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Öğe Assesment of palliative care in lung cancer in Turkey (ASPECT study)(European Respiratory Soc Journals Ltd, 2015) Bulbul, Yilmaz; Ozlu, Tevfik; Arinc, Sibel; Ozyurek, Berna A.; Gunbatar, Hulya; Senturk, Aysegul; Bahadir, Ayse[Abstract Not Available]Öğe Combination and comparison of two models in prognosis of pulmonary embolism: Results from TUrkey Pulmonary Embolism Group (TUPEG) study(Pergamon-Elsevier Science Ltd, 2014) Ozsu, Savas; Ozlu, Tevfik; Senturk, Aysegul; Ucar, Elif Yilmazel; Kirkil, Gamze; Kadioglu, Esra Ekbic; Altinsoy, BulentBackground: Clinical parameters, biomarkers and imaging-based risk stratification are widely accepted in pulmonary embolism(PE). The present study has investigated the prognostic role of simplified Pulmonary Embolism Severity Index (sPESI) score and the European Society of Cardiology (ESC) model. Methods: This prospective cohort study included a total of 1078 patients from a multi-center registry, with objectively confirmed acute symptomatic PE. The primary endpoint was all-cause mortality during the first 30 days, and the secondary endpoint included all-cause mortality, nonfatal symptomatic recurrent PE, or nonfatal major bleeding. Results: Of the 1078 study patients, 95 (8.8%) diedwithin 30 days of diagnosis. There was no significant difference between non-low-risk patients ESC [12.2% (103 of 754;)] and high-risk patients as per the sPESI [11.6% (103 of 796)] for 30-day mortality. The nonfatal secondary endpoint occurred in 2.8% of patients in the the sPESI low-risk and 1.9% in the ESC low-risk group. Thirty-day mortality occurred in 2.2% of patients the sPESI low-risk and in 2.2% the ESC low-risk group (P = NS). In the present study, in the combination of the sPESI low-risk and ESC model low-risk mortality rate was 0%. Conclusions: The sPESI andthe ESCmodel showed a similar performance regarding 30-daymortality and secondary outcomes in the present study. However, the combination of these two models appears to be particularly valuable in PE. (C) 2014 Elsevier Ltd. All rights reserved.Öğe General characteristics and therapeutic options in lung cancer in Turkey(European Respiratory Soc Journals Ltd, 2015) Ozlu, Tevfik; Bulbul, Yilmaz; Arinc, Sibel; Ozyurek, Berna A.; Gunbatar, Hulya; Senturk, Aysegul; Bahadir, Ayse[Abstract Not Available]Öğe Should Low-Molecular-Weight Heparin be Preferred Over Unfractionated Heparin After Thrombolysis for Severity Pulmonary Embolism?(Sage Publications Inc, 2016) Senturk, Aysegul; Ucar, Elif Yilmazel; Berk, Serdar; Ozlu, Tevfik; Altinsoy, Bulent; Dabak, Gul; Cakir, EbruPurpose: The role of low-molecular-weight heparin (LMWH) in managing nonmassive pulmonary embolism (PE) is well known. In unstable cases, especially after thrombolytic therapy for massive PE, unfractionated heparin (UFH) is preferred for PE management. This study aimed to investigate the effectiveness and safety of LMWH after thrombolytic therapy. Methods: A prospective, observational multicenter trial was performed in 249 patients with acute PE who required thrombolysis. Massive and submassive PEs were categorized into 2 groups depending on whether they were treated with LMWH or UFH after thrombolytic treatment. The primary end point was all-cause mortality during the first 30 days; the secondary end point included all-cause mortality, nonfatal symptomatic recurrent PEs, or nonfatal major bleeding. Results: The mean age at diagnosis was 60.7 15.5 years. The PE severity was massive in 186 (74.7%) patients and submassive in 63 (25.3%). The incidence of all-cause 30-day death was 8.2% and 17.3% in patients with LMWH and UFH, respectively (P = .031). Major hemorrhage occurred in 4% (n = 5) and 7.9% (n = 10) of patients and minor hemorrhage occurred in 9% (n = 11) and 13.4% (n = 17) of the cases treated with LMWH and UFH, respectively. Conclusion: These results suggest that LMWH treatment can be used safely in patients with PE after thrombolytic therapy.Öğe Sleep disturbances in patients with lung cancer in Turkey(Turkish Assoc Tuberculosis & Thorax, 2018) Bulbul, Yilmaz; Ozlu, Tevfik; Arinc, Sibel; Akinci Ozyurek, Berna; Gunbatar, Hulya; Senturk, Aysegul; Bahadir, AyseIntroduction: Sleep quality is known to be associated with the distressing symptoms of cancer. The purpose of this study was to analyze the impact of cancer symptoms on insomnia and the prevalence of sleep-related problems reported by the patients with lung cancer in Turkey. Materials and Methods: Assesment of Palliative Care in Lung Cancer in Turkey (ASPECT) study, a prospective multicenter study conducted in Turkey with the participation of 26 centers and included all patients with lung cancer, was re-evaluated in terms of sleep problems, insomnia and possible association with the cancer symptoms. Demographic characteristics of patients and information about disease were recorded for each patient by physicians via face-to-face interviews, and using hospital records. Patients who have difficulty initiating or maintaining sleep (DIMS) is associated with daytime sleepiness/fatigue were diagnosed as having insomnia. Daytime sleepiness, fatigue and lung cancer symptoms were recorded and graded using the Edmonton Symptom Assessment Scale. Results: Among 1245 cases, 48.4% reported DIMS, 60.8% reported daytime sleepiness and 82.1% reported fatigue. The prevalence of insomnia was 44.7%. Female gender, patients with stage 3-4 disease, patients with metastases, with comorbidities, and with weight loss > 5 kg had higher rates of insomnia. Also, patients with insomnia had significantly higher rates of pain, nausea, dyspnea, and anxiety. Multivariate logistic regression analysis showed that patients with moderate to severe pain and dyspnea and severe anxiety had 2-3 times higher rates of insomnia. Conclusion: In conclusion, our results showed a clear association between sleep disturbances and cancer symptoms. Because of that, adequate symptom control is essential to maintain sleep quality in patients with lung cancer.
