Search

Objective To investigate the factors affecting compliance with positive airway pressure (PAP) therapy and establish the relationship between compliance and pulmonary function tests (PFT) in patients with OSA. Material and methods In this prospective study, patients with OSA using PAP devices were questioned about the complaints related to the device. Depression and anxiety scales along with PFT parameters were also assessed. Results Of 98 participants, 63% were men. The mean age was 52.0 +/- 9.6 years. Sixty-seven percent of the patients were compliant with their devices. A significant difference was observed between the proportion of the participants compliant or non-compliant with the device, based on OSA severity (p < 0.05). Beck depression inventory (BDI) and Beck anxiety inventory (BAI) scores of the compliant patients were significantly lower than those of the non-compliant patients (p < 0.001, p = 0.044, respectively). No statistically significant difference was detected between the groups regarding individual pulmonary function tests (p > 0.05). The rates of nasal mask use, not having difficulty in tolerating CPAP, falling asleep, absence of abdominal distension, no facial sores, no air leakage, patients benefiting from the device, reduction in daytime sleepiness, and the belief that they are receiving appropriate therapy in participants compliant with the device were higher than those in non-compliant participants (p < 0.05). The rates of claustrophobia and discomfort due to pressure were significantly lower in patients compliant with the device than in the non-compliant patients (p < 0.05). Conclusion While no relationship was detected between PFT parameters and PAP therapy compliance, significant factors affecting the device compliance were detected. WOS:000679638200001 2-s2.0-85111554942 PubMed: 34328605

OBJECTIVE: We aimed to evaluate the perspective of the Turkish Thoracic Society (TTS) members regarding institutional preparedness, in terms of administrative measures and availability of personal protective equipment (PPE), in the first and third months of the coronavirus disease 2019 (COVID-19) pandemic in Turkey. MATERIAL AND METHODS: A 22-item online survey was e-mailed between the first and third months to TTS members, and participants’ responses were evaluated. RESULTS: The number of participants was 295 in the first survey and 141 in the second. In the second survey, the percentage of answers implying availability increased in all 18 control measures, 16 of which were statistically significant. However, there were still less than half of the respondents who reported the availability of psychological and behavioral support and some PPE, including respirators, facial protectors, goggles, and gowns. Statistical significance was observed for provision of a waiting area (P = .008), rooms for aerosol-gener-ating procedures (P = .042), and special wards for patients with suspected or definite COVID-19 (P < .001);testing healthcare workers (HCWs) with a history of contact with a COVID-19 case (P < .001);and surveillance of symptomatic HCWs (P = .048), between tertiary vs. primary and secondary healthcare facilities in the first survey, but provision of special wards (P = .002) and supply for aprons (P = .027) in the second survey. CONCLUSION: Our results showed an improvement in control measures in the third month of the pandemic. However, the persistent low availability of psychological and behavioral support and several items of PPE pointed out the need for action. Considering the health and safety of HCWs, the control measures should be actively monitored and deficiencies eliminated. ©Copyright 2021 by Turkish Thoracic Society-Available online at www.turkthoracj.org.

SUMMARY OBJECTIVE: This study aimed to evaluate the data of Turkish health care workers practicing chest medicine on their coronavirus disease 2019 (COVID-19) status and related parameters. METHODS: This descriptive study included online survey data that the Turkish Thoracic Society conducted with its members in two phases starting in June and December 2020. The 33-item survey included demographic data, smoking status, the presence of any chronic diseases, occupation, working status, and non–work-related and work-related COVID-19 exposure characteristics. RESULTS: Of 742 responses, 299 (40.3%) reported that they had contracted COVID-19. The second survey detected a higher frequency of health care workers who had contracted COVID-19 (12.1% versus 57.4%, p

WOS: 000518179400017 PubMed: 32158320 Objective: The aim of this study was to investigate the relationship between bacteriological case definitions and indoor and outdoor air quality parameters in tuberculosis (TB). Materials and Methods: A total of 200 patients with TB diagnosed and treated in our hospital during 2012-2018 were included to this study. The air monitoring measurement parameters of the National Air Quality Network [particulate matter 10 (PM10), sulfur dioxide (SO2), air temperature, air pressure, and relative humidity] for the same time period were obtained from the web page http://laboratory.cevre.gov.tr/Default. ltr.aspx. Results: Of the 200 patients, 62.5% (125) were males and 37.5% (75) were females. The rate of diagnosis based on culture and smear positivity was 48.4% (31), which was significantly higher than that in the clinic [10.9% (7)] among patients who used stove for warming. The rate of diagnosis based on culture and smear positivity [52.1% (25)] was significantly higher than that in the clinic [8.3% (4)] among patients who were exposed to biomass. The univariate analysis revealed no significant independent effect of warming and biomass use on case definition. According to the case definitions, the mean values of PM10, SO2, and temperature in the diagnosed month showed no statistically significant difference. The humidity level in the month was significantly higher, during which cases diagnosed using smear and culture positivity were compared with cases diagnosed using only culture positivity (p=0.023). Conclusion: This study indicates that biomass used as a cooking fuel is a risk factor for pulmonary TB, implying that TB occurrence can be reduced significantly by lowering or preventing the exposure to cooking smoke emitted from biomass fuel.

European-Respiratory-Society (ERS) International Congress -- SEP 28-OCT 02, 2019 -- Madrid, SPAIN WOS: 000507372407393 … European Respiratory Soc

PubMed ID: 32144590 Objective: This study aimed to determine the association between the severity of obstructive sleep apnea (OSA) and serum Clara cell protein (CC16) levels in non-smoking patients with OSA. Methods: This prospective study included non-smoking patients who presented with sleep-related disturbances and underwent polysomnography (PSG). The serum CC16 level was measured and its relationship to PSG parameters was investigated. Results: The study included 128 patients (83 men) with a mean age of 48.4 ± 11.9. OSA was detected in 66 men (70%) and 29 women (30%) (p = 0.051). The severity of OSA was mild in 32 (25%), moderate in 28 (22%), and severe in 35 (27%) of the patients. There was no significant difference in CC16 levels between the OSA group (1746 ± 1006) and the OSA negative group (1721 ± 1201, p = 0.91) levels. There was no significant difference between the CC16 levels of the each four groups. Mean serum CC16 levels were significantly lower in OSA negative men than OSA positive men (777 vs 1462, p = 0.005). No significant difference was observed in CC16 values according to OSA severity in women. Conclusion: The serum CC16 level does not differ between non-smoking OSA patients and OSA negative patients. © 2020, Springer Nature Switzerland AG.

FIRAT, ibrahim Hikmet/0000-0003-2594-4887 WOS: 000463467200004 PubMed: 30958982 OBJECTIVES: The most common chemical substances used as mass control agents are chloroacetophenone, chlorobenzylidene malononitrile, and oleoresin capsicum. These agents not only have local and rapid effects but also have systemic and long-term effects. The aim of the present study was to discuss the patterns of tear gas exposure and to investigate its effects on respiratory functions. MATERIALS AND METHODS: A face-to-face survey was conducted in 86 individuals who had been exposed to tear gas indoor and outdoor during the public protests in June 2013. RESULTS: The most frequently reported respiratory complaints included cough, dyspnea, phlegm, and chest pain. Spirometry measurements including forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) were also performed. Indoor exposers have lower mean % predicted FVC and FEV1 values than outdoor exposers. All complaints and signs were more common in indoor exposure to tear gas than in outdoor exposure. CONCLUSION: Safety of the chemicals used as mass control agents during protests is doubtful as these agents are associated with several health risks.

Akgun, Metin/0000-0003-3404-4274 WOS: 000506838600006 PubMed: 31584386 OBJECTIVES: It is considered that occupational exposure accounts for up to 25% of all cases of adult asthma. We need detailed individual-level data regarding the relationship between asthma, occupation, and work-related symptoms in Turkey to inform policies on workplace safety. This study aimed to investigate the association between asthma symptoms, occupation type, and workplace exposure in patients with asthma. MATERIALS AND METHODS: In this cross-sectional multicenter study, adult patients with asthma were investigated by a questionnaire in terms of relationship between asthma symptoms and workplace exposure. The study population was adult patients who had been diagnosed with asthma for at least six months prior to study and who were under follow-up in Ankara, Istanbul, Erzurum, Duzce, Trabzon, Denizli, and Diyarbakir. RESULTS: The mean age of the 345 cases (188 females) was 41 +/- 13 years. The majority of the patients (36.8%) were "housewives"; other common occupations were office workers (6.7%), textile workers (4%), students (3.8%), hospital staff (3.5%), and cleaners (2.9%). Thirty-five percent of patients described worsening of asthma during working periods. Among patients with a history of increased symptoms in workplace, 100 (83%) developed asthma after starting work, while 20 patients (17%) had pre-existing asthma. Half of the patients described workplace exposure to dust, fume, and gases. Exposure to cleaning supplies at home was present in 43% of the subjects. Of all housewives, 12% (n=15) described an increase in their asthma symptoms during housework. The frequency of bleach or hydrochloric acid use alone among housewives was 60% and 34%, which was significantly higher than other occupations. The FEV1/FVC ratio of housewives who frequently used hydrochloric acid (FEV1/FVC=71.5) was lower than that of non-users (FEV1/FVC=74.9) (p=0.024). CONCLUSION: Patients with asthma experience significant workplace exposures that exacerbate their symptoms. Housewives experience significant exposure that triggers allergic and asthma symptoms. It is important to raise awareness about the prevalence and risks of occupational (including in-home) exposures in asthmatics patients and physicians to minimize asthma triggers and exacerbations.

Introduction: Pulmonary function tests (PFTs) and blood checks are performed by mobile scanning devices during workplace periodic checks. It should be applied with appropriate technique and quality to evaluate the PFT. There is no data in our country about the periodical PFT being made with proper technique and quality. From this point, in this study we aimed to evaluate the technical competence of the PFTS. Methods: The periodic PFTs which were performed with service procurement in different workplaces between 2016-2017 were evaluated with a cross-sectional study.PFTs were evaluated according to the American Association of Occupational and Environmental Medicine (ACOEM) criteria; Can current volume curve be accepted? Is there an incomplete inspiration maneuver in the current volume curve? Did the person make expiration in the test? The commentary in the PRTs report and interpretation of 4 different pulmonologists participating in the study was recorded. Results: A total of 346 PFTs report of 336 (97%) male with a mean age of 34 ± 7 were evaluated. The current volume curve could be accepted in 39%, incomplete inspiratory maneuver in 61%, complete expiration maneuver in 18%, early cut of expiration in 55% ere recorded. The interpretation on the PFTs report was normal in 61% and restrictive in 33%. On the other hand, the comment of the 4 researchers: normal PFTs in 21%and 71% PFTs was determined to be repeated Discussion: During the periodic workplace screenings an importance should be given to the PFTs. The PFTs should be repeated with appropriate technique if necessary. The periodic training of the testers is also important.

WOS: 000435396300006 PubMed: 30020040 Introduction: Welding produces miscellaneous gases and particles that has various impact on respiratory system and long term exposure may result "welders'lung". The aim of this study is to describe the radiological findings of welders' and make an awereness for welders radilogical findings. Materials and Methods: The clinical and radiological findings of welders' who had hospital applications with respiratory symptoms between January 2010-January 2017 were evaluated retrospectively. Results: A total of 16 male welders with mean age 37 +/- 8 years had the mean duration of welding occupation 12 +/- 7 years. The most common symptoms were coughing (87%), sputum production (63%) and dyspnoea (63%). Thirteen welders were working in shipyards and 3 in construction business and other workplaces. Three (19%) patients had rhonchi on physical examination and these patients had decreased FEV1/FVC values below 70% on spirometry. Poorly-defined centrilobular micronodules that were not clearly visible on chest radiographs observed on thorax high resolution computed tomography. Bronchoscopy was performed to 7 patients. Iron-positive pigment granules and ferruginous bodies were revealed in 3 patients' bronchoalveolar lavage. Conclusion: Welders' chest X-ray deserve a closer look. In pulmonary radiology, there may be radiographical findings ranging from small ill defined nodules to groundglass opacites. Physcians should look more careful to welders' chest X-ray and incase of suspicious findings best can be detected on high HRCT. An awareness for the radiological findings will also reduce interventional procedures in these patients hereby, occupational history must be included in daily practice of physicians.

Birsen Ocakli,1 Ipek Ozmen,1 Eylem Acartürk Tunçay,1 Sinem Gungor,1 Hilal Altinoz,1 Nalan Adiguzel,1 Zafer Ali Sak,2 Gokay Gungor,1 Zuhal Karakurt,1 Peri Arbak3 1University of Health Sciences, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey; 2Department of Chest Diseases, Harran University, Faculty of Medicine, Sanliurfa, Turkey; 3Department of Chest Diseases, Duzce University, Faculty of Medicine, Duzce, Turkey Purpose: This study was designed to evaluate errors in inhaler technique in COPD vs asthma patients and to investigate the association of poor inhaler technique with patient demographics and clinical variables. Patients and methods: A total of 509 adult patients with COPD (n=328) or asthma (n=181) who were currently using an inhaler device were included in this study. Data on patient demographics, duration of disease, type and duration of inhaler therapy, and assessment of inhaler technique were recorded. Results: Metered dose inhaler (MDI) was the most common type of inhaler used by a similarly high percentage of patients in both COPD (83.2%) and asthma (77.3%) groups. Failure to exhale before inhaling through device (75.8% and 68.5% for MDIs; 73.2% and 71.8% for Aerolizer®/Handihaler®; 53.1% and 66.7% for Turbuhaler®) was the most common error in inhaler technique, in both COPD and asthma groups. Device-specific errors in inhaler techniques were more common in asthma patients as compared with COPD patients, particularly for MDIs (P-values ranged from 0.046 to 0.0005), as associated with female gender (failure to press the buttons on both sides of Aerolizer®/Handihaler®, P=0.006), shorter duration of disease (failure to hold MDI or head in a vertical position, P

Introduction: The effects of pesticide application on the health of the individuals living in the same environment should be considered as a public health problem.Objective: We aimed to compare respiratory complaints and respiratory functions of people living in agricultural areas, before and after pesticide application which cause air pollution. Materials and Methods: Two hundred and fifty two individuals (144 women, 108 men) living in Sanliurfa Province in Turkey (widespread cotton farming area) were asked about respiratory and systemic complaints, lung function tests were applied. After administration of pesticide, 66 individuals were examined. PM2.5 (μgr / m3) and PM10 (μgr / m3) were measured. Results: The mean values of PM2.5 (7.9 μg / m3 and 13.0 μg / m3, p Conclusion: Pesticide administration leads to decrease in respiratory function and increase in respiratory complaints of adults living in the area.

Introduction: It has been well known that occupational exposure to aluminium leads to smelter asthma and pneumoconiosis. Epidemiological studies are needed to search the exposure conditions and duration. Scope: It is aimed to investigate the type of respiratory involvement. Materials and Methods: Male aluminium foundry workers living in Adapazari district (42 male, mean age: 32.2 ± 6.9 years) compared with 33 male controls without exposure (mean age: 30.0 ± 7.9 years). Mean urine aluminium levels of workers (10.7 ± 8.8 mcg/lt) were significantly higher than those of controls (2.2 ± 0.8, p Conclusion: Mean occupational aluminium exposure of 5 years leads a significant deterioration of workers respiratory health, pulmonary funcions and radiology. Preventive measures should be taken in aluminium foundry sector.

Aim. This study aimed to assess the long-term respiratory effects of tear gases among the subjects with history of frequent exposure.Materials and Methods. A questionnaire by NIOSH and pulmonary function tests was performed in 93 males exposed to the tear gases frequently and 55 nonexposed subjects.Results. The mean numbers of total exposure and last 2 years exposure were8.4±6.4times,5.6±5.8times, respectively. Tear gas exposed subjects were presented with a higher rate for cough and phlegm more than 3 months (24.7% versus 11.3%,P>0.05). Mean FEV1/FVC and % predicted MMFR in smoker exposed subjects are significantly lower than those in smoker controls (81.7% versus 84.1%,P=0.046and 89.9% versus 109.6%,P=0.0004, resp.). % predicted MMFR in nonsmoker exposed subjects is significantly lower than that in nonsmoker controls (99.4% versus 113.1%,P=0.05). Odds ratios for chest tightness, exercise dyspnea, dyspnea on level ground, winter morning cough, phlegm, and daily phlegm were increased almost 2 to 2.5 folds among tear gas exposed subjects.Conclusion. The rates for respiratory complaints were high in the case of the exposure to the tear gases previously. Tears gas exposed subjects were found to be under the risk for chronic bronchitis.

Balbay, Ege Gulec/0000-0002-1557-7019 WOS: 000390329600037 PubMed: 28083054 Objective: To determine whether the workers' periodic chest x-ray screening techniques in accordance with the quality standards is the responsibility of physicians. Evaluation of differences of interpretations by physicians in different levels of education and the importance of standardization of interpretation. Methods: Previously taken chest radiographs of 400 workers who are working in a factory producing the glass run channels were evaluated according to technical and quality standards by three observers (pulmonologist, radiologist, pulmonologist assistant). There was a perfect concordance between radiologist and pulmonologist for the underpenetrated films. Whereas there was perfect concordance between pulmonologist and pulmonologist assistant for over penetrated films. Results: Pulmonologist (52%) has interpreted the dose of the films as regular more than other observers (radiologist; 44.3%, pulmonologist assistant; 30.4%). The frequency of interpretation of the films as taken in inspiratory phase by the pulmonologist (81.7%) was less than other observers (radiologist; 92.1%, pulmonologist assistant; 92.6%). The rate of the pulmonologist (53.5%) was higher than the other observers (radiologist; 44.6%, pulmonologist assistant; 41.8%) for the assessment of the positioning of the patients as symmetrical. Pulmonologist assistant (15.3%) was the one who most commonly reported the parenchymal findings (radiologist; 2.2%, pulmonologist; 12.9%). Conclusion: It is necessary to reorganize the technical standards and exposure procedures for improving the quality of the chest radiographs. The reappraisal of all interpreters and continuous training of technicians is required.

In this study, we aimed to investigate the respiratory symptoms of miners who were survivors from Soma mine disaster at 2014. 90 survivors from Soma mine disaster that caused 302 death were invited to include the study by telephone. 39 miners were accepted to include study. Chest radiography, pulmonary function test, and ATS-DLD 78 respiraory questionnaire including socialdemographic findings were applied to all 39 miners. Chest radiography of miners were evaluated in accordance with ILO standards by 3 certificated readers. All miners were male and mean age was 35,3±6,2 years. Mean FEV1 % and FVC % were 89,2% (54%-124%) and 88,4% (45%-124%) respectively. Cough, sputum, wheezing, and dyspnea were seen in 17 (43,6%), 16 (41%), 13 (33,3%), and 18 (46,6%) miners respectively. 5 miners had COPD and 4 miners had asthma diagnosis. 23 (59%) miners were exposed severe dust more than 1 years. 32 (82,1%) miners also had smoking history and 23 of them were current smoker. There was no relation with duration of work and presence of symptoms (p>0,05). Also there was relation with duration of work and pulmonary function tests (p>0,05). After chest radiography evaluation, 12 (30,8%) of miners were considered to have pneumoconiosis by all 3 experienced readers. There was no relation with presence of pneumoconiosis findings and duration of work and presence of symptoms (p>0,05). In conclusion, half of the patients had respiratory symptoms and one third of them has pneumoconiosis findings at chest radiography.

Immunomodulatory drugs and TNF-alpha inhibitors paradoxically can lead to interstitial lung abnormalities in some cases. 40 consecutive patients were questioned and changes in chest X-ray taken in the last 4 years have been evaluated. 40 of the patients were male. The mean age was 49.5±11.7 years. The rate of patients with ankylosing spondylitis, rheumatoid arthritis and psoriasis was 50%, 35% and 15%, respectively. Average years of disease were 11.4 ± 8.9 years. The rate of infliximab, etanercept, adalimumab and golimumab presciribed to patients was 47.5%, 32.5%, 12.5%, 32.5% and 12.5% and 7.5%, respectively. According to the order of frequency of past treatment of patients, the rate with sulfasalazine, non-steroidal anti-inflammatory drugs, methotrexate, steroids, hydroxychloroquine, azathioprine, and colchicine was 2.5%. 75%, 57.5%, 30%, 27.5%, 15%, 2.5%, respectively. The use of methotrexate in combination with inhibitors of TNF-alpha was 25%. There were parenchymal abnormalities in 44.8% of patients used sulfasalazine in their first X-ray (10% of those using abnormal, p = 0.50). There was significantly more abnormal parenchymal findings in patients using methotrexate in their third radiography (85.79y% to 30.8%, p = 0.041). The mediastinal pathology detected in the first radiographic examination of patients with hydroxychloroquine and non-hydroxychloroquine users was 50% (3/6) and 9.1% (3/33), respectively (p = 0.036). Similarly, it was 20% (2/10) and 0% in methotrexate (p = 0.045). The possible chest X-ray abnormalities may develop in patients treated with immunomodulatory and underlying disease must be carefully examined.

Yavuz, Özlem (Balikesir Author), Aim. Previous studies have shown a higher sensitization rate to hazelnut in processing workers but no relation was found between the respiratory symptoms in workplace and hazelnut sensitization. Material and Method. To evaluate the association between the hazelnut sensitization and workplace-related respiratory complaints, hazelnut processing workers had undergone a questionnaire included work-related respiratory symptoms, smoking history, pulmonary function testing, and measurement of serum IgE antibodies against hazelnut. Results. This study consisted of 88 hazelnut processing workers (79 females and 9 males), aged 14-59 years (Mean +/- SD: 33.8 +/- 10.5 years). The mean working duration was 38.8 +/- 36.6 months (min: 1-max: 180). Specific IgE against hazelnut allergens was positive in 14 of cases (17.1%). There was no significant difference between the cases with and without specific IgE against hazelnut allergens regarding respiratory symptoms, history of allergy, smoking status and spirometric values. Conclusion. 17.1% of the hazelnut processing workers were seropositive against hazelnut. Being sensitized to hazelnut was not found to be associated with work-related respiratory symptoms in this study. Further studies are needed in hazelnut workers respiratory health to search topics other than asthma.

Free radical-mediated injury to lung and pulmonary vasculature is an important mechanism in hypoxia-induced lung damage. In this study, we aimed to investigate the potential protective effects of erdosteine as an antioxidant agent on hypobaric hypoxia-induced pulmonary hypertension. Adult male rats were assigned randomly to three groups. The first group of rats was exposed to hypobaric-hypoxia and the second group was treated with erdosteine (20mg/kg, daily) for 2 weeks, during which time they were in a hypoxic chamber. These groups were compared with normoxic controls. All rats were sacrificed after 2 weeks. The hypoxia-induced increase in right ventricle to left ventricle plus septum weight ratio (from 0.20+/-0.01 to 0.26+/-0.01) was reduced significantly in the erdosteine-treated group (0.23+/-0.01). Malondialdehyde levels were elevated (from 0.33+/-0.11 to 0.59+/-0.02) and total antioxidant status was not changed significantly (from 1.77+/-0.42 to 2.61+/-0.23) by hypoxia. In contrast to the hypoxia-exposed group, malondialdehyde levels were significantly decreased in the erdosteine-treated group (0.37+/-0.02). Total antioxidant status (4.03+/-0.22) was significantly higher in erdosteine-treated rats when compared to non-treated rats. Histopathological examination demonstrated that erdosteine prevented inflammation and protected lung parenchyma and pulmonary endothelium of hypoxia-exposed rats.

Background and objectives Adverse respiratory reactions have been reported with intravascular radiographic contrast media. The aim of the present study is to assess the effects of iohexol on pulmonary functions in patients undergoing diagnostic coronary angiography (CA). Materials and methods: 30 patients enrolled in the study. The respiratory functions of the patients were measured at three different stages during angiography (before, immediately after and 2 h later) and arterial blood gas analyses were performed at six stages during CA (before, immediately after the insertion of angiography catheter, 2 min after the injection of contrast agent, at the end of angiography, an hour and 2 h after angiography). A single, experienced angiographer performed the angiography procedures via radial artery route. Totally six multiple angled views of the left and right coronary arteries were recorded in all patients by hand injection. None of the patients were performed ventriculography. Results: Angiography caused significant reduction in forced expiratory volume in 1 sec [FEV1] (from 103 ± 15 to 95 ± 17, p < 0.01), forced vital capacity [FVC] (from 99 ± 13 to 95 ± 18, p < 0.05) and maximum mid-expiratory flow rate [MMF] (from 95 ± 33 to 84 ± 29, p < 0.01) whereas there were no significant changes in the mean FEV1/FVC ratios at different stages of angiography. Statistically significant decrease in PaO2 (from 91 ± 10 to 85 ± 13 mmHg, p < 0.01) and arterial O2 saturation (from 97 ± 1% to 96 ± 1%, p < 0.01) were also observed. Data in present study showed a clinically insignificant but statistically significant restrictive impairment in pulmonary functions. Conclusions: Diagnostic CA using iohexol decreases ventilatory functions in a small but significant extent in patients without any overt pulmonary disease.

WOS:000223257800005 PubMed: 15308827 Serum Oxidant and Antioxidant Levels in Diesel Exposed Toll Collectors: Peri ARBAK, et al. Department of Chest Diseases, Abant Izzet Baysal University, Duzce School of Medicine, Turkey-it has been suggested that exposure to diesel exhaust may lead to adverse effects due to the generation of oxidants. To evaluate the end products of oxidative stress in DE exposure, toll collectors who are considered a high risk group in regard to occupational toxins were compared to controls who had office-based occupations in the same company in this cross sectional study. A total of 38 toll collectors constituted the study group. All subjects were male. The toll collectors and 29 controls were similar regarding age, smoking status and duration of work. All subjects underwent a clinical examination and an interviewer-administrated questionnaire regarding respiratory symptoms, past medical and occupational history, and pulmonary function tests were performed in all subjects. Serum malondialdehyde (MDA), nitrite+nitrate and vitamin E levels were measured. Toll collectors showed higher serum MDA (5.76 +/- 2.15 mumol/L vs. 3.07 +/- 0.76 mumol/L, p=0.0001) and nitrite+nitrate levels (96.50 +/- 45.54 mumol/L vs. 19.32 +/- 11.77 mumol/L, p=0.0001) than controls. Vitamin E levels were similar in toll collectors and controls (10.57 +/- 3.44 mg/L and 9.72 +/- 2.44 mg/L, respectively, p=0.267). There was no difference between groups in terms of the findings of clinical examinations and respiratory symptoms. In pulmonary function parameters, only peak expiratory flow (PEF) in toll collectors was significantly lower than that of controls (88.9% predicted and 104.2% predicted, respectively, p=0.012). In conclusion, we suggest that serum MDA and nitrite+nitrate levels may be used as biological markers of oxidative stress related to DE exposure, but prospective controlled clinical studies are necessary to clarify the possible association between concentrations of MDA and nitrite+nitrate and pulmonary diseases related to DE exposure.

Introduction: The aim of this study was to investigate the employment status and the relation between symptoms and workplace exposures in an adult population with asthma. Materials and methods: Asthma patients from seven tertiary chest diseases departments were included in the study and a face to face questionnaire related to occupation of the patients,duration of asthma and employement, relation between asthma symptoms and occupation was completed. Results: A total of 345 patients(54.2%female/45.8% male) with a mean age of 41.7±13.7 years were enrolled. The mean duration of asthma was 8.7±9.5 years where as mean duration of employement was 17.9±12.1years.Majority of the patients were housewives(40%),other common occupations were; office workers, textile workers, students,hospital staff, cleaners, farmers, teachers and drivers.The ratio of patients describing worsening of asthma during working period was 34.8%,additionally 23.2% reported improvement during holidays.Among the patients with a history of worsening of asthma during work,34.8% had a diagnosis of asthma before getting employed.However 83.3% stated that asthma symptoms started during the working period.Surprisingly 11.6% of the housewives defined relation between asthma symptoms and housework. Conclusion: About one third of the adult asthma patients attributed their asthma symptoms to the workplace.In the majority of this group asthma started after getting the job supporting a causality between asthma and occupation.These findings demonstrate the importance of occupation and occupational history and the impact of workplace exposures in assessment and treatment of asthma in our country.

Background: Clinical and epidemiological studies indicate that obstructive sleep apnea syndrome (OSAS) has a strong genetic basis. Objectives: To investigate the apolipoprotein E (APOE) alleles as a genetic risk factor in OSAS. Methods: A total of 73 patients (37 male) were included. All underwent full-night polysomnography and were evaluated for APOE alleles. Results: The mean age was 51 ± 12 years. Forty-two of the patients had OSAS. The APOE3 allele was found in 97.3% (71/73) of the study population. The most common APOE genotype was E3/E3 (55/73, 75.3%). Compared to the individuals with no APOE2 alleles (E3/E3, E3/E4), the individuals with at least one APOE2 allele (E2/E3, E2/E4) had a 9.37-fold greater OSAS risk (OR = 9.37, 95% CI 1.13-77.7, p = 0.019). The individuals with APOE2 alleles (E2/E3, E2/E4) compared to the individuals with only an E3/E3 allele genotype had a 10-fold greater OSAS risk (OR = 10.3, 95% CI 1.24-86.61, p = 0.0308). Compared to the individuals with no APOE4 alleles (E2/E3, E3/E3), the individuals with APOE4 alleles (E2/E4, E3/E4) had a high but insignificant risk for OSAS (OR = 2.9, 95% CI 0.55-15.05, p = 0.286). The individuals with APOE4 alleles (E2/E4, E3/E4) compared to APOE3 alleles (E3/E3) had an increased but insignificant risk for OSAS (OR = 3.62, 95% CI 0.96-19.05, p = 0.127). Conclusion: Specific APOE genotypes are associated with OSAS in a high-risk population.

Aim: Due to the scarcing data in Turkey, we examined the relationship between occupational exposures and respiratory diseases. Methods: The questionnaire -based data was collected in six industrial city centers of Turkey from six different geographical regions. The data included physician diagnosed COPD, asthma and allergic rhinitis (AR) and occupational exposures. Results: Data of the 10219 respondents were evaluated (mean age, 40.9±6.0 yrs). Current and past smoking was reported by 33.4% and 17.3%, respectively. Current working and current and past dust exposure were reported by 56.4%, 10.0% and 7.8%, respectively. Ever physician diagnosis of COPD, asthma and AR were reported by 2.8%, 5.9% and 5.9%, respectively. Any occupational exposure was significantly associated with COPD, asthma and AR after adjustments for other confounders . | | COPD | Asthma | AR | || | Any exposure | | | | | No | 1 | 1 | 1 | | Yes currently | 1.94 (1.38-2.74) | 1.68 (1.26-2.23) | 1.35 (1.005-1.81) | | Yes in the past | 1.86 (1.29-2.68) | 2.15 (1.64-2.81) | 1.85 (1.41-2.43) | | Never smoked | | | | | No | 1 | 1 | 1 | | Yes currently | 1.85 (0.88-3.89) | 1.79 (1.14-2.81) | 1.50 (0.90-2.47 | | Yes in the past | 1.74 (0.85-3.56) | 2.40 (1.60-3.59) | 2.26 (1.48-3.45) | | Ever smoker | | | | | No | 1 | 1 | 1 | | Yes currently | 2.08 (1.41-3.09) | 1.61 (1.12-2.33) | 1.30 (0.90-1.89) | | Yes in the past | 1.81 (1.18-2.78) | 1.99 (1.39-2.86) | 1.65 (1.16-2.36) | * Values are expressed as Odds Ratio and Confidence Interval Association between any occupational exposure and the diseases in the multivariate logistic regression models adjusting for age, gender, smoking status, family history of allergy and study site: Conclusion: Occupational exposures particularly in the past constitute a major risk for respiratory diseases in the adult population.

Objective: To evaluate the effects of losartan on blood pressure, erythrocytosis and the renin-angiotensin-aldosterone system (RAS) in patients with erythrocytosis and hypertensive chronic obstructive pulmonary disease (COPD).

WOS: 000343538700001, PubMed: 25105168, Background and Aim. It was observed that occupation and smoking increased each other's effects on the development of airway diseases. We aimed to search the relationship between respiratory symptoms, smoking, and occupation. Materials and Methods. 225 employees in Duzce, Turkey, were applied a survey questioning respiratory complaints, pulmonary function tests (PFTs) and cotinine measurements in urine. Results. Cough (26.7%), phlegm (30.7%), and chest tightness (21.3%) were encountered more in carpenters compared to other groups and phlegm was statistically higher at significant level compared to other groups. The complaints of cough (30.4%), phlegm (27.4%), and chest tightness (21.5%) were significantly higher in individuals whose cotinine level was above 500 ng/mL and forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) ratio, maximum midexpiratory flow rate (MMFR) values were significantly lower. Dyspnea complaint of auto painters whose cotinine level was below 500 ng/mL was significantly higher and also expected MMFR% value of this group was significantly lower compared to other groups. While age had independent effect on respiratory function tests, type of the job was found to be independently effective on MMFR. Conclusion. Smoking increases respiratory complaints of employees. In auto painters, the occupation causes airway disease regardless of smoking.

Annakkaya, Ali Nihat N/0000-0002-7661-8830; Balbay, Ege Gulec/0000-0002-1557-7019 WOS: 000347917900004 PubMed: 24914073 Objective: To investigate the prevalence of obstructive sleep apnoea syndrome in patients with primary open-angle glaucoma. Design: Case series. Setting: School of Medicine, Duzce University, Turkey. Patients: Twenty-one consecutive primary open-angle glaucoma patients (12 females and 9 males) who attended the out-patient clinic of the Department of Ophthalmology between July 2007 and February 2008 were included in this study. All patients underwent polysomnographic examination. Results: The prevalence of obstructive sleep apnoea syndrome was 33.3% in patients with primary open-angle glaucoma; the severity of the condition was mild in 14.3% and moderate in 19.0% of the subjects. The age (P = 0.047) and neck circumference (P = 0.024) in patients with obstructive sleep apnoea syndrome were significantly greater than those without the syndrome. Triceps skinfold thickness in glaucomatous obstructive sleep apnoea syndrome patients reached near significance versus those without the syndrome (P = 0.078). Snoring was observed in all glaucoma cases with obstructive sleep apnoea syndrome. The intra-ocular pressure of patients with primary open-angle glaucoma with obstructive sleep apnoea syndrome was significantly lower than those without obstructive sleep apnoea syndrome (P = 0.006 and P = 0.035 for the right and left eyes, respectively). There was no significant difference in the cup/disc ratio and visual acuity, except visual field defect, between primary open-angle glaucoma patients with and without obstructive sleep apnoea syndrome. Conclusions: Although it does not provide evidence for a cause-effect relationship, high prevalence of obstructive sleep apnoea syndrome in patients with primary open-angle glaucoma in this study suggests the need to explore the long-term results of coincidence, relationship, and cross-interaction of these two common disorders.

Sarkoidoz, idiyopatik granülomatöz bir hastalıktır. Genellikle akciğer tutulumu vardır. Tanısı, granülomatöz inflamasyonun bilinen diğer nedenlerinin dışlanması gerekliliği yüzünden zor olabilir. Çok merkezli çalışmamızda sarkoidozun klinik görünümleri ve tanısal yaklaşımlarının değerlendirilmesi amaçlandı. Çalışma protokolü internet üzerinden araştırmacılara gönderildi ve yeni tanı almış sarkoidoz olgularına ait bilgilerini göndermeleri istendi (klinik, radyolojik ve tanısal). İki yıl içinde 293 hasta verisi toplandı. Solunumsal yakınmalar, hastaların %73.3’ünde bulundu ve öksürük en sık yakınmaydı (%53.2), dispne (%40.3) ikinci sıklıktaydı. Konstitüsyonel yakınmalar hastaların yarısında görüldü. En sık olanı yorgunluktu (%38.6). En yaygın bulgu eritema nodozum (%17.1) idi. En sık akciğer radyogramı bulgusu bilateral hiler lenfadenomegali (%78.8) idi. Radyolojik evrelemede hastaların çoğunluğunun Evre I ve Evre II olduğu bulundu (sırasıyla %51.9 ve %31.7). Histolojik doğrulama 265 (%90.4) hastada gerçekleşmişti. Bronkoskopilerin üçte biri normal iken, mukozal hiperemi (%19.8) ve bronş duvarının dışarıdan basısı (%16.8) yaygın anormal bulgular idi. Sık kullanılan örnekleme yöntemleri arasında yer alan mediastinoskopide tanı başarısı %100 idi. En sık kullanılan tanı yöntemi olan transbronşiyal biyopsinin başarı oranı %48.8 idi. Sarkoidoza çok yönlü yaklaşım, sık ve seyrek rastlanan bulguları göz önünde bulundurularak ayırıcı tanı listelerinde yer alması, olası tutulmuş alanlara yönelik tanısal incelemelerin organizasyonu ve birarada çalışan ekip üyelerinin konunun uzmanı olması sayesinde iyileştirilir., Sarcoidosis is an idiopathic granulomatous disease. It usually affects the lung. The diagnosis may be problematic since the known causes of granulomatous inflammation must be excluded. This multicenter study aimed to evaluate the clinical presentations and diagnostic approaches of sarcoidosis. The study protocol was sent via internet, and the participants were asked to send the information (clinical, radiological and diagnostic) on newly diagnosed sarcoidosis cases. 293 patients were enrolled within two years. Pulmonary symptoms were found in 73.3% of the patients, and cough was the most common one (53.2%), followed by dyspnea (40.3%). Constitutional symptoms were occured in half of the patients. The most common one was fatigue (38.6%). The most common physical sign was eritema nodosum (17.1%). The most common chest radiograhical sign was bilateral hilar lymphadenomegaly (78.8%). Staging according to chest X-ray has revealed that most of the patients were in Stage I and Stage II (51.9% and 31.7%, respectively). Sarcoidosis was confirmed histopathologically in 265 (90.4%) patients. Although one-third of the bronchoscopy was revealed normal, mucosal hyperemi (19.8%) and external compression of the bronchial wall (16.8%) were common abnormal findings. The 100% success rate was obtained in mediastinoscopy among the frequently used sampling methods. Transbronchial biopsy was the most frequently used method with 48.8% success rate. Considering sarcoidosis with its most common and also rare findings in the differential diagnosis, organizing the related procedures according to the possibly effected areas, and the expertise of the team would favour multimodality diagnosis.

Coskun, Abdurrahman/0000-0002-1273-0604; Annakkaya, Ali Nihat N/0000-0002-7661-8830 WOS: 000266882200007 PubMed: 19494536 Objective: To investigate serum levels of CA 19.9, CA 125 and carcinoembryonic antigen (CEA) in patients with different stages of chronic obstructive pulmonary disease (COPD). Patients and Methods: Fifty-three consecutive patients (50 males, 3 females, mean age 67.6 +/- 10.1 years) with COPD were included in this study. Serum levels of CA 19.9, CA 25 and CEA were determined by the chemiluminescent immunometric method. Based on values obtained from pulmonary function tests, the patients were divided into 3 groups: moderate (21), severe (18) and very severe (14). Data were analyzed with a Kruskal-Wallis one-way analysis of variance test and Mann-Whitney U test. Results: The mean serum levels of CA 125 and CA 19.9 were significantly higher in patients with very severe COPD (p = 0.013 and p = 0.017, respectively) than in patients with severe and moderate COPD (p < 0.05). Patients with cor pulmonale had significantly high mean serum levels of CEA, CA 19.9 and CA 125 (p < 0.05). Patients using a long-acting beta-agonist and theophylline showed significantly higher mean serum levels of CA 125 than patients who were not (p < 0.05). Conclusion: Data showed that the increased serum tumor markers in patients with COPD might be due to the severity of COPD, medication and cor pulmonale. Copyright (c) 2009 S. Karger AG, Basel

Aims and backgroundTo evaluate the relationship between delayed diagnosis and the degree of invasion and survival in lung cancer.MethodsOne hundred and three patients (96 men) with lung cancer were included. Stages in the diagnosis of lung cancer were classified as follows: symptom-to-doctor interval, i.e., the interval from the first symptoms related to the presence of lung cancer to the first consultation with a medical professional; doctor-to-diagnosis interval, i.e., the interval between the first medical visit and confirmation of the diagnosis; and diagnosis-to-treatment interval, i.e., the interval between diagnosis and complete TNM staging and treatment. The symptom-to-treatment interval (STI) was the sum of the 3 intervals. The degree of invasion was determined by the TNM classification.ResultsThe patients were followed up for a mean period (± SD) of 7.4 ± 8.7 months. Seventy-six (74%) patients were diagnosed with non-small cell lung cancer (NSCLC) and 27 patients (26%) with small cell lung cancer (SCLC). The mean length of STI was 120 ± 101 days (median, 90). The mean length of the symptom-to-doctor interval was 63 ± 62 days (median, 45), while the doctor-to-diagnosis and diagnosis-to-treatment intervals were 41 ± 82 days (median, 10) and 16 ± 12 days (median, 12), respectively. When the STIs of the patients were correlated with tumor stage, tumor invasion, lymph node involvement and metastasis, no significant differences were found. Patients with an STI longer than 60 days had a significantly longer survival. Regarding the type of lung cancer and STI, the median survival was shorter in patients with an STI of less than 60 days both in NSCLC and SCLC, although this was not statistically significant in SCLC.ConclusionsThe shorter the diagnostic interval, the shorter was the median survival in our study. The reason for the apparent discrepancy between poor prognosis of lung cancer patients in spite of early diagnosis might be much faster progression of the disease itself.

Annakkaya, Ali Nihat N/0000-0002-7661-8830; BILGIN, CAHIT/0000-0003-2213-5881 WOS: 000243291500002 PubMed: 17078025 Purpose. To assess the effects of exposure to exhaust particles on intima-media thickness of the common carotid artery in highway toll collectors, Methods. Sixty-one highway toll collectors (HTCs) between 24 and 56 years of age (mean, 36.2 +/- 7.3) and 48 controls between 24 and 64 years of age (mean, 42.6 +/- 10.6) were evaluated with gray-scale sonography to measure intima-media thickness (IMT) of the common carotid artery (CCA). Subgroups were categorized according to duration of exhaust exposure and further divided according to tobacco use. Results. CCA IMT was higher (0.8 +/- 0.2 mm) in HTCs than in the control group (0.6 +/- 0.1 mm; p < 0.001) and remained higher when subgroups with similar smoking habits were compared. In HTCs, IMT was greater when the number of years working in tollbooths was greater (p = 0.023). IMT was lower in HTCs with an exposure duration of < 10 years compared with a duration of 10-20years (p = 0.017) or > 20years (p value not significant). Conclusion. Air pollution has a widely acknowledged negative effect on humans. This study confirms that exposure to exhaust particles might cause wall thickening of carotid arteries. (c) 2006 Wiley Periodicals, Inc.

WOS: 000230200400002 PubMed: 15899162 BACKGROUND AND OBJECTIVE: Sarcoidosis is a systemic granulomatous disease of unknown etiology. Aims of this prospective study are to evaluate degree of impairment in pulmonary function tests (PFT), arterial blood gas analysis (ABG), respiratory muscle strength, exercise capacity and correlation of these parameters with radiological stages; to further evaluate the use of cardiopulmonary exercise testing in assessment of extent of pulmonary disease; and to discuss the pathophysiologic mechanisms of limitation in exercise capacity in patients with sarcoidosis. PATIENTS AND METHOD: 29 patients with sarcoidosis were grouped according to their radiological stages (stage I: group 1; stage II, group 2; stage III, group 3). Group 1, 2 and 3 included 11, 13 and 5 patients, respectively. PFT, cardiopulmonary exercise testing and ABG were performed for each patient. RESULTS: Evaluation of all patients showed a significant decrement in exercise capacity. Patients in stage III had decreased diffusing capacity and exercise capacity. There was limitation in exercise capacity in stage I patients who had completely normal spirometry and diffusing capacity. We also found a correlation between radiological stages of the disease and exercise capacity, diffusing capacity and ABG. CONCLUSIONS: Exercise capacity is impaired also in early stages of sarcoidosis and it was found to be the earliest impaired physiological parameter in sarcoid patients. Exercise intolerance, having mutifactorial basis, is correlated with radiological stages. Circulatory impairment and impaired heart rate response to exercise have effects on limitation in exercise capacity. Especially in advanced radiological stages of disease, ventilatory and gas exchange impairment also seems to be effective on limiting exercise in patients with sarcoidosis.

WOS: 000224419300005 PubMed: 15363002 Objective: There have been controversial reports regarding the relationship between exercise tolerance and resting pulmonary function in patients with COPD. The aim of this study was to examine the relationship between resting pulmonary function tests (rPFT) and cardiopulmonary exercise testing parameters (CETP) and their value in estimating exercise tolerance of patients. Methodology: In total, 45 patients with COPD (nine females, 36 males; mean age 61.2 +/- 11.2) and 21 healthy subjects (four females, 17 males; mean age 60.3 +/- 9.7) as a control group were studied. COPD patients (group I) were divided into three subgroups according to their FEV1 (mild/group II: FEV1 60-79% of predicted; moderate/group III: FEV1 40-59%; severe/group IV. FEV1 < 40%). In controls FEV1 was greater than or equal to 80%. Results: There were significant correlations between FEV1 and CETP in group III (maximal O-2 consumption (mVO(2)), r = 0.35, P < 0.005; total treadmill time (TTT), r = 0.31, P < 0.01; total metabolic equivalent values (TMET), r = 0.29, P < 0. 01)) and in group IV (mVO(2), r = 0.49, P < 0.001; TTT, r = 0.45, P < 0.005; TMET, r = 0.31, P < 0.01; peak heart rate (pHR), r = 0.29, P < 0.02; frequency of ventricular extrasystole (fVES), r = -0.27, P < 0.05). Additionally, in group IV there were significant correlations between PaO2 and CETP (mVO(2), r = 0.41, P < 0.02; TTT, r = 0.38, P < 0.03; TMET, r = 0.31, P < 0.05; pHR, r = 0.29, P < 0.05; fVES, r = -0.28, P < 0.05). Conclusion: There are significant correlations of resting FEV1% predicted and PaO2 Values with CETP in patients with moderate and severe COPD and these parameters may also have a role as indicators of exercise tolerance in these COPD patients.

Aims and backgroundMany prognostic factors have been evaluated both for SCLC and NSCLC. The prognostic significance of blood group antigen expression of tumor tissues has been studied particularly in NSCLC, yielding divergent results. The aim of the present study was to investigate the prognostic value of the tumoral expression of blood group antigens ABH in lung cancer.MethodsThe presence of blood group antigens was assessed immunohistochemically in paraffin-embedded tumor samples from 92 patients diagnosed between 1996 and 1997. Monoclonal antibodies were used to detect blood group antigens.ResultsThe median survival was longer in NSCLC patients whose tumors were positive for blood group antigen A (P = 0.009). Since the expression of blood group antigen A in tumor cells was limited to patients with type A or AB blood, survival analysis of these patients showed survival to be longer in non-small cell lung cancer patients with blood group antigen A-positive tumors (P = 0.0019).ConclusionsExpression of blood group antigen A in tumor cells is an important, favorable prognostic factor in patients with non-small cell lung cancer, which could be useful to stratify patients with blood group A or AB according to possible outcome, and to guide therapeutic decision-making. The expression of blood group antigens ABH should be evaluated in larger series of lung cancer patients (including small and non-small cell lung cancer) with all blood types.