Wos Açık Erişimli Yayınlar
Permanent URI for this collectionhttps://hdl.handle.net/11727/10754
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Item Analysis of the relationship between tuberculosis-related mortality and nitrous oxide emission levels in the world with the environmental Kuznets curve method(2022) Torun, Serife; Yilmaz, Kadir; Ozkaya, Sevket; Yosunkaya, Sebnem; Akcay, Sule; 36326361Background/aim: It was aimed to analyze the relationship between tuberculosis-related mortality and nitrous oxide emission levels in the world with the Environmental Kuznets Curve (EKC) Method. Materials and methods: WHO ICD-10 mortality list data and the World Bank Country Data (WBCD) were used between 1997 and 2017 for 12 countries. Cubic regression analysis was used for EKC Analysis. Results: The difference between male and female deaths between 1996 and 1998 has increased sharply since 1999. Male deaths consistently occurred significantly more than female deaths. There was a significant and negative correlation between Nitrous oxide emissions (% change from 1990) and tuberculosis-related deaths, whereas there were significant and positive correlations between Nitrous oxide emissions in the energy sector (% of total) and tuberculosis-related deaths (p < 0.01). EKC analysis results showed that there is a U shaped between tuberculosis-related mortality and nitrous oxide emission levels in the world. Conclusion: Research results show that the relationship between nitrous oxide change and mortality is negative in the short term and positive in the long term. Therefore, although nitrous oxide gases cause respiratory diseases and mortality, it may be possible to transform a harmful environmental factor into a positive by developing devices or methods that will convert these gases into free radicals.Item Characteristics of hospitalised COVID-19 patients and parameters associated with severe pneumonia(2021) Turan, Onur; Mirici, Arzu; Akcali, Serap Duru; Turan, Pakize Ayse; Batum, Ozgur; Sengul, Aysun; Unsal, Zuhal Ekici; Kabakoglu, Nalan Isik; Ogan, Nalan; Torun, Serife; Ak, Guntulu; Akcay, Sule; Komurcuoglu, Berna; Sen, Nazan; Mutlu, Pinar; Yilmaz, Ulku; 34480831Background After the first case of coronavirus disease 2019 (COVID-19) was reported in China in December 2019, it caused a global pandemic, including Turkey. Objectives The aim of this study was to analyse the characteristics of hospitalised COVID-19 patients and assess the parameters related to severe pneumonia. Methods Included in the study were hospitalised COVID-19 patients with positive naso-oropharyngeal swabs. Patients' demographics, admission symptoms, laboratory and radiological findings were recorded retrospectively. Results Of 1013 patients, 583 were males (57.6%) and 430 were females (42.4%), with a mean age of 53.7 +/- 17.9. More than half of the patients had at least one comorbidities, the most common of which were hypertension and diabetes mellitus. Cough (59.8%), fatigue (49.5%) and fever (41.2%) were the most common presenting symptoms. Of the hospitalised COVID-19 patients, 84.9% had pneumonia and 83.5% had typical radiological COVID-19 appearances (94.5%: ground-glass areas). The most common laboratory findings were high C-reactive protein (CRP) (73.6%) and lactate dehydrogenase (LDH) (46.2%) levels, as well as lymphopenia (30.1%). Severe pneumonia was present in 28.1% of COVID-19 patients. Multivariate logistic regression analysis indicated that advanced age, hypotension, anaemia and elevated CRP and LDH serum levels were independent risk factors for the severity of COVID-19 pneumonia (P = .011, .006, .017, .003 and .001, respectively). Conclusion This study, as one of the first multicentre studies about characteristics of COVID-19 in Turkey, may guide about disease-related parameters and severity of pneumonia. Age, blood pressure, complete blood count and routine biochemical tests (including CRP and LDH) would appear to be important parameters for the evaluation of the severity of COVID-19 pneumonia.Item Influenza viruses and SARS-CoV-2 in adult: 'Similarities and differences'(2021) Torun, Serife; Kesim, Cagri; Suner, Aynur; Botan Yildirim, Berna; Ozen, Ozgur; Akcay, Sule; 0000-0002-8964-291X; 0000-0001-7122-4130; 0000-0001-7730-1379; 34957739; AAD-5996-2021; AAN-1681-2021Introduction: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), causing a global pandemic starting from December 2019, showed a course that resulted in serious mortality in the world. In order to understand SARSCoV-2 better, here we aimed to compare the similar and different characteristics of Influenza viruses occurring in the same season with SARS-CoV-2. Materials and Methods: A total of 144 patients (31 patients with COVID-19, 62 patients with H1N1 influenza, and 51 patients with influenza B) were included in the study. Demographic findings, chronic diseases, laboratory values, chest x-ray, and chest CT findings of the patients were evaluated retrospectively. Results: Median age of the COVID-19 patients and rate of male patients were higher than other patient groups (55 years; p< 0.001) (61% male; p< 0.001). The most common chronic medical conditions were hypertension and diabetes. Platelet numbers and alanine aminotransferase values were significantly higher in COVID-19 patients. Radiologically, bilateral (74.2%) and nonspecific distribution (58.1%), ground-glass opacities with consolidation (51.6%), patchy image (25.8%), ground-glass opacities with interstitial changes (22.6%) and halo sign (22.6%) were quite evident than other groups in COVID-19 patients (p< 0.05). Conclusion: We suggest that due to the higher PLT values observed in COVID-19 patients, initiation of anticoagulant therapy should be considered in the early stage and routine follow-up with d-dimer and fibrinogen should be applied for suspected patients. Moreover, attention should be paid in terms of possible liver toxicity of the drugs to be used in treatment due the higher ALT values observed in COVID-19 patients. Since we did not detect SARS-CoV-2 and influenza viruses concurrently in the same patient, it may be helpful to focus on only one virus in a patient with symptoms, and radiographic differences can be used to differentiate COVID-19 from influenza.Item Radiological approaches to COVID-19 pneumonia(2020) Akcay, Sule; Ozlu, Tevfik; Yilmaz, Aydin; 0000-0002-8360-6459; 32299200; AAB-5175-2021COVID-19 pneumonia has high mortality rates. The symptoms are undiagnostic, the results of viral nucleic acid detection method (PCR) can delay, so that chest computerized tomography is often key diagnostic test in patients with possible COVID-19 pneumonia. In this review, we discussed the main radiological findings of this infection.Item Evaluation of Subclinical Atherosclerosis with Carotid Intima-Media and Epicardial Fat Thickness in Patients with Sarcoidosis(2020) Yilmaz, Hatice Eylul Bozkurt; Yilmaz, Mustafa; Erol, Tansel; Sen, Nazan; Unsal, Zuhal Ekici; Kara, Sibel; Habesoglu, Mehmet Ali; Akcay, Sule; 0000-0002-3628-4661; 0000-0002-2557-9579; 0000-0002-8360-6459; 0000-0003-3225-2686; 0000-0002-4171-7484; 32584234; AAN-5153-2021; S-6973-2016; AAI-8069-2021; AAB-5175-2021; AAD-5602-2021; AAI-8947-2021OBJECTIVES: Since many similar mechanisms may play a role in the pathophysiology of sarcoidosis and atherosclerosis, the risk of subclinical atherosclerosis may be increased in patients with sarcoidosis. The aim of this study was to evaluate known markers of subclinical atherosclerosis, namely epicardial fat thickness (EFT) and carotid intima-media thickness (CIMT) in patients with sarcoidosis. MATERIALS AND METHODS: This cross-sectional study included a total of 183 subjects, including 94 patients with sarcoidosis (patient group) and a control group of 89 healthy individuals. Measurements of EFT and CIMT were taken from all subjects and recorded. The groups were compared, and differences were analyzed statistically. RESULTS: EFT was higher in patients than in control subjects (6.42 +/- 1.12 mm vs 7.13 +/- 1.41 mm, p<0.001). CIMT was higher in patients than in control subjects (0.51 +/- 0.02 mm vs 0.52 +/- 0.02 mm, p=0.003). CONCLUSION: EFT and CIMT were found to be higher in patients with sarcoidosis than in healthy people. These results indicate that the risk of subclinical atherosclerosis might be increased in these patients.Item Diagnostic importance of maximum intensity projection technique in the identification of small pulmonary nodules with computed tomography(2020) Guleryuz Kizil, Pinar; Hekimoglu, Koray; Coskun, Mehmet; Akcay, Sule; 0000-0002-0805-0841; 0000-0001-5630-022X; 0000-0002-8360-6459; 32755123; AAD-9097-2021; AAM-4120-2021; AAB-5175-2021Item Diagnostic importance of maximum intensity projection technique in the identification of small pulmonary nodules with computed tomography(2020) Guleryuz Kizil, Pinar; Hekimoglu, Koray; Coskun, Mehmet; Akcay, Sule; 0000-0001-5630-022X; 0000-0002-0805-0841; 0000-0002-8360-6459; 32718138; AAM-4120-2021; AAD-9097-2021; AAB-5175-2021Introduction: In this retrospective study, the aim is to determine the sensitivity of maximum intensity projection (MIP) technique to 3 mm-thick axial sections in patients with small pulmonary nodules identified via examination using computed tomography (CT), and to identify whether this technique provides significant reduction in duration of nodule evaluation. Materials and Methods: A total of 69 patients (339 nodules) who underwent thoracic tomography due to various complaints and in whom pulmonary nodules were identified as a result of the examination were included in the study. Their axial sections that are 3 mm-thick and MIP sections obtained in the axial plane were evaluated by two different radiologists at different times by keeping time. the dimensions and evaluation times of the nodules were recorded separately for each method. Results: Evaluation compatibility between the radiologists was found to be 86.8% and it was considered to be perfectly compatible. Sensitivity of the 1st radiologist in the detection of nodules with MIP was 81.4%, whereas the sensitivity of the 2nd radiologist was 83.4%. In the evaluation for the reporting periods, when the duration of evaluation of MIP images were compared with the gold standard, a statistically significant reduction was found in the reporting times of both radiologists (p< 0.01). Conclusion: It was found that utilization of MIP images as an alternative method to detect pulmonary modules reduces the duration of evaluation significantly and provides the ability to detect nodules with high sensitivity. According to these data, MIP imaging may be preferred as an adjunct method in the evaluation of lung nodules as it provides fast and reliable information besides classical axial sections.Item Tobacco and COVID-19(2020) Sonmez, Ozlem; Tasdemir, ZeynepAtam; kara, H. Volkan; Akcay, Sule; 0000-0002-8360-6459; AAB-5175-2021Tobacco and its products are the well-known causes of premature deaths associated with cancer, cardiovascular disease, and chronic obstructive pulmonary disease, as well as they constitute a significant risk factor that increases the tendency to respiratory system infection and other systemic infections. Active tobacco use and passive smoking increase the risk of infection. Both increase peribronchial and alveolar inflammation and fibrosis and mucosal permeability, cause inadequate mucociliary cleaning, damage to the respiratory tract epithelium resulting in fibrosis, and they adversely affect cellular and humoral immunity. Smoking has been known to increase the risk for viral infections and influenza. Similar data have been approved found for coronavirus disease-2019 (COVID-19) pandemic. Smoking is reported to be associated with the frequency of the disease and its severity of the clinical course. Severe acute respiratory syndrome-coronavirus-2 penetrates the cell using the angiotensin-converting enzyme 2 receptors. Such receptor proteins had been shown to increase in smoker individuals. Also, smoking facilitates penetration of the virus into the cell. The frequency of smoking and the rates of admission to intensive care, mechanical ventilation, and mortality have been also found to be higher was higher in severe cases. The risk for disease progression was found to be 14-fold higher in smokers. Further, the World Health Organization emphasized similar negative effects of hookah and new tobacco products such as electronic cigarettes and heated tobacco products. It is vital to underline the adverse effects of tobacco and tobacco products and to raise awareness among the public and to make efforts to smoking on every opportunity during the COVID-19 pandemic. Public awareness campaigns during the pandemic must always accompanied by the methods and strategies to avoid active and passive smoking.Item Investigation of the Relationship between Asthma and Visceral Obesity by Epicardial Fat Thickness Measurement(2019) Yilmaz, Hatice Eylul Bozkurt; Yilmaz, Mustafa; Sen, Nazan; Unsal, Zuhal Ekici; Eyuboglu, Fusun Oner; Akcay, Sule; 0000-0003-3225-2686; 0000-0002-8360-6459; AAB-5175-2021; 30664419; AAR-4338-2020; AAD-5602-2021OBJECTIVES: Obesity is a risk factor defined in recent years for asthma. It is associated not only with asthma but also with many cardiovascular diseases. Visceral obesity is a more significant risk factor than general obesity in cardiovascular diseases. Although the association of visceral obesity with cardiovascular diseases is well known, the relationship in patients with asthma is not fully understood. The aim of the present study was to investigate whether there is a relationship between asthma and visceral fat by using epicardial fat thickness (EFT) measurement. MATERIALS AND METHODS: A total of 401 subjects (229 patients with persistent asthma and 172 controls) were enrolled in the study. In our study, EFT was measured, recorded by echocardiography, and was evaluated whether there was a statistical significant difference between the two groups. RESULTS: The mean EFT was 5.84 +/- 0.79 mm in the patient group and 5.71 +/- 0.93 mm in the control group. There was no statistically significant difference between the groups (p=0.145). Similarly, when we compared control and asthma severity subgroups, we did not find statistically significant differences (control group mean 5.71 +/- 0.93 mm, mild group mean 5.86 +/- 0.81 mm, moderate group mean 5.8 +/- 0.84 mm, and severe group mean 5.83 +/- 0.67 mm, p=0.505). CONCLUSION: In the present study, we observed that the EFT did not increase in patients with asthma compared with the normal population. Based on our results, we suggest that visceral obesity may not be a significant risk factor for asthma.Item Association between pulmonologists' tobacco use and their effort in promoting smoking cessation in Turkey: a cross-sectional study(2015) Bostan, Pinar Pazarli; Demir, Canan Karaman; Elbek, Osman; Akcay, Sule; 26558993Background: A strategy to reduce the number of smoking-related deaths is to encourage the involvement of health-care professionals in tobacco-use prevention activities and cessation counseling. Previous studies have shown that physicians' smoking status affects their efforts to provide smoking cessation counseling. This study investigates the association between pulmonologists' tobacco use and their efforts in promoting smoking cessation during their routine clinical practices in Turkey. Methods: This cross-sectional study was performed among active members of the Turkish Thoracic Society (TTS) between June 2010 and February 2011 using an Internet-based self-administered questionnaire. Participants gave their written informed consent. The survey included questions about responders' sociodemographics, smoking status, and their routine clinical practice for smoking cessation counseling using the basic 5A's (Ask, Advise, Assess, Assist, and Arrange) of smoking cessation counseling. According to the total score for the 5A's protocol, smoking cessation counseling was dichotomized into low-and high-effort groups in promoting smoking cessation. Pearson's chi-square test and t-test were used to compare groups and logistic regression models for the research question, which was approved by the TTS Scientific Ethical Committee. Results: The response rate was 41 % (N = 699/1701); 9.9 % were current smokers, and 72.7 % indicated that they provided high effort in promoting smoking cessation. A univariate analysis showed that noncurrent smokers were more likely to make a high effort than current smokers (odds ratio [OR], 1.82; 95 % confidence interval [CI]: 1.09-3.05; P = 0.02). However, there was no association between tobacco use (current smoking) and making high effort in promoting smoking cessation after controlling for the two confounders, sex and practicing in smoking cessation outpatient clinic (OR, 1.47; 95 % CI: 0.86-2.50; P = 0.1). Conclusions: Despite low response rate in our study and suspicions of underreporting, the smoking rate among the pulmonologists in our study was high. Non-current smokers were more likely to provide high effort in promoting smoking cessation compared to current smokers in univariate analysis. However, after controlling for the two confounders, sex and practising in SCOC, there was no association between tobacco use and providing high effort in promoting smoking cessation. Thus, improving medical school education, specialty training and post-graduate training on smoking cessation counseling may positively affect physician' effort in promoting smoking cessation.