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Öğe Adequate use of pulmonary embolism clinical prediction rule in COPD patients(European Respiratory Soc Journals Ltd, 2011) Gunen, H.; Gulbas, G.; In, E.; Yetkin, O.; Hacievliyagil, S. S.[Abstract Not Available]Öğe Assessment of B-type natriuretic peptide in patients with pneumonia(Wiley, 2008) Yetkin, O.; Hacievliyagil, S. S.; Gunen, H.The mammalian heart synthesises and secretes B-type natriuretic peptide (BNP), which has potent diuretic, natriuretic and vascular smooth muscle-relaxing effects as well as complex interactions with the hormonal and nervous systems. Recent studies described that BNP was acute phase reactant. In this study, we aimed to evaluate BNP levels in patients with pneumonia. Twenty-one patients with pneumonia and 21 healthy control subjects were enrolled in this study. Their serum levels of BNP were measured in addition to the standard evaluations. Leucocyte count [19.3 (13.2-25.7) 10(6)/Ml VS. 9.55 (3.7-13.9) 106/Ml, p < 0.0011, erythrocyte sedimentation rate [73 (57-81) mm/h vs. 35 (4-55) mm/h, p < 0.001], C-reactive protein (CRP) [127.72 (27-290) mg/l vs. 13.19 (3-41) mg/l, p < 0.0011 and BNP [53.1 (17-91) pg/ml vs. 16.24 (1-38) pg/ml, p < 0.0011 levels significantly decreased after treatment period. Initial BNP levels were significantly higher than control groups (53.10 +/- 15.07 pg/ml vs. 18.62 +/- 14.05 pg/ml, p < 0.001) and decreased after treatment to the levels comparable with control subjects. BNP levels correlated with CRP levels at admission (r = 0.716, p < 0.001). We have shown that BNP levels show a transient increase in patients with pneumonia and correlate well with CRP.Öğe Long-term follow-up of chronic obstructive pulmonary disease patients on long-term oxygen treatment(Wiley, 2012) Gulbas, G.; Gunen, H.; In, E.; Kilic, T.Aims: Few studies exist on influence of long-term oxygen treatment (LTOT) on survival of chronic obstructive pulmonary disease (COPD) patients. This study was designed to determine whether LTOT improves survival or not in severely hypoxaemic COPD patients. Materials: COPD patients prescribed oxygen concentrator were consecutively included. Patients' baseline characteristics were noted. During follow-up, patients were divided into three groups according to LTOT utilisation: (i) non-utilisers, (ii) intermittent utilisers (< 15 h/day) and (iii) true utilisers (15 h/day). Patients' status (live or death) and, if died, the date of death were checked throughout the study. The factors which might influence mortality during 5-year period were analysed. Results: Two-hundred and twenty-eight patients completed the study. Of these patients, 55 were in Group 1, 112 were in Group 2 and 61 were in Group 3. Regarding the initial characteristics, there was not any significant difference between groups. Mean follow-up for whole group was 27.8 +/- 18.5 months. Median survivals were similar between groups (19.5 +/- 5.6, 32.5 +/- 4.1 and 30.0 +/- 5.7 months respectively) (p > 0.05). Compared with Group 1, survival was improved in Group 2 (p < 0.05) and there was a positive trend for Group 3 during first 2-year period. However, this improvement disappeared during further follow-up. Analysis of multiple factors which might influence mortality during 5-year period did not yield statistically significant parameter. Discussion and conclusion: We found that, regarding survival, any kind of LTOT proved to be beneficial over no LTOT only in the first 2 years of follow-up, and that there was not any difference between intermittent and true LTOT utilisation.Öğe Stages of COPD, pulmonary function test, anthropometric measurements and relationship with nutrition(Oxford Univ Press, 2018) Mete, B.; Pehlivan, E.; Gulbas, G.; Gunen, H.[Abstract Not Available]Öğe Venous thromboemboli and exacerbations of COPD(European Respiratory Soc Journals Ltd, 2010) Gunen, H.; Gulbas, G.; In, E.; Yetkin, O.; Hacievliyagil, S. S.The aim of the present study was to determine the prevalence of and risk factors for venous thromboembolism (VTE) in exacerbations of chronic obstructive pulmonary disease (COPD). COPD patients hospitalised with an exacerbation were included consecutively. Symptoms, signs and clinical, haematological and epidemiological parameters on admission were noted. All patients underwent computed tomographic angiography and ultrasonographic examination for deep vein thrombosis and pulmonary embolism (PE). Wells and Geneva scores were calculated. Patients were followed-up for 1 yr in order to determine mortality. Deep vein thrombosis and PE were detected in 14 and 18 patients, respectively. The prevalence of VTE was three times higher in patients with an exacerbation of unknown origin than in patients with an exacerbation of known origin (p=0.016). Of patients with VTE, 20 (95%) had high D-dimer levels. The negative predictive value of D-dimer testing was 0.98. Although the moderate-and high-risk categories of both the Wells and Geneva methods covered all PE patients, the Wells method identified 49% less potential patients for PE investigation. Mortality at 1 yr was higher (61.9% versus 31.8%) in VTE patients (p=0.013). VTE is a common problem in COPD patients hospitalised with an exacerbation, leading to high long-term mortality. D-dimer levels and the Wells criteria can be used to determine whether or not these patients are assessed for a thromboembolic event.
