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Öğe Acute Tumor Lysis Syndrome in a Small Cell Lung Cancer Case(Aves, 2005) Arbak, Peri; Bilgin, Cahit; Balbay, Oner; Bicik, ZerrinAs a result of large tumor burden, acute tumor lysis syndrome (TLS) is most often seen with lymphoproliferative disorders. An uncommon association of solid tumors and TLS also have been reported. We present a patient with metastatic lung carcinoma who developed TLS. A 58-year-old male was hospitalized for a mass in left lower lobe of lung and multiple low attenuation lesions in liver revealed by computed tomography. Liver biopsy specimen revealed metastatic small cell lung carcinoma. Cisplatin (60 mg/m(2), day1), Etoposide (120 mg/m(2), day 1,2,3) regimen was started. Biochemical parameters of the patient were in normal ranges before chemotherapy, one and two days after chemotherapy. At the seventh day of discharge from the hospital, our patient admitted to emergency department with acute renal insufficiency. Patient was recruited to hemodialysis for TLS. After 3 cycles of hemodialysis biochemical parameters were normalized. Since then etoposide regimen (100 mg/day for 14 days/monthly) was used. After 4 cycles of oral Etoposide regimen symptomatic relief and incomplete response according to chest radiograph were observed. Our case was presented with a later occurence of TLS when compared with the other cases from literature. We concluded that especially in disseminated small cell lung cancer (SCLC), clinicians must be aware of this rare but fatal complication.Öğe Alternatively new signal for sleep staging processing in patients with obstructive sleep apnea: photoplethysmography signal(Ieee, 2016) Uçar, Muhammed Kürşad; Bozkurt, Mehmet Recep; Polat, Kemal; Bilgin, CahitDiagnosis of Obstructive Sleep Apnea is done by expert doctors by examining biological signals which is obtain from the patient help of polysomnography device. Review, consists of two stages which are sleep staging and respiratory scoring. Sleep staging is done using Electroencephalogram, Electromyogram and Electrooculogram signals. Derivation of signal format gives discomfort to the patient. In order to connect the electrodes to the patient, there is a need expert technicians. In addition, the system is not suitable for use at home. When considering all these disadvantages, practical system is needed to make sleep staging. In this study, Photoplethysmography signal use will be suggested for alternative to the signals used in sleep staging process. Photoplethysmography signal can measure through the skin of any part of the body with noninvasive method. In the study, the characteristic features of Photoplethysmography signals were analyzed whether it is distinctive for sleep and wake statistically by means of Mann-Whitney U Test. According to the results obtained p < 0.05 and all properties are meaningful for sleep-wake. All features can be used as distinctive for the sleep-wakefulness are considered and also a practical sleep staging system be realized using Photoplethysmography signal.Öğe Automatic detection of respiratory arrests in OSA patients using PPG and machine learning techniques(Springer, 2017) Uçar, Muhammed Kürşad; Bozkurt, Mehmet Recep; Bilgin, Cahit; Polat, KemalObstructive sleep apnea is a syndrome which is characterized by the decrease in air flow or respiratory arrest depending on upper respiratory tract obstructions recurring during sleep and often observed with the decrease in the oxygen saturation. The aim of this study was to determine the connection between the respiratory arrests and the photoplethysmography (PPG) signal in obstructive sleep apnea patients. Determination of this connection is important for the suggestion of using a new signal in diagnosis of the disease. Thirty-four time-domain features were extracted from the PPG signal in the study. The relation between these features and respiratory arrests was statistically investigated. The Mann-Whitney U test was applied to reveal whether this relation was incidental or statistically significant, and 32 out of 34 features were found statistically significant. After this stage, the features of the PPG signal were classified with k-nearest neighbors classification algorithm, radial basis function neural network, probabilistic neural network, multilayer feedforward neural network (MLFFNN) and ensemble classification method. The output of the classifiers was considered as apnea and control (normal). When the classifier results were compared, the best performance was obtained with MLFFNN. Test accuracy rate is 97.07 % and kappa value is 0.93 for MLFFNN. It has been concluded with the results obtained that respiratory arrests can be recognized through the PPG signal and the PPG signal can be used for the diagnosis of OSA.Öğe Automatic sleep staging in obstructive sleep apnea patients using photoplethysmography, heart rate variability signal and machine learning techniques(Springer, 2018) Uçar, Muhammed Kürşad; Bozkurt, Mehmet Recep; Bilgin, Cahit; Polat, KemalIt is extremely significant to identify sleep stages accurately in the diagnosis of obstructive sleep apnea. In the study, it was aimed at determining sleep and wakefulness using a practical and applicable method. For this purpose , the signal of heart rate variability (HRV) has been derived from photoplethysmography (PPG). Feature extraction has been made from PPG and HRV signals. Afterward, the features, which will represent sleep and wakefulness in the best possible way, have been selected using F-score feature selection method. The selected features were classified with k-nearest neighbors classification algorithm and support vector machines. According to the results of the classification, the classification accuracy rate was found to be 73.36 %, sensivity 0.81, and specificity 0.77. Examining the performance of the classification, classifier kappa value was obtained as 0.59, area under an receiver operating characteristic value as 0.79, tenfold cross-validation as 77.35 %, and F-measurement value as 0.79. According to the results accomplished, it was concluded that PPG and HRV signals could be used for sleep staging process. It is a great advantage that PPG signal can be measured more practically compared to the other sleep staging signals used in the literature. Improving the systems, in which these signals will be used, will make diagnosis methods more practical.Öğe Clinical Characteristics of the Late Resolving Pneumonia Cases(Aves, 2005) Erbas, Mete; Annakkaya, Ali Nihat; Arbak, Peri; Balbay, Oner; Bilgin, Cahit; Bulut, IsmetIt has been well known that advanced age, cigarette smoking, presence of comorbid illnesses, multilobar radiographic involment, ongoing leukopenia, corticosteroid therapy are associated with late resolving pneumonia. We aimed to evaluate the effects of certain factors that were relatively less investigated such as gender, smoking, localization and pattern of radiographic involvement, the time of initiation of antibiotic therapy and antibiotic type on resolution of pneumonia. We retrospectively assessed the records and radiographs of 98 patients diagnosed as pneumonia. Mean age was 54 +/- 15 years, 52% of patients were female whereas 48% of them male. Delaying in resolution was detected in 17.3% of cases with pneumonia. Delaying in resolution of pneumonia was significantly higher in females (13/51) when compared to males (4/47). Delayed radiographic resolution was significantly more often observed in interstitial radiographic involvement than segmental and lobar involvement respectively. Mean initiation time of antibiotic therapy in patients with late resolving pneumonia was 14 +/- 6 days whereas 10 +/- 6 days with pneumonia that resolved in expected time (p<0.05). Most of the patients with normally resolving pneumonia were using single antibiotic (75/81) where all the patients in late resolving group were recieving single antibiotic. In conclusion, we decided some factors including gender initiation time of antibiotic treatment, radiografic involvement patterns have significant effects on resolutin of pneumonia.Öğe Comparison of perioperative outcomes of videothoracoscopy and robotic surgical techniques in thymoma(Elsevier Singapore Pte Ltd, 2020) Şehitoğulları, Abidin; Nasır, Ahmet; Anbar, Rüçhan; Erdem, Kemalettin; Bilgin, CahitObjective: In this study, the perioperative outcomes of video-assisted thoracoscopic surgery (VATS) and robot-assisted thoracoscopic surgery (RATS) were compared in patients with clinical stage I and stage II thymoma. Methods: The outcomes of 24 patients (10 males and 14 females; mean age: 42.5 years; range: 18-65 years) with diagnoses of clinical stage I and stage II thymoma who underwent VATS in our clinic between April 2010 and March 2018 were compared with the outcomes of 21 patients (8 males and 13 females; mean age: 41.2 years; range: 19-63 years) with the same clinical stages of thymoma who underwent RATS between March 2013 and May 2018. The operative times, postoperative complications, lengths of hospital stay, and total amounts of chest tube drainage of the patients were evaluated. Results: No postoperative mortality was observed in either group. In general, VATS was performed from the right side, and RATS was performed from the right hemithorax. The operative time was significantly longer in the VATS group than in the RATS group (106.5 min versus 75.7 min, respectively; p < 0.001). In the VATS group, the total amount of postoperative drainage from the chest tubes was greater than that in the RATS group (210 ml versus 325 ml, respectively), and the drainage time was longer in the VATS group than in the RATS group (3 days versus 5 days, respectively; p < 0.001). The length of hospital stay was longer for the patients in the VATS group than for those in the RATS group (5.3 days versus 4.1 days, respectively; p < 0.001). The levels of pain were similar in both groups. No difference in the complication rates was found between the 2 groups. Conclusion: In the treatment of clinical stage I and stage II thymoma patients, the robotic approach and excision with VATS are techniques with equal reliability. However, the use of robot-assisted thoracoscopic thymectomy technique is advantageous in terms of decreasing the total amount of postoperative drainage and shortening the length of hospital stay. (C) 2019 Asian Surgical Association and Taiwan Robotic Surgery Association. Publishing services by Elsevier B.V.Öğe Düzce Meslek Yüksek Okulu Mobilya Dekorasyon Bölümü öğrencilerinde işe bağlı solunum sistemi bulguları sıklığı(Bolu Abant İzzet Baysal Üniversitesi, 2003) Bilgin, Cahit; Arbak, Peri MeramÖZET MOBİLYA DEKORASYON ÖĞRENCİLERİNDE SOLUNUMSAL SEMPTOM SIKLIĞI VE PEF İZLEMİ Giriş ve Amaç: Mesleki astım (MA) özellikle gelişmiş ülkelerde en sık bildirilen mesleki solunumsal hastalık haline gelmiştir. İşyerlerinde yeni kimyasalların yaygın olarak kullanımı, MA'mn tanınmasında klinisyenin artan dikkati ve laboratuvar olanakları vaka artışım açıklamakta kullanılmıştır. Gelişmekte olan ülkelerdeki laboratuvar olanakları eksikliği MA tanısında daha ucuz tanısal yöntemlerin seçimini gerektirmektedir. Çalışmamızda kırsal bölge olan Düzce'de yaşayan mobilya dekorasyon öğrencilerindeki solunumsal semptomları ve evde-işte zirve ekspiratuvar akım (PEF) izleme verilerini değerlendirdik. Materyal ve Yöntem: 64 mobilya dekorasyon öğrencisinin tümü ve 62 kontrol vakası çalışmaya dahil edildi. Bütün katılımcılar; mesleki maruziyet hikayesini, solunumsal semptomları, sigara hikayesini, ailevi allerji hikayesini içeren anket formu, fizik muayene, spirometri, akciğer grafisi ve işte-iş dışında PEF değerleri takibi ile değerlendirildi. Bulgular: Demografik bulgular tabloda verilmiştir. XVKontrol grubu ile karşılaştırıldığında mobilya dekorasyon öğrencilerinde işyerinde solunumsal semptomlar daha fazla idi. İşle ilgili öksürük öğrencilerin % 23,4'ünde (15/64) görülürken, kontrol grubunda %8,1 (5/62) oranında görüldü (p=0.016). Mobilya dekorasyon öğrencilerinin % 18,8'inde (12/64) dispne gözlenirken kontrol grubunda %6,5 (4/62) oranında görülmüştü (p=0.034). İşle ilişkili konjonktivit öğrenciler (22/64) tarafından kontrollerden (6/62) daha fazla bildirilmişti (p=0.001). PEF kayıtlarının kantitatif metodla değerlendirilmesi temelinde diurnal variabilite öğrencilerin %34,4'ünde (22/64) saptanırken kontrol gurubunun %16,1'inde (10/62) tespit edildi (p=0.015). İşe bağlı solunumsal semptomların PEFR izlemine göre prediktif değerleri incelendi. İşe bağlı wheezingin pozitif prediktif değer (PPD)'i %66 ve öksürüğün PPD'i %60 idi. Tartışma ve Sonuç: Klinisyenler vaka bildirimini beklemeden tozlu işyerlerinin işe bağlı astım için potansiyel tehlike yarattığı noktasında uyanık olmalıdırlar. Seri PEF izlemleri ile işle ilişkili solunumsal değişikliklerin erken tespiti, işçilerin ve öncelikle genç yaş populasyonun solunumsal sağlığını koruyabilir.. Anahtar kelimeler: zirve ekspiratuvar akım hızlan (PEFR), mobilya üretimi, mesleki astım.Öğe Effect of symptom-to-treatment interval on prognosis in lung cancer(Sage Publications Ltd, 2007) Annakkaya, Ali Nihat; Arbak, Peri; Balbay, Öner; Bilgin, Cahit; Erbaş, Mete; Bulut, İsmetAims and background: To evaluate the relationship between delayed diagnosis and the degree of invasion and survival in lung cancer. Methods: One hundred and three patients (96 men) with lung cancer were included. Stages in the diagnosis of lung cancer were classified as follows: symptom-to-doctor interval, i.e., the interval from the first symptoms related to the presence of lung cancer to the first consultation with a medical professional; doctor-to-diagnosis interval, i.e., the interval between the first medical visit and confirmation of the diagnosis; and diagnosis-to-treatment interval, i.e., the interval between diagnosis and complete TNM staging and treatment. The symptom-to-treatment interval (STI) was the sum of the 3 intervals. The degree of invasion was determined by the TNM classification. Results: The patients were followed up for a mean period ( SD) of 7.4 +/- 8.7 months. Seventy-six (74%) patients were diagnosed with non-small cell lung cancer (NSCLC) and 27 patients (26%) with small cell lung cancer (SCLC). The mean length of STI was 120 +/- 101 days (median, 90). The mean length of the symptom-to-doctor interval was 63 +/- 62 days (median, 45), while the doctor-to-diagnosis and diagnosis-totreatment intervals were 41 +/- 82 days (median, 10) and 16 +/- 12 days (median, 12), respectively. When the STIs of the patients were correlated with tumor stage, tumor invasion, lymph node involvement and metastasis, no significant differences were found. Patients with an STI longer than 60 days had a significantly longer survival. Regarding the type of lung cancer and STI, the median survival was shorter in patients with an STI of less than 60 days both in NSCLC and SCLC, although this was not statistically significant in SCLC. Conclusions: The shorter the diagnostic interval, the shorter was the median survival in our study. The reason for the apparent discrepancy between poor prognosis of lung cancer patients in spite of early diagnosis might be much faster progression of the disease itself.Öğe Evaluation of tumor markers in asthma patients(2006) Coşkun, Abdurrahman; Balbay, Öner; Yavuz, Özlem; Memişoğulları, Ramazan; Annakkaya, Ali Nihat; Bulut, İsmet; Bilgin, CahitBackground: Although tumor markers have been used as biomarkers for monitoring response to therapy and detecting early relapse in malignancies, it is well known that most tumor marker increases are not specific enough to be used for diagnosis of cancer. Aim: The aim of this study was to investigate the serum concentrations of α-fetoprotein (AFP), carcinoembryonic antigen (CEA), cancer antigen (CA) 19-9, CA 125, CA 15-3 and IgE in asthma patients. Materials and Methods: Thirty-five newly diagnosed asthmatic patients and 14 healthy subjects were included into the study. Blood samples were drawn from antecubital vein of asthma patients and control subjects. Serum AFP, CEA, CA 125, CA 15-3 and CA 19-9 levels were determined by chemiluminescent and IgE levels by electrochemiluminescent immunometric method on automatic hormone analyzers. Results: Serum levels of AFP, CEA, CA 19-9, CA 125, and CA 15-3 of asthma patients were not significantly different when compared with the control group. In asthma patients, there was a significant negative correlation between serum IgE and CA 125 (r = -0.401; p = 0.017) and a positive correlation between CA 125 and CA 15-3 (r = 0.368; p = 0.029). Conclusions: We concluded that in asthma patients’ sera, AFP, CEA, CA 125, CA 19-9 and CA 15-3 levels were not different from control subjects. Elevation in any of these tumor markers in asthma patients should be a sign for clinicians to evaluate patients for additional diseases.Öğe Intima-media thickness of the common carotid artery in highway toll collectors(John Wiley & Sons Inc, 2006) Erdoğmuş, Beşir; Yazıcı, Burhan; Annakkaya, Ali Nihat; Bilgin, Cahit; Şafak, Alp Alper; Arbak, Peri; Tugay, AliPurpose. To assess the effects of exposure to exhaust particles on intima-media thickness of the common carotid artery in highway toll collectors, Methods. Sixty-one highway toll collectors (HTCs) between 24 and 56 years of age (mean, 36.2 +/- 7.3) and 48 controls between 24 and 64 years of age (mean, 42.6 +/- 10.6) were evaluated with gray-scale sonography to measure intima-media thickness (IMT) of the common carotid artery (CCA). Subgroups were categorized according to duration of exhaust exposure and further divided according to tobacco use. Results. CCA IMT was higher (0.8 +/- 0.2 mm) in HTCs than in the control group (0.6 +/- 0.1 mm; p < 0.001) and remained higher when subgroups with similar smoking habits were compared. In HTCs, IMT was greater when the number of years working in tollbooths was greater (p = 0.023). IMT was lower in HTCs with an exposure duration of < 10 years compared with a duration of 10-20years (p = 0.017) or > 20years (p value not significant). Conclusion. Air pollution has a widely acknowledged negative effect on humans. This study confirms that exposure to exhaust particles might cause wall thickening of carotid arteries.Öğe Investigation of Effects of Time Domain Features of the Photoplethysmography (PPG) Signal on Sleep Respiratory Arrests(Ieee, 2015) Uçar, Muhammed Kürşad; Bozkurt, Mehmet Recep; Polat, Kemal; Bilgin, CahitObstructive Sleep Apnea Syndrome is one of the major diseases of our century. Diagnosis of this disease is very difficult. The reason of the difficulty is the complexity of the system. AHI index is calculated for the diagnosis of the disease as a result of respiratory scoring process. However it is necessary to use four different signals to do this operation. The reduction of signal measurements that discomforts the patient or using different signal measurements will provide the patient to sleep closer to his/her natural sleep environment which will increase the accuracy rate of the studies that are made in literature. Changes occurring in photoplethysmography signal during respiratory events were examined. In this study, the patient data that was used respiratory events were scored Changes on the photoplethysmography signals were examined. The data that were used in this study were respiratory events tagged apnea and hypopnea. For control, the photoplethysmography signals were recorded during normal breathing in sleep. The data were analyzed using the one-way analysis of variance method. According to the obtained results, the photoplethysmography signals have significant changes in between the apnea-hypopnea classes and normal classes during respiratory pauses in sleep. However, there are not significant differences between apnea and hypopnea classes. The study concluded that, in the scoring of respiratory events, photoplethysmography could be used more efficiently using a computer software.Öğe Respiratory symptoms and peak expiratory flow rates among furniture-decoration students(Inst Agricultural Medicine, 2004) Arbak, Peri; Bilgin, Cahit; Balbay, Öner; Yeşildal, Nuray; Annakkaya, Ali Nihat; Ülger, FüsunThis study was designed to evaluate the effects of furniture production, mainly including fir tree (aberia mulleriana), on respiratory health of young workers and to compare the results with those obtained from previous Studies. Sixty-four furniture-decoration students (57 males and 7 females) and 62 controls (54 male, 8 female) from different departments in the same school were included into the Study. All participants were assessed with a questionnaire (concerning history of occupational exposure, work-related respiratory and other symptoms, smoking history, previous asthma history), full physical examination, spirometric evaluation and chest radiograph. Participants then performed serial monitoring of peak expiratory flow rates (PEER) at work and away from work within a month. Mean age of students was 20.9 +/- 3.7 years, 20.5 +/- 2.6 years in controls. There was no difference between study and control groups with regard to age, gender, smoking status and previous asthma history. Reported cough (23.4% vs. 8.1%) and shortness of breath (18.8% vs. 6.5%) were significantly higher in furniture-decoration students than in controls (p = 0.016 and p = 0.034, respectively). Furniture-decoration students had higher conjunctivitis (34.4% vs. 9.7%, p = 0.001) and rhinitis (34.4% vs. 19.4%, p = 0.044) history when compared with controls. Both students and controls were normal in terms of respiratory examination. PEF recordings were performed for approximately one month. Diurnal variability greater than 20% was seen in 12/64 (18.7%) of students at work, whereas it was detected in 4/62 (6.4%) of controls (p = 0,034). When comparing for the presence of diurnal variability greater than 20% in weekends, no difference was found between groups (p = 0.457). In conclusion, early detection of work-related respiratory changes by serial monitoring of peak expiratory flows should save the workers from hazardous respiratory effects of the furniture production, especially in young population.Öğe Retraction note: Automatic detection of respiratory arrests in OSA patients using PPG and machine learning techniques (Neural Computing and Applications, (2017), 28, 10, (2931-2945), 10.1007/s00521-016-2617-9)(Springer Science and Business Media Deutschland GmbH, 2024) Uçar, Muhammed Kürşad; Bozkurt, Mehmet Recep; Bilgin, Cahit; Polat, KemalThe Editor-in-Chief and the publisher have retracted this article. The article was submitted to be part of a guest-edited issue. An investigation by the publisher found a number of articles, including this one, with a number of concerns, including but not limited to compromised editorial handling and peer review process, inappropriate or irrelevant references or not being in scope of the journal or guest-edited issue. Based on the investigation's findings the Editor-in-Chief therefore no longer has confidence in the results and conclusions of this article. Authors Muhammed Kürşad Uçar, Mehmet Recep Bozkurt and Kemal Polat disagree with this retraction. Author Cahit Bilgin has not responded to correspondence regarding this retraction. © The Natural Computing Applications Forum 2024.Öğe Retraction Note: Automatic sleep staging in obstructive sleep apnea patients using photoplethysmography, heart rate variability signal and machine learning techniques(Neural Comput Appl, (2018), 29, (1–16), 10.1007/s00521-016-2365-x)(Springer Science and Business Media Deutschland GmbH, 2024) Uçar, Muhammed Kürşad; Bozkurt, Mehmet Recep; Bilgin, Cahit; Polat, KemalThe Editor-in-Chief and the publisher have retracted this article. The article was submitted to be part of a guest-edited issue. An investigation by the publisher found a number of articles, including this one, with a number of concerns, including but not limited to compromised editorial handling and peer review process, inappropriate or irrelevant references or not being in scope of the journal or guest-edited issue. Based on the investigation's findings the Editor-in-Chief therefore no longer has confidence in the results and conclusions of this article. Authors Muhammed Kürşad Uçar, Mehmet Recep Bozkurt and Kemal Polat disagree with this retraction. Author Cahit Bilgin has not responded to correspondence regarding this retraction. © The Natural Computing Applications Forum 2024.Öğe Serum homacysteine levels in highway toll collectors and the relationship with intima-media thickness of the carotid artery(2008) Memişoğullari, Ramazan; Erdoğmuş, Beşir; Alp, Hamit Hakan; Bilgin, Cahit; Arbak, Peri Meram; Yavuz, ÖzlemAmaç: Son zamanlarda hava kirliliği ve artmış intima-media kalınlığı (IMT) arasında bir ilişki olduğu rapor edilmiş, ancak etyolojisi tam olarak anlaşılamamıştır. Biz bu çalışmada önemli hava kirleticiler olan egsoz partiküllerine maruziyetin artmış homosistein (Hey) düzeyleriyle ilişkisi olup olmadığını ve artmış homosistein düzeylerinin artmış intima-media kalınlığı ile ilişkili olup olmadığını araştırdık. Yöntem ve Gereç: Altmışbeş erkek otoyol gişe memuru ve 43 sağlıklı erkek gönüllüde yüksek performanslı sıvı kromatografısi ile serum Hey düzeyleri ölçüldü. IMT ise Doppler Sonografi kullanılarak deneyimli bir radyolog tarafından ölçüldü. Bulgular: Otoyol gişe memurlarında serum Hey düzeyleri (14.5 ± 4.9 mmol/1, P < 0.005) ve IMT (0.757 ± 0.18 mm, P < 0.001) kontrollerden daha yüksekti (sırasıyla; 12.0 ± 2.8 mmol/1 ve 0.612 ±0.11 mm). Hem otoyol gişe memurları grubunda (r = 0.36; P < 0.005) ve hem de kontrol grubunda (r = 0.36; P < 0.05) Hey ve IMT arasında pozitif bir korelasyon bulundu. Sonuç: Egsoz partiküllerine maruziyet, sonuçta bir IMT artışına yol açabiîen Hey düzeyinde bir artıştan dolayı, oksidatif stres artışına neden olabilir. Ancak son karara varmadan önce hala daha ileri çalışmalara ihtiyaç vardır.Öğe Which patients are able to adhere to tuberculosis treatment? a study in a rural area in the northwest part of Turkey(Natl Inst Infectious Diseases, 2005) Balbay, Öner; Annakkaya, Ali Nihat; Arbak, Peri; Bilgin, Cahit; Erbaş, MeteThe purpose of this study was to investigate various factors, including demographical, socioeconomical, clinical and radiological features, of adherent and nonadherent patients with tuberculosis (TB) who were admitted to a university hospital between 1998 and 2003. One hundred and one patients (65.5%) and 53 patients (34.5%) met the criteria of adherence and nonadherence, respectively. A higher rate of adherence was observed among females than males (79.2 versus 58.4%, respectively, P = 0.012). Older patients were more nonadherent (P = 0.008). The adherence rate in non-smokers was significantly higher than that of smokers (81.4 and 52.4%, respectively, P = 0.000). Patients who underwent "family screening" were more adherent (75.7%) than those (39.5%) who did not (P = 0.000). Patients with pleurisy had higher adherence rates (81.3%), followed by patients with pulmonary TB (65.0%), while patients with extrarespiratory TB had the lowest adherence rates (45.5%) (P = 0.024). The presence of cough was significantly associated with adherence (P = 0.049). A significantly higher adherence rate was observed in patients without hemoptysis (P = 0.001). A univariate logistic regression confirmed that age, smoking, family screening, type of TB, cough and hemoptysis had significant independent effects on the adherence to treatment of TB. High-risk patients may be identified and interventions tailored to promote adherence before concluding that the patient is willfully refusing treatment.
