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Öğe Annual Changes in Forced Expiratory Flows in Toll Collectors: Results from a Four Years Observation(NATL INST OCCUPATIONAL SAFETY & HEALTH, JAPAN, 2009) Arbak, Peri; Balbay, Oener; Annakkaya, Ali Nihat; Bilgin, Cahit; Ozsahin, Sefa LeventDiesel exhaust (DE) has been accused for various health outcomes including exacerbation of asthma, chronic bronchitis. Exposure to DE has long-term effects on lung development in children and reductions in lung function have been reported. The aim of the study was to evaluate the annual changes in forced expiratory flows among toll collectors in Duzce city from 2002 to 2005. Annual FVC, FEV1 and MMF changes in smoker and nonsmoker 58 toll collectors and 37 controls selected among men who worked in the same company as officer have been followed up. No significant changes were seen in expiratory flows among smoker-nonsmoker toll collectors and controls (p>0.05). Annual FVC, FEV1 and MMF changes were not significantly different between smoker and nonsmoker toll collectors. Twelve toll collectors (20.7%) in the study group and 4 (10.8%) controls were found to have FEV1 and FVC below longitudinal lower limit of normal. The difference between groups did not reach statistically significance (p>0.05). Toll collectors (18/58) and controls (15/37) with spirometric measurements for three times showed no difference according to the rate of annual difference in either FEV1 (-21.3 +/- 133.1 ml/yr vs -44.3 +/- 166.6 (ml/yr) or FVC (13.2 +/- 202.9 ml/yr vs. -16.1 +/- 204.2 ml/yr). Further investigations including large groups with long term follow up are needed to observe annual FVC, FEV1 and MMF changes among toll collectors.Öğe Bronchial Wall Thickness in Toll Collectors(NATL INST OCCUPATIONAL SAFETY & HEALTH, JAPAN, 2010) Safak, Alp Alper; Arbak, Peri; Yazici, Burhan; Bilgin, Cahit; Erdogmus, Besir; Annakkaya, Ali Nihat; Ozsahin, Sefa LeventThere is an increasing concern about the possible adverse effects of diesel exhaust particulates on human health. In a diesel exposed occupational group composed of 120 toll collectors, a cross-sectional study was performed to evaluate the chest radiographs and 40 toll collectors were selected for computed tomography examination according to hyperinflation and linear markings. The wall thicknesses and luminal diameters of trachea, main bronchi, and segmental bronchi of right apical and posterior basal segments were measured with manual tracing method. The walls of right upper bronchus in exsmoker toll collectors were significantly thicker than those of nonsmokers (p=0.011). A positive correlation was observed between age and the right upper bronchus wall thickness (r=0.577, p=0.000). An inverse correlation was found between the working duration and the diameter of right main bronchus (r=-0.366, p=0.020). A positive correlation was seen between smoking and the right upper bronchus wall thickness (r=0.457, p=0.005). Diesel exposure might have a role in increase of thickness of large airways wall and a decrease in the diameters of large airways. Studies in this area are needed to protect the population under the diesel exposure risk.Öğe Chest X-ray and bacteriology in the initial phase of treatment of 800 male patients with pulmonary tuberculosis(SOC BRASILEIRA PNEUMOLOGIA TISIOLOGIA, 2011) Ozsahin, Sefa Levent; Arslan, Sulhattin; Epozturk, Kursat; El, Remziye; Dogan, Omer TamerObjective: To evaluate chest X-rays of patients with pulmonary tuberculosis and to determine whether the extent of radiographic lesions correlates with bacteriological parameters. Methods: In this retrospective, descriptive study, we evaluated chest X-rays, as well as AFB detection by smear microscopy and culture for Mycobacterium tuberculosis, initially and during the first two months of treatment, in 800 male patients hospitalized between 1995 and the present at a 250-bed hospital in northwestern Turkey. Results: The initial mean ESR was 58 +/- 37 mm/h. Initial sputum smears and cultures were positive in 83.8% and 89.5% of the patients, respectively. After the first month of treatment, the proportion of patients with positive sputum culture was higher among those with cavitary tuberculosis than among those with non-cavitary tuberculosis (53.7% vs. 37.7%, p < 0.001). The number of affected zones was not correlated with age, symptom duration, contact with an active tuberculosis patient, or concomitant diabetes (p > 0.05 for all) but was positively correlated with the ESR (r = 0.23, p < 0.001). During the first and second months of treatment, conversion to smear-negative status was less common in patients with bilateral involvement than in those with unilateral involvement (p < 0.001 and p = 0.002 for months 1 and 2, respectively). Disease extent did not correlate with age, symptom duration, contact with an active tuberculosis patient, or concomitant diabetes but did correlate with delayed bacteriological recovery. Conclusions: Chest X-ray and bacteriology are valuable tools for the evaluation of pulmonary tuberculosis.Öğe CLINICO-PATHOLOGICAL CHARACTERISTICS IN YOUNG AND ELDERLY PATIENTS WITH LUNG CANCER(GUNES KITABEVI LTD STI, 2011) Arslan, Sulhattin; Ozsahin, Sefa Levent; Akkurt, IbrahimIntroduction: The aim of the present study was to determine the differences between the clinico-pathological characteristics of lung cancers among elder and young patients Materials and Method: 160 patients with lung cancer were included in the study retrospectively. Age, gender, diagnostic methods, performances, accompanying diseases and histological types of the cancer of patients were all investigated. Patients were divided into two groups; the younger group, under 65 years of age and the elderly group, over 65 years of age. Both groups were compared according to the clinico-pathological features. Results: There were 124 patients (13 female, 111 male) in the younger group, 36 patients (3 female, 33 male) in the elderly group. Medical comorbidity was significantly higher (p=0.045) in the elderly group. Coughing -expectoration rate was statistically higher (p=0.014) in the younger group. Hemoptysis was significantly higher (p=0.018) in the elderly group. Poor performances were significantly higher (p=0.008) in the elderly group. Adenocarcinoma of the lung was more frequent (p=.0.037) among the younger group whereas squamous cell cancer incidence was higher (p=0.049) in the elderly group. Conclusion: While coughing-expectoration symptoms and the lung adenocarcinoma were significantly higher in the younger group, hemoptysis, medical comorbidity, poor performance and the squamous cell carcinoma were sigficantly more frequent in the elderly group.Öğe Comparing Two Different Clinical Scoring Systems for the Diagnosis of Pulmonary Thromboembolism(Aves, 2008) Berk, Serdar; Dogan, Omer Tamer; Ozsahin, Sefa Levent; Akkurt, IbrahimIntroduction: The most important stage while diagnosing the pulmonary thromboembolism is suspicion of the clinical findings, various clinical, radiological, laboratory investigations and clinical possibility methods that are used for diagnosing pulmonary thromboembolism. Two of these methods are the Wells and Geneva methods. The aim of this study is to compare the value of these two methods for diagnosing pulmonary thromboembolism. Material and Method: The study included 173 patients, 90 (52%) of whom were considered as having a pulmonary thromboembolism and were administered medical therapy, and 83 (48%) were not considered as pulmonary thromboembolism cases. Results: All the patients were evaluated according to the Wells and Geneva methods. In the patients considered as pulmonary thromboembolism cases according to the Wells method clinical possibility groups, the rates are calculated as 100%, 84%, and 1% in high, moderate and low risk groups respectively. According to the Geneva method clinical possibility groups, the rates are calculated as 72%, 53%, and 37% in high, moderate and low risk groups respectively. These two methods are statistically valuable (p<0.05) in making the diagnosis of pulmonary thromboembolism. The value of these two methods for diagnosing pulmonary thromboembolism, both clinical possibility scores and risk groups, are compared with the ROC curve. The area under the curve (AUC) for clinical possibility scores was calculated as 0.97 for Wells method and 0.60 for Geneva, and AUC for risk groups was calculated as 0.92 for Wells method and 0.60 for Geneva. Conclusion: In conclusion the Wells method calculation is more valuable for diagnosing pulmonary thromboembolism.Öğe Comparison of some characteristics of the tuberculosis patients of Sivas Tuberculosis Dispensary(Aves, 2008) Dogan, Omer Tamer; Berk, Serdar; Ozsahin, Sefa Levent; Cakmak, Evrim; Akkurt, IbrahimAim: Mass investigation for tuberculosis (TB) detection had been abandoned many years ago, however, contact tracing is still an important component of TB control. The aim of this study was to investigate the differences of the parameters age, sex, bacteriological status, and outcomes between two diagnostic methods (contact tracing, n=305 and passive method, n=6799). Material and methods: Data source was Sivas Tuberculosis Dispensary register. Results: Mean age was 19.5 +/- 0.93 in the contact cases and 34.4 +/- 0.21 in the passive method group (p<0.0001). Female ratio in the contact cases was 43%, whereas it was 53% in the passive method cases (p<0.001). Pulmonary TB ratio in the contact cases group was significantly higher than in the passive method cases group (92.5% versus 83%; p<0.001). The ratio of smear (+) reporting in the passive method cases group was 12.05% and in the contact cases group it was 15.41% (p < 0.001). M. tuberculosis culture (+) reporting in the passive method cases group was 15% and in the contact cases group it was 18% (p<0.001). Abandonment, transferred, death and treatment completion had reported 44%, 1.3%, 2.95%, 49% in the contact cases group and, 37.6%, 4%, 5.7%, 50% in the passive method cases group, respectively (p<0.011). Mean age was lower and female ratio was higher in contact cases group. Conclusion: PTB reported in contact cases is more than extra pulmonary TB reporting. Clinic-radiological diagnosis was much more reported in patients found by passive method than in contact cases. Relatively few death rates in contact cases appeared to be associated with their mild clinical conditions.Öğe Diagnostic usefulness of pregnancy-associated plasma protein-A in suspected pulmonary embolism(BIOMED CENTRAL LTD, 2013) Berk, Serdar; Dogan, Omer Tamer; Aydemir, Eylem Itir; Bingol, Asli; Ozsahin, Sefa Levent; Akkurt, IbrahimBackground: The role of biomarkers for prognostication and diagnosis of pulmonary embolism (PE) is increasing. It has been reported that pregnancy-associated plasma protein-A (PAPP-A) can be used as a proatherosclerotic marker. The present study was aimed to evaluate whether PAPP-A levels are helpful in the differential diagnosis of patients presenting with suspected PE. Methods: 53 consecutive patients evaluated for suspected PE were prospectively enrolled in the study. Serum PAPP-A levels were measured in the blood samples which were taken at admission. Multi-slice computed tomographic angiography was used to verify the diagnosis of PE. Results: PE was detected in 24 out of the 53 patients, while it was excluded in 29 patients by thorax multi-detector computerized tomography scan. No significant difference was detected in mean serum PAPP-A level between groups (5.72 +/- 0.31 mg/L vs. 5.67 +/- 0.06 mg/L, respectively). Conclusions: Serum PAPP-A level has no role in the evaluation for PE.Öğe EMOTIONAL DISORDERS AMONG TURKISH UNDERGRADUATE MEDICAL STUDENTS(PROFESSIONAL MEDICAL PUBLICATIONS, 2008) Nur, Naim; Cetinkaya, Selma; Sabanciogullari, Vedat; Ozsahin, Sefa Levent; Kavakci, OnderObjective: Large numbers of medical student are reported to be suffering from emotional health problems in recent years. Its severity has also increased throughout the world. The aim of the current study was to determine the prevalence of emotional disorders (ED) and to assess risk factors among medical students. Methodology: A total of 493 students were included in the current cross sectional study. The Twelve Item General Health Questionnaire (GHQ-12) was voluntarily answered by medical students in the first to the fifth year class. Results : A total of 27.8% of medical students were found to have emotional disorders (ED) in the presented study. Factors found to have a significant association with ED were relationship of the respondents with their parents, siblings, lecturers, course mates, boy/girlfriend as well as pressure prior to examinations and periods of training in medical school. No difference was found between gender and age groups. Conclusion: Current results showed the prevalence of emotional disorders (ED) in crucial levels among the medical students. It is suggested that medical schools authorities should be aware of these problems and take effective measures to address them.Öğe Emotional disorders among Turkish undergraduate medical students(2008) Nur, Naim; Cetinkaya, Selma; Sabanciogullari, Vedat; Ozsahin, Sefa Levent; Kavakci, OnderObjective: Large numbers of medical student are reported to be suffering from emotional health problems in recent years. Its severity has also increased throughout the world. The aim of the current study was to determine the prevalence of emotional disorders (ED) and to assess risk factors among medical students. Methodology: A total of 493 students were included in the current cross sectional study. The Twelve Item General Health Questionnaire (GHQ-12) was voluntarily answered by medical students in the first to the fifth year class. Results : A total of 27.8% of medical students were found to have emotional disorders (ED) in the presented study. Factors found to have a significant association with ED were relationship of the respondents with their parents, siblings, lecturers, course mates, boy/girlfriend as well as pressure prior to examinations and periods of training in medical school. No difference was found between gender and age groups. Conclusion: Current results showed the prevalence of emotional disorders (ED) in crucial levels among the medical students. It is suggested that medical schools authorities should be aware of these problems and take effective measures to address them.Öğe A Frame-Shift Mutation in the SLC34A2 Gene in Three Patients with Pulmonary Alveolar Microlithiasis in an Inbred Family(JAPAN SOC INTERNAL MEDICINE, 2010) Dogan, Omer Tamer; Ozsahin, Sefa Levent; Gul, Eylem; Arslan, Sulhattin; Koksal, Binnur; Berk, Serdar; Ozdemir, Ozturk; Akkurt, IbrahimPulmonary alveolar microlithiasis (PAM) is a rare disease characterized by the presence of small calculi in the alveolar space. The SLC34A2 is thought to be responsible for the disease. We encountered three siblings of an inbred family who have PAM. We examined the family of the proband who was admitted with dyspnea on exertion and cough, and eventually was diagnosed with PAM. Genetic analysis revealed that both parents (a consanguineous marriage) of the proband were carriers with heterozygous mutation of SLC34A2 gene, and three of their children were diagnosed with PAM with homozygous mutation in the SLC34A2 gene. These findings suggest that impaired activity of the SLC34A2 gene may be responsible for familial PAM.Öğe Habitual snoring in primary schoolchildren: prevalence, risk factors and school performance(DRUNPP-SARAJEVO, 2010) Arslan, Sulhattin; Ozsahin, Sefa Levent; Dogan, Oemer Tamer; Berk, Erdar; Akkurt, IbrahimObjective: We aimed to determine the prevalence of snoring in primary school children in Sivas city and to evaluate the nighttime and daytime symptoms and learning problems that may be associated with sleep problems in these children. Subjects and Methods: The questionnaire was distributed to children by their teachers at the school and was filled out by their parents. Results: Of the 2196 given questionnaires, 1952 (88.7%) were filled in adequately and were included in the evaluation. Of the students, 50.9% were girls and 49.1% were boys. The mean age of the students was 10.27 +/- 2.25 years. The prevalence of habitual snoring was 4.9%. Occasional snoring and habitual snoring were significantly more prevalent in the boys than in the girls. Habitual snorers had significantly more nighttime symptoms, such as witnessed apneas (odds ratio [OR], 22.07; 95% confidence interval [CI]; 8.64-563.4), difficulty breathing (OR, 68.46; CI, 12.11-290.76), nocturnal enuresis (OR, 4.12; CI, 1.49-11.33), compared to never snorers. There were also increased prevalence of daytime symptoms, such as falling asleep while watching television (OR, 4.67; CI, 2.63-8.26) and morning headache (OR, 4.53; CI, 2.31-8.87). The presence of predisposing factors (frequent colds, frequent tonsillitis, hay fever, and history of tonsillectomy, etc.) increased the likelihood of habitual snoring. Conclusion: Both nighttime symptoms (apnea, difficulty breathing, restless sleep, nightmares, bruxism, etc.) and daytime symptoms (falling asleep in public places, morning headache, etc.) were highly correlated with habitual snoring in children and habitual snoring was related with parent-reported poor school performance.Öğe Paradoxical Reactions in Tuberculosis Treatment: Mechanisms, Diagnosis and Approach(Bilimsel Tip Yayinevi, 2024) Buyuktuna, Seyit Ali; Kurtaran, Behice; Ozsahin, Sefa Levent; Senol, Gunes; Kilic, Aysegul Ulu; Tasbakan, MeltemParadoxical reactions (PR) refer to the worsening of clinical manifestations of tuberculosis (TB) after the initiation of TB treatment, particularly occurring during the recovery of immune function in immunocompromised individuals. This syndrome is also known as immune reconstitution inflammatory syndrome and is more common in human immunodeficiency virus (HIV)-infected individuals after the initiation of antiretroviral therapy (ART). Although the mechanisms of PR are not fully understood, excessive inflammatory responses triggered by increased antigen load and rapid immune response are considered the main cause. This is associated with a strong T-cell response to antigens of Mycobacterium tuberculosis. Paradoxical reactions in HIV-positive individuals after ART initiation is characterized by a sudden and intense activation of TB-fighting immune cells. Symptoms of PR include fever, lymphadenopathy, pulmonary infiltrates, and enlargement of existing TB lesions. A major diagnostic challenge is the exclusion of TB treatment-resistant mycobacterial infections or other infections. Management of PR mainly involves the continuation of TB and HIV treatment. Anti-inflammatory drugs, such as corticosteroids, can be used in severe PR cases. By reducing inflammation, corticosteroids can relieve the symptoms of the disease and improve the quality of life. However, the use of these drugs should be carefully monitored and side effects should be considered. Enhancing our understanding of the mechanisms behind paradoxical reactions and developing effective management strategies could significantly advance the fight against TB and HIV. This review aims to explore the mechanisms, diagnosis, and management strategies of paradoxical reactions in tuberculosis treatment.Öğe Performance of regional tuberculosis dispensaries in a province of Turkey in pre-DOTS era (1989-2002)(DRUNPP-SARAJEVO, 2010) Ozsahin, Sefa Levent; Arslan, Sulhattin; Dogan, Omer Tamer; Berk, Serdar; Akkurt, IbrahimBackground: In recent years, very few dispensary staff has been striving to apply directly observed therapy (DOT) elsewhere in Turkey, but the overwhelming majority of TB dispensaries still continue their usual practice today. Therefore, practice of any regional TB dispensary may mirror Turkey's Tuberculosis Programme practice profile. Method: Statistical Year Books of Sivas Province Health Department (from 1989 to 2002) are the main sources of data. The mid-year population numbers obtained from Statistical Year Books of Sivas Province Health Department were preferred for calculating annual incidences. Pearson's correlation coefficients and, if data ordinal, Spearman's correlation coefficients were used to determine correlations. Results: There are three TB dispensaries in the Sivas Province. Total staff number at Sivas TB dispensaries decreased within years (r = -0.92, p < 0.001). TB incidence declined within years, also(r = -0.87, p < 0.0001). Chest X-ray examinations gradually decreased within years from 20,416 examinations in 1989 to 5856 examinations in 2002 (r = -0.75, p = 0.002). Annual microscopic examinations for acid-fast bacilli (AFB) declined within years with 1400 microscopy done in 1989 decreased to 445 examinations in 2002 (r=-0.62, p=0.018). Per each TB patient, the annual mean microscopy for AFB examination was 4.49 +/- 1.47 and the mean chest radiography was 8.25 +/- 3.27 at local dispensaries in this fourteen-year period. The annual tuberculin skin test (TST) and Bacillus Calmette-Guerin (BCG) vaccinations per 100,000 population performed by local dispensaries did not statistically different within years (r = -0.45, p = 0.106 and, p = -0.15, p = 0.605, respectively). Conclusion: TB incidence declined within years, but this situation seems to be not related with improving of dispensaries performance.Öğe Physicians' conceptions about various continuing medical education activities and the rol of pharmaceutical industry Continuing medical education and pharmaceutical industry(DRUNPP-SARAJEVO, 2009) Nur, Naim; Ozsahin, Sefa LeventObjective: Scientific conferences, newsletter circulars, etc. provided by pharmaceutical industry and relationship with members of the industry, have become sources of continuing medical education (CME) activities for physicians. The aim of this study was to determine the perceived importance of various CME activities and physician-pharmaceutical industry relations. Materials and methods: This cross-sectional face to face interview study was carried out in Sivas centre, province of Turkey, during January April 2008. All physicians working in the public sector were targeted as participants in the current study. Results: Attending professional local congresses or CME courses was reported to be the most important sources of information, followed by abroad congresses or CME courses and, reading medical journals (72.7%, 70.1% and 68.8%, respectively). Attending to abroad congresses or CME courses were significantly important among women and young physicians (p=0.001) and reading medical journals were significantly higher in young physicians (p=0.002), while the importance level of own experience were significantly higher among relatively older ones (p=0.001). About half of participant (48.7%) stated that relationship between pharmaceutical industries and physicians are important in their clinical practice. Thereputation of the pharmaceutical firms was of the foremost important (84.6%) for all physicians, especiallly relatively older physicians (p=0.04). Conclusions: Our survey provides an important knowledge of perceived importance of CME activities for physicians and described a crucial level of acceptance for the involvement of the pharmaceutical, industry in CME activities.Öğe Pulmonary toxicity of chronic exposure to tobacco and biomass smoke in rats(HOSPITAL CLINICAS, UNIV SAO PAULO, 2011) Dogan, Omer Tamer; Elagoz, Sahande; Ozsahin, Sefa Levent; Epozturk, Kursat; Tuncer, Ersin; Akkurt, IbrahimOBJECTIVE: The objective of this study was to examine the separate and combined effects of tobacco and biomass smoke exposure on pulmonary histopathology in rats. INTRODUCTION: In addition to smoking, indoor pollution in developing countries contributes to the development of respiratory diseases. METHODS: Twenty-eight adult rats were divided into four groups as follows: control group (Group I, no exposure to tobacco or biomass smoke), exposed to tobacco smoke (Group II), exposed to biomass smoke (Group III), and combined exposure to tobacco and biomass smoke (Group IV). After six months the rats in all four groups were sacrificed. Lung tissue samples were examined under light microscopy. The severity of pathological changes was scored. RESULTS: Group II differed from Group I in all histopathological alterations except intraparenchymal vascular thrombosis. There was no statistically significant difference in histopathological changes between the subjects exposed exclusively to tobacco smoke (Group II) and those with combined exposure to tobacco and biomass smoke (Group IV). The histopathological changes observed in Group IV were found to be more severe than those in subjects exposed exclusively to biomass smoke (Group III). DISCUSSION: Chronic exposure to tobacco and biomass smoke caused an increase in severity and types of lung injury. CONCLUSION: Exposure to cigarette smoke caused serious damage to the respiratory system, particularly with concomitant exposure to biomass smoke.Öğe Significance of serum cardiac troponin I levels in pulmonary embolism(AME PUBL CO, 2012) Kilinc, Gonca; Dogan, Omer Tamer; Berk, Serdar; Epozturk, Kursat; Ozsahin, Sefa Levent; Akkurt, IbrahimBackground: Some biomarkers can be helpful in the diagnosis of pulmonary embolism (PE) and determining of severity and prognosis of the disease. In this study, we aimed to analyze the elevated cardiac troponin I (cTnI) levels and its association with electrocardiography (ECG) and transthoracic echocardiography (IT E) findings in patients with PE. Methods: Totally 106 patients with suspected PE were included in the study. PE was confirmed in 63 of them, whereas it was excluded in the remaining 43 patients. Levels of cTnI were measured in all patients before the prescription of the anticoagulation therapy. Results: High cTnI levels were found in 50.8% of patients with PE, and in 11.6% of patients without PE (P<0.001). Sensitivity and specificity of the test for the diagnosis of PE were 50.7%, 88.3% respectively. ECG findings were similar in PE patients having either elevated or normal cTnI levels. Approximately 75% of the PE patients with high cTnI had normal ECG findings; the most conunon pathological changes seen in ECG were S1Q3T3 pattern (similar to 31%). TTE findings were not found to be distinguishing in the patients with suspected PE and high cTnI levels. Pulmonary hypertension (PHT) was the most common echocardiographic finding (similar to 74%) in patients with PE and elevated cTnI levels. However, there was not a statistically significant difference between TTE findings in PE patients with increased and normal cTnI levels. Conclusions: In patients presenting with clinical, electrocardiographic and echocardiographic features suggesting pulmonary embolism, increased serum cTnI levels endorse the diagnosis of severe PE.Öğe Symptom prevalance of obstructive sleep apnea-hypopnea syndrome in health-care providers in central Sivas(Turkish Assoc Tuberculosis & Thorax, 2008) Dogan, Omer Tamer; Berk, Serdar; Ozsahin, Sefa Levent; Arslan, Slhattin; Duzenli, Hasan; Akkurt, IbrahimObstructive sleep apnea-hypopnea syndrome (OSAHS) is the most common sleep disorder that can lead to serious complications. Polysomnography (PSG) is the gold standard for the diagnosis of OSAHS. Unfortunately, PSG studies are expensive, time-consuming, requiring special team and equipment. Therefore, it is possible to determine the cases likely to have OSAHS requiring at least PSG by type A studies. There isn't enough data about the prevalence of OSAHS in Turkey. The aim of this study was to estimate the symptom prevalence of OSAHS in health-care providers in central Sivas. The questionnaire asking demographic features, additional diseases, habits, the symptoms related with OSAHS was performed in total of 1202 health care providers. We also performed Epworth sleepiness scale (ESS) to determine excessive daytime sleepiness. Snoring was detected in 267 partitiants. Snoring rates were 38% and 10.9% in men and in women, respectively. The rate of witnessed sleep apnea in all cases was 4.4% (n=53). Witnessed sleep apnea was reported by 42 of men (8.4%) and 11 of women (1.6%). A total of 338 partitiant had excessive daytime sleepiness. There was a significant relation between three major symptoms of OSAHS and excessive sleepiness while driving. All three major symptoms were detected in 22 cases (1.8%), of which 21 were males. This study suggested that OSAHS symptom prevalence is quite high helth-care provides in our region and, therefore expanded usage of PSG studies is required.Öğe The effects of long-term oxygen therapy on survey in patients with chronic respiratory failure(Turkish Assoc Tuberculosis & Thorax, 2008) Duzenli, Hasan; Dogan, Omer Tamer; Berk, Serdar; Ozsahin, Sefa Levent; Akkurt, IbrahimLong-term (>= 15 hours) oxygen therapy (LTOT) increases life-span and improves quality of life (QOL) in patients with chronic respiratory failure (CRF). However, in our clinical practice, we observed that very few patients are using oxygen therapy 15 hours or more. Furthermore, very few literatures about survival of non-or inadequate oxygen users were found. Thus, the aim of this study was to assess the effect of LTOT in patients with CRF. A total of 305 LTOT recommended patients with CRF in our clinic between 1996 and 2001 were found. A hundred and five patients with documented subject characteristics were included the study and followed-up similar to 20 months prospectively. They were divided into two groups whether to take LTOT (group 1, n= 71) or not (group 2, n= 34). Average life-span of the patients was 50 months in group 1 and 39 months in group 2 (p< 0.05). Survival (months) in group 1 was significantly correlated with hrs of oxygen use (r= 0.684, p= 0.001). One more hour oxygen use was statistically significantly correlated with 0.002 months more survival (F= 48.44, p< 0.05) in group 1 in logistic regression analysis. In comparisons, there were significant improvement in the post-treatment blood gas values in group 1 (p< 0.05). There were significant decreases in PFT values in the post-treatment period when compared to baseline values in both groups (p< 0.05). There was a less decrease in FEV1 values per year in group 1 than group 2 but difference was not statistically significant (p> 0.05). In conclusion our findings revealed that LTOT provides improvement of the life-span of the patients with CRF.Öğe The prevalence of sleep related disorders among the drivers and it's relation with traffic accidents(Turkish Assoc Tuberculosis & Thorax, 2006) Dogan, Omer Tamer; Dal, Ugur; Ozsahin, Sefa Levent; Akkurt, Ibrahim; Seyfikli, ZehraStudies consistently show that patients with sleep related diseases (SRD) have higher accident rates. Polysomnography (PSG) is the gold standard for the diagnosis of SRD. Sleep habits questionnaires are also useful tool for research of the prevalence of SRD on large populations. The aim of this study is to investigate the prevalence of SRD and SRD related traffic accidents on the whole population of professional drivers in Sivas city. A questionnaire that includes questions about drivers' background such as how long they have been driving, if they had any accidents, and if they drive just in Sivas city or inter state. This questionnaire composed of 50 questions about SRD and was asked to drivers answer them face to face. Three hundred forty male drivers participated for this study. Their mean age was 39.5 +/- 9.3 (21-68) years. The mean driving duration was 13.3 +/- 7.9 years. The percentage of drivers who drove in Sivas was 52.1% and 47.9% of the drivers drove inter state. The percentage of drivers who had at least one accident was 36.3%. The prevalence of habitual snoring, insomnia, sleep apnea, nocturnal myoklonus were 41.2%, 39.1%, 32.9%, and 33.6% respectively. The traffic accident Odds ratio was 1.619 for drivers with habitual snoring (95% CI, 1.034 to 2.536, p= 0.02). In conclusion, this study found out that drivers with habituel snoring seems to have tendency (approximately 2-folds) of involving in traffic accidents than drivers who do not have habituel snoring. Polysomnography of candidate drivers with sleep disordered symptoms has to be logical before giving to driving license.Öğe Thoracic Computed Tomography Findings in Malignant Mesothelioma(KOWSAR PUBL, 2012) Dogan, Omer Tamer; Salk, Ismail; Tas, Fikret; Epozturk, Kursat; Gumus, Cesur; Akkurt, Ibrahim; Ozsahin, Sefa LeventBackground: Malignant pleural mesothelioma (MPM) is an uncommon neoplasm. MPM occurs more frequently in patients born or living in certain villages of Turkey. Objectives: We aimed to review radiological findings of MPM. Patients and Methods: We reviewed the CT findings in 219 biopsy-proven MPM patients admitted to our clinic between 1993 and 2008. Results: The most common CT findings included pleural thickening (n = 197, 90%) classified as diffuse (n = 138, 63%), nodular (n = 49, 22%) and mass-type (n = 16, 7%). Pleural effusion was found in 173 patients (79%), involvement of the interlobar fissures in 159 (73%), mediastinal pleural involvement in 170 (78%), volume contraction in 142 (65%), mediastinal shift in 102 (47%) and mediastinal lymphadenopathy in 54 (25%). Conclusion: MPM may present with diverse radiological features. Pleural thickening and pleural effusion were the most frequent radiological findings. Thoracic CT scans might be assessed more cautiously in patients with environmental exposure to asbestos.
