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Objective: The aim of this present study was to investigate the eating attitudes ofsarcoidosis patients.Methods: 50 patients with sarcoidosis and 45 healthy individuals without chronicdisease were included to study. All participants evaluated for metabolic syndrome(MetS) according to National Cholesterol Education Program's Adult Treatment PanelIII (NCEP-ATP III) criteria. Eating Attitude Test (EAT) and Beck DepressionInventory (BDI) were applied to all participants. All participants evaluated formetabolic syndrome (MetS). The cut-off scores of the tests were 30 for BDI and 17for BDI.Results: When sarcoidosis cases and control group were evaluated according to EATand BDI cut-off scores; it was found that the prevalence of deterioration in eatingbehavior was higher in patients with sarcoidosis than healthy controls but theprevalence of depression was not higher (p=0.018, p=0.874 respectively).We foundthat total EAT scores were significantly higher in sarcoidosis patients who has MetS.MetS(-); EAT: 15±7, MetS(+); EAT: 27±10 p

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.

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: To investigate the incidence of bronchiectasis supposed to be made by the external compression of hiatal hernia (HH) to bronchi. Materials and Methods: The thorax computed tomography (CT) scans of patients which were carried out in Duzce University Hospital between February 2014 and August 2015 were retrospectively evaluated. The repeated scans in the same patient were excluded. Results: A total of 4388 patients were included in the study. A total of 98 HH cases were detected of which 58 (59.2%) were female. The mean age was 73.30 +/- 9.14 (45-90). The rate of HH according to small, moderate and large size was 45 (45.9%), 9 (9.2%), 44 (44.9%), respectively. The rate of hiatal hernia accompanied by bronchiectasis were similar in both males and females (P = 0.078). The prevalence of bronchiectasis was significantly high in large hernias with 81.4% rate (P = 0.009). Bronchiectasis rate was 12.343 times (OR: 12.343, 95% CI: 1.479-103.027, P = 0.009) higher in the large HH group compared to small and moderate HH groups. Hiatal hernia accompanied by bronchiectasis was 88.1% anatomically near to HH. Conclusions: Thus, hiatal hernia may cause bronchiectasis due to external compression rather than lymphadenopathy or the tumor as an etiology of bronchiectasis and should be considered in the differential diagnosis. WOS:000543398100013 2-s2.0-85086354682 PubMed: 32525118

Alasan, Fatih/0000-0003-0935-5927 WOS: 000490688100001 PubMed: 31615316 Introduction: The aim of this study was to present the follow-up results of 110 patients who were given anti-tumor necrosis factor alpha (TNF-?) therapy for rheumatic and dermatologic diseases in a country with a high rates of active and latent tuberculosis bacillus infection. Material and Methods: Between February 2008 and January 2015, 110 cases in the age range of 23?77 who are using anti-TNF-? were included in the study retro-prospectively. Results: 52.7% of them (n?=?58) were male. The most common diagnoses were rheumatoid arthritis (42.7%) and ankylosing spondylitis (38.2%). Most frequently given treatment were infliximab 37.3% and etanercept 30.9%, respectively. The 65 patients whose first tuberculin skin test (TST) value ?5?mm and above? was started daily 300?mg INH prophylaxis for 9?months but 3 patients had not been started because of refusing treatment. In only one case chemoprophylaxis has had to be interrupted because of high liver function test due to the INH prophylaxis. TST conversion was observed in 14 patients. Further follow-up, it was observed that 4 patients had TST's positivity. Isoniazide (INH) prophylaxis was started these 18 patients (42.9%). Although INH prophylaxis has been given in two patients, they developed active tuberculosis in follow-up. Conclusion: Considering the INH resistance in our country, all patients especially the ones with residual lesion and history of previous exposure, should be followed up closely during the anti-TNF-? treatment.

WOS: 000482895400001 PubMed: 31437086 The present study aimed to investigate the frequency of deep venous thrombosis (DVT) among patients with obstructive sleep apnea syndrome (OSAS). Patients who referred the preliminary diagnosis of OSAS were included in this study. D-dimer levels of all patients were measured, and D-dimer (+) patients were evaluated by Doppler USG of the lower-extremity. Mean age of the patient group was 52 +/- 12 years and 31.8% (76/239) were women. The rate of D-dimer positivity among severe-OSAS cases (15/85) was significantly higher compared to the rest (13/154) (17.6% and 8.4%, respectively; p = 0.034). The risk of D-dimer positivity was elevated by 2.3 folds in severe-OSAS cases (OR: 2,324, 95% confidence interval: 1.048-5.152). Among 28 D-dimer (+) cases, 4 (14.2%) had DVT as demonstrated by USI of the lower-extremity. All four cases with DVT had severe OSAS. D-dimer was positive in 17.6% (15/85) of all severe OSAS cases. DVT was diagnosed in 4.7% (4/85) of severe-OSAS cases. DVT frequency was 26.6% (4/15) in D-dimer (+) severe-OSAS. Findings of this study indicate that severe-OSAS can be a significant risk factor for DVT. Additionally, data obtained in this study underline the benefits of questioning severe-OSAS patients with respect to DVT symptoms, investigating D-dimer levels and evaluating D-dimer (+) severe-OSAS cases for DVT prophylaxis.

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.

Annakkaya, Ali Nihat N/0000-0002-7661-8830 WOS: 000431767800010 Acute eosinophilic pneumonia (AEP) is characterized by a febrile illness, diffuse pulmonary infiltrates, hypoxemic respiratory failure, and pulmonary eosinophilia. A temporal relationship has been described in a number of patients between the development of AEP and the recent onset of cigarette smoking. A 22-year-old male patient with no known chronic disease was admitted to the emergency service for 3 days with the complaints of cough, fever, dyspnea, and pleuritic chest pain. He was formerly a nonsmoker but was a waterpipe (narghile, hookah) tobacco smoker as a new habit once a night for the last 2 months. The erythrocyte sedimentation rate and C-reactive protein are elevated. Arterial blood gases revealed moderate hypoxemia. Computed tomography scans included bilateral, random, and patchy ground-glass opacities and also small bilateral pleural effusions. Echocardiograhic examination was normal. We had accepted the patient as an acute eosinophilic pneumonia due to rapid response to corticosteroid treatment, no microorganism in bronchoalveolar lavage (BAL) culture, and predominant eosinophilia was observed (70%-80%) in BAL.

Annakkaya, Ali Nihat N/0000-0002-7661-8830 WOS: 000361630600006 Objective: Nowadays, inhalation techniques have an important role in treatment of asthma and chronic obstructive pulmonary disease (COPD). Correct application of inhalation devices is important for optimal therapeutic efficacy. Showing inhalation techniques to patients receiving inhaler therapy in more than one visit reduce the device usage errors. It is important to observe the deficiencies and errors of the patients in the primary health care where the patients frequently admitted. In our study we aimed to evaluate the knowledge of family physians on inhaler device usage in their clinical practice. Methods: Family physicians who work in primary health care services were visited face to face. Fifty family physicians who were in the institution at visit day and agreed to participate in the study were included in the study. The questionnaire consisting of 15 questions were asked each family physician. Then, seven different inhalation devices were evaluated with 10 step scoring system of inhaler device usage. Results: Twenty eight (56%) physicians were female and 22 (44%) were male. The mean age was 36.3 +/- 6.7 years and mean working time as a family physician was 5.12 +/- 2.8 years. Nineteen physicians participated to a meeting about usage of inhaler devices in the past. Average scores for inhaler devices were found 7.96 +/- 2.91 for metered-dose inhaler, 7.54 +/- 3.93 for discus, 7.28 +/- 4.04 for handihaler, 6.38 +/- 4.4 for aerolizer, 6.12 +/- 4.22 for turbuhaler, 5.98 +/- 4 for easyhaler and 5.72 +/- 4.59 for sanohaler, respectively. There was no relation between the inhaler devices usage scores and sex, age, duration of being family physician (p>0.05). The average scores of physicians who participated to a training were better than the physicians who didn't participate for metered-dose inhalers, turbuhaler, aerolizer and handihaler (p=0.049, p=0.05, p=0.013 and p=0.021, respectively). Conclusion: We thought that training of family physicians for inhaler devices is necessary to improve patients' compliance and successful treatment.

Introduction: It has been well known that occupational exposure to aluminium leads to smelter asthma and pneumoconiosis. Epidemiological studies are needed to search the exposure conditions and duration. Scope: It is aimed to investigate the type of respiratory involvement. Materials and Methods: Male aluminium foundry workers living in Adapazari district (42 male, mean age: 32.2 ± 6.9 years) compared with 33 male controls without exposure (mean age: 30.0 ± 7.9 years). Mean urine aluminium levels of workers (10.7 ± 8.8 mcg/lt) were significantly higher than those of controls (2.2 ± 0.8, p Conclusion: Mean occupational aluminium exposure of 5 years leads a significant deterioration of workers respiratory health, pulmonary funcions and radiology. Preventive measures should be taken in aluminium foundry sector.

Annakkaya, Ali Nihat N/0000-0002-7661-8830 WOS: 000359777000013 …

WOS:000223257800005 PubMed: 15308827 Serum Oxidant and Antioxidant Levels in Diesel Exposed Toll Collectors: Peri ARBAK, et al. Department of Chest Diseases, Abant Izzet Baysal University, Duzce School of Medicine, Turkey-it has been suggested that exposure to diesel exhaust may lead to adverse effects due to the generation of oxidants. To evaluate the end products of oxidative stress in DE exposure, toll collectors who are considered a high risk group in regard to occupational toxins were compared to controls who had office-based occupations in the same company in this cross sectional study. A total of 38 toll collectors constituted the study group. All subjects were male. The toll collectors and 29 controls were similar regarding age, smoking status and duration of work. All subjects underwent a clinical examination and an interviewer-administrated questionnaire regarding respiratory symptoms, past medical and occupational history, and pulmonary function tests were performed in all subjects. Serum malondialdehyde (MDA), nitrite+nitrate and vitamin E levels were measured. Toll collectors showed higher serum MDA (5.76 +/- 2.15 mumol/L vs. 3.07 +/- 0.76 mumol/L, p=0.0001) and nitrite+nitrate levels (96.50 +/- 45.54 mumol/L vs. 19.32 +/- 11.77 mumol/L, p=0.0001) than controls. Vitamin E levels were similar in toll collectors and controls (10.57 +/- 3.44 mg/L and 9.72 +/- 2.44 mg/L, respectively, p=0.267). There was no difference between groups in terms of the findings of clinical examinations and respiratory symptoms. In pulmonary function parameters, only peak expiratory flow (PEF) in toll collectors was significantly lower than that of controls (88.9% predicted and 104.2% predicted, respectively, p=0.012). In conclusion, we suggest that serum MDA and nitrite+nitrate levels may be used as biological markers of oxidative stress related to DE exposure, but prospective controlled clinical studies are necessary to clarify the possible association between concentrations of MDA and nitrite+nitrate and pulmonary diseases related to DE exposure.

We aimed to investigate the incidence of bronchiectasis supposed to be created by the compression hiatal hernia (HH) on bronchi. The thorax computed tomography (CT) scans of patients which carried out in Duzce University, School of Medicine, between February 2014 and August 2015 were retrospectively evaluated. The repeated scans in the same patient were excluded. 4388 patients were included in the study. A total of 98 HH cases were detected. The rate of HH according to small, moderate and large, size were 45 (45.9%), 9 (9.2 %), 44 (44.9), respectively. 58 of the cases (59.2%) were female. The mean age was 73.30 ± 9.14 (45-90). 9 (9, 1) patients (8 female, %88.8) were found to have confirmed bronchiectasis on Thorax CT. The rate of hiatal hernia accompanied by bronchiectasis were similar in male and female gender (p = 0.078). The prevalence of bronchiectasis were significantly high in large hernias with 81.4% rate (p = 0.009). Demographic parameters and comparisons between Bronchiectasis+, Bronchiectasis– subgroups are shown in Table 1. Bronchiectasis rate, was 12.343 times (OR: 12.343, 95% CI: 1.479-103.027, p = 0.009) higher in large HH group compared to small and moderate HH group .Hiatal hernia accompanied by bronchiectasis with 88.1% was anatomically near to HH. As a result, it is thought that hiatal hernia may cause bronchiectasis due to external compression other than lymphadenopathy or the tumor as an etiology of bronchiectasis and should be considered in the differential diagnosis.

WOS: 000266684100017, PubMed ID: 19181507, Epidemiological characteristics of sarcoidosis differ according to geographical distribution. The aim of our study was to disclose epidemiological characteristics in our country. The data was collected from investigators, who sent information on newly-diagnosed patients via internet. In 2 years 198 female and 95 mate patients were enrolled to the study (f/m:2.08). Mean age of patients was 44 +/- 13 years (17-90). Mean age of mate patients was 38 12 while mean age of female patients was 48 13 (p < 0.001). 73.4% of patients were nonsmokers (85.4% of females; 48.4% of mates; (p < 0.001)). About 50% of our 293 patients were housewives. Familial sarcoidosis was found in 3 patients' first degree relatives. Estimated annual incidence of sarcoidosis for Turkey was calculated as 4 per 100,000 person. According to our study, 2/3 of sarcoidosis patients were women; mean age of patients was 45 and the disease began 10 years later in female patients. 80% of patients were nonsmokers; negative relation between sarcoidosis and smoking was evident especially in women. Familial sarcoidosis frequency was lower compared to other studies in the literature. There was no occupational exposure history in our patients. Our incidence rate, is similar with the results of other European studies. (C) 2008 Elsevier Ltd. All rights reserved.

Yavuz, Özlem (Balikesir Author), Aim. Previous studies have shown a higher sensitization rate to hazelnut in processing workers but no relation was found between the respiratory symptoms in workplace and hazelnut sensitization. Material and Method. To evaluate the association between the hazelnut sensitization and workplace-related respiratory complaints, hazelnut processing workers had undergone a questionnaire included work-related respiratory symptoms, smoking history, pulmonary function testing, and measurement of serum IgE antibodies against hazelnut. Results. This study consisted of 88 hazelnut processing workers (79 females and 9 males), aged 14-59 years (Mean +/- SD: 33.8 +/- 10.5 years). The mean working duration was 38.8 +/- 36.6 months (min: 1-max: 180). Specific IgE against hazelnut allergens was positive in 14 of cases (17.1%). There was no significant difference between the cases with and without specific IgE against hazelnut allergens regarding respiratory symptoms, history of allergy, smoking status and spirometric values. Conclusion. 17.1% of the hazelnut processing workers were seropositive against hazelnut. Being sensitized to hazelnut was not found to be associated with work-related respiratory symptoms in this study. Further studies are needed in hazelnut workers respiratory health to search topics other than asthma.

Background and objective: Extrapulmonary sarcoidosis is common, and is almost always associated with concomitant thoracic involvement. Extrapulmonary manifestations vary on the basis of gender, age at presentation and ethnicity. The aim of this study was to investigate extrapulmonary involvement in patients with sarcoidosis in Turkey. Methods: This study was conducted by Turkish Thoracic Society Clinical Problems Study Group. New cases of sarcoidosis between 1 June 2004 and 31 May 2006 were recorded on electronic case record forms sent to all potential investigators and information about extrapulmonary involvement was collected. Results: One hundred and nineteen of 293 patients (83 female, 36 male, mean age = 45 ± 12 years) had extrapulmonary involvement in this study (40.6%). The median time to diagnosis was 6 months and this was longer than patients with just thoracic sarcoidosis (P = 0.001). Extrapulmonary symptoms were present in 181 (61.8%) patients, and skin lesions, arthralgia and back pain were the commonest (33.4%, 20.8% and 16.4%, respectively). Incidence of organ involvement was independent of age with the exception of ocular involvement, which was higher in those under the age of 40 years (P = 0.007). Conclusions: Skin and peripheral lymph node involvement were the most common sites of extrapulmonary involvement and ocular involvement was more common in those under the age of 40 years in patients with sarcoidosis in a Turkish population.

Aims and backgroundTo evaluate the relationship between delayed diagnosis and the degree of invasion and survival in lung cancer.MethodsOne hundred and three patients (96 men) with lung cancer were included. Stages in the diagnosis of lung cancer were classified as follows: symptom-to-doctor interval, i.e., the interval from the first symptoms related to the presence of lung cancer to the first consultation with a medical professional; doctor-to-diagnosis interval, i.e., the interval between the first medical visit and confirmation of the diagnosis; and diagnosis-to-treatment interval, i.e., the interval between diagnosis and complete TNM staging and treatment. The symptom-to-treatment interval (STI) was the sum of the 3 intervals. The degree of invasion was determined by the TNM classification.ResultsThe patients were followed up for a mean period (± SD) of 7.4 ± 8.7 months. Seventy-six (74%) patients were diagnosed with non-small cell lung cancer (NSCLC) and 27 patients (26%) with small cell lung cancer (SCLC). The mean length of STI was 120 ± 101 days (median, 90). The mean length of the symptom-to-doctor interval was 63 ± 62 days (median, 45), while the doctor-to-diagnosis and diagnosis-to-treatment intervals were 41 ± 82 days (median, 10) and 16 ± 12 days (median, 12), respectively. When the STIs of the patients were correlated with tumor stage, tumor invasion, lymph node involvement and metastasis, no significant differences were found. Patients with an STI longer than 60 days had a significantly longer survival. Regarding the type of lung cancer and STI, the median survival was shorter in patients with an STI of less than 60 days both in NSCLC and SCLC, although this was not statistically significant in SCLC.ConclusionsThe shorter the diagnostic interval, the shorter was the median survival in our study. The reason for the apparent discrepancy between poor prognosis of lung cancer patients in spite of early diagnosis might be much faster progression of the disease itself.

The smoking is main public health problem and requires profound struggle. Turkey was one of the leader countries in tobacco control. Aim: To investigate the prevalence of smoking among Turkish population after tobacco control strategies begun. Methods: Population survey and population based study conducted in primary care settings with face to face interview. The study results were preliminary. It has been conducted since May 2014 and will end up May 2015. Result: The study enrolled a total of 1287 subjects (M: 38.9% and F: 61.1%) with mean age of 45 years-old (14-88). The ratio of current smokers was 21.1% (14.6% among women and 31.2% among men, p Conclusions: The present study reveals the current information about smoking in Turkey. Smoking prevalence was still higher, particularly among male population. The majority of male young population was comparatively smokers. Among female population, whether having or not a chronic disease seemed to be not influential on smoking cessation.

Smoking is main problem among family physicians. They are gate keeper and role model for their patients. Aim: To evaluate the prevalence of smoking among Turkish family physicians and smoking cessation training. Methods: The cross-sectional and primary care based study was has been conducted since May 2014 and will be completed in May 2015. The primary care-based survey was applied in face to face interview to family physicians. Results: The study enrolled 261 physicians (mean age of 46 years-old). Male to female ratio was 95/166. The frequency of current smokers was 29.1%. The ratio of current smokers among male to female physicians was significantly high (37.3% versus 14.7%; p Conclusion: The preliminary study revealed that the smoking prevalence was quite high and comparatively higher among male than female. The significant difference was more marked under age of 50. Pre-and post-graduate training on smoking cessation among family physicians seemed to be not satisfactory.

Balbay, Ege Gulec/0000-0002-1557-7019; Annakkaya, Ali Nihat N/0000-0002-7661-8830; WOS: 000366159400049 PubMed: 26127019 We present a case of 63-year-old man who was referred to the emergency department with a right-sided pneumothorax. He had a history of spontaneous pneumothorax for 2 times. The chest computed tomographic scan showed tracheobronchomegaly with an increase in the diameter of the trachea and right and left main bronchus. Fiberoptic bronchoscopy revealed enlarged trachea and both main bronchus with diverticulas. These findings are consistent with a diagnosis of Mounier-Kuhn syndrome. Mounier-Kuhn syndrome is a rare clinical and radiologic condition. It is characterized by a tracheal and bronchial dilation. Diagnosis is made by computed tomography and bronchoscopy. Mounier-Kuhn syndrome should be kept in mind in the differential diagnosis of recurrent spontaneous pneumothorax.

Background: Clinical and epidemiological studies indicate that obstructive sleep apnea syndrome (OSAS) has a strong genetic basis. Objectives: To investigate the apolipoprotein E (APOE) alleles as a genetic risk factor in OSAS. Methods: A total of 73 patients (37 male) were included. All underwent full-night polysomnography and were evaluated for APOE alleles. Results: The mean age was 51 ± 12 years. Forty-two of the patients had OSAS. The APOE3 allele was found in 97.3% (71/73) of the study population. The most common APOE genotype was E3/E3 (55/73, 75.3%). Compared to the individuals with no APOE2 alleles (E3/E3, E3/E4), the individuals with at least one APOE2 allele (E2/E3, E2/E4) had a 9.37-fold greater OSAS risk (OR = 9.37, 95% CI 1.13-77.7, p = 0.019). The individuals with APOE2 alleles (E2/E3, E2/E4) compared to the individuals with only an E3/E3 allele genotype had a 10-fold greater OSAS risk (OR = 10.3, 95% CI 1.24-86.61, p = 0.0308). Compared to the individuals with no APOE4 alleles (E2/E3, E3/E3), the individuals with APOE4 alleles (E2/E4, E3/E4) had a high but insignificant risk for OSAS (OR = 2.9, 95% CI 0.55-15.05, p = 0.286). The individuals with APOE4 alleles (E2/E4, E3/E4) compared to APOE3 alleles (E3/E3) had an increased but insignificant risk for OSAS (OR = 3.62, 95% CI 0.96-19.05, p = 0.127). Conclusion: Specific APOE genotypes are associated with OSAS in a high-risk population.

OBJECTIVES: We hypothesized that in patients with chronic obstructive pulmonary disease (COPD) some extrapulmonary effects such as increase in intra-abdominal and intra-thoracic pressures, presence of cor pulmonale and pulmonary artery hypertension could cause venous insufficiency (VI) in the lower limbs. Our aim in this study was to assess the prevalence of VI in patients with COPD in comparison with healthy controls. METHODS: Thirty-nine male patients with COPD and 36 healthy male controls were evaluated for VI. All the participants were in the same age group and their smoking intensities were similar. Patients with COPD were classified as having mild, moderate, severe or very severe disease according to criteria of the Global Initiative for Chronic Obstructive Lung Disease. All the patients and control group were examined for unilateral or bilateral VI of the common femoral vein, superficial femoral vein, deep femoral vein and popliteal vein using color duplex ultrasonography. RESULTS: The prevalence of VI of the lower extremity in patients with COPD (69.2%) was significantly higher than in the healthy control group (41.7%). The prevalence increased as the COPD severity increased and VI was detected in all the patients with very severe COPD [mild COPD, 50.0% (2/4); moderate, 58.8% (10/17); severe, 75.0% (9/12); very severe, 100% (6/6)]. CONCLUSION: VI of the lower extremity appears more frequent in patients with COPD. We suggest ruling out COPD in patients with otherwise unexplained "primary" VI.

Free radical-mediated injury to lung and pulmonary vasculature is an important mechanism in hypoxia-induced lung damage. In this study, we aimed to investigate the potential protective effects of erdosteine as an antioxidant agent on hypobaric hypoxia-induced pulmonary hypertension. Adult male rats were assigned randomly to three groups. The first group of rats was exposed to hypobaric-hypoxia and the second group was treated with erdosteine (20mg/kg, daily) for 2 weeks, during which time they were in a hypoxic chamber. These groups were compared with normoxic controls. All rats were sacrificed after 2 weeks. The hypoxia-induced increase in right ventricle to left ventricle plus septum weight ratio (from 0.20+/-0.01 to 0.26+/-0.01) was reduced significantly in the erdosteine-treated group (0.23+/-0.01). Malondialdehyde levels were elevated (from 0.33+/-0.11 to 0.59+/-0.02) and total antioxidant status was not changed significantly (from 1.77+/-0.42 to 2.61+/-0.23) by hypoxia. In contrast to the hypoxia-exposed group, malondialdehyde levels were significantly decreased in the erdosteine-treated group (0.37+/-0.02). Total antioxidant status (4.03+/-0.22) was significantly higher in erdosteine-treated rats when compared to non-treated rats. Histopathological examination demonstrated that erdosteine prevented inflammation and protected lung parenchyma and pulmonary endothelium of hypoxia-exposed rats.

Chronic necrotizing pulmonary aspergillosis is characterized by a pulmonary infiltration with cavitation in patients with chronic pulmonary disease, slight immunodeficiency or healthy patients. A 57-year-old man with non-small cell carcinoma who has had radiotherapy was admitted with a history of left side pleuritic chest pain, non-productive cough, fever and dyspnea. Aspergillus fumigatus was found in his mycological exams of BAL fluid. Serum examination presented positive galactomannan. Final diagnosis was semi-invasive pulmonary aspergillosis treated with voriconazole.

Annakkaya, Ali Nihat N/0000-0002-7661-8830; Balbay, Ege Gulec/0000-0002-1557-7019 WOS: 000347917900004 PubMed: 24914073 Objective: To investigate the prevalence of obstructive sleep apnoea syndrome in patients with primary open-angle glaucoma. Design: Case series. Setting: School of Medicine, Duzce University, Turkey. Patients: Twenty-one consecutive primary open-angle glaucoma patients (12 females and 9 males) who attended the out-patient clinic of the Department of Ophthalmology between July 2007 and February 2008 were included in this study. All patients underwent polysomnographic examination. Results: The prevalence of obstructive sleep apnoea syndrome was 33.3% in patients with primary open-angle glaucoma; the severity of the condition was mild in 14.3% and moderate in 19.0% of the subjects. The age (P = 0.047) and neck circumference (P = 0.024) in patients with obstructive sleep apnoea syndrome were significantly greater than those without the syndrome. Triceps skinfold thickness in glaucomatous obstructive sleep apnoea syndrome patients reached near significance versus those without the syndrome (P = 0.078). Snoring was observed in all glaucoma cases with obstructive sleep apnoea syndrome. The intra-ocular pressure of patients with primary open-angle glaucoma with obstructive sleep apnoea syndrome was significantly lower than those without obstructive sleep apnoea syndrome (P = 0.006 and P = 0.035 for the right and left eyes, respectively). There was no significant difference in the cup/disc ratio and visual acuity, except visual field defect, between primary open-angle glaucoma patients with and without obstructive sleep apnoea syndrome. Conclusions: Although it does not provide evidence for a cause-effect relationship, high prevalence of obstructive sleep apnoea syndrome in patients with primary open-angle glaucoma in this study suggests the need to explore the long-term results of coincidence, relationship, and cross-interaction of these two common disorders.

Annakkaya, Ali Nihat N/0000-0002-7661-8830; BILGIN, CAHIT/0000-0003-2213-5881 WOS: 000243291500002 PubMed: 17078025 Purpose. To assess the effects of exposure to exhaust particles on intima-media thickness of the common carotid artery in highway toll collectors, Methods. Sixty-one highway toll collectors (HTCs) between 24 and 56 years of age (mean, 36.2 +/- 7.3) and 48 controls between 24 and 64 years of age (mean, 42.6 +/- 10.6) were evaluated with gray-scale sonography to measure intima-media thickness (IMT) of the common carotid artery (CCA). Subgroups were categorized according to duration of exhaust exposure and further divided according to tobacco use. Results. CCA IMT was higher (0.8 +/- 0.2 mm) in HTCs than in the control group (0.6 +/- 0.1 mm; p < 0.001) and remained higher when subgroups with similar smoking habits were compared. In HTCs, IMT was greater when the number of years working in tollbooths was greater (p = 0.023). IMT was lower in HTCs with an exposure duration of < 10 years compared with a duration of 10-20years (p = 0.017) or > 20years (p value not significant). Conclusion. Air pollution has a widely acknowledged negative effect on humans. This study confirms that exposure to exhaust particles might cause wall thickening of carotid arteries. (c) 2006 Wiley Periodicals, Inc.

Various mucocutaneous reactions have been reported with the use of systemic docetaxel. We describe a 47-year-old man who developed a persistent serpentine supravenous hyperpigmented eruption (PSSHE), beginning at the site of docetaxel injection and spreading along the superficial venous network in the anterior aspect of the right forearm and distal arm. The eruption occurred after the first infusion of docetaxel following insufficient venous washing. A second infusion was administered through a vein in the other forearm, but this time, abundant venous washing was performed and a similar eruption did not occur. To our knowledge, this is the second report of docetaxel-induced supravenous discoloration and we discussed the terminology and mechanism of this unique reaction.

In some viral or bacterial infections, a minority of patients developed rapidly progressive pneumonia leading to acute lung injury (ALI)-acute respiratory distress syndrome (ARDS).

Coskun, Abdurrahman/0000-0002-1273-0604; Annakkaya, Ali Nihat N/0000-0002-7661-8830 WOS: 000266882200007 PubMed: 19494536 Objective: To investigate serum levels of CA 19.9, CA 125 and carcinoembryonic antigen (CEA) in patients with different stages of chronic obstructive pulmonary disease (COPD). Patients and Methods: Fifty-three consecutive patients (50 males, 3 females, mean age 67.6 +/- 10.1 years) with COPD were included in this study. Serum levels of CA 19.9, CA 25 and CEA were determined by the chemiluminescent immunometric method. Based on values obtained from pulmonary function tests, the patients were divided into 3 groups: moderate (21), severe (18) and very severe (14). Data were analyzed with a Kruskal-Wallis one-way analysis of variance test and Mann-Whitney U test. Results: The mean serum levels of CA 125 and CA 19.9 were significantly higher in patients with very severe COPD (p = 0.013 and p = 0.017, respectively) than in patients with severe and moderate COPD (p < 0.05). Patients with cor pulmonale had significantly high mean serum levels of CEA, CA 19.9 and CA 125 (p < 0.05). Patients using a long-acting beta-agonist and theophylline showed significantly higher mean serum levels of CA 125 than patients who were not (p < 0.05). Conclusion: Data showed that the increased serum tumor markers in patients with COPD might be due to the severity of COPD, medication and cor pulmonale. Copyright (c) 2009 S. Karger AG, Basel

Coskun, Abdurrahman/0000-0002-1273-0604; Annakkaya, Ali Nihat N/0000-0002-7661-8830 WOS: 000247571900017 PubMed: 17565927 Pregnancy-associated plasma protein-A (PAPP-A) is potentially a proatherosclerotic metalloproteinase and a new inflammatory marker. Investigators sought to evaluate the significance of PAPP-A in patients with asthma. Blood samples were collected from 35 patients and 20 control subjects. Serum PAPP-A was determined by enzyme-linked immunosorbent assay. PAPP-A levels of patients with asthma (8.1 +/- 5.0 mU/L) were higher than those of the control group (4.9 +/- 2.1 mU/L) (P

Annakkaya, Ali Nihat N/0000-0002-7661-8830 WOS: 000237173800003 PubMed: 16547981 Purpose. To evaluate the relationship between varicocele and chronic obstructive pulmonary disease (COPD) via color duplex sonography. Materials and Methods. Forty-four male patients with COPD (age range, 50-89 years; mean +/- SD, 66 +/- 9) and 44 male healthy controls (age range, 47-75 years; mean +/- SD, 65 +/- 6) were evaluated with color duplex sonography for unilateral or bilateral varicocele. Results. The incidence of right, left, and bilateral varicocele was 47.7%, 65.9%, and 38.6% respectively, in the COPD group, versus 22.7%, 52.3%, and 13.6% in the control group. The incidence of right and bilateral varicocele in the COPD group was significantly higher than in the control group (p < 0.05). The incidence of varicocele also increased with increase in COPD severity. Conclusions. The incidence of varicocele in COPD patients is high. Varicocele might be one of the most important causes of scrotal pain and infertility in COPED patients. (C) 2006 Wiley Periodicals, Inc.