Association with Asthma and Restless Legs Syndrome and Sleep Quality

Objective:We aimed to evaluate the frequency and severity of restless legs syndrome in patients with asthma and the effect of the disease on sleep quality.Materials and Methods:Forty-three patients followed by asthma and 30 healthy people were included in the study. The diagnosis of Restless Legs Syndrome was made according to the criteria of the International Restless Legs Syndrome Study Group. Excessive daytime sleepiness scores were determined according to the Epworth Sleepiness Scale (ESS). According to the Pittsburgh Sleep Quality Index (PSQI) the sleep quality and according to the Insomnia Severity Index (ISI) the insomnia was determined.Results:Male/female rate in the asthmatic group was 1/8, and the mean age was 48.88 years. The healthy control group was selected to be gender and age-matched. Restless Legs syndrome was found 25.58% (n=11) in the asthmatic group and 16.7% (n=5) in the control group, and it was also not statistically significant. The number of asthmatic patients with ESS ≥10 was six, while there was one person in the control group, and it was not statistically significant. According to the PSQI values, there was a significant difference between the asthmatic group and the control group (p<0.001); when ISI values were examined, there was no statistically significant difference between them.Conclusion:In our study, it was found that the sleep quality deteriorated at high rates in the asthmatic group. However, as expected in asthmatic patients, Restless Legs syndrome, insomnia, and incidence of excessive daytime sleepiness were not significantly higher than the control group

Analysis of the Role of Physicians in the Cessation of Cigarette Smoking Based on Medical Specialization

OBJECTIVE: Physicians do not adequately use their unique professional privilege to prevent patients from smoking. The aim of this study was to investigate the type and extent of advice given to patients by physicians of different medical specialties regarding smoking cessation. METHODS: In total, 317 volunteer physicians were included in this study. The participants rated their attitudes toward the smoking habits of their patients by completing a questionnaire. The approaches used to address the smoking habits of patients significantly differed among physicians working at polyclinics, clinics and emergency service departments (

Our Experience on Single-Port Bilateral Endoscopic Thoracal Sympathectomy for the Treatment of Palmar and Axillary Hyperhidrosis

Objective: In this study, we aimed to present our experience on endoscopic thoracic sympathectomy for palmar and axillary hyperhidrosis that does not respond to medical treatment and affects the social lives of people. Methods: We retrospectively reviewed the data of 20 patients (11 men and 9 women) with a mean age of 25.4 (17–34) years who underwent 40 bilateral endoscopic sympathectomy operations in the same session in our clinic between April 2013 and July 2014. In 12 (60%) patients at the level of T2-T3 and in 8 (40%) patients at the level of T3-T4; the sympathetic ganglions and the Kuntz nerve were ablated by using a single port approach. Postoperative chest X-ray was performed to all patients. All data regarding surgical technique, duration of operation, perioperative and postoperative complications, patient satisfaction, and long-term outcomes were presented. Results: In long-term follow-up, 12 (60%) patients developed compensatory hyperhidrosis in various body regions. There was no recurrence in any case. Eighteen patients were satisfied and two were partially satisfied with the results of endoscopic thoracic sympathectomy. One patient developed pneumothorax that required intervention, and there was expansion failure in two patients who did not require any intervention. The mean duration of operation was 34.2 (25–45) minutes. There was no surgical mortality. The mean duration of follow-up was 12.4 (5–22) months. Conclusion: We conclude that endoscopic thoracic sympathectomy is a preferable method with a low mortality and morbidity and high satisfaction in the long-term, despite the risk of late onset compensatory perspiration in elective patients with palmar and axillary hyperhidrosis

The relationship between nasal mucociliary clearance time and the degree of smoking dependence in smokers with obstructive sleep apnea syndrome

Introduction: The aim of this study was to investigate the relationship between nasal mucociliary clearance time (NMCT), degree of smoking dependence, cumulative smoking burden and OSAS severity in smokers. Material and methods: 123 patients (Group 1) with OSAS and 92 healthy controls (Group 2) were included in the study. Group 1 was divided into smokers (Group 1a) and non-smokers (Group 1b). In Group 1a, cumulative smoking burden and Fagerström nicotine dependence test (FNDT) were questioned. Saccharin test was applied to Groups 1 and 2. Student-t, Mann-Whitney-U, Anova, Kruskal-Wallis tests were used to compare the means. Results: NMCT was higher in Group 1 than Group 2 (p = 0.005). The duration of NMCT was higher in Group 1A than Group 1B (p = 0.002). In Group 1a, NMCT values of mild and moderate OSAS patients were longer than in Group 1b (p = 0.02, p = 0.01, respectively). NMCT values of patients with mild dependence were shorter than those with moderate or severe dependence (p = 0.032, p &lt; 0.001, respectively). Conclusion: Mucociliary clearance time was higher in smokers with OSAS than non-smokers. While OSAS has a negative effect on mucociliary clearance, smoking also exacerbates the condition

Can we predict patients that will not benefit from invasive mechanical ventilation? A novel scoring system in intensive care: the IMV Mortality Prediction Score (IMPRES)

Background/aim: The present study aimed to define the clinical and laboratory criteria for predicting patients that will not benefit from invasive mechanical ventilation (IMV) treatment and determine the prediction of mortality and prognosis of these critical ill patients. Materials and methods: The study was designed as an observational, multicenter, prospective, and cross-sectional clinical study. It was conducted by 75 researchers at 41 centers in intensive care units (ICUs) located in various geographical areas of Turkey. It included a total of 1463 ICU patients who were receiving invasive mechanical ventilation (IMV) treatment. A total of 158 parameters were examined via logistic regression analysis to identify independent risk factors for mortality; using these data, the IMV Mortality Prediction Score (IMPRES) scoring system was developed. Results: The following cut-off scores were used to indicate mortality risk: 8, very high risk. There was a 26.8% mortality rate among the 254 patients who had a total IMPRES score of lower than 2. The mortality rate was 93.3% for patients with total 1M PRES scores of greater than 8 (P < 0.001). Conclusion: The present study included a large number of patients from various geographical areas of the country who were admitted to various types of ICUs, had diverse diagnoses and comorbidities, were intubated with various indications in either urgent or elective settings, and were followed by physicians from various specialties. Therefore, our data are more general and can be applied to a broader population. This study devised a new scoring system for decision-making for critically ill patients as to whether they need to be intubated or not and presents a rapid and accurate prediction of mortality and prognosis prior to ICU admission using simple clinical data

Mortality prediction ability of phycians in intensive care units of Turkey (MOPAP)

ÖZ Türkiye’de yoğun bakım ünitelerinde hekimin mortaliteyi öngörebilme gücü Giriş: Yoğun bakım hekimleri giderek yoğun bakım hastalarının prognozu ile ilgili karar vermede daha fazla yer almaktadır. Bu çalışma ile; yoğun bakıma hasta triyajı ve hasta takibinde klinisyen öngörüsünün hasta mortalite tahminindeki gücünün değerlendirilmesi amaçlanmıştır. Materyal ve Metod: Bu çalışma Türkiye’nin çeşitli coğrafi bölgelerinde bulunan yoğun bakımlarda 1 Ocak 2017 - 30 Nisan 2017 tarihleri arasında yapılmıştır. Çalışma gözlemsel, çok merkezli, prospektif, kesitsel klinik araştırma olarak planlanmıştır. Bulgular: Çalışma boyunca 37 farklı yoğun bakımdan toplam 1169 entübe hasta takip edilmiştir. Hastaların 530’u (%45.3) eğitim ve araştırma hastanelerinde, 639’u (%54.7) üniversite hastanelerinde yatmaktaydı. Hastayı yoğun bakımda takip edecek hekime, takip başlangıcında hastaların sağ kalım ihtimalleri için bir skor vermeleri istendi. Skorlama “0” en kötü ihtimal, “5” en iyi olacak şekilde 0’dan 5’e kadar toplam 6 skor içermekteydi. Bu dağılıma göre 0 puan verilen 113 hastadan sadece 1 (%0.9) hasta sağ kaldı. Bir puan verilen 207 hastadan 26’sı (%12.6) sağ kaldı. En iyi puan olan 5 puan verilen 49 hastadan ise sadece 3’ü (%6.1) kaybedildi. Sağkalım oranları her puan grubunda diğer gruplara göre istatistiksel anlamlı farklıydı (r: -0.488; p< 0.001). Doktorların klinik gözlemlerine dayalı mortaliteyi tahmin etme skorları birleştirildikten sonra (0 ve 1 puan grupları birleştirilerek “tahmini eksitus”, 4 ve 5 puan grupları birleştirilerek “tahmini sağkalım”) toplam 545 hastanın 320’si tahmini eksitus, 225’i tahmini sağkalım olarak öngörülmüştür. Tahmini skorlamanın mortaliteyi öngörmedeki sensitivitesi %91.56 (95% CI: 87.96-94.37), spesifisitesi %76.89 (%95 CI: 70.82- 82.23) idi. Yine klinisyenlerin mortalite tahmininin pozitif prediktif değeri %84.93, negatif prediktif değeri %86.50 olarak tespit edildi. Klinisyenler özellikle mortaliteyi öngörmede yüksek bir başarı gösterdiler. Sonuç: Bu çalışma ile yoğun bakımda hasta takip eden hekimlerin mekanik ventilasyon desteğindeki hastalarında, hastayı kabul ettikleri anda, mortalite ile sonlanan kötü prognozu yüksek oranda doğru öngörebildikleri sonucuna varılmıştır. Yoğun bakım mortalite skorlamalarına diğer laboratuar ve klinik parametreler yanında hekimin mortalite tahmini ile ilgili görüşlerine yer verilmesi düşünülmelidir

Mortality prediction ability of phycians in intensive care units of Turkey (MOPAP)

ÖZ Türkiye’de yoğun bakım ünitelerinde hekimin mortaliteyi öngörebilme gücü Giriş: Yoğun bakım hekimleri giderek yoğun bakım hastalarının prognozu ile ilgili karar vermede daha fazla yer almaktadır. Bu çalışma ile; yoğun bakıma hasta triyajı ve hasta takibinde klinisyen öngörüsünün hasta mortalite tahminindeki gücünün değerlendirilmesi amaçlanmıştır. Materyal ve Metod: Bu çalışma Türkiye’nin çeşitli coğrafi bölgelerinde bulunan yoğun bakımlarda 1 Ocak 2017 - 30 Nisan 2017 tarihleri arasında yapılmıştır. Çalışma gözlemsel, çok merkezli, prospektif, kesitsel klinik araştırma olarak planlanmıştır. Bulgular: Çalışma boyunca 37 farklı yoğun bakımdan toplam 1169 entübe hasta takip edilmiştir. Hastaların 530’u (%45.3) eğitim ve araştırma hastanelerinde, 639’u (%54.7) üniversite hastanelerinde yatmaktaydı. Hastayı yoğun bakımda takip edecek hekime, takip başlangıcında hastaların sağ kalım ihtimalleri için bir skor vermeleri istendi. Skorlama “0” en kötü ihtimal, “5” en iyi olacak şekilde 0’dan 5’e kadar toplam 6 skor içermekteydi. Bu dağılıma göre 0 puan verilen 113 hastadan sadece 1 (%0.9) hasta sağ kaldı. Bir puan verilen 207 hastadan 26’sı (%12.6) sağ kaldı. En iyi puan olan 5 puan verilen 49 hastadan ise sadece 3’ü (%6.1) kaybedildi. Sağkalım oranları her puan grubunda diğer gruplara göre istatistiksel anlamlı farklıydı (r: -0.488; p< 0.001). Doktorların klinik gözlemlerine dayalı mortaliteyi tahmin etme skorları birleştirildikten sonra (0 ve 1 puan grupları birleştirilerek “tahmini eksitus”, 4 ve 5 puan grupları birleştirilerek “tahmini sağkalım”) toplam 545 hastanın 320’si tahmini eksitus, 225’i tahmini sağkalım olarak öngörülmüştür. Tahmini skorlamanın mortaliteyi öngörmedeki sensitivitesi %91.56 (95% CI: 87.96-94.37), spesifisitesi %76.89 (%95 CI: 70.82- 82.23) idi. Yine klinisyenlerin mortalite tahmininin pozitif prediktif değeri %84.93, negatif prediktif değeri %86.50 olarak tespit edildi. Klinisyenler özellikle mortaliteyi öngörmede yüksek bir başarı gösterdiler. Sonuç: Bu çalışma ile yoğun bakımda hasta takip eden hekimlerin mekanik ventilasyon desteğindeki hastalarında, hastayı kabul ettikleri anda, mortalite ile sonlanan kötü prognozu yüksek oranda doğru öngörebildikleri sonucuna varılmıştır. Yoğun bakım mortalite skorlamalarına diğer laboratuar ve klinik parametreler yanında hekimin mortalite tahmini ile ilgili görüşlerine yer verilmesi düşünülmelidir

Türkiye’de yoğun bakım ünitelerinde hekimin mortaliteyi öngörebilme gücü

Introduction: Intensive care physicians are increasingly involved in decision making about the prognosis of intensive care unit ICU patients. With this study; we aimed to evaluate the power of clinician foresight at prediction of mortality in patient at triage to intensive care and patient follow-up. Materials and Methods: This study was conducted in ICUs located in various geographical regions of Turkey between January 1, 2017-April 30, 2017.The clinical research was planned as observational, multicenter, cross-sectional. Results: A total of 1169 intubated patients were followed in 37 different ICU. At the beginning of the follow-up we asked the physician who will follow the patient in the ICU to give a score for the probability of survival of the patients. Scoring included a total of 6 scores from 0 to 5, with the “0” the worst probability “5” being the best. According to this distribution, only 1 (0.9%) of 113 patients who were given 0 points survived. Three (6.1%) of 49 with the best score of 5 died. Survival rates were significantly different in each score group (r:-0.488; p< 0.001). After the combined mortality estimation scores based on the clinical observations of the physicians (0 and 1 point score was combined as non-survive, 4 and 5 score was combined as survived) 320 of the 545 patients were estimated to be dead and 225 were predicted survival. Sensitivity and spesifity of scoring system to predict mortality was 91.56% (95% CI: 87.96-94.37), 76.89% (95% CI: 70.82-82.23) respectively. Conclusion: In this study, we concluded that the physicians who follow the patients in the ICU can predict the poor prognosis at the time of admission and the high mortality rate. The physician’s opinion on mortality estimation should be considered in intensive care mortality scoring in addition to other laboratory and clinical parameters. ©Telif Hakkı 2020 Tüberküloz ve Toraks. Makale metnine

Analysis of the Role of Physicians in the Cessation of Cigarette Smoking Based on Medical Specialization

OBJECTIVE: Physicians do not adequately use their unique professional privilege to prevent patients from smoking. The aim of this study was to investigate the type and extent of advice given to patients by physicians of different medical specialties regarding smoking cessation. METHODS: In total, 317 volunteer physicians were included in this study. The participants rated their attitudes toward the smoking habits of their patients by completing a questionnaire. The approaches used to address the smoking habits of patients significantly differed among physicians working at polyclinics, clinics and emergency service departments (p<0.001). Physicians working at clinics exhibited the highest frequency of inquiring about the smoking habits of their patients, while physicians working at emergency service departments exhibited the lowest frequency. RESULTS: Physicians from different medical specialties significantly differed in their responses. Physicians specializing in lung diseases, thoracic surgery, and cardiology were more committed to preventing their patients from cigarette smoking. CONCLUSIONS: The role of physicians, particularly pulmonologists and thoracic surgeons, is critical in the fight against cigarette smoking. Promoting physician awareness of this subject is highly important in all other branches of medicine