BackgroundDomiciliary noninvasive ventilation (NIV) use in stable hypercarbic COPD is becoming increasingly widespread. However, treatment compliance criteria and factors related to compliance remain to be defined.MethodsThis research was designed as a prospective, cross-sectional, multicenter real-life study. Chronic hypercapnic COPD patients who were using domiciliary NIV for at least 1 year and being followed up in 19 centers across Turkey were included in the study. The patients who used NIV regularly, night or daytime and ≥5 hours/d, were classified as “high-compliance group,” and patients who used NIV irregularly and <5 hours/d as “low-compliance group.”ResultsTwo hundred and sixty-six patients with a mean age of 64.5±10.3 years were enrolled, of whom 75.2% were males. They were using domiciliary NIV for 2.8±2 years. Spontaneous time mode (p<0.001) and night use (p<0.001) were more frequent in the high-compliance group (n=163). Also, mean inspiratory positive airway pressure values of the high-compliance group were significantly higher than the low-compliance group (n=103; p<0.001). Cardiac failure (p=0.049) and obesity (p=0.01) were significantly more frequent in the high-compliance group. There were no difference between 2 groups regarding hospitalization, emergency department and intensive care unit admissions within the last year, as well as modified Medical Research Council dyspnea and COPD Assessment Test scores. With regard to NIV-related side effects, only conjunctivitis was observed more frequently in the high-compliance group (p=0.002).ConclusionDetermination of the patients who have better compliance to domiciliary NIV in COPD may increase the success and effectiveness of treatment. This highly comprehensive study on this topic possesses importance as it suggests that patient and ventilator characteristics may be related to treatment compliance.
OBJECTIVE:The purpose of this study is to detect the prevalence and the factors associated with influenza and pneumococcal vaccination and outcomes of vaccination during 2013–2014 season in patients with chronic obstructive pulmonary disease (COPD) in Turkey.METHODS:This was a multicenter retrospective cohort study performed in 53 different centers in Turkey.RESULTS:During the study period, 4968 patients were included. COPD was staged as GOLD 1-2-3-4 in 9.0%, 42.8%, 35.0%, and 13.2% of the patients, respectively. Influenza vaccination rate in the previous year was 37.9%; and pneumococcus vaccination rate, at least once during in a life time, was 13.3%. Patients with older age, higher level of education, more severe COPD, and comorbidities, ex-smokers, and patients residing in urban areas had higher rates of influenza vaccination. Multivariate logistic regression analysis showed that advanced age, higher education levels, presence of comorbidities, higher COPD stages, and exacerbation rates were associated with both influenza and pneumococcal vaccination. The number of annual physician/outpatient visits and hospitalizations due to COPD exacerbation was 2.73 ± 2.85 and 0.92 ± 1.58 per year, respectively. Patients with older age, lower education levels, more severe COPD, comorbid diseases, and lower body mass index and patients who are male and are residing in rural areas and vaccinated for influenza had significantly higher rates of COPD exacerbation.CONCLUSIONS:The rates of influenza and pneumococcal vaccination in COPD patients were quite low, and the number of annual physician/outpatient visits and hospitalizations due to COPD exacerbation was high in Turkey. Advanced age, higher education levels, comorbidities, and higher COPD stages were associated with both influenza and pneumococcal vaccination.
Tüberküloz (TB); özellikle akciğer tutulumu ile giden ancak neredeyse tüm organları tutabilen bakteriyel bir hastalıktır. Eski zamanlardan beri bilinen bu hastalık, özellikle immunsüpresif tedavi alan hasta sayılarının artması ile tekrar gündeme gelmiştir. Günümüzde oldukça popüler tedavi seçeneklerinden olan biyolojik ilaçlar; hematolojik, otoimmün hatta malign hastalıkların tedavisinde devrim yaratmıştır. Bu ilaç sınıfı arasında; monoklonal antikorlar (adalimumab, infliximab, golimumab) ve antikor fragmanı (certolizumab) sayılabilir. Tümör nekroz faktör alfa inhibitörleri gibi biyolojik ajanlarla tedavinin artmış TB riski ile ilişkisi iyi bilinmekte ve bu tedaviyi alan kişilerin latent TB enfeksiyonu açısından değerlendirilmesi önerilmektedir. Bu derleme yazısında mevcut bilimsel literatürün gözden geçirilmesi amaçlanmıştır.
Objctives: Sleep quality related factors may affect compliance of tobacco smokers to a cessation program. This study was designed to assess sleep quality among individuals who were at least 1 year smoking free versus individuals who failed to quit smoking. Materials and Metods: In total, 682 individuals (M/F, 67/39) who were on a smoking cessation program between March 2004 and February 2011 were examined for suitability and invited by phone call for this cross-sectional study. Of those, 106 patients agreed to participate and included to the final analysis. Pittsburgh sleep quality index (PSQI) scores, respiratory function test results, and PICO measurements were compared between successful quitters (n=42) versus failed smokers (n=64). Results: Based on PSQI scores, the rate of good sleepers was 23.8% in quitters and 7.8% in smokers (p
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