DNA investigation in the exhaled breath condensate (EBC) in non-small cell lung cancer

Aim: Exhaled breath condensate (EBC), one of the materials which is used to detect mutations in the early period, is collected by completely non-invasive a technique which has no risk for the patient.  We aimed to investigate whether EBC samples are suitable for the detection of DNA or not in non-small cell lung cancer (NSCLC) and control patients.    Methods: 26 patients with NSCLC and 20 patients without lung cancer were included in the study. EBC procedure was performed by the help of Eco Screen- Jaeger device in 10-15 minutes during breathing at the tidal volume. DNA was isolated using tissue spin-column DNA isolation kit in the collected EBC.         Results: DNA amount was twofold high in the NSCLC group than non-cancer patients in spite of short time (p>0.05). However, in cancer group DNA amount was found lower in patients with endobronchial lesions than without endobronchial lesions (p>0.05). Although, there was no relationship between DNA amount and all of EBC collection time, collected sample amount and expiration air volume in the cancer group, a positive relations was detected between DNA amount and EBC collection time in the non-cancer group.   Conclusıon: This may be explained by the pathological changes which occur at the cellular level in the lungs during cancer development process. However, it may also result from relative decrease which develops from redundancy of EBC volume in the non-cancer group. The source of DNA in EBC may be considered to be pathological changes resulting from the systemic inflammatory response, apart from the localized lesion in the lungs

Chronic obstructive pulmonary disease and associated healthcare resource consumption in the Middle East and North Africa: The BREATHE study

SummaryData on COPD-related healthcare resources use are rarely documented in developing countries. This article presents data on COPD-related healthcare resource consumption in the Middle East, North Africa and Pakistan and addresses the association of this variable with illness severity. A large survey of COPD was conducted in eleven countries of the region, namely Algeria, Egypt, Jordan, Lebanon, Morocco, Pakistan, Saudi-Arabia, Syria, Tunisia, Turkey and United Arab Emirates, using a standardised methodology. A total of 62,086 subjects were screened. This identified 2,187 subjects fulfilling the “epidemiological” definition of COPD. A detailed questionnaire was administered to document data on COPD-related healthcare consumption. Symptom severity was assessed using the COPD Assessment Test (CAT). 1,392 subjects were analysable. Physician consultations were the most frequently used healthcare resource, ranging from 43,118 [95% CI: 755–85,548] consultations in UAE to 4,276,800 [95% CI: 2,320,164–6,230,763] in Pakistan, followed by emergency room visits, ranging from 15,917 [95% CI: 0–34,807] visits in UAE to 683,697 [95% CI: 496,993–869,737] in Turkey and hospitalisations, ranging from 15,563 [95% CI: 7,911–23,215] in UAE to 476,674 [95% CI: 301,258–652,090] in Turkey. The use of each resource increased proportionally with the GOLD 2011 severity groups and was significantly (p < 0.0001) higher in subjects with more symptoms compared to those with lower symptoms and in subjects with exacerbations to those without exacerbations. The occurrence of exacerbations and the CAT score were independently associated with use of each healthcare resource. In conclusion, the BREATHE study revealed that physician consultation is the most frequently COPD-related healthcare resource used in the region. It showed that the deterioration of COPD symptoms and the frequency of exacerbations raised healthcare resource consumption

St. George solunum anketinin Türkçe geçerlilik ve güvenilirliği

Giriş: Kronik obstrüktif akciğer hastalığı (KOAH)’nda sağlık durumunu değerlendirmenin önemi son yıllarda birçok çalışmada vurgulanmaktadır. Bu çalışmada amaç, St. George Solunum Anketinin Türkçe sürümünün güvenilirlik ve geçerliliğini ortaya koymaktır. Materyal ve Metod: Çalışmaya Türkiye genelinde yedi merkez katılmıştır. KOAH tanısı konulmuş ve evrelenmiş, yaşları 40- 75 yıl arasında değişen 321 hasta çalışmaya alınmıştır. Hastalara semptom skoru [dispne (breathlessness), öksürük (cough), balgam ölçümü (sputum scale) (BCSS)] Türkçe çevirisi, mMRC (Modified Medical Research Council) dispne skoru, St. George Solunum Anketi (SGRQ), KOAH Değerlendirme Testi (CAT) ve Kısa Form-36 (SF-36) uygulanmıştır. İstatistiksel değerlendirmede iç tutarlılık katsayısı, farklı hastalık düzeylerini ayırt edicilik düzeyi ve diğer ölçeklerle korelasyon hesaplanmıştır. Bulgular: Olguların yaş ortalaması 62.4 ± 8.9 yıldır ve ortalama FEV1 değeri %51.9 ± 19.2 olarak bulunmuştur. Güvenilirlik analizinde Cronbach alfa iç tutarlılık katsayısı 0.8815 olarak hesaplanmıştır. Ölçeğin toplam puanının iki hafta sonra uygulanan yeniden test sonucunun ilk değer ile korelasyonu 0.90 (p< 0.0001) olarak elde edilmiştir. Geçerlilik analizinde SGRQ’nun hem toplam puanının hem de alt ölçek puanlarının diğer ölçeklerle korelasyon katsayılarına göre CAT ile toplam skorun korelasyonu 0.782 (p< 0.0001), SF-36 alt ölçekleriyle ise -0.481 ile -0.819 arasında bulunmuştur (p< 0.0001). SGRQ toplam skorunun ve alt ölçek toplam puanlarının farklı hastalık evreleri, şiddetleri ve düzeylerine göre ayırt ediciliğine bakıldığında, tüm kriter düzeylerini anlamlı olarak (p< 0.0001) ayırt ettiği ve solunum fonksiyon testleriyle anlamlı düzeyde korelasyon (p< 0.0001) gösterdiği saptanmıştır. Sonuç: SGRQ Türkçe formu günlük klinik uygulamada güvenilir ve geçerli biçimde kullanılacak bir değerlendirme aracıdır.Introduction: The importance of the evaluation of health status in chronic obstructive pulmonary disease (COPD) is recently highlighted in many studies. In this study, we aimed to test the validity and reliability of the Turkish version of St. George Respiratory Questionnaire (SGRQ). Materials and Methods: The study was conducted in seven centers in Turkey. Three hundred and twenty one COPD patients (40-75 years) were included to the study. Turkish versions of breathlessness, Cough, and Sputum Scale (BCSS), mMRC (Modified Medical Research Council) dyspnea scale, SGRQ, COPD assessment test (CAT) and Short Form Health Survey (SF-36) were carried out to the patients. The statistical analysis of SGRQ was performed by using the coefficient of internal consistency, discriminative analysis for different stages and the correlation with the other scales. Results: The mean age was 62.4 &plusmn; 8.9 years and the mean FEV1 was 51.9 &plusmn; 19.2% pred. The coefficient of internal consis- tency (Cronbach alpha) was 0.8815. The correlation between the total score measured initially and that obtained two weeks later was found to be highly significant (r= 0.90, p&lt; 0.0001). According the results of validation of both total score and the components of SGRQ, the correlation between the total score of SGRQ and CAT was 0.782 (p&lt; 0.0001), SGRQ and SF- 36 was between -0.481 ile -0.819 (p&lt; 0.0001). The total and component scores were able to discriminate different disease stages and a significant correlation was found to be with pulmonary function tests. Conclusion: SGRQ Turkish version is a reliable and valid assessment tool for COPD patients in clinical practice

Anthropometric Methods in Evaluation of Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease (COPD) is mainly expressed by weight loss with especially fat-free mass (FFM) depletion and a low body weight correlates with increased mortality and a poor prognosis. We investigated whether anthropometric body composition equations could be used for evaluation of the body composition in COPD. Thirty clinically stable patients with COPD and 13 healthy age matched control subjects underwent the skinfolds and circumference measurements in addition to body mass index (BMI) calculations. Body fat mass (BFM) and FFM were determined by using anthropometric equations. The percent BFM, predicted from body density either using Siri’sor Brozek’sequations was determined lower than that of calculated with equations by using BMI, age and gender. The values of BFM and body weight were reduced in patients with FEV1<50%predicted compared to other participants. The FFM values also dropped depending on the severity of COPD. BMI was not statistically different among the participants while FFM index (FFMI) reflected the nutritional status of the disorders. Anthropometric equations easily and cost effectively applied for prediction of %BFM, FFM, and FFMI in patients with COPD. In addition, the FFMI can be possibly used for expressing COPD severity

The View of the Turkish Thoracic Society on the Report of the GOLD 2017 Global Strategy for the Diagnosis, Management, and Prevention of COPD

WOS: 000399794400008PubMed ID: 29404162Since the Global Initiative for Obstructive Lung Disease (GOLD) published its first guidelines on chronic obstructive pulmonary disease (COPD) in 2001, much has changed till 2017. Previous versions of GOLD guidelines mentioned the forced expiratory volume in one second (FEV1)-based approach for staging and treatment modalities. Since 2011, a composite multi-dimensional approach has been introduced to cover various aspects of the disease. Unfortunately, this approach was not found to be correlated with mortality as well as the FEV1 -based approach, despite the fact that it was better for estimating exacerbation rates. Although this assessment tool has been considered as a big step in personalized medicine, the system was rather complex to use in daily practice. In 2017, GOLD introduced a major revision in many aspects of the disease. This mainly includes a revised assessment tool and treatment algorithm. This new ABCD algorithm has excluded spirometry for guiding pharmacological therapy. Treatment recommendations are mainly based on symptoms and exacerbation rates. Escalation and de-escalation strategies have been proposed for the first time. The spirometric measurement has only been retained to confirm the diagnosis and lead to nonpharmacological therapies. In this report, the Turkish Thoracic Society COPD assembly aimed to summarize and give an insight to the Turkish interpretation of GOLD 2017

Updates in Chronic Obstructive Pulmonary Disease for the Year 2014

WOS: 000370844800007PubMed ID: 29404083Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in the world. Research conducted over the past decade has contributed much to our current knowledge of the pathogenesis and treatment of COPD. Additionally, an evolving literature has recently accumulated information about the management of COPD and also about exacerbations. This article reviews a concise summary on the updates in COPD including 1) new pathogenic mechanisms and therapeutic targets, 2) management of patients in Group B, C and D according to GOLD 2014 report; 3) prevention and management of exacerbation; 4) monitoring of natural history; and 5) essential but usually forgotten parts of the management

Effects of vaccination on clinical presentation of community acquired pneumonia (CAP)

WOS: 00020937040217

Adherence to COPD treatment in Turkey and Saudi Arabia: results of the ADCARE study.

COPD affects millions of people worldwide. Poor treatment adherence contributes to increased symptom severity, morbidity and mortality. This study was designed to investigate adherence to COPD treatment in Turkey and Saudi Arabia