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Öğe Alterations in semen parameters of toll collectors working at motorways: does diesel exposure induce detrimental effects on semen?(Wiley, 2008) Güven, Aysel; Kayıkçı, A.; Çam, Kamil; Arbak, Peri; Balbay, Öner Abidin; Çam, MeryemAir pollution is contemporarily considered to be a significant cause in impairing semen parameters. The aim of this study was to investigate possible effects of traffic pollutants, mainly the diesel exposure, on semen analysis. A total of 38 men working as toll collectors at motorways formed the study group. Simultaneously, 35 men working as office personnel constituted the control group. Factors including varicocele, chronic diseases that can affect sperm production were the exclusion criteria. No difference regarding smoking was present between the groups. Usual semen analysis according to WHO guidelines was performed. The results of semen analysis revealed decreased motility and low sperm counts in eight and seven men from the study group respectively. Besides, a man from the same group had combined abnormality of decreased motility and low sperm count. However, two men from the control group had slight motility defect and one had low sperm count. The differences regarding the abnormal sperm count and motility were significant between the groups (P = 0.002 and P = 0.003, respectively). Similarly, the ratio of sperm cells with normal morphology was significantly lower in the study group than that in the control group (P = 0.001). This observation proposes that air pollution particularly diesel exposure may have detrimental effects on sperm parameters.Öğe A case with diffuse granulomatous inflammation mimicking malignancy [Maligniteyi taklit eden yaygın granülomatöz inflamasyon olgusu](Duzce University Medical School, 2017) Erçelik, Merve; Balbay, Ege Güleç; Arbak, Peri; Ataoğlu, ÖzlemA 59-year-old female patient was admitted to outpatient clinic with a 3-week dry cough and a 2-month exercise dyspnea (MRC 2). Within the last 3 months there was a loss of 5 kg. She has never smoked. She was a housewife. In thoracic computed tomography of the patient’s postero-anterior chest x-ray, the right lower quadrant is the opacity of the right atrium. A large number of nodules (5 mm in size) in both upper lobes of the lungs, and a common reticulonodular dancer in the middle lobe of the right lingula. The desired positron emission tomography of the patient with malignancy pre-diagnosis; right lobe of the lungs, reticular densities in the left lung, gastroesophageal junction, stomach fundus and large curvature in the dorsal wall of the nasopharynx, bilateral cervical lymphadenopathies, bilateral cervical lymphadenopathies, bilateral lymph nodes, right lobe of the lungs, right scapula and left iliac bone intense hypermetabolic involvement was detected. The axillary lymph node dissection was diagnosed as granulomatous lymphadenitis. The patient was accepted as sarcoidosis, inhaled steroid therapy was initiated and followed. © 2017, Duzce University Medical School. All rights reserved.Öğe COVID-19 Hastalarında TNF-? Düşüşünü Etkileyen Faktörler(2024) Gülhan, Muhammet; Alpay, Merve; Yıldız, Şule; Yaşlı, Nevra Ezgi; Acat, Murat; Kahraman, Gözde; Arbak, PeriAmaç: Tümör nekrozis faktör-alfa (TNF-?) hücrenin hayatta kalması, farklılaşması ve çoğalması da dahil çeşitli işlevlere sahiptir. TNF-?, COVID-19 enfeksiyonu sırasında ortaya çıkan sitokin fırtınası sırasında hücre ölümünü etkileyebilir. Bu çalışmada COVID-19 hastalarında TNF-? düşüşüne etki eden faktörleri araştırmak amaçlandı. Gereç ve Yöntemler: Çalışmaya COVID-19 enfeksiyonu olan toplam 44 kişi dahil edildi. Kan sayımı, biyokimyasal incelemeler ve D-dimer incelemeleri yapıldı. Hastaların ek hastalıkları ve başlangıç semptomları kaydedildi. TNF-?, CRP ve ferritin değerleri yatışının 1. ve 7. günlerinde iki kez ölçüldü. Bu değerlerdeki değişim komorbiditelere, başlangıç semptomlarına ve steroid kullanımına göre incelendi. Bulgular: Toplam 44 hastanın %56,8'i erkek (25/44) ve %43,2'si kadındı (19/44). TNF-? düşüşü diyabetik olmayan hastalarda istatistiksel olarak anlamlı bulunurken, diyabetik hastalarda TNF-? düşüşü anlamsız bulundu. CRP düşüşü hem diyabetik hem de diyabetik olmayan hastalarda istatistiksel olarak anlamlı bulunurken, ferritin düşüşü hem diyabetik hem de diyabetik olmayan hastalarda anlamsız bulundu. Akciğer hastalığı olmayanlarda TNF-? ve CRP istatistiksel olarak anlamlı düzeyde düşerken, akciğer hastalığı olanlarda hem TNF-? hem de CRP düşüşlerinin anlamlı olmadığı görüldü. TNF-? ve CRP'deki azalma steroid ile tedavi edilmeyenlerde anlamlı değilken, TNF-? ve CRP'deki azalma steroid tedavisi alanlarda istatistiksel olarak anlamlıydı. Sonuç: Steroidler TNF-? düzeyini düşürürler. Akciğer hastalığı ve diyabeti olanlarda TNF-? düşüşü anlamlı değildir.Öğe COVID-19 infection rates among transportation and metal workers(Assoc Medica Brasileira, 2022) Öngel, Ferit Serkan; Gülenç, Nuran; Gürcanlı, Gürkan Emre; Arbak, PeriOBJECTIVE: The aim of this study was to compare the workers in the metal and transportation sectors in terms of COVID-19 infection frequency and to examine and establish links between infection frequency and the workplace working conditions. METHODS: A survey was prepared and conducted with a questionnaire prepared on the Google Form platform consisting of questions about the pandemic among the members of the All Transport Workers' and The United Metalworkers' Union in Turkey. RESULTS: The number of workers diagnosed with COVID-19 was 5.8% in the transportation sector and 2.8% in the metal sector, with a significant difference (p=0.036). The percentage of workers diagnosed with COVID-19 who worked at a physical proximity less than 2 m in the transportation sector was higher than those who worked in the metal sector (p=0.014). The proportion of those who stated that there were COVID-19 patients among their colleagues and working at a physical proximity less than 2 m at the workplace was 18.2% in the transportation and 10.6% in the metal sector, with a significant difference (p=0.003), those who took time off from work was 74%, but 28.5% successively (p<0.001). The share of those who thought that the protective equipment and/or measures were not sufficient during the pandemic was 41.9% in the transportation and 17.7% in the metal sector (p<0.001). CONCLUSION: The results emphasized that the characteristics of jobs, physical proximity during job hours, the use of protective equipment, and size of the workplaces should be considered as reasons for different infection risks in different sectors.Öğe Do the levels of particulate matters less than 10 mu m and seasons affect sleep?(Taylor & Francis Ltd, 2020) Gulhan, Pinar Yildiz; Balbay, Ege Gulec; Elverisli, Mehmet Fatih; Ercelik, Merve; Arbak, PeriBackground: There are few studies showing that the increase in particulate matters less than 10 mu m (PM10) values increases the apnea-hypopnea index (AHI). We aimed to investigate relationship between air quality parameters and the seasons with the AHI. Methods: This was a retrospective study that included 500 adults. Polysomnography (PSG) was performed on all patients. Oxygen saturation, air temperature, relative humidity, and PM10 values were recorded in Duzce for every year. The parameters of the national air quality network and sleep parameters of 500 individuals hospitalized between 2015 and 2017 were checked. Results: A total of 500 patients were included in the study, of whom 316 (63.2%) were male and 184 (36.8%) were female. While the AHI value of patients who presented during 2016 was 27.5, it had significantly declined to 20.2 in 2017 (p = .024). A significant decline was observed in AHI values of OSA patients from 2016 to 2017 (p = .043). A significant positive correlation was observed between REM-related AHI and relative humidity (r = 0.183, p = .002). Conclusions: This study showed a clear relationship between AHI and PM10 during winter when air pollution parameters are high in the region. PM10 emerged as a parameter that substantially increases the relative risk for OSA.Öğe Effects of losartan on the renin-angiotensin-aldosterone system and erythrocytosis in patients with chronic obstructive pulmonary disease and systemic hypertension(Adis Int Ltd, 2001) Ülger, Ayşe Füsun; Kumbasar, Özlem Özdemir; Karacan, Özgür; Arbak, Peri; Alper, DoğanayObjective: To evaluate the effects of losartan on blood pressure, erythrocytosis and the renin-angiotensin-aldosterone system (RAS) in patients with erythrocytosis and hypertensive chronic obstructive pulmonary disease (COPD). Design: Prospective, nonrandomised, two-period study. Patients and Participants: 24 patients were recruited, of whom 20 (17 men) completed the trial. The mean age was 55 +/- 8 years (range 40 to 65 years). Erythrocytosis was defined as a persistent elevation of the haematocrit to greater than or equal to 47% in females and greater than or equal to 50% in males. Patients were less than or equal to 65 years of age and hypertensive according to the WHO criteria. Patients who had hepatic and/or renal dysfunction, acute exacerbation of primary disease, were taking systemic corticosteroids, had any other systemic disease, or showed intolerance during the washout period were excluded. Methods: An initial 2-month period on, a standard regimen with nasal oxygen (2 L/min, 18 h/day) and bronchodilators (inhaled salbutamol, oral theophylline, inhaled ipratropium bromide) was followed by a second 2-month period during which losartan was administered as an antihypertensive agent in addition to standard therapy. Routine biochemical and haematological monitoring was carried out. Systolic and diastolic blood pressures (SBP and DBP respectively) were measured. ECG and arterial blood gas analyses were also performed for all patients at the beginning of the study, and all of these clinical and laboratory investigations were performed at 15-day intervals during the study. Plasma renin activity and serum aldosterone and erythropoietin levels were measured both at the beginning and at the end of each 2-month period. Results: No statistically significant changes were found in the measured parameters at the end of the 2-month standard treatment period. Fatigue and dizziness were reported by four of the patients during the first week of losartan treatment. Both SEP and DBP decreased by 10mm Hg with losartan treatment (p = 0.0003 and 0.0002, respectively). Haematocrit decreased from 53 +/- 3% to 48 +/- 4% (p = 0.0001). The mean arterial blood gas tension of CO2 (pCO(2)) was 54 +/- 11mm Hg and decreased to 48 +/- 4mm Hg (p = 0.01). Losartan treatment decreased serum aldosterone to 259 +/- 148 ng/dl from a mean baseline value of 156 +/- 140 ng/dl (p = 0.03). There were no statistically significant changes in pO(2) serum erythropoietin or plasma renin activity. Conclusion: Losartan controls blood pressure and reduces erythrocytosis in patients with hypertensive COPD, and is well tolerated. Although the mechanism of the effect of losartan on erythrocytosis requires further investigation, we propose that the RAS, in particular angiotensin II, has effects on the haemopoietic system and that blocking these effects decreases the haematocrit.Öğe Evaluation of Patients with COVID-19 Followed Up in Intensive Care Units in the Second Year of the Pandemic: A Multicenter Point Prevalence Study (vol 25, pg 11, 2024)(Aves, 2024) Balbay, Ege Gulec; Kayalar, Ozgecan; Balbay, Oner; Dikensoy, Oner; Arbak, Peri; Bayram, Hasan[No abstract available]Öğe Exercise capacity in sarcoidosis. Study of 29 patients(Elsevier Espana Slu, 2005) Akkoca, Öznur; Çelik, Gökhan; Ülger, Füsun; Arbak, Peri; Saryal, Sevgi; Karabıyıkoğlu, Gülseren; Alper, DoğanayBACKGROUND AND OBJECTIVE: Sarcoidosis is a systemic granulomatous disease of unknown etiology. Aims of this prospective study are to evaluate degree of impairment in pulmonary function tests (PFT), arterial blood gas analysis (ABG), respiratory muscle strength, exercise capacity and correlation of these parameters with radiological stages; to further evaluate the use of cardiopulmonary exercise testing in assessment of extent of pulmonary disease; and to discuss the pathophysiologic mechanisms of limitation in exercise capacity in patients with sarcoidosis. PATIENTS AND METHOD: 29 patients with sarcoidosis were grouped according to their radiological stages (stage I: group 1; stage II, group 2; stage III, group 3). Group 1, 2 and 3 included 11, 13 and 5 patients, respectively. PFT, cardiopulmonary exercise testing and ABG were performed for each patient. RESULTS: Evaluation of all patients showed a significant decrement in exercise capacity. Patients in stage III had decreased diffusing capacity and exercise capacity. There was limitation in exercise capacity in stage I patients who had completely normal spirometry and diffusing capacity. We also found a correlation between radiological stages of the disease and exercise capacity, diffusing capacity and ABG. CONCLUSIONS: Exercise capacity is impaired also in early stages of sarcoidosis and it was found to be the earliest impaired physiological parameter in sarcoid patients. Exercise intolerance, having mutifactorial basis, is correlated with radiological stages. Circulatory impairment and impaired heart rate response to exercise have effects on limitation in exercise capacity. Especially in advanced radiological stages of disease, ventilatory and gas exchange impairment also seems to be effective on limiting exercise in patients with sarcoidosis.Öğe Extensive Exposure to Tear Gases in Ankara(2019) Ilgaz, Aslıhan; Uyanusta, Filiz Çağla Küçük; Arbak, Peri; Müezzinoğlu, Arif; Çiftçi, Tansu Ulukavak; Akpınar, Serdar; Erkan, FeyzaOBJECTIVES: The most common chemical substances used as mass control agents are chloroacetophenone, chlorobenzylidene malononitrile, and oleoresin capsicum. These agents not only have local and rapid effects but also have systemic and long-term effects. The aimof the present study was to discuss the patterns of tear gas exposure and to investigate its effects on respiratory functions.MATERIALS AND METHODS: A face-to-face survey was conducted in 86 individuals who had been exposed to tear gas indoor andoutdoor during the public protests in June 2013.RESULTS: The most frequently reported respiratory complaints included cough, dyspnea, phlegm, and chest pain. Spirometry measurements including forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) were also performed. Indoor exposers havelower mean % predicted FVC and FEV1 values than outdoor exposers. All complaints and signs were more common in indoor exposureto tear gas than in outdoor exposure.CONCLUSION: Safety of the chemicals used as mass control agents during protests is doubtful as these agents are associated with several health risks.Öğe Impact of Earthquakes on Lung Health(Aves, 2024) Balbay, Ege Gulec; Kayalar, Ozgecan; Balbay, Oner; Dikensoy, Oner; Arbak, Peri; Bayram, HasanEarthquakes are catastrophic natural disasters that cause extensive damage to infrastructure and disrupt the lives of millions worldwide. Beyond the immediate physical and psychological damage caused by earthquakes, these events can significantly impact respiratory health. The inhalation of dust, smoke, particulates, toxic gases, and asbestos exposure can lead to various respiratory health pathologies. These include respiratory infections, exacerbations of pre-existing respiratory diseases, chest traumas, and pulmonary and venous thromboembolism. Longitudinal studies are necessary to assess the long-term respiratory health effects in affected populations. By addressing these knowledge gaps, future mitigation strategies and preparedness measures can be developed to minimize the respiratory health impacts of earthquakes and improve the well-being of affected communities. Robust building infrastructure and comprehensive earthquake preparedness are emerging as the most important determinants for not only mitigating building collapse but also significantly reducing the potential health impacts that follow. This comprehensive review aims to provide a systematic overview of the lung health impacts of earthquakes. It highlights the need for further research to identify specific pollutants, air contaminants, and environmental factors contributing to respiratory health issues following earthquakes.Öğe Pitfalls of using the ILO classification for silicosis compensation claims(Oxford Univ Press, 2022) Akgün, Metin; Özmen, İpek; Yıldırım, Elif Ozari; Tüzün, Bahar; Toreyin, Zehra Nur; Kayinova, Atinc; Arbak, PeriBackground The International Labour Organization (ILO) Classification of Radiographs of Pneumoconioses is used as the primary tool to determine compensation for pneumoconiosis in Turkey. Aims We aimed to evaluate how the ILO classification applied, but obtaining chest radiographs in the workplace for screening until the completion of compensation claim files by the referral centres, based on the ILO reading. Methods The study included 320 digital chest radiographs previously taken for screening from eight different ceramic factories and having finalised claim files by referral centres. We used an expert reference panel consisting of five ILO readers to re-evaluate all the radiographs independently using ILO standard films and reached a conclusion based on the agreement among at least three readers. The evaluation primarily included technical quality and silicosis diagnosis with an ILO 1/0 or above small profusion. The results were compared with previous findings. Results Sixty-three (20%) chest radiographs were unacceptable for classification purposes according to the ILO technical quality grades. Among the remaining 257 chest radiographs, we diagnosed 103 with silicosis (40%), while the referral centres diagnosed 182 (71%). A discrepancy was found between our results and previous evaluations. We diagnosed silicosis in 50% and 17% of the previous silicosis and normal evaluations, respectively. Conclusions Our findings suggest that the use of the ILO classification for compensation claims may be problematic due to the way of its implementation in Turkey in addition to its subjectivity.Öğe Pitfalls of using the ILO classification for silicosis compensation claims Reply(Oxford Univ Press, 2022) Akgün, Metin; Özmen, İpek; Yıldırım, Elif Ozari; Tüzün, Bahar; Toreyin, Zehra Nur; Kayinova, Atinc; Arbak, Peri[Bastract Not Available]Öğe Prognostic significance of blood group antigen expression of tumor tissue in lung cancer patients(Sage Publications Ltd, 2002) Ülger, Ayşe Füsun; Keklik, Tülay; Özdemir, Özlem Kumbasar; Arbak, Peri; Demirkazık, Ahmet; Güngör, Adem; Alper, DoğanayAims and background: Many prognostic factors have been evaluated both for SCLC and NSCLC. The prognostic significance of blood group antigen expression of tumor tissues has been studied particularly in NSCLC, yielding divergent results. The aim of the present study was to investigate the prognostic value of the tumoral expression of blood group antigens ABH in lung cancer. Methods: The presence of blood group antigens was assessed immunohistochemically in paraffin-embedded tumor samples from 92 patients diagnosed between 1996 and 1997. Monoclonal antibodies were used to detect blood group antigens. Results: The median survival was longer in NSCLC patients whose tumors were positive for blood group antigen A (P = 0.009). Since the expression of blood group antigen A in tumor cells was limited to patients with type A or AB blood, survival analysis of these patients showed survival to be longer in non-small cell lung cancer patients with blood group antigen A-positive tumors (P = 0.0019). Conclusions: Expression of blood group antigen A in tumor cells is an important, favorable prognostic factor in patients with non-small cell lung cancer, which could be useful to stratify patients with blood group A or AB according to possible outcome, and to guide therapeutic decision-making. The expression of blood group antigens ABH should be evaluated in larger series of lung cancer patients (including small and non-small cell lung cancer) with all blood types.Öğe Relationship between Diagnosis Period and Internal and External Air Quality in Patients with Tuberculosis(2020) Gülhan, Pınar Yıldız; Elverişli, Mehmet Fatih; Erçelik, Merve; Aytekin, Fuat; Balbay, Öner; Arbak, PeriObjective: The aim of this study was to investigate the relationship between bacteriological case definitionsand indoor and outdoor air quality parameters in tuberculosis (TB).Materials and Methods: A total of 200 patients with TB diagnosed and treated in our hospital during 2012-2018 were included to this study. The air monitoring measurement parameters of the National Air QualityNetwork [particulate matter 10 (PM10), sulfur dioxide (SO2), air temperature, air pressure, and relativehumidity] for the same time period were obtained from the web page http://laboratory.cevre.gov.tr/Default.ltr.aspx.Results: Of the 200 patients, 62.5% (125) were males and 37.5% (75) were females. The rate of diagnosisbased on culture and smear positivity was 48.4% (31), which was significantly higher than that in the clinic[10.9% (7)] among patients who used stove for warming. The rate of diagnosis based on culture and smearpositivity [52.1% (25)] was significantly higher than that in the clinic [8.3% (4)] among patients who were exposed to biomass. The univariate analysis revealed no significant independent effect of warming and biomassuse on case definition. According to the case definitions, the mean values of PM10, SO2, and temperature inthe diagnosed month showed no statistically significant difference. The humidity level in the month was significantly higher, during which cases diagnosed using smear and culture positivity were compared with casesdiagnosed using only culture positivity (p=0.023).Conclusion: This study indicates that biomass used as a cooking fuel is a risk factor for pulmonary TB, implying that TB occurrence can be reduced significantly by lowering or preventing the exposure to cookingsmoke emitted from biomass fuel.Öğe The Relationship Between Respiratory Complaints and Urine Aluminum Levels in Aluminum Factory Workers(Lippincott Williams & Wilkins, 2023) BilgiN, Cahit; Arbak, Peri; Balbay, Ege Gulec; Balbay, Oner; Annakkaya, Ali NihatObjectiveThis prospective case-control study aimed to investigate the forms and conditions of respiratory effects in workers working in an Aluminum Profile Factory.MethodsAll male (42 person, mean age: 32.2 +/- 6.9) workers working in an Aluminum Profile Factory were compared with 33 controls.ResultsThe urinary aluminum levels of the workers were significantly higher than the control group. Complaints of cough, sputum, shortness of breath and wheezing were statistically significantly higher than the control group. In aluminum workers, those with dyspnea had a significantly higher urinary Al level than those without dyspnea.ConclusionsIt is thought that primary and secondary prevention are both important in the workplaces with aluminum exposure. Urinary aluminum level monitoring could be key to protecting the respiratory health of the workers.Öğe Work-Related Symptoms of Patients with Asthma: A Multicenter Study(2019) Mungan, Dilşad; Özmen, İpek; Evyapan, Fatma; Topçu, Füsun; Akgün, Metin; Arbak, Peri; Bülbül, YılmazOBJECTIVES: It is considered that occupational exposure accounts for up to 25% of all cases of adult asthma. We need detailed individual-level data regarding the relationship between asthma, occupation, and work-related symptoms in Turkey to inform policies onworkplace safety. This study aimed to investigate the association between asthma symptoms, occupation type, and workplace exposurein patients with asthma.MATERIALS AND METHODS: In this cross-sectional multicenter study, adult patients with asthma were investigated by a questionnairein terms of relationship between asthma symptoms and workplace exposure. The study population was adult patients who had been diagnosed with asthma for at least six months prior to study and who were under follow-up in Ankara, İstanbul, Erzurum, Düzce, Trabzon,Denizli, and Diyarbakır.RESULTS: The mean age of the 345 cases (188 females) was 41±13 years. The majority of the patients (36.8%) were "housewives”; othercommon occupations were office workers (6.7%), textile workers (4%), students (3.8%), hospital staff (3.5%), and cleaners (2.9%). Thirtyfive percent of patients described worsening of asthma during working periods. Among patients with a history of increased symptomsin workplace, 100 (83%) developed asthma after starting work, while 20 patients (17%) had pre-existing asthma. Half of the patientsdescribed workplace exposure to dust, fume, and gases. Exposure to cleaning supplies at home was present in 43% of the subjects. Ofall housewives, 12% (n=15) described an increase in their asthma symptoms during housework. The frequency of bleach or hydrochloricacid use alone among housewives was 60% and 34%, which was significantly higher than other occupations. The FEV1/FVC ratio ofhousewives who frequently used hydrochloric acid (FEV1/FVC=71.5) was lower than that of non-users (FEV1/FVC=74.9) (p=0.024).CONCLUSION: Patients with asthma experience significant workplace exposures that exacerbate their symptoms. Housewives experience significant exposure that triggers allergic and asthma symptoms. It is important to raise awareness about the prevalence and risksof occupational (including in-home) exposures in asthmatics patients and physicians to minimize asthma triggers and exacerbations.
