The Association between Plasma D-dimer Levels and Community-Acquired Pneumonia

BACKGROUND: Plasma D-dimer levels are directly related to the intra- and extra-vascular coagulation that occurs in acute and chronic lung damage in patients with community-acquired pneumonia (CAP). OBJECTIVES: This study examines the relationship between the severity of community-acquired pneumonia and D-dimer levels. In addition, the study examines the correlations among community-acquired pneumonia, the radiological extent of the disease and mortality. METHODS: The Pneumonia Severity Index was used to classify patients into five groups. Patients were treated at home or in the hospital according to the guidelines for community-acquired pneumonia. Blood samples were taken from the antecubital vein with an injector and placed into citrated tubes. After they were centrifuged, the samples were evaluated with the quantitative latex method. RESULTS: The study included 60 patients who had been diagnosed with community-acquired pneumonia (mean age 62.5 ± 11.7) and 24 healthy controls (mean age 59.63 ± 6.63). The average plasma D-dimer levels were 337.3 ± 195.1ng/mL in the outpatient treatment group, 691.0 ± 180.5 in the inpatient treatment group, 1363.2 ± 331.5 ng/mLin the intensive care treatment group and 161.3 ± 38.1ng/mL in the control group (p<0.001). The mean D-dimer plasma level was 776.1 ± 473.5ng/mL in patients with an accompanying disease and 494.2 ± 280.1 ng/mL in patients without an accompanying disease (p<0.05). CONCLUSIONS: Plasma D-dimer levels were increased even in community-acquired pneumonia patients who did not have an accompanying disease that would normally cause such an increase

An analysis of 214 cases of rib fractures

INTRODUCTION: Rib fractures are the most common type of injury associated with trauma to the thorax. In this study, we investigated whether morbidity and mortality rates increased in correlation with the number of fractured ribs. MATERIALS AND METHODS: Data from 214 patients with rib fractures who applied or were referred to our clinic between January 2007 and December 2008 were retrospectively evaluated. The patients were allocated into three groups according to the number of fractures: 1) patients with an isolated rib fracture (RF1) (n = 50, 23.4%), 2) patients with two rib fractures (RF2) (n = 53, 24.8%), and 3) patients with more than two rib fractures (RF3) (n = 111, 51.9%). The patients were evaluated and compared according to the number of rib fractures, mean age, associated chest injuries (hemothorax, pneumothorax, and/or pulmonary contusion), and co-existing injuries to other systems. FINDINGS: The mean age of the patients was 51.5 years. The distribution of associated chest injuries was 30% in group RF1, 24.6% in group RF2, and 75.6% in group RF3 (

An analysis of 214 cases of rib fractures

INTRODUCTION: Rib fractures are the most common type of injury associated with trauma to the thorax. In this study, we investigated whether morbidity and mortality rates increased in correlation with the number of fractured ribs. MATERIALS AND METHODS: Data from 214 patients with rib fractures who applied or were referred to our clinic between January 2007 and December 2008 were retrospectively evaluated. The patients were allocated into three groups according to the number of fractures: 1) patients with an isolated rib fracture (RF1) (n = 50, 23.4%), 2) patients with two rib fractures (RF2) (n = 53, 24.8%), and 3) patients with more than two rib fractures (RF3) (n = 111, 51.9%). The patients were evaluated and compared according to the number of rib fractures, mean age, associated chest injuries (hemothorax, pneumothorax, and/or pulmonary contusion), and co-existing injuries to other systems. FINDINGS: The mean age of the patients was 51.5 years. The distribution of associated chest injuries was 30% in group RF1, 24.6% in group RF2, and 75.6% in group RF3 (p<0.05). Co-existing injuries to other systems were 24% in group RF1, 23.2% in group RF2, and 52.6% in group RF3 (p<0.05). Two patients (4%) in group RF1, 2 patients (3.8%) in group RF2, and 5 patients (4.5%) in group RF3 (total n = 9; 4.2%) died. CONCLUSION: Patients with any number of rib fractures should be carefully screened for co-existing injuries in other body systems and hospitalized to receive proper treatment

Factors Related to Microalbuminuria in Patients with Chronic Obstructive Pulmonary Disease

WOS: 000346149200011PubMed: 25491689Background. Chronic obstructive pulmonary disease (COPD) is characterized by inhaled particles and gases inducing chronic inflammation of the airways accompanied by a not fully reversible airflow limitation. Systemic inflammation has an important role in the pathogenesis of COPD. In parallel, several comorbidites can be observed. Microalbuminuria is related to endothelial dysfunction. Microalbuminuria was increased in exacerbation periods of COPD. Objectives. The aim of the study was evaluate to the presence of microalbuminuria (MA) in patients with chronic obstructive pulmonary disease (COPD) and its relationship to inflammation, arterial blood gas parameters and 24-hour ambulatory blood pressure alterations. Material and Methods. Seventy COPD patients and 40 healthy volunteers were enrolled in the study. 24-h ambulatory blood pressure monitoring (ABPM) results, including pressure and pulse rates of the subjects were recorded and the cases were classified as "dipper" if a normal fall of more than 10% in blood pressure was observed at night and "non-dipper" if not. Routine renal function tests were performed, C-reactive protein (CRP) values were examined and urine samples were obtained to scrutinize the presence of MA. Patients were allocated into two groups, those with and without MA. The spirometry and arterial blood gas results of the patients were recorded. Results. The urinary albumin creatinin ratio (64.8 +/- 91.8), CRP (21 +/- 14.8), nocturnal systolic and diastolic blood pressure (118 +/- 14 and 72 +/- 10), nocturnal and diurnal pulse (87 +/- 17 and 90 +/- 14), nocturnal pulse pressure (49 +/- 11), mean pulse (89 +/- 15), mean pulse pressure (48 +/- 10) and the number of non-dipper subjects (65) were found significantly higher in the COPD group than in the control group (10.6 +/- 6, 5.4 +/- 2.4, 105 +/- 6 and 68 +/- 7, 70 +/- 10 and 78 +/- 11, 42 +/- 1, 75 +/- 11, 42 +/- 7 and 5, respectively); (p < 0.001, < 0.001, < 0.001 and 0.041, < 0.001 and < 0.001, < 0.001, < 0.001, < 0.001 and < 0.001, respectively). Nocturnal pulse (89 +/- 17) and CRP (23.5 +/- 14.8) were found to be significantly higher in COPD patients with MA than in COPD patients without MA (78 +/- 8 and 8.8 +/- 6.3, respectively); (p = 0.021 and < 0.001, respectively). Conclusions. The facts that CRP, a systemic inflammation marker, and mean nocturnal pulse pressure values were significantly higher in the group with MA among COPD patients, and that ambulatory blood pressure values did not differ between COPD patients with and without MA, suggest both a possible role of inflammation in MA development in COPD patients and a relationship between MA and increased heart rate

PREVALANCE OF ASTHMA AND ALLERGIC DISEASES IN MID-ANATOLIA

Objective: Allergic diseases are commonly seen in childhood. In this study the prevalences of asthma and other allergic diseases were investigated among the school children in Sivas in the year 2008

Determination of probiotic properties of lactic acid bacteria and yeasts isolated from three lacto-fermented cereals mixed with whey, citrus, and tomato pomace

WOS:000864190700001This study tested the probiotic activities of bacteria and yeast isolates from three lacto-fermented cereal (LFC) products which were earlier shown high probiotic efficacy in farm animals. LFC products were freshly produced by solid-state fermentation using fresh whey without a starter culture. LFCa is a mixture of barley, whey, citrus pomace, LFCb of rye, whey, citrus pomace, and tomato pomace and LFCc of LFCb with an addition of ground thyme leaves at the end of fermentation. Six bacteria and two yeast species were isolated from LFC products and tested for probiotic activities. Candida spp and Saccharomyces spp exhibited low probiotic activities. However, lactic acid bacteria (LAB) isolates, namely, Lactobacillus plantarum O33, Pediococcus pentosaceus 10, Lactobacillus paracasei spp. paracasei O54, Enterococcus spp., Lactococcus lactis spp. lactis O3, and Lactobacillus curvatus O32 had overall high survival rates of 76% at pH 4.0, 95% at pH 5.0, 70% at 0.30% of bile salt, high exopolysaccharide production of 85 to 150 mg/L, acceptable aggregation rates of 19% of 4 h co-aggregation with E. coli and 25% auto-aggregation, high inhibition zones of 11 to 20 mm in diameter of pathogens and resistance to three antibiotics. Multivariate tests showed that Enterococcus spp. was the one with the highest probiotic efficacy. In conclusion, these LFC products can be used as probiotic supplements. Novelty impact statement: This study determined the probiotic activity of bacteria and yeasts isolated from lacto-fermented cereals, previously shown to have high efficacy in animal studies. Yeast isolates exhibited low probiotic abilities, while six lactic acid bacteria isolated exhibited strong probiotic properties. Enterococcus spp. was found with the highest probiotic activities. The results showed that the products or isolated bacteria strains can safely be used in food and feed applications for health benefits

Radiografia torácica e bacteriologia na fase inicial de tratamento de 800 pacientes masculinos com tuberculose pulmonar

OBJETIVO: Avaliar radiografias de tórax de pacientes com tuberculose pulmonar e determinar se a extensão das lesões radiográficas correlaciona-se com os parâmetros bacteriológicos. MÉTODOS: Neste estudo descritivo e retrospectivo; foram avaliadas radiografias de tórax, baciloscopias para BAAR e culturas de escarro para Mycobacterium tuberculosis no momento basal e durante os dois primeiros meses de tratamento. A amostra foi composta por 800 pacientes masculinos internados entre 1995 até o presente em um hospital com 250 leitos no noroeste da Turquia. RESULTADOS: A VHS média inicial foi de 58 ± 37 mm/h. Inicialmente, a baciloscopia e as culturas de escarro tiveram resultado positivo em 83,8% e em 89,5% dos pacientes, respectivamente. Após o primeiro mês do tratamento, a proporção de culturas positivas foi maior nos pacientes com doença cavitária do que naqueles sem doença cavitária (53,7% vs. 37,7%; p < 0,001). Não houve correlação do número de zonas afetadas com idade, duração de sintomas, contato com paciente com tuberculose ativa, diabetes concomitante (p &gt; 0.05 para todos), mas houve correlação positiva com VHS (r = 0,23, p < 0,001). Durante o primeiro e o segundo mês de tratamento, a negativação da baciloscopia foi menos frequente nos pacientes com comprometimento bilateral do que naqueles com comprometimento unilateral (p < 0,001 e p = 0,002 para os meses 1 e 2, respectivamente). A extensão da doença não se correlacionou com idade, duração dos sintomas, contato com paciente com tuberculose ativa e diabetes concomitante, mas sim com a recuperação bacteriológica atrasada. CONCLUSÕES: Radiografias de tórax e bacteriologia são ferramentas valiosas na avaliação de tuberculose pulmona

Akciğerde Yağ Embolisine Bağlı Ölüm Olgu Sunumu

Yağ embolisi, genellikle ciddi travma veya cerrahi girişim sonrası kemik iliğinden ya da yumuşak dokulardan yağ damlacıklarının serbestleşip sistemik dolaşıma geçmesidir. Gençlerde daha çok uzun kemik kırıklarından sonra, yaşlılarda ise kalça kırığı sonrası gelişmektedir. Genellikle travmadan 24-48 saat sonra ortaya çıkan klinik tablo, hafif olabileceği gibi solunum yetmezliği ve ölüme kadar ilerleyebilir. Sunulan olgu; 84 yaşında kadın olup, araç dışı trafik kazası nedeni ile sol kolda ve sol pelvik bölgede ağrı yakınmalarıyla hastaneye başvurmuştur. Ortopedi konsültasyonunda; sol omuz çıkığı, sol humerus suprakondiler kırığı ve sol ramus pubis kırığı nedeniyle kapalı redüksiyon uygulanarak taburcu edilmiş ve kazadan yaklaşık  üç saat sonra evinde öldüğü bildirilmiştir. Şüpheli ölüm olarak değerlendirilen adli olguya yapılan otopside; akciğer kesitlerinde yer yer köpüklü hemorajik özellikli sıvı çıkışı, sol omuz çıkığı, sol humerus suprakondiler kırığı ve sol ramus pubiste deplase kırık hattı görüldü. Postmortem histopatolojik incelemede; akciğerlerde interstisiyel kapiller lümenlerde evre IV yağ embolisi ve orta çaplı pulmoner damarlarda yaygın kemik iliği embolizasyonu tespit edildi. Olayın öyküsü, tıbbi belgelerin içeriği, otopsideki makroskopik ve histopatolojik inceleme verilerine göre, kişinin ölümünün araç dışı trafik kazası sonrası genel beden travmasına bağlı ekstremite kırıklarıyla birlikte akciğerde yağ embolisi sonucunda geliştiği belirlendi. Travma ile oluşan kemik kırıkları sonrası yağ embolisi oluşumunu önlemek için, kırıkların erken fiksasyonu ve immobilizasyonu önemlidir. Bu olgularının takip ve tedavisinde dikkatli olunması, tıbbi uygulama hatalarının önlenmesi yönünden de önem taşımaktadır. Ayrıca trafik kazası ile kemik kırıkları tespit edilen ve şüpheli ölüm olarak değerlendirilen olgularda otopsi ve postmortem histopatolojik incelemenin tanıyı belirlemede katkısı olduğu açıktır. Anahtar Kelimeler: Yağ embolisi, travma, adli tıp, otopsi, şüpheli ölüm