Browsing by Author "Yuncu G."
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Item Patient and physician delay in the diagnosis and treatment of non-small cell lung cancer in Turkey(Elsevier Ltd, 2015) Yurdakul A.S.; Kocatürk C.; Bayiz H.; Gürsoy S.; Bircan A.; Özcan A.; Akkoçlu A.; Uluorman F.; Çelik P.; Köksal D.; Ulubaş B.; Sercan E.; Özbudak T.; Göksel T.; Önalan T.; Yamansavci E.; Türk F.; Yuncu G.; Çopuraslan T.; Mardal T.; Tuncay E.; Karamustafaoğlu A.; Yildiz P.; Seçik F.; Kaplan M.; Çağlar E.; Ortaköylü M.; Önal M.; Turna A.; Hekimoğlu E.; Dalar L.; Altin S.; Gülhan M.; Akpinar E.; Savas T.; Firat N.; Çamsari G.; Özkan G.; Çetinkaya E.; Kamiloğlu E.; Çelik B.; havlucu Y.Aim: The early diagnosis and treatment of lung cancer are important for the prognosis of patients with lung cancer. This study was undertaken to investigate patient and doctor delays in the diagnosis and treatment of NSCLC and the factors affecting these delays. Materials and methods: A total of 1016 patients, including 926 (91.1%) males and 90 (8.9%) females with a mean age of 61.5. ±. 10.1 years, were enrolled prospectively in this study between May 2010 and May 2011 from 17 sites in various Turkish provinces. Results: The patient delay was found to be 49.9. ±. 96.9 days, doctor delay was found to be 87.7. ±. 99.6 days, and total delay was found to be 131.3. ±. 135.2 days. The referral delay was found to be 61.6. ±. 127.2 days, diagnostic delay was found to be 20.4. ±. 44.5 days, and treatment delay was found to be 24.4. ±. 54.9 days. When the major factors responsible for these delays were examined, patient delay was found to be more frequent in workers, while referral delay was found to be more frequent in patients living in villages (. p<. 0.05). We determined that referral delay, doctor delay, and total delay increased as the number of doctors who were consulted by patients increased (. p<. 0.05). Additionally, we determined that diagnostic and treatment delays were more frequent at the early tumour stages in NSCLC patients (. p<. 0.05). Discussion: The extended length of patient delay underscores the necessity of educating people about lung cancer. To decrease doctor delay, education is a crucial first step. Additionally, to further reduce the diagnostic and treatment delays of chest specialists, multidisciplinary management and algorithms must be used regularly. © 2015 Elsevier Ltd.Item Effects of non-dependent lung oxygen insuffation on oxygenation and respiratory mechanics during one-lung ventilation in patients with stage II COPD(Turkish Anaesthesiology and Intensive Care Society, 2015) Öztürk T.; Aydin D.; Yaldiz S.; Yuncu G.; Atay A.; Savaci S.Introduction: The aim of this study was to investigate the changes on oxygenation, shunt ratio and respiratory mechanics of 6 L/min oxygen insuffation to the non-dependent lung, while extrinsic PEEP (PEEPe, equivalent to the patient's PEEPi) was being applied to the dependent lung in patients undergoing lung surgery. Material and Methods: Patients with stage II COPD undergoing elective lung surgery (n=22) were intubated with a doublelumen endobronchial tube and performed a PA catheterization. One lung ventilation settings were: tidal volume 6 ml/kg, 12 breaths/min, and I: E ratio 1: 2. Procedure was performed in four sequential periods (each period continued for 15 minutes): After frst stabilization period (PEEP0-1), PEEPe (at the level of intrinsic PEEP, PEEPi) was applied in the dependent lung while the non-dependent lung was exposed to air. After second stabilization period (PEEP0-2), the non-dependent lung received 6 L/min oxygen (O2) through a catheter placed into the tube while PEEPe (at the level of PEEPi) was applied in the dependent lung (PEEPe+O2). At the end of each 15 minute period, haemodynamic data, lung compliance (C), airway resistance (R), and PEEPi were recorded and blood gas samples were obtained. Results: PaO2 was signifcantly higher during the PEEPe+O2 period (p<0.001), while Qs/Qt was signifcantly lower in the PEEPe+O2 period when compared with the PEEPe period (p<0.0001). Compliance increased signifcantly during PEEPe compared to PEEP0-1 (p<0.05). Discussion and Conclusion: The insuffation of oxygen to the non-dependent lung with application of PEEPe-equivalent to the patient's PEEPi - to the dependent lung increased oxygenation and decreased Qs/Qt in patients with moderate COPD. We recommend this simple and useful method which does not need extra equipment.