Pleural effusion following ventriculo-pleural shunt: Case reports and review of the literature

Ventriculo-pleural shunt (VPLS) is an acceptable alternative in the management of hydrocephalus. Imbalance between the production and absorption of cerebrospinal fluid an lead to formation of pleural effusion in patient with VPLS and on occasion produce symptoms. Pleural effusion could be a transudate or a non-specific exudate. We report our experience with this modality in relation to formation of pleural effusion and review the literature to make recommendation for its management. Information related to patients′ demographics, smoking history, prior pulmonary and occupational history, indication, duration and complications of the VPLS and their management was gathered to substantiate current recommendation with our experience

The frequency of asymptomatic atopy and relationship to latent tuberculosis in health workers

Objective: In recent decades, the prevalence of atopic diseases has risen. Genetic factors and environmental factors are accused for this increase. The studies examining risk factors for asymptomatic atopy are limited, although many studies have investigated environmental risk factors in atopic diseases. The aim of study, to determine the prevalence of atopic sensitization among asymptomatic health workers and to examine the effects of active smoking and latent tuberculosis for atopic sensitization

Congenital Bronchial Artery-Pulmonary Artery Fistula in a Young Adult

Primary vascular malformations such as connection between bronchial artery and pulmonary artery or pulmonary vein are quite rare. A 18-year-old male patient with the first episode of massive hemoptysis was found to have bronchial artery-pulmonary artery fistula, a rare vascular anomaly, on selective bronchial angiography. Since medical history revealed no acquired cause, it is considered congenital. He underwent bronchial artery embolization and hemoptysis was completely resolved after endovascular treatment. The presence of such vascular anomalies should be suspected in patients with massive hemoptysis. Bronchial artery embolization is a safe and effective nonsurgical treatment option for such patients. [Cukurova Med J 2015; 40(4.000): 830-835

Tobacco and COVID-19

Tobacco and its products are the well-known causes of premature deaths associated with cancer, cardiovascular disease, and chronic obstructive pulmonary disease, as well as they constitute a significant risk factor that increases the tendency to respiratory system infection and other systemic infections. Active tobacco use and passive smoking increase the risk of infection. Both increase peribronchial and alveolar inflammation and fibrosis and mucosal permeability, cause inadequate mucociliary cleaning, damage to the respiratory tract epithelium resulting in fibrosis, and they adversely affect cellular and humoral immunity. Smoking has been known to increase the risk for viral infections and influenza. Similar data have been approved found for coronavirus disease-2019 (COVID-19) pandemic. Smoking is reported to be associated with the frequency of the disease and its severity of the clinical course. Severe acute respiratory syndrome-coronavirus-2 penetrates the cell using the angiotensin-converting enzyme 2 receptors. Such receptor proteins had been shown to increase in smoker individuals. Also, smoking facilitates penetration of the virus into the cell. The frequency of smoking and the rates of admission to intensive care, mechanical ventilation, and mortality have been also found to be higher was higher in severe cases. The risk for disease progression was found to be 14-fold higher in smokers. Further, the World Health Organization emphasized similar negative effects of hookah and new tobacco products such as electronic cigarettes and heated tobacco products. It is vital to underline the adverse effects of tobacco and tobacco products and to raise awareness among the public and to make efforts to smoking on every opportunity during the COVID-19 pandemic. Public awareness campaigns during the pandemic must always accompanied by the methods and strategies to avoid active and passive smoking

Attitudes and Knowledge for Smoking Among University Students

Objective: This study was planned to clarify the extent of the smoking epidemic among young persons in Turkey. Material and Methods: The study included 3156 students from a university in the capital of Turkey. The questionnaire was prepared according to the criteria of the World Health Organization (WHO). It included items for sociodemographic features and the smoking status of students and their families, and the smoking behavior of the students. Results: The final population consisted of 3156 students. While the overall frequency of current smokers was 30.6%, the frequencies of nonsmokers, ever-smokers, occasional smokers, and ex-smokers were 36.8%, 23.2%, 4.8%, and 4.6% respectively. Current tobacco use was significantly higher among male students (p<0.001). The percentage of smokers with a family member who smoked was 73.2%. The percentage of students that had tried to cease smoking in the previous year was 68.4%. Conclusion: University students comprise a large group of young Turkish people. Because one third of university students are regular smokers, serious interventions are required to prevent young persons from starting to smoke, rather than encouraging them to stop smoking after the behavior has already become a habit

Characteristics and outcomes of end-stage renal disease patients with active tuberculosis followed in intensive care units

Tuberculosis (TB) remains a common problem in patients with chronic renal failure. In intensive care units, misdiagnosis or delayed diagnosis of TB is common. Therefore, a description of characteristics of active TB in patients with renal failure followed in intensive care units is important to reduce mortality and transmission of the disease. This study was performed to describe the characteristics of patients with renal failure admitted to the intensive care units and having active TB and evaluate predictive factors for in hospital mortality. The hospital records of 24 patients (11 women, 13 men) having ESRD and TB between 2001-2006 were reviewed. Clinical, radiological, and laboratory data on admission were recorded. Possible parameters contributing to in-hospital mortality were obtained from the medical records. In-hospital mortality rate was 66.6&#x0025;. Factors associated with mortality were decreased partial pressure of oxygen and malnutrition. Fever was reported in 8 patients and hemoptysis was reported in 3 patients. Eight patients had consolidation on chest radiograph, while 4 had normal findings Seventeen patients had pulmonary involvement, and 11 had extra pulmonary involvement. The mortality rate in TB patients followed in intensive care units is high, with 3 factors contributing to in-hospital mortality. Clinicians should consider active TB in renal failure patients being followed in the intensive care unit, even when results of a chest radiograph are normal especially in patients with unexplained poor general health or respiratory failure

Investigation of Oxidative and Antioxidative Status in Patients with Diabetic Cataracts

Aim: To investigate the oxidative and antioxidative status in diabetic patients with cataracts and nondiabetic patients with cataracts as compared to controls. Materials and methods: There were 149 subjects included in the present study. Blood was collected from type 2 diabetic patients suffering from cataracts (diabetic cataract; n = 42), senile nondiabetic patients suffering from cataracts (nondiabetic cataracts; n = 60), and healthy subjects of a control group (n = 47). Serum levels of total oxidant status (TOS), total antioxidant status (TAS), total thiol levels (TTLs), and paraoxonase 1 (PON1) were investigated in the samples. Results: TTLs were significantly reduced in diabetic cataract patients (444.8 mu mol/L) compared with both nondiabetic cataract patients (525.1 mu mol/L) and the control group (569.9 mu mol/L). Plasma PON1 levels also were significantly reduced in diabetic cataract patients (241.9 U/L) relative to the control group (178.3 U/L). There were no statistically significant differences between TAS and TOS levels among groups. Conclusion: The present study demonstrates a significant reduction in serum TTLs and serum PON1 activities in diabetic cataract patients compared with controls. These findings represent a failure in the antioxidant system, which may be related to the cataractogenic process.WoSScopu

Renal transplant improves pulmonary hypertension in patients with end stage renal disease

<p>Abstract</p> <p>Background</p> <p>Pulmonary hypertension (PH) is present in a significant proportion of patients with end stage renal disease (ESRD) and is of prognostic importance. Data on the effect of renal transplant on PH is very limited. In this study, the aim was to examine the effect of renal transplant on systolic pulmonary artery pressure (SPAP) determined by Doppler echocardiography.</p> <p>Methods</p> <p>Analysis was performed on the records of 500 consecutive patients who underwent renal transplant at our center between the years 1999 to 2008. The prevalence of PH in the preoperative assessment period was established. Patients were diagnosed as having PH when measured SPAP values were > 35 mm Hg.</p> <p>Results</p> <p>Pulmonary hypertension was detected in 85 of the 500 (17%) patients under pre-transplant evaluation. At post-transplant follow up Doppler echocardiographic examination was performed on 50 of the 85 patients. After exclusion of 8 cases (1 due to massive pulmonary thromboemboli; 7 due to graft failure requiring dialysis therapy) analyses were performed on 42 patients who had undergone both pre- and post-transplant echocardiographic examination. Mean SPAP at pre-transplant evaluation was 45.9 ± 8.8 mm Hg and in 6 (14.3%) cases SPAP was above 50 mm Hg.</p> <p>Compared to pre-transplant values, a significant decrease was observed in mean SPAP values in an average of 53 months of postoperative follow up (41.8 ± 7.4 mm Hg vs. 45.9 ± 8.8 mm Hg, p < 0.0001).</p> <p>Conclusion</p> <p>These findings indicate that patients with ESRD accompanied by PH may benefit from renal transplant. Further research is required for more concrete conclusions to be drawn on this subject.</p

Frequency and duration of smoking scenes in Turkish movies

BACKGROUND: Comprehensive tobacco control law in Turkey bans advertisement, promotion of tobacco products and sponsorship by the tobacco industry. Advertisement of tobacco products was banned on television, billboards and press media, but not on movie films. METHODS: To evaluate the frequency and duration of smoking in the movies, 60 most watched Turkish films which were on the vision during the second half of 2016 were determined for this descriptive study. Two young males having a university degree were trained on the aim and methodology of the study. Then the two observers viewed the films independently and recorded smoking scenes or direct appearance of tobacco products on a standard form. RESULTS: There were tobacco products or smoking views in 36 (60%) out of total 60 movies. In these movies there were 4.75 times tobacco occurrences as an average (median 3). Average duration of smoking occurrences was almost 3.5 min (198 s). Smokers were mostly main characters and smoking occurrences were mostly in exciting or romantic atmosphere, which are attractive for young people. DISCUSSION: In the light of Framework Convention on Tobacco Control (Article 13), smoking scenes in movies are considered as kind of tobacco advertisement and promotion, which influences smoking behavior particularly the young people. Therefore, control and prevention of smoking occurrences in movies are important for the protection of children and young people to start smoking. Some health warnings and anti-tobacco messages may be placed in the movies, to reduce tobacco views in the movies

Relation of red cell distribution width with dipper and non-dipper hypertension

Aim Red cell distribution width (RDW), an index of erythrocyte size, is associated with high risk for cardiovascular disease. Nondipping hypertension (HT) is lack of nocturnal fall in blood pressure (BP). The association between RDW and non-dipping BP in normotensive and hypertensive patients was investigated. Methods A total of 170 patients were categorized into 4 groups: Normotensive-Dipper (NT-D), Normotensive-Non-dipper (NTND), Hypertensive-Dipper (HT-D) and Hypertensive-Non-dipper (HT-ND). RDW and hs-CRP levels were measured. Results Hypertensive patients had higher RDW and hs-CRP levels (14.5 ± 0.87 vs.12.7 ± 0.66, p<0.001 for RDW; 0.99 ± 0.52 vs.0.63 ± 0.43, p<0.001 for hs-CRP). Besides, the RDW levels were higher in non-dippers (13.0 ± 0.63 vs.12.4 ± 0.55, p<0.001 for NT-ND and NT-D; 14.9 ± 0.78 vs.14.2 ± 0.82, p<0.001 for HT-ND and HT-D) Conclusion RDW is elevated in non-dipping BP both in normotensive and hypertensive subjects, which may be related with increased inflammatory state