Systemic Disease in Patients with Obstructive Sleep Apnea Syndrome

Objective In this study, we investigated 304 patients diagnosed with Obstructive sleep apnea syndrome (OSAS) and undergoing standard polysomnography in our sleep laboratory between December, 2013 and January 2015 in terms of anamnesis, drugs used and laboratory test results. Materials and Method Chronic diseases were detected in patients and their relations between OSAS were investigated. Results Severity of the disease in all patients was investigated under 3 topics according to Respiratory disturbance index (RDI). According to the results as severity of the OSAS increases, co-occurrence with systemic diseases increases. Conclusion In this study, co-occurrence of OSAS and chronic systemic diseases, characteristics of OSAS and the relation between OSAS and chronic systemic diseases were investigated

Je li fleksibilna bronhoskopija siguran postupak kod kritičnih bolesnika s respiracijskim zatajanjem?

Flexible bronchoscopy (FB) plays an important role in critical care patients. But, critical care patients with respiratory failure are at an increased risk of developing complications. Considering the developments in intensive care unit care in recent years, we aimed to evaluate the use of FB in these patients. We retrospectively reviewed patients who underwent FB in critical care between 2014 and 2020. A total of 143 patients underwent FB during the study period. Arterial blood gas measurement on the FB day revealed a mean PaO2/FiO2 of 186.94±28.47. Eighty-one (56.6%) patients underwent an fiberoptic bronchoscopy procedure under conventional oxygen supplementation, 10 (7%) on noninvasive ventilation, 13 (9.1%) on high flow nasal cannula, and 39 (27.3%) on invasive mechanical ventilation. During and immediately after bronchoscopy, none of the patients experienced life-threatening complications. Fifty-five (38.5%) patients developed complications that could be controlled. Multivariate analysis indicated that increased Apache-II score and presence of cardiovascular disease were significantly associated with an increased complication risk. Although critical care patients with respiratory failure are more prone to complications, diagnostic and therapeutic bronchoscopy may be performed following appropriate patient selection, without leading to major complications.Fleksibilna bronhoskopija (FB) igra važnu ulogu u bolesnika na kritičnoj skrbi. Međutim, ovi bolesnici na kritičnoj skrbi s respiracijskim zatajenjem imaju povećani rizik od razvoja komplikacija. S obzirom na napredak u skrbi u jedinici intenzivnog liječenja tijekom posljednjih godina cilj je bio procijeniti uporabu FB-a u ovih bolesnika. Retrospektivno smo pregledali podatke bolesnika koji su podvrgnuti FB-u u kritičnoj skrbi između 2014. i 2020. godine. Ukupno je 143 bolesnika podvrgnuto FB-u tijekom razdoblja ispitivanja. Mjerenje plinova u arterijskoj krvi na dan FB pokazalo je srednju vrijednost PaO2/ FiO2 od 186,94±28,47. Osamdeset jedan bolesnik (56,6%) podvrgnut je postupku fiberoptičke bronhoskopije pod konvencionalnim dodacima kisika, 10 (7%) na neinvazivnoj ventilaciji, 13 (9,1%) na nosnoj kanili s velikim protokom i 39 (27,3%) na invazivnoj mehaničkoj ventilaciji. Tijekom i neposredno nakon bronhoskopije niti jedan bolesnik nije doživio komplikacije opasne za život. Osim toga, 55 (38,5%) bolesnika razvilo je komplikacije koje se mogu kontrolirati. Prema multivarijatnoj analizi, povećani rezultat Apache-II i prisutnost kardiovaskularnih bolesti bili su značajno povezani s povećanim rizikom od komplikacija. Iako su bolesnici na kritičnoj skrbi s respiracijskim zatajenjem skloniji komplikacijama, dijagnostička i terapijska bronhoskopija mogu se provesti nakon odgovarajućeg odabira bolesnika, a da to ne dovede do većih komplikacija

Evaluation of coexistence of cancer and active tuberculosis; 16 case series

Introduction: Tuberculosis is an important risk factor for cancer. Pulmonary TB and lung cancer(LC) may mimic each other especially in the aspect of the clinical and radiological features. The aim of the study was to evaluate the features and risk factors of cases with coexistence cancer and active TB. Methodology: We retrospectively reviewed the medical records of patients with coexisting TB and cancer a period from 2009 to 2014. We evaluated demographic data, the ways diagnosis of TB cases, the location of TB and cancer, TB treatment results of the cases. Results: We recorded 374 TB cases in our dyspensary at this study period. In 16 (4%) of these cases, a coexistence of cancer and TB was detected. The male/female ratio was 12/4. The mean age was 62,12 ± 15,13 years. There were TST results except three cases. There were ten pulmonary TB and six extra-pulmonary TB (four peripheral lymphadenopathy TB, one abdominal TB lymphadenopathy and one salivary gland TB). Cancer types were as follows; eight lung cancer, two breast cancer, one base of tongue, one endometrium cancer, one hypopharyngeal cancer, one stomach cancer, one bladder cancer and one maxillary cancer. Diagnosis of all cases was confirmed by bacteriologic and/or histopathological examination. Squamous cell carcinoma was the most common type of cancers. This rate was 9/16. All TB cases were new. There were risk factors out of two case in the cases. Five cases were died during TB treatment. Others completed TB treatment without any complication. Conclusions: In our study, the coexistence of LC and pulmonary TB was more common. The local immunity is deteriorated in cancer cases. If there is pulmonary infiltrates in lung or peripheral lymphadenopathy, we must search tuberculosis too out of metastatic lesion and other infectious diseases. We should not make delay in the diagnosis of active TB in cancer cases. Keywords: Coexistent, Cancer, Tuberculosis, Tuberculosis treatmen

A Case of Amyopathic Dermatomyositis with Pneumomediastinum and Subcutaneous Emphysema

A 34-year-old man was admitted with dyspnea, cough, and fever. Thorax computed tomography revealed ground glass opacities and pneumomediastinum. The patient was diagnosed as amyopathic dermatomyositis due to skin lesions and radiological findings. Despite immunosuppressive treatment clinical deterioration and radiological progression were observed and the patient died because of severe hypoxemic respiratory failure. The patient presented with extremely rare occurrence of pneumomediastinum and subcutaneous emphysema in amyopathic dermatomyositis with a poor prognosis

Sarcoidosis, Celiac Disease and Deep Venous Thrombosis: a Rare Association

Sarcoidosis is a multisystem granulomatous disorder of unknown etiology and it may rarely be associated with a second disorder. Celiac disease is an immune-mediated enteropathy characterized with malabsorption caused by gluten intolerance, and several reports indicate an association between celiac disease and sarcoidosis. In addition, although celiac disease is associated with several extraintestinal pathologies, venous thrombosis has been rarely reported. Herein we present a rare case report of a patient with a diagnosis of sarcoidosis, celiac disease and deep venous thrombosis because of the rare association of these disorders. The patient was admitted with abdominal pain, weight loss, chronic diarrhea and a 5-day history of swelling in her right leg. A diagnosis of deep venous thrombosis was achieved by doppler ultrasonographic examination. The diagnosis of celiac disease was made by biopsy of duodenal mucosa and supported with elevated serum level of anti-gliadin IgA and IgG, and a diagnosis of sarcoidosis was achieved by transbronchial needle aspiration from the subcarinal lymph node during flexible bronchoscopy

Yüksek serum YKL-40 düzeyi akciğer kanserinde kötü prognozla ilişkilidir

High serum YKL-40 level is associated with poor prognosis in patients with lung cancer Introduction: YKL-40 is a glycoprotein that plays role in inflammation and malignant processes. High serum YKL-40 levels are associated with short survive in cancer and chronic obstructive pulmonary disease (COPD) is another reason to increase its’ level. However, limited knowledges are known in YKL-40 along with lung cancer and COPD. Materials and Methods: One hundred patients were involved to study with lung cancer (84 men, 16 women, and median age 62). Results were compared with 30 healthy volunteers. Thirteen patients were small cell lung cancer (SCLC), 87 patients were nonsmall cell lung cancer (NSCLC). 62% of patients were inoperable. results: Median YKL-40 level was 222.7 ± 114.1 ng/mL in patients and was 144.5 ± 105.7 ng/mL in controls (p 0.05). Patients with COPD had worse survive above all cut-off values (p 0.05). Özellikle 133 ng/mL‘ye göre KOAH tanılı 42 hastada KOAH olmayanlara göre yaşam süresi anlamlı derecede daha kısaydı (p= 0.01). sonuç: YKL-40 akciğer kanserinde yararlı bir belirteç ancak hücre tipi ve yaşam süresiyle ilişkisiz. KOAH’ın eşlik ettiği akciğer kanserli hastalarda ise yüksek serum düzeyleri kötü prognozla ilişkili bulunmuştur.http://tuberktoraks.or

Franchismo

We aimed to obtain information about the characteristics of the ICUs in our country via a point prevalence study