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    Factors associated with noninvasive ventilation response in the first day of therapy in patients with hypercapnic respiratory failure
    (Wolters Kluwer Medknow Publications, 2012) Gursel, Gul; Aydogdu, Muge; Tasyurek, Secil; Gulbas, Gazi; Ozkaya, Sevket; Nazik, Sakine; Demir, Ayse
    Background and Aim: Noninvasive ventilation (NIV) decreases mechanical ventilation indication in the early period of acute hypercapnic respiratory failure (AHcRF) and factors for success have been studied well. But, less is known about the factors influencing the NIV response in the subacute period. This study was aimed to determine the factors influencing the reduction of PaCO 2 levels within first 24 hours of therapy. Methods: NIV response was defined as reduction of PaCO 2 level below 50 mmHg within first 24 hours. Patients with AHcRF, treated with NIV, were divided into 2 groups according to this criterion; group 1 as the nonresponsive, group 2 as the responsive. The differences in NIV methods and characteristics of the two groups were evaluated and compared in this retrospective study. Results: A total of 100 patients were included in the study; 66 of them in group 1 and 34 in group 2. No significant differences were identified between the length of NIV application and intensive care unit (ICU) stay, intubation and mortality rates, across the groups. Ninety-one percent of the patients in group 2 had received all night long NIV therapy; this was just 74 in group 1 (P=0.036). Results of multivariate analysis showed that while nocturnal application was significantly associated with better response, prior home ventilation and requirement of higher pressure support (PS) levels significantly and independently associated with poorer response to NIV therapy. Conclusion: In patients with AHcRF, all night long use of NIV may accelerate healing by improving PaCO 2 reduction within the first 24 hours. A rapid response in PaCO 2 levels should not be expected in patients requiring higher PS levels and using prior home ventilation.
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    The Relationship between COVID-19 Severity and Bacillus Calmette-Guerin (BCG)/ Mycobacterium tuberculosis exposure history in healthcare workers: a multi-center study
    (Taylor & Francis Ltd, 2021) Torun, Serife; Ozkaya, Sevket; Sen, Nazan; Kanat, Fikret; Karaman, Irem; Yosunkaya, Sebnem; Sengoren Dikis, Ozlem
    The COVID-19 pandemic has brought countries' health services into sharp focus. It was drawn to our group's attention that healthcare workers (HCWs) had a lower mortality rate against higher COVID-19 incidence compared to the general population in Turkey. Since risk of exposure to tuberculosis bacillus among healthcare workers are higher than the population, we aimed to investigate if there is a relationship between BCG and Mycobacterium tuberculosis exposure history with COVID-19 severity in infected HCWs. This study was conducted with 465 infected HCWs from thirty-three hospitals to assess the relationship between COVID-19 severity (according to their hospitalization status and the presence of radiological pneumonia) and BCG and Mycobacterium tuberculosis exposure history. HCWs who required hospital admission had significantly higher rates of chronic diseases, radiological pneumonia, and longer working hours in the clinics. Higher rates of history of contact and care to tuberculosis patients, history of tuberculosis, and BCG vaccine were observed in hospitalized HCWs. HCWs who had radiological pneumonia had a significantly increased ratio of history of care to tuberculosis patients and a higher family history of tuberculosis. The findings from our study suggest that the lower mortality rate despite the more severe disease course seen in infected HCWs might be due to frequent exposure to tuberculosis bacillus and the mortality-reducing effects of the BCG vaccine.