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Aktan R, Tertemiz KC, Yiğit S, Özalevli S, Özgen Alpaydın A, Uçan ES. Usefulness of a new parameter in functional assessment in patients with idiopathic pulmonary fibrosis: desaturation - distance ratio from the six-minute walk test. Sarcoidosis Vasc Diffuse Lung Dis 2023; 40:e2023021. [PMID: 37382067 PMCID: PMC10494751 DOI: 10.36141/svdld.v40i2.14634] [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] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 06/08/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND AND AIM New parameters in the 6-minute walk test (6MWT) are needed for assessing exercise capacity in patients with idiopathic pulmonary fibrosis (IPF). To our knowledge, no previous study has investigated the potential of using the desaturation distance ratio (DDR) to assess exercise capacity specifically in patients with IPF. This study aimed to investigate whether DDR is a potential tool for assessing the exercise capacity of patients with IPF. METHODS This study conducted with 33 subjects with IPF. Pulmonary function tests and a 6MWT were performed. To calculate the DDR, first, the difference between the patient's SpO2 at each minute and the SpO2 of 100% was summed together to determine the desaturation area (DA). Next, DDR was calculated using dividing DA by the 6-minute walk test distance (6MWD) (i.e., DA/6MWD). RESULTS When correlations of 6MWD and DDR with changes (Δ) in the severity of perceived dyspnea were examined, 6MWD did not significantly correlate with ΔBorg. Conversely, there was a significant correlation between the DDR and ΔBorg (r= 0.488, p=0.004). There were significant correlations between 6MWD and FVC % (r=0.370, p=0.034), and FEV1 % (r=0.465, p=0.006). However, DDR was significantly more correlated with FVC % (r= -0.621, p< 0.001), FEV1 % (r= -0.648, p< 0.001). Moreover, there was a significant correlation between DDR and DLCO % (r= -0.342, p=0.052). CONCLUSIONS The findings of this study suggest that DDR is a promising and more useful parameter for assessing patients with IPF.
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Affiliation(s)
- Rıdvan Aktan
- a:1:{s:5:"en_US";s:28:"Izmir Universit of Economics";}.
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Ömeroğlu Şimşek G, Uçan ES, Türeyen A, Direk Tecirli N, Uyar N, Yıldız E, Demirci Atik M, İtil BO. Facing Pandemic: Burnout in Nurses in Turkey. Thorac Res Pract 2023; 24:157-164. [PMID: 37503618 PMCID: PMC10346106 DOI: 10.5152/thoracrespract.2023.22081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
OBJECTIVE Burnout syndrome is a disorder that characterized by emotional exhaustion, depersonalization, and personal lack of accomplishment perception and it is common in nurses. During the coronavirus disease 2019 pandemic, nurses tried to take care of their patients and protect themselves and their families from disease and death. This study examines the factors affecting nurses' burnout in Turkey during the coronavirus disease 2019 pandemic. MATERIAL AND METHODS Data were collected from 3523 nurses in 69 cities across Turkey by sociodemographic questions and Maslach Burnout Scale with the electronic questionnaire created in the "SurveyMonkey" application between June 9, 2020 and June 21, 2020. To assess the impact of the pandemic on nurses' burnout, nurses were categorized as those working in pandemic units and others. RESULTS The response rate was 68%, and 3523 nurses from 69 cities across Turkey participated in the survey. Analyses were conducted with 2386 nurses that answered all questions. 76.45% of the nurses were from tertiary hospitals, and 54.9% (n = 1309) worked in pandemic units. Of 2386 participants, 86.13% (n = 2055) were female, the mean age was 33.9 (±8.43), and 58.76% (n = 1402) were married. Of 2386 participants, 54.9% (n = 1309) worked in pandemic units (outpatient clinics, inpatient clinics, and intensive care units). In multivariate linear regression analyses, the emotional exhaustion score was higher in nurses working in pandemic units (P < .05). CONCLUSION The factors that have been shown to cause burnout in previous studies were similar. However, in this study, it was also seen that the pandemic is a fundamental cause of burnout.
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Affiliation(s)
| | - Eyüp Sabri Uçan
- Department of Chest Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Aynur Türeyen
- Department of Internal Medicine Nursing, Ege University Faculty of Nursing, İzmir, Turkey
| | - Neşe Direk Tecirli
- Department of Psychiatry, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Nezihe Uyar
- Department of Chest Diseases, Dokuz Eylül University Hopital, İzmir, Turkey
| | - Emre Yıldız
- Nursing Services Manager, Dokuz Eylül University Hopital, İzmir, Turkey
| | - Merve Demirci Atik
- Department of Occupational Disease, Chest Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Bahriye Oya İtil
- Department of Chest Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
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Özgen Alpaydın A, Appak Ö, Sinem Gezer N, Yiğit S, Gündüz Karayazı D, Kuruüzüm Z, Ömeroğlu Şimşek G, Özlem Eren Kutsoylu O, Arzu Sayıner A, Sevinç C, Sabri Uçan E, Levent Uğur Y, Necati Gökmen A, Yapar N. Can Some Viral Respiratory Infections Observed Before the Pandemic Announcement Be Related to SARS-CoV-2? Thorac Res Pract 2023; 24:91-95. [PMID: 37503645 PMCID: PMC10652072 DOI: 10.5152/thoracrespract.2023.22187] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 10/14/2022] [Indexed: 07/29/2023]
Abstract
OBJECTIVE There have been doubts that SARS-CoV-2 has been circulating before the first case was announced. The aim of this study was to evaluate the possibility of COVID-19 in some cases diagnosed to be viral respiratory tract infection in the pre-pandemic period in our center. MATERIAL AND METHODS Patients who were admitted to our hospital's pulmonary diseases, infectious diseases, and intensive care clinics with the diagnosis of viral respiratory system infection within a 6-month period between October 2019 and March 12, 2020, were screened. Around 248 archived respiratory samples from these patients were analyzed for SARS-CoV-2 ribonucleic acid by real-timequantitative polymerase chain reaction. The clinical, laboratory, and radiological data of the patients were evaluated. RESULTS The mean age of the study group was 47.5 (18-89 years); 103 (41.5%) were female and 145 (58.4%) were male. The most common presenting symptoms were cough in 51.6% (n = 128), fever in 42.7% (n = 106), and sputum in 27.0% (n = 67). Sixty-nine percent (n = 172) of the patients were pre-diagnosed to have upper respiratory tract infection and 22.0% (n = 55) had pneumonia, one-third of the patients (n = 84, 33.8%) were followed in the service. Respiratory viruses other than SARS-CoV-2 were detected in 123 (49.6%) patients. Influenza virus (31.9%), rhinovirus (10.5%), and human metapneumovirus (6.5%) were the most common pathogens, while none of the samples were positive for SARS-CoV-2 RNA. Findings that could be significant for COVID-19 pneumonia were detected in the thorax computed tomography of 7 cases. CONCLUSION The negative SARS-CoV-2 real-time-quantitative polymerase chain reaction results in the respiratory samples of the cases followed up in our hospital for viral pneumonia during the pre-pandemic period support that there was no COVID-19 among our cases during the period in question. However, if clinical suspicion arises, both SARS and non-SARS respiratory viral pathogens should be considered for differential diagnosis.
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Affiliation(s)
- Aylin Özgen Alpaydın
- Department of Pulmonary Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Özgür Appak
- Department of Medical Microbiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Naciye Sinem Gezer
- Department of Radiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Salih Yiğit
- Department of Pulmonary Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Damla Gündüz Karayazı
- Department of Pulmonary Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Ziya Kuruüzüm
- Department of Infectious Diseases and Clinical Microbiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Gökçen Ömeroğlu Şimşek
- Department of Pulmonary Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Oya Özlem Eren Kutsoylu
- Department of Infectious Diseases and Clinical Microbiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Ayça Arzu Sayıner
- Department of Medical Microbiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Can Sevinç
- Department of Pulmonary Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Eyüp Sabri Uçan
- Department of Pulmonary Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Yasin Levent Uğur
- Department of Intensive Care Unit, Mehmet Akif Ersoy State Hospital, Çanakkale,Turkey
| | - Ali Necati Gökmen
- Department of Anesthesiology and Reanimation, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Nur Yapar
- Department of Infectious Diseases and Clinical Microbiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
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Uçan ES, Alpaydın AÖ, Gündüz Karayazı D, Kapkaç M, Takar B, Zekioğlu O, Balcı P, Yılmaz MR. Tuberculous mastitis: A masquerading face of granulomatous mastitis. Tuberk Toraks 2022; 70:271-278. [DOI: 10.5578/tt.20229706] [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: 11/15/2022] Open
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Yapar N, Uçan ES, Bayraktar F, Gökmen N, Sayıner A, Kuruüzüm Z, Bayram B, Alp-Çavuş S, Kılınç O, Avkan-Oğuz V, Savran Y, Küçükgüçlü S, Celiloğlu M. COVID-19 Pandemic Action Plan of a University Hospital. Turk Thorac J 2021; 22:95-98. [PMID: 33646113 DOI: 10.5152/turkthoracj.2021.20141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 10/25/2020] [Indexed: 11/22/2022]
Abstract
In December 2019, in Wuhan, China, scientists observed a sudden and sharp increase in the number of cases of pneumonia and acute respiratory distress syndrome of an unknown origin. By the end of January 2020, the outbreak had spread to Asia, Europe, America, and Australia. In this article, we have outlined the pandemic action plan of our university hospital.
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Affiliation(s)
- Nur Yapar
- Department of Infectious Diseases and Clinical Microbiology, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Eyüp Sabri Uçan
- Department of Respiratory Medicine, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Fırat Bayraktar
- Department of Internal Medicine, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Necati Gökmen
- Department of Anesthesiology and Reanimation, Intensive Care Unit, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Arzu Sayıner
- Department of Medical Microbiology, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Ziya Kuruüzüm
- Department of Infectious Diseases and Clinical Microbiology, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Başak Bayram
- Department of Emergency Medicine, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Sema Alp-Çavuş
- Department of Infectious Diseases and Clinical Microbiology, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Oğuz Kılınç
- Department of Respiratory Medicine, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Vildan Avkan-Oğuz
- Department of Infectious Diseases and Clinical Microbiology, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Yusuf Savran
- Department of Internal Medicine, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Semih Küçükgüçlü
- Head of Hospital Administration, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Murat Celiloğlu
- Dean of Medical Faculty, Dokuz Eylül University School of Medicine, İzmir, Turkey
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Köktürk N, İtil BO, Altınışık G, Adıgüzel N, Akgün M, Akyıldız L, Altın S, Arıkan H, Ateş G, Ay P, Aykaç N, Babayiğit C, Bostan P, Cinel G, Çalışır HC, Çelik P, Çetinkaya PD, Dağlı E, Demir AU, Demir C, Dikensoy Ö, Edis EÇ, Elbek O, Erdinç M, Ergan B, Eyüboğlu AFÖ, Gemicioğlu B, Göksel T, Gülhan E, Gültekin Ö, Gürkan CG, Gürgün A, Havlucu Y, Başoğlu OK, Karakurt S, Karakurt Z, Kılınç O, Kocabaş A, Kul S, Müsellim B, Naycı S, Özkan M, Pınarer Ö, Saltürk C, Sandal A, Sayıner A, Şen E, Şimşek GÖ, Karadağ BT, Akyıl FT, Töreyin ZN, Uçan ES, Küçük FÇU, Varol A, Yasin Y, Yıldız T, Yorgancıoğlu AA, Bayram H. COVID-19 Pandemic and the Global Perspective of Turkish Thoracic Society. Turk Thorac J 2020; 21:419-432. [PMID: 33352098 PMCID: PMC7752113 DOI: 10.5152/turkthoracj.2020.20174] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 08/06/2020] [Indexed: 01/08/2023]
Abstract
It has been more than 3 months now since the first case of COVID-19 was reported in Turkey. Globally, the number of confirmed cases and deaths reached 9,653,048 and 491,128 respectively, as reported by 216 countries by June 27, 2020. Turkey had 1,396 new cases, 194,511 total cases, and 5,065 deaths by the same date. From the first case until today, the Turkish Thoracic Society (TTS) has been very proactive in educating doctors, increasing public awareness, undertaking academic studies, and assisting with public health policies. In the present report, social, academic, and management perspectives of the pandemic are presented under appropriate subtitles. During this critical public health crisis, TTS has once again demonstrated its readiness and constructive stance by supporting public health, healthcare workers, and the environment. This review summarizes the perspective of TTS on each aspect of the COVID-19 pandemic and casts light on its contributions.
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Affiliation(s)
- Nurdan Köktürk
- Department of Pulmonary Medicine, Gazi University School of Medicine, Ankara, Turkey
| | - Bahriye Oya İtil
- Department of Pulmonary Medicine, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Göksel Altınışık
- Department of Pulmonary Medicine, Pamukkale University School of Medicine, Denizli, Turkey
| | - Nalan Adıgüzel
- Department of Intensive Care Unit- Pulmonary Medicine, University of Health Sciences, İstanbul Süreyyapaşa Chest Diseases Training and Research Hospital, İstanbul, Turkey
| | - Metin Akgün
- Department of Pulmonary Medicine, Atatürk University School of Medicine, Erzurum, Turkey
| | - Levent Akyıldız
- Clinic of Pulmonary Medicine, Memorial Dicle Hospital, Diyarbakir, Turkey
| | - Sedat Altın
- Department of Pulmonary Medicine, University of Health Sciences, Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, İstanbul, Turkey
| | - Hüseyin Arıkan
- Yüzüncü Yıl University, Dursun Odabaş Medical Center, Medical Intensive Care Unit, Van, Turkey
| | - Güngör Ateş
- Department of Pulmonary Medicine, Sultan Hospital, Diyarbakir, Turkey
| | - Pınar Ay
- Department of Public Health, Marmara University School of Medicine, İstanbul, Turkey
| | - Nilüfer Aykaç
- Clinic of Pulmonary Medicine, Gayrettepe Florence Nightingale Hospital, İstanbul, Turkey
| | - Cenk Babayiğit
- Department of Pulmonary Medicine, Mustafa Kemal University School of Medicine, Hatay, Turkey
| | - Pınar Bostan
- İstanbul Bilgi University, School of Health Sciences, İstanbul, Turkey
| | - Güzin Cinel
- Department of Pediatric Pulmonology, Ankara Yıldırım Beyazıt University School of Medicine Ankara, Turkey
| | | | - Pınar Çelik
- Department of Pulmonary Medicine, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Pelin Duru Çetinkaya
- Department of Pulmonary Medicine, University of Health Sciences, Adana City Training and Research Hospital, Adana, Turkey
| | - Elif Dağlı
- Pediatric Pulmonologist, Turkish Thoracic Society
| | - Ahmet Uğur Demir
- Department of Pulmonary Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Canan Demir
- Clinic of Occupational Diseases, Occupational and Environmental Diseases Hospital, Ankara, Turkey
| | - Öner Dikensoy
- Department of Pulmonary Medicine, Acıbadem University School of Medicine, İstanbul, Turkey
| | - Ebru Çakır Edis
- Department of Pulmonary Medicine, Trakya University School of Medicine, Edirne, Turkey
| | - Osman Elbek
- Clinic of Pulmonary Medicine, Kadıköy Florence Nightingale Hospital, İstanbul, Turkey
| | - Münevver Erdinç
- Department of Pulmonary Medicine, Ege University School of Medicine, İzmir, Turkey
| | - Begüm Ergan
- Department of Pulmonary Medicine, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | | | - Bilun Gemicioğlu
- Department of Pulmonary Disease, İstanbul University - Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Tuncay Göksel
- Department of Pulmonary Medicine, Ege University School of Medicine, İzmir, Turkey
| | - Erkmen Gülhan
- Department of Thoracic Surgery, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Ökkeş Gültekin
- Department of Pulmonary Medicine, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Canan Gündüz Gürkan
- Department of Pulmonary Medicine, University of Health Sciences, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Alev Gürgün
- Department of Pulmonary Medicine, Ege University School of Medicine, İzmir, Turkey
| | - Yavuz Havlucu
- Department of Pulmonary Medicine, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Ozen K Başoğlu
- Department of Pulmonary Medicine, Ege University School of Medicine, İzmir, Turkey
| | - Sait Karakurt
- Department of Intensive Care Unit-Pulmonary Medicine, Marmara University School of Medicine, İstanbul, Turkey
| | - Zuhal Karakurt
- Department of Intensive Care Unit- Pulmonary Medicine, University of Health Sciences, İstanbul Süreyyapaşa Chest Diseases Training and Research Hospital, İstanbul, Turkey
| | - Oğuz Kılınç
- Department of Pulmonary Medicine, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Ali Kocabaş
- Department of Pulmonary Medicine, Çukurova University School of Medicine, Adana
| | - Seval Kul
- Department of Biostatistics, Gaziantep University School of Medicine, Gaziantep, Turkey
| | | | - Sibel Naycı
- Department of Pulmonary Medicine, Mersin University School of Medicine, Mersin, Turkey
| | - Metin Özkan
- Clinic of Pulmonary Medicine, Ankara Memorial Hospital, Ankara, Turkey
| | - Özgün Pınarer
- Galatasaray University School of Engineering, İstanbul, Turkey
| | - Cüneyt Saltürk
- Department of Pulmonary Medicine, İstanbul Yeni Yüzyıl University School of Medicine, İstanbul, Turkey
| | - Abdulsamet Sandal
- Clinic of Occupational Diseases, Occupational and Environmental Diseases Hospital, Ankara, Turkey
| | - Abdullah Sayıner
- Department of Pulmonary Medicine, Ege University School of Medicine, İzmir, Turkey
| | - Elif Şen
- Department of Pulmonary Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Gökçen Ömeroğlu Şimşek
- Department of Pulmonary Medicine, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Bülent Taner Karadağ
- Department of Pediatric Pulmonology, Marmara University School of Medicine, İstanbul, Turkey
| | - Fatma Tokgöz Akyıl
- Department of Pulmonary Medicine, University of Health Sciences, Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, İstanbul, Turkey
| | - Zehra Nur Töreyin
- Department of occupational diseases, Health Sciences University, Adana City Training and Research Hospital
| | - Eyüp Sabri Uçan
- Department of Pulmonary Medicine, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | | | - Ayhan Varol
- Clinic of Pulmonary Medicine, Kepez State Hospital, Antalya, Turkey
| | - Yeşim Yasin
- Department of Public Health, Acıbadem University School of Medicine, İstanbul, Turkey
| | - Tekin Yıldız
- Department of Pulmonary Medicine, University of Health Sciences, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - A. Arzu Yorgancıoğlu
- Department of Pulmonary Medicine, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Hasan Bayram
- Department of Pulmonary Medicine, Koç University School of Medicine, İstanbul, Turkey
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Atik M, Uçan ES, Ellidokuz H, Alptekin K. Burnout in Chest Physicians after Health Care Reforms: A Cross-Sectional Study in Turkey. Turk Thorac J 2019; 20:18-24. [PMID: 30664422 DOI: 10.5152/turkthoracj.2018.18041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 06/11/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The health reform has recently been one of the most important items on the agenda worldwide. The aim of this study is to investigate burnout syndrome in chest physicians and exhibit its connection with reform processes. MATERIALS AND METHODS In this survey, the "Socio-demographic Data Form" and "Maslach Burnout Inventory" were used. Between September and November 2016, chest physicians were reached with permissions by expertise associations via e-mail groups. A sample size of 352 physicians was included in the study out of 2,349 chest physicians in Turkey. RESULTS Among 352 physicians, 238 (67.60%) were women, and the mean age was 38.93 (±9.97). Higher burnout scores were determined in young physicians (aged ≤35), residents, those with low income, and those with ≥55 weekly working hours. The performance-based salary system was regarded as a problem by 84.7%, and 83.5% stated that they had not enough leisure time for themselves and their families. More than a half (55.7%) indicated that they would not choose the same specialty if they ever had a chance to choose again. CONCLUSION We observed that most of chest physicians in Turkey experience burnout syndrome, which might be influenced by reforms in the health care system. The health system and working conditions should be dealt with immediately by health authorities and reformed in accordance with human dignity and rights to life.
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Affiliation(s)
- Merve Atik
- Department of Chest Diseases, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Eyüp Sabri Uçan
- Department of Chest Diseases, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Hülya Ellidokuz
- Dokuz Eylül University, Institute of Oncology, İzmir, Turkey
| | - Köksal Alptekin
- Department of Psychiatry, Dokuz Eylül University School of Medicine, İzmir, Turkey
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Doruk S, Tertemiz KC, Kömüs N, Uçan ES, Kilinç O, Sevinç C. Community acquired pneumonia and direct hospital cost. Tuberk Toraks 2009; 57:48-55. [PMID: 19533437] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
In Turkey, there is inadequate data about the direct or indirect cost of community acquired pneumonia (CAP). This study aims to identify the clinical, laboratory, and radiological properties, direct hospital costs of CAP, and the factors that affect these costs. Grouping of the subjects and cost analysis were evaluated in accordance with Pneumonia Severity Index (PSI) and 'Turkish Thoracic Society (TTS) CAP Guideline'. 114 cases with an average age of 70.9 were analyzed retrospectively. Average hospital stay was 11.0 +/- 6.6 days. Three of the cases that appeared to be in group IIIb in accordance with TTS CAP Guideline, and that had a PSI score of 102.7 died. Average costs of medicine was 484.59 Euro, radiology costs were 65.38 Euro, laboratory costs were 329.38 Euro and the total cost was 1630.77 Euro. In group IIIb cases, costs of medicine and the total costs were higher than other groups. Radiological, laboratory and the total costs were not determined to be different among cases that did or did not conform to initial treatment guidelines (p> 0.05). There were no effect of gender and advanced age (>/= 65 years) on total cost (p> 0.05). Existence of a comorbid disease was detected to have increased the total cost (p= 0.003). Total costs according to PSI scoring were 1274.60 Euro in low-risk group, and 1929.49 Euro in high-risk group (p= 0.04). Hospital mortality due to CAP was 2.6%.
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Affiliation(s)
- Sibel Doruk
- Department of Chest Diseases, Faculty of Medicine, Gaziosmanpaşa University, Tokat, Turkey.
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Yorgancioğlu A, Türktaş H, Kalayci O, Yardim N, Buzgan T, Kocabaş A, Karlikaya C, Yildiz F, Ergün P, Mungan D, Kart L, Göktaş E, Musaonbaşioğlu S, Gündoğan A, Akdağ R, Akçay S, Akin M, Akkurt I, Altan P, Altunsu T, Arpaci N, Aydin C, Aydin S, Aydinli F, Aytaç B, Bavbek S, Biber C, Bingöl Karakoç G, Ceyhun G, Cakir B, Celik G, Cetinkaya T, Ciçek ME, Coban SC, Cobanoğlu N, Com S, Cöplü L, Demirkazik A, Doğan E, Ekmekçi EB, Elbir M, Erdoğan A, Ergüder T, Gemicioğlu B, Gögen S, Gülbahar O, Güngör H, Horzum E, Içer Y, Imamecioğlu AR, Kahraman N, Kakillioğlu T, Kalyoncu F, Karakaya M, Karakaya G, Karaodul G, Kesici C, Keskinkiliç B, Kilinç O, Kirmizitaş F, Kosdak M, Köktürk N, Metintaş M, Numanoğlu SC, Gümrükçüoğlu OF, Onal Z, Onal B, Ozacar R, Ozen HA, Ozkan S, Oztürk F, Polat H, Saçkesen C, Selçuk T, Serin G, Sönmez G, Sahin M, Sahinöz S, Sahinöz T, Simşek B, Tartan N, Toprak A, Tugay T, Tuncer A, Uçan ES, Unüvar N, Yapicikardeşler B, Yildirim N, Yol S, Yüksel H, Khaltaev N, Cruz A, Minelli E, Bateman E, Baena Cagnani C, Dahl R, Bousquet J. The WHO global alliance against chronic respiratory diseases in Turkey (GARD Turkey). Tuberk Toraks 2009; 57:439-452. [PMID: 20037863] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
In order to prevent and control non-communicable diseases (NCDs), the 61st World Health Assembly has endorsed an NCD action plan (WHA resolution 61.14). A package for essential NCDs including chronic respiratory diseases (CRDs) has also been developed. The Global Alliance against Chronic Respiratory Diseases (GARD) is a new but rapidly developing voluntary alliance that is assisting World Health Organization (WHO) in the task of addressing NCDs at country level. The GARD approach was initiated in 2006. GARD Turkey is the first comprehensive programme developed by a government with all stakeholders of the country. This paper provides a summary of indicators of the prevalence and severity of chronic respiratory diseases in Turkey and the formation of GARD Turkey.
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Sevinç C, Sahbaz S, Uysal U, Kilinç O, Ellidokuz H, Itil O, Gülay Z, Yunusoğlu S, Sargun S, Akkoyun KK, Uçan ES. [Microbiologic spectrum and prognostic factors of hospital-acquired pneumonia cases]. Tuberk Toraks 2007; 55:153-9. [PMID: 17602343] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
Nosocomial infections are an important cause of preventable morbidity and mortality; they also result in significant socioeconomic cost. Nosocomial pneumonia (NCP) is defined as pneumonia, which occurs 48 hours after hospitalization or after discharge from the hospital. It is the second or third most frequent infection among all hospital acquired infections, and the mortality of NCP is higher than the other hospital acquired infections. Patients, diagnosed as NCP were retrospectively analyzed in order to detect microbiological agent and prognostic factors. We evaluated 173 patients, 67.0% of them were male and 33.0% female. Comorbid diseases were present in 94.2% and a medical procedure had been applied in 75.1% of cases. A single agent was isolated in 79.2% of the cases while a mixt infection was present in 13.3%. In 7.5% of the cases, cultures were negative. Endotracheal aspirates were the most common materials (38.9%) used for detected microorganism and sputum cultures were used in 16.8% of the cases. Most commonly encountered microorganism were Pseudomonas aeruginosa, Acinetobacter spp. and Staphylococcus aureus respectively. NCP developed on approximately 18th day of hospitalization. Overall mortality rate was 45.2%. The effects of diabetes mellitus and chronic pulmonary diseases on mortality rate were analized by logistic regression analysis and it's evaluated that the mortality rates increase 3.7 times with diabetes mellitus and 2.4 times with chronic pulmonary diseases. There was no effect of mechanical ventilation history on mortality.
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Affiliation(s)
- Can Sevinç
- Department of Chest Diseases, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
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12
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Gülcü A, Sevinç C, Esen N, Kilinç O, Uçan ES, Itil O, Cimrin AH, Kömüs N, Sener G, Akkoçlu A, Gülay Z, Yücesoy M. [Microbiological results of bronchoalveolar lavage that was performed for opportunistic pulmonary infections]. Tuberk Toraks 2006; 54:249-53. [PMID: 17001542] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
Between 2001-2002; in 62 cases, 33 (53%) male, 29 (47%) female, mean age 51.4 +/- 18.1 years) bronchoalveolar lavage (BAL) was performed for diagnosis of opportunistic pulmonary infection and specimens were evaluated for results of microbiological examinations. There was hematological malignancy in 18 (29%) and solid organ malignancy in 13 (21%) cases. Thirty-one (50%) cases were immunocompromised for reasons other than malignancy. By endoscopic evaluation endobronchial lesion was seen in 2 (3%) cases, indirect tumor signs were seen in 2 (3%) cases and signs of infection were seen in 11 (18%) cases. Forty-even (76%) cases were endoscopically normal. Acid-fast bacilli (AFB) direct examination was positive in 3 (5%) cases. In 4 (6%) cases mycobacterial culture was positive, Mycobacterium tuberculosis-polymerase chain reaction (PCR) was also positive in these four cases. Examination of gram-stained smears for bacteria was associated with infection in 14 (23%) cases. Bacteriologic cultures were positive for single potential pathogen in 10 (16%) cases, and for mixed pathogens in 7 (11%) cases for a total number of 17 (27%). Fungal cultures were positive in 3 (5%) cases all of which had hematological malignancy. As a result in 24 (39%) cases microbiological agent of infection is determined: in four mycobacteria, in 17 bacteria other than mycobacteria and in three fungi.
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Affiliation(s)
- Aylin Gülcü
- Department of Chest Diseases, Faculty of Medicine, Celal Bayar University, Manisa, Turkey.
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Uçan ES, Avkan Oğuz V, Güngör O, Gülşen A, Uğural Sezak N, Tertemiz KC, Ceylan E, Kargi A, Balci P, Ada E, Sanli A. [A case of resistant pulmonary and cerebral aspergillosis successfully treated with voriconazole]. Tuberk Toraks 2006; 54:75-9. [PMID: 16615023] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023] Open
Abstract
Invasive pulmonary aspergillosis (IPA) is the most common fungal pulmonary infection in immunocompromised patients. In this disease, it is hard to diagnose, it's therapy process is variable and mortality is high. Prognosis is even worse in the cases which have cerebral aspergillosis. The patient was following up as a diagnosis of usual interstitial pneumonia and treating with corticosteroids and azothiopurine. Patient attended our clinic with headache and lose of vision. IPA and cerebral aspergillosis was the diagnosis as his examinations. Amphotericin B lipid complex treatment were given because of pulmonary and cerebral aspergillosis. Voriconazole was the second therapy because of the no response. Voriconazole is more effective in cerebral aspergillosis and treated this patient successfully.
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Affiliation(s)
- Eyüp Sabri Uçan
- Department of Chest Disease, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
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14
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Köseoğlu N, Aydin A, Uçan ES, Ceylan E, Eminoğlu O, Durak H, Güven H. [The effects of water-pipe, cigarette and passive smoking on mucociliary clearance]. Tuberk Toraks 2006; 54:222-8. [PMID: 17001538] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
We aimed to determine the effects of water-pipe smoking on lung mucociliary clearance system using radioaerosol ventilation scintigraphy and compare with cigarette and passive smoking and determine the level of exposure to tobacco smoke by measuring urinary cotinine in each group. Volunteer water-pipe only and cigarette only smokers from various cafés in Izmir city and passive smokers as control group were included in the study after exclusion and inclusion criteria. The ages, type of smoking, duration and daily amount of tobacco smoked and the medical histories of the volunteers were noted down. The pulmonary function tests (PFT), technetium-99m inhalation scintigraphy and urinary cotinine measurement with enzyme immunoassay (EIA) and were performed for each participant. Twenty water-pipe smokers, 23 cigarette smokers and 15 passive smokers were included into the study. There were no statistically significant differences among the mean ages, BMI and PFT parameters of all participants in study and control groups. Mucociliary clearance rates in terms of retention ratio after 1 hour and radioactivity half-life for each lung was lowest in the water-pipe smokers compared to others. Mucociliary clearance rate also decreased in the cigarette smokers compared to passive smokers. The differences in the mucociliary clearance rates among groups were statistically significant (p < 0.05). Urinary cotinine levels were highest in the cigarette smokers and higher in water-pipe smokers compared to passive smokers as statistically significant. As a conclusion mucociliary clearance rates decrease with tobacco smoking, being more prominent in water-pipe smokers in our study.
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Affiliation(s)
- Nalan Köseoğlu
- Department of Chest Diseases, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey.
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15
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Sahbaz S, Uçan ES, Sevinç C, Ceylan E, Alacacioğlu A, Kargi A. [A case of chronic eosinophilic pneumonia with atypical clinical and radiological progress]. Tuberk Toraks 2004; 52:171-4. [PMID: 15241702] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
Eosinophilic lung disease is characterised by eosinophilic infiltration of lung tissue besides peripherical blood and bronchoalveolar lavage (BAL) fluid eosinophilia. A 48 year-old male who attended our clinics with cough and sputum lasting for 2-3 months, has been evaluated for micronodular interstitial infiltration bilaterally in all lung areas. Eosinophilia was detected in hemogram but BAL fluid was not diagnostic. Transbronchial lung parenchymal biopsy was compliant with chronic eosinophilic pneumonia. No special cause has been found after evaluation and the case was accepted to be idiopathic. Because of unfamiliar clinical, radiological and pathological findings, we decided to present this case.
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Affiliation(s)
- Sibel Sahbaz
- Pulmonary Diseases, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
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16
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Sahbaz S, Kilinç O, Vayvada H, Topçu A, Yörükoğlu K, Uçan ES. [Distal phalanx metastasis in operated bronchial carcinoma]. Tuberk Toraks 2004; 52:378-81. [PMID: 15558362] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Abstract
A 54 years old man who admitted with thoracolomber pain and pain at left knee had history of left pneumonectomy four months ago for squamous cell lung carcinoma. At physical examination swelling and hotness at the left knee, swelling and redness of the distal phalanx of the right third finger were found. Distal phalanx was not observed at the X-ray which was taken for suspect of metastasis. Incision biopsy was performed from this lesion and microscopic findings of the material were evaluated as metastatic squamous cell carcinoma. Bone metastasis are seen frequently at bronchial carcinoma, but hand metastasis are seen in 0.2% of all cases. This case is represented because of the rare metastatic localisation of bronchial carcinoma.
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Affiliation(s)
- Sibel Sahbaz
- Pulmonary Diseases, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey.
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17
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Sayan M, Kilinç O, Yüce A, Uçan ES, Genç S. [Seropositivity against atypical pneumonia agents demonstrated in patients with community-acquired pneumonia]. MIKROBIYOL BUL 2003; 37:247-53. [PMID: 14748261] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
The aim of this study was to investigate the IgG and IgM antibody positivities against atypical pneumonia agents in patients with community-acquired pneumonia (CAP), and to compare the results with the controls. The serum samples which were collected from 53 adult patients and 20 healthy donors have been investigated by a commercial indirect immunofluorescent assay (IFA, Pneumo-slide, Vircell SL, Spain) in which nine different antigens were fixed onto a slide. In both of the study groups. IgG and IgM seropositivities were detected in different rates against one or more etiologic agents. In the patient group. IgG and IgM positivity rates for the agents were as follows, respectively; 22.6% and 28.3% for Legionella pneumophila, 9.4% and 5.6% for Mycoplasma pneumoniae, 30.1% and 7.5% for Coxiella burnetii, 33.9% and 3.7% for Chlamydia pneumoniae, 28.3% and 0 for adenovirus, 71.6% and 1.8% for respiratory syncytial virus, 30.1% and 24.5% for influenza A virus, 35.8% and 7.5% for influenza B virus, 71.6% and 1.8% for parainfluenza viruses type 1-3. The rates of IgG positivities in the control group varied between 5-55% for all of the agents except M. pneumoniae and 3 of these controls were positive for L. pneumophila IgM, 3 were positive for C. pneumoniae IgM and one was positive for influenza A virus IgM. According to the statistical evaluation, there were no significant differences for IgM seropositivities to any of the agents, between the patient and control groups (p > 0.05). These results could be attributed to one or more of the following; a) none of these microorganisms were the primary etiologic agents, b) IgM positivities were the result of reinfections with these agents, c) longer duration of IgM antibodies after the acute infections. In terms of IgG positivities between the patient and control groups, only C. burnetii showed statistically significant difference (p = 0.029). Since the type of the pathogens causing CAP are of crucial importance both for the epidemiological purposes and for planning the empirical treatment strategies, more detailed multicenter studies should be performed in our country.
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Affiliation(s)
- Murat Sayan
- Dokuz Eylül Universitesi Tip Fakültesi, Mikrobiyoloji ve Klinik Mikrobiyoloji Anabilim Dali, Izmir
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18
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Abstract
Lung uptake of intravenously injected Tc-99m-HMPAO is observed in smokers and in lung toxicity due to various agents. We investigated the Tc-99m-HMPAO uptake of bronchoalveolar lavage (BAL) cells in the lungs after incubation in in vitro conditions (6 patients), intravenous injection (IV) (7 patients) and inhalation (INH) (6 patients) of Tc-99m-HMPAO in order to show whether BAL cells are also responsible for Tc-99m-HMPAO uptake in the lungs. Cell/supernatant (C/S) count ratio was 7.0 +/- 3.5, 29.3 +/- 40.8 and 8.4 +/- 4.5 for in vitro, IV and INH groups, respectively. C/Sin vitro showed a positive correlation with % alveolar macrophages (r = 0.943, p = 0.0048) and a negative correlation with % neutrophils (r = -0.945, p = 0.0045). Cells/whole BAL fluid ratio correlated with the amount of daily cigarette consumption in INH group (r = 0.95, p = 0.0037). Tc-99m-HMPAO showed adherence to mucus after inhalation. Tc-99m-HMPAO diffuses into alveolar spaces after injection and is present in BAL fluid and BAL cells both after injection and inhalation. Glutathione concentration and oxido-reductive state of the epithelial lining fluid and BAL cells may influence the lung uptake of Tc-99m-HMPAO.
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Affiliation(s)
- Hatice Durak
- Department of Nuclear Medicine, Dokuz Eylül University School of Medicine, Inciralti, Izmir, Turkey.
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19
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Affiliation(s)
- A Yüce
- Department of Microbiology and Infectious Diseases, Dokuz Eylül University, Medical Faculty Incirati, 35340 Izmir, Turkey.
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20
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Yilmaz M, Capa G, Durak H, Degirmenci B, Evren I, Sayit E, Uçan ES. Clearance of Tc-99m DTPA aerosol in mismatched and matched pulmonary perfusion defects. Clin Nucl Med 2001; 26:109-13. [PMID: 11201465 DOI: 10.1097/00003072-200102000-00003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 11/26/2022]
Abstract
PURPOSE To evaluate clearance changes of Tc-99m DTPA aerosol in mismatched and matched pulmonary perfusion defects. MATERIALS AND METHODS Twenty-one patients (14 women, 7 men; mean age, 51 +/- 14 years) with possible pulmonary embolism were included in the study. On the day after perfusion (Q) scintigraphy with 5 mCi Tc-99m MAA, radioaerosol inhalation scintigraphy was performed using 45 mCi Tc-99m DTPA. Immediately and 45 minutes after the inhalation, early and delayed inhalation images (EI and DI, respectively) were obtained. Group 1 included 11 patients with mismatched defects who had a high probability of pulmonary embolism according to the Q/EI scan results. Group 2 included 10 patients with matched defects who had a low probability of PE. Contralateral normal lungs of 7 patients in group 2 served as controls (group 3). In groups 1 and 2, regions of interest were drawn over the mismatched and matched perfusion defects where they were best visualized, and this region of interest was mirrored to the same region on EI and DI images. For the control group, this was done in the contralateral normal lung. Mean counts in each region of interest were used for quantitative analysis, and the percentage clearance ratio was calculated using the following formula: early counts - late counts/early counts x 100. RESULTS The average percentage clearances for the three groups were as follows: group 1, 37% +/- 10%; group 2, 21% +/- 4%; group 3, 24% +/- 7%. Differences between groups 1 and 3 were significant, as were those between groups 1 and 2 (P < 0.05). Patients with mismatched perfusion defects had increased DTPA clearance compared with the control group and those with matched defects. CONCLUSIONS Vascular occlusion may lead to impairment of the alveolar-capillary barrier and consequently an increase in the clearance of Tc-99m DTPA aerosol in embolized regions. Immediately after inhalation, Tc-99m DTPA imaging should be started in the projection where perfusion defects are best seen to avoid potential misinterpretation of pulmonary embolism.
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Affiliation(s)
- M Yilmaz
- Department of Nuclear Medicine, Dokuz Eylul University, School of Medicine, Izmir, Turkey.
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21
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Abstract
Water-pipe smoking is a type of smoking habit, widely encountered in Turkey and Arabic and Middle East countries. However there is limited data about the effects of water-pipe smoking. The aim of this study is to investigate this habit with regard to the duration and amount of smoking and to analyse its characteristics and effects on pulmonary function by the correlation of the results with those of cigarette smokers and non-smokers. All cafés in Izmir city were visited for this purpose. A total of 397 males were studied in four groups: water-pipe smokers, water-pipe smokers who used to smoke cigarettes, active cigarette smokers and non-smokers. After recording a detailed history of smoking, pulmonary function tests on each person were performed. There were statistically significant differences between cigarette smokers and non-smokers within most of the parameters. The results of recent study have shown that the detrimental effects on pulmonary function of water-pipe smoking are not as great as cigarette smoking (FEV1, FEV1/FVC parameters were higher in water-pipe smokers), especially on the parameters for small airways (FEF50, MMEF parameters were higher in water-pipe smokers) (P < 0.05). It is difficult to explain the reasons exactly without estimating possible mechanisms in detail, but the most likely mechanisms arise from the smoking technique itself which involves a water filter and a long spout through which the smoke passes before reaching the lungs.
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Affiliation(s)
- G Kiter
- Dokuz Eylül University Hospital, Chest Department, Izmir, Turkey.
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22
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Yeniçerioglu Y, Sapak Sahin S, Capa G, Abadoglu O, Camsan T, Altan R, Başar M, Durak H, Uçan ES. Effects of haemodialysis on pulmonary clearance of Tc-99m diethylene triamine pentaacetate (DTPA). Scand J Urol Nephrol 2000; 34:126-30. [PMID: 10903075 DOI: 10.1080/003655900750016751] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
OBJECTIVES Hypoxaemia occurring during haemodialysis has long been known. Several mechanisms in the pathogenesis have been proposed. The present study was conducted to test whether changes in pulmonary alveolar permeability were among the operating mechanisms. MATERIALS AND METHODS Twenty haemodialysis patients (12 male, 8 female) were included in the study. The mean age was 49 years (age range: 18-85 years). Patients with known pulmonary disease, current smokers and those gaining more than 1 kg weight during the interdialytic period were excluded. Complete blood count, arterial blood gas analysis, pulmonary function tests and Tc-99m diethylene triamine pentaacetate (DTPA) inhalation scintiscan were carried out before and after haemodialysis. A bronchial provocation test was carried out after each session. A postero-anterior chest radiogram was taken for each patient. RESULTS When the results before and after haemodialysis were compared, it was observed that the pH and serum bicarbonate levels, haemoglobin and haematocrit values were significantly higher after haemodialysis. However, the platelet count was found to be decreased significantly. Bronchial hyperreactivity, tested by metacholine, Was positive in 5 of 19 patients (26%). No correlation between bronchial hyperreactivity and other factors could be identified. No significant difference was observed in pulmonary Tc-99m DTPA clearance after haemodialysis. All chest radiograms were interpreted to be within normal limits. CONCLUSIONS Since we observed no hypoxaemia following haemodialysis, we cannot comment as to whether the changes in pulmonary clearance play a role in the pathogenesis of haemodialysis-associated hypoxaemia. In order to reach reliable conclusions, additional studies are needed.
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Affiliation(s)
- Y Yeniçerioglu
- Department of Internal Medicine, Dokuz Eylül University Hospital, Izmir, Türkiye
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Açikel Ü, Silistreli E, Özelsancak N, Karabay Ö, Uçan ES, Hazan E, Oto Ö. Postpneumonectomy Bronchopleural Fistula Formation and Surgical Management. Asian Cardiovasc Thorac Ann 1999. [DOI: 10.1177/021849239900700113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Bronchopleural fistulas and empyema are the most challenging problems after lung resection. We reviewed 4 cases of successful surgical treatment of postpneumonectomy bronchopleural fistulas. Three of the patients had empyema. Primary suturing and pleural decortication were performed in one patient, decortication and fistula repair with additional omentopexy were carried out in the other 3 patients. Recurrence in one patient was successfully treated by thoracoplasty; the others have had no recurrence on follow-up. We recommend aggressive surgical intervention as the most effective treatment for bronchopleural fistula and empyema after pulmonary resection.
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Affiliation(s)
| | | | | | | | - Eyüp Sabri Uçan
- Department of Pulmonary Medicine Dokuz Eylul University School of Medicine İzmir, Turkey
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24
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Abadoğlu O, Osma E, Uçan ES, Cavdar C, Akkoç N, Küpelïoğlu A, Akbaylar H. Behçet's disease with pulmonary involvement, superior vena cava syndrome, chyloptysis and chylous ascites. Respir Med 1996; 90:429-31. [PMID: 8796237 DOI: 10.1016/s0954-6111(96)90118-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.3] [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] [Indexed: 02/02/2023]
Abstract
Behçet's disease is a chronic multisystem vasculitis of unknown aetiology. This case report describes a patient who applied to the hospital because of dyspnoea, ascites, oedema of lower extremities and recurrent episodes of haemoptysis. For the last 12 yr, he had superior vena cava syndrome (SVCS) and cardiac and pulmonary involvement of Behçet's disease, and biochemical examination of ascite fluid yielded a chylous effusion containing triglyceride 421 mg dl-1 and cholesterol 49 mg dl-1. Chyloptysis was also detected by Sudan III stain. The patient died from cardiac tamponade in spite of cardiac fenestration. To the authors' knowledge, this is the first reported case of Behçet's disease with chylous ascites and chyloptysis in the English literature.
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Affiliation(s)
- O Abadoğlu
- Chest Disease Department, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
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25
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Uçan ES, Tahaoglu K, Mogolkoc N, Dereli S, Basozdemir N, Basok O, Turktas H, Akkoclu A, Ates M. Turban pin aspiration syndrome: a new form of foreign body aspiration. Respir Med 1996; 90:427-8. [PMID: 8796236 DOI: 10.1016/s0954-6111(96)90117-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- E S Uçan
- Chest Disease Department, Medicine Faculties of Dokuz Eylül, University, Izmir, Turkey
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26
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Hatipoğlu ON, Osma E, Manisali M, Uçan ES, Balci P, Akkoçlu A, Akpinar O, Karlikaya C, Yüksel C. High resolution computed tomographic findings in pulmonary tuberculosis. Thorax 1996; 51:397-402. [PMID: 8733492 PMCID: PMC1090675 DOI: 10.1136/thx.51.4.397] [Citation(s) in RCA: 115] [Impact Index Per Article: 4.1] [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: 02/01/2023]
Abstract
BACKGROUND Although chest radiographs usually provide adequate information for the diagnosis of active pulmonary tuberculosis, minimal exudative tuberculosis can be overlooked on standard chest radiographs. The aim of the present study was to assess the findings of active pulmonary tuberculosis on high resolution computed tomographic (HRCT) scans, and to evaluate their possible use in determining disease activity. METHODS Thirty two patients with newly diagnosed active pulmonary tuberculosis and 34 patients with inactive pulmonary tuberculosis were examined. The diagnosis of active pulmonary tuberculosis was based on positive acid fast bacilli in sputum and bronchial washing smears or cultures and/or changes on serial radiographs obtained during treatment. RESULTS With HRCT scanning centrilobular lesions (n = 29), "tree-in-bud" appearance (n = 23), and macronodules 5-8 mm in diameter (n = 22) were most commonly seen in cases of active pulmonary tuberculosis. HRCT scans showed fibrotic lesions (n = 34), distortion of bronchovascular structures (n = 32), emphysema (n = 28), and bronchiectasis (n = 24) in patients with inactive tuberculosis. CONCLUSIONS Centrilobular densities in and around the small airways and "tree-in-bud" appearances were the most characteristic CT features of disease activity. HRCT scanning clearly differentiated old fibrotic lesions from new active lesions and demonstrated early bronchogenic spread. These findings may be of value in decisions on treatment.
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Affiliation(s)
- O N Hatipoğlu
- Chest Department, Dokuz Eylül University, Inciralti, Izmir, Turkey
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27
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Affiliation(s)
- N Olgun
- Department of Paediatrics, Faculty of Medicine, Dokuz Eylul University, Inciralti, Izmir, Turkey
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