Mean platelet volume is associated with disease severity in patients with obstructive sleep apnea syndrome

OBJECTIVE: Obstructive sleep apnea syndrome is associated with cardiovascular diseases and thromboembolic events. The mean platelet volume (MPV) is a predictor of cardiovascular thromboembolic events. The aim of the present study is to investigate the association between the MPV and disease severity in patients with obstructive sleep apnea syndrome. METHODS: We prospectively included 194 obstructive sleep apnea syndrome patients without cardiovascular disease (mean age 56.5±12.5 years) who were undergoing sleep tests. An overnight full laboratory polisomnography examination was conducted on each patient. The patients were divided into 3 groups according to the apnea-hypopnea index (AHI): (1) AHIlow group: 5≤AH

Biventricular Myocardial Performance Is Impaired in Proportion to Severity of Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is an independent risk factor for cardiovascular morbidity and death. Little information is available regarding the relationship between the severity of OSA and myocardial performance in OSA patients who have normal ejection fractions. We prospectively investigated this relationship, using the tissue-Doppler myocardial performance index (TD-MPI). We conducted overnight, full-laboratory polysomnographic examinations of 116 patients, and calculated the left and right ventricular TD-MPIs. Patients were classified into 3 groups in accordance with their apnea-hypopnea index (AHI) levels: AHImild (≥5 to \u3c15), AHImoderate (≥15 to \u3c30), and AHIsevere (≥30). Left and right ventricular TD-MPI values were higher in the AHIsevere group than in the AHImild and AHImoderate groups (all P \u3c0.05). In addition, right ventricular TD-MPI values in the AHImoderate group were higher than those in the AHImild group (P \u3c0.05). Right ventricular TD-MPI was significantly associated with AHI (β=0.468, P \u3c0.001), left ventricular TD-MPI, and right ventricular early-to-late filling velocities (E/A ratio) in multiple linear regression analysis. On the other hand, left ventricular TD-MPI was significantly associated with right ventricular TD-MPI and left ventricular E/A ratio (both P \u3c0.05). Our results show that OSA severity, determined by means of AHI, is independently associated with impaired right and left ventricular function as indicated by TD-MPI in patients who have OSA and normal ejection fractions

Right Heart Thrombi Accompained with Pulmonary Embolism

Aim: Right sided heart thrombus (RSHT) is rarely seen. It is generally detected during transthoracic echocardiographic (TTE) examination or multislice thoracic computed tomographic scanning for pulmonary embolism (PE). Although RSHT and PE secondary to this situation is rare, mortality during the course of process is very high. We aim to aproach right cardiac trombus and determine the results of treatment. Method: In this study 25 patients hospital records were investigated retrospectively. The data obtained consisted of diagnostic methods, presence of shock state, treatments applied and results were assessed. Results: Th present study revealed that the 32% of patients had been admitted to hospital in shock state, hospital mortality rate was 24%, and this mortality rate was not affected by different treatment choices. Conclusion: The exact incidence of RSHT is unknown. It is reported that the probability of seeing a case suffering from RSHT during echocardiographic examination performed to diagnose the PE is 9%. RSHT may cause PE anytime and requires urgent treatment. In our study, we determined that the hospital mortaliy did not change with the type of given treatment and overall mortality was determined as 24%. There are no sufficient studies searching large series on RSHT in literature. Therefore, there is no agreement on treatment tecniques

The relationship between serum ferritin levels and serum lipids and HDL function with respect to age and gender

Elevated serum ferritin (SFer) levels have been associated with chronic diseases such as coronary heart disease and diabetes mellitus type 2. The aim of this study was to examine the relationship between SFer levels and serum lipid parameters, and how this relation changes in terms of age and gender. Additionally, we investigated a possible relationship between SFer levels and high-density lipoprotein (HDL) function. SFer levels and lipid panel (total cholesterol (TC), triglyceride (TG), low-density lipoprotein-cholesterol (LDL-C) and HDL-C) of 4205 people (3139 women, 1066 men) were examined retrospectively. Study population was classified according to age and gender. Separately, 100 subjects (52 women, 48 men) were randomly recruited to investigate the relation between SFer levels, and HDL dependent paraoxonase-1 (PON1) and arylesterase (ARE) activities. In all age groups, women’s SFer levels were found to be significantly lower and HDL-C levels significantly higher compared to men. In the 50-70 ages range, TC and LDL-C levels of women were found to be significantly higher than those of men (P < 0.01). SFer levels tended to increase with age in women. Correlation analyses revealed a negative correlation between levels of SFer and HDL-C, while positive correlations existed between levels of SFer, and TC, TG and LDL-C. There was no significant correlation between SFer levels and PON1 or ARE activities. The finding that increased SFer levels are accompanied by increased serum TC, TG and LDL-C levels may help us to explain the increased risk of metabolic disorders and cardiovascular disease in postmenopausal women

Endobronchial Actinomycosis Mimicking Lung Cancer: A Case Report

Pulmoner aktinomikozis genellikle orofarengeal sekresyonlarda bulunan organizmanın aspirasyonu sonucu oluşmaktadır. Akciğerde kitle lezyon, pnömonik lezyon ve/veya plevral tutuluma neden olmakla birlikte endobronşial lezyon oldukça nadir görülmektedir.63 yaşında sigara içmeyen erkek hasta 6 aydır devam eden kuru öksürük, eforla gelen nefes darlığı ve hırıltılı solunum şikayetleri ile kliniğimize başvurdu. 15 yıldır tip-2 diabeti olan hastanın toraks bilgisayarlı tomografisinde; sağ orta lobda kısmi kollaps ile sağ diafragma konturunda elevasyon vardı. Bronkoskopide; sağda intermediyer bronşta endobronşial lezyon izlendi. Biyopsi sonucunda malignite bulgusu yoktu, aktinomikozis kolonilerine rastlandı. 21 günlük oral penisilin temelli antibiyotik tedavisi sonucunda hastanın şikayetlerinde gerileme saptandı. Kontrol amaçlı yapılan bronkoskopik incelemede lezyonlarda belirgin gerileme izlendi. Sonuç olarak, endobronşial lezyonların ayırıcı tanısında, özellikle immünsüpresif hastalık varlığında, mantar enfeksiyonları da akılda tutulmalıdır.Pulmonary actinomycosis is usually occured as a result of aspiration of the organism contained in the oropharingeal secretions. It could cause a pulmonary mass, pneumonia or pleural involvement and also rarely an endobronchial lesion. A 63 year old nonsmoker male patient admitted our clinic with complaints of dry cough, dyspnea and wheezing which have been continiuing for 6 months. The patient with type 2 diabetes mellitus for 15 years had a partial collapse in right middle lobe and elevation at right diafragma contour in computerized tomography of the thorax . An endobronchial lesion in the intermediate bronchi was viewed with fiberoptic bronchoscopy. Biopsy result showed no finding of malignancy, colonies of actinomycosis were seen. As a result of oral penicillin based antibiotic therapy for 21 days, radiological and clinical regression were detected. A prominent regression was seen in the lesions at control bronchoscopy.As a result, for the differantial diagnosis of endobronchial lesions, especially if immunosupressive disease is present, fungal infections should also be kept in mind

Tracheobronchopathia osteochondroplastica: İki olgu ve literatürün incelenmesi

Tracheobronchopathia osteochondroplastica (TO) nadir görülen bir hastalıktır. Genellikle 50 yaş üstü insanları etkiler ve klinik belirtiler obstrüküf ve infeksiyöz komplikasyonlar olunca ortaya çıkar. Bu makalede, kronik öksürük nedeniyle başvuran 50 yaşında bir kadın hasta ile hemoptizi ve kronik öksürük nedeniyle başvuran 42 yaşında bir erkek hastayı inceledik, iki olguda da bronkoskopide TO'nun tipik görünümü vardı. Alınan bronşiyal biyopsi örneklerinde kemik yapılaşması dikkati çekiyordu. Nedeni açıklanamayan kronik öksürük, hemoptizi, atelektazi ve tekrarlayan infeksiyonlarda TO mutlaka düşünülmelidir.Tracheobronchopathia osteochondroplastica (TO) is an unusual disorder. It mainly affects men over 50 years old and clinical manifestations are observed when obstructive or infectious complications occur. A 50-year old woman was investigated because of productive cough and 42 years old man was investigated because of haemoptysis. In two cases, at bronchoscopy, the typical picture of TO-was observed. Microscopic examination of the biopsy material revealed bone formation. TO should be considered in the differential diagnosis as an unusual cause of chronic persistent chough, haemoptysis, persistent atelectasis, and recurrent segmental or lobar infection

Mean Platelet Volume Decreases in Adult Patients With Obstructive Sleep Apnea After Uvulopalatal Flap Surgery

SIMSEK, GOKCE/0000-0001-5281-0986WOS: 000367905900025PubMed: 26468800Aim:The main purpose of the study was to investigate changes in mean platelet volume (MPV) values in patients with obstructive sleep apnea syndrome (OSAS) who had undergone uvulopalatal flap (UPF) surgery.Method:The study included a review of the medical records of 37 adult patients who had undergone UPF surgery after being diagnosed with OSAS. The baseline blood parameters of patients, including the MPV and platelet distribution width (PDW) values, were measured and repeated 3 months after treatment. Polysomnographic evaluations of the patients were also performed during admission and the 3rd month control. Comparisons of MPV values and their correlation with polysomnographic parameters were the main outcomes measured.Results:The blood parameters of all patients were similar except for MPV values, which were significantly lower after treatment (P0.05).Conclusion:The UPF surgery, which is a relatively simple surgical intervention to treat OSAS, alleviates nocturnal hypoxic episodes and lowers platelet volume. These may both be important predictors of adverse cardiovascular outcomes related to OSAS

Chronic pulmonary disease in rural women exposed to biomass fumes

Introduction: Biomass (organic) fuels cause indoor air pollution when used inside dwellings. We evaluated the frequencies of chronic obstructive pulmonary disease (COPD) and chronic bronchitis (CB) among rural women using biomass fuels for heating and cooking and compared them to women living in urban areas where such fuels are not used. Methods: From electoral lists we randomly selected 242 women living in rural areas near Kayseri, Turkey and 102 women living in apartments in the city having central heating and cooking with fuels other than biomass ones. Using a translated version of the American Thoracic Society questionnaire, with additional questions from the British Medical Research Council questionnaire, trained interviewers conducted personal interviews. They also collected information on fuels used for cooking and heating. All study subjects underwent a physical examination and measurement of pulmonary function. Results: We found that rural women were younger than urban women (mean age [and standard deviation], 40.5 [14.1] yr v. 43.6 [11.9] yr). More urban than rural women were current (14.7% v. 4.5%, p < 0.001) or past (11.8% v. 1.2%, p < 0.001) smokers. CB was more prevalent among rural women than urban women (20.7% v. 10.8%, p < 0.03). Similarly, COPD was more prevalent in rural women (12.4% v. 3.9%, p < 0.05). Although the pulmonary function tests were within normal limits, FEV1 values in rural women were found to be relatively low compared with those of urban women (p < 0.05). Interpretation: Rural women exposed to biomass fumes are more likely to suffer from CB and COPD than urban women even though the prevalence of smoking is higher among the latter group

Effects of Omalizumab Treatment on Some Biomarkers in Severe Allergic Asthma Patients

Objective: The mechanism of biological treatment molecule called omalizumab used in asthma treatment is thought to be versatile; however, the mechanism still remains unknown. This study was undertaken in severe asthma patients underwent omalizumab treatment, in order to investigate the relationship between biomarker expression and disease characteristics related to the immune system. Methods: Consecutive patients with severe asthma disease (n=15; Group IA, pretreatment and Group IB, post-treatment) underwent omalizumab treatment. Control group was age- and sex-matched including 25 healthy in Group II. Blood samples from both the groups were taken during their first visit (Group IA and II) and then after 12 months of treatment in asthmatic patients (Group IB). Serum levels of homocysteine (Hcy), eosinophil cationic peptide (ECP), 25-hydroxyvitamin D (25(OH)D), interleukin-1β (IL-1β), soluble OX2 (sCD200) and clinical follow-up tests including fractional exhaled nitric oxide (FeNO), asthma control test (ACT), and pulmonary function tests were evaluated. Results: After the treatment, 25(OH)D levels and pulmonary function tests, including forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) levels, were significantly increased. Furthermore, total immunoglobulin E (IgE), Hcy, ECP, FeNO, and sCD200 levels were dramatically diminished. Regression analysis revealed positive correlations between ACT-FEV1 and ACT- FVC and between FeNO-age and FeNO-ECP for Group IA patients. Negative correlations were detected between ACT-IgE, age-FEV1, FeNO-FEV1, and FeNO-FVC for Group IA patients. Conclusion: Our results suggest that the potential use of serum biomolecules in concordance to the clinical status of the asthmatic patients might be a follow-up tool for the omalizumab therapy

Aortic stiffness increases in proportion to the severity of apnoea-hypopnea index in patients with obstructive sleep apnoea syndrome

WOS: 000379940400007PubMed: 25401950Background and AimsObstructive sleep apnoea syndrome (OSA) and aortic stiffness are associated with an increased risk of cardiovascular morbidity and mortality. Although aortic stiffness increased in patients with OSA, the relationship between severity of OSA indicated with apnoea-hypopnea index (AHI) and aortic stiffness was not investigated in previous studies. The aim of this study is to investigate the relationship between the severity of OSA and aortic stiffness. MethodsIn the present study, 90 consecutive OSA patients definite diagnosed with sleep test were prospectively included (mean age 54.511.6 years). Aortic pulse wave velocity (PWV) and augmentation index (AIx) were calculated using the single-point method via the Mobil-O-Graph (R) ARCsolver algorithm. Aortic distensibility (AD) was calculated from the echocardiographically derived ascending aorta diameters and haemodynamic pressure measurements. Overnight full-laboratory polysomnography examination was conducted on each subject. Patients were classified into two groups according to their median AHI values (AHI(low) and AHI(high) groups). ResultsPWV values were higher and AD values were lower in AHIhigh group compared with AHIlow group (P<0.05, for all). AHI was associated with body mass index (BMI), systolic blood pressure, pulse pressure, aortic diameter, AD, AIx and PWV in bivariate analysis (P<0.05, for all). Multivariate linear regression analysis showed that AHI was independently associated with BMI (=0.175, P=0.047), PWV (=0.521, P<0.001) and aortic distensibility (=-0.223, P=0.020). ConclusionsAortic stiffness is associated both with the presence and the severity of OSA