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Öğe Anxiety and Depression Levels of Healthcare Workers During COVID-19 Pandemic(The European Respiratory Society, 2021) Turan, Muzaffer Onur; Demirci, Nilgün Yılmaz; Ak, Güntülü; Akçay, Şule; Aktürk, Ülkü Aka; Bilaceroğlu, Semra; Mirici, ArzuBackground: Coronavirus disease 2019 (COVID-19), which causes a pandemic in the world, has started to appear in Turkey since March 2020. Healthcare workers are at the top of the groups most at risk for COVID-19 infection, which can have a negative impact on psychological state. Objectives: It was aimed to evaluate anxiety and depression levels among healthcare workers. Methods: This cross-sectional study performed via an online survey in April 2020. Participants answered questions about sociodemographic features, personal views and experiences about COVID-19 and the Hospital Anxiety and Depression Scale (HADS). Results: A total of 300 healthcare workers, 193 men and 107 women, participated in the survey. According to HADS, 44.6% of participants scored above anxiety and 68.2% scored above depression cut-off points. Being younger than 50 and taking care of COVID-19 patients in hospitals were independently associated with anxiety risk. Female gender, young age (less than 50) and having a comorbidity were independent risk factors for depression. Conclusion: Healthcare workers were at high risk of anxiety and depression during COVID-19 outbreak. For this reason, psychological support should be given, especially to the group with high risk.Öğe Changes in inhalation therapy after combined assessment of COPD(European Respiratory Soc Journals Ltd, 2015) Turan, Muzaffer Onur; Emre, Julide Celdir; Deniz, Sami; Baysak, Aysegul; Turan, Pakize Ayse; Mirici, Arzu[Anstract Not Available]Öğe Changes in quality of life and physiological status in newly diagnosed COPD patients(European Respiratory Soc Journals Ltd, 2015) Turan, Muzaffer Onur; Kasan, Turgay; Mirici, Arzu[Anstract Not Available]Öğe Characteristics of hospitalized COVID-19 patients and parameters associated with severe pneumonia(The European Respiratory Society, 2021) Turan, Muzaffer Onur; Mirici, Arzu; Akçalı, Serap Duru; Turan, Pakize Ayşe; Batum, Özgür; Şengül, Aysun; Ünsal, Zuhal EkiciObjectives: The aim of this study is to analyse characteristics of hospitalized COVID-19 patients in Turkey. Methods: Hospitalized COVID-19 patients with positive naso-oropharyngeal swab examples from 10 different centers were included. Demographics, admission symptoms, laboratory and radiological findings were recorded retrospectively. Results: Of 1013 patients included in the study, there were 583 male (57.6%) and 430 female (42.4%), with the mean age of 53.7±17.9. More than half (%51.7) of the patients had at least one comorbid disease; the most common ones were hypertension and diabetes mellitus. Cough (59.8%), fatigue (49.5%) and fever (41.2%) were the most common presenting symptoms. There was pneumonia in 84.9% of hospitalized COVID-19 patients; 83.5% had typical radiological COVID-19 appearance (94.5%: ground glass areas). The most common laboratory findings were high CRP (73.6%) and lactat dehydrogenase (LDH) (46.2%) levels and lymphopenia (30.1%). Severe pneumonia was present in 28.1% of COVID-19 patients. Multivariate logistic regression analysis indicated that high age, hypotension, anemia, elevated serum levels of CRP and LDH were independent risk factors for severity of COVID-19 pneumonia (p=0.011, 0.006, 0.017, 0.003 and 0.001, respectively). Conclusion: Our study, which is one of the first multicenter studies about COVID-19 characteristics in Turkey, is thought to be a guide for COVID-19 patients in terms of clinical features . Age, blood pressure measurement, complete blood count and routine biochemical tests (including CRP and LDH) seem to be important parameters for evaluating the severity of pneumonia in COVID-19 patients.Öğe Characteristics of our hypoxemic COVID-19 pneumonia patients receiving corticosteroids and mortality-associated factors(Taylor & Francis Ltd, 2022) Sengul, Aysun; Mutlu, Pinar; Ozdemir, Ozer; Satici, Celal; Turan, Muzaffer Onur; Arslan, Sertac; Ogang, NalanBackground COVID-19 is a disease associated with diffuse lung injury that has no proven effective treatment yet. It is thought that glucocorticoids may reduce inflammation-mediated lung injury, disease progression, and mortality. We aimed to evaluate our patient's characteristics and treatment outcomes who received corticosteroids for COVID-19 pneumonia. Methods We conducted a multicenter retrospective study and reviewed 517 patients admitted due to COVID-19 pneumonia who were hypoxemic and administered steroids regarding demographic, laboratory, and radiological characteristics, treatment response, and mortality-associated factors. Results Of our 517 patients with COVID-19 pneumonia who were hypoxemic and received corticosteroids, the mortality rate was 24.4% (n = 126). The evaluation of mortality-associated factors revealed that age, comorbidities, a CURB-65 score of >= 2, higher SOFA scores, presence of MAS, high doses of steroids, type of steroids, COVID-19 treatment, stay in the intensive care unit, high levels of d-dimer, CRP, ferritin, and troponin, and renal dysfunction were associated with mortality. Conclusion Due to high starting and average steroid doses are more associated with mortality, high-dose steroid administration should be avoided. We believe that knowing the factors associated with mortality in these cases is essential for close follow-up. The use of CURB-65 and SOFA scores can predict prognosis in COVID-19 pneumonia.Öğe Chronic obstructive pulmonary disease phenotypes in Turkey: the COPET study-a national, multicenter cross-sectional observational study(Tubitak Scientific & Technological Research Council Turkey, 2022) Yazar, Esra Ertan; Yigitbas, Burcu Arpinar; Ozturk, Can; Calikoglu, Mukadder; Gulbas, Gazi; Turan, Muzaffer Onur; Sahin, HulyaBackground/aim: While mortality rates decrease in many chronic diseases, it continues to increase in COPD. This situation has led to the need to develop new approaches such as phenotypes in the management of COPD. We aimed to investigate the distribution, characteristics and treatment preference of COPD phenotypes in Turkey. Materials and methods: The study was designed as a national, multicenter, observational and cross-sectional. A total of 1141 stable COPD patients were included in the analysis. Results: The phenotype distribution was as follows: 55.7% nonexacerbators (NON-AE), 25.6% frequent exacerbators without chronic bronchitis (AE NON-CB), 13.9% frequent exacerbators with chronic bronchitis (AE-CB), and 4.8% with asthma and COPD overlap (ACO). The FEV 1 values were significantly higher in the ACO and NON- AE than in the AE-CB and AE NON-CB (p < 0.001). The symptom scores, ADO (age, dyspnoea and FEV 1) index and the rates of exacerbations were significantly higher in the AE-CB and AE NON-CB phenotypes than in the ACO and NON-AE phenotypes (p < 0.001). Treatment preference in patients with COPD was statistically different among the phenotypes (p < 0.001). Subgroup analysis was performed in terms of emphysema, chronic bronchitis and ACO phenotypes of 1107 patients who had thoracic computed tomography. A total of 202 patients had more than one phenotypic trait, and 149 patients showed no features of a specific phenotype. Conclusion: Most of the phenotype models have tried to classify the patient into a certain phenotype so far. However, we observed that some of the patients with COPD had two or more phenotypes together. Therefore, rather than determining which phenotype the patients are classified in, searching for the phenotypic traits of each patient may enable more effective and individualized treatment.Öğe Clinical characteristics and outcomes in hospitalized COVID-19 patients with COPD(The European Respiratory Society, 2021) Turan, Muzaffer Onur; Yigitbaş, Burcu Arpınar; Turan, Pakize Ayşe; Mirici, ArzuIntroduction: COPD can be more fatal in this in COVID-19 patients. The aim of this study was to determine the prevalence of COPD and to investigate the characteristics and prognosis of COPD patients in population infected with SARS-CoV2. Material-Method: Patients who had the diagnosis of COVID-19 by positive Polymerase Chain Reaction test in oro-nasopharyngeal swab samples were included. Patients with the airway obstruction (FEV1/FVC <70%) in the spirometrics were included in “COPD group”. The symptoms, laboratory and radiological findings, outcomes for patients with and without COPD were compared. Results: The prevalence of COPD in COVID-19 patients was 4.96% (53/1069). The mortality rate was 13.2% in COPD and 7% in non-COPD patients (p=0.092). The significant predictors of mortality were higher age, hypoxemia (p <0.001) and presence of pneumonia (p=0.043) in COVID-19 patients. Conclusion: Our research is a multicentered, retrospective cohort study, which is one of the first studies investigating the prevalence and characteristics of COVID-19 patients with COPD in Turkey. There were some demographic, symptomatic, laboratory and radiological differences between COPD and non-COPD COVID-19 patients. Although COPD patients had some poor prognostic features, there was no statistically difference between overall survival rates of COVID-19 patients with or without COPD. Significant predictors of mortality were high age, hypoxemia and presence of pneumonia in hospitalized COVID-19 patients.Öğe Evaluation of COVID-19 patients receiving long-term oxygen support in the post-COVID period(Kare Publ, 2024) Turan, Muzaffer Onur; Bozkus, Fulsen; Batum, Ozguer; Alkan, Aycan; Kabalak, Pinar Akin; Alkilinc, Ersin; Soyler, YaseminBACKGROUND AND AIM: Persistent physical and medical sequelae, including chronic hypoxemia, may be observed in patients with long-lasting post-COVID syndrome. Long-term oxygen therapy (LTOT) is commonly employed for managing chronic hypoxemia in chronic airway diseases. This study aims to assess the ongoing requirement for LTOT in Coronavirus Disease 2019 (COVID-19) patients during the post-COVID period and to ascertain the persistence of their oxygen therapy needs. METHODS: This cross-sectional, multicentered study included 320 COVID-19 patients who were evaluated for LTOT two months post-discharge. Patient demographics, symptoms at admission, and laboratory and radiological data were retrospectively collected from hospital databases. RESULTS: Continuous oxygen support was necessary for 22.9% of the patients, while 15% of the participants passed away during the post-COVID period. Factors significantly associated with the prolonged need for LTOT included admission to the intensive care unit (ICU), presence of anemia, high serum D-dimer levels (>1000 mu g/L), and low oxygen saturation levels at hospital admission (p=0.026, p=0.011, p=0.010, and p<0.001, respectively). Multivariable regression analysis identified high D-dimer levels (p=0.012) and low oxygen saturation at admission (p<0.001) as the most significant predictors of a continued need for oxygen therapy. Furthermore, advanced age, non-use of steroids in treatment, and mechanical ventilation during hospitalization were significantly linked to mortality during the post-COVID period (p=0.003, p=0.048, and p=0.009, respectively). CONCLUSIONS: ICU admission and certain laboratory parameters can predict the need for LTOT during the post-COVID process. The observation that most COVID-19 patients do not require LTOT after a two-month period suggests that clinicians should adopt a more selective approach in planning LTOT.Öğe Evaluation Of Vitamin B12 and D, Folic Acid and Homocystein Levels In Stable COPD Patients(European Respiratory Soc Journals Ltd, 2020) Turan, Muzaffer Onur; Sarioglu, Nurhan; Turan, Pakize Ayse; Ozdemir, Ozer; Fazlioglu, Nevin; Koseoglu, Mehmet; Ozkanay, Hayat[Anstract Not Available]Öğe Factors That May Affect FEV1 Change Of COPD Patients In One-Year Period(M. Tayyib KADAK, 2020) Turan, Muzaffer Onur; Turan, Pakize Ayşe; Mirici, ArzuINTRODUCTION: One of the hallmarks of COPD is the rate of FEV1 decline. There are many factors that may affect pulmonary parameters in a COPD patient. It was aimed to investigate the factors affecting FEV1 changes. MATERIAL-METHODS: COPD outpatients who attended our pulmonology clinic were included. Spirometric values and inhaler device usage performance at that time and 12 months ago were compared. RESULTS: Mean FEV1 values of 204 COPD patients decreased from 1.56±0.51 lt (53.4%) to 1.51±0.50 lt (53.2%). There was a statistically significant relationship between FEV1 change (decline / not) and gender, active smoking, regular inhaler device usage, exacerbation, hospitalization history in last year, presence of comorbidities and inhaler device adherence. FEV1 decline had positive correlation with the number of exacerbations in last year (r=0.432, p<0.001), and negative correlation with inhaler device usage score (r=-0.512, p<0.001). Multivariate regression analysis demonstrated that smoking status, number of exacerbations (per year) and inhaler therapy adherence were the factors that affect FEV1 decline in COPD patients (p=0.007, 0.001 ve 0.003, respectively). CONCLUSION: Smoking is the major parameter that affects FEV1 value in COPD. Inhaler adherence may directly affect FEV1 change. Smoking cessation, preventing COPD exacerbations and increasing inhaler therapy adherence may decrease FEV1 declines of COPD patients in one-year period.Öğe GÖĞÜS HASTALIKLARI UZMANLARINA DÜZENLİ KONTROLE GİTMEYEN KOAH HASTALARININ DEĞERLENDİRİLMESİ(2016) Turan, Muzaffer Onur; Turan, Pakize Ayşe; Mirici, ArzuAMAÇ: Kronik obstrüktif akciğer hastalığı (KOAH), komplike bir hastalık olup hastalarda risk faktörlerine maruziyet, mevcut hastalık durumu, semptomlar, tedavi etkinliğininin düzenli olarak değerlendirilmesi ve bu izleme dayalı olarak tedavinin düzenlenmesi gerekmektedir. Göğüs hastalıkları polikliniğine ilaç yazdırmaya gelen veya rapor için başvuran, düzenli poliklinik kontrollerine gelmeyen KOAH hastalarında mevcut hastalık durumu ve tedavinin değerlendirilmesi amaçlandı. YÖNTEM-GEREÇ: Çalışmaya, Ocak-Haziran 2015 tarihleri arasında Gelibolu Devlet Hastanesi göğüs hastalıkları polikliniğine, sadece ilaç yazdırmak için başvuran ve son 1 yıl içerisinde göğüs hastalıkları doktorları tarafından değerlendirilmemiş hastalar (çalışma grubu) ve kontrol amaçlı düzenli gelen hastalar (karşılaştırma grubu) dahil edildi. Hastalara solunum fonksiyon testi (SFT) ve inhaler cihaz kullanım becerisini değerlendiren bir test uygulandı. BULGULAR: Çalışma grubunda 70, karşılaştırma grubunda 60 olmak üzere toplam 130 KOAH hastası çalışmaya alındı. Çalışma grubu hastalarının %40'ı sigara içmeye devam etmekteydi. Bu hastalara SFT en son 1.67±0.98 yıl önce yapılmışken, doktor tarafından KOAH ilaç eğitimi de son olarak 1.44±0.89 yıl önce verilmişti. Çalışma grubundaki hastalara son KOAH ilaç eğitimi ve SFT uygulanmasından sonra geçen süre, karşılaştırma grubu hastalarına göre anlamlı olarak daha uzundu (p<0.001). İki grubun hastaları arasında, kullandıkları ilaçların KOAH'da birleşik değerlendirme sınıflamasına uygunluğu açısından da anlamlı fark tespit edildi (p=0.002). Çalışma grubu hastalarının inhaler cihaz beceri puanları da istatistiki açıdan anlamlı olacak şekilde daha düşüktü (p=0.035). SONUÇ: KOAH hastalarının izlemi konusunda standart bir yaklaşım olmasa da, solunum fonksiyon testi, kullandığı ilaçların uygunluğu ve inhaler tedavi uyumu gibi parametreler düzenli aralıklarla değerlendirilmelidir. Bu yüzden, herhangi bir sebeple göğüs hastalıkları polikliniğine başvuran hastalarda bu değerlendirmelerin en son ne zaman yapıldığının sorgulanması ve hastanın bütünüyle irdelenmesi önemlidir.
