Monocyte/HDL ratio in sarcoidosis patients without treatment

Aim: This study examined the effects of monocyte/high-density lipoprotein cholesterol (HDL-C) ratio (MHR) and other inflammatorymarkers in patients with sarcoidosis not receiving treatment. To our knowledge, this is the first study on the relationship betweensarcoidosis and MHR.Material and Methods: This study included 53 patients with sarcoidosis who were followed at a single, outpatient tertiary-carecentre. Data on patient demographics (age and gender), disease characteristics (duration of disease, radiographic stage, treatments);pulmonary function tests (% predicted values for forced vital capacity [FVC], forced expiratory volume at 1 second [FEV1], diffusingcapacity of the lungs for carbon monoxide [DLCO], alveolar volume [VA], forced expiratory flow [25–75% and at 50%; FEF] [FEF25-75]),blood biochemistry and hemogram findings were retrieved from hospital records.Results: Mean ± SD patient age was 51.13 ±1 1.94 years. Of the 53 patients, 42 were female and 11 were male. When compared withMHR ratio and pulmonary function test parameters, there was a negative correlation with FEV1% (P = 0.043, r = ?0.279) and DLCO% (P= 0.009, r = –0.360). There was no significant correlation between FVC, FEV25-75 or VA. No significant correlation was found betweenblood calcium, urinary calcium, SACE (serum angiotensin converting enzyme) values and MHO ratio.Conclusions: Large-scale prospective studies are needed to determine if the use of MHR as an indicator of inflammation andactivation would be helpful in the diagnosis and monitoring of patients with sarcoidosis

A rare case of kartagener’s syndrome [Nadir görülen kartagener sendromlu bir olgu]

Kartagener syndrome is a rare autosomal recessive disorder seen about in one per 30000 live births and characterized by bronchiectasis, chronic sinusitis and situs inversus triad. Absence of dynein arms in epithelial cilia is the most common defect in electron microscopic examination. Extreme sputum retention is seen due to cilial disfunction in this disease. Treatment of the disease is directed to symptoms. Infertility and deafness can be seen. It has been also observed that Kartagener syndrome decreases sleep quality. In order to protect the patients from infections, chest physiotherapy, influenza and pneumococcal vaccines are recommended. These patients should stay away from particulate included gases such as dust and smoke. In this study, a 33 year old male patient diagnosed late despite frequent hospital admissions, coexistence with obstructive sleep apnea syndrome was presented with clinical and radiological findings. © 2019, Duzce University Medical School. All rights reserved

The eating attitudes in patients with obstructive sleep apnea syndrome

WOS: 000513593400001PubMed: 32048528Aim: Obstructive sleep apnea syndrome (OSAS) patients show multiple physiological deficits and several neuropsychological comorbidities. The aim of this study was to investigate the eating attitudes in OSAS patients. Material and methods: Polysomnography records of 157 were performed. Eating Attitudes Test (EAT), Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI) were applied to all participants. Results: The mean age of the 157 individuals included in the study was 47.2 +/- 11.4 (18-76) years and 36% (n = 56) of the individuals were female and 64% (n = 101) were male. When the patients were ranked according to the severity of OSAS, 38.2% (n = 60) were severe, 20.4% (n = 32) were moderate, 24.2% (n = 38) were mild, and 17.2% (n = 27) were OSAS negative. There was a significant difference in terms of the age-and-BMI-adjusted EAT score according to OSAS severity (p = .042). There was a significant difference in the age-and-BMI-adjusted value of the EAT according to the presence of OSAS (p = .011). After controlling age and BMI, no significant correlation was found between the EAT and the BDI (r = 0.012, p = .890) in patients with OSAS while there was a significant positive correlation EAT and the BAI (r = 0.177, p = .046). Conclusions: Considering the association of OSAS with psychiatric disorders, the presence of eating disorders (EDs) becomes an important and special topic. Treatment of patients with OSAS should not only aim to improve the patient's sleep apnea, but also to improve the patient's quality of life by evaluating the patient's psychological and physical functions

A Case of Nephrotic Syndrome With Pneumocystis Jirovecii Infection

WOS: 000487340900025Pneumocystis jirovecii pneumonia (commonly called Pneumocystis pneumonia or PCP) is an opportunistic infection that occurs in immunocompromised individuals. 26 year-old male patient admitted to nephrology department for hypervolemic hyponatremia and consulted to our clinic due to the desaturation. He has been diagnosed with collapsing glomerulonephritis and he was using cyclosporine and prednisolone. Postero-anterior chest X-ray showed a blunt left cardiodiaphragmatic sinus. After ten days the patient's hypoxia deepened. Repeated chest X-ray showed bilateral perihilar heterogeneous opacity. Pneumocystis jirovecii was detected in lavage culture. We presented a case of Pneumocystis Jirovecii pneumonia secondary to cyclosporin toxicity because of a rare case

The Effect of Obstructive Sleep Apnea on Violent and Non-violent Behavior

Aim: Obstructive sleep apnea (OSA) characterized by repetitive collapse of the upper airway during sleep and thiscondition leading to oxygen desaturation, sympathetic activation, and recurrent arousals. Patients who experience sleepproblems consider themselves, less able to control impulsive, aggressive tendencies. The aim of this study was toinvestigate the effect of OSA and daytime sleepiness on violent and non-violent behaviors.Material and Methods: Hundred fifty individuals who were admitted to the Chest Disease Polyclinic for SleepDisorders of Duzce University, School of Medicine Hospital were included in the study. All patients underwentpolysomnography (PSG). All tests [Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), EpworthSleepiness Scale (ESS) and Nonviolent and Violent Offending Behavior Scale (NVOBS)] were applied to allparticipants by face to face interview.Results: In this study, no significant relationship was found between NVOBS and AHI in OSA patients. Patients withOSA; There was a significant relationship between total score of NVOBS and ESS (r=0.267 p=0.003). There was asignificant relationship between the ESS score and the BDI score (r=0.314 p <0.001) and BDI scale (r=0.319 p <0.001)scores.Conclusions: There was no significant relationship between violent and non-violent behaviors and AHI. However,there was a significant relationship between ESS and BDI, BAI and NVOBS. There may be commonneurophysiological activation mechanisms of sleep and violence action. Today, violent behavior and sleep problemsincrease and further research is needed to investigate the relationship between sleep problems and violent behavior.Amaç: Obstrüktif uyku apne (OUA) üst hava yollarının uyku sırasında daralması ile karakterizedir ve bu durum oksijen desaturasyonu, sempatik aktivasyon, tekrarlayan arousallara neden olur. Uyku problemi yaşayan insanlar kendilerini agresif eğilimleri olan ve dürtüselliklerini daha az kontrol edebilen kişiler olarak düşünürler. Bu çalışmanın amacı OUA ve gündüz uykululuk halinin, şiddet içeren ya da içermeyen davranışlar üzerine etkilerini araştırmaktır. Gereç ve Yöntemler: Düzce Üniversitesi Tıp Fakültesi Hastanesi Göğüs Hastalıkları Polikliniğine uyku bozuklukları nedeniyle başvuran 150 kişi çalışmaya dâhil edildi. Tüm hastalara polisomnografi (PSG) yapıldı. Tüm diğer testler [Beck depresyon ölçeği (BDÖ), Beck anksiyete ölçeği (BAÖ), Epworth uykululuk skalası (EUS) ve Şiddet içeren ve içermeyen suç davranışları ölçeği (ŞİSDÖ)] katılımcılarla yüz yüze görüşme ile yapıldı. Bulgular: Bu çalışmada OUA hastalarında ŞİSDÖ ile apne-hipopne indeksi (AHI) arasında anlamlı bir ilişki saptanmadı. OUA’li hastalarda toplam ŞİSDÖ skoru ile EUS arasında anlamlı bir ilişki bulundu (r=0,267 p=0,003). EUS ile BDÖ skoru (r=0,314 p <0,001) ve BAÖ skalası skoru (r=0,319 p <0,001) arasında anlamlı bir ilişki vardı. Sonuç: AHI ile şiddet içeren ve şiddet içermeyen davranışlar arasında bir ilişki yoktu. Bununla birlikte ESS ile BDÖ, BAÖ, ŞİSDÖ arasında anlamlı bir ilişki vardı. Uyku ve şiddet davranışlarının ortak nörofizyolojik bir mekanizması olabilir. Çalışmamız gündüz uykululuk halinin artmasıyla şiddet eğiliminin arttığını göstermiştir. Uyku problemleri ile şiddet davranışlarının arasındaki ilişkiyi araştırmak için ileri çalışmalara ihtiyaç vardı

Do the levels of particulate matters less than 10 mu m and seasons affect sleep?

WOS: 000483191800001PubMed: 31441672Background: There are few studies showing that the increase in particulate matters less than 10 mu m (PM10) values increases the apnea-hypopnea index (AHI). We aimed to investigate relationship between air quality parameters and the seasons with the AHI. Methods: This was a retrospective study that included 500 adults. Polysomnography (PSG) was performed on all patients. Oxygen saturation, air temperature, relative humidity, and PM10 values were recorded in Duzce for every year. The parameters of the national air quality network and sleep parameters of 500 individuals hospitalized between 2015 and 2017 were checked. Results: A total of 500 patients were included in the study, of whom 316 (63.2%) were male and 184 (36.8%) were female. While the AHI value of patients who presented during 2016 was 27.5, it had significantly declined to 20.2 in 2017 (p = .024). A significant decline was observed in AHI values of OSA patients from 2016 to 2017 (p = .043). A significant positive correlation was observed between REM-related AHI and relative humidity (r = 0.183, p = .002). Conclusions: This study showed a clear relationship between AHI and PM10 during winter when air pollution parameters are high in the region. PM10 emerged as a parameter that substantially increases the relative risk for OSA

Relationship between Diagnosis Period and Internal and External Air Quality in Patients with Tuberculosis

WOS: 000518179400017PubMed: 32158320Objective: The aim of this study was to investigate the relationship between bacteriological case definitions and indoor and outdoor air quality parameters in tuberculosis (TB). Materials and Methods: A total of 200 patients with TB diagnosed and treated in our hospital during 2012-2018 were included to this study. The air monitoring measurement parameters of the National Air Quality Network [particulate matter 10 (PM10), sulfur dioxide (SO2), air temperature, air pressure, and relative humidity] for the same time period were obtained from the web page http://laboratory.cevre.gov.tr/Default. ltr.aspx. Results: Of the 200 patients, 62.5% (125) were males and 37.5% (75) were females. The rate of diagnosis based on culture and smear positivity was 48.4% (31), which was significantly higher than that in the clinic [10.9% (7)] among patients who used stove for warming. The rate of diagnosis based on culture and smear positivity [52.1% (25)] was significantly higher than that in the clinic [8.3% (4)] among patients who were exposed to biomass. The univariate analysis revealed no significant independent effect of warming and biomass use on case definition. According to the case definitions, the mean values of PM10, SO2, and temperature in the diagnosed month showed no statistically significant difference. The humidity level in the month was significantly higher, during which cases diagnosed using smear and culture positivity were compared with cases diagnosed using only culture positivity (p=0.023). Conclusion: This study indicates that biomass used as a cooking fuel is a risk factor for pulmonary TB, implying that TB occurrence can be reduced significantly by lowering or preventing the exposure to cooking smoke emitted from biomass fuel

Relationship between Diagnosis Period and Internal and External Air Quality in Patients with Tuberculosis

WOS: 000518179400017PubMed: 32158320Objective: The aim of this study was to investigate the relationship between bacteriological case definitions and indoor and outdoor air quality parameters in tuberculosis (TB). Materials and Methods: A total of 200 patients with TB diagnosed and treated in our hospital during 2012-2018 were included to this study. The air monitoring measurement parameters of the National Air Quality Network [particulate matter 10 (PM10), sulfur dioxide (SO2), air temperature, air pressure, and relative humidity] for the same time period were obtained from the web page http://laboratory.cevre.gov.tr/Default. ltr.aspx. Results: Of the 200 patients, 62.5% (125) were males and 37.5% (75) were females. The rate of diagnosis based on culture and smear positivity was 48.4% (31), which was significantly higher than that in the clinic [10.9% (7)] among patients who used stove for warming. The rate of diagnosis based on culture and smear positivity [52.1% (25)] was significantly higher than that in the clinic [8.3% (4)] among patients who were exposed to biomass. The univariate analysis revealed no significant independent effect of warming and biomass use on case definition. According to the case definitions, the mean values of PM10, SO2, and temperature in the diagnosed month showed no statistically significant difference. The humidity level in the month was significantly higher, during which cases diagnosed using smear and culture positivity were compared with cases diagnosed using only culture positivity (p=0.023). Conclusion: This study indicates that biomass used as a cooking fuel is a risk factor for pulmonary TB, implying that TB occurrence can be reduced significantly by lowering or preventing the exposure to cooking smoke emitted from biomass fuel

Unclear Issues Regarding COVID-19

Scientists from all over the world have been intensively working to discover different aspects of Coronavirus disease 2019 (COVID-19) since the first cluster of cases was reported in China. Herein, we aimed to investigate unclear issues related to transmission and pathogenesis of disease as well as accuracy of diagnostic tests and treatment modalities. A literature search on PubMed, Ovid, and EMBASE databases was conducted, and articles pertinent to identified search terms were extracted. A snow-ball search strategy was followed in order to retrieve additional relevant articles. It was reported that viral spread may occur during the asymptomatic phase of infection, and viral load was suggested to be a useful marker to assess disease severity. In contrast to immune response against viral infections, cytotoxic T lymphocytes decline in SARS-CoV-2 infection, which can be partially explained by direct invasion of T lymphocytes or apoptosis activated by SARS-CoV-2. Dysregulation of the urokinase pathway, cleavage of the SARS-CoV-2 Spike protein by FXa and FIIa, and consumption coagulopathy were the proposed mechanisms of the coagulation dysfunction in COVID-19. False-negative rates of reverse transcriptase polymerase chain reaction varied between 3% and 41% across studies. The probability of the positive test was proposed to decrease with the number of days past from symptom onset. Safety issues related to infection spread limit the use of high flow nasal oxygen (HFNO) and continuous positive airway pressure (CPAP) in hypoxic patients. Further studies are required to elucidate the challenging issues, thus enhancing the management of COVID-19 patients