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Isik A.H.,Gazi University | Guler I.,Gazi University | Sener M.U.,Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital
Telemedicine and e-Health | Year: 2013

Objective: The main objective of this study is presenting a real-time mobile adaptive tracking system for patients diagnosed with diseases such as asthma or chronic obstructive pulmonary disease and application results at home. The main role of the system is to support and track chronic pulmonary patients in real time who are comfortable in their home environment. It is not intended to replace the doctor, regular treatment, and diagnosis. Materials and Methods: In this study, the Java 2 micro edition-based system is integrated with portable spirometry, smartphone, extensible markup language-based Web services, Web server, and Web pages for visualizing pulmonary function test results. The Bluetooth® (Bluetooth SIG, Kirkland, WA) virtual serial port protocol is used to obtain the test results from spirometry. General packet radio service, wireless local area network, or third-generation-based wireless networks are used to send the test results from a smartphone to the remote database. The system provides real-time classification of test results with the back propagation artificial neural network algorithm on a mobile smartphone. It also provides the generation of appropriate short message service-based notification and sending of all data to the Web server. In this study, the test results of 486 patients, obtained from Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital in Ankara, Turkey, are used as the training and test set in the algorithm. Results: The algorithm has 98.7% accuracy, 97.83% specificity, 97.63% sensitivity, and 0.946 correlation values. The results show that the system is cheap (900 Euros) and reliable. Conclusions: The developed real-time system provides improvement in classification accuracy and facilitates tracking of chronic pulmonary patients. © Mary Ann Liebert, Inc.

Ozyurek B.A.,Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital | Ulasli S.S.,Afyon Kocatepe University | Bozbas S.S.,Baskent University | Bayraktar N.,Baskent University | Akcay S.,Baskent University
Multidisciplinary Respiratory Medicine | Year: 2013

Background: Surfactant Protein D (SP-D) is an important marker in chronic obstructive pulmonary disease (COPD). Serum SP-D levels increase while lung production of SP-D decreases in COPD. SP-D is a specific biomarker for monitoring COPD, assessment of exacerbation frequency and arrangement of treatment modalities. In the present study, we aimed to investigate the correlation between serum and induced sputum SP-D levels with severity and acute exacerbations of COPD. Method: 20 healthy subjects, older than 40 years, with at least 10 pack/years smoking history (group 1), 20 stage I-II COPD patients (group 2), and 20 stage III-IV COPD patients (group 3) were enrolled in the study. All subjects performed pulmonary function tests. Venous blood samples were taken to determine complete blood count, C-reactive protein(CRP) and serum SP-D levels. Induced sputum samples were obtained to determine SP-D level. COPD patients were followed up for acute exacerbations for 6 months. Results: Serum SP-D levels of group 3 were the highest and induced sputum SP-D levels of group 2 were the lowest among the three groups. SP-D levels of induced sputum decreased in patients with increasing number of cigarette pack/years (p = 0.03, r = -0.115), whereas serum SP-D levels increased in these patients (p = 0.0001, r = 0.6). Induced sputum SP-D levels in COPD patients receiving inhaled corticosteroid treatment were significantly higher than in patients who were not receiving inhaler corticosteroid treatment (p = 0.005). An inverse correlation between serum SP-D levels and FEV1 (%) was found and there was a positive correlation between the serum SP-D levels and exacerbations frequency in 6-month follow up period (p = 0.049, r = -0.252; p = 0.0001, r = 0.598 respectively). Conclusion: Our study demonstrates the adverse effects of smoking on local SP-D levels since low levels of induced sputum SP-D were found in the group of current smokers, who were not receiving inhaled corticosteroid treatment. Relationship between serum SP-D and COPD exacerbations frequency suggests that serum SP-D level may be used as a lung-specific biomarker during the follow up and progression of COPD. © 2013 Akinci Ozyurek et al.; licensee BioMed Central Ltd.

Yekeler E.,Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital | Ulutas H.,Inonu University
Annals of Thoracic Surgery | Year: 2012

In the etiology of chylothorax, traumas and malignancies are the first two leading causes. Today in pediatric patients, the most common cause of chylothorax includes the complications secondary to cardiothoracic operations. Bilateral chylothorax is rarely observed after severe vomiting leading to increase in intrathoracic pressure. In idiopathic chylothorax, bilateral localization is dominant. A 9-year-old girl who presented to our emergency department with the complaints of dyspnea and back pain following severe vomiting received a diagnosis of bilateral chylothorax. The patient was treated with the insertion of a bilateral chest tube, and pleurodesis was performed in left hemithorax. Examination did not reveal a pathology to this condition, except the vomiting observed 2 days previously after the meal. © 2012 The Society of Thoracic Surgeons.

Yllmaz D.,Hacettepe University | Capan N.,Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital | Canbakan S.,Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital | Besler H.T.,Hacettepe University
Nutrition Journal | Year: 2015

Background: Fat-free mass (FFM) depletion has been shown to be a better predictor of mortality than BMI in chronic obstructive pulmonary disease (COPD) patients. The specific aim of the current study was to assess the nutritional status of stable COPD patients in relation to fat free mass index profiles. Methods: We investigated 65 male moderate-to-severe stable COPD patients. A self-reported questionnaire was applied about general characteristics and smoking history. Nutritional intake was assessed by using a 54-item quantitative food frequency questionnaire. Weight, height, mid-upper arm circumference (MUAC), waist circumference (WC), handgrip strength and body composition measurements were taken by a trained dietitian. The data were analyzed with SPSS 15.0 software. Results: The mean age of the patients was 62.1∈±∈8.9 years. Among all of the patients 13.8% was underweight (BMI∈<∈21 kg/m2) and 18.5% had a low fat-free mass index (FFMI∈<∈16 kg/m2). The percentages of the patients who did not meet the daily recommended intakes (RNI) were highest for magnesium (93.8%) and calcium (92.3%). Mean daily consumptions of milk-yogurt, red meat and fruits were significantly low in the low FFMI group compared to normal FFMI group (for all; p∈<∈0.05). Patients with normal FFMI had significantly higher weight, height, WC, MUAC, handgrip strength, fat and fat-free mass than the patients with low FFMI (for all; p∈<∈0.05). Conclusions: Dieticians should be aware of COPD patients with low FFMI in order to evaluate the nutritional intake and therefore plan nutritional strategies to improve prognosis of the disease. © 2015 Yllmaz et al.; licensee BioMed Central.

Alemdaroglu E.,Ankara Physical Medicine and Rehabilitation Training and Research Hospital | Erturk A.,Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital | Eroglu A.G.,Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital
Clinical Rheumatology | Year: 2013

Sarcoidosis infrequently involves the phalanges and the adjacent soft tissue. The management of bone lesions is not clear. We present herein the results of methotrexate therapy applied for 1 year in a sarcoidosis patient with hand involvement and large hilar lymphadenopathies. © Clinical Rheumatology 2009.

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