Broncofibroscopia. A atropina é necessária como pré-medicação?

RESUMO: Os autores decidiram analisar a importancia da atropina como premedicação na broncofibroscopia (BFB).Avaliaram 93 doentes que íam ser submetidos à BFB e dividiram-nos em dois grupos.O primeiro grupo (I) era constituído por doentes a quem foi administrado 10mg de diazepam i.m., enquanto que o segundo grupo (II) era constituído por doentes a quemJoram administrados l0mg de diazepam i.m.e 0,5 mg de atropina i.m.A tensão arterial e o pulso foram monitorizados durante e depois da BFB. A glicémia também foi monitorizada antes e depois da BFB.A quantidade de secreções bronquicas e as complicações foram registadas durante e depois do exame.As tensões arteriais foram elevadas em ambos os grupos mas só a diastólica foi significativamente mais elevada comparada com a diastólica medida antes do exame, no grupo que fez atropina. Nao havia diferenóas na comparação intergrupos.A frequência do pulso estava elevada em ambos os grupos antes e depois da BFB. O aumento da frequência do pulso no grupo II era significativamente maior quando comparada como grupo I (<0,05).A glicemia era significativamente maior depois do exame do que antes do exame, contudo não há diferençãs significativas entre os dois grupos.As complicaçãoes e a produção de secreções bronquicas foram identicas nos dois grupos.A administração de atropina como premedicação na BFB não mostrou ter vantagens, pelo contrario podeni ter algumas desvantagens potenciais, tais como hiperglicemias em doentes diabeticos e taquiarritmias nos doentes cardfacos. Palavras-chave: Broncofibroscopia (BFB), Atropina, Premedicaçã

Deteriorations of pulmonary function, elevated carbon monoxide levels and increased oxidative stress amongst water-pipe smokers

Objectives: A water pipe (hookah) is a tobacco smoking tool which is thought to be more harmless than a cigarette, and there are no adequate studies about its hazards to health. Water-pipe smoking is threatening health of the youth in the world today. The objective of this study has been to investigate the carbon monoxide (CO) levels in breath, examine the changes in pulmonary function tests (PFT) and to assess the change of the oxidative stress parameters in blood after smoking a water pipe. Material and Methods: This study is a cross-sectional analytical study that has included 50 volunteers who smoke a water pipe and the control group of 50 volunteers who smoke neither a cigarette nor a water pipe. Carbon monoxide levels were measured in the breath and pulmonary function tests (PFTs) were performed before and after smoking a water pipe. Blood samples were taken from either the volunteer control group or water-pipe smokers group after smoking a water pipe for the purpose of evaluation of the parameters of oxidative stress. Results: Carbon monoxide values were measured to be 8.08±7.4 ppm and 28.08±16.5 ppm before and after smoking a water pipe, respectively. This increment was found statistically significant. There were also significant reductions in PFTs after smoking a water pipe. Total oxidative status (TOS), total antioxidant status (TAS) and oxidative stress index (OSI) were found prominently higher after smoking a water pipe for the group of water-pipe smokers than for the control group. Conclusions: This study has shown that water-pipe smoking leads to deterioration in pulmonary function and increases oxidative stress. To the best of our knowledge this study is the only one that has shown the effect of water-pipe smoking on oxidative stress. More studies must be planned to show the side effects of water-pipe habit and protective policies should be planned especially for young people in Europe. Int J Occup Med Environ Health 2017;30(5):731–74

The Geographical Distribution of Morbidity Caused By Chronic Obstructive Pulmonary Disease in Turkey: COPDTURKEY-2

Background: Chronic obstructive pulmonary disease (COPD) is one of the most prevalent causes for morbidity and mortality, and it creates a cumulative economic and social burden. Aims: To determine the distribution of the prevalence of patients in Turkey who were diagnosed with COPD and their morbidity rates, according to the regions and cities they belong to. Moreover, the study contributes to the prevention and cure services of COPD that should be planned in the future. Study Design: A retrospective cohort. Methods: The database of the Social Security Institution from 2016 has been scanned. All the data with prescription registration, with the code ICD-10, J44.0-J44.9, which were aimed for diagnosing and/or cure, have been evaluated with a retrospective cohort. Results: In 2016, 955,369 patients who were admitted as outpatients to the hospitals were diagnosed with COPD. The average number of annual COPD cases that were admitted was 2.09. Twenty percent (20\%) of the outpatient applications were via emergency room. The rate of hospitalization among the applicants was 17.75\%. with a total of 1,994,325. The average annual number of hospitalizations of men was higher than that of women. The average number of hospitalization days was 6.52. The region with the highest prevalence of outpatient admission and hospitalization was the Black Sea Region. Conclusion: The high rate of hospitalization was considered to be the outcome of the insufficient ``outpatient{''} management