Clinical Factors Affecting the Direct Cost of Patients Hospitalized with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Background: Chronic obstructive pulmonary disease (COPD) is a disease of increasing significance in terms of economic and social burden due to its increasing prevalence and high costs. Direct costs of COPD are mostly associated with hospitalization expenditures. In this study, our objective was to investigate the costs of hospitalization and factors affecting these costs in patients hospitalized due to acute exacerbation of COPD (AECOPD)

Microorganisms isolated in COPD patients hospitalised for acute exacerbations and their clinical correlations

[No Abstract Available

Microorganisms isolated in COPD patients hospitalised for acute exacerbations and their clinical correlations

WOS: 00044965090228

Eosinophilic Granulomatosis With Polyangiitis (Churg Strauss Syndrome): Case Report

Polianjitisle birlikte seyreden eozinofilik granülomatozis (Churg Strauss sendromu), nadir, sıklıkla solunum sistemini tutan ve özellikle küçük ve orta çaplı damarları etkileyen, astım ve doku eozinofilisi ile karakterize, sistemik nekrotizan bir vaskülittir. Lökotrien antagonistlerini de içeren pek çok ilacın bu hastalığın gelişiminde rolü olduğundan şüphelenilmektedir. Biz de klinik ve radyolojik bulgularla tanı alan ve lökotrien reseptör antagonistleri ile ilişkili olmadığını düşündüğümüz bir olguyu sunmak istedik.Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic necrotizing vasculitis characterized by tissue and blood eosinophilia. Several drugs including leukotriene receptor antagonists (LTRAs) are suspected to trigger EGPA development. Here, we present a case of EGPA unrelated to LTRAs

Evaluation of Clinical Data and Mortality among COPD Patients Receiving Domiciliary NIMV Therapy

very severe chronic obstructive pulmonary disease (COPD) patients. This study was aimed to investigate the clinical data and mortality among COPD patients receiving domiciliary NIMV treatment.MATerIAL ANd MeTHods: A total of 40 COPD patients who were prescribed domiciliary NIMV at discharge between January 2010 and December 2011 were contacted by phone regarding their current health status, and the electronic patient charts of 34 patients who used NIMV regularly were retrospectively reviewed.resULTs: The mean age of the patients was 67±15 years and 59% of them were females. The mean length of hospital stay was 14.5±6.82 days. Rate of admission to intensive care unit and use of invasive mechanical ventilation was 56% and 27%, respectively. The median follow up duration was 17 months. The 6-months, 1-year, 2-years and overall mortality rates were 24%, 38%, 50% and 56%, respectively. For patients surviving at least one year after domiciliary NIMV initiation (n=21), the mean number of hospitalizations in the year before-and after-NIMV initiation were 1.38±1.28 and 0.57±0.93 (p=0.003), respectively. Mean daily NIMV use was 8.91±4.46 hours. Mean daily NIMV use of the patients with a lifespan 2 years (11.82±4.02 hours/day versus 6.0±2.62 hours/day, respectively) (p2 years (11.82±4.02 hours/day versus 6.0±2.62 hours/day, respectively) (p<0.001). Long term oxygen was prescribed for the first time to 62% of the patients using NIMV.CoNCLUsIoN: Domiciliary NIMV may have numerous beneficial effects such as decreasing hospital admissions for acute COPD exacerbations and related costs. It is very important in the battle against COPD, a disease with significant morbidity, mortality and economic burden

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

Tıp Fakültesi Hastanesinde Çalışan Hemşire ve Araştırma Görevlisi Doktorlarda Horlama ve Obstrüktif Uyku Apne Sendrom Sıklığının Araştırılması

Amaç: Uyku bozuklukları kişinin üretkenliğini ve performansını olumsuz yönde etkileyerek yaşam kalitesinin azalmasına neden olan önemli bir halk sağlığı sorunudur. Uyku düzeninin bozulduğu vardiyalı çalışan kişilerde uyku bozukluklarının görülme sıklığı çok belirgindir. Çoğu vardiyalı çalışan sağlık çalışanlarında obstrüktif uyku apne sendromu (OUAS) ile ilgili yeterli veri yoktur ve bu çalışma sağlık çalışanlarında tüm gece polisomnografi (PSG) testi ile yapılan ülkemizdeki ilk çalış- madır. Çalışmamızda hastanemizde görevli hemşire ve asistan doktorlarda horlama ve OUAS sıklığını araştırmayı amaçladık. Yöntemler: Hastanemizde görevli olan ve çalışmaya katılmayı kabul eden tüm hemşire ve asistan doktorlara yüz yüze görüşme yöntemiyle anket uygulandı. Horlama şikayetine, tanıklı apne ve/veya gündüz aşırı uykululuk hali (GAUH) eşlik eden kişilere tüm gece PSG tetkiki önerildi. Polisomnografi yapılan olgularda OUAS sıklığı ve OUAS saptanan ve saptanmayan olgularda nöbet tutma oranları karşılaştırıldı. Bulgular: Çalışmaya 257 kişi katıldı. Katılımcıların %63'ünü hemşireler, %37'sini ise asistan doktorlar oluşturuyordu. Olguların %34,2'si erkek idi. Olguların yaş ortalaması 28,8±3,7 (19-39 yıl), vücut kitle indeksi ortalaması 24,03±3,85 kg/m2 idi. Çalışmaya katılanlarda aylık tutulan gece nöbet ortalaması 7,6±3,8 gün idi. Olguların %28,8'inde (n=74) horlama, %2,7'sinde (n=7) tanıklı apne, %7,8'inde (n=20) GAUH (Epworth uykululuk skalası >=11) tespit edildi. PSG önerilen 20 kişiden 4'ü (%1.6) PSG çalışmasını reddetti. 16 olguya (%6.2) PSG yapıldı. PSG sonuçlarına göre, OUAS prevalansının sağlık çalışanlarında %4,7, vardiyalı çalışan sağlık personelinde ise %5,1 olduğunu bulduk. OUAS tespit edilenlerin %91,7'si (11/12) nöbet tutmaktayken, OUAS tespit edilmeyenlerin %83,3'ü (204/245) nöbet tutmaktaydı (p=0,697). OUAS saptananların hepsi erkek iken, OUAS saptanmayanların %31'i erkek idi (p=11). Four (1.6%) of the 20 participants who were proposed to undergo PSG refused this examination. Sixteen cases were exposed to PSG (6.2%). According to the PSG results, the prevalence of OSAS was 4.7% among all healthcare providers and 5.1% among the health staff working shifts. Of the cases with OSAS, 91.7% (11/12) were working shifts while 83.3% (204/245) of those without OSAS were working shifts (p=0.697). All of the cases diagnosed with OSAS were male, but 31% of the cases without OSAS were male (p<0.001). Conclusion: For those healthcare providers who are engaged in duties requiring significant amounts of attention and concentration, the symptoms related to sleep disorders should be questioned and diagnostic evaluation and treatment should be performed for suspected case

SOLITARY PULMONARY NODULE DUE TO COMPLICATED COAL WORKER'S PNEUMOCONIOSIS WITHOUT MINOR OPACITY

Komplike kömür işçisi pnömokonyozu (KİP) akciğer dokusunda 1 cm veya daha büyük pnömokonyoza bağlı nodüllerin varlığı olarak tanımlanır ve basit pnömokonyoz zemininde gelişir. Minör opasite olmaksızın komplike KİP ortaya çıkması beklenen bir durum değildir. Biz de minör opasite olmaksızın tek nodülle ortaya çıkan ve nodülün karakteristik özellikleri açısından öncelikle pnömokonyoz dışı nedenlere bağlı pulmoner nodülü akla getiren ilginç bir komplike KİP olgusunu sunmayı amaçladık. Altmış beş yaşında erkek hastanın 25 yıl kömür madeninde çalıştığı ve daha sonra emekli olduğu öğrenildi. Akciğer grafisinde belirgin bir patoloji tespit edilmedi. Hastanın toraks tomografis'nde sol akciğer alt lob laterobazal segmentte 16 mm çaplı subplevral nodül görüldü. Bronkoskopide bronş mukozasında bir kaç adet antrakotik pigmentasyon görüldü. Hastaya tanı ve tedavi açısından videotorakoskopi yardımlı akciğer cerrahisi ile birlikte wedge rezeksiyon yapıldı. Akciğer wedge rezeksiyon materyalinin patololojik incelemesinde ardışık bant tarzında dizilim gösteren karbon pigment birikimlerinin yer aldığı iyi sınırlı nekrobiyotik nodül tespit edildi ve hastaya KİP tanısı koyuldu. Takip altına alınan hastanın en son çekilen tomografisinde (cerrahiden 1 buçuk yıl sonra) yeni bir lezyon veya progresyon tespit edilmedi. Sonuç olarak komplike KİP'in beklenmedik yerlerde ve beklenmedik radyolojik görünümlerde ortaya çıkabileceği unutulmamalı, soliter pulmoner nodülleri olan hastalarda mutlaka meslek öyküsü sorgulanmalı ve invazif girişimlere karar vermeden önce hasta bu açıdan da değerlendirilmelidir.Complicated coal worker's pneumoconiosis (CWP) was defined the nodules that equal or greater than 1cm Complicated CWP was developed on the basis of simple pneumoconiosis. Complicated CWP without minor opacity was seen very rarely. We aimed to introduce an interesting case of complicated CWP without minor opacity that suggest the nonpneumoconiosis diseases. Sixty five age years old patient was retired from coal mine. There was no pathological view on chest x-ray. In computed thorax tomography there was 16mm diameter of pulmonary nodule in laterobasal segment of lower lobe of left lung. A few anthracotic pigmentation on bronchus mucosa were determined in bronchoscopy. Videoassociated thoracoscopic surgery was performed. Carbon pigmentation was seen in the surgical material of pulmonary nodule. The patient was followed up for 1.5 years. At the end of the follow up period there were no pathological view in control computed thorax tomography. In conclusion complicated CWP may have seen in varied radiological view and different areas of the lung. In the patients with solitare pulmonary nodule occupational history should be questioned attentively and before the invazive interventions the patients should be evaluted in this respect

Serum midkine levels in patients with obstructive sleep apnea

WOS: 00045197940302