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    Akciğer Kanseri Semptom Taramasının Sigara Bıraktırmadaki Rolü
    (2022) Balbay, Öner; Kalkanlı, Nevin; Karataş, Naciye; Yeşiloğlu, Reşat; Arbak, Peri Meram; Annakkaya, Ali Nihat
    Amaç: 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.
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    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 Levent
    Diesel 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.
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    Applications of Traditional Medicine Among Patients Attending the Chest Disease Clinic
    (Düzce Üniversitesi, 2024) Arbak, Peri Meram; Ersoy, Nermin
    Objective: Among various traditional practices for respiratory complaints, the most common one involves the consumption of herbs in different forms. Method: Patients who visited the chest diseases clinic (n=204) were asked whether they used herbal remedies as a part of traditional medicine, aside from the treatments provided at the clinic. Results: The rate of traditional medicine application for their health complaints among the patients was 39.7% (81/204). The most frequently used applications were ginger tea (18.5%), lemon juice (18.5%), pine cone syrup (16%), and carob molasses (14.8%). Patients mainly used traditional medicine for chest pain (50%), phlegm (47.1%), cough (43.1%), and shortness of breath (35.4%). The use of traditional medicine was significantly lower in patients experiencing shortness of breath (35.4% of those who used folk medicine compared to 64.6% of those who did not, p=0.001). The frequency of traditional medicine use was 50% in sarcoidosis patients, 43.1% in asthma patients, and 30% in COPD patients. Among regular medication users, the rate of traditional medicine use was 41.5%.Conclusion: In addition to regular medication use for respiratory complaints and diseases, patients also included traditional medicine applications at an average rate of 40%. When questioning the use of regular medication and/or traditional medicine of patients, valuable information will be obtained regarding both their compliance with treatment and the possible benefits and harms of the traditional medicine products they use.
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    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 Nihat
    Objective: 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.
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    Aşı Karşıtlığı; Özerkliğin Kötüye Kullanımı
    (2022) Arbak, Peri Meram
    Aşılar önlenebilir ve bulaşıcı hastalıklardan korunmakta en önemli araçlardan biridir. Aşı karşıtlığı ise aşılanma hızlarını azaltmakta ve bulaşıcı hastalıklardan ölümü artırmaktadır. Aşı karşıtlığının altında yatan nedenler; aşının yan etkilerinden korkma, aşıya ilişkin önyargılar, sağlık eğitiminin eksikliğidir.Zorunlu aşı kampanyaları genel toplumun iyilik ve sağlıklılık sonucuna ulaşmak için etkili şekilde uygulanan halk sağlığı uygulamalarıdır. Aşılanma yoluyla hem bireysel hem de toplumsal bağışıklık sağlanmaktadır. Böylece hastalığın bulaşması da azalmaktadır. Aşı karşıtlığı, aşılama yoluyla sağlanacak toplumsal bağışıklığı engelleyeceği için genel toplumun sağlığını kötü şekilde etkilemektedir. Aşı karşıtlığı biyoetik perspektifle bakıldığında hem bireysel hem de toplumsal bağışıklığın engellenmesiyle yararlılık kavramına ters düşmektedir. Aşı karşıtlığı 20. yüzyılın başından bu yana gözlenmiştir ve aşı karşıtları kendi bedenleriyle ilgili kararların kendilerine ait olduğu söylemini kullanmışlardır. Biyoetik perspektifte özerklik kavramı, kişinin özgür iradesiyle, dış baskı olmaksızın kendi kararlarını alabilmesidir. Ancak salgın hastalıklar ve afet durumlarında genel toplumun yararı kişinin özerk tutumunun önüne geçmektedir. Sonuçta bireysel özerkliğin aşı karşıtlığı şeklinde ortaya çıkması hem toplum sağlığını, hem de bireyin sağlığını tehdit altına sokmaktadır.
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    Bir Üniversite Hastanesindeki Oksijen Tedavisi Nemlendiricilerinin Mikrobiyolojik Açıdan İncelenmesi
    (2019) Akar, Nida; Arbak, Peri Meram; Öztürk, C. Elif; Kılınçel, Özge; Çalışkan, Emel; Şahin, İdris; Öksüz, Şükrü
    Amaç: Hastane enfeksiyonları tıp dünyasının çözüm bulmaya çalıştığı öncelikli sorunlar arasında yeralmaya devam etmektedir. Yatan hastalarda nozokomiyal pnömoniye sebep olabilecek kaynaklardanbiri de oksijen tedavisi sırasında kullanılan nemlendirme cihazlarıdır. Bu çalışmada Düzce Üniversitesi Araştırma ve Uygulama Hastanesi’nin çeşitli servislerinde bulunan oksijen tedavisi nemlendiricilerinimikrobiyolojik açıdan incelemek amaçlanmıştır.Gereç ve Yöntemler: 16.9.2016—20.3.2017 döneminde toplam 102 adet oksijen tedavisi nemlendiricisinden steril kaplara su örnekleri alınarak %5 koyun kanlı agar, eosin methylene blue agar, Sabourauddextrose agar ve Löwenstein–Jensen besiyerine ekim yapıldı. Üreyen koloniler konvansiyonel ve otomatize yöntemler kullanılarak tanımlandı.Bulgular: Yüz iki örneğin 69’unda (%68) toplam 98 adet mikroorganizma üremiştir. Bu organizmaların75’i (%77) bakteri, 23’ü (%23) mantar idi. Bakterilerin 56’sı (%75) nonfermentatif Gram-negatif bakteri(Chryseobacterium indologenes, Pseudomonas aeruginosa, Acinetobacter lwoffii, Acinetobacter baumannii, Acinetobacter ursingii, Acinetobacter haemolyticus, Sphingomonas paucimobilis, Stenotrophomonas maltophilia, Delftia acidovorans, Brevundimonas diminuta); 13’ü (%18) Corynebacterium spp.;2’si (%3) Rhizobium radiobacter; 1’i (%1) Bacillus spp.; 1’i (%1) Neisseria spp.; 1’i (%1) Staphylococcusepidermidis; 1’i ise (%1) Mycobacterium gordonae idi. Mantarların ise 21’i (%91) küf mantarı (Fusariumspp., Aspergillus spp., Penicillium spp., Exophiala spp., Cladosporium spp., Acremonium spp., Cladophialophora spp., Alternaria spp.); 2’si (%9) maya mantarı (Candida krusei, Candida albicans) idi.Tartışma ve Sonuç: Servislerde bulunan oksijen tedavisi nemlendiricilerinin kullanımı ve dezenfeksiyonuile ilgili kurallara yeterince uyulmadığı görülmüştür. Sağlık çalışanlarının bu kurallara riayet konusundaeğitilmesi ve denetlenmesi gerektiği düşünülmüştür.
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    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 Levent
    There 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.
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    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 Meram
    Background: 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.
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    Chest Diseases Clinic, Pandemic Experiences
    (Duzce Univ, 2020) Annakkaya, Ali Nihat; Gulhan, Pinar Yildiz; Balbay, Ege Gulec; Balbay, Oner Abidin; Arbak, Peri Meram
    As 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.
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    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 Fatih
    Objective 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.
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    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 Meram
    Objective: 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.
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    A comparative analysis of errors in inhaler technique among COPD versus asthma patients
    (Dove Medical Press Ltd, 2018) Ocaklı, Birsen; Özmen, İpek; Tuncay, Eylem Acartürk; Güngör, Sinem; Altınöz, Hilal; Adıgüzel, Nalan; Arbak, Peri Meram
    Purpose: This study was designed to evaluate errors in inhaler technique in COPD vs asthma patients and to investigate the association of poor inhaler technique with patient demographics and clinical variables. Patients and methods: A total of 509 adult patients with COPD (n=328) or asthma (n=181) who were currently using an inhaler device were included in this study. Data on patient demographics, duration of disease, type and duration of inhaler therapy, and assessment of inhaler technique were recorded. Results: Metered dose inhaler (MDI) was the most common type of inhaler used by a similarly high percentage of patients in both COPD (83.2%) and asthma (77.3%) groups. Failure to exhale before inhaling through device (75.8% and 68.5% for MDIs; 73.2% and 71.8% for Aerolizer (R)/Handihaler (R); 53.1% and 66.7% for Turbuhaler (R)) was the most common error in inhaler technique, in both COPD and asthma groups. Device-specific errors in inhaler techniques were more common in asthma patients as compared with COPD patients, particularly for MDIs (P-values ranged from 0.046 to 0.0005), as associated with female gender (failure to press the buttons on both sides of Aerolizer (R)/Handihaler (R), P=0.006), shorter duration of disease (failure to hold MDI or head in a vertical position, P < 0.001, and to keep Turbuhaler (R) upright, P=0.005), and shorter duration of inhaler usage (failure to hold head in a vertical position during MDI usage, P=0.006, and to keep Turbuhaler (R) upright, P=0.012). Conclusion: In conclusion, our findings revealed that errors in inhaler technique in terms of inhalation maneuvers and device handling were similarly common in COPD and asthma patients. Errors in certain device handling maneuvers, particularly with MDIs, were more common among asthma patients than among COPD patients and associated with female gender and shorter durations of disease and inhaler therapy.
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    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, Erim
    Objective: 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, Basel
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    COVID-19 in Turkish health care workers practicing chest medicine
    (Assoc Medica Brasileira, 2021) Sandal, Abdulsamet; Toreyin, Zehra Nur; Salturk, Cuneyt; Arbak, Peri Meram
    OBJECTIVE: This study aimed to evaluate the data of Turkish health care workers practicing chest medicine on their coronavirus disease 2019 (COVID-19) status and related parameters. METHODS: This descriptive study included online survey data that the Turkish Thoracic Society conducted with its members in two phases starting in June and December 2020. The 33-item survey included demographic data, smoking status, the presence of any chronic diseases, occupation, working status, and non-work-related and work-related COVID-19 exposure characteristics. RESULTS: Of 742 responses, 299 (40.3%) reported that they had contracted COVID-19. The second survey detected a higher frequency of health care workers who had contracted COVID-19 (12.1% versus 57.4%, p<0.001) than the first survey. The analysis of the association between study parameters and COVID-19 in health care workers using logistic regression revealed statistical significance with working at the onset of the outbreak (OR 3.76, 95%CI 1.09-12.98, p=0.036), not working at the time of survey (OR 5.69, 95%CI 3.35-9.67, p<0.001), COVID-19 history in colleagues (OR 2.27, 95%CI 1.51-3.41, p<0.001), any non-work-related COVID-19 exposure (OR 4.72, 95%CI 2.74-8.14, p<0.001), COVID-19 exposure at home (OR 6.52, 95%CI 3.52-12.08, p<0.001), and COVID-19 history in family members (OR 8.16, 95%CI 5.52-12.08, p<0.001) after adjusting for age and sex. The study also observed an inverse relationship between the use of aprons and goggles and COVID-19 in health care workers. CONCLUSION: Occupational and nonoccupational characteristics are related to COVID-19 in health care workers practicing chest medicine. Therefore, active surveillance to detect health care workers contracting COVID-19 and to document and control occupational and nonoccupational risks should be provided.
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    Do We Question Occupational and Environmental Exposure Adequately in the Outpatient Clinic of Chest Diseases?
    (2014) Balbay, Ege Güleç; Binay, Songül; Süner, Kezban Özmen; Çakıroğlu, Emine Banu; Arbak, Peri Meram
    Amaç: Göğüs hastalıklarında öykü alma aşamasında, bireylerin mesleki ve çevresel maruziyetleri ile sigara kullanma öykülerini ayrıntılı olarak kaydetmek hastalık tanısında çok önem taşımaktadır. Bu çalışmada, göğüs hastalıkları polikliniğinde alınan meslek anamnezlerinin kalitesini araştırmak planlanmıştır. Yöntemler: Tıp fakültesi göğüs hastalıkları polikliniğine ayaktan başvurmuş 320 ardışık hastanın (158 kadın, 162 erkek) kayıtları retrospektif olarak değerlendirildi. Kayıtlarda bireylerin meslek öykü- lerinin ayrıntılı olarak alınıp alınmadığı, çevresel maruziyetlerin ve sigara kullanımının sorgulanma şekli değerlendirildi. Bulgular: Kadın hastaların yaş ortalaması 51,6173 iken, erkeklerinki 55,116,1 idi. En sık karşılaşılan meslekler; ev hanımı (%37,5), çiftçi (%12,8) ve işçi (%12,2) idi. Ayrıntılı meslek öyküsü %21,9 oranında alınmış ve erkeklerde (%79) kadınlardan (%31) daha yüksek oranda bulunmuştu (p0.001). İşçilerin %60'ında çalışılan işyeri sorgulanırken, halen çalışılan işten önceki işler %10,6 oranında sorgulanmıştı. Toplam 9 bireye (%2,8) yaşadığı ortam sorulmuştu. Sigara kullanımı olguların %90,6'sında sorgulanmıştı. Toplam 290 sigara kullanan olgunun 183'üne (%63,1) paket.yıl sorgulaması yapılmıştı. Sonuç: Göğüs hastalıkları polikliniğinde ayrıntılı mesleki anamnez, çevresel maruziyet öyküsü ve sigara kullanımı öyküsü kayıtlarının yeterli derecede yapılmadığı gözlenmiştir.
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    Does periodic lung screening of films meets standards?
    (Professional Medical Publications, 2016) Binay, Songül; Arbak, Peri Meram; Şafak, Alp Alper; Balbay, Ege Güleç; Bilgin, Cahit; Karataş, Naciye
    Objective: To determine whether the workers' periodic chest x-ray screening techniques in accordance with the quality standards is the responsibility of physicians. Evaluation of differences of interpretations by physicians in different levels of education and the importance of standardization of interpretation. Methods: Previously taken chest radiographs of 400 workers who are working in a factory producing the glass run channels were evaluated according to technical and quality standards by three observers (pulmonologist, radiologist, pulmonologist assistant). There was a perfect concordance between radiologist and pulmonologist for the underpenetrated films. Whereas there was perfect concordance between pulmonologist and pulmonologist assistant for over penetrated films. Results: Pulmonologist (52%) has interpreted the dose of the films as regular more than other observers (radiologist; 44.3%, pulmonologist assistant; 30.4%). The frequency of interpretation of the films as taken in inspiratory phase by the pulmonologist (81.7%) was less than other observers (radiologist; 92.1%, pulmonologist assistant; 92.6%). The rate of the pulmonologist (53.5%) was higher than the other observers (radiologist; 44.6%, pulmonologist assistant; 41.8%) for the assessment of the positioning of the patients as symmetrical. Pulmonologist assistant (15.3%) was the one who most commonly reported the parenchymal findings (radiologist; 2.2%, pulmonologist; 12.9%). Conclusion: It is necessary to reorganize the technical standards and exposure procedures for improving the quality of the chest radiographs. The reappraisal of all interpreters and continuous training of technicians is required.
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    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 Meram
    The 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.
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    The effect of particular matter pollution on emergency room visits due to COPD and asthma and the association with hospitalization rate in Duzce City
    (European Respiratory Soc Journals Ltd, 2012) Balbay, Ege Güleç; Arbak, Peri Meram; Balbay, Öner Abidin; Annakkaya, Ali Nihat
    …
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    Effect of symptom-to-treatment interval on prognosis in lung cancer
    (Sage Publications Ltd, 2007) Annakkaya, All Nihat; Arbak, Peri Meram; Balbay, Öner Abidin; Bilgin, Cahit; Erbaş, Mete; Bulut, İsmet
    Aims and background: To evaluate the relationship between delayed diagnosis and the degree of invasion and survival in lung cancer. Methods: One hundred and three patients (96 men) with lung cancer were included. Stages in the diagnosis of lung cancer were classified as follows: symptom-to-doctor interval, i.e., the interval from the first symptoms related to the presence of lung cancer to the first consultation with a medical professional; doctor-to-diagnosis interval, i.e., the interval between the first medical visit and confirmation of the diagnosis; and diagnosis-to-treatment interval, i.e., the interval between diagnosis and complete TNM staging and treatment. The symptom-to-treatment interval (STI) was the sum of the 3 intervals. The degree of invasion was determined by the TNM classification. Results: The patients were followed up for a mean period ( SD) of 7.4 +/- 8.7 months. Seventy-six (74%) patients were diagnosed with non-small cell lung cancer (NSCLC) and 27 patients (26%) with small cell lung cancer (SCLC). The mean length of STI was 120 +/- 101 days (median, 90). The mean length of the symptom-to-doctor interval was 63 +/- 62 days (median, 45), while the doctor-to-diagnosis and diagnosis-totreatment intervals were 41 +/- 82 days (median, 10) and 16 +/- 12 days (median, 12), respectively. When the STIs of the patients were correlated with tumor stage, tumor invasion, lymph node involvement and metastasis, no significant differences were found. Patients with an STI longer than 60 days had a significantly longer survival. Regarding the type of lung cancer and STI, the median survival was shorter in patients with an STI of less than 60 days both in NSCLC and SCLC, although this was not statistically significant in SCLC. Conclusions: The shorter the diagnostic interval, the shorter was the median survival in our study. The reason for the apparent discrepancy between poor prognosis of lung cancer patients in spite of early diagnosis might be much faster progression of the disease itself.
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    Effects of antithyroid medication on the flow-volume loop in patients with hyperthyroidism
    (2004) Arbak, Peri Meram; Bahçebaşı, Zerrin Bicik; Şafak, Alper; Çınar, Yelda; Ülger, Füsun
    Astım tanısı bulunmayan 20 hipertiroidi olgusunda anütiroid tedavinin akım-volüm eğrileri üzerindeki etkilerini değerlendirmek üzere prospektif bir çalışma düzenlendi. Antitiroid tedavinin başlangıcında ve üçüncü ayının sonunda hastaların tiroid hormonları (Total T3, Total T4 ve TSH), ultrasonografi ile tiroid bezi volümleri, boyun çevresi ölçümleri ve akım-volüm eğrileri değerlendirildi. Propilüourasil tedavisi ile tiroid bezi volümünde ve boyun çevresi ölçümünde istatistiksel olarak anlamlı azalma görüldü (sırasıyla; p 0.001 ve p 0.001). Çalışmanın en önemli sonucu maksimal ekspirasyon ortası akım hızı (MMEFR) parametresinde üç aylık propiltiourasil tedavisi sonrası görülen düzelme idi. Vital kapasitenin %25'indeki ortalama ekspiratuar akım hızı (FEF_{25}) ve vital kapasitenin %75'indeki ortalama ekspiratuar akım hızı (FEF_{75}) parametrelerinde kaydedilen artışlar tüm ekspiratuar akım parametrelerindeki düzelme ile uyumluydu (sırasıyla; p 0.044 ve p 0.012). Sonuçta hipertiroidi tedavisi için propiltiourasil kullanan hastaların akım-volüm eğrilerinde en erken değişiklik ekspiratuar akım parametrelerindeki düzelme olarak bulundu.