotinine levels and Fagerström Nicotine Tolerance Questionnaire were performed. Results: 106 (55%) of 117 active, 66 (32%) passive smokers and 26 (13%) non-smokers were male and the mean age was 30.3 ± 6.6 (18-55). 56 (27%), 33 (16%), 80 (38%), and 40 (19%) were doctors, nurses, assistant staff and officers respectively. Mean CO level was higher in active smokers (18 ppm) than passive smokers (1.9 ppm) and non-smokers (1.5 ppm) (p=0.001). Mean urinary cotinine level was higher in active smokers (949.5 ng/ml), than passive smokers (11.3 ng/ml) and non-smokers (0.00 ng/ml) (p=0.000). Nicotine consumption in active smokers was positively and significantly related with CO, urine cotinine levels and nicotine dependency (<0.05). Conclusion: It is concluded that environmental tobacco smoke has been found to be very high in hospitals and smoke-free hospital programs should ibe started immediately.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 Once-daily bronchodilators for chronic obstructive pulmonary disease: Indacaterol versus tiotropium(2010) Donohue J.F.; Fogarty C.; Lötvall J.; Mahler D.A.; Worth H.; Yorgancioǧlu A.; Iqbal A.; Swales J.; Owen R.; Higgins M.; Kramer B.Rationale: Indacaterol is the first once-daily, long-acting inhaled β2-agonist bronchodilator studied in patients with chronic obstructive pulmonary disease (COPD). Objectives: To demonstrate greater efficacy of indacaterol versus placebo on FEV1 at 24 hours post dose (trough) after 12 weeks, to compare efficacy with placebo and tiotropium, and to evaluate safety and tolerability over 26 weeks. Measurements: Patients with moderate-to-severe COPD were randomized to double-blind indacaterol 150 or 300 μg or placebo, or open-label tiotropium 18 μg, all once daily, for 26 weeks. The primary efficacy outcome was trough FEV1 at 12 weeks. Additional analyses (not adjusted for multiplicity) included transition dyspnea index (TDI), health status (St George's Respiratory Questionnaire [SGRQ]), and exacerbations. Serum potassium, blood glucose, and QTc interval were measured. Results: A total of 1,683 patients (age, 63.3 yr; post-bronchodilator FEV 1, 56% predicted; FEV1/FVC, 0.53) were randomized to the four treatment arms.Trough FEV1 at Week 12 increased versus placebo by 180 ml with both indacaterol doses and by 140 ml with tiotropium (all P < 0.001 vs. placebo). At Week 26, for indacaterol 150/300 μg, respectively, versus placebo, TDI increased (1.00/1.18, P < 0.001) and SGRQ total score decreased (-3.3/-2.4, P <0.01); corresponding results with tiotropium were 0.87 (P < 0.001) for TDI and (-1.0, P = not significant) for SGRQ total score. The incidence of adverse events, low serum potassium, high blood glucose, and prolonged QTc interval was similar across treatments. Conclusions: Indacaterol was an effective once-daily bronchodilator and was at least as effective as tiotropium in improving clinical outcomes for patients with COPD. Clinical trial registered with clinicaltrials.gov (NCT 00463567).Item Turkish thoracic society asthma management and prevention guideline: Key points; [Türk toraks derneǧi astım tanı ve tedavi rehberi: Anahtar noktalar](Ankara University, 2011) Yildiz F.; Oǧuzülgen I.K.; Dursun B.; Mungan D.; Gemicioǧlu B.; Yorgancioǧlu A.Asthma still has high morbidity and cost despite all advances in pathogenesis, diagnosis and treatment. Although asthma can be controlled with proper diagnosis and treatment, the low rates of control in our country and in the world can not be attributed to the variable course of the disease and patients' psycho-social behaviours for chronic disease. In this context, Turkish Thoracic Society (TTS) has decided to update Asthma Diagnosis and Management Guide latest published in 2000. National data were collected, compiled and prepared by authors, and final form given by the TTS Asthma and Allergy Study Group, after presenting to consultant individuals and institutions. In June 2009, the National Asthma Management and Prevention Guideline were published in Turkish. In this paper, we aimed to present the national guide in English with its basics and individual differences.Item Long acting beta-2 agonists in the treatment of asthma and their safety; [Astım tedavisinde uzun etkili beta-2 agonistlerin yeri ve güvenilirliǧi](Ankara University, 2011) Türktaş H.; Şekerel B.; Karakaya G.; Yildiz F.; Yorgancioǧlu A.Inhaled corticosteroids are the preferred primary long-term treatment for asthma. The first option in patients who are uncontrolled with inhaled steroids is adding long-acting beta-2 agonists. The addition of a long-acting beta-agonist to an inhaled corticosteroid has been accepted as effective therapy for almost two decades Despite the widespread use and their clinical benefit, controversy regarding their safety arose after their introduction. Concerns about the safety of long-acting beta-2 agonist therapy, has led to the appearance of multiple publications and recommendations. The evidence supports the use of long-acting beta-2 agonists plus inhaled corticosteroids in a single inhaler device to increase adherence and reduce the potential use of long-acting beta-2 agonists monotherapy. This review examines and commands on the available clinical data and safety concerns of long-acting beta-2 agonists use in patients with asthma.Item Relationship of systemic antiinflammatory markers and functional parameters in chronic obstructive pulmonary disease; [Kronik obstrüktif akciǧer hastalıǧında fonksiyonel paramatrelerle sistemik antiinflamatuar belirteçlerin ilişkisi](AVES, 2011) Satar S.; Alpaydin A.Ö.; Var A.; Coşkun A.Ş.; Çelik P.; Yorgancioǧlu A.Objective: Airway inflammation and oxidative stress biomarkers increase in chronic obstructive pulmonary disease (COPD) and this is thought to be related to faster decrease in lung functions. Systemic markers of oxidative stress include nitric oxide (NO) and malonyl dialdehyde (MDA), while antioxidant markers are erythrocyte superoxide dismutase (SOD) and gluthathionperoxidase (GSH-Px). We investigated the relationship between levels of systemic oxidative/antioxidant markers and functional parameters. Material and Method: Fifty-one COPD patients without any systemic inflammation were included in the study. Pulmonary function test parameters were evaluated. 6-minute walk test (6MWT) and dyspnea severity were recorded. Twelve healthy persons in a control group were also included in the study. Venous blood specimens of the patients and the control group were collected and serum NO, MDA and erythrocyte SOD, GSHPx levels were measured. Results: Mean age of the patients were 62.94±10.56 years. When the control group and COPD patients were compared; MDA (p<0.001), NO (p=0.012) and GSH-Px (p=0.012) were significantly higher in the control group than COPD patients. However, when the age factor was controlled, only MDA(p=0.017) was found higher in the control group. As forced expiratory volume in 1st second (FEV1) decreased; NO, SOD, MDA and GSH-Px increased, although there was no statistical significance. Like FEV1, 6MWT and dyspnea severity by VAS did not show any statistical significance with the parameters investigated. Conclusion: From the results, we could not observe the reflections of oxidant/antioxidant imbalance on functional parameters in COPD. This may be due to incomplete systemic response to local disorders as well as the attempts of antioxidant systems to maintain an equilibrium resembling that in healthy individuals.Item Validity and reliability of "asthma quality of life questionnaire" in a sample of Turkish adult asthmatic patients; ["Asthma quality of life questionnaire" yaşam kalitesi anketinin erişkin astımlı Türk hasta örneǧinde geçerliliǧi ve güvenilirliǧi](Ankara University, 2011) Özgen Alpaydin A.; Yorgancioǧlu A.; Yilmaz O.; Bora M.; Göktalay T.; Çelik P.; Yüksel H.We aimed to investigate the validity and reliability and of "Asthma Quality of Life Questionnaire (AQLQ)" in Turkish adult asthmatic patients. New or previously diagnosed [according to Global Initative for Asthma (GINA) 2008] symptomatic 118 consecutive stable asthmatic patients between 18 and 55 years old were included. Asthma severity was determined and Turkish adaptation of the AQLQ was administered. Lara asthma symptom scales (LASS), pulmonary function tests, Turkish adaptation of Medical Outcomes Survey Short Form-36 (SF-36) were evaluated. All assessments were done twice at recruitment and after 10 weeks. During this period patients were allowed to make modifications on their medication when necessary. Among the recruited 118 patients 95 were female and 14 were lost in the follow-up. Sixty-two percentages of the patients had mild and 38% moderate asthma. The internal consistency of AQLQ was high (Cronbach's alpha 0.81-0.87) and item-total score correlations were ranging from 0.75-0.89. The cross-sectional and longitudinal correlations between AQLQ total and domain scores and SF36 domain scores were in a range of little or fair degree (r= 0.241-0.626, p< 0.005). Total AQLQ scores were observed significantly different according to disease severity and LASS both in the first (p< 0.001, both) and 10 weeks follow-up visits (p= 0.006, p< 0.001 respectively). A statistical significant change was observed in AQLQ symptom score as in total LASS changed (p< 0.001, both) in the follow-up. Our results demonstrated that Turkish version of AQLQ is feasible, reliable, valid and sensitive to changes in adult asthmatics.Item Asthma programmes in diverse regions of the world: Challenges, successes and lessons learnt(2011) Lalloo U.G.; Walters R.D.; Adachi M.; De Guia T.; Emelyanov A.; Fritscher C.C.; Hong J.; Jimenez C.; King G.G.; Lin J.; Loaiza A.; Nadeau G.; Neffen H.; Sekerel B.E.; Yorgancioǧlu A.; Zar H.J.International surveys have demonstrated that asthma is still underdiagnosed and undertreated in many parts of the world. Despite improvements in the standard of asthma care delivered in many areas, as evidenced by improved global asthma mortality data, much information on projects and programmes undertaken in resource-limited regions of the world is not in the public domain. The aim of this report is to review projects and programmes in diverse regions around the world so that health care providers, planners and consumers may draw on the successes, failures and lessons learnt. Such real world experiences may contribute to achieving Global Initiative for Asthma goals of asthma control. Asthma projects and programmes in Argentina, Australia, Brazil, China, Japan, Mexico, Philippines, Russia, South Africa and Turkey were discussed by a group of experts in asthma care, the Advancing Asthma Care Network, from their respective countries, over a course of three satellite meetings in 2010. Collective analyses consistently identified low rates of dissemination and implementation of national and international treatment guidelines, low levels of continuing medical education and training of primary health care professionals and access and distribution of inhaled corticosteroids to be major barriers that are critical to the overall success of a national asthma management programme. In the less developed asthma programmes, under-recognition and undertreatment further limited the success of the programmes. Evidence from well-established national asthma management programmes suggests that establishment of a successful programme entails a logical progression through specific developmental stages, starting with political/stakeholder endorsement and commitment, followed by epidemiological evaluation, evaluation of disease burden, evaluation of access to care and best therapy, and finally optimisation and maintenance therapy for individual patients. © 2011 The Union.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 Reliability and validity of Turkish version of COPD Assessment Test; [KOAH deǧerlendirme testinin Türkçe geçerlilik ve güvenilirliǧi](Ankara University, 2012) Yorgancioǧlu A.; Polatli M.; Aydemir Ö.; Yilmaz Demirci N.; Kirkil G.; Nayci Atiş S.; Köktürk N.; Uysal A.; Akdemir S.E.; Özgür E.S.; Günakan G.Introduction: This study is aimed to evaluate the reliability and validity of the Turkish version of chronic obstructive pulmonary disease (COPD) Assessment Test (CAT) in seven centers. Materials and Methods: 321 patients between 4-75 years of age, diagnosed and staged by Global Initiative for Obstructive Lung Disease (GOLD) 2011 criteria were included. The Breathlessness, Cough, Sputum scale (BCSS), mMRC (Modified Medical Research Council) dyspnea index, St. George Respiratory Questionnaire (SGRQ), CAT and Short Form-36 (SF-36) were used concurrently. In the statistical analyses, internal consistency, item-total score correlation, explorative factor analysis, correlation with other scales were calculated. Results: The mean age was 62.4 ± 8.9 years and 89.7% of the patients were male (n= 288). Mean FEV 1% was 51.9 ± 19.2 and most of the patients were in Stage 3. CAT total score was 17.8 ± 9.5. In the internal consistency, Cronbach alpha coefficient was found as 0.9116 and item-total score correlation coefficients were between 0.62-0.79 and all were statistically significant (p< 0.0001). The correlation of the test-retest score calculated after two weeks with the initial score was 0.96 (p< 0.0001). In the structural validity, factor analysis with principle component analysis and varimax rotation was performed. One factor solution was achieved with eigenvalue of 4.956 and it represented 61.9% of the total variance. All the items were contained in the factor and the factor loads were between 0.71-0.85. The correlation coefficients of CAT with other indexes were moderate to good. The discrimination of CAT among disease stages has been shown to be significant (p< 0.0001) and a significant correlation was found with pulmonary function tests (p< 0.0001). Conclusion: It is demonstrated The Turkish version of COPD Assessment Tool is reliable and valid.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.