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Öğe CARDIOPULMONARY EXERCISE TESTING AT SILICOSIS: A MODALITY TO EVALUATE WORKING PERFORMANCE(Parlar Scientific Publications (P S P), 2019) Arslan, Sertac; Karavelioglu, YusufIn an examination of the relationship between silicosis and lung function, most of the studies focus on pulmonary function tests (PFT). However, no enough data can be found about cardiopulmonary exercise testing (CPET) of silicosis patients. In this study, we applied CPET to silicosis patients; as well as pulmonary function tests to see whether silicosis effects exercise capacity. Fifty-two silicosis patients, diagnosed at an occupational disease hospital, were included in our study when they admitted to a university hospital occupational disease clinic for follow-up. Informed consent was provided from the patients. CPET and PFT were performed to the patients in addition to chest X-ray and high resolution tomography (HRCT). Statistical analyses were achieved by SPSS (Version 22.0, SPSS Inc., Chicago, IL, USA). Mean +/- Standard deviation and median were used for descriptive statistics. Kruskal-Wallis Test was used to compare groups, because parametric test assumption was not provided for continuous variables. Post-hoc analysis were performed to find the source of difference. Correlation between continuous variables was analysed by Spearman's correlation coefficient. P value <0.05 was accepted as statistically significant. Peak VO2, VAT, maximum load values did not reveal significant difference between ILO category 1,2 and 3 silicosis patients. Respiratory exchange ratio (RER) differency found close to the significance between ILO categories (p=0,057). Increasing ILO categories revealed increased peak RER values at decreased maximum load (category 3 versus 2; p=0,050, r=0,635 and category 3 versus 1; p=0,023,r= - 0,529). FEV1/FVC found decreased at category 3 (p=0.488). After adjustment for smoking, decreased FEV1/FVC at category 3 found significant (p=0.025). Smoking is one of the important factors that can confound the association between silicosis and lung function. After adjustment for smoking, only FEV1/FVC was decreased with disease progression. CPET revealed no any difference between silicosis categories. According to the literature, during early categories of silicosis, pulmonary function loss is limited. Hence, cardiopulmonary exercise testing might be one of the modalities to evaluate workforce loss at silicosis patients.Öğe Did free drugs for smoking cessation effect treatment success?(Discovery Publication, 2019) Arslan, SertacBackground and Aim: Drugs used for smoking cessation had not been paid by health insurance system in our country; however, these drugs started to be given freely by community health services in case an authorized doctor prescribe them. We evaluate the treatment success after smoking cessation drugs become free. Methods: Eighty-five patients (48 males, 37 females) admitted to smoking cessation clinic at a university in Corum between July 1st 2015 - December 31st 2015 were evaluated retrospectively. Results: Mean age of patients was 37.9 years. Most common symptoms were exercise dyspnea (71.8%) and productive cough (61.2%). Sixty-six patients were prescribed Vareniclin (77.6%) and bupropion prescribed 19 patients (22.4%). At the end of 3 months therapy 26 patients (30.6%) quit smoking. Percentage of smoking cessation was 33.3% for males and 27% for females; moreover, 33.3% for varenicline and 21.1% for bupropion group (p=0.309). Mean duration of smoking was 22.1 years for quitters and 16.5 years for non-quitters (p=0.068). Fagerstrom smoking scale was adapted to the study as low (0-4), moderate (5-7), high (8-10) nicotine dependence. Percentage of quitters was 20.8%, 30.4% and 36.8% for low, moderate and high dependence patients respectively (p=0.411). There was no significant difference between varenicline and bupropion for treatment success according to nicotine dependence levels. For the patients who quit smoking, pre-treatment and post-treatment spirometry tests were compared. Mean PEF% were increased from 71.6% to 77.7% (p=0.062), mean MEF75% were increased from 75.2% to 81.2% (p=0.075). Conclusion: Free drugs for smoking cessation treatment may decrease treatment success.Öğe Evaluation of Alone or Combined Colistin Therapy Success in Patients with Carbapenem-Resistant Acinetobacter Pneumonias(Derman Medical Publ, 2015) Diken, Ozlem Ercen; Tumturk, Ayhanim; Arslan, SertacAim Carbapenem-resistant gram negative bacteria represent an increasing problem worldwide for intensive care units. We aimed to detect the outcome of different treatment regimens and mortality rates of Acinetobacter infection in our clinic. Is combined colistin therapy superior or not? Material and Method: 23 cases diagnosed and treated in our unit with documented Acinetobacter infections between January 2013 and June 2014 were retrospectively evaluated in terms of treatments administered and mortality rates. Results: 19 of 23 patients were treated in ICU and 4 of 23 patients were treated in normal patient ward. Among 19 ICU patients, 2 patients in cefoperazone + sulbactam - susceptible groups and 3 patients with cefaperazone + sulbactam - resistant groups died with colistin monotherapy. Among patients receiving combined treatment, two patients were given amikacin + colistin combination and they both died. A single patient receiving colistin + rifampicin combination responded well. Of the 4 patients treated in the normal patient ward, 3 had carbapenem resistance, and of these, only 1 was susceptible to colistin. This patient received colistin + tigecycline combination and had good response. Discussion: The combined colistin treatment seems plausible in terms of reducing mortality in Acinetobacter infections of lung. We believe that in patients with carbapenem-resistant Acinetobacter infections, a consideration should be given to rifampicin or tigecycline combination with colistin.Öğe The effect of Blood Urea Nitrogen/Albumin Ratio in the Short-Term Prognosis of Chronic Obstructive Pulmonary Disease(Erciyes Univ Sch Medicine, 2021) Baha, Ayse Demir; Fendoglu, Turkan Zeynep Isikdogan; Kokturk, Nurdan; Kilic, Hatice; Hasanoglu, Hatice Canan; Arslan, Sertac; Alhan, AslihanObjective: There is no definite laboratory parameter in predicting short-term prognosis in patients with chronic obstructive pulmonary disease (COPD). Our aim was to evaluate the prognostic effect of serum blood urea nitrogen (BUN)/albumin ratio in COPD patients. Materials and Methods: A retrospective study comprising of 264 COPD patients who were in exacerbation period and selected from 4 centers was carried out. Data on demographic characteristics, disease characteristics, comorbid conditions and short-term prognosis of patients were obtained. and analyzed. Results: The BUN/Albumin ratio was higher in patients with oxygen saturation <90% (p=0.004). There was no difference between global obstructive lung disease (GOLD) stages means of BUN/Albumin ratio but this rate was higher in those with infective exacerbations (p=0.019). The BUN/albumin ratio of patients who were discharged (5.3 +/- 2.2) was significantly higher than the patients who were transferred to the intensive care unit [ICU] (11.7 +/- 6.0) (p<0.0001). The cut-off level of BUN/albumin ratio in prediction of the need for ICU was7.2 (sensitivity 80%, specificity 85.4%) and the area under the receiver operating characteristic (ROC) curve was 0.911 (95% CI: 0.861-0.961) (p<0.001). The cut-off level of BUN/albumin ratio in prediction of mortality was 8.1 (sensitivity 88.2%, specificity 85.4%) and the area under the ROC curve was 0.963 (95% CI: 0.930-0.995) (p<0.001). Conclusion: BUN/albumin ratio can be used as an affordable, inexpensive and practical method for determining the short-term prognosis in hospitalized COPD patients. Prospective studies involving more patients are needed.
