Ozlem Salman Sever

The effect of adding gender item to Berlin Questionnaire in determining obstructive sleep apnea in sleep clinics.

Background and Aim: We aimed to validate the Turkish version of Berlin Questionnaire (BQ) and developped a BQ-gender (BQ-G) form by adding gender component. We aimed to compare the two forms in defining patients with moderate to severe obstructive sleep apnea (OSA) in sleep clinics. Methods: Four hundred and eighty five consecutive patients, refered to our sleep clinic for snoring, witnessed apnea and/or excessive daytime sleepiness were enrolled to the study. All patients underwent in-laboratory polysomnography (PSG). Patients with sleep efficiency less than 40% and total sleep time less than 4 hours, chronic anxiolitic/sedative drug usage, respiratory tract infection within past two weeks were excluded from the study. All the patients fulfilled BQ. The test and retest for BQ were applied in 15-day interval in 30 patients. Results: Totally 433 patients were enrolled to the study (285 male, 148 female).The mean age of the patients was 47,5 ± 10.5 (21-79). 180 patients (41.6%) had apnea-hypopnea index (AHI) ≤ 15, while 253 patients (58,4%) had AHI > 15. The κ value was 48–94 and the the truth value was 69-94% for the test-retest procedure. Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and area under the curve AUC were 84.2%, 31.7%, 48.7%, 63.4%, and 0.579 in order for BQ and 79.9 %, 51.7%, 63.2% , 69.6%, and 0.652 for BQ-G. Conclusion: The results showed that BQ-G is relatively better than BQ in determining moderate to severe OSA in sleep clinics where most of the patients are sleep apneic but both of the tests were found to have insufficient validities in defining moderate to severe OSA in sleep clinics.

The effect of smoking on QuantiFERON results in diagnosis of latent tuberculosis infection

Despite the promising results of QuantiFERON-TB test (QFT) in diagnosis of latent tuberculosis infection (LTBI) ,false negative or indetermined test results are well documented in diffrent study settings. Cigarette smoking is known to reduce the interferon gamma (IFN-γ) response to antigenic challenge.But the influence of smoking on QTF test performance to diagnose LTBI among healthy subjects is unknown. The aim of this study to evaluate the effect of smoking on QFT test performance in healty subjects in intermidate TB prevalence setting. Method: 240 donor candiddates for organ transplantation (110 women, 130 men) with a mean age 42,5± 12,3 involved in this study. Patients recruited prospectively between March 2014 and March 2015. Their demographic features, smoking history, QTF test levels and results were recorded. The risk of LTBI was evaluated via questionnaire consisting the history of occupation, high probability for TB exposure, Isoniazide prophlaxis and radiologic (chest Xray or thorax Ct scan) findings related to sequelae tuberculosis lesion. Smoking was analysed as a risk factor for false negative QFT results. Results: In the study group 128 (% 53) subjects had negative smoking history, 31 (%12,9) were quited and 80(%33) were active smokers. When we analyse the QTB results; sattistically higher quantitative MTB specific response were observed in non smokers (3,09±3,6 ; 1,6±3,1 p= 0,027). False nefative result rate were high among smokers than nonsmokers (29 % 76,3 vs 9 %23,7; p Conclusion: Smoking has a role in QFT false negative results, causing a decrease of QFT sensitivity in helathy population.