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    Immunization status in chronic obstructive pulmonary disease: A multicenter study from Turkey
    (WOLTERS KLUWER MEDKNOW PUBLICATIONS, 2019) Ozlu, Tevfik; Bulbul, Yilmaz; Aydin, Derya; Tatar, Dursun; Kuyucu, Tulin; Erboy, Fatma; Koseoglu, Handan Inonu; Anar, Ceyda; Sunnetcioglu, Aysel; Gulhan, Pinar Yildiz; Sahin, Unal; Ekici, Aydanur; Duru, Serap; Ulasli, Sevinc Sarinc; Kurtipek, Ercan; Gunay, Sibel; Okutan, O.; Yildiz, B. P.; Cetinkaya, P. D.; Arslan, S.; Cakmak, G.; Cirak, A. K.; Sarioglu, N.; Kocak, N. D.; Akturk, U. A.; Demir, M.; Kilic, T.; Dalli, A.; Hezer, H.; Altintas, N.; Acat, M.; Dagli, C. E.; Kargi, A.; Yakar, F.; Kirkil, G.; Baccioglu, A.; Gedik, C.; Intepe, Y. S.; Karadeniz, G.; Onyilmaz, T.; Saylan, B.; Baslilar, S.; Sariman, N.; Ozkurt, S.; Arinc, S.; Kanbay, A.; Yazar, E. E.; Yildirim, Z.; Kadioglu, E. E.; Gul, S.; Sengul, A.; Berk, S.; Dikis, O. S.; Kurt, O. K.; Arslan, Y.; Erol, S.; Korkmaz, C.; Balaban, A.; Erbay, Toru U.; Sogukpinar, O.; Uzaslan, E. K.; Babaoglu, E.; Bahadir, A.; Baris, S. A.; Ugurlu, A. O.; Ilgazli, A. H.; Fidan, F.; Kararmaz, E.; Guzel, A.; Alzafer, S.; Cortuk, M.; Hocanli, I; Ortakoylu, M. G.; Erginel, M. S.; Yaman, N.; Erbaycu, A. E.; Demir, A.; Duman, D.; Tanriverdi, H.; Yavuz, M. Y.; Sertogullarindan, B.; Ozyurt, S.; Bulcun, E.; Yuce, G. D.; Sariaydin, M.; Ayten, O.; Bayraktaroglu, M.; Tekgul, S.; Erel, F.; Senyigit, A.; Kaya, S. B.; Ayik, S.; Yazici, O.; Akgedik, A.; Yasar, Z. A.; Hayat, E.; Kalpaklioglu, F.; Sever, F.; Sarac, P.; Ugurlu, E.; Kasapoglu, U. S.; Gunluoglu, G.; Demirci, N. Y.; Bora, M.; Talay, F.; Ozkara, B.; Yilmaz, M. U.; Yavsan, D. M.; Cetinoglu, E. D.; Balcan, M. B.; Ciftci, T.; Havan, A.; Gok, A.; Nizam, M.
    OBJECTIVE: The purpose of this study is to detect the prevalence and the factors associated with influenza and pneumococcal vaccination and outcomes of vaccination during 2013-2014 season in patients with chronic obstructive pulmonary disease (COPD) in Turkey. METHODS: This was a multicenter retrospective cohort study performed in 53 different centers in Turkey. RESULTS: During the study period, 4968 patients were included. COPD was staged as GOLD 1-2-3-4 in 9.0%, 42.8%, 35.0%, and 13.2% of the patients, respectively. Influenza vaccination rate in the previous year was 37.9%; and pneumococcus vaccination rate, at least once during in a life time, was 13.3%. Patients with older age, higher level of education, more severe COPD, and comorbidities, ex-smokers, and patients residing in urban areas had higher rates of influenza vaccination. Multivariate logistic regression analysis showed that advanced age, higher education levels, presence of comorbidities, higher COPD stages, and exacerbation rates were associated with both influenza and pneumococcal vaccination. The number of annual physician/outpatient visits and hospitalizations due to COPD exacerbation was 2.73 +/- 2.85 and 0.92 +/- 1.58 per year, respectively. Patients with older age, lower education levels, more severe COPD, comorbid diseases, and lower body mass index and patients who are male and are residing in rural areas and vaccinated for influenza had significantly higher rates of COPD exacerbation. CONCLUSIONS: The rates of influenza and pneumococcal vaccination in COPD patients were quite low, and the number of annual physician/outpatient visits and hospitalizations due to COPD exacerbation was high in Turkey. Advanced age, higher education levels, comorbidities, and higher COPD stages were associated with both influenza and pneumococcal vaccination.
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    The value of pleural fluid anti-A60 IgM in BCG-vaccinated tuberculous pleurisy patients
    (Elsevier, 2003) Kunter, E.; Cerrahoğlu, K.; İlvan, A.; Işıtmangil, T.; Okutan, O.; Kartaloğlu, Z.; Çavuşlu, S.
    Objectives To determine if detection of IgM and IgG antibodies against mycobacterial antigen A60, together with the Mantoux tuberculin skin test (TST), could be used in the diagnosis of tuberculous pleurisy (TP) in BCG-vaccinated cases. Methods We investigated 125 BCG-vaccinated patients with pleural effusion. Of these, 88 had TP and 37 had non-tuberculous pleurisy (NTP). TST and anti-A60 IgM and IgG measurements by ELISA were performed in the sera and pleural effusions of both groups. Results Cut-off values, in optical density, for serum anti-A60 IgM, pleural fluid anti-A60 IgM, serum anti-A60 IgG and pleural fluid anti-A60 IgG were defined as 0.624, 0.614, 0.464, and 0.613, respectively. TP patients had higher IgG and IgM levels in the serum (P < 0.001 and P < 0.05, respectively) and pleural effusion (P < 0.001 and P < 0.001, respectively). Regardless of the diagnosis, IgG and IgM levels were higher in the sera (P < 0.001 and P < 0.05, respectively) and pleural effusions (P < 0.001 and P < 0.001, respectively) of TST-positive cases, and serum and pleural fluid IgM levels were higher (P < 0.001 and P < 0.001, respectively) in the TST-positive TP cases. Sensitivity and specificity of TST were 65% and 68%, respectively. As a single parameter, pleural fluid anti-A60 IgM had the highest sensitivity (77%) and specificity (94%) in patients with negative TST. Conclusion We suggest that in populations where tuberculosis prevalence is high and BCG vaccination is common, pleural fluid anti-A60 IgM can facilitate the diagnosis of TP.
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    The value of pleural fluid anti-A60 IgM in BCG-vaccinated tuberculous pleurisy patients.
    (Elsevier, 2003) Kunter, E.; Cerrahoğlu, K.; İlvan, A.; Işıtmangil, T.; Okutan, O.; Kartaloğlu, Z.; Çavuşlu, Ş.
    Objectives: To determine if detection of IgM and IgG antibodies against mycobacterial antigen A60, together with the Mantoux tuberculin skin test (TST), could be used in the diagnosis of tuberculous pleurisy (TP) in BCG-vaccinated cases. Methods: We investigated 125 BCG-vaccinated patients with pleural effusion. Of these, 88 had TP and 37 had non-tuberculous pleurisy (NTP). TST and anti-A60 IgM and IgG measurements by ELISA were performed in the sera and pleural effusions of both groups. Results: Cut-off values, in optical density, for serum anti-A60 IgM, pleural fluid anti-A60 IgM, serum anti-A60 IgG and pleural fluid anti-A60 IgG were defined as 0.624, 0.614, 0.464, and 0.613, respectively. TP patients had higher IgG and IgM levels in the serum (P < 0.001 and P < 0.05, respectively) and pleural effusion (P < 0.001 and P < 0.001, respectively). Regardless of the diagnosis, IgG and IgM levels were higher in the sera (P < 0.001 and P < 0.05, respectively) and pleural effusions (P < 0.001 and P < 0.001, respectively) of TST-positive cases, and serum and pleural fluid IgM levels were higher (P < 0.001 and P < 0.001, respectively) in the TST-positive TP cases. Sensitivity and specificity of TST were 65% and 68%, respectively. As a single parameter, pleural fluid anti-A60 IgM had the highest sensitivity (77%) and specificity (94%) in patients with negative TST. Conclusion: We suggest that in populations where tuberculosis prevalence is high and BCG vaccination is common, pleural fluid anti-A60 IgM can facilitate the diagnosis of TP.