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Sumer C, Okumus G, Isik EG, Turkmen C, Bilge AK, Inanc M. (18)F-fluorodeoxyglucose uptake by positron emission tomography in patients with IPAH and CTEPH. Pulm Circ 2024; 14:e12363. [PMID: 38618292 PMCID: PMC11009453 DOI: 10.1002/pul2.12363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 02/26/2024] [Accepted: 03/24/2024] [Indexed: 04/16/2024] Open
Abstract
Pulmonary arterial hypertension (PAH) is driven by pathologies associated with increased metabolism such as pulmonary revascularization, vasoconstriction and smooth muscle cell proliferation in pulmonary artery wall. 18-fluorodeoxyglucose positron emission tomography (18FDG-PET) is an imaging technique sensitive to glucose metabolism and might be considered as a non-invasive method for diagnosis due to significant role of inflammation in idiopathic pulmonary artery hypertension (IPAH) and chronic thromboembolic pulmonary hypertension (CTEPH). The present study aimed to investigate the role of PET/CT imaging of patients with IPAH and CTEPH as an alternative diagnosis method. Demographic characteristics, FDG uptake in lungs, pulmonary artery and right ventricle (RV) of 17 patients (10 IPAH, 7 CTEPH), and 30 controls were evaluated. PET scanning, 6-min walk test, pro-BNP level, right heart catheterization of patients were performed both at the onsert and after 6-month PAH specific treatment. IPAH and CTEPH patients had significantly higher left lung FDG (p = 0.006), right lung FDG (p = 0.004), right atrial (RA) FDG (p < 0.001) and RV FDG (p < 0.001) uptakes than controls. Positive correlation was detected between the RV FDG uptake and the mean pulmonary artery pressure (mPAP) (r = 0.7, p = 0.012) and between the RA FDG uptake and the right atrial pressure (RAP) (r = 0.5, p = 0.02). Increased RV FDG and RA FDG uptakes predicts the presence of pulmonary hypertension and correlates with mPAP and RAP, respectively, which are important indicators in the prognosis of PAH. Further studies are required whether FDG PET imaging can be used to diagnose or predict the prognosis of pulmonary hypertension.
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Affiliation(s)
- Celik Sumer
- Department of Pulmonary DiseasesIstanbul University Istanbul Faculty of MedicineIstanbulTurkey
| | - Gulfer Okumus
- Department of Pulmonary DiseasesIstanbul University Istanbul Faculty of MedicineIstanbulTurkey
| | - Emine Goknur Isik
- Department of Nuclear MedicineIstanbul University Istanbul Faculty of MedicineIstanbulTurkey
| | - Cuneyt Turkmen
- Department of Nuclear MedicineIstanbul University Istanbul Faculty of MedicineIstanbulTurkey
| | - Ahmet Kaya Bilge
- Department of CardiologyIstanbul University Istanbul Faculty of MedicineIstanbulTurkey
| | - Murat Inanc
- Department of RheumatologyIstanbul University Istanbul Faculty of MedicineIstanbulTurkey
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Sagcan G, Dogan Z, Uzun H, Cuhadaroglu C, Okumus G, Arseven O. Impact of Promising Biomarkers on Severity and Outcome of Acute Pulmonary Embolism. Int J Gen Med 2023; 16:3301-3309. [PMID: 37551292 PMCID: PMC10404424 DOI: 10.2147/ijgm.s416541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/28/2023] [Indexed: 08/09/2023] Open
Abstract
Background Acute pulmonary embolism (APE) is a common clinical condition. Its severity ranges from asymptomatic radiological findings to fatal obstructive shock. The potential circulating biomarkers have been studied to predict APE outcomes. This study aimed to explore their predictive power on prognosis in APE. Material and Method It was a prospective observational study between March 2008 and April 2010. All consecutive patients diagnosed with APE were categorized as massive/high-risk, submassive/moderate-risk, and non-massive/low-risk. Cardiac troponin T (cTnT), myoglobin, N-terminal pro-brain natriuretic peptide (NT-proBNP), heart-type fatty acid-binding protein (H-FABP), growth differentiation factor-15 (GDF-15), and D-dimer levels were measured. Results Of these patients, 14 (29.8%), 16 (34.0%), and 17 (36.2%) patients were categorized as low-risk, moderate-risk, and high risk-patients, respectively. There was no significant difference between the patient groups categorized based on the risk stratification in terms of demographic and clinical characteristics. The cTnT, myoglobin, HFABP, and D-dimer levels have also not differed significantly between the groups. There was a significant difference between the groups in respect of NT-proBNP and GDF-15 levels (p=0.009 and p=0.037, respectively). Nine (19.1%) patients had died by the 3rd-month follow-up. Adverse events were seen in 26 (55.3%) patients. GDF-15 had the highest area under the curve (AUC) value for predicting any adverse event (cut-off value=9.3 ng/mL, AUC=0.796, CI (confidence interval) 95%: 0.653-0.899). NT-ProBNP was determined as the best predictor for mortality (cut-off value=229.2 pg/mL, AUC=0.889, CI 95%: 0.756-0.964). Conclusion Higher levels of NT-proBNP and GDF-15 were found to be associated with more severe APE, worse outcomes, and mortality.
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Affiliation(s)
- Gulseren Sagcan
- Department of Chest Diseases, Faculty of Medicine, Acıbadem University, İstanbul, Turkey
| | - Zeki Dogan
- Department of Cardiology, Faculty of Medicine, Istanbul Atlas University, Istanbul, Turkey
| | - Hafize Uzun
- Department of Medical Biochemistry, Faculty of Medicine, Istanbul Atlas University, Istanbul, Turkey
| | - Caglar Cuhadaroglu
- Department of Chest Diseases, Faculty of Medicine, Acıbadem University, İstanbul, Turkey
| | - Gulfer Okumus
- Department of Chest Diseases, Faculty of Medicine, Istanbul University, İstanbul, Turkey
| | - Orhan Arseven
- Department of Chest Diseases, Faculty of Medicine, Istanbul University, İstanbul, Turkey
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Can A, Coskun R, Karabacak DE, Tuzer OC, Yegit OO, Karadag P, Oztop N, Beyaz S, Okumus G, Demir S, Gelincik A. Common but neglected problem in chronic spontaneous urticaria: Sleep disturbance. Allergy Asthma Proc 2023; 44:179-185. [PMID: 37160750 DOI: 10.2500/aap.2023.44.230011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Background: Association of chronic spontaneous urticaria (CSU) with sleep disturbance has not been evaluated in studies that involve a large number of patients. Objective: In this study, we aimed to evaluate the sleep attitude and circadian rhythm in patients with CSU. Methods: As the patient group, recently diagnosed 100 patients with CSU, 100 patients with allergic rhinitis (AR) as the patient control group, and 100 healthy controls (HCs) were included. The Pittsburgh Sleep Quality Index (PSQI) questionnaire, sleep hygiene index (SHI), Epworth Sleepiness Scale (ESS) questionnaire, and the morningness-eveningness questionnaire (MEQ) were filled to assess sleep quality and circadian rhythm. CSU disease activity was evaluated by urticaria activity score-7 (UAS-7). Patients with concomitant diseases, e.g., psychiatric illnesses, that possibly affect sleep status or those who use related medications and at moderate or high risk of obstructive sleep apnea according to the STOP-Bang questionnaire were excluded from the study. Results: PSQI, SHI, and ESS scores were higher, and the MEQ score was lower in patients with CSU and patients with AR than those in the HCs (p < 0.001, for each score). However, the scores were not different among the patients with CSU and the patients with AR. UAS-7 was only correlated with PSQI scores (r = 0.402, p < 0.001). In addition, blood eosinophil counts and the serum C Reactive Protein (CRP) level were correlated with sleep quality (p = 0.02). Conclusion: The poor sleep quality, impaired sleep hygiene, increased daytime sleepiness, and intermediate type of circadian rhythm were observed in the patients with CSU and the patients with AR. Physicians should be aware of sleep problems in patients with CSU that might affect their quality of life and the success of their treatment.
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Affiliation(s)
- Ali Can
- From the Division of Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Raif Coskun
- Division of Immunology and Allergic Diseases, Department of Internal Medicine, Cemil Tascioglu City Hospital, Istanbul, Turkey, and
| | - Deniz Eyice Karabacak
- From the Division of Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ozdemir Can Tuzer
- From the Division of Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Osman Ozan Yegit
- From the Division of Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Pelin Karadag
- From the Division of Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Nida Oztop
- From the Division of Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Sengul Beyaz
- From the Division of Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Gulfer Okumus
- Department of Chest Disease, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Semra Demir
- From the Division of Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Aslı Gelincik
- From the Division of Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Sagcan G, Konukoglu D, Uzun H, Arseven O, Okumus G, Cuhadaroglu C. Importance of oxidative stress in the evaluation of acute pulmonary embolism severity. BMC Pulm Med 2022; 22:382. [PMID: 36253755 PMCID: PMC9575210 DOI: 10.1186/s12890-022-02076-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 05/23/2022] [Indexed: 12/05/2022] Open
Abstract
Background Pulmonary embolism (PE) is a common and potentially life-threatening disorder. Our study was aimed to investigate whether oxidative stress markers can be used as clinical markers in the evaluation of acute PE (APE) severity. Methods 47 patients with objectively documented diagnosis of APE were recorded. Of these patients, 14 had low-risk PE, 16 had moderate-risk PE, and 17 had high-risk PE. 21 healthy subjects were also enrolled in this study. Ischemia-modified albumin (IMA), prooxidants-antioxidants balance (PAB), advanced protein oxidation products (AOPPs), and ferric reducing antioxidant power (FRAP) were measured as oxidative stress parameters to evaluate the role of oxidative stress. Results In the low-risk and moderate-risk APE groups, AOPPs and PAB levels were significantly higher and FRAP levels were significantly lower than those in the control group. AOPPs and IMA levels in the patients with high-risk PE were significantly higher than those in both the low-risk and moderate-risk APE patients. There was a significant correlation between levels of AOPPs and the levels of both IMA (r: 0.462, p < 0.001) and PAB (r:0.378, p < 0.005). Serum FRAP levels were negatively correlated with PAB (r:− 0.683, p < 0.001) and AOPPs levels (r:− 0,384, p < 0.001). There was also a significant positive correlation between the serum IMA and PAB levels. Conclusions We clearly demonstrated that reactive oxygen species formation is significantly enhanced in APE. IMA and AOPPs may be used as clinical markers in the evaluation of APE severity in clinical practice. However, further studies with larger patient populations and longer follow-up periods are required to confirm the mechanisms underlying these findings.
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Affiliation(s)
- Gülseren Sagcan
- Department of Respiratory Medicine, Acibadem Medical Faculty, Acibadem University, Istanbul, Turkey.
| | - Dildar Konukoglu
- Department of Medical Biochemistry, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Hafize Uzun
- Department of Medical Biochemistry, Faculty of Medicine, İstanbul Atlas University, Istanbul, Turkey
| | - Orhan Arseven
- Department of Respiratory Medicine, İstanbul Medical Faculty, İstanbul University, Istanbul, Turkey
| | - Gulfer Okumus
- Department of Respiratory Medicine, İstanbul Medical Faculty, İstanbul University, Istanbul, Turkey
| | - Caglar Cuhadaroglu
- Department of Respiratory Medicine, Acibadem Medical Faculty, Acibadem University, Istanbul, Turkey
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Ertan O, Aslan GK, Akinci B, Bilge AK, Inanc M, Okumus G. Effect of Ground-Based Walk Training in Pulmonary Hypertension. Am J Cardiol 2022; 174:172-178. [PMID: 35473778 DOI: 10.1016/j.amjcard.2022.03.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 03/09/2022] [Accepted: 03/15/2022] [Indexed: 11/29/2022]
Abstract
This study aimed to determine the effect of ground-based walking training on exercise capacity, physical activity, quadriceps muscle strength, and quality of life (QoL) in patients with pulmonary hypertension. A total of 24 patients were included in the study. Patients were randomly assigned to 2 groups as the walking group or the control group. The walking group participated in 30-minute supervised ground-based walking training 2 days/week for 8 weeks. Also, they walked unsupervised at least 1 day/week. The control group received no intervention. The number of weekly steps taken in both groups was recorded using a pedometer. In addition to the sociodemographic and clinic characteristics of the patients, the endurance shuttle walk test, incremental shuttle walk test, and 6-minute walk test were used for the evaluation of exercise capacity, and an activity monitor and pedometer for physical activity, a dynamometer for quadriceps muscle strength, and emPHasis-10 for QoL. After 8 weeks, endurance capacity, maximal exercise capacity, and the number of steps significantly improved in the walking group (p <0.05). The 6-minute walk distance, physical activity, quadriceps muscle strength, and QoL were similar in both groups (p >0.05). The results of the study showed that ground-based walking could improve endurance capacity, maximal exercise capacity, and the number of steps. Quadriceps muscle strength also improved in the walking group. No adverse effects were reported during the training period. Ground-based walking training can be performed safely in patients with pulmonary hypertension.
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Affiliation(s)
- Ozge Ertan
- Department of Physiotherapy and Rehabilitation, Istanbul University-Cerrahpasa, Institute of Graduate Studies, Istanbul, Turkey
| | - Goksen Kuran Aslan
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Buket Akinci
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Biruni University, Istanbul, Turkey
| | - Ahmet Kaya Bilge
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Murat Inanc
- Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Gulfer Okumus
- Department of Chest Disease, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Elitok A, Emet S, Karaayvaz EB, Erdogan O, Aydogan M, Engin B, Cevik E, Orta H, Okumus G, Bilge AK. The relationship between T-wave peak-to-end interval and hemodynamic parameters in patients with pulmonary arterial hypertension. Ann Noninvasive Electrocardiol 2020; 25:e12764. [PMID: 32304627 PMCID: PMC7507547 DOI: 10.1111/anec.12764] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 03/25/2020] [Accepted: 03/25/2020] [Indexed: 12/31/2022] Open
Abstract
Background T‐wave peak‐to‐end interval (TPEI) is a measure of repolarization dispersion on surface electrocardiogram (ECG). TPEI has been reported as a prognostic parameter with heart disorders. In this study, we aimed to evaluate the relationship between echocardiogram‐derived right heart parameters, right heart catheterization (RHC) measurements, and TPEI in patients with precapillary pulmonary arterial hypertension (PAH). Methods Thirty‐eight patients (29 females and 9 males, mean age of 54.9 ± 10.9 years) who had undergone RHC for a preliminary diagnosis of pulmonary hypertension (PH) were included in the study. We performed transthoracic echocardiography (TTE), and resting 12‐lead ECG was recorded before RHC. TPEI was measured from leads of V1‐V6, DII, DIII, and aVF, and these values are averaged to obtain the global TPEI. Results Duration of TPEI was significantly correlated with mean PAP, pulmonary vascular resistance (PVR), and cardiac index (CI). Longer TPEI was associated with higher N terminal probrain natriuretic peptide (NT pro‐BNP) level, lower 6‐min walk distance (6MWD), and lower tricuspid annular plane systolic excursion (TAPSE). Conclusion Prolongation of TPEI could be a new predictor of adverse outcome in PAH and may provide additional prognostic information for patients with PAH.
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Affiliation(s)
- Ali Elitok
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Samim Emet
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ekrem Bilal Karaayvaz
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Onur Erdogan
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mehmet Aydogan
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Berat Engin
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Erdem Cevik
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Huseyin Orta
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Gulfer Okumus
- Department of Chest Disease, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ahmet Kaya Bilge
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Aslan GK, Akıncı B, Yeldan I, Okumus G. A randomized controlled trial on inspiratory muscle training in pulmonary hypertension: Effects on respiratory functions, functional exercise capacity, physical activity, and quality of life. Heart Lung 2020; 49:381-387. [PMID: 32143877 DOI: 10.1016/j.hrtlng.2020.01.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 01/06/2020] [Accepted: 01/06/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Impaired respiratory muscle function may be one of the causes of increased dyspnea, reduced exercise capacity, and physical activity (PA), and poor quality of life in pulmonary hypertension (PH). OBJECTIVE To investigate the effects of threshold inspiratory muscle training (TIMT) on respiratory functions, functional exercise capacity, PA, and QoL in patients with PH. METHODS Thirty patients with PH were randomly allocated to a TIMT (n = 15) and sham group (n = 15). Three patients in the sham group could not participate in the program. The TIMT group (n = 15) trained at 30% of the maximal inspiratory pressure (MIP), and the sham group (n = 12) performed at lowest pressure without change in threshold pressure. In both groups, patients performed TIMT at home for 15 min, twice per day, with the MIP load determined by the trainer, and were supervised once weekly at the hospital for eight weeks. The primary outcomes were MIP and maximal expiratory pressure (MEP). The secondary outcome measures included spirometric measurements, six-minute walking distance (6MWD), PA (SenseWear armband and International Physical Activity Questionnaire-Short Form-IPAQ-Short Form), and QoL (Minnesota Living with Heart Failure-MLHF). RESULTS After the training, changes in MIP (p = 0.023) were higher in the intervention group compared with the sham group. Differences in MEP, FEV1 (%), FVC (%), FEV1/FVC (%), 6MWD, %6MWD, IPAQ-SF, MLHFQ, and armband parameters were not significantly different between the groups (p > 0.05). CONCLUSIONS The results of the study demonstrated that TIMT could increase MIP and did not improve other parameters of respiratory functions, functional exercise capacity, PA, and QoL in patients with PH.
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Affiliation(s)
- Goksen Kuran Aslan
- Istanbul University-Cerrahpasa, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Bakırköy, Istanbul, Turkey.
| | - Buket Akıncı
- Biruni University, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Istanbul, Turkey.
| | - Ipek Yeldan
- Istanbul University-Cerrahpasa, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Bakırköy, Istanbul, Turkey.
| | - Gulfer Okumus
- Istanbul University, Istanbul Faculty of Medicine, Department of Chest Disease, Istanbul, Turkey.
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Turktas H, Okumus G, Uzun O, Ozdemir Kumbasar O, Altinisik G, Bingol Z, Borekci S, Cottin V, Musellim B. Survey of Physician’s Knowledge, Attitudes, and Practices Regarding Idiopathic Pulmonary Fibrosis in Turkey. Turk Thorac J 2020; 21:44-48. [DOI: 10.5152/turkthoracj.2019.180181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 12/26/2018] [Indexed: 11/22/2022]
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Odevoglu P, Demir R, Okumus G, Kucukoglu MS, Kuran Aslan G. Validity and reliability of the Turkish version of the EmPHasis-10 questionnaire in patients with pulmonary hypertension. J Eval Clin Pract 2019; 25:896-902. [PMID: 30793455 DOI: 10.1111/jep.13115] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 01/24/2019] [Accepted: 01/24/2019] [Indexed: 12/17/2022]
Abstract
RATIONALE, AIMS, AND OBJECTIVES The aim of the study was to evaluate the reliability and validity of the Turkish version of the EmPHasis-10 questionnaire to ensure cultural adaptation. METHODS This study involved translation, back translation, and cross-cultural adaptation. One hundred and one patients who were diagnosed as having pulmonary hypertension (PH) for at least 6 months were evaluated using the Turkish version of EmPHasis-10. Turkish version of the Minnesota Living with Heart Failure Questionnaire (MLHFQ) was used as gold standard to assess the validation of the Turkish version of the EmPHasis-10 questionnaire. Relationship between MLHFQ and EmPHasis-10 was analysed using Spearman correlation analysis to assess the validation. Cronbach alpha (internal consistency) and exploratory factor analyses were used to assess the questionnaire's reliability. RESULTS The statistical analysis showed that the EmPHasis-10 questionnaire showed a high validity with MLHFQ (r = 0.85) (P = 0.001). Reliability analysis showed that EmPHasis-10 had a high level of Cronbach alpha (α = 0.98) and internal consistency (ICC = 0.97). CONCLUSIONS The Turkish version of EmPHasis-10 is a quality of life questionnaire specific to PH. It has a high-level validity and reliability questionnaire that can be used by researchers and physicians.
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Affiliation(s)
- Pinar Odevoglu
- School of Health Sciences, Division of Physiotherapy and Rehabilitation, Halic University, Istanbul, Turkey
| | - Rengin Demir
- Cardiology Institute, Department of Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Gulfer Okumus
- Istanbul Faculty of Medicine, Department of Chest Disease, Istanbul University, Istanbul, Turkey
| | - M Serdar Kucukoglu
- Cardiology Institute, Department of Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Goksen Kuran Aslan
- Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Abstract
Objective: To examine the serum levels of leptin and adiponectin in different obstructive sleep apnea (OSA) phenotypes. Methods: Obese patients who were admitted to our sleep laboratory were included. All patients underwent spirometry, daytime arterial blood gas analysis, polysomnography and transthoracic echocardiography. Serum levels of adiponectin and leptin were recorded. Results: Analysis included 146 OSA patients (81 females, 65 males, age: 49.8 ± 10.7 years, body mass index: 40.3 ± 4.9 kg/m2, 47.9% severe OSA, 42.5% severe obesity). Females had higher leptin and adiponectin levels (p < 0.001; p < 0.001, respectively). Leptin levels were higher in patients with severe obesity (p < 0.001). Severe OSA patients had lower leptin and adiponectin levels (p = 0.023; p = 0.035, respectively). Conclusion: Adipokine levels were different especially in OSA patients with severe obesity, female gender and severe OSA.
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Affiliation(s)
- Zuleyha Bingol
- Department of Pulmonary Medicine, Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey
| | - Ekrem Bilal Karaayvaz
- Department of Cardiology, Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey
| | - Aysegul Telci
- Department of Biochemistry, Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey
| | - Ahmet Kaya Bilge
- Department of Cardiology, Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey
| | - Gulfer Okumus
- Department of Pulmonary Medicine, Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey
| | - Esen Kiyan
- Department of Pulmonary Medicine, Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey
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Orucova H, Cagatay T, Bingol Z, Cagatay P, Okumus G, Kiyan E. Comparison of arterial and venous blood gases in patients with obesity hypoventilation syndrome and neuromuscular disease. Ann Thorac Med 2019; 14:192-197. [PMID: 31333769 PMCID: PMC6611197 DOI: 10.4103/atm.atm_29_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES: Obesity hypoventilation syndrome (OHS) and some neuromuscular diseases (NMD) present with hypercapnic respiratory failure. Arterial blood gas (ABG) analysis is important in the diagnosis, follow-up, and treatment response of these diseases. However, ABG sampling is difficult in these patients because of excessive subcutaneous fat tissue, muscle atrophy, or contracture. The aim of this study is to investigate the value of venous blood gas (VBG), which is an easier and less complicated method, among stable patients with OHS and NMD. METHODS: The study included stable OHS and NMD patients who had been previously diagnosed and followed up between March 2017 and May 2017 in the outpatient clinic. ABG was taken from all patients in room air, and peripheral VBG was taken within 5 min after ABG sampling. RESULTS: Thirty-six patients with OHS and 46 patients with NMD were included in the study. There was a moderate positive correlation between arterial and venous pH values for all patients (rs = 0.590, P < 0.001). There were a strong and very strong positive correlations between arterial and venous pCO2 and HCO3 values (rs = 0.725 and rs = 0.934, respectively) (P < 0.001). There was no correlation between arterial and venous pO2 and saturation values. There was an agreement in Bland–Altman method for the values of ABG and VBG (pH, pCO2, and HCO3). CONCLUSIONS: There was a correlation between ABG and VBG values (pH, pCO2, and HCO3). VBG parameters (pH, pCO2, and HCO3) can be used safely instead of ABG parameters which have many risks, during treatment and follow-up of patients with OHS and NMD.
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Affiliation(s)
- Hicran Orucova
- Department of Pulmonary Medicine, Istanbul Faculty of Medicine, Istanbul University, İstanbul, Turkey
| | - Tulin Cagatay
- Department of Pulmonary Medicine, Istanbul Faculty of Medicine, Istanbul University, İstanbul, Turkey
| | - Zuleyha Bingol
- Department of Pulmonary Medicine, Istanbul Faculty of Medicine, Istanbul University, İstanbul, Turkey
| | - Penbe Cagatay
- Istanbul University - Cerrahpasa, High School of Health Care Professions Biostatistics, İstanbul, Turkey
| | - Gulfer Okumus
- Department of Pulmonary Medicine, Istanbul Faculty of Medicine, Istanbul University, İstanbul, Turkey
| | - Esen Kiyan
- Department of Pulmonary Medicine, Istanbul Faculty of Medicine, Istanbul University, İstanbul, Turkey
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Cagatay T, Bingol Z, Kıyan E, Yegin Z, Okumus G, Arseven O, Erkan F, Gulbaran Z, Erelel M, Ece T, Cagatay P, Kılıçaslan Z. Follow‐up of 1887 patients receiving tumor necrosis‐alpha antagonists: Tuberculin skin test conversion and tuberculosis risk. Clin Respir J 2017; 12:1668-1675. [DOI: 10.1111/crj.12726] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 09/03/2017] [Accepted: 10/08/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Tulin Cagatay
- Department of Pulmonary, Istanbul Medical Faculty, Istanbul UniversityIstanbul Turkey
| | - Zuleyha Bingol
- Department of Pulmonary, Istanbul Medical Faculty, Istanbul UniversityIstanbul Turkey
| | - Esen Kıyan
- Department of Pulmonary, Istanbul Medical Faculty, Istanbul UniversityIstanbul Turkey
| | - Zeynep Yegin
- Department of Pulmonary, Istanbul Medical Faculty, Istanbul UniversityIstanbul Turkey
| | - Gulfer Okumus
- Department of Pulmonary, Istanbul Medical Faculty, Istanbul UniversityIstanbul Turkey
| | - Orhan Arseven
- Department of Pulmonary, Istanbul Medical Faculty, Istanbul UniversityIstanbul Turkey
| | - Feyza Erkan
- Department of Pulmonary, Istanbul Medical Faculty, Istanbul UniversityIstanbul Turkey
| | - Ziya Gulbaran
- Department of Pulmonary, Istanbul Medical Faculty, Istanbul UniversityIstanbul Turkey
| | - Mustafa Erelel
- Department of Pulmonary, Istanbul Medical Faculty, Istanbul UniversityIstanbul Turkey
| | - Turhan Ece
- Department of Pulmonary, Istanbul Medical Faculty, Istanbul UniversityIstanbul Turkey
| | - Penbe Cagatay
- High School of Health Care Professions Biostatistic, Istanbul UniversityIstanbul Turkey
| | - Zeki Kılıçaslan
- Department of Pulmonary, Istanbul Medical Faculty, Istanbul UniversityIstanbul Turkey
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Akbay NO, Bingol Z, Kiyan E, Karaayvaz EB, Bilge AK, Issever H, Okumus G. Fractional Exhaled Nitric Oxide Measurement in Pulmonary Hypertension: A Follow-Up Study. Clin Appl Thromb Hemost 2017; 24:483-488. [PMID: 28393619 DOI: 10.1177/1076029617702243] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Pulmonary hypertension (PH) is a fatal disease although significant improvements in treatment are achieved. Easily implemented and noninvasive prognostic techniques are needed while following-up these patients. The aim was to investigate the role of fractional exhaled nitric oxide (FeNO) in follow-up for patients with PH. In this longitudinal study, patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic PH (CTEPH) who were seen in PH Outpatient Clinic, Istanbul Faculty of Medicine, Istanbul University, were enrolled in the study. Echocardiography, 6-minute walking test, brain natriuretic peptide, and FeNO measurements were performed, and World Health Organization functional class was evaluated to all patients at baseline, and third, and sixth months. Right-heart catheterization and pulmonary function tests at the time of diagnosis were recorded. The study comprised 31 patients (23 women, 8 men; mean age: 53.4 ± 17.1 years) with PAH (n = 19) and CTEPH (n = 12) and 80 healthy controls. Patients with PH had lower FeNO values than the control group (16.5 ppb vs 19.8 ppb; P < .05). Fractional exhaled nitric oxide values did not change during follow-up and did not correlate with other follow-up measures except tricuspid annular plane systolic excursion values. Fractional exhaled nitric oxide was higher in the idiopathic PAH subgroup at baseline and at third month than patients with PAH associated with other diseases. Fractional exhaled nitric oxide did not change in patients who had clinical deterioration. As a conclusion; Patients with PH had lower FeNO values than healthy controls, but FeNO did not change significantly during follow-up. Large-scale studies with prolonged follow-up periods are needed to understand the role of FeNO in the follow-up of the patients with PH.
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Affiliation(s)
- Nilay Orak Akbay
- 1 Istanbul Medical Faculty, Pulmonary Medicine, Istanbul University, Istanbul, Turkey
| | - Zuleyha Bingol
- 1 Istanbul Medical Faculty, Pulmonary Medicine, Istanbul University, Istanbul, Turkey
| | - Esen Kiyan
- 1 Istanbul Medical Faculty, Pulmonary Medicine, Istanbul University, Istanbul, Turkey
| | | | - Ahmet Kaya Bilge
- 2 Istanbul Medical Faculty, Cardiology, Istanbul University, Istanbul, Turkey
| | - Halim Issever
- 3 Istanbul Medical Faculty, Public Health, Istanbul University, Istanbul, Turkey
| | - Gulfer Okumus
- 1 Istanbul Medical Faculty, Pulmonary Medicine, Istanbul University, Istanbul, Turkey
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Aslan GK, Akinci B, Yeldan I, Okumus G. Respiratory muscle strength in patients with pulmonary hypertension: The relationship with exercise capacity, physical activity level, and quality of life. Clin Respir J 2016; 12:699-705. [PMID: 27860259 DOI: 10.1111/crj.12582] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 10/20/2016] [Accepted: 11/11/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Pulmonary hypertension (PH) is characterized by exertional dyspnea, fatigue, chest pain, dizziness, and syncope. Physical activity, peripheral, and respiratory muscle strength reduces in pateints with PH. Little is known about respiratory muscle weakness and related outcomes. OBJECTIVES The aims of the study were to determine respiratory muscle strength and to investigate the relationship between respiratory muscle strength and spirometric measurements, exercise capacity, physical activity level, quality of life, and pulmonary hemodynamics in patients with PH. METHODS In total, 33 patients aged 25-80 years who were diagnosed as having PH and 24 healthy volunteers were included in the study. To measure respiratory function, spirometry, maximal inspiratory (MIP), and expiratory pressures (MEP) were used. Physical activity level was determined with activity monitoring (SenseWear Armband) and the International Physical Activity Questionnaire-Short Form. Exercise capacity was determined using the 6-minute walk test. Quality of life was evaluated with the Minnesota Living with Heart Failure Questionnaire (MLHFQ). RESULTS Maximal inspiratory pressure and MEP values of the patients with PH were significantly lower than the age- and sex-matched healthy controls (P < .0001). Significant relationships were found between the MIP and six MWD (r = .40, P = .02), vigorous physical activity (r = .38, P = .03), moderate physical activity (r = 61, P < .001), and arm band-average metabolic equivalent (r = .39, P = .02). CONCLUSION The relationship between maximum inspiratory pressure, exercise capacity, and physical activity level showed that a decrease in exercise capacity or physical activity level may be a predictor for decreased MIP.
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Affiliation(s)
- Goksen Kuran Aslan
- Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Istanbul University, Istanbul, Turkey
| | - Buket Akinci
- Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Biruni University, Istanbul, Turkey
| | - Ipek Yeldan
- Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Istanbul University, Istanbul, Turkey
| | - Gulfer Okumus
- Istanbul Faculty of Medicine, Department of Chest Disease, Istanbul University, Istanbul, Turkey
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Okumus G, Kiyan E, Arseven O, Tabak L, Bayrak EK, Unaltuna NE, Issever H. Platelet Glycoprotein Ia 807c/T and 873g/A Polymorphisms in Patients With Venous Thromboembolism. Clin Appl Thromb Hemost 2016; 13:101-3. [PMID: 17164499 DOI: 10.1177/1076029606296422] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Two silent polymorphisms (807C/T and 873G/A) within glycoprotein Ia (GPIa) gene have been implicated in increased risk of developing thrombosis and myocardial infarction in affected individuals. The aim of this study was to investigate the GPIa gene polymorphism in patients with venous thromboembolism (VTE). A multiplexed allele specific-polymerase chain reaction (AS-PCR)–based method was used to determine the GPIa 807T/873A allele frequency in 77 patients with VTE and 106 healthy controls. The allelic frequency for 807T/873A was 33% in the patient group and 38% in the control group. The allelic frequency for 807C/873G was 66% in the patient group and 62% in the control group. The genotypic frequencies were 8% for 807TT/873AA, 42% for 807CC/GG, and 50% for 807CT/GA in the patient group. In the control group, the frequencies were 12% for 807TT/873AA, 35% for 807CC/873GG, and 52% for 807CT/873GA. As a result, the glycoprotein Ia 807C/T and 873G/A dimorphisms were not shown as risk factors for VTE.
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Affiliation(s)
- Gulfer Okumus
- Istanbul Medical Faculty, Department of Pulmonary Diseases, Istanbul University, Turkey.
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Okumus G, Aslan GK, Arseven O, Ongen G, Issever H, Kiyan E. The role of an activity monitor in the objective evaluation of patients with pulmonary hypertension. Clin Respir J 2016; 12:119-125. [PMID: 27149246 DOI: 10.1111/crj.12495] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 04/02/2016] [Accepted: 04/28/2016] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Patients with pulmonary hypertension (PH) show no symptoms at rest, but symptoms are triggered by physical activities. OBJECTIVES The primary aim of our study was to assess physical activity of patients with PH by using an activity monitor. The secondary aim was to evaluate the correlation between the activity monitor parameters and 6-min walk distance (6MWD), activity of daily living (ADL), quality of life, WHO functional class and PH classification. METHODS Thirty-eight patients with pulmonary arterial hypertension (PAH) and seven patients with chronic thromboembolic PH were included in the study. Physical activity was assessed using a SenseWear arm band. A 6-min walk test was performed. Daily living activities were assessed using the 'nottingham extended activity of daily living index' (NEADL). For quality of life assessments, 'Minnesota living with heart failure' (MLHF) and 'Short form-36' (SF-36) surveys were used. RESULTS Physical activity, exercise capacity, quality of life and contribution to ADL were lower in patients with PH. These data were associated with the 6MWD, quality of life and ADL index scores. We also found weak and moderate correlations between activity monitor data and SF-36 sub-group scores, MLHF and NEADL scores (P < 0.05). For the group with PAH, idiopathic PAH patients had more exercise capacity and total energy expenditure compared with patients with scleroderma-associated PAH. CONCLUSION Correlation between activity monitor data and 6MWD, most of SF-36 sub-group scores, MLHF scores and NEADL index scores suggest that activity monitor can be used in the evaluation of patients with PH.
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Affiliation(s)
- Gulfer Okumus
- Department of Chest Disease, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Goksen Kuran Aslan
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University, Istanbul, Turkey
| | - Orhan Arseven
- Department of Chest Disease, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Gul Ongen
- Department of Chest Disease, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Halim Issever
- Department of Public Health, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Esen Kiyan
- Department of Chest Disease, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Bingol Z, Pıhtılı A, Cagatay P, Okumus G, Kıyan E. Clinical predictors of obesity hypoventilation syndrome in obese subjects with obstructive sleep apnea. Respir Care 2015; 60:666-72. [PMID: 25587164 DOI: 10.4187/respcare.03733] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Arterial blood gas (ABG) analysis is not a routine test in sleep laboratories due to its invasive nature. Therefore, the diagnosis of obesity hypoventilation syndrome (OHS) is underestimated. We aimed to evaluate the differences in subjects with OHS and pure obstructive sleep apnea (OSA) and to determine clinical predictors of OHS in obese subjects. METHODS Demographics, body mass index (BMI), Epworth Sleepiness Scale score, polysomnographic data, ABG, spirometric measurements, and serum bicarbonate levels were recorded. RESULTS Of 152 obese subjects with OSA (79 females/73 males, mean age of 50.3 ± 10.6 y, BMI of 40.1 ± 5.6 kg/m(2), 51.9% with severe OSA), 42.1% (n = 64) had OHS. Subjects with OHS had higher BMI (P = .02), neck circumference (P < .001), waist circumference (P < .001), waist/hip ratio (P = .02), Epworth Sleepiness Scale scores (P = .036), ABG and serum bicarbonate levels (P < .001), apnea-hypopnea index (P = .01), oxygen desaturation index (P < .001), and total sleep time with S(pO2) < 90% (P < .001) compared with subjects with pure OSA (n = 88). They also had lower daytime PaO2 (P < .001), sleep efficiency (P = .032), mean S(pO2) (P < .001), and nadir S(pO2) (P < .001). Serum bicarbonate levels and nadir S(pO2) were the only independent predictive factors for OHS. A serum bicarbonate level of ≥ 27 mmol/L as the cutoff gives a satisfactory discrimination for the diagnosis of OHS (sensitivity of 76.6%, specificity of 74.6%, positive predictive value of 54.5%, negative predictive value of 88.9%). A nadir S(pO2) of < 80% as the cutoff gives a satisfactory discrimination for the diagnosis of OHS (sensitivity of 82.8%, specificity of 54.5%, positive predictive value of 56.9%, negative predictive value of 81.4%). When we used a serum bicarbonate level of ≥ 27 mmol/L and/or a nadir S(pO2) of < 80% as a screening measure, only 3 of 64 subjects with OHS were missed. CONCLUSIONS Serum bicarbonate level and nadir saturation were independent predictive factors for the diagnosis of OHS.
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Affiliation(s)
| | - Aylin Pıhtılı
- Clinic of Pulmonary Medicine, Private Keçiören Hospital, Ankara, Turkey
| | - Penbe Cagatay
- Department of Biostatistics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Iliaz S, Cagatay T, Bingol Z, Okumus G, Iliaz R, Kuran G, Kiyan E, Cagatay P. Does the 6-minute walk test predict nocturnal oxygen desaturation in patients with moderate to severe COPD? Chron Respir Dis 2014; 12:61-8. [PMID: 25480424 DOI: 10.1177/1479972314562406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Patients with chronic obstructive pulmonary disease (COPD) who have nocturnal oxygen desaturation (NOD) can be treated with nocturnal oxygen therapy (NOT) to avoid possible morbidity and mortality. Although there is no definite data recommending NOT alone, our aim is to evaluate the relationship between desaturation during the six-minute walk test (6MWT) and NOD in COPD. Fifty-five stable patients with COPD were enrolled in this study. The 6MWT and nocturnal oximetry were performed. Patients with comorbid diseases and respiratory failure were excluded. In total, 55 patients (49 males and 6 females, mean age: 65.8 ± 8.4 years) were analysed. Twenty-seven of the patients had moderate COPD and the remainder (n = 28) had severe COPD. Three patients (11%) with moderate COPD and 12 patients (42.9%) with severe COPD desaturated during 6MWT (p = 0.003). NOD was observed in five patients with severe COPD (17.9%). There were no patients with NOD in the moderate COPD group. Three (25%) of patients with severe COPD who desaturated during the 6MWT also had NOD. NOD was more common in patients with severe COPD and the patients with higher carbon dioxide levels (p = 0.02 and p = 0.001). Three patients (11%) with moderate COPD desaturated during the 6MWT; however they did not have NOD. Although the sample size in this study was too small to be conclusive, NOD was more common in desaturators during the 6MWT particularly in patients with severe COPD.
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Affiliation(s)
- Sinem Iliaz
- Department of Pulmonology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Tulin Cagatay
- Department of Pulmonology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Zuleyha Bingol
- Department of Pulmonology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Gulfer Okumus
- Department of Pulmonology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Raim Iliaz
- Department of Internal Medicine, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Goksen Kuran
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University, Istanbul, Turkey
| | - Esen Kiyan
- Department of Pulmonology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Penbe Cagatay
- Department of Biostatistics, Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Cagatay T, Bingol Z, Yegin Z, Okumus G, Kiyan E, Arseven O, Erkan F, Gulbaran Z, Erelel M, Ece T, Kilicaslan Z. Clinical Characteristics of Tuberculosis Patients Who Were on Therapy of Tumor Necrozing Factor Alpha Antagonists. Chest 2014. [DOI: 10.1378/chest.1888702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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20
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Musellim B, Okumus G, Uzaslan E, Akgün M, Cetinkaya E, Turan O, Akkoclu A, Hazar A, Kokturk N, Calisir HC. Epidemiology and distribution of interstitial lung diseases in Turkey. Clin Respir J 2013; 8:55-62. [PMID: 23711298 DOI: 10.1111/crj.12035] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 04/21/2013] [Accepted: 05/20/2013] [Indexed: 11/30/2022]
Abstract
INTRODUCTION There is very few data on the epidemiological features of interstitial lung diseases (ILD) in the literature. These studies on this subject suffer from limited number of patients. OBJECTIVE The goal of this study was to evaluate the epidemiological features of ILD in Turkey. METHODS Fifty-four investigators, 31 centres in 19 cities from six regions of Turkey, participated in the study. Two thousand two hundred forty-five newly diagnosed patients (51.8% females), led by Turkish Thoracic Society Clinical Problems Study Group, enrolled in this prospective study. RESULTS The mean age was 51.8 ± 16.7 years. The mean age among males was 50.5 ± 18.6 years and 53.0 ± 14.6 years among females (P < 0.001). 23.8% of the cases had ILD with known causes, while 39.4% were in granulomatous group, 23.7% were idiopathic, and 4.4% were in the unclassified group. Overall, histopathologically confirmed diagnosis rate was 40.4%. Sarcoidosis was the most common disease (37%), whereas cases with idiopathic pulmonary fibrosis (IPF) constituted 19,9% of patients. 53% of the sarcoidosis patients were females, and the ratio reaches to 75% under 50 years of age (for this group, IPF ratio is %3). In contrast, sarcoidosis and IPF ratios were equal in males (25%). Sarcoidosis was 8% in men over 50, while IPF was %45. CONCLUSION The overall incidence of ILD in Turkey was computed to be 25.8/100,000.
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Affiliation(s)
- Benan Musellim
- Department of Pulmonary Diseases, Cerrahpasa Medical Faculty, Istanbul University, İstanbul, Turkey
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Simone B, De Stefano V, Leoncini E, Zacho J, Martinelli I, Emmerich J, Rossi E, Folsom AR, Almawi WY, Scarabin PY, den Heijer M, Cushman M, Penco S, Vaya A, Angchaisuksiri P, Okumus G, Gemmati D, Cima S, Akar N, Oguzulgen KI, Ducros V, Lichy C, Fernandez-Miranda C, Szczeklik A, Nieto JA, Torres JD, Le Cam-Duchez V, Ivanov P, Cantu-Brito C, Shmeleva VM, Stegnar M, Ogunyemi D, Eid SS, Nicolotti N, De Feo E, Ricciardi W, Boccia S. Risk of venous thromboembolism associated with single and combined effects of Factor V Leiden, Prothrombin 20210A and Methylenetethraydrofolate reductase C677T: a meta-analysis involving over 11,000 cases and 21,000 controls. Eur J Epidemiol 2013; 28:621-47. [PMID: 23900608 DOI: 10.1007/s10654-013-9825-8] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Accepted: 07/02/2013] [Indexed: 12/16/2022]
Abstract
Genetic and environmental factors interact in determining the risk of venous thromboembolism (VTE). The risk associated with the polymorphic variants G1691A of factor V (Factor V Leiden, FVL), G20210A of prothrombin (PT20210A) and C677T of methylentetrahydrofolate reductase (C677T MTHFR) genes has been investigated in many studies. We performed a pooled analysis of case-control and cohort studies investigating in adults the association between each variant and VTE, published on Pubmed, Embase or Google through January 2010. Authors of eligible papers, were invited to provide all available individual data for the pooling. The Odds Ratio (OR) for first VTE associated with each variant, individually and combined with the others, were calculated with a random effect model, in heterozygotes and homozygotes (dominant model for FVL and PT20210A; recessive for C677T MTHFR). We analysed 31 databases, including 11,239 cases and 21,521 controls. No significant association with VTE was found for homozygous C677T MTHFR (OR: 1.38; 95 % confidence intervals [CI]: 0.98-1.93), whereas the risk was increased in carriers of either heterozygous FVL or PT20210 (OR = 4.22; 95 % CI: 3.35-5.32; and OR = 2.79;95 % CI: 2.25-3.46, respectively), in double heterozygotes (OR = 3.42; 95 %CI 1.64-7.13), and in homozygous FVL or PT20210A (OR = 11.45; 95 %CI: 6.79-19.29; and OR: 6.74 (CI 95 % 2.19-20.72), respectively). The stratified analyses showed a stronger effect of FVL on individuals ≤ 45 years (p value for interaction = 0.036) and of PT20210A in women using oral contraceptives (p-value for interaction = 0.045). In this large pooled analysis, inclusive of large studies like MEGA, no effect was found for C677T MTHFR on VTE; FVL and PT20210A were confirmed to be moderate risk factors. Notably, double carriers of the two genetic variants produced an impact on VTE risk significantly increased but weaker than previously thought.
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Affiliation(s)
- Benedetto Simone
- Institute of Public Health - Section of Hygiene, Department of Public Health, Università Cattolica del Sacro Cuore, L.go F.Vito 1, 00168, Rome, Italy
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Okumus G, Kiyan E, Bilge AK, Bingol Z, Comce F, Bolayir M, Kuran G, Kiyan A, Tabak L, Arseven O. Can Brain Natriuretic Peptide (BNP) be a Predictor for Pulmonary Arterial Hypertension? Turk Thorac J 2011. [DOI: 10.5152/ttd.2011.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Okumus G, Musellim B, Cetinkaya E, Turker H, Uzaslan E, Yenturk E, Uzun O, Saglam L, Kumbasar OO, Celik G, Annakkaya AN, Altiay G, Tabak L, Sakar A, Kiter G, Erturan S, Turktas H, Yalniz E, Akkoclu A, Ogus C, Dogan OT, Ozkan M, Aktogu S, Uzel I, Ongen G. Extrapulmonary involvement in patients with sarcoidosis in Turkey. Respirology 2011; 16:446-50. [PMID: 20946338 DOI: 10.1111/j.1440-1843.2010.01878.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVE Extrapulmonary sarcoidosis is common, and is almost always associated with concomitant thoracic involvement. Extrapulmonary manifestations vary on the basis of gender, age at presentation and ethnicity. The aim of this study was to investigate extrapulmonary involvement in patients with sarcoidosis in Turkey. METHODS This study was conducted by Turkish Thoracic Society Clinical Problems Study Group. New cases of sarcoidosis between 1 June 2004 and 31 May 2006 were recorded on electronic case record forms sent to all potential investigators and information about extrapulmonary involvement was collected. RESULTS One hundred and nineteen of 293 patients (83 female, 36 male, mean age = 45 ± 12 years) had extrapulmonary involvement in this study (40.6%). The median time to diagnosis was 6 months and this was longer than patients with just thoracic sarcoidosis (P = 0.001). Extrapulmonary symptoms were present in 181 (61.8%) patients, and skin lesions, arthralgia and back pain were the commonest (33.4%, 20.8% and 16.4%, respectively). Incidence of organ involvement was independent of age with the exception of ocular involvement, which was higher in those under the age of 40 years (P = 0.007). CONCLUSIONS Skin and peripheral lymph node involvement were the most common sites of extrapulmonary involvement and ocular involvement was more common in those under the age of 40 years in patients with sarcoidosis in a Turkish population.
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Affiliation(s)
- Gulfer Okumus
- Department of Pulmonary Diseases, Istanbul Medical Faculty, Istanbul University, Turkey.
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Ozkok A, Ucar AS, Akpinar TS, Okumus G, Kiyan E, Arseven O. Multiple Systemic Infarctions as a Complication of Bronchial Artery Embolization With Polyvinyl Alcohol: A Case Report. J Clin Med Res 2011; 3:275-7. [PMID: 22383919 PMCID: PMC3279493 DOI: 10.4021/jocmr665w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2011] [Indexed: 11/03/2022] Open
Affiliation(s)
- Abdullah Ozkok
- Istanbul Faculty of Medicine, Department of Internal Medicine, Istanbul University, Istanbul, Turkey
- Corresponding author: Abdullah Ozkok, Istanbul Faculty of Medicine, Department of Internal Medicine, Istanbul University, 34390, Fatih/Istanbul/Turkey.
| | - Ayse Serra Ucar
- Istanbul Faculty of Medicine, Department of Internal Medicine, Istanbul University, Istanbul, Turkey
| | - Timur Selcuk Akpinar
- Istanbul Faculty of Medicine, Department of Internal Medicine, Istanbul University, Istanbul, Turkey
| | - Gulfer Okumus
- Istanbul Faculty of Medicine, Department of Chest Medicine, Istanbul University, Istanbul, Turkey
| | - Esen Kiyan
- Istanbul Faculty of Medicine, Department of Chest Medicine, Istanbul University, Istanbul, Turkey
| | - Orhan Arseven
- Istanbul Faculty of Medicine, Department of Chest Medicine, Istanbul University, Istanbul, Turkey
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Musellim B, Kumbasar O, Ongen G, Cetinkaya E, Turker H, Uzaslan E, Yenturk E, Uzun O, Saglam L, Celik G, Okumus G, Annakkaya A, Altiay G, Tabak L, Sakar A, Kiter G, Erturan S, Turktas H, Yalniz E, Akkoclu A, Ogus C, Dogan O, Ozkan M, Aktogu S, Uzel I. Epidemiological features of Turkish patients with sarcoidosis. Respir Med 2009; 103:907-12. [DOI: 10.1016/j.rmed.2008.12.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2008] [Revised: 11/02/2008] [Accepted: 12/08/2008] [Indexed: 10/21/2022]
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Kiyan E, Okumus G, Cuhadaroglu C, Deymeer F. Sleep apnea in adult myotonic dystrophy patients who have no excessive daytime sleepiness. Sleep Breath 2009; 14:19-24. [PMID: 19484280 DOI: 10.1007/s11325-009-0270-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2009] [Revised: 05/10/2009] [Accepted: 05/13/2009] [Indexed: 11/28/2022]
Abstract
PURPOSE Sleep apnea is common in myotonic dystrophy (MD) and may cause respiratory failure. Most of the sleep studies have been performed in patients with excessive daytime sleepiness (EDS), which is a characteristic and strong predictor of sleep apnea. Therefore, we investigated the prevalence of sleep apnea in adult MD patients who have no EDS. MATERIALS AND METHODS Epworth Sleepiness Scale was used to exclude EDS and a score over 10 was accepted as an indicator of EDS. Sleep studies of 17 adult MD patients with the Epworth sleepiness scale score < or =10 were retrospectively reviewed. Spirometry (n = 16) and daytime arterial blood gasses were used to evaluate the relationship with nocturnal parameters. RESULTS On admission to the outpatient chest clinic, seven patients had normal spirometry, and ten had daytime hypercapnia and/or hypoxemia. All but one had sleep apnea (apnea-hypopnea index > or =5 events/h of sleep; mild in five, moderate in seven, and severe in four). Hypopneas were more common than apneas (16.9 +/- 13.2 events/h vs. 4.6 +/- 4.1 events/h). Nocturnal desaturation episodes were very frequent (oxygen desaturation index, 19.7 +/- 20.3/h of sleep). Three patients had central sleep apnea and 13 had obstructive sleep apnea. Body mass index, spirometry parameters (FVC and FEV1) and arterial oxygen tension were moderately correlated with nocturnal oxygenation parameters. Apnea-hypopnea index showed moderate correlation with spirometry parameters (FVC and FEV1). CONCLUSION Sleep apnea and oxygen desaturations are very common in MD patients who report no excessive daytime sleepiness. Daytime lung function parameters are not sufficiently reliable for screening sleep apnea. Therefore, we recommend routine polysomnography in MD patients.
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Affiliation(s)
- Esen Kiyan
- Department of Pulmonary Diseases, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
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Ozyigit LP, Kiyan E, Okumus G, Yilmazbayhan D. Isolated laryngo-tracheal amyloidosis presenting as a refractory asthma and longstanding hoarseness. J Asthma 2009; 46:314-7. [PMID: 19373642 DOI: 10.1080/02770900802660956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Respiratory tract amyloidosis is characterized by deposition of amyloid fibril protein at any site along the respiratory tract ranging from the larynx to the pulmonary parenchyma. Usually, it is not associated with primary systemic amyloidosis. We report a case with isolated laryngotracheal amyloidosis, which is relatively a rare condition, together with a history of refractory asthma accompanied with longstanding hoarseness.
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Affiliation(s)
- Leyla Pur Ozyigit
- Department of Chest Medicine, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey
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Okumus G, Kiyan E, Arseven O, Tabak L, Diz-Kucukkaya R, Unlucerci Y, Abaci N, Unaltuna NE, Issever H. Hereditary Thrombophilic Risk Factors and Venous Thromboembolism in Istanbul, Turkey: The Role in Different Clinical Manifestations of Venous Thromboembolism. Clin Appl Thromb Hemost 2008; 14:168-73. [PMID: 17895505 DOI: 10.1177/1076029607305620] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The aim of this study was to investigate the hereditary thrombophilic risk factors in patients with venous thromboembolism (VTE) and whether these risk factors play a different role in patients with isolated pulmonary embolism (PE) as compared with patients with deep vein thrombosis (DVT) and patients with PE + DVT. The protein C (PC), protein S, antithrombin activities, homocysteine levels, and factor V Leiden (FVL) G1691A and prothrombin G20210A mutations were evaluated in 191 patients with VTE and 191 controls. The prevalence of FVL and PC deficiency were higher in patients ( P = .003 and P = .02, respectively). There was no significant difference for the other risk factors. The combination of thrombophilic risk factors was significantly higher in patients with DVT + PE as compared with patients with isolated PE or DVT ( P = .04). In conclusion, the most important hereditary risk factors for VTE in this study were the FVL mutation and PC deficiency.
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Affiliation(s)
- Gulfer Okumus
- Department of Pulmonary Diseases, Istanbul Medical Faculty, Istanbul University, Capa-Istanbul, Turkey.
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Abstract
Alveolar echinococcosis, which is caused by Echinococcus multilocularis, is a very aggressive and potentially fatal infestation which always affects the liver primarily and metastasizes to any part of the body. Imaging studies are usually highly suspicious of carcinoma or sarcoma, and biopsy may provide the first indication of infection. We report a case of disseminated alveolar echinococcosis with liver, lung, and bone involvement mimicking a metastatic malignancy.
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Affiliation(s)
- Abdullah Ozkok
- Istanbul Faculty of Medicine, Department of Internal Medicine, Istanbul University, Istanbul, Turkey.
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