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Öğe Barotrauma Associated with Mechanical Ventilation(Aves, 2017) Uysal, Funda Elmas; Ekren, Pervin Korkmaz; Kuntman, Atilla; Bacakoglu, FezaObjective: The incidence of barotrauma in patients who received mechanical ventilation (MV) has decreased due to protective MV strategies. This study aimed to assess the incidence, treatment, and prognosis of barotrauma in patients who received MV in our tertiary intensive care unit (ICU) and to discuss with the literature. Material and Methods: Patients hospitalized between January 2008 and December 2014 were assessed. Those who had barotrauma were retrospectively analyzed. Results: Invasive MV was performed in 861 of 1341 patients. Barotrauma was seen in 19 (2.2%) patients. These patients' (mean age, 63.2 +/- 18.2 years; 14 males) median APACHE II score was 18, and their median duration of MV was 168 h. Acute Respiratory Distress Syndrome(ARDS) was diagnosed in 57.9% of the patients at admission, and volume-controlled ventilation was mostly used (47.4%). Barotrauma occurred on day 8 (median; range, day 4-21). Pneumonia was diagnosed in 84.2% of the patients. Pressure support ventilation was mostly used (47.4%) at the time of barotrauma. All patients had pneumomediastinum. Pneumothorax was diagnosed in 16 (84.2%) patients (bilaterally in 3 patients). Subcutaneous emphysema was seen in 11 patients (57.9%). Pneumothorax was treated by tube thoracostomy in 15 patients (83.3%). While the mortality rate was 26.3% in first 24 h, the overall mortality rate was 100%. Conclusion: The incidence of barotrauma was lower among our ICU patients who received MV, but the prognosis of these patients was poor.Öğe Comparison of Eosinophilic and Non-eosinophilic Cases with Chronic Obstructive Pulmonary Disease (COPD) in terms of Clinical Arrival, Exacerbations, Quality of Life and Response to Treatment: A Prospective Study(European Respiratory Soc Journals Ltd, 2019) Kaptan, Yagmur; Sunel, Asli; Ekin, Zubeyde; Nart, Deniz; Uysal, Funda Elmas; Sayiner, Abdullah; Gurgun, Alev[No abstract available]Öğe Does the Body Composition Worsens From GOLD Categories A to D in Patients With COPD?(Amer Coll Chest Physicians, 2016) Gurgun, Alev; Uysal, Funda Elmas; Ekren, Pervin Korkmaz; Karadag, VolkanÖğe Effects of pulmonary rehabilitation in patients with mild-to-moderate chronic obstructive pulmonary disease: Bottom of an iceberg(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2018) Ekren, Pervin Korkmaz; Gurgun, Alev; Uysal, Funda Elmas; Tuncel, Senay; Deniz, Sami; Karapolat, Hale; Bacakoglu, FezaObjectives: This study aims to compare the effects of pulmonary rehabilitation (PR) in patients with mild-to-moderate and severe-to-very severe chronic obstructive pulmonary disease (COPD). Patients and methods: Between January 2005 and December 2010, a total of 76 patients with mild-to-moderate (Global Initiative for Chronic Obstructive Lung Disease [ GOLD] Stages I+II, n=33, mean age 66.0 +/- 8.6 years) and severe-to-very severe (GOLD Stages III+IV, n=43, mean age 63.5 +/- 8.8 years) COPD completed an eight-week outpatient PR program. Incremental and endurance shuttle walk tests (ISWT, ESWT), St. George's Respiratory Questionnaire (SGRQ), Chronic Respiratory Questionnaire (CRQ), and Hospital Anxiety and Depression Scale were assessed before and after PR. Changes after the intervention were compared between two groups. Results: There were significant improvements in the ISWT and median 60 m [(-150)-(400)] in mild-to-moderate group and 70 m [(0)-(270)] in severe-to-very severe group (both, p<0.001). The ESWT time improved in both groups, 122s [(-279)-(665)] (p=0.002) and 61s [(-180)( 878)] (p<0.001), respectively. Significant effects were observed in all domains of the SGRQ except the impact score in mild-to-moderate patients. There were significant improvements in all domains except the symptoms score in severe-to-very severe patients. Using the CRQ, a significant improvement was shown in all domains of CRQ except the dyspnea score of mild-to-moderate patients. Anxiety and depression scores decreased after PR in both groups (p<0.05). According to changes in outcomes, there was no difference in any parameters between two groups. Conclusion: This study demonstrates that patients with mild-to-moderate COPD benefit from PR comparably to patients with severe-to-very-severe COPD. Although patients with mild-to-moderate COPD are not usually symptomatic, our findings suggest that they should be included in PR.Öğe Evaluation of Smoking and Other Tobacco Product Habits of Ege University Faculty of Health Sciences Students: A cross-sectional Survey Study(European Respiratory Soc Journals Ltd, 2020) Uysal, Funda Elmas; Gurgun, Alev; Hassoy, Hur; Guduk, Zafer; Ciray, Nazmiye; Ergin, Isil; Ata, Batuhan[No Abstract Available]Öğe Evaluation of Traffic Accident Risk in In-City Bus Drivers: the Use of Berlin Questionnaire(2018) Taşbakan, Mehmet Sezai; Ekren, Pervin Korkmaz; Uysal, Funda Elmas; Başoğlu, Özen K.OBJECTIVES: Traffic accidents associated with high mortality rate may produce serious problems especially in highways. Obstructive sleep apnea (OSA) has been associated with a high risk for traffic accidents due to excessive daytime sleepiness even in in-city drivers. in the present study, it was aimed to evaluate the rate of OSA symptoms and to identify risk factors associated with traffic accidents in in-city bus drivers. MATERIAL AND METHODS: A self-administered questionnaire including demographic and anthropometric features, sleep and work schedules, Berlin questionnaire, Epworth sleepiness score (ESS), and history of traffic accidents was used. RESULTS: the questionnaire was conducted for 1400 male bus drivers (mean age, 38.0±6.4 y, body mass index, 27.8±3.9 kg/m 2 ). A total of 1058 (75.6%) drivers had one or more accidents while driving bus. According to the Berlin questionnaire, 176 (12.6%) drivers were found to have high OSA risk and the accident rate was 83.0% in high-risk group, whereas 74.5% of low-risk drivers had accidents (p=0.043). the drivers with a history of traffic accident were older (p=0.030), had higher ESS (p=0.019), and were more in the high-risk OSA group according to the Berlin questionnaire (p=0.015). in multivariate linear regression analysis, traffic accident was associated with only Berlin questionnaire (p=0.015). CONCLUSION: the present results support that city bus drivers with high OSA risk according to Berlin questionnaire have increased accident rates. Therefore, we suggest using Berlin questionnaire for screening sleep apnea not only in highway drivers but also in in-city bus drivers.Öğe Evaluation of Traffic Accident Risk in In-City Bus Drivers: The Use of Berlin Questionnaire(Bilimsel Tip Publishing House, 2018) Tasbakan, Mehmet Sezai; Ekren, Pervin Korkmaz; Uysal, Funda Elmas; Basoglu, Ozen K.OBJECTIVES: Traffic accidents associated with high mortality rate may produce serious problems especially in highways. Obstructive sleep apnea (OSA) has been associated with a high risk for traffic accidents due to excessive daytime sleepiness even in in-city drivers. In the present study, it was aimed to evaluate the rate of OSA symptoms and to identify risk factors associated with traffic accidents in in-city bus drivers. MATERIAL AND METHODS: A self-administered questionnaire including demographic and anthropometric features, sleep and work schedules, Berlin questionnaire, Epworth sleepiness score (ESS), and history of traffic accidents was used. RESULTS: The questionnaire was conducted for 1400 male bus drivers (mean age, 38.0 +/- 6.4 y, body mass index, 27.8 +/- 3.9 kg/m(2)). A total of 1058 (75.6%) drivers had one or more accidents while driving bus. According to the Berlin questionnaire, 176 (12.6%) drivers were found to have high OSA risk and the accident rate was 83.0% in high-risk group, whereas 74.5% of low-risk drivers had accidents (p=0.043). The drivers with a history of traffic accident were older (p=0.030), had higher ESS (p=0.019), and were more in the high-risk OSA group according to the Berlin questionnaire (p=0.015). In multivariate linear regression analysis, traffic accident was associated with only Berlin questionnaire (p=0.015). CONCLUSION: The present results support that city bus drivers with high OSA risk according to Berlin questionnaire have increased accident rates. Therefore, we suggest using Berlin questionnaire for screening sleep apnea not only in highway drivers but also in in-city bus drivers.Öğe Pulmonary Rehabilitation Response in Elderly and Younger Patients With COPD(Amer Coll Chest Physicians, 2016) Gurgun, Alev; Ekren, Pervin Korkmaz; Uysal, Funda Elmas; Karapolat, Hale; Tuncel, SenayÖğe What should be the appropriate minimal duration for patient examination and evaluation in pulmonary outpatient clinics?(Medknow Publications & Media Pvt Ltd, 2017) Musellim, Benan; Borekci, Sermin; Uzan, Gulfidan; Sak, Zafer Hasan Ali; Ozdemir, Secil Kepil; Altinisik, Goksel; Altunbey, Sinem Agca; Sen, Nazan; Kilinc, Oguz; Yorgancioglu, Arzu; Yilmaz, Nafiye; Ulasli, Sevinc Sarinc; Salepci, Banu; Ocakli, Birsen; Sokullu, Zinet Gul Ersoy; Uzun, Oguz; Kurtulus, Serif; Uslu, Selen; Saritas, Emel; Genc, Sebahat; Annakkaya, Ali Nihat; Aydin, Omur; Bilgin, Cahit; Turk, Murat; Ozmen, Ipek; Tasbakan, Mehmet Sezai; Halis, Ayse Nigar; Bahcecioglu, Sakine Nazik; Dabak, Gul; Isik, Sacide Rana; Ozturk, Ayse Bilge; Akgun, Metin; Pihtili, Aylin; Ozkan, Gulcihan; Balbay, Ege Gulec; Okumus, Gulfer; Onen, Zeynep Pinar; Yasayancan, Nursen; Uysal, Funda Elmas; Hanta, Ismail; Kaya, Zuleyha; Turker, Hatice; Berkesoglu, Cigdem; Celik, Pinar; Cetinkaya, Pelin Duru; Gundogus, Baran; Ongen, Gul; Tuncay, Esin; Erboy, FatmaINTRODUCTION: Patient examinations performed in a limited time period may lead to impairment in patient and physician relationship, defective and erroneous diagnosis, inappropriate prescriptions, less common use of preventive medicine practices, poor patient satisfaction, and increased violent acts against health-care staff. OBJECTIVE: This study aimed to determine the appropriate minimal duration of patient examination in the pulmonary practice. METHODS: A total of 49 researchers from ten different study groups of the Turkish Thoracic Society participated in the study. The researchers were asked to examine patients in an almost ideal manner, without time constraint under available conditions. RESULTS: A total of 1680 patient examinations were reviewed. The mean duration of patient examination in ideal conditions was determined to be 20.4 +/- 9.6 min. Among all steps of patient examination, the longest time was spent for "taking medical history." The total time spent for patient examination was statistically significantly longer in the university hospitals than in the governmental hospitals and training and research hospitals (P < 0.001). Among different patient categories, the patients with a chronic disorder presenting for the first time and were referred from primary or secondary to tertiary care for further evaluation have required the longest time for patient examination. CONCLUSION: According to our study, the appropriate minimal duration for patient examination is 20 min. It has been observed that in university hospitals and in patients with chronic pulmonary diseases, this duration has been increased to above 25 min. The durations in clinical practice should be planned accordingly.
