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Öğe Association of asthma-related symptoms with snoring and apnea and effect on health-related quality of life(Elsevier, 2005) Ekici, Aynur; Ekici, Mehmet; Kurtipek, Ercan; Keleş, Hatice; Kara, Türkan; Tunçkol, Müge; Koçyiğit, PınarObjectives: This study aimed to investigate the association of asthma-related symptoms with snoring and apnea, and to assess their effects on health-related quality of life (HRQL). Design: Population-based cross-sectional study. Subjects and methods: A total of 10,224 parents and grandparents of students from 14 randomly selected primary schools in city center were asked to answer questionnaires sent by their children. All subjects were questioned for asthma-related symptoms, sleep-related disorders (snoring and apnea), and for HRQL using the Respiratory Questionnaire, Sleep and Health Questionnaire, and Short Form-12 (SF-12) Health Survey, respectively. Results: The overall response rate to questionnaires was 97.7%, and all analysis was performed on 7,469 subjects (3,920 women and 3,549 men) who provided sufficient responses to questions. There were 2,713 subjects who reported asthma-related symptoms. The snoring and the observed apnea were more prevalent in subjects with asthma-related symptoms (54.0% vs 41.4%; odds ratio [OR], 1.7; 95% confidence interval [CI], 1.5 to 1.8; p < 0.001) than those without asthma-related symptoms (16.7% vs 7.0%; OR, 2.7; 95% CI, 2.3 to 3.1; p < 0.001), respectively. Asthma-related symptoms were found to be associated with snoring (OR, 1.5; 95% CI, 1.3 to 1.6; p < 0.001) and observed apnea (OR, 2.2; 95% CI, 1.8 to 2.5; p < 0.001) after adjusting for gender, age, body mass index, income, education, and smoking. Also, HRQL was found to be adversely affected by asthma-related symptoms, snoring, and observed apnea (beta = - 0.26, p < 0.001; beta = - 0.07, p < 0.001; and beta = - 0.08, p < 0.001, respectively, for SF-12 overall score) after adjusting for other confounding factors. Conclusion: Present data suggest that there is a link between the sleep-related breathing disorders and asthma-related symptoms. Moreover, the presence of snoring and observed apnea in individuals with asthma-related symptoms causes further impairment in HRQL. The effects on HRQL of coexistence of these three disorders should be supported by clinical studies.Öğe Astım koah ve bronşektazili hastalarda serum leptin düzeyi ile vücut kitle indeksi, solunum fonksiyonları ve yaşam kalitesi arasındaki ilişki(Kırıkkale Üniversitesi, 2005) Kurtipek, Ercan; Kalpaklıoğlu, Ayşe FüsunIV ÖZET Kurtipek E., Astım, KOAH ve bronşektazi'Ii hastalarda serum leptin düzeyi ile vücut kitle indeksi, solunum fonksiyonları ve yaşam kalitesi arasındaki ilişki, Kırıkkale Üniversitesi Tıp Fakültesi Göğüs Hastalıkları ve Tüberküloz Anabilim Dalı Uzmanlık Tezi, Kırıkkale 2005. Bu tezde astım, kronik obstrüktif akciğer hastalığı (KOAH) ve bronşektazi'Ii hastaların serum leptin düzeyleri ile, vücut kitle indeksi (VKİ), solunum fonksiyonları ve yaşam kalitesi arasındaki ilişkiyi araştırmak amaçlanmıştır. Bu amaçla çalışmaya yaşlan 18'den büyük olan, stabil dönemdeki 78 astım'lı, 67 KOAH'lı, 37 bronşektazi'Ii hasta ile 34 sağlıklı kontrol, toplam 216 kişi alındı. Vücut kitle indeksi (VKİ) 'ne göre tüm olgular, VKİ> 25kg/m2 olanlar Grup A ve VKİ<25kg/m2 olanlar Grup B şeklinde iki ayrı grupta değerlendirildiler. Alınan kan örneklerinde serum leptin düzeyi ELİZA yöntemiyle çalışıldı ve tüm grupların solunum fonksiyonları zorlu ekspiratuar manevra ile akıma duyarlı spirometre ile ölçüldü. Obezite-spesifik yaşam kalitesi (Impact of Weight on Quality of Life, IWQOL-Lite questionnaire), anketi ile de yaşam kaliteleri değerlendirildi. Astım'lı hastaların VKİ'i, KOAH ve bronşektazi'lilerden daha yüksekti (sırasıyla 29.84±6.46, 25.78±4.96, 27.64±5.19 ve p=0.0001, p=0.20). Astım'lılarda KOAH ve kontrol grubuna göre serum leptin düzeyi yüksek bulunurken (sırasıyla 12.36 ng/ml, 3.35 ng/ml, ve 5.21ng/ml, p=0.0001 ve p=0.0001), bronşektazi'Ii hastalar ile karşılaştırıldığında anlamlı fark yoktu (8.49ng/ml, p=0.1). KOAH'lılarda leptin düzeyi kontrol grubundan düşüktü (p=0.71). Bronşektazi'Ii hastaların serum leptin düzeyi kontrol grubu ve KOAH'lılara göre daha yüksek bulundu (p=0.34 ve p=0.01). Lineer regresyon analiziyle astım, KOAH ve bronşektazi'Ii hasta gruplarında VKİ'i ile serum leptin düzeyi arasında belirgin korelasyon varken (sırasıyla beta=0.44, p=0.0001, beta=0.25, p=0.04 ve beta=0.44, p=0.01), kontrol grubunda yoktu (beta=0.24, p=0.24). Buna göre en belirgin korelasyon astımlı hastalarda gözlenirken, bronşektazi'Ii hastalarda da kuvvetli korelasyon görüldü. Tüm hasta gruplarının beklenen % FEV ı 'leri kontrol grubuna göre daha düşüktü (p<0.05). Hasta gruplarını kendi aralarında karşılaştırdığımızda ise sadece KOAH'lılar da astım'lılara göre beklenen % FEV ı 'leri anlamlı olarak düşükken (p<0.05), diğer gruplar arasında fark yoktu (p>0.05). Ayrıca astım'lı hastalarda lineer regresyon analizi ile grup A'da VKİ'i ile serum leptin düzeyi ve IWQOL arasında pozitif korelasyon saptanırken (sırasıyla beta= 0.36, p=0.01 ve beta=0.58, p=0.0001), grup B'de VKİ'i ile leptin düzeyi ve IWQOL arasında korelasyon yoktu.VKİ >25 kg/m2 olan grupların tamamında VKİ ile IWQOL arasında korelasyon bulunurken, VKİ <25 kg/m2 olan grupların hiçbirinde korelasyon görülmedi. Sonuç olarak kronik havayolu hastalıklarından hem astımda hem bronşektazide artmış serum leptin düzeyinin önemli bir prediktör olduğu düşünülebilir. VKİ >25 kg/m2 olan hasta ve kontrol gruplarında IWQOL-Lite anketiyle belirlenen yaşam kalitesinin bozulması, kronik havayolu hastalıklarının doğrudan obezite-yaşam kalitesine etkisinin olmadığını, yalnızca VKİ'nin rolünün olduğunu düşündürmektedir. Anahtar Kelimeler: Astım, KOAH, bronşektazi, vücut kitle indeksi, leptinÖğe Effect of body mass index on quality of life in allergic/asthmatic patients(Ocean Side Publications Inc, 2006) Kalpaklıoğlu, A. Füsun; Kara, Türkan; Kurtipek, Ercan; Saygun, MeralEvaluation of quality of life (QoL) is of particular interest in patients suffering from chronic diseases. Although studies have shown an association between QoL and obesity and allergy/asthma, the effect of obesity on QoL is not well known. The aim of this study was to assess the impact of body mass index (BMI) as a contributory factor on QoL in patients with a diagnostic label of allergy/asthma. We surveyed 100 patients (69 F/31 M) (age 34.15 +/- 13.32 years), and 65 healthy controls (42 F/23 M) (age 35.45 +/- 8.96 years). QoL was determined by SF-36. BMI >= 25 kg/m(2) was accepted as overweight/obesity. Forty-five percent of the patients had BMI >= 25 kg/m(2) with no difference between the genders. They were significantly older and more likely to have less education level than those with BMI < 25 kg/m(2). Quality-of-life scores among patients with allergy/asthma were lower than those in the control group, irrespective of BMI. However, increased BMI was found to be related with improved quality of life among controls. Pearson's analysis showed that BMI was inversely correlated with physical functioning among patients (r = -0.229, p = 0.034), but in the control group it was positively correlated with QoL. All the domains of SF-36, except role-physical ones, among female subjects were significantly impaired more than those of male patients. It has been shown that the major determinants of impaired QoL are female sex, older age, and less educational status in patients with allergic/asthmatic symptoms. The impact of BMI on QoL could be undermined, because it seems to play a minor role.Öğe Effect of psychological on respiratory symptoms(2005) Ekici, Aydanur; Oğuztürk, Ömer; Ekici, Mehmet; Kurtipek, Ercan; Akın, Ahmet; Arslan, Mesut; Tunçkol, MügeAmaç: Psikolojik durumun solunum semptomu bildirmeye ve solunum sisteminin objektif ölçümlerine etkisinin olup olmadığını araştırdık. Materyal ve Metotlar: Çalışmaya silah fabrikasında çalışan 1090 erkek işçi ve biomasse maruz kalan 420 kadın alındı. Olgular respiratuar sorgulama formu ile sorgulanarak portable spirometre cihazı ile solunum fonksiyonları ölçüldü.Psikolojik durum HAD scalası ile ölçülerek ;median değere göre yüksek ve düşük HAD total skorlu gruplar olarak sınıflandırıldılar. Bulgular: Erkeklerde: Kronik öksürük (%17,6 vs %10,7 p0,001), Kronik balgam (13,2% vs.8,9%, p0,02) ve muhtemel astım (%39,5 vs %25,5, p0,0001) yüksek HAD total skorlu grupta düşük HAD total skorlu grupa göre önemli olarak daha sık bulunurken kesin astım (%6,2 vs %4,6, p0,2) için gruplar arasında fark yoktu. Kadınlarda: Kronik öksürük (%34,8 vs %23,5 p0,009), kronik balgam (%23,9 vs. %15,4, p0,02) ve muhtemel astım (%53,5 vs %35,3, p0,0001) yüksek HAD total skorlu grupta düşük HAD total skorlu grupa göre önemli olarak daha sık bulunurken kesin astım (%7,0 vs %9,0, p0,4) için gruplar arasında fark yoktu. Sonuç: Respiratuar sorgulamada semptom bildirme sıklığı psikolojik durumdan etkilenebilir.Respiratuar sorgulama ve psikolojik durum göstergeleri eşzamanlı olarak yorumlanmalıdır.Öğe EFFECT OF PSYCHOLOGICAL STATUS ON RESPIRATORY SYMPTOMS(Gazi Univ, Fac Med, 2005) Ekici, Aydanur; Oguzturk, Omer; Ekici, Mehmet; Kurtipek, Ercan; Akin, Ahmet; Arslan, Mesut; Kara, TurkanObjective: To investigate whether psychological status affects respiratory symptom reporting and objective measures of the respiratory system. Materials and Methods: This study was performed in 1090 male gun factory workers and in 420 women exposed to biomass. The subjects were questioned using a Respiratory questionnaire. Respiratory functions were measured by portable spirometer. Psychological status was measured by HAD scale. Groups with high HAD total scores and low HAD total scores were classified by the median value. Results: In males: Chronic cough (17.6% vs. 10.7% p=0.001), chronic phlegm (13.2% vs. 8.9%, p=0.02), and probable asthma (39.5% vs. 25.5%, p=0.0001) were significantly more frequent in the group with high HAD total scores than in the group with low HAD total scores but definite asthma was not (6.2% vs. 4.6%, p=0.2). In women: Chronic cough (34.8% vs. 23.5% p=0.009), chronic phlegm (23.9% vs. 15.4%, p=0.02), and probable asthma (53.5% vs. 35.3%, p=0.0001) were significantly more frequent in the group with high HAD total scores than in the group with low HAD total scores but definite asthma was not (7.0% vs. 9.0%, p=0.4). Conclusion: Psychological status might affect the frequency of symptom reporting in respiratory questionnaires. The questionnaires and psychological status indices should be interpreted simultaneously.Öğe Evaluation and impact of chronic cough: comparison of specific vs generic quality-of-life questionnaires(Elsevier Science Inc, 2005) Kalpaklıoğlu, Ayşe Füsun; Kara, Türkan; Kurtipek, Ercan; Koçyiğit, Pınar; Ekici, Aydanur; Ekici, MehmetBackground: Chronic cough is a common condition that has a significant impact on health-related quality of life (HRQoL). Objective: To investigate whether chronic cough is associated with adverse psychological and physical effects on quality of life (QoL) using different HRQoL questionnaires. Methods: Forty patients were recruited for the study. The diagnostic workup was mainly based on the pathogenic triad in chronic cough: postnasal drip syndrome, asthma, and gastroesophageal reflux disease. The HRQoL was evaluated with the cough-specific quality-of-life questionnaire (CQLQ), Leicester Cough Questionnaire (LCQ), Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and Hospital Anxiety and Depression Scale. Results: Symptom scores were significantly correlated with the CQLQ and LCQ (beta =.415 and beta = -.272, respectively) but not with the SF-36. A statistically significant difference was found in all questionnaires, except the physical component summary domain of the SF-36, after specific therapy. Correlation between the 2 specific HRQoL questionnaires was moderate to high when pretreatment and posttreatment scores were compared (r = -0.42 and r = -0.60). Concurrent validity of the LCQ was higher than the CQLQ when compared with the SF-36 domains. The effect size of each specific QoL questionnaire was I or higher after treatment, whereas it was much less in the SF-36. There was no change in depression with treatment despite anxiety. Posttreatment symptom scores were related with anxiety (r > 0.40) Conclusions: Because HRQoL is important to patients, a cough-specific HRQoL instrument, either the CQLQ or LCQ, should be routinely used to optimally evaluate the impact of cough on patients and to evaluate the efficacy of cough-modifying agents. Ann Allergy Asthma Immunol. 2005;94:581-585.Öğe Obstructive airway diseases in women exposed to biomass smoke(Academic Press Inc Elsevier Science, 2005) Ekici, Aydanur; Ekici, Mehmet; Kurtipek, Ercan; Akın, Ahmet; Arslan, Mesut; Kara, Türkan; Demir, SelmaThe majority of women living in rural areas in Turkey use biomass fuels for domestic energy and are exposed to high levels of indoor air pollution every day. The objective of this study was to compare the presence of chronic airway diseases (CAD) in two groups of nonsmoking women older than 40 years with (exposed group, n = 397) and without a history of exposure to biomass cooking (liquid petroleum gas (LPG); control group, n = 199), in 2002 in Kirikkale, Turkey. Detailed respiratory symptoms were collected with a standard questionnaire adapted from that of the British Medical Research Council. Exposure was calculated as the average hours spent daily for cooking multiplied by the number of years. CAD were defined as either chronic airway obstruction (CAO; (forced expiratory volume in 1 s/forced vital capacity) < 0.70), chronic bronchitis, or chronic bronchitis with CAO. The prevalence of CAD in the exposed group was found to be higher than that in the LPG group (28.5% vs. 13.6%, crude odds ratios (ORs) 2.5 (1.5-4.0), P = 0.0001). The fraction of CAD attributed to exposure to biomass smoke after adjusting for possible confounding factors was 23.1% (95% confidence interval (CI) 13.4-33.2). Acute symptoms during exposure to biomass smoke were important predictors for the presence of CAD. Biomass smoke pollution is an important contributing factor in the development of CAD in nonsmoking women living in a rural area. The presence of acute symptoms during cooking in women in rural areas should signal to general practitioners the possibility of CAD. (c) 2005 Elsevier Inc. All rights reserved.Öğe Psychological status and quality of life in elderly patients with asthma(Elsevier Science Inc, 2005) Oğuztürk, Ömer; Ekici, Aydanur; Kara, Murat; Ekici, Mehmet; Arslan, Mesut; Iteginli, Ahmet; Kurtipek, ErcanThe psychological status and quality of life of 70 stable patients with asthma age greater than or equal to60 years and 40 age-matched comparison subjects were examined. The patients with long-standing asthma (duration greater than or equal to 8 years) had lower quality-of-life scores than those with recent-onset asthma (duration < 8 years). In multivariate linear regression analysis with adjustment for age, gender, duration of disease, and level of bronchial hyperreactivity, worse quality of life was predicted by anxiety, depression, and asthma severity scores. In elderly patients with long-standing asthma, disease severity significantly impairs quality of life. Impaired quality of life in these patients may be partly related to psychological status indicators.Öğe Respiratory findings in gun factory workers exposed to solvents(W.B. Saunders Ltd, 2004) Çakmak, Aytül; Ekici, Aydanur; Ekici, Mehmet; Arslan, Mesut; İteginli, Ahmet; Kurtipek, Ercan; Kara, TürkanObjective: Gun factory workers are exposed to many solvents (toluene, acetone, butanol, xylene, benzene, trichloroethylene). We investigated whether chronic exposure to solvents had adverse effect on respiratory system. Material and methods: The workers were questionnaired by modified Medical Research Council's respiratory questionnaire before morning start shift. Then physical examination and measurement of pulmonary functions by portable dry rolling spirometer were performed. The study group consisted of 1091 gun factory workers. The workers were grouped according to their smoking habits (smokers, [exposed n: 353 vs. unexposed n: 339] and non-smokers [exposed n: 58 vs. unexposed n: 341]). Asthma-related symptoms were defined as either definite asthma, probable asthma, and possible asthma. Results: In non-smokers, the report of asthma-related symptoms was more prevalent in exposed workers than unexposed (39.7% vs. 21.7% OR 2.4[l.3-4.3], respectively P=0.003). In smokers, the report of asthma-related symptoms was more common in exposed group than unexposed (50.7% vs. 42.5% OR 1.4[l.0-1.9], respectively P=0.03). Logistic regression analysis showed that smoking (OR 2.8 [2.0-3.8] P=0.00001) and exposure to solvents (OR 1.4[l.1-1.9] P=0.01) were independent risk factors for asthma-related symptoms, after adjusting for age. Logistic regression analysis identified that smoking (OR 3.3[2.3-4.6] P=0.00001) was independent risk factors for chronic bronchitis. Multiple linear regression analysis of lung-function parameters (% forced expiratory volume (FEV1), FEV1/forced vital capacity, FEF25-75) indicated significant effects of smoking. Conclusion: Present study indicated significant effects of smoking and exposure to solvents, with the smoking effect being the most important on asthma-related symptoms of gun factory workers. © 2003 Elsevier Ltd. All rights reserved.Öğe Serum Leptin Levels in Asthma, COPD and Bronchiectasis(Derman Medical Publ, 2015) Kurtipek, Ercan; Kalpaklioglu, Aye Fusun; Kisa, UslerAim: The aim of the present study is to compare body mass indexes (BMI) and serum leptin levels of most frequently observed three chronic airway diseases; namely, Asthma, Chronic Obstructive Pulmonary Disease (COPD) and bronchiectasis. Material and Method: The study included a total of 216 people, 78 asthma, 67 COPD, and 37 bronchiectasis patients who were in stable period and 34 healthy individuals all aged above 18. Control group consisted of non-smokers and non-corticosteroid users. Of all the participants, the blood samples were taken in order to determine serum leptin levels and BMI were calculated, and pulmonary function tests measured at rest. Results: The BMI levels of all the groups was above >25 kg/m2. There were no statistical differences between the control and patient groups with regard to BMI (p>0.05). Comparing patient groups, the BMI of asthma patients was higher than those with COPD and bronchiectasis (29.84 +/- 6.46, 25.78 +/- 4.96, 27.64 +/- 5.19, p=0.0001, p=0.20). FEV1 results of COPD patients were lower than those with asthma and bronchiectasis (63.25 +/- 19.26, 76.73 +/- 20.35, 72.75 +/- 20.17 and p=0.0001, p=0.06). Serum leptin levels of asthma patients were higher than the COPD, bronchiectasis patients, as well as that of the control group (12.36 +/- 11.16 ng/ml, 3.35 +/- 4.71 ng/ml, 8.49 +/- 7.85 ng/ml and 5.21 +/- 6.83 ng/ml, p=0.0001, p=0.09 and p=0.0001, respectively). Serum leptin level of COPD patients was lower than control group, but it was not statistically significant (p=0.71). Serum leptin levels of the patients with bronchiectasis were higher than healthy control group members; yet, not statistical significant (p=0.34). However serum leptin levels of the patients with bronchiectasis were higher than the patient COPD groups and this was statisticaly significant (p=0.01). Istatistically significant different emerge on comparing serum leptin levels and BMI of the asthma, COPD and bronchiectasis patients in the Lineear regression analysis made (beta=0.80, p=0.0001, beta=0.32, p=0.006 ve beta=0.82, p=0.0001 respectively). The relation between serum leptin levels and BMI of the healty control group members were not found statistically significant (beta=0.36, p=0.13). Discussion: Among the chronic airway disesases, only in patient with asthma serum leptin levels could be considered and a predictor.
