Seher Satar - Academia.edu (original) (raw)
Papers by Seher Satar
Güncel göğüs hastalıkları serisi, Aug 5, 2020
Journal of Clinical Nursing, Jul 26, 2021
Jornal Brasileiro De Pneumologia, Dec 17, 2023
Objetivo: Uma das limitações comuns após a pneumonia por COVID-19 é a diminuição da capacidade de... more Objetivo: Uma das limitações comuns após a pneumonia por COVID-19 é a diminuição da capacidade de exercício. A identificação dos fatores que afetam a capacidade de exercício e a avaliação dos pacientes em risco são importantes para determinar a estratégia de tratamento. Este estudo foi conduzido para determinar os preditores de diminuição da capacidade de exercício em pacientes pós-COVID-19 longa. Métodos: Foi investigada a associação da capacidade de exercício medida pelo incremental shuttle walk test (ISWT, teste de caminhada incremental) com idade, sexo, variáveis espirométricas, força muscular respiratória e periférica, qualidade de vida, fadiga, escala hospitalar de ansiedade e depressão, envolvimento na radiografia de tórax e status de atendimento. Os pacientes foram divididos em três grupos: pacientes ambulatoriais, pacientes internados e pacientes em UTI. A análise de regressão foi utilizada para determinar quais parâmetros eram preditores significativos da capacidade de exercício. Resultados: Dos 181 pacientes incluídos no estudo, 56 (31%) eram do sexo feminino. O ISWT médio em porcentagem dos valores previstos (ISWT%prev) foi de 43,20% em toda a amostra, enquanto foi de 52,89%, 43,71% e 32,21% nos grupos de pacientes ambulatoriais, internados e em UTI, respectivamente. A análise de regressão linear mostrou que os preditores de diminuição do ISWT%prev foram sexo (β = 8,089; p = 0,002), pontuação na escala mMRC (β = −7,004; p ≤ 0,001), CVF%prev (β = 0,151; p = 0,003), e força de preensão manual (β = 0,261; p = 0,030). Conclusões: Em pacientes pós-COVID-19 longa, sexo, percepção de dispneia, padrão restritivo da função respiratória e diminuição da força muscular periférica são preditores de redução da capacidade de exercício que persiste três meses após COVID-19. Nesse contexto, sugerimos que a reabilitação pulmonar pode ser uma terapia importante para pacientes pós-COVID-19. Descritores: COVID-19; Exercício; Força muscular; Reabilitação; Teste de caminhada.
Journal of Health Sciences and Medicine
Aims: The impact of postoperative complications after surgery for lung cancer is substantial, wit... more Aims: The impact of postoperative complications after surgery for lung cancer is substantial, with the increasing age of patients and the presence of comorbidities. Impairment in exercise capacity is a potential modifiable risk factor for postoperative complications. This study aimed to assess the contribution of preoperative pulmonary rehabilitation (PR) for increasing operability conditions in non-small cell lung cancer (NSCLC) for patients with limited pulmonary functions and postoperative results. Methods: The patients with NSCLC who had preoperative pulmonary rehabilitation and underwent surgical resection in our clinics between 2010-2019 were evaluated retrospectively. The patients enrolled in a comprehensive, multidisciplinary, supervised outpatient 10-day duration PR program preoperatively, consisting of bronchial hygiene, breathing control, energy conservation techniques, exercise training (endurance and strength), psychological support, and nutritional support. Exercise ca...
Journal of Pulmonology and Intensive Care
Aims: Early diagnosis and treatment affect mortality in hospital-acquired pneumonia (HAP). Theref... more Aims: Early diagnosis and treatment affect mortality in hospital-acquired pneumonia (HAP). Therefore, clinicians need some objective parameters for guiding treatment. The aim of this study was to determine the course of ‘‘clinical pulmonary infection score’’ (CPIS), C-reactive protein (CRP) and procalcitonin (PCT) in patients under treatment as well as the relationship of these parameters with each other and mortality. Methods: This single-center, prospective, cross-sectional study focused on cases of HAP in hospitalized patients. In patients with HAP; CPIS, CRP and PCT assays were assessed on the first day. Appropriate treatment was initiated according to Turkish Thoracic Society HAP Task Force recommendations. On the 3rd day, CPIS evaluation and on the 4th day CRP and PCT analysis were repeated. All the patients’ one month mortality rates were recorded. Results: Among the 25 patients, there were 14 females. The mean age was 66±15 years. The mean duration for HAP development was 9....
Turkish Journal of Medical Sciences
Revista da Associação Médica Brasileira
OBJECTIVE: This study aimed to investigate if there is any correlation between the quantitative c... more OBJECTIVE: This study aimed to investigate if there is any correlation between the quantitative computed tomography and the impulse oscillometry or spirometry results of post-COVID-19 patients. METHODS: The study comprised 47 post-COVID-19 patients who had spirometry, impulse oscillometry, and high-resolution computed tomography examinations at the same time. The study group consisted of 33 patients with quantitative computed tomography involvement, while the control group included 14 patients who did not have CT findings. The quantitative computed tomography technology was used to calculate percentages of density range volumes. The relationship between percentages of density range volumes for different quantitative computed tomography density ranges and impulse oscillometry-spirometry findings was statistically analyzed. RESULTS: In quantitative computed tomography, the percentage of relatively high-density lung parenchyma, including fibrotic areas, was 1.76±0.43 and 5.65±3.73 in the control and study groups, respectively. The percentages of primarily ground-glass parenchyma areas were found to be 7.60±2.86 and 29.25±16.50 in the control and study groups, respectively. In the correlation analysis, the forced vital capacity% predicted in the study group was correlated with DRV% [(-750)-(-500)] (volume of the lung parenchyma that has density between (-750)-(-500) Hounsfield units), but no correlation with DRV% [(-500)-0] was detected. Also, reactance area and resonant frequency were correlated with DRV% [(-750)-(-500)] , while X 5 was correlated with both DRV% [(-500)-0] and DRV% [(-750)-(-500)] density. Modified Medical Research Council score was correlated with predicted percentages of forced vital capacity and X 5. CONCLUSION: After COVID-19, forced vital capacity, reactance area, resonant frequency, and X 5 correlated with the percentages of density range volumes of ground-glass opacity areas in the quantitative computed tomography. X 5 was the only parameter correlated with density ranges consistent with both ground-glass opacity and fibrosis. Furthermore, the percentages of forced vital capacity and X 5 were shown to be associated with the perception of dyspnea.
Tüberküloz ve toraks, Mar 1, 2023
Journal of Cardiopulmonary Rehabilitation and Prevention, 2007
Los cuidados paliativos son un abordaje comprensivo a largo plazo que puede ser paralelo o integr... more Los cuidados paliativos son un abordaje comprensivo a largo plazo que puede ser paralelo o integrado al tratamiento del cáncer, mientras que la rehabilitación pulmonar es una estrategia que impacta desenlaces específicos.
Iranian Rehabilitation Journal
Objectives: Idiopathic pulmonary fibrosis (IPF) is characterized by progressively worsening lung ... more Objectives: Idiopathic pulmonary fibrosis (IPF) is characterized by progressively worsening lung function, ventilation capacity, dyspnea, and finally reduced exercise intolerance. All of these have a significant negative impact on functional capacity and quality of life. In this study, we aim to evaluate the effects of pulmonary rehabilitation (PR) in IPF and assess the predictors of success. Methods: Data from 17 IPF patients who completed the program from the total of 27 patients who applied to PR were used in our study. We evaluated their pulmonary function tests, exercise capacity, peripheral-respiratory muscle strength, body composition, quality of life, and psychological states before and after PR. Results: Following the PR program, improvements over the minimal clinically important differences were observed in almost all parameters compared to the baseline; however, statistically significant improvements were only observed in the medical research council (P=0.020), the St. Ge...
Turkish Journal of Medical Sciences
Between 2007 and 2015, 839 COPD patients were referred to our PR center, however, 163 were consid... more Between 2007 and 2015, 839 COPD patients were referred to our PR center, however, 163 were considered inappropriate for PR due to conditions such as uncontrolled heart failure, hypertension, cancer, unstable angina pectoris, severe pulmonary embolism or thrombosis, or major neurological diseases. So 676 patients were eligible for the PR program and were included in the study. While 509 patients who completed the program formed the PR group and the remaining 167 patients who did not complete the program for various reasons (active work-life, Background/aim: Chronic Obstructive Pulmonary Disease (COPD) is one of the most common causes of death worldwide. Therefore, optimizing medical therapy in the comprehensive management of the disease, as well as including pulmonary rehabilitation (PR) in the treatment, is essential. The goal of our study was to determine the impact of PR on the survival of COPD patients. Materials and methods: Between 2007-2015, 509 COPD patients who completed the PR constituted the PR group, while 167 patients who applied but could not complete it after the initial evaluations formed the control group. In the PR group, dyspnea perception, exercise capacity, muscle strength, body composition, quality of life, psychosocial status, and i-BODE scores were assessed at the beginning and end of the program, whereas in the control group, these assessments could only be conducted at the beginning. Also, after PR, our PR participants have prescribed a home exercise program, and they were recalled to the hospital at the 3rd, 6th, 12th, 18th, and 24th months for follow-up visits. Results: A statistically significant improvement was found in almost all the data (except FEV1/FVC, BORG after exercise, and FFMI) after PR. There was a statistically significant difference in 5-year survival in favor of the PR group (p = 0.006), and in PR patients who accompanied the home exercise program vs. those who did not (p = 0.000). Also the gains in MRC (p = 0.003; OR: 2.20; CI: 1.319-3.682), MEP (p = 0.041; OR: 1.02; CI: 1.001-1.035), and i-BODE (p = 0.006; OR: 0.914; CI: 0.857-0.974) increased the survival. Conclusion: Apart from incorporating PR into treatment in the comprehensive management of COPD, we demonstrated that maintaining a home exercise program for at least two years following PR increased 5-year survival significantly.
Advances in Respiratory Medicine
Introduction: Pulmonary rehabilitation (PR) is an effective approach for patients with chronic pu... more Introduction: Pulmonary rehabilitation (PR) is an effective approach for patients with chronic pulmonary disease, and it is also recommended for patients with bronchiectasis. The aims of the current study were to evaluate the efficacy of a multidisciplinary PR program and identify factors associated with improvement in patients with bronchiectasis. Material and ethods: We obtained data from patients with bronchiectasis who completed our PR program which consisted of education and training regarding bronchial hygiene. Pulmonary function test results, body composition, exercise capacity, quality of life, and psychological status were assessed before and after the PR program. Results: We enrolled 130 patients in this retrospective study. Most patients had a history of pneumonia. The Medical Research Council (MRC) dyspnea scale, incremental shuttle walking test (ISWT), endurance shuttle walking test (ESWT), St. George’s Respiratory Questionnaire (SGRQ), Chronic Respiratory Questionnaire...
Journal of Ankara University Faculty of Medicine
Objectives: Kyphoscoliosis (KS) is a common spinal deformity. The most common symptoms are dyspne... more Objectives: Kyphoscoliosis (KS) is a common spinal deformity. The most common symptoms are dyspnea, reduced exercise capacity, and impaired quality of life. The aim of our study was to investigate the effectiveness of pulmonary rehabilitation (PR) in patients with KS and in which patients the gainings are prominent. Materials and Methods: Forty-six patients who were diagnosed as KS and completed a multidisciplinary comprehensive supervised outpatient PR program were evaluated. Pulmonary functions, body composition, exercise capacity, respiratory and peripheral muscle strength, quality of life, psychological states were assessed before and after the PR program. The data of the patients were reviewed retrospectively. Results: After the PR program, statistically significant differences were observed in Medical Research Council (MRC) levels, Borg, incremental shuttle walking test, endurance shuttle walking test, six minutes walk test, maximal inspiratory pressure, maximal expiratory pressure, hand grip test, deltoid and quadriceps 1-repetition maximum tests, St. George Respiratory Questionnaire (SGRQ), chronic respiratory diseases questionnaire, hospital anxiety and depression scores (HAD-anxiety/depression). There was a statistically significant negative correlation between the initial FEV 1 and the gain in anxiety. We also found a statistically significant negative correlation between the initial MRC, SGRQ, anxiety values and the gainings in depression data. Conclusion: After multidisciplinary comprehensive PR program, there was an improvement in perception of dyspnea, muscle strengths, exercise capacities, quality of life, anxiety and depression scores. Our results indicate that the most prominent gainings were in the early stages of the disease.
Idiopathic interstitial pneumonias, 2020
Respiratory Case Reports, 2022
Muscle weakness acquired in intensive care, postintensive care syndrome, psychological dysfunctio... more Muscle weakness acquired in intensive care, postintensive care syndrome, psychological dysfunction and changes in body composition are the main reasons cited in Pulmonary Rehabilitation (PR) applications after discharge in cases followed up in the intensive care unit (ICU) due to COVID-19 pneumonia. Although the limitations of face-to-face PR applications during the pandemic have made tele-PR more common, the appropriate patient profile for PR is still unknown. In this case series, video conferencingmediated tele-PR was applied as a hybrid approach and compared with PR in a face-to-face format in five cases referred after ICU. After the initial and final evaluations and the first two exercise sessions were performed in the outpatient PR unit, the program was continued via a video-conferencing method. At the end of the total 18 sessions, a decrease was noted in the perception of dyspnea, and an increase in exercise capacity and muscle strength. A decrease in the severity of COVID-19-related fatigue was also noted.
Respiratory Case Reports, 2022
Various radiological findings have been detected associated with SARS-CoV-2 (COVID-19). We presen... more Various radiological findings have been detected associated with SARS-CoV-2 (COVID-19). We present here a middle-aged patient with a thick-walled cavitary lesion resembling lung cancer radiologically after COVID-19. Most of the etiological factors for cavitary lung lesions were investigated, and no specific cause was found. After empirical dual antibiotic treatment, the cavitary and the nodular lesion were observed to regress almost completely in control thorax computed tomography. For this reason, we considered the cavity of our patient as a late complication of COVID-19 and also we advocate the importance of monitoring patients with clinical data and laboratory values as well as radiological findings after contracting COVID-19.
European Respiratory Journal, 2020
Rehabilitation and Chronic Care, 2018
L ung transplantation (LTx) is a therapeutic, effective, and life-saving intervention for selecte... more L ung transplantation (LTx) is a therapeutic, effective, and life-saving intervention for selected patients with end-stage pulmonary disease who are unresponsive to medical or surgical treatment. All chronic lung diseases commonly occur in association with several comorbidities. One of the most common and important extrapulmonary manifestations is skeletal muscle dysfunction, 1 , 2 which results in deteriorated physical activity, exercise capacity, and quality of life. 3 Although exercise capacity and quality of life have been found to be improve after LTx, especially after the fi rst year, exercise capacity is lower than in healthy controls. 4 , 5 The most important reason for exercise intolerance is skeletal muscle dysfunction. The main underlying mechanisms of skeletal muscle dysfunction are not fully understood, but there are several possible causes such as time spent in the intensive care unit, hospital stay duration, and sedentary lifestyle after discharge. Furthermore, muscle weakness may be infl uenced by infections, acute rejection, and the use of immunosuppressive medication in LTx recipients. 6 It has also been shown that changes in skeletal muscle are associated with decreased oxidative capacity, lactate threshold, and ratio of type I muscle fi bers. 7 Therefore, pulmonary rehabilitation (PR), as a comprehensive, multidisciplinary approach, is advocated pre-LTx and in the post-LTx period. The aim of this study was to investigate the effect of a multidisciplinary, comprehensive outpatient PR program on exercise capacity; hand, quadriceps, and respiratory muscle strength; dyspnea and quality of life; psychological status; pulmonary function; and body composition in LTx recipients in the early period after hospital discharge. METHODS SAMPLE CHARACTERISTICS Twenty-three bilateral LTx recipients were referred to the PR center between 2013 and 2017. This study was conducted in accordance with the amended Declaration of Helsinki. The patients' parameters were recorded after obtaining intuitional review board approval and receiving written informed consent. The diagnoses of the 23 patients were chronic obstructive pulmonary disease (30%), idiopathic pulmonary fi brosis (30%), histiocytosis-X (13%), silicosis (9%), bronchiectasis (9%), α-1 antitrypsin defi ciency (4%), and pulmonary alveolar proteinosis (4%). Six patients did not complete the PR program. The reasons of dropout were 1 case each of bronchial stenosis, venous thrombosis, and pneumonia, and 3 with transportation problems. The initiation of the program was 75 ± 15 d after LTx. The demographic characteristics of patients are presented in Table 1. All patients were under immunosuppressive treatment including tacrolimus, mycophenolate mofetil, systemic steroids, and prophylactic antifungal, antibacterial, and antiviral treatment as with the standard recommended medical treatment for LTx recipients. 8 None of the recipients had symptoms or diagnoses of infectious and noninfectious complications such as anastomotic problems, allograft rejection,
Güncel göğüs hastalıkları serisi, Aug 5, 2020
Journal of Clinical Nursing, Jul 26, 2021
Jornal Brasileiro De Pneumologia, Dec 17, 2023
Objetivo: Uma das limitações comuns após a pneumonia por COVID-19 é a diminuição da capacidade de... more Objetivo: Uma das limitações comuns após a pneumonia por COVID-19 é a diminuição da capacidade de exercício. A identificação dos fatores que afetam a capacidade de exercício e a avaliação dos pacientes em risco são importantes para determinar a estratégia de tratamento. Este estudo foi conduzido para determinar os preditores de diminuição da capacidade de exercício em pacientes pós-COVID-19 longa. Métodos: Foi investigada a associação da capacidade de exercício medida pelo incremental shuttle walk test (ISWT, teste de caminhada incremental) com idade, sexo, variáveis espirométricas, força muscular respiratória e periférica, qualidade de vida, fadiga, escala hospitalar de ansiedade e depressão, envolvimento na radiografia de tórax e status de atendimento. Os pacientes foram divididos em três grupos: pacientes ambulatoriais, pacientes internados e pacientes em UTI. A análise de regressão foi utilizada para determinar quais parâmetros eram preditores significativos da capacidade de exercício. Resultados: Dos 181 pacientes incluídos no estudo, 56 (31%) eram do sexo feminino. O ISWT médio em porcentagem dos valores previstos (ISWT%prev) foi de 43,20% em toda a amostra, enquanto foi de 52,89%, 43,71% e 32,21% nos grupos de pacientes ambulatoriais, internados e em UTI, respectivamente. A análise de regressão linear mostrou que os preditores de diminuição do ISWT%prev foram sexo (β = 8,089; p = 0,002), pontuação na escala mMRC (β = −7,004; p ≤ 0,001), CVF%prev (β = 0,151; p = 0,003), e força de preensão manual (β = 0,261; p = 0,030). Conclusões: Em pacientes pós-COVID-19 longa, sexo, percepção de dispneia, padrão restritivo da função respiratória e diminuição da força muscular periférica são preditores de redução da capacidade de exercício que persiste três meses após COVID-19. Nesse contexto, sugerimos que a reabilitação pulmonar pode ser uma terapia importante para pacientes pós-COVID-19. Descritores: COVID-19; Exercício; Força muscular; Reabilitação; Teste de caminhada.
Journal of Health Sciences and Medicine
Aims: The impact of postoperative complications after surgery for lung cancer is substantial, wit... more Aims: The impact of postoperative complications after surgery for lung cancer is substantial, with the increasing age of patients and the presence of comorbidities. Impairment in exercise capacity is a potential modifiable risk factor for postoperative complications. This study aimed to assess the contribution of preoperative pulmonary rehabilitation (PR) for increasing operability conditions in non-small cell lung cancer (NSCLC) for patients with limited pulmonary functions and postoperative results. Methods: The patients with NSCLC who had preoperative pulmonary rehabilitation and underwent surgical resection in our clinics between 2010-2019 were evaluated retrospectively. The patients enrolled in a comprehensive, multidisciplinary, supervised outpatient 10-day duration PR program preoperatively, consisting of bronchial hygiene, breathing control, energy conservation techniques, exercise training (endurance and strength), psychological support, and nutritional support. Exercise ca...
Journal of Pulmonology and Intensive Care
Aims: Early diagnosis and treatment affect mortality in hospital-acquired pneumonia (HAP). Theref... more Aims: Early diagnosis and treatment affect mortality in hospital-acquired pneumonia (HAP). Therefore, clinicians need some objective parameters for guiding treatment. The aim of this study was to determine the course of ‘‘clinical pulmonary infection score’’ (CPIS), C-reactive protein (CRP) and procalcitonin (PCT) in patients under treatment as well as the relationship of these parameters with each other and mortality. Methods: This single-center, prospective, cross-sectional study focused on cases of HAP in hospitalized patients. In patients with HAP; CPIS, CRP and PCT assays were assessed on the first day. Appropriate treatment was initiated according to Turkish Thoracic Society HAP Task Force recommendations. On the 3rd day, CPIS evaluation and on the 4th day CRP and PCT analysis were repeated. All the patients’ one month mortality rates were recorded. Results: Among the 25 patients, there were 14 females. The mean age was 66±15 years. The mean duration for HAP development was 9....
Turkish Journal of Medical Sciences
Revista da Associação Médica Brasileira
OBJECTIVE: This study aimed to investigate if there is any correlation between the quantitative c... more OBJECTIVE: This study aimed to investigate if there is any correlation between the quantitative computed tomography and the impulse oscillometry or spirometry results of post-COVID-19 patients. METHODS: The study comprised 47 post-COVID-19 patients who had spirometry, impulse oscillometry, and high-resolution computed tomography examinations at the same time. The study group consisted of 33 patients with quantitative computed tomography involvement, while the control group included 14 patients who did not have CT findings. The quantitative computed tomography technology was used to calculate percentages of density range volumes. The relationship between percentages of density range volumes for different quantitative computed tomography density ranges and impulse oscillometry-spirometry findings was statistically analyzed. RESULTS: In quantitative computed tomography, the percentage of relatively high-density lung parenchyma, including fibrotic areas, was 1.76±0.43 and 5.65±3.73 in the control and study groups, respectively. The percentages of primarily ground-glass parenchyma areas were found to be 7.60±2.86 and 29.25±16.50 in the control and study groups, respectively. In the correlation analysis, the forced vital capacity% predicted in the study group was correlated with DRV% [(-750)-(-500)] (volume of the lung parenchyma that has density between (-750)-(-500) Hounsfield units), but no correlation with DRV% [(-500)-0] was detected. Also, reactance area and resonant frequency were correlated with DRV% [(-750)-(-500)] , while X 5 was correlated with both DRV% [(-500)-0] and DRV% [(-750)-(-500)] density. Modified Medical Research Council score was correlated with predicted percentages of forced vital capacity and X 5. CONCLUSION: After COVID-19, forced vital capacity, reactance area, resonant frequency, and X 5 correlated with the percentages of density range volumes of ground-glass opacity areas in the quantitative computed tomography. X 5 was the only parameter correlated with density ranges consistent with both ground-glass opacity and fibrosis. Furthermore, the percentages of forced vital capacity and X 5 were shown to be associated with the perception of dyspnea.
Tüberküloz ve toraks, Mar 1, 2023
Journal of Cardiopulmonary Rehabilitation and Prevention, 2007
Los cuidados paliativos son un abordaje comprensivo a largo plazo que puede ser paralelo o integr... more Los cuidados paliativos son un abordaje comprensivo a largo plazo que puede ser paralelo o integrado al tratamiento del cáncer, mientras que la rehabilitación pulmonar es una estrategia que impacta desenlaces específicos.
Iranian Rehabilitation Journal
Objectives: Idiopathic pulmonary fibrosis (IPF) is characterized by progressively worsening lung ... more Objectives: Idiopathic pulmonary fibrosis (IPF) is characterized by progressively worsening lung function, ventilation capacity, dyspnea, and finally reduced exercise intolerance. All of these have a significant negative impact on functional capacity and quality of life. In this study, we aim to evaluate the effects of pulmonary rehabilitation (PR) in IPF and assess the predictors of success. Methods: Data from 17 IPF patients who completed the program from the total of 27 patients who applied to PR were used in our study. We evaluated their pulmonary function tests, exercise capacity, peripheral-respiratory muscle strength, body composition, quality of life, and psychological states before and after PR. Results: Following the PR program, improvements over the minimal clinically important differences were observed in almost all parameters compared to the baseline; however, statistically significant improvements were only observed in the medical research council (P=0.020), the St. Ge...
Turkish Journal of Medical Sciences
Between 2007 and 2015, 839 COPD patients were referred to our PR center, however, 163 were consid... more Between 2007 and 2015, 839 COPD patients were referred to our PR center, however, 163 were considered inappropriate for PR due to conditions such as uncontrolled heart failure, hypertension, cancer, unstable angina pectoris, severe pulmonary embolism or thrombosis, or major neurological diseases. So 676 patients were eligible for the PR program and were included in the study. While 509 patients who completed the program formed the PR group and the remaining 167 patients who did not complete the program for various reasons (active work-life, Background/aim: Chronic Obstructive Pulmonary Disease (COPD) is one of the most common causes of death worldwide. Therefore, optimizing medical therapy in the comprehensive management of the disease, as well as including pulmonary rehabilitation (PR) in the treatment, is essential. The goal of our study was to determine the impact of PR on the survival of COPD patients. Materials and methods: Between 2007-2015, 509 COPD patients who completed the PR constituted the PR group, while 167 patients who applied but could not complete it after the initial evaluations formed the control group. In the PR group, dyspnea perception, exercise capacity, muscle strength, body composition, quality of life, psychosocial status, and i-BODE scores were assessed at the beginning and end of the program, whereas in the control group, these assessments could only be conducted at the beginning. Also, after PR, our PR participants have prescribed a home exercise program, and they were recalled to the hospital at the 3rd, 6th, 12th, 18th, and 24th months for follow-up visits. Results: A statistically significant improvement was found in almost all the data (except FEV1/FVC, BORG after exercise, and FFMI) after PR. There was a statistically significant difference in 5-year survival in favor of the PR group (p = 0.006), and in PR patients who accompanied the home exercise program vs. those who did not (p = 0.000). Also the gains in MRC (p = 0.003; OR: 2.20; CI: 1.319-3.682), MEP (p = 0.041; OR: 1.02; CI: 1.001-1.035), and i-BODE (p = 0.006; OR: 0.914; CI: 0.857-0.974) increased the survival. Conclusion: Apart from incorporating PR into treatment in the comprehensive management of COPD, we demonstrated that maintaining a home exercise program for at least two years following PR increased 5-year survival significantly.
Advances in Respiratory Medicine
Introduction: Pulmonary rehabilitation (PR) is an effective approach for patients with chronic pu... more Introduction: Pulmonary rehabilitation (PR) is an effective approach for patients with chronic pulmonary disease, and it is also recommended for patients with bronchiectasis. The aims of the current study were to evaluate the efficacy of a multidisciplinary PR program and identify factors associated with improvement in patients with bronchiectasis. Material and ethods: We obtained data from patients with bronchiectasis who completed our PR program which consisted of education and training regarding bronchial hygiene. Pulmonary function test results, body composition, exercise capacity, quality of life, and psychological status were assessed before and after the PR program. Results: We enrolled 130 patients in this retrospective study. Most patients had a history of pneumonia. The Medical Research Council (MRC) dyspnea scale, incremental shuttle walking test (ISWT), endurance shuttle walking test (ESWT), St. George’s Respiratory Questionnaire (SGRQ), Chronic Respiratory Questionnaire...
Journal of Ankara University Faculty of Medicine
Objectives: Kyphoscoliosis (KS) is a common spinal deformity. The most common symptoms are dyspne... more Objectives: Kyphoscoliosis (KS) is a common spinal deformity. The most common symptoms are dyspnea, reduced exercise capacity, and impaired quality of life. The aim of our study was to investigate the effectiveness of pulmonary rehabilitation (PR) in patients with KS and in which patients the gainings are prominent. Materials and Methods: Forty-six patients who were diagnosed as KS and completed a multidisciplinary comprehensive supervised outpatient PR program were evaluated. Pulmonary functions, body composition, exercise capacity, respiratory and peripheral muscle strength, quality of life, psychological states were assessed before and after the PR program. The data of the patients were reviewed retrospectively. Results: After the PR program, statistically significant differences were observed in Medical Research Council (MRC) levels, Borg, incremental shuttle walking test, endurance shuttle walking test, six minutes walk test, maximal inspiratory pressure, maximal expiratory pressure, hand grip test, deltoid and quadriceps 1-repetition maximum tests, St. George Respiratory Questionnaire (SGRQ), chronic respiratory diseases questionnaire, hospital anxiety and depression scores (HAD-anxiety/depression). There was a statistically significant negative correlation between the initial FEV 1 and the gain in anxiety. We also found a statistically significant negative correlation between the initial MRC, SGRQ, anxiety values and the gainings in depression data. Conclusion: After multidisciplinary comprehensive PR program, there was an improvement in perception of dyspnea, muscle strengths, exercise capacities, quality of life, anxiety and depression scores. Our results indicate that the most prominent gainings were in the early stages of the disease.
Idiopathic interstitial pneumonias, 2020
Respiratory Case Reports, 2022
Muscle weakness acquired in intensive care, postintensive care syndrome, psychological dysfunctio... more Muscle weakness acquired in intensive care, postintensive care syndrome, psychological dysfunction and changes in body composition are the main reasons cited in Pulmonary Rehabilitation (PR) applications after discharge in cases followed up in the intensive care unit (ICU) due to COVID-19 pneumonia. Although the limitations of face-to-face PR applications during the pandemic have made tele-PR more common, the appropriate patient profile for PR is still unknown. In this case series, video conferencingmediated tele-PR was applied as a hybrid approach and compared with PR in a face-to-face format in five cases referred after ICU. After the initial and final evaluations and the first two exercise sessions were performed in the outpatient PR unit, the program was continued via a video-conferencing method. At the end of the total 18 sessions, a decrease was noted in the perception of dyspnea, and an increase in exercise capacity and muscle strength. A decrease in the severity of COVID-19-related fatigue was also noted.
Respiratory Case Reports, 2022
Various radiological findings have been detected associated with SARS-CoV-2 (COVID-19). We presen... more Various radiological findings have been detected associated with SARS-CoV-2 (COVID-19). We present here a middle-aged patient with a thick-walled cavitary lesion resembling lung cancer radiologically after COVID-19. Most of the etiological factors for cavitary lung lesions were investigated, and no specific cause was found. After empirical dual antibiotic treatment, the cavitary and the nodular lesion were observed to regress almost completely in control thorax computed tomography. For this reason, we considered the cavity of our patient as a late complication of COVID-19 and also we advocate the importance of monitoring patients with clinical data and laboratory values as well as radiological findings after contracting COVID-19.
European Respiratory Journal, 2020
Rehabilitation and Chronic Care, 2018
L ung transplantation (LTx) is a therapeutic, effective, and life-saving intervention for selecte... more L ung transplantation (LTx) is a therapeutic, effective, and life-saving intervention for selected patients with end-stage pulmonary disease who are unresponsive to medical or surgical treatment. All chronic lung diseases commonly occur in association with several comorbidities. One of the most common and important extrapulmonary manifestations is skeletal muscle dysfunction, 1 , 2 which results in deteriorated physical activity, exercise capacity, and quality of life. 3 Although exercise capacity and quality of life have been found to be improve after LTx, especially after the fi rst year, exercise capacity is lower than in healthy controls. 4 , 5 The most important reason for exercise intolerance is skeletal muscle dysfunction. The main underlying mechanisms of skeletal muscle dysfunction are not fully understood, but there are several possible causes such as time spent in the intensive care unit, hospital stay duration, and sedentary lifestyle after discharge. Furthermore, muscle weakness may be infl uenced by infections, acute rejection, and the use of immunosuppressive medication in LTx recipients. 6 It has also been shown that changes in skeletal muscle are associated with decreased oxidative capacity, lactate threshold, and ratio of type I muscle fi bers. 7 Therefore, pulmonary rehabilitation (PR), as a comprehensive, multidisciplinary approach, is advocated pre-LTx and in the post-LTx period. The aim of this study was to investigate the effect of a multidisciplinary, comprehensive outpatient PR program on exercise capacity; hand, quadriceps, and respiratory muscle strength; dyspnea and quality of life; psychological status; pulmonary function; and body composition in LTx recipients in the early period after hospital discharge. METHODS SAMPLE CHARACTERISTICS Twenty-three bilateral LTx recipients were referred to the PR center between 2013 and 2017. This study was conducted in accordance with the amended Declaration of Helsinki. The patients' parameters were recorded after obtaining intuitional review board approval and receiving written informed consent. The diagnoses of the 23 patients were chronic obstructive pulmonary disease (30%), idiopathic pulmonary fi brosis (30%), histiocytosis-X (13%), silicosis (9%), bronchiectasis (9%), α-1 antitrypsin defi ciency (4%), and pulmonary alveolar proteinosis (4%). Six patients did not complete the PR program. The reasons of dropout were 1 case each of bronchial stenosis, venous thrombosis, and pneumonia, and 3 with transportation problems. The initiation of the program was 75 ± 15 d after LTx. The demographic characteristics of patients are presented in Table 1. All patients were under immunosuppressive treatment including tacrolimus, mycophenolate mofetil, systemic steroids, and prophylactic antifungal, antibacterial, and antiviral treatment as with the standard recommended medical treatment for LTx recipients. 8 None of the recipients had symptoms or diagnoses of infectious and noninfectious complications such as anastomotic problems, allograft rejection,