Browsing by Author "Karadağ, Mehmet"
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Item Analysis of TNF-alpha G308A and C857T gene polymorphisms in Turkish patients with obstructive sleep apnea syndrome(Ortadogu Yayınevi, 2012-10) Karkucak, Mutlu; Ursavaş, Ahmet; Ocakoğlu, Gökhan; Görükmez, Orhan; Yakut, Tahsin; Ercan, İlker; Karadağ, Mehmet; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Genetik Anabilim Dalı.; 0000-0002-9027-1132; 0000-0002-2382-290X; AAG-8744-2021; AAI-3169-2021; AAH-5180-2021; 8329319900; 15832295800; 56681045900; 6602802424; 6603789069; 6601970351Objective: Tumor necrosis factor-alpha (TNF-alpha) is an important indicator of inflammation. Recent studies have demonstrated a relationship between inflammation and obstructive sleep apnea syndrome (OSAS). The aim of this study was to investigate the association between TNF-alpha G308A and C857T gene polymorphisms and OSAS in Turkish patients. Material and Methods: Sixty-nine patients who were diagnosed with OSAS and 42 control subjects were included in the study. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used to detect TNF-alpha G308A and C857T gene polymorphisms. The level of significance for statistical analysis was set at p<0.05. Results: The distribution of genotypes was not significantly different between subjects with a definite diagnosis of OSAS and the control group (p> 0.05). However, the mean body mass index of the OSAS group was significantly different from that of the control group (p<0.05). Conclusion: To our knowledge, this study is the first to analyze the relationship between OSAS and INF-alpha G308A and C857T gene polymorphisms in Turkish patients. Our results do not support an association between OSAS and TNF-alpha G308A and C857T gene polymorphisms.Publication Assessment of the risk of obstructive sleep apnoea syndrome among healthcare workers(Turkish Assoc Tuberculosis & Thorax, 2019-01-01) Güçlü, Özge Aydın; İntepe, Yavuz Selim; Acican, Turan; Arslan, Sertaç; Sertoğullarından, Bünyamin; Karadağ, Mehmet; KARADAĞ, MEHMET; Bursa Uludağ Üniversitesi/Tıp Fakültesi.; 0000-0002-9027-1132; AAG-8744-2021Introduction: Sleep deprivation is known to increase the risks for workplace accidents, neuro-behavioural symptoms and reduced quality of life. Shift work leads to sleep related problems, such as sleep deprivation, poor sleep quality and daytime sleepiness. The purpose of our study is to assess snoring prevalence and obstructive sleep apnoea risk among healthcare workers (HCWs) by using the Berlin Questionnaire.Materials and Methods: HCWs employed at different centres that agreed to take part in this study were enrolled. Employing the Berlin Questionnaire, demographic characteristics, smoking histories, comorbidities, on-call shifts, number of on-call shifts and sleep durations of the participants were surveyed.Results: 604 HCWs including specialist, nurse, junior doctor, medical student, clinical academic, health technician and hospital staff were enrolled in this study. In terms of sleep apnoea, 92 (15.1%) participants were identified as high-risk and 512 (84.8%) as low-risk according to the findings of the questionnaire. When the two groups identified as high and low risk for sleep apnoea according to the Berlin Questionnaire were compared, significant differences were found between the two groups in terms of age, sex, height, weight, BMI value and hypertension (p< 0.001 for all variables). Multivariate logistic regression analysis has shown that on-call shifts (OR=0.199, CI=0.053-0.747, p=0.017) are negative associated with sleep apnoea risk.Conclusion: With extended working hours and on-call shifts increasing the risk of sleep disorders among HCWs, surveys designed for screening can be used to identify the prospective cases in this population for further examination.Publication Associated factors with short-term mortality in pulmonary thromboembolism patients(European Respiratory, 2015-09-01) Çetinoğlu, Ezgi Demirdöğen; Dilektaşlı, Aslı Görek; Güçlü, Özge Aydın; Özkaya, Güven; Coşkun, Funda; Ursavaş, Ahmet; Karadağ, Mehmet; Çetinoğlu, Ezgi Demirdöğen; GÖREK DİLEKTAŞLI, ASLI; AYDIN GÜÇLÜ, ÖZGE; ÖZKAYA, GÜVEN; COŞKUN, NECMİYE FUNDA; URSAVAŞ, AHMET; KARADAĞ, MEHMET; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı; 0000-0002-7400-9089; 0000-0001-7099-9647; 0000-0003-1005-3205; 0000-0003-0297-846X; 0000-0003-3604-8826; 0000-0002-9027-1132; JPK-7012-2023; AAG-8744-2021; AAI-3169-2021; AAD-1271-2019; A-4421-2016; AAG-9930-2019; AAH-9812-2021; DTT-7416-2022Publication Association between burnout, anxiety and insomnia in healthcare workers: A cross-sectional study burnout, anxiety and insomnia in healthcare workers(Routledge Journals, Taylor & Francis, 2021-01-23) Aydin Guclu, Ozge; Akkoyunlu, Muhammed Emin; Acican, Turan; Sertogullarindan, Bunyamin; Kirbas, Gokhan; Selimoglu Sen, Hatice; Lakadamyali, Huseyin; Intepe, Yavuz Selim; Arslan, Sertac; Firat Gursoy, Sibel; Kaya, Akin; Karadağ, Mehmet; KARADAĞ, MEHMET; Bursa Uludağ Üniversitesi/Tıp Fakültesi.; 0000-0003-1005-3205; 0000-0002-9027-1132; 0000-0002-2866-6686; 0000-0002-5697-5291; JSK-7543-2023; AAP-7682-2020; AAG-8744-2021; AAG-9930-2019; D-5756-2018; W-1764-2017All healthcare workers (HCWs) encounter stress during in their working lives, and are constantly exposed to adverse conditions. The present study evaluates the relationship between burnout syndrome, anxiety levels and insomnia severity among healthcare workers, who mostly work in shifts. The Maslach Burnout Inventory, the Insomnia Severity Index and the Beck Anxiety Inventory were used to measure burnout, insomnia severity and anxiety status, respectively. This cross sectional study included a total of 1,011 HCWs and 679 (67.2%) of the study respondents were women. The respondents were aged 20-72, with a mean age of 35.67 +/- 8.61 years. Fifty-eight percent (n = 589) of the participants were rotating shift workers. Working on-call led to a significant difference in all burnout parameters (for each, <0.001). Age and on-call duty were seen to lead to a significant difference in the severity of insomnia (p = 0.028, p < 0.001, respectively). The total ISI score was found to be statistically significant positively correlated with the MBI subscales and the total BAI score (for each, <0.001). An increased awareness of the impact of sleep deprivation, burnout and anxiety among HCWs and meaningful interventions promoting change within the healthcare system are needed.Item Association between serum neopterin, obesity and daytime sleepiness in patients with obstructive sleep apnea(W B Saunders, 2008-08) Ursavaş, Ahmet; Karadağ, Mehmet; Oral, Arzu Yılmaztepe; Demirdöǧen, Ezgi Şen; Oral, Haluk Barbaros; Ege, Ercüment; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji ve Enfeksiyon Hastalıkları Anabilim Dalı.; 0000-0003-0463-6818; 0000-0003-0463-6818; 0000-0002-7400-9089; 0000-0002-7400-9089; AAI-3169-2021; A-5841-2017; AAG-8744-2021; AAH-9812-2021; K-7285-2012; 8329319900; 6601970351; 23091316500; 14062849300; 7004498001; 6701341320Objective: Obesity and obstructive sleep apnea (OSA) and systemic inflammation may interact through biochemical pathways. Neopterin (NP) is a monocyte/macrophage activation marker produced by macrophages in response to interferon-gamma secreted by activated T lymphocytes. This study examines the association between NP, obesity and OSA. Patients and methods: The study included 22 newly diagnosed OSA (+) patients and 18 OSA patients. Subjects with history of coronary artery disease, transplant patients, history of alcohol and drug abuse, history of HIV and any other significant medical. illnesses such as active infections, autoimmune disease, malignancy, liver disease, pulmonary disease (COPD, asthma, ...), neuromuscular disease, patients on immunomodulating therapy or HMG-CoA reductase inhibitors were excluded. Results: There were no significant differences in age, body mass index (BMI), and smoking habits of the OSA (+) patients and OSA (-) patients. Serum NP levels did not show any significant difference between the OSA (+) patients and OSA (-) patients, however, NP levels were positively correlated with BMI (r = 0.320, p = 0.044). There was no significant correlation between NP and any of the polysomnographic parameters. The result of stepwise regression analyses (r 2 = 0.320, p < 0.001) showed that high serum NP levels (p = 0.004) and apnea-hypopnea index (AHI) were a risk factor for elevated Epworth sleepiness score, independent of BMI. Conclusion: We suggest that serum NP levels correlate with BMI. There was a significant relationship between serum NP levels and excessive daytime sleepiness in OSA patients.Publication Association of fatigue with mental well-being, quality of life and exercise capacity in sarcoidosis: A case-control comparision(Amer, 2015-01-01) Dilektaşlı, Aslı Görek; Çetinoğlu, E. Demirdöğen; Acet, N. Aylin; Gökmen, Nilüfer E.; Karadağ, Mehmet; Uzaslan, Esra; GÖREK DİLEKTAŞLI, ASLI; Çetinoğlu, E. Demirdöğen; ACET ÖZTÜRK, NİLÜFER AYLİN; KARADAĞ, MEHMET; UZASLAN, AYŞE ESRA; Uludağ Üniversitesi/Tıp Fakültesi; 0000-0001-7099-9647; 0000-0002-7400-9089; 0000-0002-6375-1472; 0000-0002-9027-1132; Z-1424-2019; JPK-7012-2023; AAG-8744-2021; DTT-7416-2022; AAH-9812-2021; Z-1424-2019; CQV-5946-2022; CDI-1977-2022Item A case of recurrent pneumonia due to Arnold Chiari malformation(European Respiratory Society Journals, 2015-09-01) Çetinoğlu, Ezgi Demirdöğen; Güçlü, Özge Aydın; Dilektaşlı, Aslı Görek; Ursavaş, Ahmet; Karadağ, Mehmet; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; 0000-0002-7400-9089; 0000-0003-1005-3205; 0000-0001-7099-9647; 0000-0003-4482-5904; 0000-0002-9027-1132; EOU-1892-2022; AAG-9930-2019; CNP-1063-2022; AAI-3169-2021; AAG-8744-2021; 14062849300; 57203790565; 36466376600; 8329319900; 6601970351Item Catheter-directed therapy in acute pulmonary embolism with right ventricular dysfunction: A promising modality to provide early hemodynamic recovery(Int Scientific Information, 2016-04-15) Dilektaşlı, Aslı Görek; Çetinoğlu, Ezgi Demirdoğen; Acet, Nilüfer Aylin; Erdoğan, Cüneyt; Ursavaş, Ahmet; Özkaya, Güven; Coşkun, Funda; Karadağ, Mehmet; Ege, Ercüment; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0002-9027-1132; 0000-0002-6375-1472; 0000-0003-3604-8826; 0000-0003-0297-846X; AAG-8744-2021; Z-1424-2019; AAD-1271-2019; A-4421-2016; AAI-3169-2021; 36466376600; 57189524206; 56507253300; 8293835700; 8329319900; 16316866500; 21734137500; 6601970351; 6701341320Background: Catheter-directed therapy (CDT) for pulmonary embolism (PE) is considered as an alternative to systemic thrombolysis (ST) in patients with hemodynamically unstable acute PE who are considered at high bleeding risk for ST. We aimed to evaluate the efficacy and safety of CDT in the management of acute PE with right ventricular dysfunction (RVD). The primary outcomes were mortality, clinical success, and complications. Secondary outcomes were change in hemodynamic parameters in the first 24 hours following the procedure. Material/Methods: Medical records of consecutive patients diagnosed as having acute massive or submassive PE with accompanying RVD treated by immediate CDT at our institution from January 2007 to January 2014 were reviewed. Patient characteristics, mortality, achievement of clinical success, and minor and major bleeding complications were analyzed in the overall study group, as well as massive vs. submassive PE subgroups. Change in hemodynamic parameters in the second, eighth, and 24th hours after the CDT procedure were also analyzed. Results: The study included 15 consecutive patients (M/F=10/5) with a mean age of 54.2 +/- 16.6 years who underwent immediate CDT. Nine of the patients had submassive PE, and 6 had massive PE. In-hospital mortality rate was 13.3% (95% CI, 0.04-0.38). One major, but not life-threatening, bleeding episode was evident in the whole group. Hemodynamic parameters were stabilized and clinical success was achieved in 14/15 (93.3%; 95% CI, 70.2-98.8) of the patients in the first 24 hours. Notably, the hemodynamic recovery was significantly evident in the first 8 hours after the procedure. Conclusions: CDT is a promising treatment option for patients with acute PE with RVD with no fatal bleeding complication. In experienced centers, CDT should be considered as a first-line treatment for patients with acute PE and RVD and contraindications for ST, with the advantage of providing early hemodynamic recovery.Item Circulating ICAM-1 and VCAM-1 levels in patients with obstructive sleep apnea syndrome(Karger, 2007) Ursavaş, Ahmet; Karadağ, Mehmet; Rodoplu, Erkan; Yılmaztepe, Arzu; Oral, Haluk Barbaros; Gozo, R. Oktay; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; 0000-0003-0463-6818; 0000-0003-0463-6818; 0000-0002-9027-1132; A-5841-2017; K-7285-2012; AAI-3169-2021; AAG-8744-2021; 8329319900; 6601970351; 15838170200; 8606136100; 7004498001; 15836640800Background: Obstructive sleep apnea syndrome (OSAS)-induced hypoxic stress modulates circulating inflammatory mediators causing accelerated atherogenesis. Objectives: We hypothesized that OSAS-induced hypoxia might result in cardiovascular disease due to increased expression of intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) on the endothelial surface. Methods: Thirty-nine subjects with moderate-to-severe OSAS and 34 non-apneic controls matched for age, gender, body mass index (BMI), smoking history, and cardiovascular disease were included in this prospective study. Overnight polysomnography was performed. Circulating ICAM-1 and VCAM-1 levels in the serum were measured by enzyme-linked immunosorbent assay. Results: Circulating levels of both ICAM-1 (480.1 +/- 216.7 vs. 303.4 +/- 98.6 ng/ml, p < 0.0001) and VCAM-1 (1,156.6 +/- 79.8 vs. 878.8 +/- 71.1 ng/ml, p = 0.002) were significantly increased in the OSAS group compared to the control group. For an ICAM-1 cutoff level of 375 ng/ml, predictive sensitivity and specificity for OSAS were 69.2% (95% confidence interval, CI: 52.4-83.0%) and 82.4% ( 95% CI: 65.5-93.2%), respectively. For a VCAM-1 cutoff level of 859 ng/ml, predictive sensitivity and specificity for OSAS were 74.4% (95% CI: 57.9-86.9%) and 64.7% ( 95% CI: 46.5-80.2%), respectively. There was a significant positive correlation between circulating levels of ICAM-1 and ln of AHI (r = 0.276, p = 0.018). Multiple logistic regression analyses showed that OSAS was associated with high ICAM-1 and high VCAM-1 levels independent of age, gender, BMI, smoking status and cardiovascular disease. Conclusion: We conclude that OSAS can independently increase circulating levels of adhesion molecules.Item Çocuklarda olası OSAS'ın okul başarısına etkisi(Uludağ Üniversitesi, 2016) Güler, Nurcan; Karadağ, Mehmet; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.Obstriktif uyku apnesi, uyku sırasında total veya parsiyel üst solunum yolu tıkanıklığı atakları ile karaterize, genellikle kan gazı değişim anormallikleri ve uyku kesintileri ile sonuçlanan bir durumdur. Herhangi bir yaşta ortaya çıkabilir. Pediyatrik obstrüktif uyku apnesi (OSA) yaygın bir bozukluktur ve genel pediyatrik popülasyonun %1-4‟ünü etkiler. Uyku sırasında horlama, nefes darlığı ve apne olarak kendini gösterir ve gün içi yorgunluk, okul performansında düşüş, nörokognitif bozulma, gelişim bozukluğu, hipertansiyon, kor pulmonare, pulmoner hipertansiyon ve hatta ölüm dahil çocuğun gün içindeki davranış, performans ve sağlığı üzerinde belirgin istenmeyen etkilere sahiptir. Çocuklarda OSA‟nın tanı ve değerlendirmesi için altın standart uyku laboratuarı temelli polisomnografidir (PSG). Yine de, PSG pek çok durumda ulaşılamayabilen pahalı bir tekniktir. Dahası uykuyla ilişkili solunum bozuklukları (SRBD) (Sleep-Related Breathing Diserders)‟e bağlı olarak nörodavranışsal morbiditeyi öngörmede çok etkili olmadığı düşünülmektedir. Zira standart PSG‟de iyi saptanamayan horlama gibi OSA‟nın bazı özellikleri kognitif ve davranışsal morbiditeyle ilişkili olabilir. Chervin ve ark. tarafından geliştirilen ve doğrulanan Pediyatrik Uyku Anketi (PSQ) SRBD için %81 sensitive ve %87 spesifitesi olduğu gösterilmiĢ olan 22 maddelik bir ankettir. SRBD‟nin görece yüksek prevalansı ve bu hastalığın olduğu düşünülen bütün çocuklara PSG yapılmasının göreceli zorlukları dikkate alındığında, SRBD tanısı ve etkisini öngörecek bir anketin kullanımı her iki tanısal algoritma ve terapiye yardım edebilecek maliyet etkin bir metoddur. Biz bu çalışmamızda PSQ anketi ve çocukların demografik özelliklerinin bulunduğu ve okul başarılılarının sorulduğu U.Ü.T.F.Bilimsel Araştırma Anketi A-B ilköğretim ve ortaöğretim öğrencilerine uyguladık. Bursa Osmangazi ve Nilüfer ilçelerinde bulunan 7 okula toplam 2000 adet anket formu (önlü-arkalı toplam iki sayfa) ve onam formu dağıltıldı. Araştırmamıza 909 ilk-orta öğrenim öğrencisi katıldı. Okul başarısı iii değerlendirmede Eylül 2015 - Ocak 2016 eğitim öğrenim dönem sonu karne başarı ortalama notu baz alındı. 22 maddelik uyku anketi sorularından 8 veya daha fazla pozitif yanıt veren öğrenci olası obstrüktif uyku apne sendromu (OSAS Obstructive sleep apnea syndrome) kabul edildi. Uyku anketine göre olası OSAS olan öğrencilerin okul başarısı puanları olası OSAS olmayanlara göre anlamlı oranda düşük bulundu. Bu çalışmamızda çocukluk çağındaki olası OSAS okul başarısını azaltığını göstererek tezimizi doğruladık. Çalışmamızın temel sınırlaması PSG OSAS tanısı için altın standart olduğundan bütün çocuklar için PSG değerlendirmesinin yokluğudur. Klinik pratikte, çocuk ve adölesanlar OSAS için incelenmeli ya da alternatif olarak taranmalıdır.Publication Coexistence of localized tracheobronchial amyloidosis and chronic hepatitis b infection(Medycyna Praktyczna, 2019-04-30) Güçlü, Özge Aydın; URSAVAŞ, AHMET; GÖREK DİLEKTAŞLI, ASLI; DEMİRDÖĞEN, EZGİ; Demirdöğen, Ezgi; Dilektaşlı, Aslı Görek; KARADAĞ, MEHMET; Karadağ, Mehmet; Akyıldız, Elif Ülker; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; 0000-0003-1005-3205; 0000-0002-7400-9089; 0000-0001-7099-9647; 0000-0002-9027-1132; JPK-7012-2023; AAG-8744-2021; AAH-9812-2021; AAI-3169-2021Publication Coexistence of sarcoidosis and sjogren's syndrome: A case-report(Amer, 2015-10-01) Dilektaşlı, Aslı Görek; Çetinoğlu, Ezgi Demirdoğen; Durmuş, Eda; Uzaslan, Esra; Ege, Ercüment; Karadağ, Mehmet; GÖREK DİLEKTAŞLI, ASLI; Çetinoğlu, Ezgi Demirdoğen; Durmuş, Eda; UZASLAN, AYŞE ESRA; Ege, Ercüment; KARADAĞ, MEHMET; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı; 0000-0001-7099-9647; 0000-0002-7400-9089; 0000-0002-9027-1132; AAG-8744-2021; JPK-7012-2023; DTT-7416-2022; ETU-0442-2022; CDI-1977-2022; CPF-5844-2022Item Comorbid conditions and social determinants of smoking in the adult population(European Respiratory Soc Journals Ltd, 2018-09-15) Uzaslan, Esra; Güçlü, Özge A.; Öztürk, Nilüfer A. A.; Dilektaşlı, Aslı; Çetinoğlu, Ezgi D.; Karadağ, Mehmet; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Ana Bilim Dalı.; 0000-0003-1005-3205; 0000-0002-6375-1472; 0000-0002-9027-1132; AAG-9930-2019; Z-1424-2019; AAI-1004-2021; AAG-8744-2021Item Comparison of 3-months treatment adherence and estimating residual apnea hypopnea index between home versus in-laboratory auto-titrating positive airway pressure titration(Wiley, 2020-07-01) Aydın, Özge Güçlü; Ursavaş, Ahmet; Kasapoğlu, Fikret; Ocakoğlu, Gökhan; Karadağ, Mehmet; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kulak Burun Boğaz Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0002-9027-1132; AAI-3877-2021; AAH-5180-2021; HLG-6346-2023; AAG-8744-2021; 8329319900; 56254721200; 15832295800; 6601970351Purpose We aimed to assess the accuracy of home titration in estimating apnea hypopnea index (AHI) and optimal pressure values and to compare improvements in subjective daytime sleepiness, sleep quality and quality of life, along with 3-months treatment adherence of patients that received at-home versus in-laboratory auto-titrating positive airway pressure (APAP) titration. Materials and Methods In patients with a diagnosis of obstructive sleep apnea syndrome (OSAS), a study arm of laboratory attended APAP titration was compared with a study arm of home titration using an APAP device for three days. Subjective questionnaires were evaluated before and after 3 months of treatment. Results Fifty-three patients with newly diagnosed OSAS were enrolled. There was a significant positive correlation between PSG AHI and APAP AHI (r(s) = 0.43,P = 0.003) and the fixed pressure for the APAP arm was positively correlated with the APAP PSG arm of the study (r(s) = 0.71,P < 0.001). When the Bland-Altman graphs were compared, it was seen that the measurements obtained by the APAP AHI method were 0.3 units higher than the PSG AHI measurements, and that the mean of the measurement differences between the two methods was not different than 0 (P[H-0: Mean = 0] = 0.551). After 3 months of treatment, average nightly use was slightly higher in the APAP arm (P = 0.387). Conclusions The results indicate that both titration methods were not clinically inferior in terms of a fixed optimal pressure, residual events, 3-months treatment adherence and change in subjective sleepiness, sleep quality and quality of life after treatment.Item COVID-19 pnömonisi geçiren olgularda uykusuzluk şiddeti ve uyku kalitesinin değerlendirilmesi(Bursa Uludağ Üniversitesi, 2022) Yazıcı, Gamze; Karadağ, Mehmet; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.Uykusuzluk genel olarak uykuya başlamada güçlük, yeterli zaman ya da fırsat olmasına karşın uykunun süresinde, bütünlüğünde ve kalitesinde yetersizlik ve gün içine yansıyan olumsuz sonuçları ile tanımlanır. Çalışmada COVID-19 pnömonisi geçiren olgularda uykusuzluk şiddeti ve uyku kalitesinin değerlendirilmesi amaçlanmıştır. Mart 2020 - Ekim 2021 arasında COVID-19 pnömonisi geçiren, Bursa Uludağ Üniversitesi Göğüs Hastalıkları Polikliniği'ne ayaktan başvuran, pandemi kliniklerinde ve pandemi yoğun bakım ünitelerinde yatarak tedavi görmüş 250 hasta retrospektif olarak değerlendirildi.Çalışma yapılırken Obstruktif Uyku Apnesi Sendromu(OSAS) açısından hastaların semptomları sorgulandı.OSAS tanısı ve genel olarak uyku ile ilişkili solunum bozuklukları tanısı olan hastalar çalışmaya alınmadı.Hastaların demografik özellikleri, sigara kullanımları, komorbid hastalıkları, uyku süreleri, tedavi şekilleri, pandemi klinik ve yoğun bakım ünitesinde yatış süreleri not edildi.Uyku kalitesi Pitssburgh Uyku Kalitesi ölçeği (PSQI) ile Uykusuzluk Şiddeti İndeksi (ISI) ile değerlendirildi. Olgulara Pittsburgh Uyku Kalitesi İndeksi uygulandığında, total ortalama skor 6 [0-18] olarak saptandı. Hastaların 164'ü (%65,6) 5 ve üzerinde skor alarak kötü uyku kalitesine sahip olduğu saptandı. Pandemi kliniğinde daha uzun süreyle yatan hastaların uyku kalitesinin istatistiki anlamlı olarak daha kötü olduğu saptanmıştır. İmmünsüpresif hastalığı olan COVID-19 olguları insomnia açısından değerlendirildiğinde, immünsüpresif hastalık varlığının şiddetli insomnia riskinde artış ile ilişkili, istatistiki anlamlı olduğu belirlendi (p=0,001). Yoğun bakım ünitesinde takip edilen olguların Uykusuzluk Şiddeti İndeksi(ISI) total skoru ortalama değeri 7,5 [0-28], ayaktan tedavi verilen hastaların 7 [0-27] saptanmış iken kliniklerde takip edilen hastalarınki 5 [0-28] olarak saptanmıştır (p=0,023). Özellikle COVID-19'u ağır geçiren, yoğun bakımda ve hastanede uzun süre yatan hastalar olmak üzere, COVID-19 pnömonisi geçiren tüm hastalar taburculuk sonrasında psikiyatrik durum ve uyku bozukluklarının ortaya çıkabileceği unutulmamalı ve bu açıdan değerlendirilmelidir.Item CPAP tedavisi verilen obstrüktif uyku apne sendromlu hastalarda pulmoner arter basıncı ve pro-BNP düzeylerinin değerlendirilmesi(Uludağ Üniversitesi, 2009) Demirci, Ayşen Yıldız; Karadağ, Mehmet; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.Obstrüktif Uyku Apne Sendromu (OUAS), pulmoner hipertansiyona (PHT) ve brain natriüretik peptid (BNP) yüksekliğine neden olabilen sık görülen bir hastalıktır. PHT gelişiminde kabul edilen mekanizmalar; aralıklı hipoksik vazokonstrüksiyon, sistemik inflamasyon ve hiperkoagulabilite durumlarıdır. OUAS'da altın standart tedavi yöntemi olan sürekli pozitif hava yolu basıncı (Continuous Positive Airway Pressure=CPAP) tedavisinin OUAS hastalarında pulmoner arter basıncı (PAB) ve BNP düzeyleri üzerine olan etkileri araştırılmaktadır. Bu çalışmada, CPAP tedavisi için uygun olup tedavi verilen OUAS tanısı almış hastalarda, 6 aylık CPAP tedavisinin PAB ve pro-BNP üzerine olan etkileri araştırıldı.Çalışmaya alınan hastalar U.Ü.T.F. Göğüs hastalıkları uyku laboratuarında polisomnografi yapıldıktan sonra polisomnografi sonucuna göre, AHİ<5 olanlar kontrol grubu olarak, AHİ>15 olan kronik obstrüktif akciğer hastalığı (KOAH) ve kalp yetmezliği bulunmayan hastalar OUAS grubunda alındı. OUAS grubunda 37 hasta, kontrol grubunda 13 hasta çalışmaya dahil edildi. Tüm hastalara Kardiyoloji Anabilim Dalı'nda Doppler ekokardiyografi yapıldı ve alınan kan örneklerinde pro-BNP düzeylerine bakıldı. OUAS grubundaki hastalar, 6 ay süresince takibe alındı. 10 hasta CPAP tedavisini bıraktı. Tedaviye devam eden 27 hastada 6 ay sonunda ekokardiyografi ve pro-BNP ölçümleri tekrarlandı. OUAS grubu ile kontrol grubunun ve tedaviye devam eden hastalarda başlangıç ve 6 ay sonundaki veriler karşılaştırıldı. OUAS grubu ile kontrol grubu arasında yaş, cinsiyet, sigara içimi, sistemik hipertansiyon ve diyabet açısından fark yoktu. OUAS grubu ve kontrol grubu arasında PAB ve pro-BNP değerleri arasında anlamlı fark saptanmadı. Ancak iki grup arasında ekokardiyografi parametrelerinde E/A ve mitral deselerasyon zamanı arasında anlamlı fark mevcuttu. OUAS grubunda 6 aylık CPAP tedavisi sonunda pro-BNP değerlerinde anlamlı fark saptanmazken, PAB'nda hafif ancak istatistiksel olarak anlamlı olmayan bir azalma saptandı. OUAS'lu hastalarda PHT olan 10 hastada yapılan alt grup analizinde, 6 aylık tedavi sonunda PAB'nda anlamlı düşme olduğu gözlendi.Yaptığımız çalışma sonucunda, CPAP tedavisinin PAB'nda azalma sağlayabileceği, ekodiyografik olarak erken dönemde diyastolik disfonksiyon geliştiği ve OUAS'ta, CPAP tedavsinin Pro-BNP düzeyleri üzerindeki etkilerini araştırmak için daha geniş kapsamlı çalışmaların yapılması gerektiği kanısına varıldı.Publication Diagnostic accuracy of a modified STOP-BANG questionnaire with national anthropometric obesity indexes(Aves, 2019-04-01) Öztürk, Nilüfer Aylin Acet; Dilektaşlı, Asli Görek; Çetinoğlu, Ezgi Demirdöğen; Ursavaş, Ahmet; Karadağ, Mehmet; GÖREK DİLEKTAŞLI, ASLI; Çetinoğlu, Ezgi Demirdöğen; URSAVAŞ, AHMET; KARADAĞ, MEHMET; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; 0000-0001-7099-9647; 0000-0002-7400-9089; 0000-0002-9027-1132; AAI-3169-2021; AAG-8744-2021; JPK-7012-2023; DTT-7416-2022; AAH-9812-2021OBJECTIVES: Obstructive sleep apnea (OSA) is a very common sleep-related disorder and has many medical complications. Although the STOP-BANG questionnaire is an attractive screening tool because of high sensitivity, it lacks power in specificity. The aim of the present study was to evaluate and compare the diagnostic accuracy of standard STOP-BANG and a modified STOP-BANG questionnaire, using national cut-off values for neck circumference that determined OSA, in a sleep center population.MATERIALS AND METHODS: One hundred eighty-five participants who were referred to the sleep-disordered breathing clinic were consecutively enrolled. We used 40 cm and 36 cm as the cut-off values for neck circumference, thus scoring patients accordingly and creating a modified STOP-BANG score with national anthropometric obesity indexes.RESULTS: The median neck circumferences were 41 (39-44) cm, 40 (37-42) cm, and 43 (40-45) cm for total population, female gender, and male gender, respectively. The mean STOP-BANG score was 4.5 +/- 1.5, and the mean modified STOP-BANG score was 4.9 +/- 1.5. Discrimination of OSA measured by area under the curve for both questionnaires is comparable (p>0.05). Sensitivity to define OSA (apnea-hypopnea index (AHI)>= 1.5) was 92.2% and 93.8% for original and modified STOP-BANG questionnaire, respectively. Sensitivity for moderate (AHI >= 15) and severe OSA (AHI >= 30) was identical for both questionnaires.CONCLUSION: The STOP-BANG questionnaire has an excellent sensitivity, but modest specificity and adding national obesity indexes for neck circumference achieved similar results in terms of sensitivity and specificity with the original questionnaire.Item Diagnostic performance of EBUS-TBNA and its interrelation with PET-CT in patients with extra-thoracic malignancies(Türk Tüberküloz ve Toraks Derneği, 2020-10-03) Güçlü, Özge Aydın; Demirdöğen, Ezgi; Ursavaş, Ahmet; Öztürk, Nilüfer Aylin Acet; Özkaya, Güven; Karadağ, Mehmet; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0002-9027-1132; 0000-0002-7400-9089; 0000-0002-6375-1472; 0000-0003-0297-846X; AAG-8744-2021; AAH-9812-2021; Z-1424-2019; AAI-3169-2021; A-4421-2016; 14062849300; 8329319900; 57203790565; 57200859646; 16316866500; 6601970351Introduction: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a well-established diagnostic tool for lung cancer, sarcoidosis, and suspected metastatic extra-thoracic malignancy (ETM). Patients with primary ETM often have hypermetabolic mediastinal/hilar lymph node enlargement in the PET-scan done for initial staging or post treatment follow-up. We aimed to determine the diagnostic performance of EBUS-TBNA and the relationship between PET-SUV values and diagnosis of malignancy metastasis in patients with ETM. Materials and Methods: Results of EBUS-TBNA in ETM patients with suspected MLN metastasis were retrospectively analysed (May 2016 to July 2019). Non-malign results were confirmed for surgery or clinical/radiological follow-up. Lymph nodes with a high FDG-uptake (SUV > 2.5, MLN) were reported as suspicious for metastasis. Results: Of the 588 EBUS procedures, 109 were included in the analysis. Patient' mean age was 62.5 +/- 10.1 years; there were 35 men and 74 women. Primary malignancies were breast cancer in 33, gastrointestinal in 23, female genital tract in 17, head and neck in 14, genitourinary cancer in 13, malignant melanoma in 6, sarcoma in 2 and kaposi sarcoma in 1. According to EBUS-TBNA smear and cell block histopathologic evaluations, 16 patients' results (14.7%) were malignant compatible with metastasis of ETM. Among the 93 patients with non-malignant diagnosis, EBUS-TBNA revealed a granulomatous lympadenitis compatible with sarcoid reaction in 7 and tuberculosis in 2. A total of 9 patients underwent surgical procedures after EBUS-TBNA, with a definitive histological diagnosis of granulomatous lymphadenitis in 2, malignancy in 5 and, reactive lymph node in 2. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of EBUS-TBNA were 76.19% (95% CI 52.83-91.78), 100% (95% CI 95.89-100.00), 100%, 94.62% (95% CI 89.12-97.12) and 95.4%, respectively. Conclusion: EBUS-TBNA sampling has high diagnostic performance. Histopathological confirmation requirement for MLN should be kept in mind in patients with ETM, even they have negative EBUS results.Publication Did the smokers level of knowledge on copd changed in the last decade? Results of two surveys done on world copd days 2003 and 2013(Wiley, 2015-12-01) Uzaslan, Esra; Dilektaşlı, Aslı Görek; Çetinoğlu, Ezgi Demirdoğen; Coşkun, Funda; Karadağ, Mehmet; UZASLAN, AYŞE ESRA; GÖREK DİLEKTAŞLI, ASLI; Çetinoğlu, Ezgi Demirdoğen; COŞKUN, NECMİYE FUNDA; KARADAĞ, MEHMET; Uludağ Üniversitesi; 0000-0001-7099-9647; 0000-0002-7400-9089; 0000-0003-3604-8826; 0000-0002-9027-1132; AAG-8744-2021; AAI-1004-2021; AAD-1271-2019; JPK-7012-2023; DTT-7416-2022; AAH-9812-2021Item Does asthma knowledge of internship year students differ than physicians in specialization training(Elsevier, 2005-10) Uzaslan, Esra; Erdem, Eşref; Coşkun, Funda; Erdoğan, Beril; Ediger, Dane; Karadağ, Mehmet; Gözü, Oktay; Uludağ Üniversitesi/Tıp Fakültesi.; 0000-0002-9027-1132; 0000-0003-3604-8826; 0000-0002-8083-8713; AAE-9142-2019; AAG-8744-2021; AAD-1271-2019; AAJ-7893-2021The goal of this survey was to assess the knowledge, attitudes and beliefs of interns (students in internship year of medical faculty)about asthma and its management and to compare the correct response rate of interns with physicians in specialization training (PST) in teaching hospitals.