Öznur Akkoca Yildiz

Health-Related Quality of Life in Patients with Sleep-Related Breathing Disorders: Relationship with Nocturnal Parameters, Daytime Symptoms and Comorbid Diseases

Background: Sleep-related breathing disorders (SRBD) are frequently encountered health problems in the general population. Habitual snoring and obstructive sleep apnea/hypopnea syndrome (OSAHS) constitute most SRBD diagnoses. Although the decrease in quality of life is a well-known entity in SRBD patients, there is not enough data regarding the underlying pathophysiological mechanisms to explain this deterioration. Objectives: The aim of this study was to investigate which parameters were affecting the quality of life in patients with SRBD. Methods: Medical Outcome Survey – Short Form 36 (SF-36) and Epworth Sleepiness Scale were used in 135 patients with SRBD (69 patients with OSAHS and 66 patients with habitual snoring), and Charlson comorbidity index was calculated. Acquired data were compared with leading symptoms and polysomnographic findings in these patients. Results: All SF-36 scores were significantly decreased in SRBD patients. However, there were no significant differences in the SF-36 scores of these patients. Also, no significant correlation was found between the severity of OSAHS and the SF-36 scores. Similarly, none of the polysomnographic parameters was found significantly correlated with SF-36 scores. In contrast, all SF-36 scores were influenced by body mass index, Epworth Sleepiness Scale score, mean nocturnal saturation and the presence of coexisting diseases. Conclusions: According to the results of multiple variance analysis, we concluded that the quality of life depends on a number of collaborative factors such as obesity, mean nocturnal saturation, symptoms related to SRBD and the presence of comorbid diseases, rather than only on one independent parameter in the patients with SRBD.

Evaluation of the relationship between radiological abnormalities and both pulmonary function and pulmonary hypertension in coal workers’ pneumoconiosis

Objective:  The aim of this study was to investigate the effect of the radiological evidence of emphysema, and the extent of interstitial involvement, on lung function and pulmonary arterial pressure (PAP) in patients with coal workers’ pneumoconiosis (CWP).

How do patients with asthma and COPD behave during fasting

BACKGROUND-OBJECTIVE Several factors might affect the adherence to treatment in patients with asthma and COPD. Among these factors, the effect of religious beliefs and behaviours has been less studied so far. In this study, the effect of fasting on drug use behaviours of patients with asthma and COPD were comparatively analysed. METHODS A total of 150 adult patients with asthma and 150 adult patients with COPD were consecutively enrolled into this cross-sectional study. The patients were asked whether they fast during Ramadan and if the answer was yes, they were kindly asked to respond to further questions related to use of inhaled medications during that particular time. RESULTS The majority of the cases from both groups [98 (65.3%) of asthma patients and 139 (92.6%) of COPD] were fasting during Ramadan. The majority of the patients with COPD (n=126; 90.6%) reported that they quitted their regular therapy basis during Ramadan. On the other hand, the majority of asthma patients used their controller inhaled medications during Ramadan and preferred to use them on iftar and sahur times (n=81, 82.6%). CONCLUSION Our results showed that in a Muslim population, the patients with asthma and COPD do not feel their diseases to be an inhibitory factor for fasting during Ramadan. However, fasting seems to be an important determining factor in medication compliance by modifying the drug use behaviours in each group in a different way. Therefore, the patients should be informed about the effects of fasting on their disease and the allowed drugs during fasting.

Airway Hyperresponsiveness: A Comparative Study of Methacholine and Exercise Challenges in Seasonal Allergic Rhinitis with or without Asthma

Background. Asymptomatic airway hyperreactivity in allergic rhinitis is a risk factor for later development of asthma. Although non-specific bronchial hyperresponsiveness (BHR) has been measured by several stimuli, the most appropriate measurement technique still remains unclear. Objective. To investigate whether an exercise challenge can be used to predict BHR in seasonal allergic rhinitis patients with or without asthma and to compare this bronchial reactivity with a methacholine challenge technique. Methods. Forty-six consecutive patients with seasonal allergic rhinitis only (n = 31) and with both seasonal allergic rhinitis and asthma (n = 15) were included in the study during the pollination period. Subjects underwent first methacholine (mch) and then exercise challenge testing (ECT). There was a 1-week interval between the tests. ECT was performed on a bicycle ergometer. Positive result was defined as a 15% decrease in forced expiratory volume in 1 second (FEV1) post-exercise. A patients bronchial reactivity to methacholine was considered as hyperresponsive if PC20 was less than 8 mg/mL. Results. Mch PC20 values were significantly lower in patients with both rhinitis and asthma (p < 0.062). Among the 46 patients, mch PC20 values were significantly different between patients who had positive and negative exercise challenge tests (p = 0.007). All patients with rhinitis alone had a negative ECT and 10 had a positive mch challenge. Change in FEV1 values after ECT was significantly higher in patients with both rhinitis and asthma compared to those with rhinitis alone (p = 0.009). There was a significant relation between positivity of mch and exercise challenges (p = 0.025). ECT positivity was found to be a significant confounding factor in the diagnosis of asthma (p = 0.001). Specificity and sensitivity values were 100% and 24% for ECT and 68% and 100% for mch, respectively. Conclusion. Exercise challenge presents poor diagnostic value for detecting bronchial responsiveness in individuals with allergic rhinitis alone during the pollen season.

Does the 2017 revision improve the ability of GOLD to predict risk of future moderate and severe exacerbation

In 2017 update, GOLD separated spirometry from ABCD classification.