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Öğe A 37-Year-Old Asymptomatic Male Case of Mass Lesion in the Right Upper Zone detected on Chest x-Ray: What is your Diagnosis?(Aves, 2015) Alaşan,Fatih; Ünlü, Elif Nisa; Annakkaya, Ali Nihat…Öğe ACE Gene Polymorphisms in Patients with OSAS(Wiley-Blackwell, 2015) Ayada, Ceylan; Toru, Ümran; Genç, Osman; Şimşek, Hasan; Admış, Özlem; Annakkaya, Ali Nihat…Öğe Akciğer Kanseri Semptom Taramasının Sigara Bıraktırmadaki Rolü(2022) Balbay, Öner; Kalkanlı, Nevin; Karataş, Naciye; Yeşiloğlu, Reşat; Arbak, Peri Meram; Annakkaya, Ali NihatAmaç: Bu çalışmada Düzce ilinde 30 yaş ve üzeri sigara içenlerde akciğer kanseri semptom taramasının sigara bırakmadaki rolü araştırıldı. Gereç ve Yöntemler: Randomize 700 hane seçilerek 30 yaş üzeri sigara anamnezi olan 500 olgu çalışmaya alındı. Olguların sigara alışkanlıkları ve akciğer kanseri semptomları bir anket formuyla yüz yüze görüşmeyle sorgulandı. Sigaranın akciğer kanseri için önemli bir risk faktörü olduğu vurgulandı. Halen aktif sigara içen 474 olgunun 353'üne 6 ay sonra telefonla sigara alışkanlıkları yeniden sorgulandı. Bulgular: Toplam 353 sigara içen olgunun 32’si (%9,1) kadın, 321’i (%90,9) erkekti. Yaş ortalaması 46±9 olan olguların, ortalama 36±24 paket-yıl sigara anamnezi vardı. 130'u (%36,8) sigarayı bırakmayı düşünüyordu ve 65'i (%18,4) sigarayı bırakmayı denemişti. 6 ay sonraki kontrolde 17 olgu (%4,8) sigarayı bırakmış, 59 olgu (%16) sigarayı azaltmış, 2 olgu (%0,6) ise artırmıştı. Sigarayı bırakanların hiçbiri ilk görüşmede bırakmayı düşündüğünü söyleyenler veya daha önce bırakmayı deneyenlerden değildi. Sigarayı bırakanların yaş ortalaması sigara içmeye devam edenlere göre daha yüksekti (p=0,044) ve sigarayı bırakanların daha uzun süredir sigara içme öyküleri vardı (p=0,001). Hemoptizi ve çomak parmak semptomlarının varlığı sigara bırakma oranlarını anlamlı düzeyde artırmaktaydı (sırasıyla p=0,048, p=0,013). Bu çalışmada akciğer kanseri semptom sorgulamasından 6 ay sonraki sigara bırakma oranı (%4,8), kendiliğinden sigarayı bırakma oranından (%1) anlamlı düzeyde yüksekti (p=0,001). Sonuç: Akciğer kanseri semptom taramasıyla sigara bırakma oranları artırılabilir. Sigara bırakma poliklinikleri yanında bu tip yaklaşımlar sigara mücadelesine katkıda bulunabilir.Öğe Annual Changes in Forced Expiratory Flows in Toll Collectors: Results from a Four Years Observation(Natl Inst Occupational Safety & Health, Japan, 2009) Arbak, Peri Meram; Balbay, Öner Abidin; Annakkaya, Ali Nihat; Bilgin, Cahit; Ozsahin, Sefa LeventDiesel exhaust (DE) has been accused for various health outcomes including exacerbation of asthma, chronic bronchitis. Exposure to DE has long-term effects on lung development in children and reductions in lung function have been reported. The aim of the study was to evaluate the annual changes in forced expiratory flows among toll collectors in Duzce city from 2002 to 2005. Annual FVC, FEV1 and MMF changes in smoker and nonsmoker 58 toll collectors and 37 controls selected among men who worked in the same company as officer have been followed up. No significant changes were seen in expiratory flows among smoker-nonsmoker toll collectors and controls (p>0.05). Annual FVC, FEV1 and MMF changes were not significantly different between smoker and nonsmoker toll collectors. Twelve toll collectors (20.7%) in the study group and 4 (10.8%) controls were found to have FEV1 and FVC below longitudinal lower limit of normal. The difference between groups did not reach statistically significance (p>0.05). Toll collectors (18/58) and controls (15/37) with spirometric measurements for three times showed no difference according to the rate of annual difference in either FEV1 (-21.3 +/- 133.1 ml/yr vs -44.3 +/- 166.6 (ml/yr) or FVC (13.2 +/- 202.9 ml/yr vs. -16.1 +/- 204.2 ml/yr). Further investigations including large groups with long term follow up are needed to observe annual FVC, FEV1 and MMF changes among toll collectors.Öğe Are serum eosinophilic cationic protein levels of toll collectors affected by diesel exhaust exposure?(Professional Medical Publications, 2016) Bilgin, Cahit; Arbak, Peri Meram; Yavuz, Özlem; Balbay, Ege Güleç; Balbay, Öner Abidin; Annakkaya, Ali NihatObjective: There are few studies on the diesel exhaust particulates (DEP) / eosinophilic cationic protein (ECP) level relationship. This study aimed to detect ECP levels in a highly DE exposed group, named as toll collectors. Methods: In a cross-sectional study, levels of serum ECP, rates of respiratory symptoms, mean levels of respiratory functions, smoking status, and variations in peak expiratory flow (PEF) during weekends and working days were compared for 68 toll collectors (TC) (range of age, 24-48 years) and 28 controls (range of age, 25-61 years). All subjects in the study group were men. Results: No significant difference was observed in terms of symptoms and smoking rates between the toll collectors and control group. The number of toll collectors [12/68 (17.7%) vs 1/28 (3.5%)] with diurnal PEF variability in the working period was higher than that of controls (p=0.058). Mean ECP level of toll collectors was higher than that of controls (32.8 vs 21.4 ng/L), but the difference was not significant. Mean ECP levels were higher in subjects experiencing diurnal PEF variability during work and off-work periods (34.9 vs 28.3 ng/L, p=0.410). Conclusions: Serial PEF measurements combined with serum ECP measurements did not add a new tool to detect the sensitivity of workers dealing with DE. Much more diesel exhaust exposed workers should be included to search for cheap and available methods when evaluating airway.Öğe Assessment of the frequency of deep venous thromboembolism in obstructive sleep apnea syndrome(Taylor & Francis Ltd, 2019) Bahar, Yağmur; Annakkaya, Ali Nihat; Şen, Çiğdem; Oktay, Mehtap; Aytekin, Fuat; Balbay, Öner AbidinThe present study aimed to investigate the frequency of deep venous thrombosis (DVT) among patients with obstructive sleep apnea syndrome (OSAS). Patients who referred the preliminary diagnosis of OSAS were included in this study. D-dimer levels of all patients were measured, and D-dimer (+) patients were evaluated by Doppler USG of the lower-extremity. Mean age of the patient group was 52 +/- 12 years and 31.8% (76/239) were women. The rate of D-dimer positivity among severe-OSAS cases (15/85) was significantly higher compared to the rest (13/154) (17.6% and 8.4%, respectively; p = 0.034). The risk of D-dimer positivity was elevated by 2.3 folds in severe-OSAS cases (OR: 2,324, 95% confidence interval: 1.048-5.152). Among 28 D-dimer (+) cases, 4 (14.2%) had DVT as demonstrated by USI of the lower-extremity. All four cases with DVT had severe OSAS. D-dimer was positive in 17.6% (15/85) of all severe OSAS cases. DVT was diagnosed in 4.7% (4/85) of severe-OSAS cases. DVT frequency was 26.6% (4/15) in D-dimer (+) severe-OSAS. Findings of this study indicate that severe-OSAS can be a significant risk factor for DVT. Additionally, data obtained in this study underline the benefits of questioning severe-OSAS patients with respect to DVT symptoms, investigating D-dimer levels and evaluating D-dimer (+) severe-OSAS cases for DVT prophylaxis.Öğe Association between varicocele and chronic obstructive pulmonary disease(John Wiley & Sons Inc, 2006) Erdoğmuş, Beşir; Yazıcı, Burhan; Balbay, Öner; Annakkaya, Ali Nihat; Özdere, Betül Ayça; Bulut, İsmetPurpose. To evaluate the relationship between varicocele and chronic obstructive pulmonary disease (COPD) via color duplex sonography. Materials and Methods. Forty-four male patients with COPD (age range, 50-89 years; mean +/- SD, 66 +/- 9) and 44 male healthy controls (age range, 47-75 years; mean +/- SD, 65 +/- 6) were evaluated with color duplex sonography for unilateral or bilateral varicocele. Results. The incidence of right, left, and bilateral varicocele was 47.7%, 65.9%, and 38.6% respectively, in the COPD group, versus 22.7%, 52.3%, and 13.6% in the control group. The incidence of right and bilateral varicocele in the COPD group was significantly higher than in the control group (p < 0.05). The incidence of varicocele also increased with increase in COPD severity. Conclusions. The incidence of varicocele in COPD patients is high. Varicocele might be one of the most important causes of scrotal pain and infertility in COPED patients. (C) 2006 Wiley Periodicals, Inc.Öğe Bronchial Wall Thickness in Toll Collectors(Natl Inst Occupational Safety & Health, Japan, 2010) Şafak, Alp Alper; Arbak, Peri Meram; Yazıcı, Burhan; Bilgin, Cahit; Erdoğmuş, Beşir; Annakkaya, Ali Nihat; Özşahin, Sefa LeventThere is an increasing concern about the possible adverse effects of diesel exhaust particulates on human health. In a diesel exposed occupational group composed of 120 toll collectors, a cross-sectional study was performed to evaluate the chest radiographs and 40 toll collectors were selected for computed tomography examination according to hyperinflation and linear markings. The wall thicknesses and luminal diameters of trachea, main bronchi, and segmental bronchi of right apical and posterior basal segments were measured with manual tracing method. The walls of right upper bronchus in exsmoker toll collectors were significantly thicker than those of nonsmokers (p=0.011). A positive correlation was observed between age and the right upper bronchus wall thickness (r=0.577, p=0.000). An inverse correlation was found between the working duration and the diameter of right main bronchus (r=-0.366, p=0.020). A positive correlation was seen between smoking and the right upper bronchus wall thickness (r=0.457, p=0.005). Diesel exposure might have a role in increase of thickness of large airways wall and a decrease in the diameters of large airways. Studies in this area are needed to protect the population under the diesel exposure risk.Öğe Burnout Status of Health Care Personnel Working in Oncology and their Coping Methods(Drunpp-Sarajevo, 2011) Balbay, Öner Abidin; Işıkhan, Vedat; Balbay, Ege Güleç; Annakkaya, Ali Nihat; Arbak, Peri MeramBackground: Working in oncology leads health care personnel (HCP) to feels stress, lack of satisfaction and to have psychological and physical problems and to be unproductive, estranged from job and to experience burnout. Objective: The aim of this study was to determine burnout state and the coping methods in HCP working in oncology. Methods: Interview Form, Maslach Burnout Inventory and Ways of Coping Inventory were administered total 444 HCP. Results: At the result of study HCP scored 1.76 in emotional exhaustion, 1.05 in depersonalization and 2.25 in lack of personal accomplishment [score range: 0-4]. These scores demonstrate that HCP experience moderate level burnout. It was established that HCP utilize mostly search for social support approach (X: 2.04) and they were least frequently found to use submissive approach (X: 0,97) [range: 0-3] in coping with burnout. It was established that, for emotional exhaustion nurses, other HCP who are consider their income inadequate and feel they have excessive work load form a risk group and for depersonalization with high education level, males, physicians, other HCP who are find their income inadequate run higher risk. It was also found that physicians and HCP with higher level of education, HCP who are feel themselves under excessive work load have a higher risk of experiencing lack of personal accomplishment. Conclusion: Our study demonstrated that it was not possible to avoid burnout in oncology clinics. The administrators should rapidly put into effect projects and regulations which may protect personnel from burnout.Öğe Carcinoid and schwannoma in lung: Two cases(Springer, 2012) Erdem, H.; Oktay, M.; Uzunlar, A.K.; Aydın, L. Yılmaz; Annakkaya, Ali Nihat; Yıldırım, U.; Şahiner, C.…Öğe Chest Diseases Clinic, Pandemic Experiences(Duzce Univ, 2020) Annakkaya, Ali Nihat; Gulhan, Pinar Yildiz; Balbay, Ege Gulec; Balbay, Oner Abidin; Arbak, Peri MeramAs the chest diseases clinic of Duzce Medical School, we were one of the departments that took an active role in the COVID-19 pandemic. Chest diseases department; It was one of the main branches in the differential diagnosis, treatment and follow-up of COVID-19 cases. In this process, our assistants, who were our hands and arms, were our fighters who were at the forefront of the pandemic process. During the pandemic process, we worked every day with an order consisting of a faculty member and two assistants. We continued our scientific meeting and assistant trainings online so that our training activities are not interrupted. On the one hand, we continued our scientific activities by participating in the studies, planning new research, and writing projects. As a result, when we look back, we have completed this difficult process by further enhancing our sense of solidarity that exists as a department in the pandemic process we experienced for the first time in our lives.Öğe Clinical and polysomnographic evaluation of sleep-related breathing disorders in patients with sarcoidosis(Springer Heidelberg, 2022) Ataoğlu, Özlem; Annakkaya, Ali Nihat; Arbak, Peri Meram; Yıldız Gülhan, Pınar; Elverişli, Mehmet FatihObjective This study aimed to evaluate the frequency of obstructive sleep apnea (OSA) in patients with sarcoidosis and related clinical factors. Materials and method Consecutive patients diagnosed with sarcoidosis in our clinic were evaluated for OSA risk during sleep using the Epworth Sleepiness Scale, Stanford Sleepiness Scale, Pittsburgh Sleep Quality Index, Berlin questionnaire, STOP and STOP-BANG questionnaires, and polysomnography (PSG). Results A total of 60 sarcoidosis patients (mean age: 50 +/- 11 years, 45 (75%) women) were included in the study. Polysomnography was performed in 54 cases and revealed the diagnosis of OSA in 70% (38/54) of the patients. The mean age was higher in patients with sarcoidosis and OSA (54 +/- 11 vs. 47 +/- 13, p = 0.041) and body mass index values were significantly higher as well (31.9 +/- 4.4 vs, 29.0 +/- 4.6 kg/m(2), p = 0.034). Polysomnography revealed a higher rate of OSA in patients with sarcoidosis who had high-risk scores in Pittsburgh Sleep Quality Index, STOP questionnaire, and STOP-BANG questionnaire (p = 0.024, p < 0.001, and p < 0.001, respectively). Based on polysomnography, OSA was detected in 39% (5/13) with stage 1 sarcoidosis, 78% (28/36) with stage 2, and in all cases (5/5) with stage 3. OSA frequency and apnea-hypopnea index (AHI) were determined to increase with advanced sarcoidosis stage (p = 0.003, p = 0.043, respectively). AHI was positively correlated with sarcoidosis stage (p = 0.003, r = 0.391). The prevalence of OSA was significantly higher in patients receiving treatment compared to treatment-naive patients (88% vs. 57%, p = 0.018). Multivariate logistic regression analysis revealed the stage of the disease (p = 0.026) to be the single independent risk factor associated with increased risk of OSA in patients with sarcoidosis. Conclusion High rates of OSA were detected in sarcoidosis, increasing with the advanced disease stage. The findings suggest that patients with sarcoidosis and advanced age, obesity, steroid treatment, and involvement of lung parenchyma (stages 2 and 3) should be evaluated for OSA risk. Further investigations are needed to establish the potential causes of the high prevalence of OSA in sarcoidosis.Öğe The Clinical Correlations of Fatigue in Patients with Sarcoidosis(2022) Gülhan, Pınar Yıldız; Balbay, Ege Güleç; Kumbasar, Özlem Özdemir; Erçelik, Merve; Annakkaya, Ali Nihat; Arbak, Peri MeramObjective: Fatigue is considered a frequent and characteristic feature of sarcoidosis. This study was designed to determine the prevalence of fatigue in patients with sarcoidosis and to determine its potential clinical correlations in relation to symptom severity. Methods: A total of 56 sarcoidosis patients were included. Data on patient demographics, anthropometrics, disease characteristics, pulmonary function tests, 6-min walking distance (6MWD), blood biochemistry and hemogram findings were retrieved from hospital records. Psychometric instruments involved fatigue assessment scale (FAS), Beck Depression Inventory (BDI) and Short Form-36 (SF-36) for health-related QOL (HRQOL). Results: Mean±SD patient age was 50.9±11.9 years. Of 56 patients, 44 were females and 12 were males. When compared to FAS score <22 and FAS score ?22-34 subgroups, FAS score ?35 (severe fatigue) subgroup was associated with significantly higher patient age and significantly lower SF-36 physical health scores. Total FAS scores were correlated positively with age (r=0.349, p=0.008) and BDI scores (r=0.515, p<0.001), while negatively with MIP (r=-0.321, p=0.019) and SF-36 physical health (r=-0.402, p=0.003) and mental health (r=-0.351, p=0.009) scores. BDI score (OR 1.146, 95% CI: 1.020 to 1.288, p=0.021) was determined to be the single independent predictor of increased likelihood of a patient with sarcoidosis to have FAS score ?22. Conclusions: Our findings emphasize that deterioration in respiratory functions may contribute to development of fatigue among sarcoidosis patients, and besides the fatigue, depressive symptoms and anxiety should also be an integral part of the multidisciplinary management of sarcoidosis patients.Öğe Comparison of Serum CA 19.9, CA 125 and CEA Levels with Severity of Chronic Obstructive Pulmonary Disease(Karger, 2009) Bulut, İsmet; Arbak, Peri Meram; Coşkun, Abdurrahman; Balbay, Öner Abidin; Annakkaya, Ali Nihat; Yavuz, Özlem; Gülcan, ErimObjective: To investigate serum levels of CA 19.9, CA 125 and carcinoembryonic antigen (CEA) in patients with different stages of chronic obstructive pulmonary disease (COPD). Patients and Methods: Fifty-three consecutive patients (50 males, 3 females, mean age 67.6 +/- 10.1 years) with COPD were included in this study. Serum levels of CA 19.9, CA 25 and CEA were determined by the chemiluminescent immunometric method. Based on values obtained from pulmonary function tests, the patients were divided into 3 groups: moderate (21), severe (18) and very severe (14). Data were analyzed with a Kruskal-Wallis one-way analysis of variance test and Mann-Whitney U test. Results: The mean serum levels of CA 125 and CA 19.9 were significantly higher in patients with very severe COPD (p = 0.013 and p = 0.017, respectively) than in patients with severe and moderate COPD (p < 0.05). Patients with cor pulmonale had significantly high mean serum levels of CEA, CA 19.9 and CA 125 (p < 0.05). Patients using a long-acting beta-agonist and theophylline showed significantly higher mean serum levels of CA 125 than patients who were not (p < 0.05). Conclusion: Data showed that the increased serum tumor markers in patients with COPD might be due to the severity of COPD, medication and cor pulmonale. Copyright (c) 2009 S. Karger AG, BaselÖğe Comparison of the 2000 and 2005 outbreaks of tularemia in the Duzce region of Turkey(Natl Inst Infectious Diseases, 2007) Özdemir, Davut; Şencan, İrfan; Annakkaya, Ali Nihat; Karadenizli, Aynur; Güçlü, Ertuğrul; Sert, Erhan; Kafalı, AliTularemia caused by Francisella tularensis, which is considered a biological warfare agent, is a widely distributed zoonosis. In this study, we aimed to compare a 2005 outbreak of tularemia that was confirmed as waterborne by PCR to outbreak of tularemia that was reported as waterborne in 2000 and to investigate the changes of epidemiological characteristics between these two outbreaks occurring in the same region. In the present study, a total of 11 patients were diagnosed with tularemia. In the 2000 outbreak, oropharyngeal type was observed in 19 patients, and ulceroglandular type in 3 patients. In the 2005 outbreak, oropharyngeal type was observed in 8 patients, and oculoglandular type in 3 patients. However, our cases are not sufficient to make a conclusion that the characteristics of tularemia seem to be changing.Öğe Comparison of the tuberculin skin test and the quantiferon test for latent Mycobacterium tuberculosis infections in health care workers in Turkey(Natl Inst Infectious Diseases, 2007) Özdemir, Davut; Annakkaya, Ali Nihat; Tarhan, Gülnur; Şencan, İrfan; Cesur, Salih; Balbay, Öner Abidin; Güçlü, ErtuğrulThe aim of this study was to compare the efficacy of the tuberculin skin test (TST) and the quantiferon test (QFT) for detecting latent tuberculosis infection (LTBI) in health care workers (HCWs). Seventy-six participants who were working in Duzce University Hospital, where tuberculosis patients were being treated, were included in the study. TST was performed according to the Mantoux technique. QFT was performed in accordance with the manufacturer's instructions. A positive TST result was defined as an induration diameter of >= 15 mm. TSTs were positive in 41 of 76 participants (53.9%) and QFT was positive in 65 of 76 participants (85.5%). There was a significant difference between the numbers of QFT-positive and TST-positive cases (P = 0.02). When the induration diameter of TST was >= 20 min, QFT positivity was 100%. Multivariate analysis revealed that there was a significant correlation between the percentage of patients with QFT positivity and the induration diameter of TST (P = 0.009). QFT thus seems to be more effective for LTBI diagnosis than TST. However, large-scale trials including quantitative measurement of QFT in subgroups taking into account the division where HCWs are employed and the different results of TST might clarify the usefulness of QFT in LTBI diagnosis.Öğe THE DISTRIBUTION OF FV-LEIDEN, PROTHROMBIN AND PLASMINOGEN ACTIVATOR INHIBITOR GENE MUTATIONS IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA(Medecine Et Hygiene, 2014) Balbay, Ege Güleç; Küçük, Enes; Balbay, O.; Annakkaya, Ali Nihat; Sılan, Fatma; Çiçekliyurt, Meliha MerveAim: To investigate Factor V Leiden (FVL), Plasminogen Activator Inhibitor (PAI) or Prothrombin (F2L) gene polymorphisms among OSAS patients. Methods: 62 patients (35 male, 27 female) with the suspected diagnosis of OSAS were included. All patients filled out a questionnaire regarding sleep disturbance and underwent polysomnographic (PSG) examination. Genotypes were determined by a polymerase chain reaction and reverse hybridization. Results: The mean age was 51 +/- 12. 20 of the patients were not OSAS while 42 was OSAS. The distribution of FVL genotypes for 1691 GG, GA and AA is found 95 %, 5% and 0% in control group and 88.1%, 11.9% and 0% in patient groups (p:0.654) respectively. The mutant genotype was not observed for both FVL and F2L G20210A. The distribution of F2L 2021 GG, GA, AA was found 95%, 5% and 0% in control group while 97.6%, 2.4% and 0% in patient group (p:0.545) respectively. The genotype frequencies of the OSAS patients for PAT were 45.5% for wild, 45% for heterozygote, and 10% for homozygote mutant genotype in control group and 31% for wild, 47.6% for heterozygote, and 21.4% for homozygote mutant genotype in patient group (p:0.413). No significant associations with these three polymorphism were observed for OSAS and the data was shown as odds value for FVL, F2L respectively; ORFVL=2.5 (95% CI: 0.280-23.573), ORF2L =0.463 (95% CI: 0.027-7.811). Conclusion: Although FVL mutation was insignificantly high in OSAS patients, it may be an important risk factor in known hypercoagulabi-Öğe Duzce University Hospital in the Pandemic Process: From the Perspective of Chief Physician(Duzce Univ, 2020) Akcan, Fatih Alper; Onec, Kursad; Annakkaya, Ali Nihat; Pehlivan, Mevlut; Karaduman, Zekeriya Okan; Balbay, Oner Abidin; Ergun, Hacer AkWe aimed to compile the effects of the preparations on the new coronavirus outbreak (Covid-19) in the largest pandemic, which is still visible in the world. Pandemics have caused millions of people to become ill, disabled and death for centuries Thanks to past pandemics that deeply affect the society health, socially and economically, preparations have been made again against possible pandemics. Preparations may not go as planned. Desperation may occur for unforeseen situations. Despite these despair, the tool that can contribute in practice besides the basic principles in combating pandemics can be obtained from the past. Like every pandemic, the pandemic will end one day. Those applied and not implemented after the outbreak will be evaluated and will remain a lesson from the past for future outbreaks.Öğe The Effect of Continuous Positive Airway Pressure (CPAP) Therapy on Serum Caspase-3 Level in Patients with Obstructive Sleep Apnea (OSA)(Springer Heidelberg, 2024) Kaypak, Mustafa Kemal; Annakkaya, Ali Nihat; Davran, Fatih; Gulhan, Pinar Yildiz; Yuregir, UgurIntroductionIntermittent hypoxemia has an important role in the physiopathogenesis of obstructive sleep apnea (OSA) complications. Increased apoptosis due to intermittent hypoxemia may be an important clinical entity in OSA. In this study, we aimed to evaluate caspase-3 enzyme level, which is an indirect marker of increased apoptosis in patients with OSA and to evaluate the effect of OSA treatment with continuous positive airway pressure on caspase-3 enzyme level.Materials and methodsThis study included 141 consecutive patients admitted to the sleep-disordered breathing laboratory within 6 months. Caspase-3 was measured in routine blood samples obtained on the morning of polysomnography (PSG) performed at night. The compliance of the patients to CPAP treatment was evaluated and caspase-3 levels were checked again after treatment.ResultsA total of 141 patients, 39 females (27,7%) and 102 males (72,3%) were included in the study. The mean age of the patients was 49 +/- 12 years (min-17, max-77). According to PSG results, OSA was detected in 95.7% (135/141) of the cases. Mild OSA was 35 (24.8%), moderate OSA 39 (27.7%) and severe OSA 61 (43.3%) cases. Median caspase-3 enzyme levels were similar in men and women in the study group. There was no statistically significant difference in hemogram parameters and caspase-3 enzyme levels between the groups divided according to the presence and severity of OSA. It was determined that caspase-3 enzyme level did not change significantly after 3 months of CPAP treatment in OSA compared to pretreatment. Caspase-3 was found to have a negative correlation with both the percentage of daily use of CPAP therapy and the percentage of CPAP device use for more than 1 h per night. It was found that the control caspase-3 level decreased statistically significantly as the percentage of daily use of CPAP therapy increased (r = -0.397, p = 0.030). It was found that the control caspase-3 level decreased statistically significantly as the percentage of CPAP therapy use for more than 1 h per night increased (r = -0.411, p = 0.024).ConclusionThe results of this study did not reveal a relationship between the severity of OSA and caspase-3 levels. However, blood caspase-3 levels decreased as treatment compliance increased, suggesting that CPAP treatment may correct increased apoptosis in OSA. There is a need for more comprehensive studies on this issue.Öğe THE EFFECT OF NATURAL GAS WARMING ON EMERGENCY APPLICATIONS DUE TO RESPIRATORY TRACT DISEASES IN CHILDREN IN DUZCE CITY(Parlar Scientific Publications (P S P), 2019) Gülhan, Pınar Yıldız; Balbay, Ege Güleç; Annakkaya, Ali Nihat; Balbay, Öner Abidin; Arbak, Peri MeramThe use of natural gas for heating purposes causes less air pollution than solid fuels. Preventing air pollution decreases hospital admissions due to respiratory infections in children. The aim of the study is to examine the impact of using more clean fuel for heating purpose on hospital admissions with respiratory tract diseases in children. The records of 126.940 pediatric patients who were admitted to Duzce University Medical Faculty Pediatric Emergency Medicine outpatient clinic between 2014 and 2017 were reviewed. The records of children diagnosed with respiratory diseases (n: 46137) were examined. During the same period, air monitoring measurements of the national air quality network were recorded. Of the children, 55.5% were male and 45.5% were female. Most of the children were among the age group of 2-5 years (44%). Between 2014 and 2017, the mean PM10 was observed to decrease (2014: 114.4, 2017:79, p < 0.0001), rate of natural gas usage (2014:52.9%, 2017: 64.2%, p<0.0001) increased, rates of stove usage (2014:47%-2017:35.7%, p<0.0001) decreased, annual mean air temperature values (2014:13.9-2017:16.7, p<0.0001) increased significantly. When all pediatric emergency admissions between 2014 and 2017 were examined, the number of those diagnosed with respiratory tract disease reduced while the number of general pediatric emergency admissions increased. The use of more clean fuels for heating purposes was observed to decrease the incidence of acute respiratory tract infections significantly in the preschool and school age group children. The use of clean fuel should be encouraged since preventing childhood infections would protect from the chronic lung diseases that may occur during adulthood.
