Current diagnosis and treatment in pulmonary thromboembolism

Pulmonary thromboembolism (PTE), is usually a complicationof deep vein thrombosis (DVT). Pulmonary thromboembolismdevelops as a result of obstruction of pulmonaryartery and / or branches with pieces that rupturedfrom the deep vein thrombosis of the leg. Pulmonarythromboembolism and DVT is also referred as venousthromboembolism (VTE) because of two events often remaintogether. The true incidence is uncertain because ofmore than half of the patients can be lost before the diagnosis.Despite the many new developments in the lastdecade on the diagnosis and treatment, PTE is still one ofthe difficult to diagnose and fatal diseases of lungs. Classicaland contemporary approaches to the diagnosis andtreatment of PTE were evaluated together in this review.J Clin Exp Invest 2013; 4 (3): 405-410Key words: Pulmonary, thromboembolism, diagnosis,treatmen

The discrepancies between assessments of physicians in microfilm examination for tuberculosis screening

Objectives: Microfilm (MF) are used in community based screening for tuberculosis (TB) in Turkey. This study aimed differences in evaluation between various physicians.Materials and Methods: In the Mardin Prison, 253 microfilms(MFs) were obtained during periodic TB screening in January 2006. A chest disease specialist doctor, a radiologyspecialist doctor and a general practitioner doctor assessed the MFs separately. The results were classified as i) Normal, ii) Active TB disease findings, iii) and Sequel TB disease findings.Results: A total of 13 MFs were not taken into considerationbecause of technically unsatisfactory radiographs. The end results were as follows; three physicians had agreed about diagnosis in 159 MFs (66.2%). In 81 MFs (33.8%) at least one physician had a different opinion about microfilm. The general practitioner reported 19 MFs (8%) as active TB disease findings and the radiology specialistdoctor reported 22 MFs (9%) as active TB disease. However, the chest diseases specialist doctor reported 26 MFs (11%) as having active TB disease findings. No significant difference was found in active TB diagnosis between three physicians (p>0.05). The frequency of sequelTB diagnosis was higher in Chest disease specialist compared with other physicians (p<0.05).Conclusion: Although MF is a fast screening method, considerable disagreement was found in evaluating abnormalfindings among reporting physicians. As TB is a disease with various radiologic appearances, usage of microbiological diagnostic modalities should be added to subjective radiographic methods

Is household contact screening enough in tuberculosis patients? A Village screening results

Objectives: Transmission of tuberculosis (TB) disease occurs with droplet infection and contact time and intensity are important factors in contagion. In this report, the results of a village TB screening were presented, due to a non-compliant patient that abandoned regular TB treatment. Materials and methods: In ‘Diyarbakir No.1 Tuberculosis Dispensary, TB treatment was started in a 18 year-old male patient with the diagnosis of ‘new sputum smear positive lung tuberculosis’. However, this patient lost to follow-up of therapy in the second month. After three months, the patient was found again and then anti-TB drugs were began for the diagnosis of ‘treatment after interruption smear positive lung tuberculosis’. Therefore directly observed TB treatment was given to this patient and therapy resulted in complete cure.Results: Patient was an inhabitant of a village bound to Diyarbakir city and 810 people lived there, thus a microfilm screening was performed in this village. Microfilms of 485 persons were taken and tuberculin skin test (TST) was performed to 225 people in this investigation. Sputum smear was obtained from 15 people. Four additional people diagnosed as pulmonary TB so these people received antituberculosis therapy. Eighteen people took prophylactic isoniazid therapy due to positive TST reactivity. Four patients with TB were close relatives of the index patient. In this village, tuberculosis prevalence was 617 per thousand in 2006. Conclusion: In low-socioeconomic people, TB patient should be looked for not only with passive methods, but also with active methods. Furthermore, TB scanning should be carried not only in index patient’s household contacts, but also in persons having close relationships with him because of social life

THE EVALUATION OF HIGH SCHOOL 12TH GRADE STUDENTS’ OPINIONS ABOUT THE EFFECTIVENESS OF PHYSICAL EDUCATION CLASSES

The present study is conducted to identify 12th grade high school students’ opinions about the effectiveness of physical education classes. In the study, the interview method of qualitative research method is used. In order to obtain data of the study, open-ended questions that are designed to evaluate students' views and suggestions are used. These questions are following: (1) How do you find the teaching of the lesson, (2) What are the achievements of the course, (3) What are popular and unpopular aspects of the lessons, (4) How do you relate these classes with other courses, (5) What are your recommendations in terms of how to do the class. The research group was formed with 50 students who are studying in the 12th grade in official high schools depending on Gaziantep Directorate of National Education. Content analysis is applied to the data obtained from student’s opinions. Consequently, considering high school 12th grade students’ opinions about physical education classes, it can be said that physical education classes are effective and efficient. It is identified that students think physical education classes are important as they contribute to the development of physical, psychological and social aspects of human beings. However, the number of class hours and environmental conditions are not sufficient enough so this affects the effectiveness of the classes negatively.  Article visualizations

Value of a new inflammatory parameter in malignant pleural mesothelioma prognosis

Malignant Pleural Mesothelioma (MPM) generallyassociated with asbestos exposure is a tumor withpoor prognosis. Modified Glasgow Prognostic Score(GPS) which may be a prognostic parameter in patientswith MPM is a designed based score including increasedC-reactive protein (CRP) levels and decreased albumin.In this study we aimed to investigate the effect of GPSscore on the prognosis of MPM and the role of other potentialfactors.Methods: In this retrospective planned study 140 histologicaldiagnosed MPM patients were included.Results: Mean age of 140 MPM patients were 52.92years (83 male and 57 female). A total of 91 patients hadenvironmental asbestos exposure and exposure timewas the 31 years. Symptoms of the patients started approximately4.8 months before the application. The mostfrequently seen symptoms were in 125 patients dyspnea,in 94 patients chest pain and in 22 patients weight loss.GPS score of the patients were as follows; 64 patientstwo, 14 patients one, 22 patients zero. Of the patients,112 died and 28 were alive. Mean survival time was 14months. Patients with GPS score 2 lived for 10 months,GPS score 1 lived for 15 and GPS score 0 lived for 18months. This difference was statistically significant. Furthermore,the male sex and age older than 65 years werefound as poor prognostic parameters on the survival.Conclusion: A simple and inexpensive parameter able tobe used to estimate the prognosis of MPM patients couldnot be developed .GPS score increases in inflammatoryconditions. GPS is a simple and inexpensive parameterthat can be used for detecting the severity of patients withMPM.Key words: Modified Glasgow Prognostic Score, MalignantPleural Mesothelioma, Prognosi

The importance of mean platelet volume in early mortality of pulmonary embolism

Objective: In this study whether mean platelet volume(MPV) is associated with early period hospital mortalityor not in patients with pulmonary embolism (PE) was investigated.Methods: Data of patients that hospitalized in chest diseasesclinic with the diagnosis of PE between the years2009-2012 were screened retrospectively from digital archivesystem. The demographic data, symptoms, treatmentoutcomes and MPV values in complete blood countof patients were recorded.Results: The mean age was 57.93 ± 18.52 years (16-91).The number of patients is 143 and 91 women (63.9%),52 men (36.4%), respectively. MPV values were availablefor 137 of 143 patients. 129 of patients were discharged,and 8 had died in the early period of hospitalization. Themean MPV value was 7.85 ± 1.40 fL in patients who experiencedand 9.08 ± 1.61 fL in died respectively. The differencewas statistically significant (p = 0.01).Conclusion: The results of this study suggests that increasedMPV value may be used as a marker for earlyhospital mortality in patients with PE. J Clin Exp Invest2013; 4 (3): 298-301Key words: Mean platelet volume, mortality, pulmonary embolis

Assessment of the sleep parameters in patients with obstructive sleep apnea syndrome with a

Objective: In this study, traffic accident with a history ofobstructive sleep apnea syndrome (OSAS) in patientswith polysomnographic parameters was investigated.Methods: A total of 77 OSAS patients were included inthe study. All-night polysomnographic recordings obtainedfrom patients with enuresis parameters and thepresence of traffic accidents recorded in standard form.Results: The mean age of patients was 45.15 ± 11.53years. 53% of the patients were male and 47% female.The mean apnea hypopnea index (AHI) in patients was13.54 events/h. History of traffic accidents was found in12% patients. Apnea hypopnea index, supine AHI, arousalindex and oxygen desaturation index were found significantlydifferent parameters between history of trafficaccidents group and non-history of traffic accidents group(p <0.05).Conclusion: In this study, patients with OSAS severity ofthe disease with a history of traffic accidents were associatedthe relationship between the parameters. This relationshipwith the severity of the disease might be due tothe negative effects on attention. J Clin Exp Invest 2013;4 (2): 204-207Key words: OSAS, traffic accident, AH

Tuberculosis control status of Diyarbakir province between the years 2005-2010

Objective: Tuberculosis (TB) control programs contain international and national level acceptable standardized diagnosis, treatment and prevention practices. Analysis of TB data in a region by aspect of national data can determines the level of compliance with TB control programs in there and will help to determine the right forward strategy. In this study, five years of Diyarbakir TB of data were examined in comparison with the data of the our country. Methods: Diyarbakir and Turkey TB data recorded in two groups according Department of the Ministry of Health's annual reports for the years 2006-2010. Demographic, diagnostic, and treatment TB data of each group determined and compared with each other by statistical analyze Results: Five-year average TB case rate of Diyarbakir data were (22.8/100.000) and the rate of pulmonary TB smear is tested (80.1%) were lower than national average rate (25.6 /100.000), and the national rate of pulmonary TB smear is tested (88.3%) . Both TB culture study rate (40.1%) and culture positivity (45.5%) were found lower the cultures which made the national average (62.6%) and culture positivity rate (80.4%). TB Cure rate (43.9%) was slightly lower the country of cure rate (58.5%). Treatment success (86.5), leaving treatment (5.7%) and mortality (2.7%) was found similar to the data of the national data. Conclusion: Low rate of bacteriological examination results and low cure rate of TB in Diyarbakır, thought to be the reasons making it difficult to control TB in there. Comprehensive studies to determine potential problems like sociodemographic factors, health services, infrastructure and equipment considered

A Single Imaging Modality in the Diagnosis, Severity, and Prognosis of Pulmonary Embolism

Introduction. This study aimed to investigate the currency of computerized tomography pulmonary angiography-based parameters as pulmonary artery obstruction index (PAOI), as well as right ventricular diameters for pulmonary embolism (PE) risk evaluation and prediction of mortality and intensive care unit (ICU) requirement. Materials and Methods. The study retrospectively enrolled 203 patients hospitalized with acute PE. PAOI was calculated according to Qanadli score. Results. Forty-three patients (23.9%) were hospitalized in the ICU. Nineteen patients (10.6%) died during the 30-day follow-up period. The optimal cutoff value of PAOI for PE 30th day mortality and ICU requirement were found as 36.5% in ROC curve analysis. The pulmonary artery systolic pressure had a significant positive correlation with right/left ventricular diameter ratio (r=0.531, P<0.001), PAOI (r=0.296, P<0.001), and pulmonary artery diameter (r=0.659, P<0.001). The patients with PAOI values higher than 36.5% have a 5.7-times increased risk of death. Conclusion. PAOI is a fast and promising parameter for risk assessment in patients with acute PE. With greater education of clinicians in this radiological scoring, a rapid assessment for diagnosis, clinical risk evaluation, and prognosis may be possible in emergency services without the need for echocardiography

A Single Imaging Modality in the Diagnosis, Severity, and Prognosis of Pulmonary Embolism

Introduction. This study aimed to investigate the currency of computerized tomography pulmonary angiography-based parameters as pulmonary artery obstruction index (PAOI), as well as right ventricular diameters for pulmonary embolism (PE) risk evaluation and prediction of mortality and intensive care unit (ICU) requirement. Materials and Methods. The study retrospectively enrolled 203 patients hospitalized with acute PE. PAOI was calculated according to Qanadli score. Results. Forty-three patients (23.9%) were hospitalized in the ICU. Nineteen patients (10.6%) died during the 30-day follow-up period. The optimal cutoff value of PAOI for PE 30th day mortality and ICU requirement were found as 36.5% in ROC curve analysis. The pulmonary artery systolic pressure had a significant positive correlation with right/left ventricular diameter ratio ( = 0.531, &lt; 0.001), PAOI ( = 0.296, &lt; 0.001), and pulmonary artery diameter ( = 0.659, &lt; 0.001). The patients with PAOI values higher than 36.5% have a 5.7-times increased risk of death. Conclusion. PAOI is a fast and promising parameter for risk assessment in patients with acute PE. With greater education of clinicians in this radiological scoring, a rapid assessment for diagnosis, clinical risk evaluation, and prognosis may be possible in emergency services without the need for echocardiography