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    CT features of pulmonary embolism in patients with COVID-19 pneumonia
    (Verduci Publisher, 2023) Ekici, M.; Ekici, A.; Kaygusuz, S.; Inanc, F.
    OBJECTIVE: The aim of this study was to describe the Computed Tomogra-phy (CT) features of pulmonary embolism in pa-tients hospitalized for acute COVID-19 pneumo-nia and to evaluate the prognostic significance of these features.PATIENTS AND METHODS: This retrospec-tive study included 110 consecutive patients who were hospitalized for acute COVID-19 pneumonia and underwent pulmonary com-puted tomography angiography (BTPA) on the basis of clinical suspicion. The diagnosis of COVID-19 infection was determined by CT find-ings typical of COVID-19 pneumonia and/or a positive result of a reverse transcriptase-poly-merase chain reaction test.RESULTS: Of the 110 patients, 30 (27.3%) had acute pulmonary embolism and 71 (64.5%) had CT features of chronic pulmonary embolism. Of the 14 (12.7%) patients who died despite receiv-ing therapeutic doses of heparin, 13 (92.9%) had CT features of chronic pulmonary embolism and 1 (7.1%) of acute pulmonary embolism. CT features of chronic pulmonary embolism were more com-mon in deceased patients than in surviving pa-tients (92.9% vs. 60.4%, p=0.01, respectively). Low oxygen saturation and high urine microalbumin creatinine ratio at admission in COVID-19 patients are important determinants of mortality after ad-justing for sex and age in logistic procedures.CONCLUSIONS: CT features of chronic pul-monary embolism are common in COVID-19 pa-tients undergoing Computed Tomography Pul-monary Angiography (CTPA) in the hospital. The coexistence of albuminuria, low oxygen satura-tion and CT features of chronic pulmonary em-bolism at admission in COVID-19 patients may herald fatal outcomes.
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    Disorders of glucose metabolism and insulin resistance in patients with obstructive sleep apnoea syndrome
    (Wiley, 2012) Bulcun, E.; Ekici, M.; Ekici, A.
    Objective: Insulin resistance (IR) and disorders of glucose metabolism (DGM) are risk factors for cardiovascular diseases. There are different reasons for development of DGM in patients with obstructive sleep apnoea syndrome (OSAS) and this association is controversial. We investigated the frequency of DGM and IR in patients with OSAS and determining factors for these disorders. Method: One hundred and twelve untreated patients with OSAS and 19 non-apnoeic snoring subjects upon polysomnography were included in this study. Oral glucose tolerance test (OGTT) was performed in all subjects who had fasting blood glucose < 125 mg/dl. IR method was analysed using homeostasis assessment model (HOMA-IR). Diabetes mellitus (DM), impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) were defined according to values of OGTT. DGM was defined as having one of the diagnoses of DM, IGT or IFG. Subjective sleepiness of all subjects was assessed with Epworth Sleepiness Scale (ESS). Excessive daytime sleepiness (EDS) was described as ESS score >= 10. Results: Fasting glucose and the rate of DGM in patients with OSAS were higher than in non-apnoeic snoring subjects. DGM were shown in % 15.7 of non-apnoeic snoring subjects, 29.6% of mild sleep apnoea, 50% of moderate sleep apnoea and 61.8% of severe sleep apnoea. The rate of DGM in patients with moderate and severe OSAS was higher than in non-apnoeic snoring subjects and in patients with severe OSAS higher than in patients with mild OSAS. DGM are associated with body mass index (BMI), severity of OSAS, arousal index and EDS. In addition, IR is associated with apnoea hypopnoea index, BMI, arousal index and ESS score. Conclusion: Obstructive sleep apnoea syndrome is associated with high frequency of DGM. In addition, the progression of disease from simple snoring and mild OSAS to severe OSAS increases the rate of DGM. Thus, DGM especially in patients with severe OSAS should be examined in regular periods.
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    Effect of azithromycin on the severity of bronchial hyperresponsiveness in patients with mild asthma
    (Taylor & Francis Ltd, 2002) Ekici, A.; Ekici, M.; Erdemoğlu, A.K.
    The effect of azithromycin on bronchial hyperresponsiveness was measured in a group of 11 patients with mild asthma. Azithromycin 250 mg orally was administered intermittently to all the patients twice a week for eight weeks. The only other treatment was inhaled beta2 agonist, when required. A histamine inhalation test was performed at the beginning and at the fourth and the eighth week of the study. The mean PC20 values increased significantly over the initial value at the eighth week after the administration of azithromycin (p < 0.05) but mean values for FEV1 and FEV1 percent predicted did not differ significantly. These results suggested that eight weeks of intermittent, low-dose administration of azithromycin in patients with mild asthma might reduce the severity of bronchial hyperresponsiveness.
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    Effect of chronic diseases and associated psychological distress on health-related quality of life
    (Wiley, 2007) Keleş, H.; Ekici, A.; Ekici, M.; Bulcun, E.; Altinkaya, V.
    Background: The purpose of this study was to clarify the correlations between the presence of comorbidities and psychological distress and health-related quality of life (HRQL). This was a population-based cross-sectional study. Methods: Parents and grandparents of students from seven randomly selected primary schools in the city centre were asked to answer questionnaires sent by their children. All subjects were questioned for somatic diseases, psychological distress and HRQL by Health Questionnaire, Hospital Anxiety and Depression scale and short-form-12 health survey, respectively. Results: Out of 5024 parents and grandparents (mean age 52.3 +/- 14.3 years, range 20-104 years) of primary school students 4605 returned the questionnaires, a figure that corresponds to the overall response rate of 91.6%. Chronic diseases substantially reduced HRQL and this effect did not differ markedly with the type of chronic disease. Association of comorbidities with psychological distress further impaired HRQL. As the number of chronic diseases was increased, HRQL and physical and mental functioning declined. The worst HRQL was observed in subjects who had five or more comorbidities associated with psychological distress. Conclusion: The present study indicates significant adverse effects of chronic diseases and psychological distress on HRQL in adults, the effect of psychological distress being the most important. Our results lead us to suggest that in the management of comorbidities, the detection of the presence and severity of associated psychological distress and its treatment, besides the specific treatment of comorbidities, may provide dramatic improvement in HRQL of the patients.
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    Female sexual and hormonal status in patients with bronchial asthma: Relationship with respiratory function tests, psycho logic and somatic status (conferenceObject)
    (Wiley-Blackwell Publishing, Inc, 2004) Basar, M.; Ekici, A.; Ekici, M. S.; Kara, T.; Tuglu, D.; Batislam, E.
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    Importance of Inhaler Device Use Status in the Control of Asthma in Adults: The Asthma Inhaler Treatment Study
    (Daedalus Enterprises Inc, 2014) Yildiz, Fusun; Erbagci, A.; Demirel, Y. S.; Akcali, S. D.; Ekici, A.; Dursunoglu, N.; Ozer, A.
    BACKGROUND: Proper education and training in correct inhalation technique has been reported to have a substantial role in the achievement of optimal therapeutic benefit and asthma control. The present study was designed to evaluate inhaler technique and the role of education in relation to asthma control among patients with persistent asthma in Turkey. METHODS: A total of 572 patients with persistent asthma (mean +/- SD age 42.7 +/- 12.2 y, 76% females) were included in this non-interventional, observational, registry study conducted across Turkey. Data on the effective and correct use of inhaler devices were collected via the Ease of Use for the Inhaler Device Questionnaire to patients and physicians. RESULTS: Asthma control (overall 61.5% at baseline, and increased to 87.3% during follow-up) was better, with significant improvement in technique and decrease in basic errors to the range 0-1, regardless of the inhaler type. Overall, the most common basic error associated with inhalation maneuvers was failure to exhale before inhaling through the device (18.9%). There was concordance between the patients and physicians in the ratio of correct inhaler technique only for spray-type inhalers. CONCLUSIONS: Close follow-up with repeated checking of the patient's inhaler technique and correction of errors each time by a physician seem to be associated with a significant decrease in the percent of patients who make basic errors in inhalation maneuvers and device-independent errors, and with better control of persistent asthma.
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    Minnesota Multiphasic Personality Inventory Profile of patients with allergic rhinitis
    (B C Decker Inc, 2003) Muluk, N.B.; Oguzturk, O.; Koc, C.; Ekici, A.
    The aim of this study was to investigate the relationship between allergic rhinitis and personality traits in a nonpsychiatric population of proven allergic status. Subjects were assigned to the allergic group (n = 29) and the nonallergic group (n = 29) on the basis of the medical examination, allergic prick tests, and self-reported allergic status. Analysis of Minnesota Multiphasic Personality Inventory Profile (MMPI) profiles showed that male subjects with allergic rhinitis had significantly higher scores on depression, paranoia, and social introversion. Depression, hypochondriasis, and hysteria scores were significantly higher in female subjects. It may be concluded that patients with allergic rhinitis have poorer psychological function compared with the nonallergic subjects.
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    Perception of bronchoconstriction in elderly asthmatics
    (Taylor & Francis Ltd, 2001) Ekici, M.; Apan, A.; Ekici, A.; Erdemoglu, A.K.
    The impaired perception of bronchoconstriction in asthmatic patients may increase the risk of severe exacerbation. To characterize the perception of bronchoconstriction in elderly asthma patients, we compared the perception in older patients with that of younger patients. To determine the influence of perception of long-standing diseases, we further evaluated the perception in early-onset elderly asthma patients and in late-onset elderly, asthma patients. The study group consisted of 80 stable asthmatic patients. The patients were grouped according to their age (group 1, < 60 years, n = 37; group 2 greater than or equal to 60 years, n = 43). Each group was separated into two subgroups according to the duration of symptoms (late-onset asthma IA and 2A, <5 years, early-onset asthma IB and 2B, greater than or equal to 5 years). A histamine inhalation test was performed for each patient. Dyspnea was assessed by modified Borg scale. The Borg score in forced expiratory volume in I see (FEV1) reduction by 20% was determined as perception score 20 (PS20). The mean perception scores of the elderly asthmatic patients were significantly lower than those of the younger asthmatic patients (group 1, PS20 = 2.35 +/- 0.17; group 2, PS20 = 1.37 +/- 0.12; p < 0.0001). The differences of mean perception score (PS20) between early- and late-onset subgroups were insignificant (1A, 2.63 +/- 0.30 and IB, 2.07 +/- 0.16; p = 0.101: 2A, 1.36 +/- 0.19 and 2B, 1.59 +/- 0.120; p = 0.91). The mean perception scores of male asthmatic patients were significantly lower than those of female patients (p = 0.03). There was a correlation between PS20 and %FEV1 in the younger group (r = 0.392, p = 0.02), but not in the elderly, group (r = 139, p = 0.375). The correlation between PS20 and PD20 in both younger and elderly group was insignificant (p > 0.05). Elderly, asthmatics perceive less intense respiratory, distress for a decrease of 20% in FEV1 than do younger asthmatics. This underperception of bronchoconstriction may result in a delay in medical care during an acute asthmatic episode. Thus, we strongly recommend that elderly, asthmatic patients should be followed up more frequently and closely.
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    Perception of bronchoconstriction in obstructive pulmonary diseases (disease-specific dyspnoea)
    (Portland Press Ltd, 2003) Ekici, A.; Yilmaz, S.; Ekici, M.; Kalpaklioglu, F.; Karadeniz, Y.; Arslan, M.; Kurtipek, E.
    The perception of dyspnoea differs between subjects with obstructive pulmonary diseases, partly because the underlying mechanisms for bronchoconstriction are different. We investigated the perception of bronchoconstriction in subjects with bronchiectasis, asthma and chronic bronchitis and possible contributing factors. Forty-seven non-smoking subjects with bronchiectasis, 50 subjects with asthma and 31 with chronic bronchitis were challenged with histamine. The Borg score was assessed before and after each challenge. The perception score corresponding to a fall in the forced expiratory volume in 1 s (FEV1)by 20% (PS20) was calculated. The mean values of DeltaBorg/DeltaFEV(1), (the Borg score change divided by the change in FEV1 as a percentage of the baseline FEV1) and PS20 of subjects with bronchiectasis and chronic bronchitis were significantly lower than in subjects with asthma after histamine challenge. The ratio of non-perceivers was higher in bronchiectasis (25.5%) and in chronic bronchitis (32.3%) than in asthma (4.0%). When all subjects were considered, DeltaBorg/DeltaFEV, values were significantly related to female sex(r(2)=11.5%, P=0.0001), but not to age, duration of the disease, PD20 or baseline FEV1%. The present study indicates that perception of histamine-induced bronchoconstriction is lower in patients with bronchiectasis and chronic bronchitis than in asthmatic patients, and that sex partially contributes to this difference.
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    Treatment characteristics in elderly asthmatics
    (Wiley, 2008) Ekici, M.; Ekici, A.; Keles, H.; Akin, A.
    In this study, we evaluated the effect of ageing on treatment response by comparing two groups of patients with asthma. All asthmatic patients in the study were assessed on repeated occasions once admitted to the hospital: soon after admission (0 h), and then at 5th, 10th, 24th, 48th, 72nd hour, 7th day and in stable period. We compared two groups of patients: younger asthmatics, which had 33 younger aged < 60, and elderly asthmatics, comprised of 29 elderly aged >= 60 years. The Asthma Quality of Life Questionnaire (AQLQ) was used to assess health-related quality of life in study. The increases in FEV1% values observed soon after the hospital admission (0 h), and at 5th, 10th, 24th, 48th, 72nd hour, 7th day and in stable period in younger group were similar that in elderly group. The Borg scores observed soon after the hospital admission (0 h), and 5th, 10th, 24th, 48th and 72nd hour in elderly asthmatics was usually higher than that in younger asthmatics. However, symptom scores observed in elderly asthmatics soon after the hospital admission and at 72nd hour were higher than those in younger asthmatics. Furthermore, decreases in the total AQLQ score and asthma severity score from exacerbation to stable period in both asthmatics were not different. Present study indicated that the airways obstruction, AQLQ and other diseases characteristics of younger and elderly asthmatics could improve at similar rates with treatment. In addition, similar exacerbation severity in elderly asthmatics was perceived more intense than younger asthmatics.