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Öğe Asthma-chronic obstructive pulmonary disease overlap: Results from a national-multicenter study; [Astım KOAH overlap: Ulusal çok merkezli bir çalışma sonuçları](Ankara University, 2024) Çelik G.E.; Aydin Ö.; Şen E.; Demir T.; Gemicioğlu B.; Kiyan E.; Mungan D.Introduction: Patients with asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) have a greater disease burden than those with COPD or asthma alone. In this study, it was aimed to determine the prevalence, risk factors, and clinical features of ACO because there are limited national data in Türkiye. Materials and Methods: The study was conducted in a cross-sectional design in nine tertiary-care hospitals. The patients followed with a diagnosis of asthma or COPD for at least one year were enrolled in the study. The frequency of ACO and the characteristics of the patients were evaluated in the asthma and COPD groups. Results: The study included 408 subjects (F/M= 205/203, mean age= 56.24 ± 11.85 years). The overall prevalence of ACO in both groups was 20.8% (n= 85). The frequency was higher in the COPD group than in the asthma group (n= 55; 33.3% vs. n= 22; 9.8%), respectively (p= 0.001). Patients with ACO had similarities to patients with COPD in terms of advanced age, sex, smoking, exposure to biomass during childhood, being born in rural areas, and radio-logic features. Characteristics such as a history of childhood asthma and allergic rhinitis, presence of chronic sinusitis, NSAID hypersensitivity, atopy, and high eosinophil counts were similar to those of patients with asthma (p< 0.001). The annual decline in FEV1 was more prominent in the ACO group (mean=-250 mL) than in the asthma (mean change=-60 mL) and COPD (mean change=-230 mL) groups (p= 0.003). Conclusion: This study showed that ACO was common among patients with asthma and COPD in tertiary care clinics in our country. ACO should be considered in patients with asthma and COPD who exhibit the abovementioned symptoms. © 2024 by Tuberculosis and Thorax.Öğe Asthma-KOAH overlap syndrome [Astım-KOAH overlap sendromu](Ankara University, 2015) Şen E.; Oğuzülgen K.; Bavbek S.; Günen H.; Kiyan E.; Türktaş H.; Yorgancioğlu A.; Polatli M.; Yildiz F.; Çelik G.; Demir T.; Gemicioğlu B.; Mungan D.; Saryal S.; Sayiner A.; Yildirim N.Asthma and chronic obstructive pulmonary disease (COPD) are common lung diseases characterized by chronic airway inflammation and airway obstruction. Among patient with COPD and asthma; there is a group of patients with an overlap between clinical, functional characteristics and airway inflammation patterns, named “Asthma-COPD Overlap Syndrome” (ACOS). ACOS is a syndrome characterized by reversible but persistant airflow limitation (postbronchodilator FEV1/FVC < 70%) which has some features of both asthma and COPD. ACOS should be suspected in a patient > 40 years, with smoking history, previous asthma diagnosis or history of childhood asthma who has persistant airflow limitation and reversible ariway obstruction (defined by an increase of > %12 of FEV1 pred or increase of FEV1 > 200 mL after inhalation of 400 mcg salbutamol or 1000 mcg terbutaline). The prevalence for ACOS has been reported 11-55% in different case series to date and increases by age and is more frequent in females in different age groups. Patients with ACOS are younger than COPD patients and older than asthma patients. Frequent and severe exacerbations and related hospitalization and emergency room visits are common in ACOS and this causes an impaired quality of life. Current recommendations of guidelines for pharmacologic treatment of ACOS have been composed of a combination with optimal COPD and asthma treatment. Future therapeutic approaches should be based on endotypes. Clinical phenotype and underlying endotype driven clinical studies may be the base of ACOS guidelines. © 2015, Ankara University. All rights reserved.Öğe Koah ve astımda atak [KOAH ve astımda atak](Ankara University, 2015) Yildirim N.; Demir T.; Gemicioğlu B.; Kiyan E.; Oğuzülgen K.; Polatli M.; Saryal S.; Sayiner A.; Yorgancioğlu A.; Bavbek S.; Çelik G.E.; Günen H.; Mungan D.; Şen E.; Türktaş H.; Yildiz F.Chronic obstructive pulmonary disease (COPD) and asthma are airway diseases with acute exacerbations. Natural course of both disease are affected by exacerbations. COPD exacerbations may be caused by infections and other causes; indoor and outdoor pollution, cardiovascular diseases, asthma-COPD overlap syndrome, COPD- obstructive sleep apnea syndrome, pulmonary embolism, gastro-oesophageal reflux, anxiety-depression, pulmonary hypertension. Exposure to triggering factors, viral infections, treatment insufficiency may cause asthma exacerbations. Smoking cessations, prevention of infections, long-acting anticholinergics, long-acting ß2 agonists, inhaled corticosteroids, phosphodiesterase-4 inhibitors, mucolytics, prophilactic antibiotics can be effective on the prevention of COPD exacerbations. Asthma exacerbations may be decreased by the avoidance of allergens, viral infections, occupational exposures, airpollution, treatment of comorbid diseases. Effective treatment of asthma is required to prevent asthma exacerbations. Inhaled steroids and combined treatments are the most effective preventive therapy for exacerbations. Patient education and cooperation is an element of the preventive measures for asthma attacks. Compliance to therapy, inhalation techniques, written asthma plans are required. The essential of COPD and asthma exacerbation treatment is bronchodilator therapy. Steroids are also implemented to the therapy, targeting the inflammation. Specific treatments of the cause (infection, airpollution, pulmonary embolism etc.) should be administered. © 2015, Ankara University. All rights reserved.Öğe Prevalence of asthmatic smokers: Turkish experience (PASTE Study)(Blackwell Publishing Ltd, 2014) Yildiz F.; Dursun A.B.; Disçi R.; Abadoglu O.; Atalay F.; Ates G.; Buyukoglan H.; Ceyhan B.; Ceylan E.; Deveci F.; Ediger D.; Ekici A.; Erdinc M.; Gemicioglu B.; Goktalay T.; Meral M.; Mungan D.; Ogus C.; Ozge C.Background: Although both asthma and smoking are major health problems worldwide, smokers are often excluded from asthma studies. Objectives: It was aimed to verify the prevalence of asthmatic smokers in Turkey and assess the effects of smoking based on clinical parameters, exacerbations and hospitalizations because of lack of national data about the prevalence of smoking among asthmatics. Methods: The study protocol was comprised of a retrospective questionnaire. The asthmatic patients were followed in the outpatient clinics of 18 tertiary hospitals selected from seven different geographical regions in Turkey. We evaluated demographic data, smoking habits, asthma-related diseases, respiratory function and emergency visits. Results: The study population included 1385 patients (M/F: 343/1042), and the mean age was 45.1±14.0 years. Current and former smoking prevalence was 11.4% and 15.1%, respectively. Smoker rates were higher in males and younger asthmatics compared with females and older asthmatics (P<0.01 and P<0.05, respectively). Smoking history ranged from 0.20 to 90 pack-years (the mean was 12.9), and smokers had a higher level of education compared with nonsmokers (P<0.01). Socioeconomically, the most developed region had the highest rate of smoker asthmatics (33.9%; P=0.014). There was an increase in the number of exacerbations in smoker asthmatics during the previous year, but it was not statistically significant (P>0.05). Conclusion: We showed that the smoking prevalence in Turkey was lower in asthmatics (11.4%) compared with the general population (44.5%). Nevertheless, every effort should be made to encourage asthmatics to stop smoking because smoking is a modifiable risk factor for adverse asthma health outcomes. © 2013 John Wiley and Sons Ltd.Öğe Treatment of severe asthma: Expert opinion [Agi{dotless}r asti{dotless}m tedavisi: Uzman görüşü](Ankara University, 2014) Türktaş H.; Bavbek S.; Çelik G.; Demir T.; Gemicioglu B.; Günen H.; Kiyan E.; Mungan D.; Oguzülgen I.K.; Polatli M.; Saryal S.; Sayiner A.; Şen E.; Yildirim N.; Yildiz F.; Yorgancioglu A.Severe asthmatics account 10% of the all asthmatic population. Those asthmatics whose disease is inadequately controlled account for up to half of the cost for asthma, because they have more emergency room visits, more hospital admission and greater absenteeism from work. New therapeutic options were tried in those patients whose asthma was uncontrolled with standart high dose inhaled corticosteroid and long acting beta-2 agonsit combination therapy. In this paper taking into account the conditions of our country, current literature was reviewed and treatment options was discussed and graded recommendations are made for daily clinical practice in patients with severe treatment-refractory asthma.
