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Obstructive sleep apnea syndrome (OSAS) is characterized by repetitive episodes of upper airway obstruction which occurs during sleep and usually associated with a reduction in oxygen saturation, and it is one of the common health problems with significant mortality and morbidity. It is very well-known that OSAS alters the serum levels of several hormones by the effect of hypoxia on central neurotransmitters that causes changes in the hypothalamic-pituitary-adrenal axis (HPA) in relation with sleep fragmentation. Growth hormone secretion (GH) is affected by several factors such as age, sex, obesity, body composition and sleep quality. Also, the oxygen content of the inhaled air affects the secretion of GH. On the other hand, intermittent hypoxemia increases GH secretion. In this study, we aimed to examine the serum level of GH in patients with OSAS.

OBJECTIVE: Differential diagnosis of idiopathic pulmonary fibrosis (IPF) is important among fibrotic interstitial lung diseases (ILD). This study aimed to evaluate the rate of IPF in patients with fibrotic ILD and to determine the clinical-laboratory features of patients with and without IPF that would provide the differential diagnosis of IPF. MATERIAL AND METHODS: The study included the patients with the usual interstitial pneumonia (UIP) pattern or possible UIP pattern on thorax high-resolution computed tomography, and/or UIP pattern, probable UIP or possible UIP pattern at lung biopsy according to the 2011 ATS/ERS/JRS/ALAT guidelines. Demographics and clinical and radiological data of the patients were recorded. All data recorded by researchers was evaluated by radiology and the clinical decision board. RESULTS: A total of 336 patients (253 men, 83 women, age 65.8±9.0 years) were evaluated. Of the patients with sufficient data for diagnosis (n=300), the diagnosis was IPF in 121 (40.3%), unclassified idiopathic interstitial pneumonia in 50 (16.7%), combined pulmonary fibrosis and emphysema (CPFE) in 40 (13.3%), and lung involvement of connective tissue disease (CTD) in 16 (5.3%). When 29 patients with definite IPF features were added to the patients with CPFE, the total number of IPF patients reached 150 (50%). Rate of male sex (p, Roche, Financial Disclosure: This research received unconditional financial support from the company of Roche.

Aim: In this study, the role of lung cancer symptom screening in smokers aged 30 and over in Duzce city was investigated.Materials and Methods: 500 cases over 30 years of age with a smoking history randomly selected from 700 households were included in the study. The smoking habits and symptoms of lung cancer cases were evaluated by a questionnaire with a face to face manner. It was emphasized that smoking is an important risk factor for lung cancer. Smoking habits were re-questioned by phone in 353 of 474 active smokers 6 months later.Results: Of the 353 smokers, 32 (9.1%) were female and 321 (90.9%) were male. It consisted of cases with a mean age of 46±9 and an average of 36±24 pack/year smoking history. 130 cases (%36.8) were intended to smoking cessation and 65 (%18,4) had tried smoking cessation. In the 6 months follow-up 17 (%4.8) of them had given up smoking, 59 (%16) of them had decreased, and 2 (%0,6) of them had increased it. The cases who had given up smoking were not the ones who had an intention to smoking cessation and had tried to quit at the first interview. Those who quit smoking had a higher mean age (p=0.044) and had a longer smoking history (p=0.001). The presence of hemoptysis and clubbing symptoms significantly increased smoking cessation rates (p=0.048, p=0.013, respectively). In this study, the quit rate after 6 months of lung cancer symptom questioning (4.8%) was significantly higher than the spontaneous smoking cessation rate (1%) (p=0.001).Conclusion: Smoking cessation rates can be increased by screening for lung cancer symptoms. Along with smoking cessation outpatient clinics, such approaches can contribute to the fight against smoking., Amaç: Bu çalışmada Düzce ilinde 30 yaş ve üzeri sigara içenlerde akciğer kanseri semptom taramasının sigara bırakmadaki rolü araştırıldı.Gereç ve Yöntemler: Randomize 700 hane seçilerek 30 yaş üzeri sigara anamnezi olan 500 olgu çalışmaya alındı. Olguların sigara alışkanlıkları ve akciğer kanseri semptomları bir anket formuyla yüz yüze görüşmeyle sorgulandı. Sigaranın akciğer kanseri için önemli bir risk faktörü olduğu vurgulandı. Halen aktif sigara içen 474 olgunun 353'üne 6 ay sonra telefonla sigara alışkanlıkları yeniden sorgulandı.Bulgular: Toplam 353 sigara içen olgunun 32’si (%9,1) kadın, 321’i (%90,9) erkekti. Yaş ortalaması 46±9 olan olguların, ortalama 36±24 paket-yıl sigara anamnezi vardı. 130'u (%36,8) sigarayı bırakmayı düşünüyordu ve 65'i (%18,4) sigarayı bırakmayı denemişti. 6 ay sonraki kontrolde 17 olgu (%4,8) sigarayı bırakmış, 59 olgu (%16) sigarayı azaltmış, 2 olgu (%0,6) ise artırmıştı. Sigarayı bırakanların hiçbiri ilk görüşmede bırakmayı düşündüğünü söyleyenler veya daha önce bırakmayı deneyenlerden değildi. Sigarayı bırakanların yaş ortalaması sigara içmeye devam edenlere göre daha yüksekti (p=0,044) ve sigarayı bırakanların daha uzun süredir sigara içme öyküleri vardı (p=0,001). Hemoptizi ve çomak parmak semptomlarının varlığı sigara bırakma oranlarını anlamlı düzeyde artırmaktaydı (sırasıyla p=0,048, p=0,013). Bu çalışmada akciğer kanseri semptom sorgulamasından 6 ay sonraki sigara bırakma oranı (%4,8), kendiliğinden sigarayı bırakma oranından (%1) anlamlı düzeyde yüksekti (p=0,001).Sonuç: Akciğer kanseri semptom taramasıyla sigara bırakma oranları artırılabilir. Sigara bırakma poliklinikleri yanında bu tip yaklaşımlar sigara mücadelesine katkıda bulunabilir.

As the chest diseases clinic of Duzce Medical School, we were one of the departments that took an active role in the COVID-19 pandemic. Chest diseases department; It was one of the main branches in the differential diagnosis, treatment and follow-up of COVID-19 cases. In this process, our assistants, who were our hands and arms, were our fighters who were at the forefront of the pandemic process. During the pandemic process, we worked every day with an order consisting of a faculty member and two assistants. We continued our scientific meeting and assistant trainings online so that our training activities are not interrupted. On the one hand, we continued our scientific activities by participating in the studies, planning new research, and writing projects. As a result, when we look back, we have completed this difficult process by further enhancing our sense of solidarity that exists as a department in the pandemic process we experienced for the first time in our lives. WOS:000588563300005

Amaç: Bu çalışmanın amacı, hastaların polisomnografi (PSG) verileri ile PSG incelemesi sonrası sabah hastaların kendileri tarafından bildirilen verilerin birbiri ile uyumunu değerlendirmektir.Gereç ve Yöntemler: Çalışmaya Düzce Üniversitesi Tıp Fakültesi Göğüs Hastalıkları Uyku Polikliniği’ne başvurmuş ardışık 134 kişi dahil edildi. PSG ve uyku algısı ile ilgili sorular tüm katılımcılara aynı hekim tarafından yüz yüze görüşme ile uygulandı.Bulgular: Çalışmaya dahil edilen hastaların 90’ı (%67,2) erkek ve 44’ü (%32,8) kadın olup yaş ortalaması 47,3±12,6 yıl idi. Obstrüktif uyku apnesi (OUA) negatif olan hastalarda, hastaların sabah uyandıktan sonra kendileri tarafından bildirilen uyku süresi ile PSG cihazı ile ölçülen uyku süresi arasında anlamlı bir korelasyon varken (p=0,042; r=0,301), OUA (+) olan hastalarda hastaların sabah uyandıktan sonra kendileri tarafından bildirilen uyku süresi ile PSG cihazı ile ölçülen uyku süresi arasında korelasyon yoktu (p=0.269, r=0.125). Benzer şekilde, OUA (-) olan hastalarda hastaların sabah uyandıktan sonra kendileri tarafından bildirilen uyku latansı ile PSG cihazı ile ölçülen uyku latansı arasında anlamlı bir korelasyon varken (p=0.026, r=0.352), OUA (+) olan hastalarda hastaların sabah uyandıktan sonra kendileri tarafından bildirilen uyku latansı ile PSG cihazı ile ölçülen uyku latansı arasında korelasyon yoktu (p=0.060, r=0.223).Sonuç: OUA hastalarını değerlendirirken ve hastaların PSG sonrası ve öncesi tedavilerini açıklarken, hastaların algılarının bozulmuş olabileceği akılda tutulmalıdır. Bu nedenle, hasta ile görüşmelerde daha çok zaman ayırmak ve açıklamalarımızı daha açık ve anlaşılır bir şekilde yapmak gerektiğini düşünmekteyiz., Aim: The aim of this study, is to evaluate the consistency with the polysomnography (PSG) data of the patients and the data reported by the patients themselves after PSG examination in the morning.Material and Methods: One hundred and thirty-four consecutive individuals who were admitted to the Chest Disease Polyclinic for Sleep Disorders of Duzce University Medical Faculty were included in the study. PSG and the questions related to sleep perception was applied by the same physician with face to face interview to all participants.Results: Of the patients included in the study 90 (67.2%) were male and 44 (32.8%) were female, and the mean age was 47.3±12.6 years. While there was a significant correlation (p=0.042, r=0.301) between the sleep time reported by the patients themselves after waking up in the morning and the sleep time measured by the PSG in patients without obstructive sleep apnea (OSA), there was no correlation in OSA (+) patients (p=0.269, r=0.125). Similarly, while there was a significant correlation (p=0.026, r=0.352) between the sleep latency reported by the patients themselves after waking up in the morning and the sleep latency measured by the PSG in OSA (-) patients, there was no correlation in OSA (+) patients (p=0.060, r=0.223).Conclusion: While evaluating OSA patients and explaining their treatment before and after PSG, it should be kept in mind that they might have impaired perception. Therefore, we thought that we should spend more time to patients, and to make our explanations more clearly and understandably.

Aim: The aim of thisstudy was to investigate the factors that determine hospitalization reasons,duration of hospitalization and the mortality of lung cancer patients. Material andMethod:151 patients who were admitted to the chest diseases clinic of our hospitalwith lung cancer diagnosis between 2013-2018 were evaluated retrospectively.The pathology reports, ICD-10 diagnostic codes, laboratory results andanamnesis archive were used in examination. Results: 90.1% of caseswere male (n=136) and 9.9% (n=15) were female. The mean age was 65±10 (minimum:45 years, maximum: 86 years). The most common diagnosis was Non Small Cell LungCancer (NSCLC) (84%). The most common symptom was dyspnea, (77.5%) most commonreason for hospitalization was pneumonia (54.3%). When smoking history wasquestioned, 44.2% of the patients were still smoking. Considering the situationof hospital discharge, there was a statistically significant difference betweengroups in terms of cell diagnosis (p=0.008). Considering of hospitalizationduration; It was significantly shorter in diabetes patients (p=0.023). Amongthe other comorbidities, although the duration of hospitalization was long, butit did not reach statistical significance in COPD and heart failure patients(p=0.455 p=0.519, respectively).Conclusion: In this study,we reviewed the causes of hospitalization in lung cancer patientsretrospectively. Taking preventive measures interms of pneumonia that may occur in the follow-up of cancer patients mayreduce hospitalization and patient costs, morbidity and mortality. Training andtreatments that given for smoking cessation are important in the prognosis ofthe disease., Amaç: Bu çalışmanınamacı akciğer kanseri tanılı hastalarda; yatış nedenlerini, yatış sürelerini vemortaliteyi etkileyen faktörleri incelemektirGereç veYöntemler:Hastanemiz göğüs hastalıkları kliniğine 2013-2018 tarihleri arasında akciğerkanseri tanısı ile başvurup yatışı yapılan 151 hasta geriye yönelikdeğerlendirildi. İnceleme sırasında hastaların patoloji raporları, ICD–10 tanıkodları, laboratuvar sonuçları ve anamnez arşivine kaydedilen bilgilerindenyararlanıldı.Bulgular: Vakaların%90,1’i erkek (n=136), %9,9’u (n=15) kadındı. Yaş ortalaması 65±10 (minimum:45, maksimum: 86 yıl) idi. En sık tanı Küçük Hücre Dışı Akciğer Kanseri (KHDAK)idi (%84). Hastalarda görülen en sık semptom nefes darlığı (%77,5), en sıkyatış nedeni pnömoni idi (%54,3). Sigara öyküsü sorgulandığında; hastaların%44,2’si halen sigara içmeye devam ediyordu. Taburculuk durumudeğerlendirildiğinde gruplar arasında hücre tanısı (p=0,008) açısından anlamlıistatistiksel fark vardı. Yatış süreleri göz önünde bulundurulduğunda gruplararasında; diyabet bulunan hastalarda yatış süresi anlamlı olarak kısaydı(p=0,023). Diğer komorbiditelerden KOAH ve kalp yetmezliği olanlarda yatışsüresi uzun olsa da istatistiksel olarak anlamlılığa ulaşmadı (sırasıyla;p=0,455 p=0,519).Sonuç: Buçalışmada akciğer kanseri tanısı almış hastaların yatış nedenleriniretrospektif olarak inceledik. Kanser hastalarının takibinde gelişebilecekpnömoni açısından koruyucu önlemler almak hastane yatış ve hasta maliyetlerini,morbidite ve mortaliyeyi azaltabilir. Sigara konusunda verilecek eğitim vetedaviler hastalığın prognozunda önem arz etmektedir.

WOS: 000512905300018 Aim: Obstructive sleep apnea syndrome (OSAS) is characterized by decreased airflow (hypopnea) or complete interruption (apnea) and is characterized by airway narrowing, decreased oxyhemoglobin saturation, hypercapnia, and hyperventilation associated therewith. It is known that genetic factors play role in the pathogenesis of OSAS. Multi-drug resistant-1 (MDR-1) gene products have a role in the pathogenesis of several diseases related to oxidative stress. We aimed to evaluate the frequency of MDR-1 gene C/T polymorphism in patients with OSAS. Material and Method: This study was performed on 43 OSAS and 23 healthy individuals. Blood samples from each individual were collected in tubes with ethylenediaminetetraacetic add (EDTA). DNA was extracted from the blood samples. The MDR-1 gene polymorphism was detected by polymerase chain reaction (PCR) and enzyme digestion techniques. Results: The frequencies of MDR-1 genotypes were found 27.9% for CC, 41.9% for CT and 30.2% for TT in the OSAS group and 17.4% for CC, 65.2% for CT and 17.4% for TT in the control group. The distribution of MDR-1 gene C alleles was found to be 48.8% in COPD group and 50.0% in the control group; T alleles were found to be 51.2% in OSAS group and 50.0% in the control group. There was no statistically significant difference observed between the groups for genotype and allele frequency of MDR-1 gene (p>0.05). Discussion: We believe these results can be useful for large-scale population genetic research considering the frequency of the MDR-1 gene variation in OSAS patients in the Turkish population.

WOS: 000480511400054 The use of natural gas for heating purposes causes less air pollution than solid fuels. Preventing air pollution decreases hospital admissions due to respiratory infections in children. The aim of the study is to examine the impact of using more clean fuel for heating purpose on hospital admissions with respiratory tract diseases in children. The records of 126.940 pediatric patients who were admitted to Duzce University Medical Faculty Pediatric Emergency Medicine outpatient clinic between 2014 and 2017 were reviewed. The records of children diagnosed with respiratory diseases (n: 46137) were examined. During the same period, air monitoring measurements of the national air quality network were recorded. Of the children, 55.5% were male and 45.5% were female. Most of the children were among the age group of 2-5 years (44%). Between 2014 and 2017, the mean PM10 was observed to decrease (2014: 114.4, 2017:79, p < 0.0001), rate of natural gas usage (2014:52.9%, 2017: 64.2%, p

Aim: The aim of this study, is to evaluate the consistency with the polysomnography (PSG) data of the patients and the data reported by the patients themselves after PSG examination in the morning. Material and Methods: One hundred and thirty-four consecutive individuals who were admitted to the Chest Disease Polyclinic for Sleep Disorders of Duzce University Medical Faculty were included in the study. PSG and the questions related to sleep perception was applied by the same physician with face to face interview to all participants. Results: Of the patients included in the study 90 (67.2%) were male and 44 (32.8%) were female, and the mean age was 47.3±12.6 years. While there was a significant correlation (p=0.042, r=0.301) between the sleep time reported by the patients themselves after waking up in the morning and the sleep time measured by the PSG in patients without obstructive sleep apnea (OSA), there was no correlation in OSA (+) patients (p=0.269, r=0.125). Similarly, while there was a significant correlation (p=0.026, r=0.352) between the sleep latency reported by the patients themselves after waking up in the morning and the sleep latency measured by the PSG in OSA (-) patients, there was no correlation in OSA (+) patients (p=0.060, r=0.223). Conclusion: While evaluating OSA patients and explaining their treatment before and after PSG, it should be kept in mind that they might have impaired perception. Therefore, we thought that we should spend more time to patients, and to make our explanations more clearly and understandably. © 2019, Duzce University Medical School. All rights reserved.

WOS: 000287819600022, Introduction: To investigate the effects of hazelnut exposure on pulmonary functions in a cross-sectional study on hazelnut processing workers. Materials-methods: One hundred fifty hazelnut workers (137 females and 13 males), and seventy controls (63 females and 7 males) were included. A questionnaire regarding the respiratory symptoms was given to all subjects. Standard pre-shift and post-shift forced expiratory pulmonary functions were obtained from all participitants by spirometry. Furthermore, dust particles were measured according to their sizes. Results: The occurences of common respiratory complaints as cough (8%) and dyspnea (6%) were significantly higher in hazelnut workers than the controls (p=0.009 and p=0.029, respectively). Both of the pre-shift and post-shift spirometric values of hazelnut workers were significantly lower than those of controls. Post-shift FVC (2738.9 +/- 652.2) was significantly lower than pre-shift FVC (2765.8 +/- 634.8) in hazelnut workers (p=0.024). Nine hazelnut (6.0%) workers have shown a decrease of more than 10% in post shift FEV 1 whereas none of the controls have had abnormal decrease in post shift values (p=0.060). Conclusion: A significant deterioration in both restrictive and obstructive pulmonary functions was observed in hazelnut workers. Preventive measures against dusty workplaces should be undertaken to protect the respiratory health of hazelnut workers.

WOS: 000405969500005, PubMed ID: 28808489, INTRODUCTION: Patient examinations performed in a limited time period may lead to impairment in patient and physician relationship, defective and erroneous diagnosis, inappropriate prescriptions, less common use of preventive medicine practices, poor patient satisfaction, and increased violent acts against health-care staff. OBJECTIVE: This study aimed to determine the appropriate minimal duration of patient examination in the pulmonary practice. METHODS: A total of 49 researchers from ten different study groups of the Turkish Thoracic Society participated in the study. The researchers were asked to examine patients in an almost ideal manner, without time constraint under available conditions. RESULTS: A total of 1680 patient examinations were reviewed. The mean duration of patient examination in ideal conditions was determined to be 20.4 +/- 9.6 min. Among all steps of patient examination, the longest time was spent for "taking medical history." The total time spent for patient examination was statistically significantly longer in the university hospitals than in the governmental hospitals and training and research hospitals (P < 0.001). Among different patient categories, the patients with a chronic disorder presenting for the first time and were referred from primary or secondary to tertiary care for further evaluation have required the longest time for patient examination. CONCLUSION: According to our study, the appropriate minimal duration for patient examination is 20 min. It has been observed that in university hospitals and in patients with chronic pulmonary diseases, this duration has been increased to above 25 min. The durations in clinical practice should be planned accordingly.

İt has been known that prognosis is poor in lung cancer vvith pleural effusion. The records of 44 lung cancer patients vvith pleural effusion admitted to our clinic betvveen 2003-2009 were evaluated. Thirty nine patients (88.6%) were male and five of them were (11.4%) femaie. Mean age of patients was 62.8 ± 11.7 (minimum 36-maximum 93) years. Thirty three patients (75.0%) were diagnosed as non small celi lung cancer (NSCLC) whereas remaining (25.0%) were presented as small celi lung cancer. Most of the cases (16/33) were diagnosed as sçuamous celi cancer in patients vvith NSCLC vvhereas the remaining were ade-nocarcinoma (seven cases), large celi cancer (two cases) and non-classified NSCLC (eight cases). The stages in most of the cases were presented as T4 (43.2%), N1 (27.3%), MO (43.2%) and stage (36.4%). Pleural effusion was in right side (43.2%) and minimal (45.5%) in size in the majority of cases. Most of the pleural effusions were in the same side vvith tumor (88.6%>), were exudative (61.4%>) and were not evaluated microscopically (61.4%). The ratio of the patients undement chemotherapy and presented vvith regression in pleural effusion was high after the first course then it decreased in the later courses (39.1 %> -»9.1 %>). The ratio of patients vvhose effusions remained stable after the first course increased in the later courses and remained above 50% (56.6%> -»63.6%>). The ratio of patients vvith Progressive pleural effusions increased in the later courses (4.3%> ->27.3%o). İn conclusion; pleural effusion might be mostly seen in the later stages of lung cancer. Most of the pleural effusions were minimal and located at the same side vvith tumor. The regression response that was achieved in the first course of chemotherapy decreased in the later courses. Progression in pleural effusions increased in the later courses., Plevra sıvısının eşlik ettiği akciğer kanseri tablosunda prognozun sıklıkla kötü olduğu bilinmektedir. Kliniğimizde 2003-2009 yılları arasında görülmüş plevra sıvısının eşlik ettiği 44 akciğer kanseri hastasının kayıtları değerlendirildi. Olguların 39 (%88.6)'u erkek, 5 (%11.4)'i kadındı. Olguların yaş ortalaması 62.8 ± it.7 (36-93) idi. Küçük hücreli dışı akciğer kanseri (KHDAK) tamlı olgu sayısı 33 (%75.0) iken, küçük hücreli akciğer kanseri tamlı olanların sayısı 11 (%25.0) idi. KHDAK olgularının çoğunluğunu (16 olgu) yassı hücreli akciğer Ca oluştururken, kalanları (yedi olgu) adenokanser, büyük hücreli (iki olgu) ve tiplendirilememiş (sekiz olgu) idi. Olguların çoğunlukla T4 (%43.2), N1 (%27.3), MO (%43.2) ve evre 4 (%36.4) dağılımına uyduğu gözlendi. Olguların plevra sıvısı sıklıkla sağ akciğerde (%43.2), minimal (%45.5), kitle ile aynı tarafta (%88.6), eksüda içeriğinde (%61.4), mikroskobik olarak direkt muayene ile değerlendirilmemişti (%61.4). Kemoterapi uygulanan ve sıvıda regresyon gözlenen olguların oranı ilk kürde yüksek iken sonraki kürlerde azaldı (%39.1 -» %9.1). Plevra sıvısı stabil kalan olguların oranı ilk kürden itibaren artarak tüm kürlerde %50'nin üstünde seyretti (%56.6 -> %63.6). Plevra sıvısında progresyon gözlenen olguların oranı ilk kürden son kürlere giderek artış gösterdi (%4.3 -> %27.3). Sonuçta; akciğer kanserlerinde plevra sıvısının daha sıklıkla ileri evrelerde izlenebildiği, olguların çoğunun minimal sıvılı olduğu ve kitle ile sıvının aynı tarafta yer aldığı gözlendi, ilk kürde sağlanan sıvıda regresyon yanıtının diğer kürlerde azaldığı ve sıvıda progresyon oranının ilerleyen kürlerde arttığı gözlendi.

Annakkaya, Ali Nihat N/0000-0002-7661-8830 WOS: 000451979404055 …

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