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Yorgancioğlu A, Türktaş H, Kalayci O, Yardim N, Buzgan T, Kocabaş A, Karlikaya C, Yildiz F, Ergün P, Mungan D, Kart L, Göktaş E, Musaonbaşioğlu S, Gündoğan A, Akdağ R, Akçay S, Akin M, Akkurt I, Altan P, Altunsu T, Arpaci N, Aydin C, Aydin S, Aydinli F, Aytaç B, Bavbek S, Biber C, Bingöl Karakoç G, Ceyhun G, Cakir B, Celik G, Cetinkaya T, Ciçek ME, Coban SC, Cobanoğlu N, Com S, Cöplü L, Demirkazik A, Doğan E, Ekmekçi EB, Elbir M, Erdoğan A, Ergüder T, Gemicioğlu B, Gögen S, Gülbahar O, Güngör H, Horzum E, Içer Y, Imamecioğlu AR, Kahraman N, Kakillioğlu T, Kalyoncu F, Karakaya M, Karakaya G, Karaodul G, Kesici C, Keskinkiliç B, Kilinç O, Kirmizitaş F, Kosdak M, Köktürk N, Metintaş M, Numanoğlu SC, Gümrükçüoğlu OF, Onal Z, Onal B, Ozacar R, Ozen HA, Ozkan S, Oztürk F, Polat H, Saçkesen C, Selçuk T, Serin G, Sönmez G, Sahin M, Sahinöz S, Sahinöz T, Simşek B, Tartan N, Toprak A, Tugay T, Tuncer A, Uçan ES, Unüvar N, Yapicikardeşler B, Yildirim N, Yol S, Yüksel H, Khaltaev N, Cruz A, Minelli E, Bateman E, Baena Cagnani C, Dahl R, Bousquet J. The WHO global alliance against chronic respiratory diseases in Turkey (GARD Turkey). Tuberk Toraks 2009; 57:439-452. [PMID: 20037863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
In order to prevent and control non-communicable diseases (NCDs), the 61st World Health Assembly has endorsed an NCD action plan (WHA resolution 61.14). A package for essential NCDs including chronic respiratory diseases (CRDs) has also been developed. The Global Alliance against Chronic Respiratory Diseases (GARD) is a new but rapidly developing voluntary alliance that is assisting World Health Organization (WHO) in the task of addressing NCDs at country level. The GARD approach was initiated in 2006. GARD Turkey is the first comprehensive programme developed by a government with all stakeholders of the country. This paper provides a summary of indicators of the prevalence and severity of chronic respiratory diseases in Turkey and the formation of GARD Turkey.
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Abstract
OBJECTIVE Inhaled corticosteroids have become a key element in the maintenance treatment of bronchial asthma. Recent studies have shown that administration of inhaled corticosteroids is associated with evidence of derangement in bone turnover. Therefore, we studied the bone mineral density (BMD) of asthmatic women receiving long-term inhaled corticosteroids and compared them with healthy individuals matched for age, sex, menopausal status and body mass index. METHODOLOGY Thirty-two female patients with bronchial asthma, who had been using inhaled corticosteroids (beclomethasone dipropionate 750-1500 microg/day) regularly for at least 3 months, were included in the study. Bone mineral density measurements were done with dual X-ray absorptiometry in the lumbar area of the spine and the hip. Detailed laboratory examination was also done for the patients and 26 controls. RESULTS There was a significant decrease in BMD of the patient group at the lumbar region and femur as compared with normal controls. In the patients there was a significant negative correlation between the duration of therapy, daily and cumulative doses, and BMD at the lumbar region but not BMD at the femur. CONCLUSIONS These results indicate that long-term use of inhaled corticosteroids is associated with significant bone loss in asthmatic women and is especially related to the duration of therapy. Therefore, it is necessary to appropriately screen and give prophylactic treatment to those who are likely to develop osteoporosis from inhaled corticosteroid treatment.
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Affiliation(s)
- A Sivri
- Departments of Physical Medicine and Rehabilitation and; Chest Disease, University of Hacettepe, Ankara, Turkey.
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Ozer N, Tokgözoglu L, Cöplü L, Kes S. Echocardiographic evaluation of left and right ventricular diastolic function in patients with chronic obstructive pulmonary disease. J Am Soc Echocardiogr 2001; 14:557-61. [PMID: 11391283 DOI: 10.1067/mje.2001.111474] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study was to investigate the effects of chronic obstructive pulmonary disease (COPD) on left ventricular and right ventricular diastolic and systolic functions. Forty-eight patients with severe COPD were studied. Patients were divided into 2 subgroups according to pulmonary artery pressures: 25 patients with pulmonary hypertension (group 1) and 23 patients with normal pulmonary artery pressure (group 2). As a control group, 59 normal subjects were studied (group 3). Patients in group 1 had higher tricuspid peak A velocity, lower tricuspid E velocity, longer isovolumetric relaxation time, higher mitral A wave, lower mitral E wave, and slower color propagation velocity than groups 2 and 3. There was no significant difference between left ventricular diastolic filling parameters between groups 2 and 3. Patients with COPD and pulmonary hypertension have left and right ventricular diastolic dysfunction. However, patients with COPD and normal pulmonary artery pressure have normal left and right ventricular diastolic function.
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Affiliation(s)
- N Ozer
- Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Kalyoncu AF, Selçuk ZT, Enünlü T, Demir AU, Cöplü L, Sahin AA, Artvinli M. Prevalence of asthma and allergic diseases in primary school children in Ankara, Turkey: two cross-sectional studies, five years apart. Pediatr Allergy Immunol 1999; 10:261-5. [PMID: 10678723 DOI: 10.1034/j.1399-3038.1999.00031.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The prevalence of allergic diseases is reported to have increased worldwide. Two questionnaire surveys, five years apart, were conducted to evaluate the trend of prevalence rates and possible risk factors among primary school children in Ankara, Turkey. A previous survey in 1992 revealed the lifetime prevalences of asthma, wheezing, allergic rhinitis and atopic dermatitis were 17.4%, 23.3%, 28% and 6.1%, and the prevalences for the last 12 months were 8.3%, 11.9%, 15.4% and 4%, respectively. The survey was repeated with the same questionnaire in the same age group (6-13 years) of the same school in May 1997. The parents of 358 boys and 380 girls completed the questionnaire. The lifetime and last 12 months' prevalences of asthma, wheezing, rhinitis and atopic dermatitis were 16.8%, 22.5%, 18.7%, 6.5%, and 9.8%, 13.3%, 14.1%, 4.3%, respectively. There was a significant change only for the lifetime prevalence of rhinitis (p < 0.001). The rate of indoor smoking had declined from 73.9% to 64%, and pet ownership had risen from 7.9% to 22.9% (p < 0.001 for both). Atopic family history was the most prominent risk factor for all types of allergic disorders. Male gender was a significant risk factor for current asthma and wheezing [odds ratio (OR) = 1.80 and 1.59; 95% confidence intervals (CI) = 1.09-2.98 and 1.01-2.48, respectively], and passive smoking affected the occurrence of allergic rhinitis (OR = 1.84; CI = 1.13-3.00). The prevalence rates of allergic diseases among primary school children in Ankara stabilized during a 5-year period for all diseases other than allergic rhinitis. However, there are changing behavior patterns, i.e. indoor smoking and keeping pet animals, which that may have affected these rates.
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Affiliation(s)
- A F Kalyoncu
- Hacettepe University, School of Medicine, Department of Chest Diseases, Ankara, Turkey
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Selçuk ZT, Emri S, Sahin AA, Baris YI, Cöplü L, Kalyoncu F, Artvinli M. Malignant mesothelioma and erionite exposure. Eur Respir J 1999; 14:480-1. [PMID: 10515434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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Karakuş S, Yalçin S, Güler N, Cöplü L, Ayhan A. Angiocentric T-cell lymphoma of the lung mimicking metastatic carcinoma. Case report. J Exp Clin Cancer Res 1998; 17:371-3. [PMID: 9894778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Angiocentric T-cell lymphoma is a peripheral T-cell lymphoma (PTCL) which typically involves nose and upper respiratory system mostly presenting as a multisystemic disease. Intrathoracic involvement is common in NHL and the most common manifestation is mediastinal lymphadenopathy. However, malignant lymphomas presenting within the lung are rare and may be either primary or a manifestation of widely disseminated disease. We report a case with multiple pulmonary nodules mimicking metastatic carcinoma of the lung. This type of involvement is not common: when extensive, as in our case, differential diagnosis from metastatic carcinoma is essential.
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Affiliation(s)
- S Karakuş
- Dept. of Internal Medicine, School of Medicine, Hacettepe University, Ankara, Turkey
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Başçil N, Tütüncü T, Kisacik G, Sivri A, Cöplü L. Breathlessness in a patient with rheumatoid vasculitis. Postgrad Med J 1998; 74:294-7. [PMID: 9713616 PMCID: PMC2360931 DOI: 10.1136/pgmj.74.871.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- N Başçil
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Cöplü L, Cağlar M, Kisacik G, Söylemezoğlu F, Altay Sahin A. Sarcoidosís with thyroid involvement. Sarcoidosis Vasc Diffuse Lung Dis 1997; 14:86-7. [PMID: 9186997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Kalyoncu AF, Karakoca Y, Demir AU, Alpar R, Shehu V, Cöplü L, Sahin AA, Baris YI. Prevalence of asthma and allergic diseases in Turkish university students in Ankara. Allergol Immunopathol (Madr) 1996; 24:152-7. [PMID: 8939270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
An epidemiological study was performed in the students of Hacettepe University from various parts of Turkey to find the prevalence of asthma and allergic diseases and search for geographical differences in Turkey. A questionnaire related with symptoms of asthma and allergic diseases was distributed to 4600 students and filled by 4331 students (1884 males, 43.5%-2447 females, 56.5%). Periodic prevalence of asthma or allergic disease during the last 12 months was 13.5%. The prevalence of awakening with chest tightness and/or feeling of retrosternal pressure in the last month was 2%. The current prevalences of the seasonal and perennial rhinoconjunctivitis, flexural eczema, food and drug intolerances, pollen and pet animal hypersensitivities were 6.4%, 1.6%, 0.8%, 4.5%, 3%, 5.2%, and 1% respectively. Drug, food, and pollen hypersensitivities were distinctively more common in the females, whereas wheezing was more common in males. Wheezing, wheezing associated shortness of breath, nocturnal asthma for the last 1 and 12 months were more common in the students from eastern region than those from western region. The highest asthmatic attack rate was reported in the eastern region. Seasonal rhinitis and pollen allergy were more prevalent in central region than northern region. No significant geographical difference was observed regarding the drug and pet hypersensitivities. Our study has shown the importance of asthma and allergic diseases as a public health problem. Explanation of the observed geographical differences aware for further studies.
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Affiliation(s)
- A F Kalyoncu
- Hacettepe University Hospital, Department of Chest Diseases, Anakara, Turkey
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Cöplü L, Dumortier P, Demir AU, Selçuk ZT, Kalyoncu F, Kisacik G, DeVuyst P, Sahin AA, Bariş YI. An epidemiological study in an Anatolian village in Turkey environmentally exposed to tremolite asbestos. J Environ Pathol Toxicol Oncol 1996; 15:177-82. [PMID: 9216803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
After several cases of malignant pleural mesothelioma (MPM) were detected in the village of Kureyşler in the Kütahya district of western Turkey, an epidemiological study was conducted. A questionnaire was completed by 124 villagers who were older than 20 years and standard posteroanterior chest X-rays were taken. The films were evaluated by three chest physicians. Samples of the white stucco that had been used by almost all villagers for indoor painting for many years were mineralogically examined. Chest X-rays showed that 23 (18%) had pleural plaques and calcifications compatible with asbestos exposure. Male sex and old age were associated with occurrence of pleural plaques. An analysis of white stucco samples revealed tremolite asbestos. In conclusion, tremolite fibers might be the cause of the high incidence of pleural plaques and MPM cases in the village of Kureyşler.
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Affiliation(s)
- L Cöplü
- Chest Department, Hacettepe University, School of Medicine, Ankara, Turkey
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Kalyoncu AF, Cöplü L, Selçuk ZT, Emri AS, Kolaçan B, Kocabaş A, Akkoçlu A, Erkan L, Sahin AA, Bariş YI. Survey of the allergic status of patients with bronchial asthma in Turkey: a multicenter study. Allergy 1995; 50:451-5. [PMID: 7573836 DOI: 10.1111/j.1398-9995.1995.tb01177.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Patients diagnosed with bronchial asthma (BA) were prospectively enrolled to assess their allergen spectra and atopic status. The patients came from five major cities (Ankara, Izmir, Samsun, Elaziğ, and Adana) in different regions of Turkey. Atopic status, total IgE levels, and allergen spectra were determined in 1149 patients and 210 controls who were spouses of the patients sharing the same environment but not consanguinity with the patients. Total IgE levels were significantly higher in the asthmatic patients. For both groups, total IgE levels were higher in both atopic and male subjects. Atopy rates were 42% in asthmatics and 26.1% in controls, declining notably by age in both groups. The most common allergen in both groups was house-dust mite (HDM), which was more frequently detected in coastal regions (Samsun, Izmir, and Adana). Allergen spectra of the patients included HDM, pollens, cockroach, pet animals, and molds in decreasing order of frequency. Phleum pratense and Artemisia vulgaris were the most common pollens in all regions, whereas Olea europaea was the most common in Izmir. Pollen sensitivity was least frequent in Elaziğ. For all of the regions, pet sensitivity was less common than, and mold sensitivity was comparable to, that of Western countries. In conclusion, BA patients in Turkey displayed significant differences in their allergen spectra and total IgE levels from control subjects and BA patients in Western countries.
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Affiliation(s)
- A F Kalyoncu
- Hacettepe University, Faculty of Medicine, Department of Chest Diseases, Ankara, Turkey
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Abstract
The first epidemiologic survey of the prevalence of childhood asthma and other allergic disease in Ankara, Turkey, was done in May 1992. A questionnaire on factors influencing the atopic status and allergic symptoms was distributed to parents of 1226 children aged 6-12 years. In this questionnaire, parents were asked to give information about physician-diagnosed asthma and atopic dermatitis (AD), and self-reported wheezing and rhinoconjunctivitis (perennial or seasonal). The overall response rate was 85% and included 502 boys (48.5%) and 534 girls (51.5%). The lifetime prevalences of asthma, wheezing, rhinoconjunctivitis, and AD were 17.4%, 23.3%, 28%, and 6.1%, respectively, and the reported prevalences for the last 12 months were 8.3%, 11.9%, 15.4%, and 4%, respectively. Asthma and other allergic disease had been recognized in 23.2% of the children during the last year; in half of these, more than one disease was present. Eight percent of the families kept pet animals; 95.4% of children had been breast-fed, of whom 61% for more than 6 months; and at least one person smoked at home in the case of 73.9% of children. Some health insurance was available to 72.8% of the families. Cumulative prevalences of wheezing, rhinoconjunctivitis, and AD were significantly associated with the presence of pets, passive smoking at home, and absence of health insurance. The prevalence of asthma was not affected by any of these factors except atopic family history. In conclusion, asthma and other allergic diseases constitute a major health problem for schoolchildren in Ankara.
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Affiliation(s)
- A F Kalyoncu
- Department of Chest Diseases, Hacettepe University Hospital, Ankara, Turkey
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Abstract
Diagnosis of asbestosis and bronchiolo-alveolar carcinoma was made in a 55-year-old Turkish woman who was a nonsmoker. She originated from and was living in an area with a high prevalence of environmental diseases attributed to tremolite asbestos. Mineralogic analysis of lung tissue revealed very high concentrations of asbestos bodies (1.64 x 10(6)/g of dry tissue) and tremolite fibers (173.7 x 10(6) of dry tissue). This case illustrates the following points: (1) In some areas, environmental exposure can lead to cumulated fiber retention comparable to occupational exposure and thus can represent a risk for lung fibrosis (asbestosis). (2) Lung cancer as a complication of environmental asbestosis also should be considered as a potential environmental disease.
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Affiliation(s)
- P De Vuyst
- Chest and Pathology Department, Erasme Hospital, University of Brussels, Belgium
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Sahin AA, Cöplü L, Selçuk ZT, Eryilmaz M, Emri S, Akhan O, Bariş YI. Malignant pleural mesothelioma caused by environmental exposure to asbestos or erionite in rural Turkey: CT findings in 84 patients. AJR Am J Roentgenol 1993; 161:533-7. [PMID: 8394641 DOI: 10.2214/ajr.161.3.8394641] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Malignant pleural mesothelioma in rural Turkey frequently results from environmental exposure to tremolite asbestos or fibrous zeolite (erionite). The aim of this study was to determine the CT features of malignant pleural mesothelioma in patients exposed to asbestos or erionite. MATERIALS AND METHODS The CT scans of 84 patients with proved malignant pleural mesothelioma were retrospectively evaluated. Twenty patients (24%) had been exposed to erionite and 64 patients (76%) had been exposed to asbestos. The CT scans were interpreted by seven observers who did not know the clinical or pathologic findings. RESULTS CT scans showed either unilateral pleural thickening or pleural nodules/masses in all patients. Pleural nodules were present in 25 patients (30%) and pleural masses in 44 patients (52%). Pleural effusion was found in 61 patients (73%), mediastinal pleural involvement in 78 (93%), pleural calcifications in 52 (62%), involvement of the interlobar fissures in 64 (76%), and volume contraction in 61 (73%). Reduced size of the hemithorax was significantly correlated with chest wall involvement. On the basis of CT findings, the preassigned staging was changed in 21 patients (25%), including 44% of the patients with disease that had been classified as stage I. CT findings were not significantly different between the patients exposed to erionite and those exposed to asbestos. CONCLUSION The most common CT findings in cases of malignant pleural mesothelioma were unilateral pleural thickening or pleural nodules/masses with or without effusion. CT provided valuable information on the extent of the disease, which was important for staging. Although the CT features are not pathognomonic, they provide valuable clues to the diagnosis in patients who have been exposed to mineral fibers.
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Affiliation(s)
- A A Sahin
- Department of Chest Diseases, Hacettepe University, School of Medicine, Ankara, Turkey
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Selçuk ZT, Cöplü L, Emri S, Kalyoncu AF, Sahin AA, Bariş YI. Malignant pleural mesothelioma due to environmental mineral fiber exposure in Turkey. Analysis of 135 cases. Chest 1992; 102:790-6. [PMID: 1325339 DOI: 10.1378/chest.102.3.790] [Citation(s) in RCA: 62] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
We reviewed data from 135 patients with environment-associated malignant pleural mesothelioma (MPM) from the Central Anatolian region of Turkey. The most significant factors suggesting the diagnosis of MPM were the village where the patient resided and the typical presenting symptoms and signs of unilateral exudative pleural effusion associated with nonpleuritic chest pain. Computed tomography and ultrasonography were very useful for evaluating the extension of the tumor in the thoracic and abdominal cavities and chest wall. The tissue diagnosis was established by either thoracoscopy (39 percent) or pleural biopsy (39 percent) in the majority of the cases. The median survival after diagnosis was 13.52 months for erionite-associated MPM and 21.56 months for asbestos-associated MPM. The actuarial survival curves for the fibrous minerals were significantly different for survival computed both from onset of the symptoms and after diagnosis. Medical or surgical treatment or both did not change the outcome of the disease.
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Affiliation(s)
- Z T Selçuk
- Department of Chest Diseases, Hacettepe University School of Medicine, Ankara, Turkey
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Cöplü L, Emrí S, Selçuk ZT, Kalyoncu F, Balkanci F, Sahín AA, Bariş YI. Life threatening chylous pleural and pericardial effusion in a patient with Behçet's syndrome. Thorax 1992; 47:64-5. [PMID: 1539151 PMCID: PMC463562 DOI: 10.1136/thx.47.1.64] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Chylothorax and chylopericardium secondary to thrombosis of the superior vena cava and the innominate and subclavian veins were diagnosed in a patient with Behçet's syndrome. Immunosuppressive treatment, diet, and underwater seal drainage led to a diminished volume of pleural fluid and pericardial fluid and to a diminished concentration of triglyceride in them; pleurodesis with tetracycline was then performed.
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Affiliation(s)
- L Cöplü
- Department of Chest Diseases, School of Medicine, Hacettepe University, Ankara, Turkey
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Kalyoncu AF, Cöplü L, Emri AS. Indiscriminate prescribing of NSAIDs. N Z Med J 1991; 104:388. [PMID: 1923081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Abstract
Hypertrophic pulmonary osteoarthropathy occurred in a patient with proved pulmonary alveolar microlithiasis, an association not previously reported.
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Affiliation(s)
- S Emri
- Department of Chest Diseases, Hacettepe University, School of Medicine, Ankara, Turkey
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