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Öğe Association between cytokines in induced sputum and severity of chronic obstructive pulmonary disease(W B Saunders Co Ltd, 2006) Hacievliyagil, SS; Gunen, H; Mutlu, LC; Karabulut, AB; Temel, ICytokines are known to be increased in induced sputum in chronic obstructive pulmonary disease (COPD). In this study, the relationship between the levels of interleukin-6 (IL-6), interleukin-8 (IL-8), and tumour necrosis factor-alpha (TNF-alpha) in induced sputum of patients with exacerbation of COPD, and the severity of the disease, pulmonary function tests (PFT), arterial blood gases (ABG) were studied. Twenty-four patients with exacerbation of COPD were included in the study. The patients were grouped according to their PFT into two as: Group 1 (FEV, below 50% of the predicted value, severe-very severe COPD, n = 12) and, Group 2 (FEV, above 50% of the predicted value, mild-moderate COPD, n = 12). The levels of IL-6, IL-8 and TNF-alpha in induced sputum of the subjects were measured. The mean levels of IL-6, IL-8 and TNF-alpha in induced sputum were found to be higher in Group 1 (severe-very severe COPD) than in Group 2 (mild-moderate COPD). The differences in IL-6 and IL-8 levels between groups were statistically significant (P < 0.05). A significant correlation was observed between the IL-6 value and FEV1 (r = -0.435, P = 0.034), FEV1/FVC (r = -0.446, P = 0.029), PaO2 (r = -0.711, P = 0.000), SaO(2) (r = -0.444, P = 0.030) and disease duration (r = 0.427, P = 0.037), respectively. Also, the level of IL-8 in induced sputum was inversely correlated with FEV1 (r = -0.562, P = 0.004), PaO2 (r = -0.540, P = 0.006) and SaO(2) (r = -0.435, P = 0.034). However, all three cytokines were positively correlated with the smoking load (r = 0.653, P = 0.001; r = 0.439, P = 0.032; r = 0.649, P = 0.001). We conclude, therefore, that in exacerbated COPD cases with greater degrees of obstruction of the airways have higher levels of cytokines in induced sputum. This can be interpreted to mean that these cytokines are related to the clinical parameters like the ABG and PFT and seem to be the determinant of the severity of the disease. (c) 2005 Elsevier Ltd. All rights reserved.Öğe Factors affecting survival of hospitalised patients with COPD(European Respiratory Soc Journals Ltd, 2005) Gunen, H; Hacievliyagil, SS; Kosar, F; Mutlu, LC; Gulbas, G; Pehlivan, E; Sahin, IFactors determining in-hospital mortality and long-term survival of patients hospitalised with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are not precisely understood. The aim of the present study was to assess the parameters related to in-hospital mortality and long-term survival after hospitalisation of patients with AECOPD. Clinical and epidemiological parameters on admission in 205 consecutive patients hospitalised with AECOPD were prospectively assessed. Patients were followed-up for 3 yrs. Factors determining short- and long-term mortality were analysed. In total, 17 patients (8.3%) died in hospital. In-hospital mortality was significantly associated with lower arterial oxygen tension (Pa,O-2), higher carbon dioxide arterial tension, lower arterial oxygen saturation and longer hospital stay. The overall 6-month mortality rate was 24%, with 1-, 2- and 3-yr mortality rates of 33%, 39% and 49%, respectively. Cox regression analysis revealed that long-term mortality was associated with longer disease duration (relative risk (RR)=1.158), lower albumin (RR=0.411), lower Pa,O-2 (RR=0.871) and lower body mass index (RR=0.830). When the model was run for the time elapsed since first hospitalisation, it also appeared as statistically significant (RR=1.195). These findings show that patients hospitalised with acute exacerbations of chronic obstructive pulmonary disease have poor short- and long-term survival. Prediction of survival status may be enhanced by considering arterial oxygen tension, albumin, body mass index, disease duration and time elapsed since the first hospitalisation.Öğe Increased plasma viscosity in patients with history of pulmonary embolism(Amer Coll Chest Physicians, 2004) Mutlu, LC; Tek, I; Hacievliyagil, SS; Gunen, H; Kaya, A; Numanoglu, N; Yetkin, O[Abstract Not Available]
