Impact of Restless Legs Syndrome on the Sleep Quality in Chronic Obstructive Pulmonary Disease

Objective: It is well known that various sleep disorders are common in cases of chronic obstructive pulmonary disease (COPD). However, restless legs syndrome (RLS) has not been extensively studied in these patients. The aim of the current study was to investigate the prevalence of RLS and its impact on sleep quality in patients with COPD. Methods: The study included a total of 50 patients with COPD with a mean age of 67.2±7.7 years; 39 (78%) were male. The RLS diagnosis was made based on the questionnaire items standardized by the International RLS study group. Dyspnea severity (mMRC), quality of life (CAT), sleep quality [Pittsburgh sleep quality index (PSQI)], and daytime sleepiness [Epworth sleepiness scale (ESS)] were evaluated using certain specific questionnaires. The subjects were studied in two groups: RLS-positive and RLS-negative groups. Results: In the study population, RLS was detected in 17 (34%) patients. It was found that the RLS-positive subjects had a longer disease duration (p=0.006), a higher hospital admission rate (p=0.008), and lower spirometric values (p=0.023 for FVC; p=0.001 for FEV1). The CAT score was significantly higher in the RLS-positive group (p=0.019). The RLS-positive group had higher PSQI and ESS scores (p<0.001 for both). There were negative correlations between PSQI, ESS scores, and spirometric measures (FVC and FEV1), whereas PSQI and ESS scores had positive correlations with disease duration, mMRC, and CAT scores. Conclusion: In our study, it was observed that RLS is a common condition in patients with COPD. As the duration and severity of COPD increases, RLS becomes more prevalent and sleep quality deteriorates

Carbonic Anhydrase IX as a Marker of Disease Severity in Obstructive Sleep Apnea

Background and Objectives: Carbonic anhydrase (CA) enzymes are a family of metalloenzymes that contain a zinc ion in their active sites. CA enzymes have been implied in important situations such as CO2 transport, pH regulation, and oncogenesis. CA-IX is a transmembrane glycoprotein and stimulates the expression of hypoxia-inducible factor-1 (HIF-1) CA-IX. This study aimed to determine serum CA-IX levels in OSA patients in whom intermittent hypoxia is important and to investigate the relationship between serum CA-IX levels and disease severity. Materials and Methods: The study included 88 people who applied to Malatya Turgut Özal University Training and Research Hospital Sleep Disorders Center without a history of respiratory disease, malignancy, and smoking. Patients were divided into three groups: control (AHI n = 31), mild–moderate OSA (AHI = 5–30, n = 27) and severe OSA (AHI > 30, n = 30). The analysis of the data included in the research was carried out with the SPSS (IBM Statistics 25, NY, USA). The Shapiro–Wilk Test was used to check whether the data included in the study had a normal distribution. Comparisons were made with ANOVA in multivariate groups and the t-test in bivariate groups. ANCOVA was applied to determine the effect of the CA-IX parameter for OSA by controlling the effect of independent variables. The differentiation in CA-IX and OSA groups was analyzed regardless of BMI, age, gender, and laboratory variables. ROC analysis was applied to determine the parameter cut-off point. Sensitivity, specificity, and cut-off were calculated, and the area under the curve (AUC) value was calculated. Results: Serum CA-IX levels were 126.3 ± 24.5 pg/mL in the control group, 184.6 ± 59.1 pg/mL in the mild–moderate OSA group, and 332.0 ± 39.7 pg/mL in the severe OSA group. Serum CA-IX levels were found to be higher in the severe OSA group compared to the mild–moderate OSA group and control group and higher in the mild–moderate OSA group compared to the control group (p p p 2 and mean SaO2 (r = –0.371, p = 0.004; r = –0.319, p = 0.017, respectively). A positive correlation between CA-IX and desaturation index (CT90) was found (r = 0.369, p = 0.005). A positive correlation was found between CA-IX and CRP (r = 0.340, p = 0.010). When evaluated by ROC curve analysis, the area under the curve (AUC) value was determined as 0.940 (95% CI 0.322–0.557; p Conclusions: Our study found that serum CA-IX value was higher in OSA patients than in control patients, and this elevation was associated with hypoxemia and inflammation. CA-IX value can be a fast, precise, and useful biomarker to predict OSA

Two cases with silicosis caused by denim sandblasting

Bilinen en eski meslek hastalıklarından biri olan silikozis, solunabilir büyüklükteki silika kristallerinin akciğer dokusunda geri dönüşümsüz ve ilerleyici bir fibrotik reaksiyon oluşturması ile karakterize tedavisi olmayan bir hastalıktır. Son yıllarda özellikle küçük ve denetimsiz atölyelerde uygunsuz koşullarda yapılan kot kumlama işi hastalığın gelişiminde farklı bir işkolu haline gelmiştir. 3 yıldır kot kumlama işinde çalışan 20 ve 28 yaşlarında iki erkek hasta, nefes darlığı ve kilo kaybı şikayetleri ile kliniğimize başvurdu. Posteroanterior akciğer grafilerinde ve toraks bilgisayarlı tomografilerinde özellikle her iki üst ve orta zonlarda ve periferik bölgelerde yoğun yerleşimli, yaygın retikülonodüler ve nodüler opasiteler izlendi. Solunum fonksiyon testlerinde restriktif tipte ventilasyon bozukluğu saptandı. Birinci olgumuza transbronşiyal biyopsi ile silikozis tanısı kondu. İkinci olgu ise ilki ile benzer yakınmaları, radyolojik bulguları ve mesleksel maruziyet öyküsü nedeniyle ileri girişimsel inceleme yapılmadan tanı aldı. İş gücünün ucuz olduğu gelişmekte olan ülkelerde kot kumlama işinde çalışanlarda bir toplum sağlığı sorunu haline gelen silikozis çalışma şartlarının düzeltilmesi ile önlenebilir. Kotlar beyazlarken kararan hayatlara son vermek için daha fazla önlem alınması gerektiği inancındayız.Silicosis which is one of the oldest known occupational diseases is characterized by an irreversible and progressive fibrotic reaction occuring in the lungs caused by inhaling crystalline silica dust. Effective treatment for silicosis is not available. Recently, denim sandblasting especially being made in uncontrolled small-scale workplace in primitive conditions has been a striking occupation leading to silicosis . Twenty and 28 years old male patients who work in denim sandblasting for 3 years were admitted to our clinics with complaints of dyspnea and loss of weight. Chest X ray and thorax computerized tomography revealed bilateral diffuse reticulonodular and nodular opacities which were prominent in the upper and middle zones and peripheric area of pulmonary parenchyma. Restrictive disorder was observed at their pulmonary function tests. Silicosis was diagnosed by performing transbronchial biopsy in one case. Because of the similarity of complaints, radiological findings and occupational history with the former patient, no other further and invasive procedure was performed and the other patient was also diagnosed as silicosis. In developing countries in which the labor force is very cheap, silicosis becomes a public health problem in denim sandblasters and can be prevented with improvement of working conditions. We believe that further precaution must be taken to stop darkened lives while jeans is bleaching

Approach of pulmonologists in Turkey to noninvasive mechanical ventilation use at home for chronic respiratory failure

WOS: 000386262800001PubMed ID: 27266279Introduction: To define approach of pulmonologists in Turkey to noninvasive mechanical ventilation ( NIV) use for chronic respiratory failure ( CRF), the most currently applied technique for home mechanical ventilation. Patients and Methods: A 38-question survey, developed and tested by the authors, was distributed throughout Turkey to 2205 pulmonologists by e-mail. Results: Twenty-seven percent of the pulmonologists responded ( n= 596). Domiciliary NIV was reported to be prescribed by 340 physicians [ 57.1% of all responders and 81% of pulmonologists practicing NIV at clinical practice ( n= 420)]. NIV prescription was associated with physician's title, type of hospital, duration of medical license, total number of patients treated with NIV during residency and current number of patients treated with NIV per week ( p< 0.05). Main estimated indications were listed as chronic obstructive pulmonary disease ( median, 25-75 percentile of the prescriptions: 75%, 60-85), obesity hypoventilation syndrome ( 10%, 2-15), overlap syndrome ( 10%, 0-20) and restrictive lung disease ( 5%, 2-10). For utilization of NIV at home, Bilevel positive airway pressure-spontaneous mode ( 40%, 0-80) and oronasal mask ( 90%, 60-100) were stated as the most frequently recommended mode and interface, respectively. Pressure settings were most often titrated based on arterial blood gas findings ( 79.2%). Humidifier was stated not to be prescribed by approximately half of the physicians recommending domicilliary NIV, and the main reason for this ( 59.2%) was being un-refundable by social security foundation. Conclusion: There is a wide variation in Turkey for prescription of NIV, which is supposed to improve clinical course of patients with CRF. Further studies are required to determine the possible causes of these differences, frequency of use and patient outcomes in this setting

Where Brain, Body and World Collide

The production cross section of electrons from semileptonic decays of beauty hadrons was measured at mid-rapidity (|y| &lt; 0.8) in the transverse momentum range 1 &lt; pt &lt; 8 Gev/c with the ALICE experiment at the CERN LHC in pp collisions at a center of mass energy sqrt{s} = 7 TeV using an integrated luminosity of 2.2 nb^{-1}. Electrons from beauty hadron decays were selected based on the displacement of the decay vertex from the collision vertex. A perturbative QCD calculation agrees with the measurement within uncertainties. The data were extrapolated to the full phase space to determine the total cross section for the production of beauty quark-antiquark pairs