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Öğe Assesment of palliative care in lung cancer in Turkey (ASPECT study)(European Respiratory Soc Journals Ltd, 2015) Bulbul, Yilmaz; Ozlu, Tevfik; Arinc, Sibel; Ozyurek, Berna A.; Gunbatar, Hulya; Senturk, Aysegul; Bahadir, Ayse[No abstract available]Öğe Association of Fragmented QRS with Subclinical Left Ventricular Dysfunction in Patients with Obstructive Sleep Apnea(Karger, 2015) Adar, Adem; Kiris, Abdulkadir; Bulbul, Yilmaz; Bektas, Huseyin; Acat, Murat; Casim, Hasan; Onalan, OrhanObjective: We aimed to investigate whether fragmented QRS (fQRS) is associated with subclinical left ventricular (LV) dysfunction in patients with obstructive sleep apnea (OSA). Subjects and Methods: A total of 141 patients with OSA who had normal LV ejection fraction (LVEF) were included in the study. The fQRS was defined as the presence of an additional R wave, notching of R or S wave or the presence of fragmentation in 2 contiguous electrocardiography (ECG) leads. Subclinical LV dysfunction was defined as the presence of a tissue Doppler-derived Tei index of >= 0.5 in the absence of impaired LVEF (<50%) as assessed by transthoracic echocardiography. Results: Of the 141 patients, 71 (50.4%) had subclinical LV dysfunction. Overall, the prevalence of the fQRS was 61% (86/141). Patients with fQRS had significantly higher Tei indices than those without fQRS [median 0.66, interquartile range (IQR) 0.39 vs. median 0.40, IQR 0.15, p < 0.001]. The presence of fQRS on ECG predicted subclinical LV dys-function in univariate logistic regression analysis [odds ratio (OR) 6.69, 95% confidence interval (CI) 3.10-14.43]. The association remained significant after adjusting for all potential confounders (OR 4.59, 95% CI 1.94-10.87). Conclusion: fQRS on ECG was an independent predictor of subclinical LV dysfunction in patients with OSA. This simple tool might help to identify OSA patients who could be at risk for developing overt cardiac dysfunction. (C) 2015 S. Karger AG, BaselÖğe General characteristics and therapeutic options in lung cancer in Turkey(European Respiratory Soc Journals Ltd, 2015) Ozlu, Tevfik; Bulbul, Yilmaz; Arinc, Sibel; Ozyurek, Berna A.; Gunbatar, Hulya; Senturk, Aysegul; Bahadir, Ayse[No abstract available]Öğe Immunization status in chronic obstructive pulmonary disease: A multicenter study from Turkey(Wolters Kluwer Medknow Publications, 2019) Ozlu, Tevfik; Bulbul, Yilmaz; Aydin, Derya; Tatar, Dursun; Kuyucu, Tulin; Erboy, Fatma; Koseoglu, Handan InonuOBJECTIVE: The purpose of this study is to detect the prevalence and the factors associated with influenza and pneumococcal vaccination and outcomes of vaccination during 2013-2014 season in patients with chronic obstructive pulmonary disease (COPD) in Turkey. METHODS: This was a multicenter retrospective cohort study performed in 53 different centers in Turkey. RESULTS: During the study period, 4968 patients were included. COPD was staged as GOLD 1-2-3-4 in 9.0%, 42.8%, 35.0%, and 13.2% of the patients, respectively. Influenza vaccination rate in the previous year was 37.9%; and pneumococcus vaccination rate, at least once during in a life time, was 13.3%. Patients with older age, higher level of education, more severe COPD, and comorbidities, ex-smokers, and patients residing in urban areas had higher rates of influenza vaccination. Multivariate logistic regression analysis showed that advanced age, higher education levels, presence of comorbidities, higher COPD stages, and exacerbation rates were associated with both influenza and pneumococcal vaccination. The number of annual physician/outpatient visits and hospitalizations due to COPD exacerbation was 2.73 +/- 2.85 and 0.92 +/- 1.58 per year, respectively. Patients with older age, lower education levels, more severe COPD, comorbid diseases, and lower body mass index and patients who are male and are residing in rural areas and vaccinated for influenza had significantly higher rates of COPD exacerbation. CONCLUSIONS: The rates of influenza and pneumococcal vaccination in COPD patients were quite low, and the number of annual physician/outpatient visits and hospitalizations due to COPD exacerbation was high in Turkey. Advanced age, higher education levels, comorbidities, and higher COPD stages were associated with both influenza and pneumococcal vaccination.Öğe Sleep disturbances in patients with lung cancer in Turkey(Turkish Assoc Tuberculosis & Thorax, 2018) Bulbul, Yilmaz; Ozlu, Tevfik; Arinc, Sibel; Akinci Ozyurek, Berna; Gunbatar, Hulya; Senturk, Aysegul; Bahadir, AyseIntroduction: Sleep quality is known to be associated with the distressing symptoms of cancer. The purpose of this study was to analyze the impact of cancer symptoms on insomnia and the prevalence of sleep-related problems reported by the patients with lung cancer in Turkey. Materials and Methods: Assesment of Palliative Care in Lung Cancer in Turkey (ASPECT) study, a prospective multicenter study conducted in Turkey with the participation of 26 centers and included all patients with lung cancer, was re-evaluated in terms of sleep problems, insomnia and possible association with the cancer symptoms. Demographic characteristics of patients and information about disease were recorded for each patient by physicians via face-to-face interviews, and using hospital records. Patients who have difficulty initiating or maintaining sleep (DIMS) is associated with daytime sleepiness/fatigue were diagnosed as having insomnia. Daytime sleepiness, fatigue and lung cancer symptoms were recorded and graded using the Edmonton Symptom Assessment Scale. Results: Among 1245 cases, 48.4% reported DIMS, 60.8% reported daytime sleepiness and 82.1% reported fatigue. The prevalence of insomnia was 44.7%. Female gender, patients with stage 3-4 disease, patients with metastases, with comorbidities, and with weight loss > 5 kg had higher rates of insomnia. Also, patients with insomnia had significantly higher rates of pain, nausea, dyspnea, and anxiety. Multivariate logistic regression analysis showed that patients with moderate to severe pain and dyspnea and severe anxiety had 2-3 times higher rates of insomnia. Conclusion: In conclusion, our results showed a clear association between sleep disturbances and cancer symptoms. Because of that, adequate symptom control is essential to maintain sleep quality in patients with lung cancer.Öğe Subclinical Left Ventricular Dysfunction in Patients with Obstructive Sleep Apnea Reply(Karger, 2016) Onalan, Orhan; Adar, Adem; Kiris, Abdulkadir; Bulbul, Yilmaz; Bektas, Huseyin; Acat, Murat; Casim, Hasan[No abstract available]
