Search

OBJECTIVE: Chronic obstructive pulmonary disease (COPD) that is the third leading cause of death in the world is one of the main economic burden. The cost is primarily due to COPD exacerbations and hospitalizations. We aimed to determine the factors associated with increasing costs in severe COPD exacerbation. MATERIAL AND METHODS: It was a multicenter and prospective observational recording study. 294 patients who severe COPD exacerbation were included in the study. An amount of more than 429.58 euros was accepted as increasing costs (IC). Factors associated with IC were determined by regression analysis. RESULTS: Mean age was 69.90 ± 9.79/years (minimum: 40 maximum: 95), mean costs were 594.9 ± 70.9 euros. About 83.7% of the patients were male, 24.1% (71) were active smokers, and 81% (238) had at least 1 comorbidity. Factors associated with IC in the regression analysis were delay of discharge (due to prolonged consultation), antibiotic use longer than 7 days, need to enteral/parenteral feeding, application of pulmonary rehabilitation (physiotherapy) at hospitalization, and refusal to be discharged. CONCLUSION: The increasing costs in severe COPD exacerbation depends not only treatment but also the patient's social status and hospital-related factors. We think that the cost of severe COPD exacerbation can be reduced by interventions on interchangeable factors such as patient's social status and hospital-related factors. [ABSTRACT FROM AUTHOR]

Objective: Tuberculosis is still a major health problem in developing countries. The definite diagnose is culture for tubercule bacilli, but it takes time, so workers try to find new methods. It has been shown that the activity of serum adenosine deaminase (sADA) increases in patients with tuberculosis. In our study, we investigated the sADA levels, before and during treatment with the clinical, radiological, and laboratory parameters to determine whether it is a helpful parameter for diagnosis, also we researched whether sADA levels can be used for monitoring. Material and Method: 72 lung tuberculosis patients and 20 healthy individuals were examined between January 2007- June 2008. The patients' first, intermediary, and final sADA activities were measured with their clinical, radiological, and laboratory assessments. The initial levels of patients were compared with the control group and the first, intermediary and final sADA levels were compared to each other. Results: First sADA activities of patients were higher than the healthy group (p=0.000). An obvious decrease was observed during and after the treatment comparing to initial levels. The final sADA activities were still higher and the difference was significant (p=0.000). Conclusion: Although the definite diagnosis for pulmonary tuberculosis is culture of bacilli, we consider high sADA levels can be a helpful parameter for diagnosis, can be used in monitoring and response to the antituberculoterapy. We expect comprehensive studies with more extensive cases about this subject will contribute to the literature. [ABSTRACT FROM AUTHOR]