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Öğe Clinical differences between elderly and non-elderly patients with COVID-19(Aves, 2022) Ucsular, Fatma Demirci; Karadeniz, Gulistan; Polat, Gulru; Ayrancı, Aysu; Yalniz, Enver; Kazankaya, Fatmanur; Guldaval, FilizOBJECTIVE: Comorbidity frequency and mortality rates are higher in elderly patients with COVID-19. The disease is also more severe in elderly patients. This study aims to examine the characteristics of the COVID-19 disease, severity, comorbidities, and mortality rates in elderly patients by comparing them with nonelderly patients. MATERIAL AND METHODS: This study was designed as a retrospective study. 469 patients who were followed up in outpatient, inpatient, and intensive care units with the diagnosis of COVID-19 between March 11, 2020, and June 01, 2020, were retrospectively included in the study. Patients were divided into two groups who were >= 65 years named as the elderly group and <65 years referred to as nonelderly. Survival data was generated from the death notification system on August 02, 2020. RESULTS: A total of 469 patients including elderly(n=101) and nonelderly(n=368) were included in the study retrospectively. The incidence of severe pneumonia(31%/12.6%) and critical illness(16%/5.8%), comorbidity (85%/37.2%) and hospitalization time(8/5 days) were significantly higher in the elderly group(p<0.05). 23 (22.8%) of elderly patients and 27(7.3%) of nonelderly patients died (p=0.000). Mortality was found to be 3.5 times higher than in the non-elderly group. The expected survival time was 145.85 days(CI 95%:133-158.66) in the elderly patients and 170.36 days(CI 95%:166-174.6) in the nonelderly patients (p<0.000). In ROC analysis, the sensitivity of age was 86%(73.3-94.2), specificity was 66.83%(62.1-71.3), and the cut-off>56 (AUC:0.775; p <0.001) in predicting mortality. CONCLUSION: Mortality is high, comorbidities are more frequent, and the disease is more severe in elderly patients with COVID-19. Age above 56 can be used as a cut-off to predict mortality.Öğe The comparison of exacerbation and pneumonia before and after conjugated pneumococcal vaccination in patients with chronic obstructive pulmonary disease, and the effect of inhaled corticosteroid use on results(Turkish Assoc Tuberculosis & Thorax, 2022) Sahin, Gorkem Vayisoglu; Karadeniz, Gulistan; Polat, Gulru; Yalniz, Enver; Ayrancı, Aysu; Ucsular, Fatma Demirci; Gucsav, Mutlu OnurThe comparison of exacerbation and pneumonia before and after conjugated pneumococcal vaccination in patients with chronic obstructive pulmonary disease, and the effect of inhaled corticosteroid use on results Introduction: Pneumococcal infections and exacerbations are important causes of mortality and morbidity in chronic obstructive pulmonary disease (COPD). The use of inhaled corticosteroids and pneumococcal vaccination are suggested for the control of the disease progression and exacerbations. The aim of this study is to assess the effect of pneumococcal conjugate vaccine on pneumonia and exacerbation in COPD patients using inhaled corticosteroids (ICSs). The secondary aim is to analyze the effect of ICS use and different ICS types, if administered, on exacerbation and pneumonia incidence in the study population. Materials and Methods: Medical records of 108 adult patients with COPD who were vaccinated with the pneumococcal conjugate vaccine (PCV13) were retrospectively evaluated. The number of acute exacerbations and pneumonia within one year before and after vaccination were evaluated in all included COPD patients. The comparison analysis was also performed based on the ICS types. Results: There were statistically significant differences between the mean numbers of pneumonia and exacerbations before and after vaccination (p< 0.05). There were no significant differences in the mean pneumonia attacks and acute exacerbations between patients using ICS and not using ICS (p> 0.05). Conclusion: This study revealed that PCV13 provides a significant decrease in both exacerbation and pneumonia episodes in COPD patients. On the other hand, the use of ICSs and the types of ICSs were not found to have adverse effects on pneumonia and acute exacerbations in vaccinated COPD patients.Öğe Determining factors affecting the acceptability of spirometry: A survey study in a tertiary chest diseases center(Turkish Assoc Tuberculosis & Thorax, 2023) Gucsav, Mutlu Onur; Polat, Gulru; Unat, Damla Serce; Bayramic, Eda; Yilmaz, Emine Sena DikmentepeDetermining factors affecting the acceptability of spirometry: A survey study in a tertiary chest diseases center Introduction: Unlike other laboratory tests, spirometry requires the participant's full compliance with the maneuvers in the test for an acceptable test result. In this study, we aimed to determine the suitability of spirometric tests regarding acceptability and the factors associated with acceptability. Materials and Methods: Before the test, our 15-scale questionnaire, prepared by us in the respiratory function laboratory, was applied to the participants who requested spirometric examination in our hospital. Afterwards, patients were subjected to spirometric analysis. Spirogram results of the participants were evaluated by four clinicians who were experts in the field based on the acceptability criteria in the American Thoracic Society and European Respiratory Society Spirometry Standardization Guidelines. Participants were divided into two groups as those who met the acceptability criteria and those who did not. Both groups were compared regarding demographic data, comorbidities, education levels, and questions in the questionnaire. Results: The acceptability spirometry rate was 71.2%. The most common error among those who could not perform an acceptable test was the inability to complete the expiratory time to the time that would create a plateau, with 37.3%. Education level and acceptability of spirometry were not related (p= 0.228). Asthma was statistically significantly higher in the group that per-formed acceptable spirometry (p= 0.049). Acceptable spirometry rate was statistically significantly higher in the participants who had previously per-formed spirometric tests compared to the other group (p< 0.001). The test success of the participants who did not have success anxiety about the test was significantly higher than the other group (p= 0.033). Conclusion: Reduction of participants' anxiety and repetitive testing increases test acceptability. For this reason, in our clinical practice, we recommend that people who want a spirometry test relieve their anxiety about the test and repeat the test in unacceptable tests.Öğe Evaluation of whether smoking cessation among advanced lung cancer patients has a significant effect on anxiety and depressive symptoms(Kare Publ, 2023) Guldaval, Filiz; Polat, Gulru; Anar, Ceyda; Ayranci, Aysu; Karadeniz, Gulistan; Gayaf, Mine; Turk, Merve AyikBACKGROUND AND AIM: Continued smoking has a detrimental effect on lung cancer patients, which may already be associated with anxiety and depression. There is a belief among some that smoking cessation will further increase anxiety and depression in these patients, reducing their quality of life. In this study, we aimed to determine whether there was a difference in anxiety, depression, and quality of life scores between ex-smokers after the diagnosis of lung cancer and current smokers.METHODS: One hundred patients with advanced lung cancer were included in the study. Demographic characteristics were recorded, and the smoking status of patients was questioned. The Hospital Anxiety and Depression Scale and European Organization for Research and Treatment of Cancer Quality of Life tests were performed to evaluate anxiety, depression, and quality of life.RESULTS: The mean age was 61 & PLUSMN;8 years. Adenocarcinoma was the most common type of cancer, and 64% of the cases were at stage 4. Of the total 100 patients, 8 had never smoked, 23 were smokers, and 69 were ex-smokers. After the diagnosis of lung cancer, 17 patients quit smoking. No statistically significant difference was found between smoking status and anxiety or depression and quality of life scores (p>0.05). There was no difference between anxiety or depression and quality of life scores between patients who quit smoking after the diagnosis and those who continued (p>0.05).CONCLUSIONS: Patients with lung cancer should not be abstained from smoking cessation because of the possibility of increased anxiety or depression; rather, patients should be supported for smoking cessation at any stage.Öğe Pneumothoraxes after CT-guided percutaneous transthoracic needle aspiration biopsy of the lung: A single-center experience with 3426 patients(Turkish Assoc Tuberculosis & Thorax, 2023) Polat, Gulru; Ozdemir, Ozer; Unat, Damla Serce; Karadeniz, Gulistan; Ayranci, Aysu; Unat, Omer Selim; Buyuksirin, MelihIntroduction: The purpose of this study is to determine how long patients who developed pneumothorax were followed up on in the emergency department, how many patients required chest tube placement, and what factors influenced the need for a chest tube in patients who underwent computed tomography (CT)-guided percutaneous trans -thoracic fine needle aspiration biopsy (PTFNAB).Materials and Methods: Patients who developed pneumothorax following CT-guided PTFNAB were analyzed retrospectively. In cases with pneumotho-rax, the relationship between chest tube placement and the size of the lesion, the lesion depth from the pleural surface, the presence of emphysema, and the needle entry angle were investigated. It was determined how long the patients were followed up in the emergency department, when a chest tube was pla-ced, and when patients who did not require chest tube placement were discharged.Results: CT-guided PTFNAB was performed in 3426 patients within two years. Pneumothorax developed in 314 (9%) cases and a chest tube was placed in 117 (37%). The risk factor for chest tube placement was found to be the lesion depth from the pleural surface. The lesion depth from the pleural surface of >24 mm increased the risk of chest tube placement by 4.8 times. Chest tubes were placed at an average of five hours (5.04 +/- 5.57).Conclusion: This study has shown that in cases with pneumothorax that required chest tube placement, the lesion depth from the pleural surface is a risk factor. Patients who developed pneumothorax on CT during the procedure had chest tubes placed after an average of five hours.Öğe Risk Factors for Presence of Resistant Microorganisms in Sputum Cultures of Patients with Infectious Exacerbations of Chronic Obstructive Lung Disease(Bilimsel Tip Yayinevi, 2022) Buyuksirin, Melih; Senol, Gunes; Polat, Gulru; Ayranci, Aysu; Guldaval, Filiz; Serce Unat, DamlaIntroduction: Antibiotics reduce the risk of short-term mortality. Certain bacteria may be resistant to initial regimens which is related to mortality. The aim of this study was to find risk factors for the presence of resistant bacteria during exacerbation of Chronic Obstructive Pulmonary Disease (COPD). Materials and Methods: Ethics committee approval was obtained for the study. The patients hospitalized with an exacerbation of COPD between 2015 and 2020 were retrospectively ieviewed. The patients with a sputum culture result were divided into: Group A with conventional microorganisms (susceptible to initial antibiotic regimen) and Group B with non-conventional microorganisms (resistant to initial antibiotic regimen). The risk factors for Group B microorganisms were investigated. Results: One hundred and nineteen patients were included in the study. Median age was 68 (40-88) years. There were 22 patients in Group A and 97 in Group B. Most common microorganism in Group A was Haemophilus influenza (12.6%). Most encountered microorganisms in Group B were Pseudomonas aeruginosa (49.6%). Male sex (HR= 2.9; 95% CI= 0.9-9.5; p= 0.073), age >61 (HR=4.8; 95% CI= 1.7-13.6; p= 0.003), and >5 hospitalizations last year (HR= 8.2; 95% CI= 0.9-67.7; p= 0.051) were found to be independent risk factors for resistant microorganisms. Conclusion: Proposed risk factors for the isolation of multidrug resistant microorganism in patients hospitalized with COPD exacerbations should be considered when choosing the initial antibiotic regimen.
