Introducing a new risk factor for Lumbar Disc Herniation in females : vertical angle of the sacral curvature

Kanat, Ayhan/0000-0002-8189-2877WOS: 000313134700003PubMed: 23323164Objective : To characterize the importance of the vertical angle of the sacral curvature (VASC) in lumbar disc herniations. Methods : Morphological data derived from lumbar sagittal MRI imaging. the statistical significance of the findings are discussed. the angles of 60 female patients with lumbar disc herniations (LDH) were compared with the 34 female patients without LDH. Results : 128 of the 185 patients met our inclusion criteria. the vertical angle of sacral curvature is statistically significantly bigger in females with lumbar disc herniations when compared to subjects in control group, 28.32 and 25.4, respectively. (p=0.034<0.05). Same difference was not seen in males. Conclusion : the vertical angle of sagittal sacral curvature may be another risk factor in females with lumbar disc herniations

Dirençli granülomatöz polianjiitis olgusu

Vaskülitler, kan damarlarının inflamatuvardestrüksiyonu ile karakterize heterojen bir grup hastalıktır. Vaskülitler tutulan damar özelliğine göre klinik bulgu verebilir. Primer vaskülitler damar tutulum özelliklerine göre büyük, orta ve küçük damar vasküliti olarak ayrılır. Granülomatöz polianjiitis GPA ANCA ilişkili küçük damar vaskülitidir. GPA sınırlı ve sistemik tutulumla seyredebilir. Bu olgu, akciğer tutulumu olan sistemik ve sınırlı GPA olgularında tedavive yan etkileri paylaşmak için sunulmuştu

Flexible bronchoscopy may decrease respiratory muscle strength: premedicational midazolam in focus

BACKGROUND: Flexible bronchoscopy (FB) is a procedure accepted to be safe in general, with low complication rates reported. On the other hand, it is known that patients with pre-existing respiratory failure have developed hypoventilation following FB. In this study the effects of FB on respiratory muscle strength were investigated by measuring maximum respiratory pressures. METHODS: One hundred and forty patients, aged between 25 and 90 years, who had undergone diagnostic bronchoscopy between February 2012 and May 2012, were recruited to the study. Pre- and post-procedure maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) were measured. A correlation between the MIP and MEP changes and patient characteristics and FB variables were investigated. RESULTS: Significant decreases in both MIP and MEP values were observed following FB (p < 0.001 for both). Decreases were attributed to the midazolam used for sedation. Significant decreases in respiratory muscle strengths were observed especially in the high-dose midazolam group, compared to both low-dose and non-midazolam groups. CONCLUSIONS: It was determined that respiratory muscle weakness may arise post-procedure in patients who have undergone FB, and this is constitutively related to midazolam premedication. Respiratory muscle weakness might play a role in potential hypoventilation in critical patients who undergo FB

Modified outpatient dexamethazone, cytarabine and cisplatin regimen may lead to high response rates and low toxicity in Lymphoma

Objective: Our purpose was to investigate the efficacy of and establish a toxicity profile for a modified regimen of dexamethasone, cytarabine and cisplatin (DHAP) for lymphoma outpatients. Subjects and Methods: Fifty-one lymphoma patients, 26 with Hodgkin's disease and 25 with non-Hodgkin's lymphoma, were included. The patients' median age was 32 years (range: 17-61). Twenty had progressive/refractory disease and 31 relapsed disease. Twenty-five were in clinical stage I/II and 26 in clinical stage III/IV before the initiation of salvage chemotherapy. DHAP consisted of dexamethasone (40 mg i.v. on days 1-4), cytarabine (2 g/m(2) i.v. as 3-hour infusion on days 2 in the evening and 3 in the morning) and cisplatin (35 mg/m(2) as 2-hour infusion on days 1-3) were administered every 21 days. A total of 154 cycles of modified DHAP were administered, with a median of 3 cycles per patient (range: 2-4). Results: The main toxicity was myelosuppression. WHO grade III-IV neutropenia and grade III-IV thrombocytopenia were observed in 27 (52.9%) and 21 (41%) patients, respectively. The overall response rate (85% for Hodgkin's disease and 95% for non-Hodgkin's lymphoma) was 88.3% (39.2% complete response and 49.1% partial response). Conclusion: The results showed that this outpatient schedule of DHAP was well tolerated and an effective salvage regimen

Vaccine breakthrough hypoxemic COVID-19 pneumonia in patients with auto-Abs neutralizing type I IFNs

Life-threatening `breakthrough' cases of critical COVID-19 are attributed to poor or waning antibody response to the SARS- CoV-2 vaccine in individuals already at risk. Pre-existing autoantibodies (auto-Abs) neutralizing type I IFNs underlie at least 15% of critical COVID-19 pneumonia cases in unvaccinated individuals; however, their contribution to hypoxemic breakthrough cases in vaccinated people remains unknown. Here, we studied a cohort of 48 individuals ( age 20-86 years) who received 2 doses of an mRNA vaccine and developed a breakthrough infection with hypoxemic COVID-19 pneumonia 2 weeks to 4 months later. Antibody levels to the vaccine, neutralization of the virus, and auto- Abs to type I IFNs were measured in the plasma. Forty-two individuals had no known deficiency of B cell immunity and a normal antibody response to the vaccine. Among them, ten (24%) had auto-Abs neutralizing type I IFNs (aged 43-86 years). Eight of these ten patients had auto-Abs neutralizing both IFN-a2 and IFN-., while two neutralized IFN-omega only. No patient neutralized IFN-ss. Seven neutralized 10 ng/mL of type I IFNs, and three 100 pg/mL only. Seven patients neutralized SARS-CoV-2 D614G and the Delta variant (B.1.617.2) efficiently, while one patient neutralized Delta slightly less efficiently. Two of the three patients neutralizing only 100 pg/mL of type I IFNs neutralized both D61G and Delta less efficiently. Despite two mRNA vaccine inoculations and the presence of circulating antibodies capable of neutralizing SARS-CoV-2, auto-Abs neutralizing type I IFNs may underlie a significant proportion of hypoxemic COVID-19 pneumonia cases, highlighting the importance of this particularly vulnerable population

Relationship of Lung Diffusion Capacity With Airway Obstruction in Asthma

Amaç: Karbon monoksit difüzyon kapasitesinin (DLco) ölçümü, alveole-kapiller membranda gaz değişimi hakkında bilgi veren önemli bir solunum fonksiyon testidir. Çalışmada astımlı hastalarda obstrüksiyon derecesiyle DLco arasındaki ilişki araştırılmaktadır. Yöntem: Çalışmaya önceden astım tanısı almış ve DLco’yu etkileyecek ilave bir hastalığı olmayan ve sigara içmeyen 91 (ortalama yaş: 37.29.4, 18-56 yaş) ve kontrol grubu olarak gönüllü 47 (ortalama yaş: 38.08.7, 22-56 yaş) kişi katıldı. Tüm olguların akım hızları, akciğer volümleri ve DLco ölçümleri Vmax22 spirometre cihazı ile yapıldı. Hastalar Global Initiative for Asthma (GINA) rehberinde tanımlanan FEV1 ve PEF parametreleri kullanılarak obstrüksiyon derecesine göre 3 gruba ayrıldı. Buna göre; FEV1 ve PEF değeri % 80 olan hastalar Grup 1’e (n:25), FEV1 veya PEF değeri % 80 olup FEV1 veya PEF değerinin herhangi biri % 60-80 arasında olanlar Grup 2’ye (n:29) ve FEV1 veya PEF değerinin herhangi biri % 60 olan hastalar Grup 3’e (n:37) dahil edildi. Bulgular: Astımlı hastalarla kontrol grubu arasında DLco, DLco (%), alveoler volüm (VA) ve DLco/VA değerleri bakımından istatistiksel olarak anlamlı bir farklılık bulunmadı. Sonuç: Astımlılarda DLco obstrüksiyon derecesinden etkilenmemektedir Bu da astımda efektif VA azalmamasına bağlıdır. DLco ölçümü kronik hava yolu obstrüksiyonu olan hastalarda astımın özellikle amfizemden ayrımında önemli bir yere sahiptir.Objective: The carbon monoxide diffusion capacity (DLco) measurement is an important pulmonary function test, giving information about gas exchange through the alveolocapillary membrane. In this study, the relationship between DLco and the degree of bronchial obstruction in patients with asthma has been investigated. Methods: The study included 91 nonsmoker subjects (mean age: 37.2&plusmn;9.4, range: 18-56 years) who were previously diagnosed as asthma and not having any diseases affecting DLco, and 47 nonsmoker voluntary subjects (mean age: 38.0&plusmn;8.7, range: 22-56 years) as controls. Flow rates, lung volumes and DLco measurements of all subjects were performed via Vmax22 spirometer. The patients were subdivided into 3 groups according to the degree of bronchial obstruction, using the parameters of FEV1 and PEF defined in Global Initiative for Asthma (GINA) guideline. Patients who had FEV1 and PEF values &amp;#8805; 80 % were included into group 1 (n:25); FEV1 or PEF values &amp;#8805; 80 % and any one of FEV1 or PEF values between 60 and 80 % into group 2 (n:29); and any one of FEV1 or PEF values &amp;#8804; 60 % into group 3 (n:37). Results: There was not a statistically significant difference between patients with asthma and controls regarding to DLco, DLco (%), VA and DLco/VA values. Conclusion: DLco is not affected by the degree of bronchial obstruction in asthma. This is related to that the effective alveolar volume is not reduced in asthma. DLco measurement has an important role in differentiation of asthma, especially from emphysema

Multiple Primary Tumors (Report of Two Cases)

Amaç: Akciğer kanserlerinin seyrinde metastazlar daha sık görülmekle birlikte ender rastlanılan multipl primer tümörlerin tanımlanması amaçlanmıştır. Olgu sunumu: Biri akciğer ve cilt altı, diğeri akciğer ve böbrek yerleşimli eşzamanlı olarak saptanan multipl primer tümörlü iki olgu sunuldu. Cerrahi rezeksiyon uygulanan olgulardan ilkinde histopatoloji; akciğerde adenokarsinom ile gluteal bölgede cilt altında miksoid liposarkom, ikincisinde ise akciğerde küçük hücreli karsinom ve böbrekteki hipernefroma idi. Tedaviyi takiben 1. olgu 20 aydır tümörsüz ve sağlıklı yaşamını sürdürürken 2. olguda ise adjuan kemoterapiyi takiben 16. ayda serebral ve multipl akciğer metastazları saptandı. Sonuç: Eşzamanlı saptanan bu tümörlerin gerek lokalizasyonları gerekse histopatolojik kombinasyonları dolayısıyla ender rastlanmaları nedeniyle, multipl primer tümörler literatür ışığında gözden geçirilmiştir.Objective: it was aimed to report rare multiple primary tumors, however, its metastases in the course of pulmonary carcinomas are more common. Case report: Two patients with multiple primary tumors, synchronous pulmonary/subcutaneous tumors in the first case and pulmonary/kidney tumors in the second were introduced. Ali tumors were treated surgically. Histopathological examination of the first case showed combination of adenocarcinoma in the right lung and myxoid liposarcoma in the right buttock, and the second case showed the right pulmonary small cell carcinoma and hypernephroma in the left kidney. After the surgical treatment, survival of the first case was 20 months without any recurrence. Although adjuvant chemotherapy was performed on the second case, widespread metastases were found in the postoperative 16th month. Conclusion: Synchronous multiple primary tumors are very rare in these localizations with these histopathological combinations. For this reason in this article they were reviewed in the light of literature

Progesterone Treatment Experience in a Patient with Lymphangioleiomyomatosis Presenting with Recurrent Pneumothorax

Lymphangioleiomyomatosis (LAM) is a rare interstitial lung disease. Patients with LAM generally present with dyspnea and spontaneous pneumothorax. Today, while there is no proven medical treatment method for LAM, progesterone is among the widely used drugs. In this report, the effect of approximately 1 year of progesterone treatment in a patient with LAM, presenting with recurrent pneumothorax, was evaluated

Radiological and functional assessment of pulmonary involvement in the rheumatoid arthritis patients

The aim was to evaluate the findings of high resolution computed tomography (HRCT) and pulmonary function tests (PFT) in the rheumatoid arthritis (RA) patients with and without pulmonary symptoms and to determine their role in prediction of respiratory system involvement. Among 54 consecutive RA patients, 22 (41%) were symptomatic and 32 (59%) were asymptomatic after detailed respiratory examination. Abnormal findings in PFTs were present in 10 (45%) symptomatic and 15 (47%) asymptomatic patients. PFT results were similar in both groups. A total of 18 (82%) symptomatic and 16 (50%) asymptomatic patients had abnormalities in HRCT scans. About 16 (80%) of 20 patients with normal HRCT scans had no pulmonary symptoms at all and we noted a significant correlation (P < 0.05). HRCT was more useful mean than PFTs in evaluation of pulmonary involvement in the RA patients; however, no correlation was present between various respiratory symptoms and abnormal findings both in PFTs and HRCT scans