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Although there are many sleep-related complaints in chronic obstructive pulmonary disease (COPD) patients, nocturnal leg cramps have not been adequately and extensively studied. This study fills a significant gap in the literature by determining the prevalence and influencing factors of nocturnal leg cramps in COPD patients. However, our findings also underscore the need for further research, inspiring future studies and interventions in this area. This study was conducted with a rigorous methodology, employing a comprehensive approach to evaluate the probability of experiencing nocturnal leg cramps in 215 COPD and 215 control group patients matched for age and gender. Logistic regression analysis was used, supplemented by artificial neural networks, to identify the influencing factors. This robust methodology ensures the reliability and validity of our findings. The findings of this study are not only significant but also enlightening, shedding light on the prevalence and influencing factors of nocturnal leg cramps in COPD patients. The frequency of experiencing these cramps was found to be 40.9% in chronic obstructive pulmonary patients and 21.9% in the control group (p <.05). In COPD patients, factors such as milk group food consumption, blood erythrocyte level, the cover used while sleeping, blood creatinine level, the presence of coronary artery disease, the diagnosis of diabetes mellitus, the upper mid-arm muscle area, and use of drugs with methylxanthine active ingredient methylxanthine were found to affect the occurrence of these cramps. Our findings not only call for further research but also have immediate practical implications. They highlight the crucial role of nurses in managing nocturnal leg cramps in COPD patients. By controlling patients' cold stress, the bed covers they use, and their dairy product consumption, nurses can significantly contribute to managing these cramps, thereby improving the quality of life for these patients. This underscores the importance of their role in patient care and management. [ABSTRACT FROM AUTHOR]

Aims: It is extremely important to determine the relationship between COPD and self‐management (SM) in the disease process. However, the impact of symptom management (SpM) on this relationship is still unclear. The study aimed to examine the mediating role of SpM in the effect of the COPD stage on SM. Design: A predictive correlational study was reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Methods: This study was conducted between 15 February 2023 and 15 June 15 2023, with 306 patients. Data were collected using the Symptom Management Scale for Self‐Efficacy and the Chronic Disease Self‐Management Scale. Descriptive statistics and Process Macro Model 4 in the SPSS program were used for data analysis. Results: Most of the patients were in the moderate stage of COPD; their SM scores were at low levels; SpM scores were at moderate levels. The model was significant, and the variables explained 65% of the model. The COPD stage was significantly positively correlated with SpM and negatively correlated with SM. There was a significant positive impact between SpM and SM. The positive and significant standardised indirect effect of SpM on SM evidenced a full mediating effect. Conclusions: Symptom management has a full mediating role in the effect of the COPD stage on SM. It was revealed that the level of SM can be increased by achieving SpM. Implications for the Profession and/or Patient Care: Symptoms are vital in COPD. Progression of COPD increases symptom severity. Being successful in SpM greatly contributes to the achievement of self‐management. Therefore, nurses should definitely consider symptom control in strengthening self‐management in the care of patients with COPD. Patient or Public Contribution: Patients' COPD stage was determined by a pulmonologist involved in the study. Voluntary patients with COPD hospitalised in the pulmonology clinic were included in the study. [ABSTRACT FROM AUTHOR]

INTRODUCTION Asthma and COPD management have a broad framework, and smoking cessation plays an essential role. We examine the management of asthma and COPD patients not only for inhaler treatment options but also for essential interventions, such as smoking cessation support. METHODS Data were collected cross-sectionally from pulmonology departments of three government hospitals in Türkiye between May and September 2022. Patients aged ≥18 years who had been diagnosed with asthma or COPD for at least a year, were included in the study. The demographic and clinical characteristics of the patients were investigated. Routine cessation interventions were implemented for current smokers, and they were followed via phone calls after one month regarding their quit status and access to cessation clinics. RESULTS Data from 145 patients with asthma and 148 patients with COPD were analyzed. The rate of current smoking among patients with asthma and COPD was 18.8% and 34.5%, respectively. Current smoking was negatively associated with age (<65 years) and disease duration (years) for both diseases (p<0.05). In addition, for asthmatics, presence of pulmonary disease in the family (OR:0.28, 95% CI: 0.10-0.79) and for COPD patients presence of hospitalization (OR: 0.26, 95% CI: 0.07-0.93) were negatively associated with current smoking. After one month, 85.1% of current asthmatic smokers had not tried to call a quitline, while 14.8% had tried to contact a quitline. Among current smoker COPD patients, only 1.9% had visited a smoking cessation clinic. CONCLUSIONS Tobacco cessation support seems to be neglected in asthma and COPD management. Instead, pulmonologists and patients focus on pharmaceutical treatments, which constitute the other component of care. [ABSTRACT FROM AUTHOR]

Background: Despite current developments in pharmacological treatments, complementary and alternative medicine practices have been widely used in patients with Chronic Obstructive Pulmonary Disease (COPD). It should be known why and for what purpose complementary and alternative medicine applications, which are accepted by a large part of the society, are used. The aim of this study was to evaluate the use of complementary and alternative medicine (CAM) practices in patients with COPD and factors affecting this condition. Methods: This study designed as a descriptive study research was conducted in 244 patients with COPD. Data were collected using the Beliefs about Medicines Questionnaire [BMQ-Turkish Translation (BMQ-T)] and Morisky Green Levine Medication Adherence Scale (MGLS). Results: It was found that patients with higher scores on the Specific Necessity Subscales of the BMQ-T Scale (β=0.420, p= .03), being unemployed (β=1.234, p= .01), having less income than expenses (β=1.511, p= .02) and having frequent exacerbations in the last year (β=0.367, p= .02) affected the use of CAM according to multivariate regression analysis. Conclusion: It was revealed that having the belief in the necessity of medications, being unemployed, having less income than expenses, and having frequent COPD exacerbations were the most influential factors affecting the use of CAM. [ABSTRACT FROM AUTHOR]

Introduction: Chronic obstructive pulmonary disease (COPD) is one of the most important morbidity and mortality reasons worldwide. The purpose of our study is to evaluate physician-diagnosed COPD epidemiology according to age groups. Methods: ICD10 J44.0-9 diagnoses codes in the database of Turkish Social Security Institution between 2007 and 2016 was checked through. Distribution of COPD through age groups (40-49, 50-59, 60-69, 70-79, and 80 years and older) among male and female population still alive in 2016 was calculated. Results: 56.7% of 3,168,459 patients with average age of 62.53±15.07 were males. It was determined that 3.2% prevalence in female age group of 40-49 increased up to 23.1% in the age of 80+, 4.2% prevalence in male age group of 40-49 increased up to 35.3% in the age of 80+. In total, it increased from 3.7% to 27.7% in the same group of ages. Rate of the patients between the ages of 40-69 was calculated as 66% of the total number of patients. Discussion and Conclusion: As a result, physician-diagnosed COPD prevalence in Türkiye has an increasing trend by age both in male and female population. One out of each four individuals over the age of 80 years is diagnosed with COPD. Such an evaluation shows that COPD is more frequently in older ages. However, it is not correct to limit COPD as an advanced age disease, since the majority of the patient population is 70 years and under. [ABSTRACT FROM AUTHOR]

Objectives: It was aimed to determine the factors affecting the development of chronic obstructive pulmonary disease (COPD) in pneumoconiosis cases. Methods: Pneumoconiosis cases were divided into two groups as those with only pneumoconiosis and those with coexistence of pneumoconiosis and COPD. Demographic data, smoking habits, pulmonary function test, radiological findings, and occupational risk factors of the cases were compared. Results: Chronic obstructive pulmonary disease was detected in 134 of 465 pneumoconiosis cases (28.8%) included in the study. It was determined that patients who developed COPD were statistically significantly older, had longer exposure duration, had lower forced expiratory volume in 1 second, forced vital capacity, and forced expiratory volume in 1 second/forced vital capacity values, and had more pulmonary symptoms. Chronic obstructive pulmonary disease development was more common in sandblasting workers, dental technicians, and miners than in other occupations. Conclusion: It has been shown that the risk of developing COPD is high in cases of pneumoconiosis, independent of smoking, especially in certain occupational groups. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study was conducted to determine the prevalence of oral mucositis in chronic obstructive pulmonary disease patients and the risk factors likely to be effective in the development of oral mucositis. MATERIAL AND METHODS: This prospective cross-sectional study was carried out with 147 patients with chronic obstructive pulmonary disease who were monitored for 7 days from their admittance to the chest diseases clinic of a university hospital between January 2021 and January 2022. Patient Information Form, Oral Assessment Guide, and World Health Organization Mucositis Grading Scale were used to obtain the study data. RESULTS: While 81% of the patients in the study were male, the mean age was 64.6 ± 10.0 years, and the duration of chronic obstructive pulmonary disease diagnosis was 8.58 ± 6.52 years. In the study, while 61.9% of the total 147 patients monitored for 7 days had findings in favor of oral mucositis, the severity of oral mucositis and the mean total oral mucosa score of the patients were found to increase significantly in these 7 days of the monitoring period (P <.001). As per the logistic regression findings, the duration of chronic obstructive pulmonary disease diagnosis (95% CI 1.05-1.49; P =.010), the presence of medication use containing corticosteroids (95% CI 6.05-72.17; P <.001), and the amount of oxygen administered to the patient (95% CI 1.07-3.44; P =.029) were found to be significant risk factors associated with the development of oral mucositis. CONCLUSION: The results indicate that the severity of oral mucositis has a tendency to increase in chronic obstructive pulmonary disease patients from the third day of treatment, and oral care is critically important in patients, who are with a longer diagnosis of chronic obstructive pulmonary disease, who are treated with medications containing corticosteroids and who need high-intensity oxygen therapy. [ABSTRACT FROM AUTHOR]

Objective: We evaluated and compare sleep quality and disorders according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) A, B, C, D groups in patients with Chronic Obstructive Pulmonary Disease (COPD) and to determine sleep disorders. Materials and Methods: Our study included 94 patients who applied to Pamukkale University Medical Faculty Hospital Chest Diseases Polyclinic between January 2016 and January 2017, were diagnosed with COPD according to GOLD criteria, were not in a COPD attack at the time of admission and agreed to participate in the study. Results: In patients with COPD, as the severity of stages increased, a decrease in mean FEV1 values was detected and as the FEV1 values decreased, the mean oxygen values measured during the night decreased. According to the GOLD stage, there was no significant difference between total sleep periods, sleep activity, sleep latency, rapid eye movement (REM) sleep duration, and non-REM sleep duration. According to polysomnography results, apnea-hypopnea index (AHI) was found to be below 5 in 40% of the patients. There was no statistically significant difference between the AHI and COPD stages (p=0.581). Conclusion: No significant difference was found between the COPD stage and AHI severity. However, as COPD stages increased, a decrease in mean nocturnal oxygen saturation was detected. Nocturnal oxygen desaturation is the main cause of comorbidities observed in patients COPD. As a result, careful attention should be given to night desaturation in advanced patients with COPD, and the necessary procedures must be performed to prevent comorbidities. [ABSTRACT FROM AUTHOR]

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Background: Noncommunicable diseases account for the majority of all deaths and impose a high socioeconomic burden, causing disability and premature deaths. Pharmacists can contribute to the prevention and management of these diseases through the provision of pharmaceutical care services. Aim: The aim of this study was to implement a nationwide practice developed by the Turkish Pharmacists' Association aiming to realize pharmaceutical care provision of standard quality to patients with asthma, chronic obstructive pulmonary disease, diabetes and hypertension at community pharmacies through a continuing professional development approach. Setting: Community pharmacies in Turkey. Development: A project with the involvement of all community pharmacists who were willing to participate was developed. After piloting, the 'project' turned into a 'practice' with a focus on asthma, chronic obstructive pulmonary disease, diabetes and hypertension management. Implementation: The training process occurred as a peer-training activity. Consultants and academic staff trained the trainer pharmacists during a 3-day course. Community pharmacists (n = 6161) received training regarding pharmaceutical care, asthma, chronic obstructive pulmonary disease, diabetes and hypertension from their peer trainers (n = 341) and began to practice pharmaceutical care and follow-up of patients' outcomes on a regular basis. Evaluation: Among all community pharmacists in Turkey (n = 26,177), 24% attended training. Among these pharmacists, 21% started to implement practice. With community pharmacists' contribution to patient care, significant improvements in the majority of the outcome parameters regarding asthma, chronic obstructive pulmonary disease, diabetes and hypertension management were noted. Conclusion: This first nationwide practice showed us that community pharmacists can help improve the health outcomes of patients with asthma, chronic obstructive pulmonary disease, diabetes and hypertension through the provision of pharmaceutical care services. [ABSTRACT FROM AUTHOR]

Background: Alpha-1 antitrypsin deficiency (AATD) is associated with increased susceptibility to chronic obstructive pulmonary disease (COPD). AATD results from mutations in the SERPINA1 gene and over 500 rare mutations have been identified. Despite these findings and recommendations from major healthcare organizations, testing of COPD patients and their family members for AATD remains inadequate., Methods: We examined genotypes and clinical characteristics of COPD patients (index cases; n = 14) treated at Recep Tayyip Erdoğan University Chest Diseases Department and their relatives (n = 17)., Results: When index cases were compared with screened relatives positive for AATD (n = 14), index cases were older and more predominantly male than screened relatives. Both groups had extensive smoking histories. All of the index cases and one of the screened relatives had been diagnosed with COPD. Clinical characterization of the COPD cases (14 index cases; 1 screened relative) showed that they had moderate to severe COPD with pre-treatment AAT levels of 0.59 ± 0.40 g/L (mean ± SD) and a COPD Assessment Test (CAT) score of 16.0 ± 8.12. The majority of these patients (73.3%) had panlobular emphysema. Five of the patients were treated with AAT augmentation which led to a decrease in the number of COPD exacerbations. Genotyping revealed that the most common rare allele identified in this population was M Palermo (c.227&#95;229delTCT mutation on the M1(Val 213 ) allelic background)., Conclusions: More testing and research need to be done to identify the relative prevalence of rare AATD variants. Earlier identification could lead to more effective treatment of affected individuals and improvement in their quality of life., Competing Interests: Declarations. Ethics approval and consent to participate: Written informed consent was obtained from the patients described herein for their anonymized information to be published in this article. Ethical approval was provided from Recep Tayyip Erdoğan University Ethical Committee, date: 28.09.2023 and number: 2023/224. This study was completed in accordance with the Helsinki Declaration as revised in 2013. Consent for publication: Written informed consent was obtained from the patients described herein for their anonymized information to be published in this article. Competing interests: DK, EA, SO, BYK, NH, TGT and ÜS have no competing interests related to this work. BD was an employee of Grifols Deutschland at the time this study was conducted, and LO is an employee of Progenika., (© 2024. The Author(s).)

Objective: This study was conducted to assess the relationship between the symptoms experienced by women with COPD and the quality of their sexual life. Method: This study was designed as a descriptive cross-sectional study. The study was conducted at a hospital's chest diseases clinic located in the western of Turkey. The sample comprises 62 female patients hospitalized with diagnosis of COPD. A questionnaire form, the Medical Research Council Scale (MRCS), the COPD Assessment Test (CAT) and the Sexual Quality of Life-Female (SQOL-F) applied to the women with COPD. Frequency, percentage, mean, standard deviation, Kruskal Wallis test, Mann-Whitney U Test, correlation and regression analysis, were used for the data analysis process. Findings: The decrease in the education level of the participants who have any accompanying chronic disease, and experience symptoms during sexual intercourse negatively affects their quality of sexual life. The quality of sexual life decreases as age, duration of marriage and duration of illness increase (p < 0.05). The results of the linear regression analysis carried out to predict the quality of sexual life of women with COPD shown that the increase in mMRC and CAT significantly decreased the quality of sexual life. These variables explain 58% of the variance. Conclusions: The result of the study shown the sexual quality of life of women with COPD was impaired and COPD symptoms affect them. [ABSTRACT FROM AUTHOR]

Background/aim: While mortality rates decrease in many chronic diseases, it continues to increase in COPD. This situation has led to the need to develop new approaches such as phenotypes in the management of COPD. We aimed to investigate the distribution, characteristics and treatment preference of COPD phenotypes in Turkey. Materials and methods: The study was designed as a national, multicenter, observational and cross-sectional. A total of 1141 stable COPD patients were included in the analysis. Results: The phenotype distribution was as follows: 55.7% nonexacerbators (NON-AE), 25.6% frequent exacerbators without chronic bronchitis (AE NON-CB), 13.9% frequent exacerbators with chronic bronchitis (AE-CB), and 4.8% with asthma and COPD overlap (ACO). The FEV1 values were significantly higher in the ACO and NON-AE than in the AE-CB and AE NON-CB (p < 0.001). The symptom scores, ADO (age, dyspnoea and FEV1) index and the rates of exacerbations were significantly higher in the AE-CB and AE NON-CB phenotypes than in the ACO and NON-AE phenotypes (p < 0.001). Treatment preference in patients with COPD was statistically different among the phenotypes (p < 0.001). Subgroup analysis was performed in terms of emphysema, chronic bronchitis and ACO phenotypes of 1107 patients who had thoracic computed tomography. A total of 202 patients had more than one phenotypic trait, and 149 patients showed no features of a specific phenotype. Conclusion: Most of the phenotype models have tried to classify the patient into a certain phenotype so far. However, we observed that some of the patients with COPD had two or more phenotypes together. Therefore, rather than determining which phenotype the patients are classified in, searching for the phenotypic traits of each patient may enable more effective and individualized treatment. [ABSTRACT FROM AUTHOR]

The present study determines the effects of dyspnea and fatigue on the sex life and marital adjustment of patients with COPD. The study sample of this descriptive research included individuals hospitalized in the Pulmonary Diseases Clinic of a university hospital in Turkey who voluntarily accepted to participate in the study. The data for the research were collected using a question form, the Modified British Medical Research Council Dyspnea Scale (mMRC), the Arizona Sexual Experience Scale-Female Form, the Arizona Sexual Experience Scale-Male Form, the Marriage Adjustment Test, the COPD and Asthma Fatigue Scale, and the COPD Assessment Test (CAT). The data, in the form of numbers, percentages means and standard deviations, were assessed with Mann–Whitney U-tests, Kruskal–Wallis tests, One Way Analyses of Variance and t tests. Of the participants with COPD, 83.3% reported that the disease affected their sex life; 83.6% reported that they had not consulted a physician about sexual problems due to believed the disease ends sexual desire, as one of the obstacles preventing help being sought in this matter; 95.8% reported using no methods other than medical ones to resolve their sexual problems; 90.3% reported encountering problems during sexual intercourse; and 58.3% stated that the symptom with the greatest effect on their sex life was dyspnea. COPD was reported to affect marital adjustment in 54.2, and 55.8% reported that the disease had led to the development of good relations between the partners, and thus better adjustment. It was found in the present study that dyspnea had a negative effect on the patients' sex life, but no effect on the marital adjustment of individuals with Chronic Obstructive Pulmonary Disease; while fatigue negatively affected the patients' sex life, but positively affected marital adjustment. [ABSTRACT FROM AUTHOR]

This study was conducted for the aim of assessing the effect of nursing care applied to patients with chronic obstructive pulmonary disease on their sexual experiences and quality of life. The sample of the study was determined via power analysis, patients were assigned groups using a simple random sampling method. The data were collected between December 2019–June 2020. The researcher applied the nursing care to patients in the experimental group in their home three times. There was a statistically significant difference between posttest mean scores of the Short Form-36 Health-Related Quality of Life Questionnaire subscales and Arizona Sexual Experiences Scale of the patients in the experimental and control groups (p < 0.05). In this study, it was determined that there was an increase in the Health-Related Quality of Life Questionnaire mean score of patients with COPD after the nursing care; whereas, there was a slight decrease in the Arizona Sexual Experiences Scale mean score. [ABSTRACT FROM AUTHOR]

Objectives: Hospital‐at‐home (HAH), a pioneering health care model, is an accepted alternative to hospital treatment for patients with a chronic obstructive pulmonary disease (COPD) exacerbations. The aim of the present study was to analyze the effectiveness of HAH for patients with COPD exacerbations. Methods: Two hundred six patients with COPD exacerbations who were admitted to our emergency room (ER) received the HAH model between January 2008 and March 2010. The number of patient's hospitalization, admission to emergency room, unscheduled outpatient attendance, and the length of stay in hospital (day) were recorded before and after a one‐year period of HAH. Results: After a one‐year follow‐up period of the HAH program, the number of patient who had hospitalization, admission to ER, unscheduled outpatient attendance rates was decreased 41.3%, 54.4%, 49.5% respectively. The decreases for all parameters were found to be statistically significant (P < 0.001). Additionally the total number of length of stay in hospital (day) after a one‐year period after HAH was decreased (46.5%). Conclusion: Integrated care services, including home care units where HAH models are performed, are necessary to improve the health of patients with COPD, as well as to better manage their condition in terms of disease burden. Physicians should consider this form of management, especially because there is increasing pressure on inpatient bed requirement in Turkey. [ABSTRACT FROM AUTHOR]

Objective: The incidence of osteoporosis increased in patients with chronic obstructive pulmonary disease (COPD), and fractures due to osteoporosis are a significant cause of morbidity. Thus, risk assessment and taking necessary precautions are essential in these patients. This study aimed to assess the fracture risk of patients with COPD scanned with dual-energy X-ray absorptiometry (DXA) using the fracture risk assessment tool (FRAX) and to identify their treatment status. Materials and Methods: Patients who presented to the Physical Therapy Outpatient Clinic of Aydın Atatürk State Hospital and diagnosed with COPD between January 2014 and January 2019 were included in the study. Results of DXA and pulmonary function test performed within the last year were recorded. According to the DXA results, patients were divided into osteoporotic, osteopaenic and normal groups. Patients were also classified into group A, B, C and D according to the Global Initiative for Chronic Obstructive Lung Disease classification. FRAX values were calculated using an online calculator. Results: Ninety-five patients with COPD were enrolled in the study. According to their DXA values, 39 (41.1%), 41 (43.2%) and 15 (15.8%) patients were allocated in the osteoporotic, osteopaenic and normal groups, respectively. The 10-year major osteoporotic and hip fracture risks, calculated using FRAX, was the highest in the osteoporotic group, followed by the osteopaenic group (p<0.001 and p<0.001, respectively). Thirty-six patients (92.3%) in the osteoporotic group received medical treatment for osteoporosis, whereas only 13 (31.7%) patients in the osteopaenic group received medical treatment. FRAX assessment revealed that both major osteoporotic and hip fracture risks were higher in groups C and D (p=0.002 and p=0.002, respectively). Conclusion: All patients with COPD, particularly those in groups C and D, should be assessed with both DXA and FRAX, regarding osteoporosis and fracture risks, and preventive measures/treatment should be planned when required. [ABSTRACT FROM AUTHOR]

In the studies about self-care agency in chronic obstructive pulmonary disease (COPD) patients with a high agency of self-care have been found to be more successful at disease management. Determining the self-care agency (SCA) and affecting factors in patients with COPD are important nursing interventions in order to plan proper care and to support the SCA for patients with COPD. This study was conducted to determine SCA and affecting factors in patients with COPD. Totally 226 patients with COPD who applied to chest diseases outpatient clinics of a governmental hospital in Turkey were recruited to the study between November 2012 and April 2013. Data were collected with a “patient identification form” which was prepared after a literature review and with the “self-care agency scale (SCAS). According to the research results, mean score of SCA of patients with COPD was found to be 70.15±13.75. Patients with COPD who were male, high school graduates, married, governmental officers, and who had given up smoking and who perceived their health status as good had a significantly higher level of SCA than other groups (p<0.05). İn the present study it was seen that patients’ SCAS scores were at a moderate level. SCA of patients with COPD is affected by gender, education status, marital status, occupation, smoking status and perception of health. This study provides basic data for the future researches. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to determine the effect of regular walking programs on the respiratory parameters, quality of life and emergency service presentation frequency in COPD patients. Methods: A semi experimental study, 46 patients admitted to the respiratory clinic of a public hospital. The patients received a 16 week walking program using pedometers under nurse monitoring. Data was collected using a patient identification form, the St George Respiratory Diseases Questionnaire, and walking program application chart. Results: After the regular walking program, an increase in the daily walking durations. One year after the walking program, no statistically significant differences in the respiratory parameters values of the patients could be found. The decreases in the quality of life total scores of the patients were found to be statistically significant. No statistically significant difference in the emergency service presentation and repeated hospitalization frequencies of the patients could be found. Conclusion: In the study conducted under the nurse's accompaniment, regular walking program improved the quality of life of COPD patients in the long term without any effect on respiratory parameters or the frequencies of emergency service presentation and repeated hospitalization. [ABSTRACT FROM AUTHOR]

BACKGROUND: Activities of daily living (ADL) are important for an independent life. As COPD progresses, the ability to complete ADL is usually reduced. Knowing the possible factors that influence the ability to perform ADL may allow better targeting of appropriate rehabilitation programs to increase the independence levels and/or to prevent further decreases in patients with COPD. Therefore, the aim of this study was to investigate ADL performance as measured by the London Chest Activity of Daily Living scale, which is a commonly used measure in patients with COPD. METHODS: This cross-sectional study included 44 clinically stable subjects who were not taking antibiotics and had not made any changes in their medications for at least three weeks with a COPD diagnosis based on Global Initiative for Chronic Obstructive Lung Disease. Demographic characteristics, pulmonary function, ADL measured by the London Chest Activity of Daily Living scale, functional exercise capacity via the 6-min walk distance, disease-related symptoms measured by the COPD Assessment Test, and peripheral and respiratory muscle strength were evaluated. A multiple linear regression (stepwise) analysis was used to determine the variables that have the greatest influence on ADL (ie, the London Chest Activity of Daily Living scale score). RESULTS: The London Chest Activity of Daily Living scale score had moderate correlations with the COPD Assessment Test score (r = 0.31, P = .041), maximum expiratory pressure value (r = -0.37, P = .01), 6-min walk distance (r = -0.48, P = .001), knee extensor muscle strength (r = -0.47, P = .001), handgrip strength (r = -0.44, P = .003). The 6-min walk distance, COPD Assessment Test score and maximal expiratory pressure values were significant and independent determinants of the London Chest Activity of Daily Living scale, with 40.1% of the variance in subjects with COPD. CONCLUSIONS: Functional exercise capacity, disease-related symptoms, and expiratory muscle strength have the greatest influence on ADL in the subjects with COPD. The level of independence to perform ADL can be increased by improving functional exercise capacity, reducing symptoms, and increasing expiratory muscle strength in subjects with COPD. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to determine the impact of health coaching on respiratory functions, treatment adherence, self-efficacy, and quality of life in chronic obstructive pulmonary disease patients. Methods: This study was conducted as an experimental study with non-randomized control group in chronic obstructive pulmonary disease individuals. The study group included a total of 54 chronic obstructive pulmonary disease patients (27 patients both health coaching and control groups), was selected between 13 July 2016 and 2 July 2017. Data were collected by using a questionnaire form, St. George Respiratory Questionnaire, 8-Item Morisky Adherence Scale, and chronic obstructive pulmonary disease Self-Efficacy Scale. A total of 12 coaching interviews were conducted with the patients in the health coaching group. Results: After health coaching intervention, self-efficacy scale general score, and St. George Respiratory Questionnaire, total scores were found statistically significant different between 2 groups in interaction values. There was a significant difference in the 8-Item Morisky Adherence Scale scores for degree of treatment adherence between the groups. Conclusion: The health coaching intervention is recommended, as it contributes to facilitate the treatment adherence and increase the self-efficacy skills by improving the quality of life of the chronic obstructive pulmonary disease patients. [ABSTRACT FROM AUTHOR]

Background: Chronic Obstructive Pulmonary Disease (COPD) is an important cause of morbidity and mortality. Admission at the hospital is thought to be related to parameters indicating the severity of the disease. The aim of this study is to investigate the general characteristics of the patients who are hospitalized with acute exacerbation of COPD and to determine the factors affecting the lenght of hospitalization. Material and Methods: Patients with acute COPD exacerbation at the Harran University Medical Faculty Hospital between 2015 and 2018 were studied retrospectively. Sociodemographic data, disease stages, hemogram, biochemistry, c-reactive protein levels and lenght of stay were recorded in the data of patients with COPD acute exacerbation. Exclusion criteria were asthma, other obstructive lung diseases such as bronchiectasis, and patients who were discharged on their own voluntarily, while the study inclusion criteria were COPD patients over 40 years of age. Based on the guidelines of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) for COPD diagnosis and staging. Results: A total of 119 patients (29.3%) were female and 90 (75.6%) were male, whose mean age was 68.1 ± 10.7 years. Of the patients included in the study, 81 (68.0%) were over 65 years old and 38 (31.9%) patients were under 65 years old. The mean duration of stay at the hospital was 9.3 ± 6.0 days, 9.8 ± 4.9 days for women and 9.2 ± 6.3 days for men. Elderly patients (≥65 years) were in the hospital for 9.8 ± 6.5 days and younger patients (<65 years) were in the hospital for 8.2 ± 4.6 days (p: 0.175). The most frequent symptom was dsypnea (80.6%). Of the patients included in the study, 10 (8.4%) were group A, 54 (45.3%) were from group B, 28 (23.5%) were from group C and 27 (22.6%) were from group D.nAs the severity of the disease increased, there was a statistically significant decrease in FEV1 (p: 0.000), FVC (p: 0.000) and FEV1 / FVC (p: 0.000) levels. The level of eosinophil (p:0.006) in group A and the level of alanine aminotransferase (p:0.021) and urea (p:0.026) in group C were statistically significantly higher than the other groups. Conclusion: Most of the patients hospitalized with acute exacerbation of COPD are elderly male patients. As COPD progression and blood urea levels increase, the length of stay in the hospital increases. [ABSTRACT FROM AUTHOR]

BACKGROUND: Ultrasound-based diaphragmatic thickness fraction is a reflection of the size and function of the diaphragm. This study aimed to examine the value of this measurement in identifying patients with COPD who are at high risk for the development of symptoms and exacerbations. METHODS: This cross-sectional study included 53 subjects with COPD. Respiratory function test results, ultrasonography-based diaphragmatic thickness, symptom scores (modified Medical Research Council dyspnea scale); COPD Assessment Test results, and number of previous exacerbations and admissions were recorded. RESULTS: Only age showed an inverse and weak relation with percent thickness fraction (r = -0.37, P = .006). None of the other variables tested correlated significantly with percent thickness fraction. No association was found between percent thickness fraction and exacerbation frequency, modified Medical Research Council dyspnea scale and COPD Assessment Test symptom scores, or Global Initiative for Chronic Obstructive Lung Disease ABCD risk/symptom assessments. CONCLUSIONS: Diaphragmatic thickness fraction measurements based on diaphragmatic ultrasound assessment in subjects with COPD seemed to be unable to identify subjects at high risk of symptoms and exacerbations as defined by the Global Initiative for Chronic Obstructive Lung Disease ABCD composite disease index. [ABSTRACT FROM AUTHOR]

This interventional study was carried out to determine the effect of music therapy on anxiety and the various physical findings in patients with chronic obstructive pulmonary disease in the pulmonary diseases service. Ninety-six patients (28 females, 68 males) of 114 adult patients who were hospitalized between November 10, 2013, and March 10, 2014, were included in the study. Ninety-six patients were separated in 3 groups. The data for the study were collected from a questionnaire form of sociodemographic and clinical characteristics, a patient follow-up form, and the Beck Anxiety Scale. SPPS 11.5 was used for data analysis. The Kolmogorov-Smirnov Test was used to determine whether the data showed normal distribution. The nonparametric Kruskal-Wallis Test was used to determine the differences between mean anxiety scores on day 0, day 5, and day 15, and the differences in physiological findings on day 0, day 5, and day 15. There was a significant decrease in anxiety level average on day 5 ( P≤ .0001) and day 15 ( P≤ .0001) of the study in both the Western classical music and Turkish classical music groups compared with control group. There was also a significant decrease in systolic blood pressure and diastolic blood pressure averages in both music groups compared with control group ( P≤ .005). There was no significant difference in heart rates and respiration rate average between the Western classical music and Turkish classical music groups compared with the control group ( P> .05). [ABSTRACT FROM AUTHOR]

BACKGROUND: We aimed to investigate the predictor role of the plasma levels of lipid parameters and atherogenic indices on development of atherosclerosis in subjects with COPD. METHODS: We retrospectively analyzed 104 male subjects diagnosed with stable COPD in hospital records. We excluded subjects with exacerbation, with known cardiovascular diseases and other chronic diseases, receiving anti-hyperlipidemic treatment, without sufficient past medical history, and lacking needed laboratory data. Additionally, 40 age-matched male healthy controls were also enrolled. C-reactive protein, total cholesterol, triglycerides, low-density lipoprotein cholesterol, and high- density lipoprotein cholesterol levels of COPD and the control group were analyzed. Atherogenic indices (atherogenic index of plasma, cardiogenic risk ratio, and atherogenic coefficient) were calculated. RESULTS: C-reactive protein, triglyceride, atherogenic index of plasma, cardiogenic risk ratio, and atherogenic coefficient values were significantly higher in subjects with stable COPD than in control subjects (P < .05 for all). High-density lipoprotein cholesterol level was significantly lower in subjects with COPD than in the control group (P < .001). C-reactive protein, lipid profiles, and atherogenic indices were similar in lower-risk (stage A and B) and higher-risk (stage C and D) subjects with COPD. Cardiogenic risk ratio and atherogenic coefficient were negatively correlated with FEV, in all stable subjects with COPD and in higher-risk subjects with COPD (r = -0.27, P = .01 and r = -0.35, P = .01, respectively). CONCLUSIONS: We concluded that atherogenic indices (atherogenic index of plasma, cardiogenic risk ratio, atherogenic coefficient) could be considered as a useful predictor for atherosclerosis and cardiovascular diseases in stable COPD patients. Nevertheless, further prospective investigations on this issue are warranted. [ABSTRACT FROM AUTHOR]

This descriptive study was conducted to determine the care burden and social support levels of caregivers to patients with chronic obstructive pulmonary disease (COPD). The primary caregivers of 112 patients with COPD hospitalized in the chest diseases service of a university hospital were involved in the study. Data of the study were collected by using the Patient and Caregiver Information Form, which was prepared by reviewing the literature, Katz Index of Independence in Activities of Daily Living, Zarit Burden Interview, and Multidimensional Scale of Perceived Social Support. While the care burden mean score of caregivers of patients with COPD was 40.91 ± 20.58, the mean score of Multidimensional Scale of Perceived Social Support was 54.13 ± 18.84. In this study, it was determined that female caregivers, as well as individuals stating that their physical and psychological health was affected and those having difficulty giving care and needing help, had higher levels of care burden, whereas the spouses, as well as individuals with lower levels of income and those stating that their physical and psychological health was affected, had lower levels of social support. [ABSTRACT FROM AUTHOR]

BACKGROUND: Oxidative damage is a major contributing factor to carcinogenesis and obstructive disorders in lungs. Current evidence suggests that the inflammatory processes yield to oxidative mechanisms, which underlie COPD, lung cancer, and obstructive sleep apnea syndrome (OSAS). This study aimed to evaluate the oxidative damage in these diseases by evaluating the oxidative and antioxidant biomarkers. METHODS: Malondialdehyde, 8-oxo-7,8-dihydro-2'-deoxyguanosine, and coenzyme Q10 levels were evaluated in the blood samples of subjects with COPD, lung cancer, and OSAS by high-pressure liquid chromatography. RESULTS: A total of 111 participants (35 females, 76 males) with OSAS (n = 29), COPD (n = 26), and lung cancer (n =28) and healthy controls (n = 28) were included in the study. The malondialdehyde and coenzyme Q10 levels were significantly higher in all 3 diseases when compared with controls (P < .01), whereas 8-oxo-7,8-dihydro-2'-deoxyguanosine levels were only significantly higher than in healthy controls in subjects with lung cancer (P = .005). The highest levels of malondialdehyde and coenzyme Q10 were determined in subjects with OSAS and lung cancer, respectively. The highest 8-oxo-7,8-dihydro-2'-deoxyguanosine levels were also observed in subjects with lung cancer, but the differences of this biomarker with other diagnoses were not statistically significant (P = .56). CONCLUSION: Oxidative damage was observed in all 3 diagnoses, and, as a response to oxidative stress, antioxidant mechanisms were also active in these diseases. Malondialdehyde and 8-oxo-7,8-dihydro-2'-deox-yguanosine were found to be efficiently usable in the evaluation of oxidative damage in chronic respiratory diseases. [ABSTRACT FROM AUTHOR]

It has been shown that Long Term Oxygen Therapy (LTOT) improves polycythemia secondary to hypoxemia and right heart failure, decreases pulmonary hypertension, improves quality of life and increases life expectancy in COPD patients. In our study we aimed to evaluate clinical data, mortality, patient's adherence and efficiency of the therapy in COPD patients receiving LTOT. Mean age was 70.5%±9.7 and 57% of the participiants were male. It was shown that one year hospital admission count after LTOT (0.56±0.79) was decreased according to one year hospital admission count before LTOT (1.14±1.64). When arterial blood gas values after LTOT compared to the values at the time prescription PaO2 was increased (47.9±4, 53.4±9) and PaCO2 was decreased (56.1±11, 50.5±11). Although there was no significant difference in pulmonary artery pressure after LTOT, a significant increase was determined in hematocrit (38.37±6, 40.14±6). 41.1% of the patients had at least once device maintanence, and after LTOT only 38.4% had a clinical control due to COPD. The most common reason for irregular use was lack of necessity. Mean daily oxygen usage was 13.88±4.35 hours/day and 68.8% of the patients were using 15 hours or more. Mean follow-up of the patients were 17.85±14.53 (1-55) months and mortality rate in this period was 67%. Mortality was higher in LTOT with 15hours/day or more compared to less than 15 hours (respectively 54.6%, 12.5%). In conclusion, all patients with an indication for LTOT should be followed by national registry system and monitored in terms of technical services. Patients adherence and routine controls should be provided. [ABSTRACT FROM AUTHOR]

IntroductionChronic obstructive pulmonary disease (COPD) may cause some psychiatric disorders such as depression and anxiety, similar to other chronic diseases. Treatment adherence may be affected by worsening of cognitive functions. We aimed to show whether the symptoms of anxiety and depression affect treatment adherence by patients.MethodSeventy-eight COPD patients were analysed at the first visit. The use of bronchodilator therapy was revised for standardization before they attended a second visit after six months. Hospital Anxiety and Depression Scale (HADS), Anxiety Sensitivity Index-3 (ASI-3) and SF-36 Questionnaire were carried out at that visit. ‘National Guide of Turkish Thoracic Society for Asthma’ was used for scoring method of use of the bronchodilator and evaluating treatment adherence (including maintenance therapy).ResultsSixty-two of 78 patients, 53 (85.5%) men and nine (14.5%) women with a mean age of 64.9 ± 9.9 joined the second visit. Thirty-three patients (53.2%) had a high-treatment adherence (HTA), whereas 29 (46.8%) had a low-treatment adherence (LTA). There were high scores of anxiety in 18 (29%) and depression in 11 (17.7%) patients. There was no statistical difference between the HTA and LTA groups in means of age, gender, educational level, presence of comorbidity, classification of COPD, high anxiety scores according to HADS and ASI-3 scores. Of the patients, 41.4% in the LTA group were still smoking, whereas it was only 12.1% in the HTA group (P = 0.009). The LTA group had higher depression scores (P = 0.004) than the HTA group. Dyspnea was found more frequent in LTA patients (P = 0.047); vitality score was also statistically low in this group (P = 0.01).ConclusionAs a result, continuing smoking and the presence of depression symptoms may decrease adherence to treatment. Therefore, to increase the adherence to treatment and reduce symptoms such as dyspnea, it is important to treat any depressive symptoms that are present and to help patients cease smoking. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The purpose of this study was to determine the effects of education on inhaler using skills of elderly patients with COPD. MATERIAL AND METHODS: This pre-test- post-test quasi-experimental study including a control group was conducted with 80 patients. The study was performed in a chest and occupational diseases hospital in the Western Black Sea Region of Turkey between 01 January and 30 June 2011. Data were collected using a "Patient Information Form", a "Skill Chart for Inhaler Device Use". Official and ethical permissions were obtained from the relative institutions., and written informed consent was obtained from the patients. Descriptive statistical methods and chi-square test were used to evaluate the data. RESULTS: It was found that inhaler using skills of the patients in the experimental group showed a greater improvement after education as compared pre-education values and those values in the control group. CONCLUSION: It was concluded that education on inhaler usage techniques improved patients' skills on using inhaler devices correctly in the experimental group. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The effects of long term oxygen therapy (LTOT) on the quality of life and survival of chronic obstructive pulmonary disease (COPD) patients with respiratory failure, and the compliance to LTOT were investigated in this prospective cohort study. MATERIAL AND METHODS: Fifty-four COPD patients, in whom LTOT was indicated, were recruited to the study between February 2006 and July 2007. Patients received two follow-up visits at 5 and 10 months, and were followed for approximately 19 months. Echocardiography was performed and the dyspnoea score (Medical Research Council, MRC) and St. George Respiratory Questionnaire (SGRQ) were applied at the initial and follow-up visits. In addition, the duration of oxygen treatment and indication for maintenance of LTOT was evaluated. RESULTS: The mean age of the patients was 64 years; 7 were female and 47 were male. The mean duration of oxygen treatment prior to the first and second follow-up visits were 9.8 and 10.6 hours, respectively. The percentage of effective LTOT use (1 5 hours or more) at the first and second follow-up visits was 31 % and 46%, respectively. There was no statistically significant difference in the survival of patients who were using effective and ineffective oxygen treatment. The mean baseline pulmonary arterial pressure showed a significant decrease from 50 mmHg at baseline to 40mmHg at the second follow-up visit in patients using effective LTOT (p=0.01). The symptom scores of SGRQ at the second follow-up visit were higher than the baseline values (p=0.005). CONCLUSION: In the present study, patient compliance to LTOT was low. Although there was a decrease in pulmonary artery pressure, and an improvement in the life quality of patients as a result of LTOT use, LTOT had no effect on the survival of patients. [ABSTRACT FROM AUTHOR]

Background: Chronic obstructive pulmonary disease (COPD) is an important cause of mortality worldwide. Aims: The aim of this study was to establish the prevalence of chronic obstructive pulmonary disease (COPD) in residents who were ≥40 years old and living in a heavily industrialised city of Turkey, Kocaeli, using the Burden of Obstructive Lung Disease Initiative questionnaire. Study Design: Cross-sectional study. Methods: 1035 residents ≥40 years old and living in Kocaeli were surveyed. Spirometry and the basic BOLD questionnaire was performed. Results: 946 subjects entered into the analysis. The prevalence of stage I or higher COPD was 13.3% (8.7% for women and 16.5% for men), the prevalence of COPD at GOLD stage II or higher was 7.1% (4.1% for women and 9.2% for men). We also noted a high prevalence of COPD in never-smokers. Conclusion: Besides cigarette smoking, occupational exposure to fumes, chemicals and dusts might have also contributed to the high prevalence of COPD noted in residents who were ≥40 years old and living in Kocaeli, Turkey. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Chronic Obstructive Pulmonary Disease (COPD) is an increasingly important cause of morbidity and mortality in the world. The aim of this cross-sectional study was to determine the prevalence and associated risk factors of pre-diagnosed COPD, over age 40 in the centre of Isparta province. MATERIAL AND METHODS: Data was collected by face-to-face interviews using a structured questionnaire form. RESULTS: According to the results, 272 of the 677 male participants (40%) and 226 of the 995 female participants (23%) had two or more symptoms of COPD (p<0.01). In terms of smoking status, 155 of 360 (43%) smoking participants (who smoke or have smoked in the past) had two or more symptoms of COPD, whereas only 343 of 1312 non-smoking participants (26%) had two or more symptoms of COPD (p<0.01). Among the non-smoker's, 970 participants identified none of the indoor air pollution factors in their home and 147 of them (15%) had two or more symptoms of COPD, whereas 213 participants identified at least one air pollution risk factor and 61 of them (27%) had two or more symptoms of COPD (p<0.01). CONCLUSION: It is suggested that smoking and indoor air pollution are important risk factors of COPD over the age 40 in the centre of Isparta province, Turkey. [ABSTRACT FROM AUTHOR]

Aims and objectives. The study was conducted to determine the relationship between the subjective dyspnoea perception and objective dyspnoea indicators, quality of life and functional capacity. Background. Even though dyspnoea severity is generally assessed through objective parameters such as respiratory functions and arterial blood gases, studies indicate that subjectively perceived dyspnoea is not always consistent with objective dyspnoea indicators. For that reason, it is necessary to assess the changes caused by dyspnoea on quality of life and on functional capacity in addition to objective dyspnoea indicators to assess subjective dyspnoea in the most accurate way in patients with COPD. Design. A correlational study. Methods. The subjective dyspnoea was evaluated via the Basal Dyspnea Index and Visual Analog Scale, whereas objective dyspnoea was evaluated through respiratory function tests and arterial blood gases, which are physiological measurements. The quality of life was assessed with SF-36 and St. George's Respiratory Diseases Questionnaire. Functional capacity was evaluated with the six-minute walking distance test. Results. Basal Dyspnea Index score was associated with respiratory functions (FEV1, FVC, FEV1/FVC), arterial blood gases (SaO2, PaO2, pH), the quality of life and functional capacity, while Visual Analog Scale score was not associated with these measurements. Conclusions. Subjective dyspnoea severity assessed by Basal Dyspnea Index is related to the objective dyspnoea indicators, quality of life and functional capacity. In the assessment of dyspnoea, Basal Dyspnea Index is an appropriate measure, whereas Visual Analog Scale is not. In the light of these results, we recommend that Basal Dyspnea Index should be used in the assessment of dyspnoea in patients with COPD. Relevance to clinical practice. We conclude that dyspnoea will be evaluated in the most accurate and short way with the Basal Dyspnea Index. In addition, the effects of dyspnoea on quality of life and functional capacity will be predicted by Basal Dyspnea Index. [ABSTRACT FROM AUTHOR]

Chronic obstructive pulmonary disease ( COPD) affects the lives of individuals in a number of ways; it causes an increase in the need for help and support and a decline in self-care agency and quality of life. This research has been conducted in patients with COPD hospitalized in the Pulmonary Department of Erzincan State Hospital in the eastern Turkey to examine the effect of anxiety and depression on self-care agency and quality of life ( n = 135). The results showed that 69.6% and 85.6% of the patients were at risk for anxiety and depression, respectively, and that the mean scores of self-care agency and quality of life decreased as the mean scores of anxiety and depression increased. It was also established that the mean score of the quality of life increased as the mean score of self-care agency went up. It could be concluded that the majority of the patients are at risk for anxiety and depression and that presence of anxiety or depression has a negative effect on the self-care agency and the quality of life. The recognition and treatment of depression and anxiety in patients with COPD provide significant improvements in self-care agency and quality of life of patients. [ABSTRACT FROM AUTHOR]

Background: While mortality rates decrease in many chronic diseases, it continues to increase in COPD. This situation has led to the need to develop new approaches such as phenotypes in the management of COPD. We aimed to investigate the distribution, characteristics and treatment preference of COPD phenotypes in Turkey., Methods: The study was designed as a national, multicenter, observational and cross-sectional. A total of 1141 stable COPD patients were included in the analysis., Results: The phenotype distribution was as follows: 55.7% nonexacerbators (NON-AE), 25.6% frequent exacerbators without chronic bronchitis (AE NON-CB), 13.9% frequent exacerbators with chronic bronchitis (AE-CB), and 4.8% with asthma and COPD overlap (ACO). The FEV1 values were significantly higher in the ACO and NON-AE than in the AE-CB and AE NON-CB (p < 0.001). The symptom scores, ADO (age, dyspnoea and FEV1 ) index and the rates of exacerbations were significantly higher in the AE-CB and AE NON-CB phenotypes than in the ACO and NON-AE phenotypes (p < 0.001). Treatment preference in patients with COPD was statistically different among the phenotypes (p < 0.001). Subgroup analysis was performed in terms of emphysema, chronic bronchitis and ACO phenotypes of 1107 patients who had thoracic computed tomography. A total of 202 patients had more than one phenotypic trait, and 149 patients showed no features of a specific phenotype., Discussion: Most of the phenotype models have tried to classify the patient into a certain phenotype so far. However, we observed that some of the patients with COPD had two or more phenotypes together. Therefore, rather than determining which phenotype the patients are classified in, searching for the phenotypic traits of each patient may enable more effective and individualized treatment.

Objective: We aimed to investigate the prevalence of Helicobacter pylori (H. pylori) in patients with chronic obstructive pulmonary disease (COPD) using the C-14 urea-breath test (C14UBT) and to determine whether there is an association between H. pylori infection and the severity of COPD. This is the first report in the literature of the use of C14UBT to investigate the prevalence of H. pylori in patients with COPD. Materials and Methods: Fifty subjects with COPD (38 males and 12 females, aged 61±10 years) and 20 control subjects (10 males and 10 females, aged 55±11 years) were evaluated. C14UBT was used to determine H. pylori infection. Results: The prevalences of H. pylori infection in subjects with COPD and in controls were 72% and 65%, respectively (p=0.56). Forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) values were significantly higher in the H. pylori-infected subjects with COPD than in the uninfected subjects (p=0.008 and p=0.006, respectively). Conclusion: The presence of H. pylori infection in COPD patients affects pulmonary functions, but the effects of H. pylori infection on the respiratory system and COPD are not clear. [ABSTRACT FROM AUTHOR]

Background and aims: To investigate the relationship between disease-related factors and balance, and a history of falls in chronic obstructive pulmonary disease (COPD). Methods: Thirty-six patients with COPD and twenty healthy individuals were studied. Pulmonary function (pulmonary function test), hypoxemia (analysis of arterial blood gases), history of falls and tripping (number of falls and tripping in the past year), balance (Berg's Balance Scale-BBS), quadriceps femoris muscle strength (manual muscle test), and exercise capacity (6-minute walking test-6MWT) were assessed. Results: BBS scores were significantly different between groups (p=0.001). BBS scores, frequency of falls and tripping were correlated in COPD patients (p≤0.01). BBS score and frequency of falls were correlated with dyspnea and peripheral oxygen saturation measured after the 6MWT, partial arterial oxygen pressure, and arterial oxygen saturation values in COPD patients (p<0.05). Conclusions: According to our results, hypoxemia, dyspnea and fatigue are disease-related factors, which are related with balance impairment and falls in COPD patients. For this reason, we suggest that assessment of and training to improve balance impairment among the elderly with COPD should be a component of pulmonary rehabilitation programs in clinical practice. [ABSTRACT FROM AUTHOR]

Aim: To determine the effect of passive smoking on the development of chronic obstructive pulmonary disease (COPD) among persons who spend a long time in cafes. Materials and methods: The study sample included 348 male smokers who were older than 40 years and spend a long time in cafes. The questions were derived from the European Coal and Steel Community (ECSC) questionnaire. We also inquired about the nature of cafe visits (hours/day, visits/week, visits/month). Results: COPD was found in 18.1% (63/348 subjects) of the smokers aged ≥40 years. In these 63 subjects, based on spirometry results, the rate of mild and moderate airflow limitation was 23.8% (15/63) and 76.2% (48/63), respectively. Of the 63, 60 (95%) had no previous diagnosis of COPD. After we had accounted for known risk factors for the development of COPD, we identified new risk factors: time spent in cafes (hours/day), the number of cafe visits per week (visits/week), and the number of cafe visits per month (visits/month), which had higher odds ratios for smokers without COPD (5.376, 2.721, and 2.337, respectively). Conclusion: Spending time in cafes regularly may contribute as an additional risk factor for the development of the COPD. [ABSTRACT FROM AUTHOR]

Objectives: Infections are the major causes of the acute exacerbations of chronic obstructive pulmonary disease (AE-COPD). The aim of the study was to detect the incidence of common respiratory viruses and atypical agents in hospitalized patients with AE-COPD. Patients and Methods: A prospective study was conducted in tertiary regional thoracic center. Serum samples of 86 consecutive severe AE-COPD patients were studied by ELISA method for detection humoral response of respiratory syncytial virus (RSV), Mycoplasma pneumoniae, adenovirus, Chlamydia pneumonia and Legionella pneumophilia. Four-fold increase in antibody titers of double serum samples obtained at twoto four-week intervals for lgG or positive result for 1gM were considered diagnostic for infection. The severity of COPD was interpreted by spirometry. Patients whose forced expiratory volume in one second (FEV1) was below 50% were evaluated as having severe COPD. Results: Positive sera were detected in 55 patients (63.9%). The incidence of RSV, M. pneumoniae, adenovirus, C. pneumoniae and L. pneumophilia infections were found as 29%, 15%, 7%, 3%, and 2.5%, respectively. Combined infections were also detected. Conclusion: The findings suggest that respiratory viral and atypical infections seem to have substantial frequency in acute exacerbations. [ABSTRACT FROM AUTHOR]

Background. Data on the use and efficacy of complementary and alternative medicine (CAM) in patients with asthma are limited, and there is a lack of studies documenting the use of CAM in patients with chronic obstructive pulmonary disease (COPD) in Turkey. Aim. To determine the prevalence of CAM usage in patients with asthma and COPD and to assess the clinical and demographic factors associated with the use of CAM. Materials and methods. A total of 521 patients (313 with asthma and 208 with COPD) were randomly enrolled into this cross-sectional survey. A face-to-face interview was conducted using a structured questionnaire. Results. One hundred sixty-three patients (52%) with asthma and 70 patients (33%) with COPD were reported to be using some form of CAM (p < 0.001). The most popular modalities were herbal remedies (46% and 28% in the two groups, respectively) and animal products (28% and 5% in the two groups, respectively). CAM-practicing asthma patients were typically younger with longer duration of disease and higher income than the CAM-practicing COPD patients. For the patients, the main source of information on CAM practices was their relatives and friends. Only a small number of the patients consulted with their physicians about CAM. The main reasons to use CAM for patients with asthma and COPD were harmlessness and symptomatic relief, respectively. CAM-related adverse effects and difficulties to obtain CAM were significantly higher in patients with asthma than in patients with COPD. Conclusion. There is a high prevalence of CAM usage in patients with asthma and COPD in Turkey. Hence, becoming familiar with CAM therapy and inquiring about patient practice of CAM as part of the routine medical history will allow the physicians to provide reliable information to their patients on these medical practices. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to evaluate clinical and laboratory findings of hospitalized asthma and chronic obstructive pulmonary disease (COPD) patients with COVID-19 and demonstrate that they have different symptoms and/or laboratory results and outcomes than COVID-19 patients with comorbidity (CoV-com) and without comorbidity (CoV-alone)., Methodology: The data of the demographic, clinical, laboratory findings of hospitalized CoV-alone, asthma, COPD patients with COVID-19 (CoV-asthma, CoV-COPD, respectively), and CoV-com were analyzed., Results: Out of 1082 patients hospitalized for COVID-19, 585 (54.1%) had CoV-alone, 40 (3.7%) had CoV-asthma, 46 (4.3%) had CoV-COPD and 411 (38%) had CoV-com. Cough, shortness of breath, fever and weakness were the most common four symptoms seen in all COVID-19 patients. Shortness of breath, myalgia, headache symptoms were more common in CoV-asthma than the other groups (p < 0.001, p < 0.01, p < 0.05 respectively). Sputum was more common in CoV-COPD than other groups (p < 0.01). COPD group most frequently had increased values, different from the other groups with CRP>5ng/mL in 91.3%, D-dimer > 0.05mg/dL in 89.1%, troponin > 0.014micg/L in %63.9, INR>1.15 in 52.2%, CK-MB>25U/L in 48.5%, PT>14s in 40.9% of patients (p < 0.05, p < 0.001, p < 0.001, p < 0.001, p < 0.05, p < 0.001, respectively). NT-ProBNP was found to have the highest AUC value and the best differentiating parameter for CoV-asthma from CoV-alone. Typical CT findings were present in 44.4% of CoV-alone, 57.5% of CoV-asthma, 28.3% of CoV-COPD and 38.9% of CoV-com groups. CoV-COPD and CoV-com patients died more frequently than other groups (17.8%, 18.5%)., Conclusions: CoV-asthma and CoV-COPD patients might have different symptoms and laboratory parameters than other COVID-19 patients which can guide the physicians., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2021 Bilun Gemicioglu, Hafize Uzun, Sermin Borekci, Ridvan Karaali, Sebuh Kurugoglu, Pınar Atukeren, Sabri Sirolu, Sinem Durmus, Ahmet Dirican, Mert Ahmet Kuskucu, Fehmi Tabak.)

Introduction: Since GOLD 2017 separates spirometry results from 'ABCD' groups, there have been some changes to the stages of COPD patients. Our aim was to investigate the shifts in COPD groups after GOLD 2017., Methods: COPD patients from outpatient clinics of 3 hospitals in Turkey were stratified into old and new ABCD groups according to exacerbation history, mMRC evaluation and spirometry results for both GOLD 2011 and 2017 assessments. Treatment protocols were also evaluated if they were suitable for both classifications., Results: There were 578 patients (334 men, 244 women) with a mean age of 65.21±10.42. The distribution of patients from group A to D was 28%, 15%, 15%, 42% (GOLD 2011) and 36%, 22%, 7% and 35% (GOLD 2017) respectively. There were shifts from group C to A (53.4%) and D to B (18.4%). The treatment suitability was 66.3% in GOLD 2011 and 60.9% in GOLD 2017. The most common inappropriate treatment protocol was triple therapy. Presence of exacerbations in last year, mMRC score, FEV1 level (p < 0.01 for three parameters) and proportion of males (p = 0.029) were statistically significantly higher in groups C and D of GOLD 2017 compared with new patients in group A and B of GOLD 2017 (shifted from GOLD 2011's C-D groups)., Conclusion: There were shifts from group C to A and D to B with GOLD 2017, which means some high-risk COPD patients were reclassified into low-risk groups. Despite guideline updates, there are still many COPD patients with overtreatment. To our knowledge, this is the first study examining transitions between COPD groups after GOLD 2017 in Turkey., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Aim: Our aim was to evaluate changes in attitudes of pulmonologists in Turkey towards COPD guidelines and their choice of first-line treatments for COPD patients., Material-Method: 333 physicians who completed the questionnaire were included in this cross-sectional questionnaire study. The questionnaire contained demographic data, professional information, extent of guideline use, rationales behind using or not using a guideline. The data was compared with the same survey conducted previously in 2011 and was analyzed by appropriate statistical methods., Results: 80 physicians were resident pulmonologists (24%), 250 physicians were specialists (75.1%). 298 (89.5%) physicians reported that they follow at least one guideline for selection of the appropriate treatment in COPD. The current application of guidelines when compared with the first survey in 2011, was found to be decreased, 91.2% and 89.5%, respectively (p = 0.07). 46.8% (n = 156) of participants thought that guidelines provided the physicians more legal protection (p < 0.001). The number of physicians who didn't follow the guidelines due to workload increased over this period of time (36.8% in 2011, 85.3% in 2018, p < 0.001). The number of physicians using inhaler steroid combinations as their first choice of treatment was found to be similar with the previous survey (p = 0.909)., Conclusion: According to the results of previous questionnaire, the application of COPD guidelines has decreased. The number of pulmonologists who declared they have no time for following or applying guidelines has profoundly increased since 2011. Despite the warnings of these guidelines, the use of inhaler steroid combination as a first treatment option in COPD is still common., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Purpose: Osteoporosis is a systemic skeletal disease with a consequent increase in fractures rates. Osteoporosis may be primary which is related with normal aging, or secondary which occurs in the presence of an underlying disease or medication. Osteoporosis is one of the significant comorbidities in chronic obstructive pulmonary disease (COPD). In this study, we aimed to investigate the presence of osteoporosis and the influencing factors in COPD patients., Patients and Methods: This is a two-group comparison study that was conducted among 30 COPD patients on inhaled corticosteroid (ICS) and 33 controls. It was conducted in the outpatient clinics at the Departments of Physical Medicine and Rehabilitation and Pulmonary Diseases in Bursa Uludag University Hospital, a tertiary reference center, in the northwest region of Turkey. For both groups, demographic variables, osteoporosis risk questioning, body mass index (BMI), bone mineral density (BMD), biochemical blood tests, vertebral fractures on lumbar and thoracic x-rays were recorded. COPD patients were also evaluated for lung functions via spirometry., Results: Thirty patients with COPD (Group 1) and 33 controls (Group 2) were included in the study. Comparing the demographic and biochemical data, no difference was found between the groups except smoking (pack/year) (p<0.001) and erythrocyte sedimentation rate (p<0.001), which were significantly high in COPD group. BMD in the COPD group was significantly lower in both hip and lumbar regions compared with the controls. There were significant correlations between L2 BMD values and pulmonary function tests. BMI was significantly low in osteoporotic COPD patients when compared with the non-osteoporotic COPD patients (p=0.002)., Conclusion: In patients with COPD using inhaled corticosteroids, BMD was significantly low compared with the controls. Osteoporotic COPD patients had significantly lower BMI than non-osteoporotic. These findings suggest that pulmonary dysfunction and low BMI are associated with osteoporosis in COPD patients., Competing Interests: The authors report no conflicts of interest in this work., (© 2020 Ozcakir et al.)

Objective: We aimed to investigate the effect of inhaled corticosteroids (ICS) in the outcomes of community-acquired pneumonia (CAP), as well as to determine if ICS usage is exist among the risk factors for mortality in those patients., Materials and Methods: In this retrospective cross-sectional multicentre study, 1069 hospitalised CAP patients were investigated using CAP Database of Turkish Thoracic Society (TURKCAP Database). The patients were divided into two groups, depending on their ICS use. The data were analysed by appropriate statistical methods., Results: 172 (75.8%) of the 227 patients who were on ICS had COPD and 37 (16.3%) had asthma. There were fewer patients with fever among ICS-users compared to non-ICS users (P = 0.013), and less muscle pain (P = 0.015) and fewer GIS symptoms (P = 0.022). No statistically significant difference was found between ICS use/ type of ICS and the duration of hospitalisation (P = 0.286). The multivariate regression analysis showed that patients using ICS had lower body temperature and, less crackles/bronchial sound. In the multivariate logistic regression model lung cancer (OR: 6.75), glucose (OR: 1.01) and CURB-65 (OR: 1.72) were significantly associated with mortality in the CAP patients. ICS usage were not found to be associated with mortality., Conclusion: The use of ICS by the patients with CAP admitted to the hospital is not independently related with any radiological pattern, hospitalisation duration and mortality. ICS usage may diminish fever response and may suppress the findings of crackles and/or bronchial sounds. This needs further confirmation., (© 2020 John Wiley & Sons Ltd.)

Introduction: The concept of self-efficacy in chronic obstructive pulmonary disease (COPD) and the development of self-efficacy in individuals are extremely significant. Increasing the self-efficacy level in individuals with COPD will contribute to the effective management of symptoms. Moreover, exercise is essential in COPD management and nursing care., Objectives: This study aimed to evaluate the results of the validity and reliability study of the Turkish version of the COPD Exercise Self-Regulatory Efficacy Scale (Ex-SRES) developed by Davis et al. METHODS: This is a methodological study conducted with 160 patients diagnosed with COPD. Data were collected using the Personal Information Form and COPD Ex-SRES. Moreover, the Cronbach's α value was calculated, and the test-retest reliability was performed for reliability analysis., Results: The item total correlation scores of the Turkish version were between 0.608 and 0.853 points. The total score correlation coefficients of all the items in the scale were over 0.30. In this respect, the item total correlation values of the Turkish version of the Ex-SRES were at an appropriate level of reliability. In addition, the total Cronbach's α coefficient of the scale was calculated as 0.96., Conclusion: The Turkish version of the Ex-SRES was found to have high validity and reliability and to be a precise tool that specifically measures exercise self-efficacy in the COPD patient group., (© 2019 John Wiley & Sons Ltd.)

Purpose: In order to determine the clinical and sociodemographic characteristics of newly diagnosed treatment-naïve asthma and COPD patients in Turkey, a multicenter study in 2012 was initiated . We aimed to investigate the characteristics and therapies of COPD patients in the original study in more detail., Patients and Methods: This nation-wide, multicentric, non-interventional, prospective, real-life observational cohort study was conducted in 122 centers. The newly diagnosed patients were not receiving any treatment before the recruitment. Their general characteristics, the combined GOLD 2011 COPD categories and exacerbation histories were noted. The patients were followed up with 3 voluntary visits for 1 year. Their adherence to the inhaled treatment according to GOLD 2011 was evaluated during follow-up visits., Results: The study included 776 COPD patients. Their mean age was 59.4±9.1 years, and 11.9% of the patients were female. 35.1% of the patients were in the GOLD 2011 C and D category. 12.6% are frequent exacerbators, and 52.8% had at least one comorbid condition. 71.8% overtreatment rate was detected. Their attendance rates for three follow-up visits became 55.9%, 32.9% and 18.7%, respectively. The adherence rate to the treatment was measured as 81.9%., Conclusion: Although these patients were diagnosed for the first time, the GOLD C and D categories and frequent exacerbator phenotype were found at a high rate. They were usually prescribed an overtreatment regimen. We think that newly diagnosed COPD patients should be evaluated carefully, and best effort should be made to treat these patients in accordance with the recommendations of the major COPD guidelines., Competing Interests: The study is financially supported by “Abdi Ibrahim Ilac San. ve Tic. AS, Turkey.” All authors are members of the advisory board of the study and received payment from “Abdi Ibrahim Ilac San. ve Tic. AS, Turkey” for this. Professor Hakan Gunen reports non-financial support from Abdiİbrahim Pharmaceutical Company, during the conduct of the study; Abdiİbrahim Turkey Pharmaceutical Company paid the publication processing fee, outside the submitted work. Dr Tevfik Ozlu reports personal fees from Abdiibrahim, during the conduct of the study; Prof. Dr. Oznur Abadoglu reports grants from Abdi İbrahim, during the conduct of the study. Dr Bilun Gemicioglu reports Clinical research grants from Sanofi, AstraZeneca, Novartis; Consultancy or lecture grants from Abdi Ibrahim, Deva, Novartis, during the conduct of the study. Prof. Dr. Zeynep Misirligil report grants, personal fees from Abdi İbrahim İlaç San. ve Tic. AS, during the conduct of the study. The authors report no other conflicts of interest in this work., (© 2020 Suerdem et al.)

Introduction: Risk of osteoporosis known to increase in chronic obstructive pulmonary disease (COPD), but is usually overlooked, especially in male patients., Objectives: The present study compares the bone mineral density (BMD) measurements of male COPD patients with emphysema and the chronic bronchitis phenotype, and evaluates the association between density of emphysema and osteoporosis., Methods: Ninety-four patients with COPD, and with emphysema and the chronic bronchitis phenotype, were included in the prospective study. A high-resolution computed tomography (HRCT) was used for the diagnosis of emphysema, and a dual X-ray absorptiometry was used to measure the BMD of the lumbar vertebrae and neck of the femur., Results: Emphysema phenotype 45.75% and chronic bronchitis phenotype 54.25%, based on their clinical findings and a quantitative volumetric analysis by HRCT. Osteoporosis was found 60.47% and 17.65% of patients with emphysema and bronchitis, while osteopenia was detected 27.91% and 41.18% of patients with emphysema and bronchitis, respectively. A negative correlation was found between HRCT emphysema density and the bone densitometer t-score in patients with osteoporosis. Among the patients with osteoporosis, a positive correlation was found between Body Mass Index (BMI) and the bone densitometer t-score. Only BMI and emphysema score were found to be independent risk factors for a low BMD. One unit drop in BMI increased the risk of osteoporosis by 28% (OR = 1.28, 95% CI 1.14-1.45) (P < 0.001). One unit increase in emphysema score increased the risk of osteoporosis by 6% (OR = 1.06, 95% CI 1.03-1.09) (P < 0.001)., Conclusion: Especially male patients with emphysema, high dyspnea score, low BMI and frequent exacerbations should be evaluated for osteoporosis., (© 2019 John Wiley & Sons Ltd.)