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

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

Two cases of extrapulmonary onset granulomatosis with polyangiitis which caused diffuse alveolar haemorrhage

Granulomatosis with polyangiitis (GPA) is a rare form of vasculitis. Multidisciplinary therapeutic approach and early diagnosis assume vital importance in management of patients with diffuse alveolar haemorrhage caused by GPA, which is a rare complication. The purpose of this study was to present the diagnostic and therapeutic challenges experienced by clinicians in management of two severe cases of GPA with insidious extrapulmonary manifestations which rapidly progressed into acute kidney injury, alveolar haemorrhage and acute respiratory failure

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

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

RESEARCH BURDEN OF INTERSTITIAL LUNG DISEASES IN TURKEY - RBILD

Introduction: The aim of our study is to investigate the etiological distribution of ILD in Turkey by stratifying the epidemiological characteristics of ILD cases, and the direct cost of initial diagnosis of the diag-nosed patients. Material-Method: The study was conducted as a multicenter, prospective, cross-sectional, clinical observation study. Patients over the age of 18 and who accepted to participate to the study were included and evaluated as considered to be ILD. The findings of diagnosis, examination and treatment carried out by the cent-ers in accordance with routine diagnostic procedures were recorded observationally. Results: In total,1070 patients were included in this study. 567 (53%) of the patients were male and 503 (47%) were female. The most frequently diagnosed disease was IPF (30.5%). Dyspnea (75.9%) was the highest incidence among the presenting symptoms. Physical examination found bibasilar inspiratory crackles in 56.2 % and radiological findings included reticular opacities and interlobular septal thickenings in 55.9 % of the cases. It was observed that clinical and radiological findings were used most frequently (74.9%) as a diagnostic tool. While the most common treatment approaches were the use of systemic steroids and antifibrotic drugs with a rate of 30.7% and 85.6%, respectively. The total median cost from the patient's admission to diagnosis was 540 Turkish Lira. Conclusion: We believe that our findings compared with data from other countries will be useful in showing the current situation of ILD in our country to discuss this problem and making plans for a solution