Psoriazis hastalarında obstrüktif uyku apne sendromu semptom sıklığı

Aim: Psoriasis is a frequently seen chronic systemic inflammatory disease accompanied by several comorbid conditions that affects 2-3% of the general population. One of the comorbidities rarely accompanying psoriasis is obstructive sleep apnea syndrome (OSAS). OSAS is a disease characterized by recurrent complete (apnea) or partial (hypopnea) upper airway obstruction episodes and frequently by decreased blood oxygen saturation. The purpose of this study was to evaluate the risk factors for OSAS by investigating OSAS symptoms in psoriasis patients. Material and Methods: Eighty-two patients aged over 16, diagnosed with psoriasis, and under follow-up by the Duzce University Medical of Faculty, Dermatology and Venereal Diseases Polyclinic, Turkey, were included in the study. Patients’ OSAS symptoms were investigated. The Epworth Sleepiness Scale was used to assess excessive daytime somnolence. Results: Of the patients 51.2% (n=42) were male and 48.8% (n=40) female. Patients’ mean age was 47.09±14.10 years. Patients’ mean time of psoriasis diagnosis was 16.97±10.55 years, and mean Psoriatic Area Severity Index (PASI) score was 11.25±6.32. Severe disease was present in 54.9% of patients (n=45) based on PASI classification. Prevalence of 56.1% for snoring, 25.6% for excessive daytime sleepiness, and 15.9% for witnessed apnea were determined in these patients. Forty-seven (57.3%) cases had at least one major symptom. The most common minor symptoms were inability to sleep with 25.6% (n=21) and insufficient disrupted sleep with 22.0% (n=18). Conclusion: Prevalence of OSAS symptoms in psoriasis patients were found high. Psoriasis patients with OSAS symptoms must be referred to relevant specialists for polysomnographic evaluation. © 2019, Duzce University Medical School. All rights reserved.Amaç: Psoriazis toplumda sık görülen, genel nüfusun %2-3’ünü etkileyen, birçok komorbiditenin eşlik ettiği kronik sistemik enflamatuvar bir hastalıktır. Psoriazis’e eşlik eden nadir görülen komorbiditeler arasında obstrüktif uyku apne sendromu (OUAS) yer almaktadır. OUAS uyku sırasında tekrarlayan tam (apne) veya parsiyel (hipopne) üst solunum yolu obstrüksiyonu epizodları ve sıklıkla kan oksijen satürasyonunda azalma ile karakterize bir hastalıktır. Bu çalışmanın amacı psoriazis hastalarında OUAS semptomları sorgulanarak, OUAS risk faktörlerini değerlendirmektir. Gereç ve Yöntemler: Düzce Üniversitesi Tıp Fakültesi Deri ve Zührevi Hastalıkları polikliniğinden takipli ve Psoriazis tanılı 16 yaşından büyük 82 hasta çalışmaya alındı. Hastalar OUAS semptomları açısından sorgulandı. Aşırı gündüz uykululuğu değerlendirmek için ise Epworth uykululuk skalası kullanıldı. Bulgular: Hastaların %51,2 (n=42)’sı erkek, %48,8 (n=40)’i kadındı. Hastaların yaş ortalaması 47,09±14,10 yıl idi. Hastaların ortalama psoriazis tanı süreleri 16,97±10,55 yıl, ortalama Psoriatik Alan Şiddet İndeksi (PAŞİ) 11,25±6,32 idi. PAŞİ sınıflamasına göre hastaların %54,9 (n=45)’ü şiddetliydi. Bu hastalarda horlama için %56,1, gündüz aşırı uyku hali için %25,6, tanıklı apne için %15,9’luk prevalans saptandı. En az bir semptomu olan olgu sayısı 47 (%57,3) idi. Minör semptomlar sorgulandığında en sık gözlenen %25,6 (n=21) ile uyuyamama ve %22,0 (n=18) ile yetersiz bölünmüş uyku şikayetiydi. Sonuç: Psoriazis hastalarında OUAS semptom sıklığı yüksek olarak bulunmuştur. OUAS semptomları olan psoriazis hastaları muhakkak polisomnografik değerlendirme için ilgili uzmanlara yönlendirilmelidir

Kronik Obstrüktif Akciğer Hastalarda Geleneksel ve Tamamlayıcı Tıp Yöntemi Kullanımlarının Değerlendirilmesi

Amaç: Kronik obstrüktif akciğer hastalığında (KOAH) semptomların hafifletilmesinde Geleneksel ve Tamamlayıcı Tıp (GETAT) yöntemlerinin kullanımı giderek artmaktadır. KOAH hastalarının GETAT yöntemlerini kullanım durumlarının belirlenmesini amaçladık.Materyal ve Metot: Göğüs hastalıkları polikliniğine Aralık 2018 ve Şubat 2019 tarihleri arasında başvuran KOAH hastaları çalışmaya dahil edildi. Hastalara GETAT yöntemleri hakkındaki eğilimlerini ölçen sorular yöneltildi, demografik verileri kaydedildi.Bulgular: Çalışmaya katılan 94 hastanın yaş ortalaması 65,6±10,0 (minimum: 42, maksimum: 84 yıl) olup vakaların %84’ü erkek (n=79), %16’sı (n=15) kadındı. Hastaların %39,4’ü (n=37) GETAT yöntemlerinden birini kullandığını ve kullanan hastaların %70,3’ü (n=26) yarar gördüğünü ifade etmişlerdi. Bitkisel, apiterapi, apiterapi ve bitkisel tedavileri birlikte kullananlar ve aromaterapi yöntem oranları sırasıyla %73, %8,1, %10,8, %8,1 olarak bulundu. Hastaların %82,2’sinin (n=74) GETAT yöntemleri ile ilgili hekiminden bilgi almak istediği görüldü. KOAH hastaları evrelerine göre ayrıldığında, ileri evre (evre 3-4) hastalarının erken evre ( evre 1-2) hastalara göre GETAT yöntemini daha çok kullandığı gözlendi (p=0,004).Sonuç: Sağlık personeli tarafından GETAT yöntemlerini kullanım durumlarının sorgulanması gerektiğini düşünmekteyiz.Objective: The use of traditional and complementary medicine (TCAM) methods for the alleviation of symptoms in chronic obstructive pulmonary disease (COPD) is increasing. We aimed to determine the use of TCAM methods in COPD patients. Materials and Methods: Patients with COPD who were admitted pulmonary diseases clinic between December 2018-February 2019 were included to study. Patients were asked questions measuring their tendency about TCAM methods and demographic data were recorded. Results: The mean age of the 94 patients was 65.6±10.0 (min:42, max:84) and 84% (79) of the participants was male, 16% (n=15) was female. 39.4% (n=37) of the patients declared that they was used at least one TCAM methods and 70.3% (n=26) of them have benefit from this method. Herbal, apitherapy, apitherapy and herbal treatments together and aromatherapy method rates were 73%, 8.1%, 10.8%, 8.1% respectively. It was seen that 82.2% (n=74) of the patients wanted to get information from their physician about TCAM methods. When patients were divided into groups according to their stages; it was observed that late stage (end and severe stage) patients used TCAM method more than early and moderate stage (p=0.004). Conclusion: We think that the use of TCAM methods should be questioned by the health personnel

The Relation between Air Pollution and Respiratory Tract Diseases in Duzce City by Months

Annakkaya, Ali Nihat N/0000-0002-7661-8830; Balbay, Ege Gulec/0000-0002-1557-7019WOS: 000300538400018Aim: In this study, it's aimed to investigate the relationship between the levels of particulate matter (PM10) and sulphur dioxide (SO2) and the admittance of the patients with the diagnosis of COPD, asthma, respiratory tract diseases to policlinics in the central part and counties of Duzce. Materials-Methods: Between 1 January 2009 and 31 December 2009 in Duzce Ataturk State Hospital, the patients diagnosed as COPD, asthma, acute bronchitis, pneumonia, acute nasopharyngitis, acute pharyngitis, acute tonsillitis, allergic rhinitis at chest diseases, internal medicine, ENT, pediatric polyclinics were retrospectively evaluated. The monthly average values of SO2 and PM10 of Duzce had been obtained from the official data of Ministry of Environment and Forests. Results: Fifty-three percent (15,606) of total 29,367 cases were female. 64.4% of the cases were adults. The average SO, and PM10 concentration of Duzce city was highest in November, December, January and those were the lowest in July, August, September and October. The applications with the diagnosis of acute bronchitis were higher than the remaining applications in January (26.9%) and December (25.4%), while those were the lowest in July 16.4%) and September (20.4%), respectively. The applications with the diagnosis of COPD were more frequent in January (10%), February (10.9%), March (13.1%), but less in September (5.9%). The cases with asthma were most admitted in December (10.6%), January (9.6%) but less frequently in September (6.1%) (p = 0.000). Also the pneumonia cases were frequently admitted in November (10.6%), January (9.6%). The admission rates of the patients with COPD, asthma, acute bronchitis were similar among the central part, seaside and far from seaside. The most common admittance was due to the allergic rhinitis at the seaside part (119/479, 24.8%) (p = 0.000). Upper respiratory tract disease applications (58%) were higher than the lower respiratory tract diseases applications in the months that the air pollution was the highest (p = 0.000). Conclusion: It was speculated that polyclinics admissions of COPD, asthma, acute bronchitis, pneumonia, acute nasopharyngitis, acute pharyngitis, acute tonsillitis, allergic rhinitis seemed to be associated with air pollution and also living in the seaside may lead to more increase in applications regarding allergic rhinitis

The relationship between obstructive sleep apnea syndrome and two common urological disorders

WOS: 000449650903454

The Role of G(i) and G(s) Proteins in Hypoxic Vasoconstriction of Lamb Isolated Pulmonary Artery Rings

Silan, Coskun/0000-0002-8352-6571; silan, coskun/0000-0002-8352-6571WOS: 000333080000018Hipoksik pulmoner vazokonstriksiyon akcigerlerde ventilasyon perfüzyon dengesini saglayan fizyolojik uyum mekanizmasidir. Hipoksemi ile seyreden progressif akciger hastaliklarmin patogenezinde önemli rol oynamakia birlikte saglikli bireylerde de görülmektedir. Yogun çali5malara ragmen, hipoksik pulmoner vazokonstriksiyonun mekanizmasi henüz bulunamamijtir. G proteinleri vasküler endotel ve düz kas hücrelerinde reseptör aracilikli sinyal iletimine aracilik ederek vasküler tonusun düzenlenmesinde önemli rol oynayan membrana bagli protein ailesidir. Biz bu çalijmada, kuzu izole pulmoner arterierinde izlenen hipoksik vazokonstriksiyonun oluj mekanizmasinda G, ve G^ proteinlerlnin rolünüsaptamayiamacladik. Pulmoner arterler yeni kesilmi5 kuzularin sol akciger alt loblarmdanizole edildi. ArterlerKrebs-Henseleitsolüsyonu ile dolu olan izole organ banyosuna asildi ve izometrik kontraksiyonlar bilgisayarli poligrafi sistemi ile baglantili olan izometrik transdüsir yoluyla devamli olarak kaydedildi. Solüsyon %75 N^- %20 0^- %5 COj (Normoksik) ve %95 N^- %5 COj (Hipoksik) kari^imi içeren gaziar ile havalandinidi. Organ banyosundaki parsiyel oksijen konsantrasyonu oksijen elektrodu kullanilarak sürekli olarak ölcüldü. G¡ ve G^ proteinlerin rolünü ara^tirmak için kolera ve pertusis toksini kullanildi. Çali^mada, dinlenme gerimindeki geni? çapli pulmoner arterlerde hipoksiye bagli bir gerim artiji izlenmedi ancak hipoksi 3 ^ilVl 5-HT ile prekontrakte edilmi? dokularda kontraksiyona (1.7+0.5 mN/mm^ n=10) sebep oldu. Hipoksik vazokonstriksiyon 2 |ig/ml kolera toksini ile inkübasyon sonrasi inhibe (2.6±0.4 mN/mm^'den 1.0±0.4 mN/mm^'ye kadar, n=6) ve 2 (ig/ml pertusis toksini ile inkübasyon sonrasi potansiyalize (0.6±0.4 mN/mm^'den 1.7±0.3 mN/mm^'ye kadar, n=6) oldu. Bu sonuçlar G¡ ve G, proteinleri ile iliçkili sinyal iletiminin geni? çapli kuzu izole pulmoner arterinde gelljen hipoksik vazokonstriksiyonda önemli bir mekanizma olabilecegini gösterdi.Hypoxic pulmonary vasoconstriction (HPV) is an intrapulmonary adaptive mechanism that matches alveolar ventilation to perfusion. However during prolonged alveolar hypoxia HPV occurs with many pulmonary diseases. Despite intensive studies, cellular mechanisms of HPV are still not well defined. G proteins are a family of membrane-associated proteins believed to be involved in the transduction of various signals including the regulation of vascular tonus. In this study, we aimed to determine the contribution of G(i) and G(s) proteins in hypoxic vasoconstriction of lamb isolated pulmonary artery rings. Pulmonary arteries were isolated from left lower lobe of freshly slaughtered lamb. Arteries suspended in an organ bath filled with Krebs-Henseleit solution and isometric contraction recorded continuously via an isometric transducer connected to a computerised polygraphy system. The solution aerated with 75% N-2 - 20% O-2 - 5% CO2 (normoxic) and 95% N-2 - 5% CO2 (hypoxic) pO(2) of bathing medium was measured continuosly using an oxygen electrode. Pertussis toxin and cholera toxin were used to investigate the role of G(i) and G(s) proteins. In the present study, we observed that hypoxia had no effect on resting force in large artery rings, but it caused a further contraction (1.7 +/- 0.5 mN/mm(2), n=10) in 3 mu M 5-HT precontracted pulmonary arteries rings. Hypoxic vasoconstriction was inhibited by preincubation with 2 mu g/ml cholera toxins (from 2.6 +/- 0.4 mN/mm(2), to 1.0 +/- 0.4 mN/mm(2), n=6) and potentiated by preincubation with pertussis toxins (2 mu g/ml) (from 0.6 +/- 0.4 mN/mm(2), to 1.7 +/- 0.3 mN/mm(2), n=6). These results indicate that signal transduction mediated by G(i) and G(s) proteins may be an important mechanism in the hypoxic vasoconstriction in lamb isolated large pulmonary arteries

The effect of particular matter pollution on emergency room visits due to COPD and asthma and the association with hospitalization rate in Duzce City

Annakkaya, Ali Nihat N/0000-0002-7661-8830WOS: 000449650900818

The effect of particular matter pollution on emergency room visits due to COPD and asthma and the association with hospitalization rate in Duzce City

Annakkaya, Ali Nihat N/0000-0002-7661-8830WOS: 000449650900818

Bronchiolectasis due to giant thoracic vertebral osteophytes

Balbay, Ege Gulec/0000-0002-1557-7019WOS: 000366655100013PubMed: 26196099

Maligniteyi Taklit Eden Yaygın Granülomatöz İnflamasyon Olgusu

Elli dokuz yaşında kadın hasta 3 haftadır devam eden kuru öksürük ve 2 aydır olan efor dispnesi (MRC 2) ile polikliniğimize başvurdu. Son 3 ay içerisinde 5 kg kaybı mevcuttu. Hiç sigara içmemişti. Mesleği ev hanımı idi. Hastanın postero-anterior akciğer grafisinde sağ alt zonda sağ atriyum kenarını silen opasite olması üzerine çekilen toraks bilgisayarlı tomografisinde; her iki akciğer üst loblarda büyüğü 5 mm olmak üzere birkaç adet nodül, solda lingula ve sağda orta lobda yine yaygın retikülonodüler dansiteler izlendi. Hastanın malignite ön tanısıyla istenen pozitron emisyon tomografisinde; nazofarenks dorsal duvarında, bilateral servikal lenfadenopatilerde, her iki akciğerde parankim nodüllerinde, sağ akciğer hiler alanda, sol akciğerde retiküler dansitelerde, gastroözafagial bileşkede, mide fundus ve büyük kurvaturunda, karaciğerde, iliak istasyonlarda multipl lenfadenopatilerde, sağ skapula ve sol iliak kemik iliğinde yoğun hipermetabolik tutulum saptandı. Yapılan axiller lenf nodu diseksiyonu granülomatöz lenfadenit olarak saptandı. Hasta sarkoidoz olarak kabul edildi, inhale steroid tedavisi başlandı ve takibe alındı

Is the sleep perception of obstructive sleep apnea patients reliable? [Obstrüktif uyku apnesi hastalarının uyku algıları güvenilir mi?]

Aim: The aim of this study, is to evaluate the consistency with the polysomnography (PSG) data of the patients and the data reported by the patients themselves after PSG examination in the morning. Material and Methods: One hundred and thirty-four consecutive individuals who were admitted to the Chest Disease Polyclinic for Sleep Disorders of Duzce University Medical Faculty were included in the study. PSG and the questions related to sleep perception was applied by the same physician with face to face interview to all participants. Results: Of the patients included in the study 90 (67.2%) were male and 44 (32.8%) were female, and the mean age was 47.3±12.6 years. While there was a significant correlation (p=0.042, r=0.301) between the sleep time reported by the patients themselves after waking up in the morning and the sleep time measured by the PSG in patients without obstructive sleep apnea (OSA), there was no correlation in OSA (+) patients (p=0.269, r=0.125). Similarly, while there was a significant correlation (p=0.026, r=0.352) between the sleep latency reported by the patients themselves after waking up in the morning and the sleep latency measured by the PSG in OSA (-) patients, there was no correlation in OSA (+) patients (p=0.060, r=0.223). Conclusion: While evaluating OSA patients and explaining their treatment before and after PSG, it should be kept in mind that they might have impaired perception. Therefore, we thought that we should spend more time to patients, and to make our explanations more clearly and understandably. © 2019, Duzce University Medical School. All rights reserved