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COŞKUN, NECMİYE FUNDA

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  • YayınAçık 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-1271-2019
    Background: 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
    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-3169-2021
    Objective 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
    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-1271-2019
    Introduction: 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.