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Permanent URI for this collectionhttps://hdl.handle.net/11443/932
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Item Obesity might be a good prognosis factor for COPD patients using domiciliary noninvasive mechanical ventilation(DOVE MEDICAL PRESS LTD, 2016-01-01) Altinoz, Hilal; Adiguzel, Nalan; Salturk, Cuneyt; Gungor, Gokay; Mocin, Ozlem; Takir, Huriye Berk; Kargin, Feyza; Balci, Merih; Dikensoy, Oner; Karakurt, ZuhalCachexia is known to be a deteriorating factor for survival of patients with chronic obstructive pulmonary disease (COPD), but data related to obesity are limited. We observed that obese patients with COPD prescribed long-term noninvasive mechanical ventilation (NIMV) had better survival rate compared to nonobese patients. Therefore, we conducted a retrospective observational cohort study. Archives of Thoracic Diseases Training Hospital were sought between 2008 and 2013. All the subjects were prescribed domiciliary NIMV for chronic respiratory failure secondary to COPD. Subjects were grouped according to their body mass index (BMI). The first group consisted of subjects with BMI between 20 and 30 kg/m(2), and the second group consisted of subjects with BMI >30 kg/m(2). Data obtained at the first month's visit for the following parameters were recorded: age, sex, comorbid diseases, smoking history, pulmonary function test, 6-minute walk test (6-MWT), and arterial blood gas analysis. Hospital admissions were recorded before and after the domiciliary NIMV usage. Mortality rate was searched from the electronic database. Overall, 118 subjects were enrolled. Thirty-eight subjects had BMI between 20 and 30 kg/m(2), while 80 subjects had BMI >30 kg/m(2). The mean age was 65.8+/-9.4 years, and 81\% were male. The median follow-up time was 26 months and mortality rates were 32\% and 34\% for obese and nonobese subjects (P=0.67). Improvement in 6-MWT was protective against mortality. In conclusion, survival of obese patients with COPD using domiciliary NIMV was found to be better than those of nonobese patients, and the improvement in 6-MWT in such patients was found to be related to a better survival.Item Influence of Gender on Inhaler Technique(DAEDALUS ENTERPRISES INC, 2020-01-01) Ocakli, Birsen; Ozmen, Ipek; Tuncay, Eylem Acarturk; Gungor, Sinem; Ozalp, Aylin; Yasin, Yesim; Adiguzel, Nalan; Gungor, Gokay; Karakurt, ZuhalThis study was designed to evaluate the influence of gender on the inhaler technique of subjects on inhaler therapy and to determine the factors predicting the correct inhaler technique and a change of inhaler device. METHODS: A total of 568 adult subjects (276 male, 292 female) on inhaler therapy were included in this cross-sectional, observational study. Data on sociodemographic characteristics, inhaler therapy, subject-reported difficulties, and technician-reported errors in inhaler technique were recorded. RESULTS: A change of inhaler device was noted in 71.0\% of male subjects and 77.4\% of female subjects, and this was based on the physicians' decision in most cases (41.7\% and 51.7\%, respectively). A higher percentage of female subjects reported difficulties with using inhalers (63.7\% vs 40.6\%, P < .001). Overall, having received training on the inhaler technique was associated with a higher likelihood of correct inhaler technique (odds ratio 12.56, 95\% CI 4.44-35.50, P < .001) and a lower risk of device change (odds ratio 0.46, 95\% CI 0.27-0.77, P = .004). CONCLUSIONS: Errors in the inhaler technique, including inhalation maneuvers and device handling, were common in subjects on inhaler therapy. Subject-reported difficulties with using inhalers were more prevalent among female subjects, whereas errors in the inhaler technique identified by direct observation were similarly high in both genders. Overall, a lack of training on the inhaler technique predicted a higher likelihood of errors in the inhaler technique and a change of inhaler device.