Kişi: COŞKUN, NECMİYE FUNDA
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Yayın Açık Erişim Tolerability and efficacy of second-line antifibrotics in patients with idiopathic pulmonary fibrosis(Elsevier, 2021-11-24) Çilli, Aykut; Uzer, Fatih; Sevinç, Can; Coskun, Funda; Ursavaş, Ahmet; Öner, Sukriye; Köse, Firat; Coskun, Funda; COŞKUN, NECMİYE FUNDA; Ursavas, Ahmet; URSAVAŞ, AHMET; Bursa Uludağ Üniversitesi/Tıp Fakültesi.; Bursa Uludağ Üniversitesi/Tıp Fakültesi.; 0000-0003-3604-8826; AAI-3169-2021; AAD-1271-2019Background: The antifibrotic drugs nintedanib and pirfenidone reduce disease progression in idiopathic pulmonary fibrosis (IPF) and have also shown to improve survival. Switching first-line antifibrotic drug may required in IPF due to disease progression or intolerable adverse effects. The aim of this study was to assess the safety and efficacy of second-line antifibrotic treatment in patients with IPF.Material and methods: This retrospective, multicenter study was conducted at three referral interstitial lung disease centers who received first-line antifibrotics more than one month and switched the treatment to a second line antifibrotic agent during January 2016-June 2021. The drug's safety was evaluated based on the type of adverse effect. Disease progression was defined as an absolute decline in FVC of >10% within 12 months with or without radiological progression.Results: Among 629 consecutive patients with IPF, 66 patients switched antifibrotics. The median duration of antifibrotics was 13 (1-41) months prior to the switch, and 14 (2-42) months after the switch. The mean age was 70.6 +/- 8.9 years and, median FVC (%) was 72.1 +/- 18.7 at the initiation of first-line antifibrotics. The most common reason for the switch was disease progression (56%) followed by severe adverse effects (SAEs) (44%). SAEs were significantly less observed after the switch compared before the switch (43.9% vs12.1%, respectively, p < 0.001). Eighteen patients had adverse effects due to second-line antifibrotics. Among these patients, 10 had mild adverse effects and 8 had severe adverse effects. While there was no change in the FVC (%) values in 30.3% patients 12 months after the first-line antifibrotic treatment (before the switch), there was no change in the FVC (%) values in 40% patients at the end of 12 months after the switch. Fourteen patients (42.4%) who received antifibrotic treatment before the switch had more than 10% decline in FVC (%) at the end of 12 months. Eight patients (32.0%) had 10% or more decline in FVC (%) 12 months after the switch.Conclusion: Patients with IPF who do not tolerate first-line antifibrotic treatment or those showing disease progression despite treatment, switching antifibrotics may be a feasible management strategy.Yayın Sadece Metadata Effects of the covid-19 pandemic on the follow-up and treatment of patients with idiopathic pulmonary fibrosis: A cross-sectional, multicentre phone call survey(Bmj Publishing Group, 2021-01-01) Coskun, Funda; Hanta, Ismail; Cilli, Aykut; Ozkaya, Guven; Ursavas, Ahmet; Sevinc, Can; Ursavas, Ahmet; URSAVAŞ, AHMET; Coskun, Funda; COŞKUN, NECMİYE FUNDA; 0000-0003-3604-8826; AAD-1271-2019; AAI-3169-2021Objective To learn about the attitudes and behaviours of patients with idiopathic pulmonary fibrosis (IPF) in relation to the difficulties experienced during the COVID-19 pandemic. Design A cross-sectional, multicentre phone call survey. Setting Four university hospitals in Turkey. Participants The study included patients with IPF receiving antifibrotics for at least 3 months and with doctor appointment and/or scheduled routine blood analysis between March and May 2020 (the first 3 months after the official announcement of the COVID-19 pandemic in Turkey). Interventions Phone calls (a 5 min interview) were performed in June 2020. A questionnaire and the Hospital Anxiety-Depression Scale were applied. Main outcome measures Patients' preferences for disease monitoring, patients' attitudes and behaviours towards IPF, drug continuation, COVID-19 diagnosis and anxiety/depression status. Results The study included 115 patients with IPF (82 male; mean age, 68.43 +/- 7.44 years). Of the patients, 73.9% had doctor appointment and 52.2% had scheduled routine blood testing; 54.5% of patients with doctor appointment self-cancelled their appointments and 53.3% of patients with scheduled routine blood testing did not undergo testing. Of the patients, 32.2% were on nintedanib and 67.8% were on pirfenidone; self-initiated drug discontinuation rate was 22.6%. The percentage of patients communicating with their physicians was 35.7%. The route of communication was by phone (34.8%). The frequency of depression and anxiety was 27.0% and 38.3%, respectively. The rates of drug discontinuation (35.1% vs 16.7%, p<0.05) and depression (37.8% vs 21.8%, p=0.07) were higher in nintedanib users than in pirfenidone users. Only two (1.7%) patients had COVID-19 diagnosis. Conclusions During the COVID-19 pandemic, a significant proportion (>50%) of patients self-cancelled their appointments and nearly a quarter of patients discontinued their medications. Providing a documentation of the problems experienced by patients with IPF about management of the necessary requirements during the COVID-19 pandemic, this study may be a model for patients with chronic diseases.Yayın Sadece Metadata Understanding university students' smoking behaviors towards tobacco-free campus policy(Turkish Assoc Tuberculosis & Thorax, 2021-01-01) Karadag, Mehmet; Aydin Güçlü, Ozge; Gorek Dilektaşlı, Aslı; Coskun, Funda; Uzaslan, Esra; Gorek Dilektasli, Asli; GÖREK DİLEKTAŞLI, ASLI; Aydin Guclu, Ozge; AYDIN GÜÇLÜ, ÖZGE; Karadag, Mehmet; KARADAĞ, MEHMET; Coskun, Funda; COŞKUN, NECMİYE FUNDA; Uzaslan, Esra; UZASLAN, AYŞE ESRA; Bursa Uludağ Üniversitesi/Tıp Fakültesi.; 0000-0002-9027-1132; 0000-0003-1005-3205; 0000-0001-7099-9647; 0000-0003-3604-8826; AAG-8744-2021; AAG-9930-2019; AAD-1271-2019Introduction: Tobacco-free college campuses refer to colleges and universities that have implemented policies prohibiting the use of tobacco products at all indoor and outdoor campus locations. We aimed to evaluate university students' smoking behaviors and their attitudes towards "Tobacco-Free Campus Policy".Materials and Methods: A total of 10,383 university students were included in this cross-sectional study. The questionnaire was sent via web-based student information system. Demographical variables, the frequency of tobacco use, the addiction levels of the smoker students, and their perspective on the Tobacco-Free Campus Policy were evaluated.Results: The study population consisted of 5461 (52.6%) males and their mean age was 22.1 +/- 3.9 years. Among the students, 3992 (38.4%) were current smokers and the age of first smoking was 16.5 +/- 2.78 years. According to FTND scores, 15.1% of participants have high dependence, and 7.5% of them have very high dependence. There was a significant difference among participants who finds unacceptable "Tobacco-Free Campus Policy" in terms of gender (70.7% males vs. 29.3% females, p< 0.001) and smoking habit (7% never smoker, 4.1% ex-smoker, 88.9% current smoker, p< 0.001).Conclusion: The Tobacco-Free Campus Policy is important to fight against the tobacco industry in order to protect the right to health of all tobacco users and those who do not use it and should be considered as a goal to be achieved in order to live in a healthy environment.Yayın Açık Erişim Evaluation of efficacy and safety of pirfenidone 200 mg tablets in patients with idiopathic pulmonary fibrosis in a real-life setting(Tubitak Scientific & Technological Research Council Turkey, 2021-01-01) Cilli, Aykut; Hanta, Ismail; Sevinc, Can; Odemi, Ayse; Coskun, Necmiye Funda; COŞKUN, NECMİYE FUNDA; Ursavas, Ahmet; URSAVAŞ, AHMET; Bursa Uludağ Üniversitesi/Tıp Fakültesi.; 0000-0003-3604-8826; 0000-0002-4069-9181; AAI-3169-2021; AAD-1271-2019Background/aim: Phase III trials have demonstrated a significant efficacy and an acceptable safety for pirfenidone in patients having mild to moderate idiopathic pulmonary fibrosis (IPF). Real-life data on the use of pirfenidone 200 mg tablets are limited. This study aimed to investigate the efficacy and safety of pirfenidone 200 mg tablets for the treatment of IPF in a real-life setting. Materials and methods: A retrospective, multicenter study conducted in four university hospitals in Turkey between January 2017 and January 2019. Clinical records of patients diagnosed with mild to moderate IPF and receiving pirfenidone (200 mg tablets, total 2400 mg/day) were reviewed retrospectively and consecutively. Pulmonary function measurements including forced vital capacity (FVC%) and diffusing capacity of the lungs for carbon monoxide (DLCO%) were analyzed at baseline and after 6-month of pirfenidone treatment. Descriptive statistics were expressed as mean, standard error or median (minimum-maximum), number and percentage, where appropriate. Results: The study included 82 patients, of whom 87.8% were males (mean age, 66 years). After 6-month of treatment, 7 patients discontinued the treatment. Of the remaining 75 patients, 71 (94.6%) remained stable, 4 (5.4%) had progressive disease as evident by a decline in the FVC% of at least 10% while on treatment, and 45 (61.3%) had improved cough. At least one adverse event (AE) associated with the treatment was observed in 28 (37.3%) patients. Conclusion: Pirfenidone 200 mg was effective and well tolerated and associated with relatively mild and manageable AEs in IPF patients.Yayın Sadece Metadata Association of cytotoxic T lymphocyte subsets with disease severity in Covid-19(Wiley, 2021-08-01) Kızmaz, Muhammed Ali; Çağan, Eren; Şimşek, Abdurrahman; Dombaz, Fatma; Tezcan, Gülçin; Aşan, Ali; Demir, H. İbrahim; Bal, S. Haldun; Ermiş, Diğdem Yöyen; Coşkun, Necmiye Funda; Akalın, E. Halis; Oral, Haluk Barbaros; Budak, Ferah; Kızmaz, Muhammed Ali; ŞİMŞEK, ABDURRAHMAN; Dombaz, Fatma; TEZCAN, GÜLÇİN; Demir, H. İbrahim; BAL, SALİH HALDUN; YÖYEN ERMİŞ, DİĞDEM; COŞKUN, NECMİYE FUNDA; AKALIN, EMİN HALİS; ORAL, HALUK BARBAROS; BUDAK, FERAH; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İmmünoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Diş Hekimliği Fakültesi/Temel Bilimler Bölümü.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Klinik Mikrobiyoloji ve Enfeksiyon Hastalıkları Anabilim Dalı.; 0000-0001-5334-7911; 0000-0001-8850-0269; 0000-0001-7288-3250; 0000-0002-5956-8755; 0000-0002-8856-7356; 0000-0001-7585-7971; 0000-0003-3604-8826; 0000-0001-7530-1279; 0000-0003-0463-6818; 0000-0001-7625-9148; 0000-0003-3604-8826; HKN-2347-2023; IZP-9398-2023; AAH-3843-2020; F-4657-2014; AAG-7381-2021; K-7285-2012; AAU-8952-2020; DWR-5356-2022; GPN-1473-2022; KBR-5535-2024; GYL-2038-2022; AAD-1271-2019Yayın Sadece Metadata Interleukin-21: A potential biomarker for diagnosis and predicting prognosis in covid-19 patients(Tubitak Scientific & Technological Research Council Turkey, 2021-01-01) Acet Ozturk, Nilufer Aylin; ACET ÖZTÜRK, NİLÜFER AYLİN; Ursavas, Ahmet; URSAVAŞ, AHMET; Gorek Dilektasli, Asli; GÖREK DİLEKTAŞLI, ASLI; Demirdogen, Ezgi; DEMİRDÖĞEN, EZGİ; Coskun, Necmiye Funda; COŞKUN, NECMİYE FUNDA; Ediger, Dane; EDİGER, DANE; Uzaslan, Ayse Esra; UZASLAN, AYŞE ESRA; Yoyen-Ermis, Digdem; YÖYEN ERMİŞ, DİĞDEM; Karaca, Mert; KARACA, MERT; Terzi, Orkun Eray; TERZİ, ORKUN ERAY; Bayram, Merve; BAYRAM, MERVE; Omer Topcu, Dilara; ÖMER TOPÇU, DİLARA; Yigitliler, Busra; Yurttas, Ahmet; YURTTAŞ, AHMET; Maharramov, Shahriyar; Yazici, Gamze; YAZICI, GAMZE; Oral, Haluk Barbaros; ORAL, HALUK BARBAROS; Karadag, Mehmet; KARADAĞ, MEHMET; Bursa Uludağ Üniversitesi/Tıp Fakültesi.; 0000-0002-6375-1472; 0000-0001-7099-9647; 0000-0002-7400-9089; 0000-0003-3604-8826; 0000-0002-2954-4293; 0000-0001-5871-8769; 0000-0003-0463-6818; 0000-0002-9027-1132; AAG-7406-2021; AAD-1271-2019; AAH-3888-2021; K-7285-2012; AAG-8744-2021; AAI-3169-2021; JPK-7012-2023; AAE-9142-2019Background/aim: COVID-19 patients have a wide spectrum of disease severity. Several biomarkers were evaluated as predictors for progression towards severe disease. IL-21 is a member of common gamma-chain cytokine family and creates some specific effects during programming and maintenance of antiviral immunity. We aimed to assess IL-21 as a biomarker for diagnosis and outcome prediction in patients hospitalized with COVID-19. Materials and methods: Patients with a preliminary diagnosis of COVID-19 and pneumonia other than COVID-19 admitted to a tertiary care hospital were included consecutively in this comparative study. Results: The study population consisted of 51 patients with COVID-19 and 11 patients with non-COVID-19 pneumonia. Serum IL-21 concentration was markedly higher, and serum CRP concentration was significantly lower in COVID-19 patients compared to nonCOVID-19 pneumonia patients. Within COVID-19 patients, 10 patients showed radiological and clinical progression. Patients with clinical worsening had lower lymphocyte count and haemoglobin. In addition to that, deteriorating patients had higher urea, LDH levels, and elevated concentration of both IL-6 and IL-21. The cut-off value of 106 ng/L for IL-21 has 80.0% sensitivity, %60.9 specificity for discriminating patients with clinical worsening. Multivariable analysis performed to define risk factors for disease progression identified IL-6 and IL-21 as independent predictors. Odds ratio for serum IL-6 concentrations >_ 3.2 pg/mL was 8.07 (95% CI: 1.3747.50, p = 0.04) and odds ratio for serum IL-21 concentrations >_ 106 ng/L was 6.24 (95% CI: 1.04 - 37.3, p = 0.02). Conclusion: We identified specific differences in serum IL-21 between COVID-19 and non-COVID-19 pneumonia patients. Serum IL-21 measurement has promising predictive value for disease progression in COVID-19 patients. High serum IL-6 and IL-21 levels obtained upon admission are independent risk factors for clinical worsening.Yayın Sadece Metadata Anxiety and depression levels of healthcare workers during covid-19 pandemic(European Respiratory Soc Journals, 2021-09-05) Turan, Muzaffer Onur; Demirci, Nilgun Yilmaz; Ak, Guntulu; Akcay, Sule; Akturk, Ulku Aka; Bilaceroglu, Semra; ; Kokturk, Oguz; Mirici, Arzu; Cengiz, Ozdemi. R.; Sen, Nazan; Yilmaz, Ulku; Coşkun, Funda; COŞKUN, NECMİYE FUNDA; Bursa Uludağ Üniversitesi/Tıp Fakültesi.; 0000-0001-6160-3778; 0000-0001-8849-193X; 0000-0002-9703-9598; 0000-0003-3604-8826; 0000-0002-4171-7484; AFP-3587-2022; O-8969-2018; C-9348-2014; HKN-2974-2023; JAI-8635-2023; AAD-1271-2019Yayın Sadece Metadata Il-21: A potential biomarker for diagnosis and predicting prognosis in covid-19 patients(European Respiratory Society Journals, 2021-09-05) Öztürk, Nilüfer Aylin Acet; Ursavaş, Ahmet; Dilektaşlı, Aslı Görek; Demirdöğen, Ezgi; Coşkun, Funda; Ediger, Dane; Uzaslan, Esra; Yöyen-Ermiş, Diğdem; Karaca, Mert; Terzi, Orkun; Bayram, Merve; Ömer, Dilara; Yiğitliler, Büşra; Yurttaş, Ahmet; Maharramov, Shahriyar; Çelik, Gamze; Oral, Barbaros; Karadağ, Mehmet; ACET ÖZTÜRK, NİLÜFER AYLİN; URSAVAŞ, AHMET; GÖREK DİLEKTAŞLI, ASLI; DEMİRDÖĞEN, EZGİ; COŞKUN, NECMİYE FUNDA; EDİGER, DANE; UZASLAN, AYŞE ESRA; YÖYEN ERMİŞ, DİĞDEM; KARACA, MERT; TERZİ, ORKUN ERAY; BAYRAM, MERVE; ÖMER TOPÇU, DİLARA; YURTTAŞ, AHMET; ORAL, HALUK BARBAROS; KARADAĞ, MEHMET; MAHARRAMOV, SHAHRİYAR; YAZICI, GAMZE; Bursa Uludağ Üniversitesi/Tıp Fakültesi.; 0000-0002-6375-1472; 0000-0002-7400-9089; 0000-0003-3604-8826; 0000-0002-2954-4293; 0000-0001-5871-8769; 0000-0002-9027-1132; AAG-8744-2021; JPK-7012-2023; AAH-3888-2021; AAE-9142-2019; AAI-3169-2021; AAD-1271-2019Yayın Sadece Metadata Frailty: An indicator for poor outcomes among in-hospital pulmonology patients(European Respiratory Soc Journals, 2021-09-05) Öztürk, Nilüfer Aylin Acet; Dilektaşlı, Aslı Görek; Güçlü, Özge Aydın; Ursavaş, Ahmet; Demirdoğen, Ezgi; Coşkun, Funda; Uzaslan, Esra; Karadağ, Mehmet; ACET ÖZTÜRK, NİLÜFER AYLİN; GÖREK DİLEKTAŞLI, ASLI; AYDIN GÜÇLÜ, ÖZGE; URSAVAŞ, AHMET; DEMİRDÖĞEN, EZGİ; COŞKUN, NECMİYE FUNDA; UZASLAN, AYŞE ESRA; KARADAĞ, MEHMET; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; 0000-0002-6375-1472; 0000-0003-1005-3205; 0000-0002-7400-9089; 0000-0003-3604-8826; 0000-0002-9027-1132; AAI-3169-2021; JPK-7012-2023; AAG-8744-2021; AAD-1271-2019; Z-1424-2019; CNP-1063-2022; AAG-9930-2019; CDI-1977-2022Yayın Sadece Metadata Impact of covid-19 pneumonia on pulmonary function, functional exercise capacity and quality of life(European Respiratory Soc Journals, 2021-09-05) Dilektasli, Asli Gorek; GÖREK DİLEKTAŞLI, ASLI; Ozturk, Nilufer; ACET ÖZTÜRK, NİLÜFER AYLİN; Odabas, Ayten; Demirdogen, Ezgi; DEMİRDÖĞEN, EZGİ; Ursavas, Ahmet; URSAVAŞ, AHMET; Coskun, Funda; COŞKUN, NECMİYE FUNDA; Guclu, Ozge Aydin; AYDIN GÜÇLÜ, ÖZGE; Ediger, Dane; EDİGER, DANE; Uzaslan, Esra; UZASLAN, AYŞE ESRA; Bursa Uludağ Üniversitesi/Tıp Fakültesi.; 0000-0002-7400-9089; 0000-0003-3604-8826; 0000-0003-1005-3205; 0000-0002-2954-4293; AAI-3169-2021; AAE-9142-2019; JPK-7012-2023; AAD-1271-2019