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    Airway inflammation and tiotropium treatment in stable COPD patients
    (Tubitak Scientific & Technological Research Council Turkey, 2014) Ozol, Duygu; Karamanli, Harun; Uysal, Sema; Yigitoglu, Muhammet Ramazan; Yildirim, Zeki
    Background/aim: Chronic obstructive pulmonary disease (COPD) is an inflammatory disease of the lung associated with progressive airflow limitation. The aim of this study is to assess the influence of tiotropium treatment on airway inflammation and symptoms in stable COPD patients. Materials and methods: Inflammatory markers were measured in the expired breath condensate fluid (EBC) before starting tiotropium treatment and at the end of the first month. Results: Twenty-two patients (81% men). with a mean age of 65.4 +/- 10.1 years completed the study. The mean nitrotyrosine and 8-isoprostane levels for oxidative stress markers in EBC before and after treatment were 4.5 +/- 2.3, 3.5 +/- 1.9 pg/mL (P = 0.06) and 7.3 +/- 10.8, 8.1 +/- 11.7 pg/mL (P = 0.28), respectively. The mean interleukin-6 and tumor necrosis factor-alpha levels for inflammation markers in EBC before and after treatment were 1.03 +/- 1.1, 0.77 +/- 0.8 pg/mL (P = 0.41) and 27.8 +/- 2.6, 29.2 +/- 5.7 pg/mL (P = 0.36) respectively. The mean symptom scores decreased significantly with tiotropium and a mean increase of 124.6 +/- 0.86 mL was observed in a lung function test (FEV1). Conclusion: Although a 4-week treatment with tiotropium did not modify any of the inflammatory or oxidative stress markers in EBC fluid, tiotropium treatment helps to control symptoms in COPD.
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    Evaluation of Arterial Blood Flow Changes by Orbital Doppler in Chronic Obstructive Pulmonary Disease and Asthma
    (Bmj Publishing Group, 2015) Yakut, Zeynep Ilerisoy; Karadag, Remzi; Ozol, Duygu; Senturk, Aysegul
    Purpose: Both chronic obstructive pulmonary disease (COPD) and asthma are important causes of morbidity and mortality worldwide. They primarily affect the lungs, but they have various extrapulmonary manifestations. The aim of our study was to evaluate the hemodynamic changes in orbital vessels of the patients with COPD and asthma using color Doppler ultrasonography and compare the results with healthy control subjects. Methods: Thirty-seven patients with COPD, 37 patients with asthma, and 41 healthy control subjects were included in this study. All patients with COPD were in moderate to severe group according to GOLD (Global Initiative for Chronic Obstructive Lung Disease), and similarly, all patients with asthma were in moderate to severe persistent group according to GINA (Global Initiative for Asthma) 2006 guidelines. End-tidal carbon dioxide, peripheral oxygen saturation, pulse rate, and respiratory rate were measured by using pulse oximeter in all patients. Measurements were performed in only 1 randomly selected eye of each participant. The peak systolic velocity, end diastolic velocity, and resistance index were measured in the central retinal artery, temporal posterior ciliary artery, and nasal posterior ciliary artery using the color Doppler ultrasonography technique. Results: The peak systolic velocity, end diastolic velocity, and resistance index values of temporal posterior ciliary artery and nasal posterior ciliary artery were significantly higher in COPD and asthma than in the control subjects. There was no difference between asthma and COPD. Conclusions: We concluded that retrobulbar hemodynamics change in COPD and asthma is showing 1 of the systemic effects in these diseases.
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    Increased Exhaled 8-Isoprostane and Interleukin-6 in Patients with Helicobacter pylori Infection
    (Wiley-Blackwell, 2016) Yildirim, Zeki; Bozkurt, Bulent; Ozol, Duygu; Armutcu, Ferah; Akgedik, Recep; Karamanli, Harun; Kizilirmak, Deniz
    BackgroundHelicobacter pylori (H. pylori) infection triggers both local inflammation, usually in gastric mucosa, and chronic systemic inflammation. It is assumed that this local and systemic inflammation is caused by extracellular products excreted by H. pylori. The aim of this study was to investigate the possible association between H. pylori infection and a local inflammatory response in the airway by using exhaled breath condensate technique. Materials and MethodsThis study includes 41 H. pylori seropositive patients who have gastric symptoms and 27 healthy control subjects. Pulmonary function tests (PFT), chest X ray, and physical examination were performed in all patients and interleukin-6 (IL-6), 8-isoprostane and nitrotyrosine levels were measured in exhaled breath condensate. ResultsLevels of IL-6 and 8-isoprostane in exhaled breath condensate (EBC) were significantly higher in H. pylori positive patients than control subjects (p < 0.05). Nitrotyrosine levels were also higher in H. pylori positive patients but the difference was not statistically significant. Both groups had similar leukocyte counts, C-reactive protein (CRP) levels and PFT parameters. ConclusionH. pylori infection causes an asymptomatic airway inflammation which can be detected by exhaled breath condensate. The clinical importance of this inflammation remains unclear.
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    Interaction of Metabolic Syndrome with Asthma in Postmenopausal Women: Role of Adipokines
    (Springer/Plenum Publishers, 2013) Aydin, Murat; Koca, Cemile; Ozol, Duygu; Uysal, Sema; Yildirim, Zeki; Kavakli, Havva Sahin; Yigitoglu, M. Ramazan
    The increasing prevalence of both asthma and obesity are major health problems. Recent studies established a possible link between obesity and asthma; however, the underlying mechanism is not clear. The aim of the study was to analyze the prevalence of metabolic syndrome in postmenopausal subjects with asthma and search the interactions between adipokines, metabolic syndrome, and asthma. A total of 45 female patients (57.5 +/- 13.9 years) with asthma and 30 healthy subjects (59.6 +/- 12.8 years) in postmenopausal status were enrolled in this study. For the diagnosis of metabolic syndrome, modified World Health Organization diagnostic criteria were used. Blood levels of glucose, lipid profile, HbA1c, insulin, CRP, leptin, adiponectin, tumor necrosis factor-alpha, interleukin (IL)-6, IL-8 and plasminogen activator inhibitor-1 (PAI-1) were measured. The mean body mass index was 29.6 +/- 5.4 for asthma patients and 28.2 +/- 5.3 for the control group. The incidence of metabolic syndrome was found as 26 % for both groups. Insulin resistance as calculated by homeostasis model assessment (HOMA-IR) and fasting insulin levels were significantly higher in asthma patients (p < 0.001 for both parameters). Leptin levels were significantly higher (p = 0.001) and adiponectin levels were lower (p = 0.029) in asthma patients compared to controls. We concluded that although incidence of obesity and metabolic syndrome was not higher in postmenopausal asthma patients than controls, there was an impairment of glucose metabolism and altered adipokine levels in asthma patients.
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    Obesity Hypoventilation Syndrome
    (Aves, 2013) Ozol, Duygu; Kokturk, Oguz
    Obesity hypoventilation syndrome is characterized by obesity, hypoventilation with hypercapnia, somnolence and sleep related breathing disorders in the absence of significant lung, nerological, metabolic or respiratory muscle diseases. The prevalence of this disease increases rapidly both in worldwide and in our country as a result of the increasing trend in obesity. It is an important cause of both mortality and morbidity by causing pulmonary hypertension and low health related life quality. Increasing awareness of this disease in physicians will lead to early diagnosis and suitable treatment.
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    Pittsburgh Sleep Quality Index scores and their relationship with body measurements in late menopause patients
    (Tubitak Scientific & Technological Research Council Turkey, 2014) Ayrim, Aylin; Aktepe Keskin, Esra; Ozol, Duygu
    Background/aim: With an increase in life expectancy, women live about one-third of their lives in the postmenopausal period. Our aim was to investigate the findings regarding quality of sleep and sleep apnea in postmenopausal women and research the relationship between sleep complaints and body measurements. Materials and methods: The Pittsburgh Sleep Quality Index (PSQI) was administered to all participants and their height, weight, and neck circumferences were measured. Results: A total of 206 patients (mean age: 61.4 +/- 8.8 years) were included. Their mean weight gain after menopause was 8.1 +/- 12.8 kg, and their mean neck circumference and body mass index was 39.7 +/- 2.6 cm and 33.4 2.1, respectively. The rate of patients who snored each night increased from 3.4% to 13.2% (P = 0.000) after menopause. The rate of self-reported poor sleep quality was found in 57.8% of patients according to the PSQI global score (>= 5). The prevalence of sleep medication usage increased from 5.8% to 11.2% with menopause. Although body measurements were a little lower in patients with a total PSQI score of less than 5, this difference was insignificant. Conclusion: The prevalence of self-reported poor sleep quality was high in the postmenopausal period and the prevalence of snoring increased significantly with weight gain after menopause.
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    Polysomnographic findings in persistent allergic rhinitis
    (Springer Heidelberg, 2017) Bozkurt, Bulent; Ugur, K. Serife; Karamanli, Harun; Kucuker, Fatma; Ozol, Duygu
    Persistent allergic rhinitis (PAR) is characterized by a chronic, eosinophilic inflammation with nasal congestion and rhinorrhea. Nasal congestion can constitute to sleep-disordered breathing problems that range from simple snoring to obstructive sleep apnea syndrome (OSAS). The purpose of this study was to investigate the effect of PAR on sleep quality and severity of OSAS. The study included 150 patients presenting with typical symptoms of sleep apnea. Fifty-five patients were diagnosed as PAR (group-1) and were compared with age and body mass index matched 95 individuals (group-2) without any nasal disease. Skin prick tests and polysomnography were performed in all patients. There were no differences between groups for polysomnographic findings including sleep architecture, arousal and respiratory index, and mean and minimal oxygen saturations. Simple snoring was determined in 41.8 % allergic and 32.6 % non-allergic patients. Mild OSAS was determined in 32.7 % allergic and 29.4 % non-allergic patients. Moderate OSAS was determined in 9 % allergic and 17.8 % non-allergic patients. Severe OSAS was determined in 16.3 % allergic and 20 % non-allergic patients. Their entire Epworth sleepiness scale index was also found similar. Our data pointed out that in patients with sleep-related breathing disorders symptoms, presence of PAR does not affect polysomnographic parameters compared with other patients without any nasal inflammation. Besides, prevalence of OSAS was similar between groups.
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    What is the most reliable marker in the differential diagnosis of pulmonary embolism and community-acquired pneumonia?
    (Lippincott Williams & Wilkins, 2016) Ates, Hale; Ates, Ihsan; Bozkurt, Bulent; Celik, Huseyin Tugrul; Ozol, Duygu; Yildirim, Zeki
    Because of similar clinical manifestations and laboratory findings, differential diagnosis of pulmonary embolism and community-acquired pneumonia (CAP) is generally difficult. Therefore, this study was conducted to find good markers for the easy, cheap, and fast differential diagnosis of pulmonary embolism and CAP. Thirty-four patients diagnosed with pulmonary embolism and 38 patients with CAP who were admitted to either emergency department or chest diseases outpatient clinic were included in this study. On admission and third day, complete blood count, C-reactive protein (CRP), erythrocyte sedimentation rate, procalcitonin (PCT), and D-dimer levels of each patient were measured. Neutrophil-to-lymphocyte ratio (NLR) was calculated using the formula NLR = neutrophil count/lymphocyte count. NLR/D-dimer and PCT/D-dimer ratios were also calculated. First day neutrophil count (P = 0.005), NLR (P = 0.002), CRP (P < 0.001), erythrocyte sedimentation rate (P < 0.001), PCT (P < 0.001), NLR/D-dimer (P < 0.001), and PCT/D-dimer (P < 0.001) levels were higher in patients with CAP compared with patients with pulmonary embolism. In stepwise logistic regression analysis done with all the parameters used for the differential diagnosis of pulmonary embolism and CAP, CRP, PCT/D-dimer, and NLR/D-dimer were found to be independent predictive factors for the presence of CAP. Among these factors, NLR/D-dimer ratio was found to be the most sensitive (97.4%) to have the highest negative predictive value 96.7% and to be the most accurate (area under curve = 0.921) (91.7%) parameter for the differential diagnosis of pulmonary embolism and CAP. In this study, NLR/D-dimer ratio was found to be more sensitive and more selective with negative predictive value and area under curve for the differential diagnosis of pulmonary embolism and CAP compared with other laboratory tests.