PET-CT findings of progressive massive fibrosis in retired coal miners

WOS: 00020937040059

Diagnostic Value of Adenosine Deaminase Level for the Differential Diagnosis of Tuberculosis and Malignancy in Exudative Lymphocytic Pleurisy

WOS: 000382877000004Objective: To evaluate the diagnostic performance of adenosine deaminase (ADA) levels in patients with exudative lymphocytic pleurisy for the differential diagnosis of tuberculous pleurisy (TBP) and malignant pleural effusion (MPE). Methods: Data on patients with exudative lymphocytic pleurisy were retrospectively analyzed. The study population comprised 54 patients. Thirty-seven were diagnosed with TBP and 17 were diagnosed with MPE. Results: Significant differences were determined in terms of age and ADA, total protein, albumin, and LDH levels between the TBP and MPE groups. The optimal cut-off value of ADA levels was 35.1 U/L for diagnosing TBP. Sensitivity and specificity were 92% and 100%, respectively. Logistic regression analysis was performed to assess independent variables associated with TBP. Independent predictive factors in the model were ADA (OR: 1.21, 95% CI: 1.06-1.39, p=0.006)], and (OR: 0.92, 95% CI: 0.84-1.00, p=0.052)]. The AUC value by the regression equation was 0.979 (p= 50), two different cut-off values (> 13.51 and > 35.1) for each age range were found in all, but one, TBP patients. Conclusion: ADA levels are useful for the diagnosis of TBP in cases where pleural biopsy cannot be performed or that are inconclusive in making a diagnosis of TBP. In this group, reducing the conventional cut-off value and/or performing an age-based approach seems to improve the diagnostic performance of ADA levels

Social media video analysis methodology for sarin exposure

As social media becomes increasingly ubiquitous, many events are recorded and released on social media platforms, including chemical weapon attacks. We develop an objective tool in order to evaluate brief and unstructured social media videos for analysing sarin exposure from a civilian medical pathology perspective. We developed and validated this new questionnaire using a standardized procedure that includes content domain specification, item pool generation, content validity evaluation, a pilot study, and assessment of reliability and validity. In total, 51 sarin attacks and 48 matched videos were analysed. Cronbach's alpha for all 20 items was 0.75, which indicates adequate internal reliability. The test-retest reliability was 0.96, which indicates good internal reliability. The inter-observer intraclass correlation coefficient was 0.97. After verifying sampling adequacy with the Kaiser-Meyer-Olkin measure and the factorability of the items with Barlett's test of sphericity, a factor analysis was performed. According to the principal axis factoring, a six-factor solution explained 51.86% of the total variance. The receiver-operating characteristic curve analysis showed that the Video Score Questionnaire has a sensitivity of 0.817, a specificity of 0.478, and an efficiency of 65.3. Therefore, the Video Score Questionnaire is reliable and valid for evaluating sarin attacks from brief and unstructured social media videos

Serum midkine levels in patients with obstructive sleep apnea

WOS: 00045197940302

Evaluating the Efficiency of Long Term Oxygen Therapy and Mortality in Chronic Obstructive Pulmonary Disease

WOS: 000367540700004It has been shown that Long Term Oxygen Therapy (LTOT) improves polycythemia secondary to hypoxemia and right heart failure, decreases pulmonary hypertension, improves quality of life and increases life expectancy in COPD patients. In our study we aimed to evaluate clinical data, mortality, patient's adherence and efficiency of the therapy in COPD patients receiving LTOT. Mean age was 70.5%+/- 9.7 and 57% of the participiants were male. It was shown that one year hospital admission count after LTOT (0.56 +/- 0.79) was decreased according to one year hospital admission count before LTOT (1.14 +/- 1.64). When arterial blood gas values after LTOT compared to the values at the time prescription PaO2 was increased (47.9 +/- 4, 53.4 +/- 9) and PaCO2 was decreased (56.1 +/- 11, 50.5 +/- 11). Although there was no significant difference in pulmonary artery pressure after LTOT, a significant increase was determined in hematocrit (38.37 +/- 6, 40.14 +/- 6). 41.1% of the patients had at least once device maintanence, and after LTOT only 38.4% had a clinical control due to COPD. The most common reason for irregular use was lack of necessity. Mean daily oxygen usage was 13.88 +/- 4.35 hours/day and 68.8% of the patients were using 15 hours or more. Mean follow-up of the patients were 17.85 +/- 14.53 (1-55) months and mortality rate in this period was 67%. Mortality was higher in LTOT with 15hours/day or more compared to less than 15 hours (respectively 54.6%, 12.5%). In conclusion, all patients with an indication for LTOT should be followed by national registry system and monitored in terms of technical services. Patients adherence and routine controls should be provided

Platelet Indices in Patients with Coal Workers' Pneumoconiosis

WOS: 000380278500024PubMed: 27107875Coal workers' pneumoconiosis (CWP) is caused by an accumulation of coal particles in the lung parenchyma. Reactive oxygen species (ROS) play an important role in the pathogenesis of CWP. It is well documented that ROS stimulate platelet activation, adhesion, and aggregation. The aim of the present study was to investigate the relationship between platelet indices and CWP. The demographic features, occupational and medical history, exposure time, and complete blood count of retired coal miners were retrospectively analysed. The control group comprised healthy subjects who had not worked underground. Chest radiographs were evaluated according to the CWP classification of the International Labour Office. The study population was divided into following groups: 50 controls, 97 without CWP, 142 simple pneumoconiosis (SP), 157 progressive massive fibrosis (PMF). The platelet count, mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) were significantly higher in patients with CWP compared to those in patients without CWP and controls. The platelet count, MPV, and PCT were higher in patients with PMF compared to those in the SP group (p < 0.05). The results of multiple logistic regression analyses indicated that the platelet count, MPV, and PCT were independently associated with the development of CWP. Platelet indices may be considered as disease markers for pneumoconiosis in coal miners and as a useful indicator of the progression of pneumoconiosis

Comparison of diagnostic values of procalcitonin, C-reactive protein and blood neutrophil/lymphocyte ratio levels in predicting bacterial infection in hospitalized patients with acute exacerbations of COPD

WOS: 000362900000002PubMed: 25586444Viral or bacterial upper respiratory infections are the most common cause of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Based on available data, no reliable parameter has been presented to distinguish between bacterial and nonbacterial exacerbations. Therefore, we compared the diagnostic value of procalcitonin (PCT) level, which is a newer marker for predicting bacterial infections in patients with AECOPD, to routine parameters such as C-reactive protein (CRP) levels and the neutrophil/lymphocyte (N/L) ratio. This study included all consecutive patients who were admitted for a diagnosis of AECOPD between January 1 and March 31, 2014. PCT, CRP, and the N/L ratio were assessed in addition to cultures from tracheal aspirates or sputum on the first day of admission. Patients with a pneumonic infiltration on chest radiographs, or an extrapulmonary infection focus, or whose blood samples were not obtained for PCT and/or CRP at the same time as sputum culture were excluded from the study. A total of 77 patients were included with a mean age of 71.7 +/- A 9.5 years. Bacteria were isolated in 37.4 % of the patients. Mean PCT levels were significantly higher in patients with positive sputum cultures than in patients with negative sputum cultures. The cut-off values for PCT, CRP, and the N/L ratio for predicting a bacterial infection were 0.40 ng/mL, 91.50 mg/L, and 11.5, respectively; sensitivity was 61, 54, and 61 % respectively; specificity was 67, 52, and 58 %, respectively; and the area under the curve (AUC) values were 0.64, 0.52, and 0.58, respectively. The AUC value of PCT was significantly better for predicting bacterial infection compared with the CRP level or the N/L ratio (p = 0.042). PCT was better than CRP and the N/L ratio for predicting a bacterial infection in hospitalized patients with AECOPD. However, we find PCT not so reliable in predicting bacterial infection in AECOPD due to sensitivity and specificity of less than 80 % and a low AUC value

The Impact of Obstructive Sleep Apnoea and Nasal Continuous Positive Airway Pressure on Circulating Ischaemia-Modified Albumin Concentrations

The aim of the present study was to evaluate the impact of obstructive sleep apnoea syndrome (OSAS) and the effects of nasal continuous positive airway pressure (CPAP) on circulating ischaemia-modified albumin (IMA) concentrations. The study included 97 newly diagnosed OSAS patients and 30 nonapnoeic controls. Blood samples were obtained in the morning after polysomnography. After 3 months of CPAP treatment, 31 patients with moderate-severe OSAS were reassessed for serum IMA concentrations. Significantly higher serum IMA concentrations were measured in the OSAS group than in the control group [0.518±0.091 absorbance units (ABSU), 0.415±0.068 ABSU, P<0.001]. Serum IMA concentrations correlated significantly with the apnoea-hypopnoea index, mean SaO2, desaturation index, and C-reactive protein concentrations. Multiple logistic regression analyses showed that OSAS increased the serum IMA concentration independent of age, sex, body mass index, smoking habit, and cardiovascular disease. After 3 months of treatment with CPAP, OSAS patients had significantly lower serum IMA concentrations (0.555±0.062 ABSU to 0.431±0.063 ABSU, P<0.001). The results showed that OSAS is associated with elevated concentrations of IMA, which can be reversed by effective CPAP treatment

Disseminated hydatid disease treated with albendazole: 15-year experience

Medical therapy is recommended in various situations such as multiple cysts, high risk surgery , presence of small cyst and perioperative phase in the treatment of hydatid cyst. Present study was designed to determine the features of disseminated hydatid cyst cases, outcome of albendazole treatment , diagnosis and management of complications and patients outcome. Methods: 21 patients who had the diagnosis of hydatid cyst based on clinical, radiological, and pathological findings with multiple hydatid cyst in a single organ and/or more than one organ were retrospectively analyzed. The mean age was 34±17.9 (range, 7-71) and F/M was 17/4. Hydatid disease was detected as multiple cysts in the lung in four patients, as multiple cysts in the lung and pleura in one case, and as multiple organ involvement in 16 cases. The most common presentation was the involvement of both lung and liver. The most common symptom was cough. Four asymptomatic patients were detected during family screening. In six patients, Albendazole was started before the operation and the remainders were started after the operation. Cure was achieved in eight patients at the end of medical and/or surgical treatment. Convenient medical treatment with albendazole treatment in appropriately selected patients is an effective treatment option with minimal side effects in hydatid cyst disease. [Med-Science 2018; 7(4.000): 935-9

Combination and comparison of two models in prognosis of pulmonary embolism: Results from TUrkey Pulmonary Embolism Group (TUPEG) study

WOS: 000335910900010PubMed ID: 24690480Background: Clinical parameters, biomarkers and imaging-based risk stratification are widely accepted in pulmonary embolism(PE). The present study has investigated the prognostic role of simplified Pulmonary Embolism Severity Index (sPESI) score and the European Society of Cardiology (ESC) model. Methods: This prospective cohort study included a total of 1078 patients from a multi-center registry, with objectively confirmed acute symptomatic PE. The primary endpoint was all-cause mortality during the first 30 days, and the secondary endpoint included all-cause mortality, nonfatal symptomatic recurrent PE, or nonfatal major bleeding. Results: Of the 1078 study patients, 95 (8.8%) diedwithin 30 days of diagnosis. There was no significant difference between non-low-risk patients ESC [12.2% (103 of 754;)] and high-risk patients as per the sPESI [11.6% (103 of 796)] for 30-day mortality. The nonfatal secondary endpoint occurred in 2.8% of patients in the the sPESI low-risk and 1.9% in the ESC low-risk group. Thirty-day mortality occurred in 2.2% of patients the sPESI low-risk and in 2.2% the ESC low-risk group (P = NS). In the present study, in the combination of the sPESI low-risk and ESC model low-risk mortality rate was 0%. Conclusions: The sPESI andthe ESCmodel showed a similar performance regarding 30-daymortality and secondary outcomes in the present study. However, the combination of these two models appears to be particularly valuable in PE. (C) 2014 Elsevier Ltd. All rights reserved