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Öğe Assessment of palliative care in lung cancer in turkey(Assessment of palliative care in lung cancer in turkey, 2017) Kilic, T.; Kirkil, G.Objective: To investigate the symptoms of lung cancer in Turkey and to evaluate approaches to alleviate these symptoms. Subjects and Methods: This study included 1,245 lung cancer patients from 26 centers in Turkey. Demographic characteristics as well as information regarding the disease and treatments were obtained from medical records and patient interviews. Symptoms were evaluated using the Edmonton Symptom Assessment Scale (ESAS) and were graded on a scale between 0 and 10 points. Data were compared using the. 2, Student t, and Mann-Whitney U tests. Potential predictors of symptoms were analyzed using logistic regression analysis. Results: The most common symptom was tiredness (n = 1,002; 82.1%), followed by dyspnea (n = 845; 69.3%), appetite loss (n = 801; 65.7%), pain (n = 798; 65.4%), drowsiness (n = 742; 60.8%), anxiety (n = 704; 57.7%), depression (n = 623; 51.1%), and nausea (n = 557; 45.5%). Of the 1,245 patients, 590 (48.4%) had difficulty in initiating or maintaining sleep. The symptoms were more severe in stages III and IV. Logistic regression analysis indicated a clear association between demographic characteristics and symptom distress, as well as between symptom distress (except nausea) and well-being. Overall, 804 (65.4%) patients used analgesics, 630 (51.5%) received treatment for dyspnea, 242 (19.8%) used enteral/parenteral nutrition, 132 (10.8%) used appetite stimulants, and 129 (10.6%) used anxiolytics/antidepressants. Of the 799 patients who received analgesics, 173 (21.7%) reported that their symptoms were under control, and also those on other various treatment modalities (dyspnea: 78/627 [12.4%], appetite stimulant: 25/132 [18.9%], and anxiolytics/antidepressants: 25/129 [19.4%]) reported that their symptoms were controlled. Conclusion: In this study, the symptoms progressed and became more severe in the advanced stages of lung cancer, and palliative treatment was insufficient in most of the patients in Turkey. (C) 2016 S. Karger AG, BaselÖğe A comparison of propofol-midazolam and midazolam alone for sedation in endobronchialultrasound-guided transbronchial needle aspiration: a retrospective cohort study(Wıley, 111 rıver st, hoboken 07030-5774, nj usa, 2017) Yalcinsoy, Murat; Calisir, Haluk C.ObjectivesEndobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a new, minimally invasive, bronchoscopic technique used in the evaluation of inthrathoracic lymph nodes.Use of sedation drugs before the procedure differs among centres. There is no standardization about sedation before EBUS-TBNA.We used a policy decision to shift from use of propofol with midazolam vs midazolam alone in a large tertiary hospital to evaluate the diagnostic yield and safety of EBUS-TBNA procedure. MethodsFiles of all the patients who were performed EBUS-TBNA between the dates of September 2010 and May 2014 were surveyed. All the EBUS-TBNA cases were performed under sedation of propofol and midazolam with an accompanying anesthesiologist in the beginning, however, sedation is applied with midazolam without an accompanying anesthesiologist after April 2013 due to changes in sedation policy. The diagnostic yield and complication rates were compared by chi-squared analysis between two groups. ResultsThe files of 340 EBUS-TBNA performed patients were evaluated. Of the patients 274 eligible patients were analysed. 152 patients who fulfilled the inclusion criteria were analysed in propofol-midazolam (P) sedated group and 122 patients were analysed in midazolam (M) group. There is no statistically significant difference between two different sedated groups in terms of age and gender. Diagnostic value was detected as 77.6% in P group and 85.7% in M group and the difference was not statistically significant. No difference between complication rates of both groups was observed. ConclusionBoth sedation-types for performing EBUS-TBNA showed similar diagnostic value and complication rates in our study. Propofol with midazolam application requires with an accompanying anaesthesiologist, therefore, it increases cost. EBUS-TBNA procedures had been performed in safe with no decrease in diagnostic yield under moderate sedation.Öğe Ratio and regional distribution of genetic mutation ın lung cancer ın turkey (redıgma)(European respıratory soc journals ltd, 442 glossop rd, sheffıeld s10 2px, england, 2018) Kılıç, TalatÖğe Prognosis of hospitalized patients with community-acquired pneumonia(ELSEVIER SCIENCE BV, PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS, 2018) Yalçınsoy, MuratIntroduction: The long-term prognosis of patients with community-acquired pneumonia (CAP) has attracted increasing interest in recent years. The objective of the present study is to investigate the short and long-term outcomes in hospitalized patients with CAP and to identify the predictive factors associated with mortality. Patients and methods: The study was designed as a retrospective, multicenter, observational study. Hospitalized patients with CAP, as recorded in the pneumonia database of the Turkish Thoracic Society between 2011 and 2013, were included. Short-term mortality was defined as 30-day mortality and long-term mortality was assessed from those who survived 30 days. Predictive factors for short- and long-term mortality were analyzed. Results: The study included 785 patients, 68% of whom were male and the mean age was 67 +/- 16 (18-92). The median duration of follow-up was 61.2 +/- 11.8 (37-90) months. Thirty-day mortality was 9.2% and the median survival of patients surviving 30 days was 62.8 +/- 4.4 months. Multivariate analysis revealed that advanced age, the absence of fever, a higher Charlson comorbidity score, higher blood urea nitrogen (BUN)/albumin ratios and lower alanine aminotransferase (ALT) levels were all predictors of long-term mortality. Conclusion: Long-term mortality following hospitalization for CAP is high. Charlson score and lack of fever are potential indicators for decreased long-term survival. As novel parameters, baseline BUN/albumin ratios and ALT levels are significantly associated with late mortality. Further interventions and closer monitoring are necessary for such subgroups of patients. (C) 2017 Sociedade Portuguesa de Pneumologia. Published by Elsevier Espana, S.L.U.Öğe Prevalence of malnutrition in COPD and its relationship with the parameters related to disease severity(DOVE MEDICAL PRESS LTD, PO BOX 300-008, ALBANY, AUCKLAND 0752, NEW ZEALAND, 2018) Mete, Burak; Pevlihan, Erkan; Gülbaş, GaziObjective: The aim of the study was to determine the nutritional status and anthropometric values in a group of patients with COPD and to examine the relationship between these factors and disease severity. Methods: A total of 105 COPD patients were included in this cross-sectional study. The patients underwent spirometric exmination. Mini nutritional assessment form was applied, and the anthropometric values of the patients were measured by bioelectrical impedance method. Nutrient registration forms were given using a 3-day, 24-hour recall method to assess the nutrient uptake. COPD severity was determined using the Global Initiative for Chronic Obstructive Lung Disease criteria, and the correlations between nutritional status and disease severity parameters were measured. Results: The prevalence of malnutrition in our patients with COPD was found to be 17%. Spirometric parameters were found to be significantly lower in patients with low body mass index (BMI) and malnutrition. As the modified Medical Research Council dyspnea scale score increased, the frequency of malnutrition increased (P=0.002). Positive significant correlation was found between spirometric variables and muscle mass and fat external tissue volume of the patients. Patients receiving higher protein content in diet showed a better muscle mass amount (P<0.001). Conclusion: Our study results confirmed that malnutrition is an important and frequently encountered problem in COPD patients, and spirometric values of the patients with malnourishment and with low BMI are significantly lower. We think that nutritional status should be evaluated in every COPD patient, and nutritional intake should be tailored individually.Öğe Effect of cpap on sleep spindles in patients with osa(Elsevıer scıence bv, po box 211, 1000 ae amsterdam, netherlands, 2018) Yetkin, Ozkan; Aydogan, DenizObjective: Consequences of OSAS include excessive daytime sleepiness, divided sleep architecture, impaired neurocognitive performance, and significant psychosocial disruption. In this study we aimed to evaluate sleep spindles changes before and after PAP treatment in patient with OSA. Methods: Seventy-three consecutive patients (M/F:61/12) who applied to Sleep Disorders Center of Inonu University Hospital and met the inclusion criteria were enrolled to this study. Full-night polysomnography and CPAP titration were performed. Results: Mean AHI were detected as 43,8 +/- 24,4 and mean oxygen saturation was 79% in patients under full night PSG. Singificant increasing were observed on spindle count under CPAP titration (192 +/- 98.vs 347 +/- 165 per hour p < 0.001)) and also significant increasing was recorded on oxygen saturation (79 15 vs 94 +/- 4% p < 0.001). Conclusion: Both spindle count and oxygen saturation were recorded to be significantly increased under CPAP titration while there was a significant decrease in apnea-hypopnea. We have shown that significant increase in number of spindles can be achieved with CPAP treatment, those to be decreased in patient with OSA. Number of spindles may play a role as an indicator of better outcome in OSA patients.Öğe Stages of copd, pulmonary function test, anthropometric measurements and relationship with nutrition(European journal of publıc health, 2018) Mete, B; Pehlivan, E; Gulbas, G; Gunen, H
