Evaluation of patients with fibrotic interstitial lung disease: Preliminary results from the Turk-UIP study

OBJECTIVE: Differential diagnosis of idiopathic pulmonary fibrosis (IPF) is important among fibrotic interstitial lung diseases (ILD). This study aimed to evaluate the rate of IPF in patients with fibrotic ILD and to determine the clinical-laboratory features of patients with and without IPF that would provide the differential diagnosis of IPF. MATERIAL AND METHODS: The study included the patients with the usual interstitial pneumonia (UIP) pattern or possible UIP pattern on thorax high-resolution computed tomography, and/or UIP pattern, probable UIP or possible UIP pattern at lung biopsy according to the 2011 ATS/ERSARS/ALAT guidelines. Demographics and clinical and radiological data of the patients were recorded. All data recorded by researchers was evaluated by radiology and the clinical decision board. RESULTS: A total of 336 patients (253 men, 83 women, age 65.8 +/- 9.0 years) were evaluated. Of the patients with sufficient data for diag-nosis (n=300), the diagnosis was IPF in 121 (40.3%), unclassified idiopathic interstitial pneumonia in 50 (16.7%), combined pulmonary fibrosis and emphysema (CPFE) in 40 (13.3%), and lung involvement of connective tissue disease (CTD) in 16 (5.3%). When 29 patients with definite IPF features were added to the patients with CPFE, the total number of IPF patients reached 150 (50%). Rate of male sex (p<0.001), smoking history (p<0.001), and the presence of clubbing (p=0.001) were significantly high in patients with IPE None of the women <50 years and none of the men <50 years of age without a smoking history were diagnosed with IPE Presence of at least 1 of the symptoms suggestive of CTD, erythrocyte sedimentation rate (ESR), and antinuclear antibody (FANA) positivity rates were significantly higher in the non-IPF group (p<0.001, p=0.029, p=0.009, respectively). CONCLUSION: The rate of IPF among patients with fibrotic ILD was 50%. In the differential diagnosis of IPF, sex, smoking habits, and the presence of clubbing are important. The presence of symptoms related to CTD, ESR elevation, and EANA positivity reduce the likelihood of IPF

Chimney grafts for a juxtarenal aneurysm in an octogenarian patient with left main coronary artery disease and symptomatic carotid stenosis : case report

Jukstarenal anevrizmalı hastalarda kompleks bir açık cerrahi onarım gerekmektedir ki, bu da mortalite ve morbiditeyi artırır. Kolay uygulanabilir bir metot olarak chimney prosedürü gelişti- rilmiştir. Seksen bir yaşında, jukstarenal anevrizması, sol ana koroner arterde ciddi darlığı, unsta- bil anjinası, sol iliak arter tıkanıklığı ve semptomatik karotis arter darlığı olan bir erkek hasta sunuyoruz. Hasta acil kombine koroner ve karotis işlemlerinin ardından gerçekleştirilen sol ak- sillo-femoral bypass'ın yanısıra, aşamalı chimney greftler ve aort-uni-iliak stent-greftleme ile tedavi edildi. Hasta postoperatif 10. günde komplikasyonsuz taburcu edildi. Chimney greftler; tekniğin esnekliği, daha kısa işlem süresi, özel imal edilmesi gereken araçlara gereksinim duyulmaması ne- deniyle karmaşık vakalarda cazip bir alternatif olarak görünmektedir.FIGURE 1: Digital substraction angiography of chimney grafts to bilateral renal arteries and aorto-uni-iliac stent-grafting (A). Patent superior mesen- teric artery at proximal attachment site (B

Midterm results with the use of polycarbonate urethane heterografts for dialysis access

Dialysis access surgery is currently one of the most common vascular operations as the dialysis patient population inceases. Although autogenous arteriovenous fistulae stand as the preferred method of access due to excellent patency and lower complication rates, grafts may provide alternative approaches when an autogenous fistula is impractical usually due to depleted veins. We aimed in this study to assess early and midterm outcome with the use of Expedial (TM) heterografts (LeMaitre Vascular Ltd., Wrexham, UK) for angioaccess between October 2000 and December 2004. Patients were prospectively followed for pre- and peri-operative course with 1st, 6th and 12th month outpatient controls for patency and complication rates. A total of 34 heterografts were implanted in 30 patients (22 males and 8 females; median age 60.6 years, range 32 - 70). The mean follow-up for 30 patients were 16.3 +/- 6.1 (range 4 - 30) months. 28 grafts (82.4%) were placed in forearm position. Primary and secondary patencies were found as 81% and 94%, respectively (p = 0. 15), with the median censored primary and secondary patencies of 27 1.7 months (95% CI, 23.38 to 30.67) and 30.42 +/- 1.1 months (95% CI, 28.30 to 32.54), respectively. Only presence of diabetes was found as a significant risk factor in the regression model (p = 0.01). We suggest that the polycarbonate urethane heterografts with acceptable patency/complication rates and shorter maturation times for dialysis access serve an alternative for these patients. (c) 2005 Tohoku University Medical Press

True aneurysm of extracranial internal carotid artery in a 10-year-old

Introduction. In this report, we describe a very unusual case, true aneurysm of the internal carotid artery, in a child

Extracardiac Off-Pump Fontan Completion for Single Ventricle With Dextrocardia

Extracardiac off-pump is reported to result in better early hemodynamics and shorter mechanical ventilation periods. We present a case report of extracardiac off-pump Fontan in a 5-year-old girl with single ventricle and dextrocardia

An alternative patch repair technique during valve replacement for native valve endocarditis

A patient with native valve endocarditis and vegetation on anterior mitral leaflet underwent aortic valve replacement with preservation of aortic noncoronary leaflet as a patch over the inflammated intervalvular fibrous body. This technique may minimize prosthetic material use, which is the most important risk factor for reinfection

Candida albicans endocarditis and a review of fungal endocarditis: Case report

Endocarditis due to fungal etiology is rare, but it is the most severe form of infective endocarditis. Fungal endocarditis is commonly complicated by systemic embolizations, and the difficulty in isolating the fungi with routine blood cultures complicates the diagnostic process. In these culture-negative cases of endocarditis, etiologic diagnosis is made with histopathologic examination of the cardiac valve, embolic materials, and systemic ulcers. In this case report, the presented patient with fungal endocarditis and its neurologic complications was treated with a surgical and medical approach