The Effect of Smoking on Functional Parameters of Healthy Individuals

Worldwide, smoking is one of the preventable causes of death. It is a persistent health problem in Turkey and 43.5% of adult population is smoking. The aim was to study the effects of smoking on pulmonary function test, exercise capacity, dyspnea index and life quality. 139 cases, 83.5% of whom were men with mean age of 62 were evaluated; 36 cases (25.9%) were nonsmokers, 46 (33.1%) were smokers and 57 (41.0%) were ex-smokers. Spirometric measurements of smokers were found lower than that of both nonsmokers and ex-smokers. 6MWT distance, dyspnea index and oxygen saturation did not differentiate among nonsmokers, smokers and ex-smokers. Physical component score of SF36 life quality was not associated with smoking. Only mental component score of smokers was found lower than that of ex-smokers. 6MWT distance, dyspnea index, SpO(2) and life quality of cases whose exposure to smoking was = 50 package-year was not different than nonsmokers and cases with = 50 package-year exposure to smoking; however, dyspnea index and SpO2 were found significantly high and significantly low respectively. There were losses in exercise capacity, dyspnea perception and life quality of smokers and these functional losses were associated with the level of exposure to smoking

The importance of the at risk COPD patients (Stage 0) and clinical differences

Chronic obstructive pulmonary disease (COPD) is an important world health problem and estimated that the prevalance will increase. In early period this disease in symptomatic with cough, sputum and dyspnea. FEV1/FVC was greater than 70% in early period and it was accepted as stage 0 (at risk) COPD before the last The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline. In last GOLD guideline this stage is excluded. In this study we aimed to find out the clinical differences between this cases and healty population. Prospectively spirometric measures, exercise capasity, dyspnea index, saturation of O-2 (SpO(2)) and life quality are compaired between two groups. We evaluated 58 at risk cases and 63 healty adults. There was no difference between two groups about age, sex and smoke sessations. In at risk group 77.6% cough, 53.4% sputum and 62.1% dyspnea were the symptoms. In curently smokers cough and sputum were dominant symptoms however dyspnea was dominant symptom in exsmokers. Absolute FEV1, FEF25-75 values, predicted FEV1/FVC, FEV1, FVC, PEF, FEF25-75 % values are lower in at risk group (p0.05). Dyspnea index before walking were not different between two groups (p>0.05) however dyspnea index after walking and change were higher in at risk group (p>0.05). Resting SpO(2), SpO(2) after exercise and desaturation with exercise (Delta SpO(2)) were lower in at risk group but not statisticaly significant. Physical and mental components of Short Form 36 (SF36) scores were similar in two groups (p>0.05). COPD at risk group is seperated from healty population with chronic respiratory symptoms and inhalation of smoke or other irritans. In these cases spirometric measures are significantly worse although functional parametres are similar with healty population, so it is thought about being a subclinical disease. These cases must be educated about COPD, encouraged about giving up smoking and prevented occuring COPD

Pleural empyema due to Salmonella typhi

65 years old female was admitted to hospital with fever, purulant sputum and dispnea. The patient has hepatic chirosis secondary to autoimmun hepatitis and hepatocelluler carsinoma. Immunosupressive treatment is used for autoimmun hepatitis. In physical examination matite and diminished respiratory sounds were determined at right hemithorax. Ascitis was determined in abdominal examination. Chest X-ray showed pleural effusion in right hemithorax. Seroushemoragical fluid was aspirated by thorasynthesis. Pleural fluid pH was 6.9 and had an exudative nature. The patient was the diagnosed as empyema. Right tube thorachostomia was performed and sulbactam-ampicillin 6 g/day therapy was started. In patient's ascit fluid no bacteria and leucocytes was seen. Salmonella typhi was isolated from pleural fluid. No microorganisms were isolated from ascit fluid, urine and stool culture. Klebsiella pneumoniae is isolated in patient's hemoculture. Clinical improving was detected. Chest X-ray showed totaly regretion of pleural fluid and the tube thoracostomy removed. We presented this case because of rarely seen microorganism (S. typhi) in immuncompromised patients a cause of pleural empyema which is frequently seen gastrointestinal infections

Radiological, Clinical and Laboratory Findings in Patients with Pulmonary Thromboembolism

Aim: Pulmonary thromboembolism (PTE) remains an important cause of mortality and morbidity. We aimed to analyse symptoms, radiological, clinical and laboratory findings on admission in patients with PTE

Community acquired pneumonia and direct hospital cost

In Turkey, there is inadequate data about the direct or indirect cost of community acquired pneumonia (CAP). This study aims to identify the clinical, laboratory, and radiological properties, direct hospital costs of CAP, and the factors that affect these costs. Grouping of the subjects and cost analysis were evaluated in accordance with Pneumonia Severity Index (PSI) and 'Turkish Thoracic Society (TTS) CAP Guideline'. 114 cases with an average age of 70.9 were analyzed retrospectively. Average hospital stay was 11.0 +/- 6.6 days. Three of the cases that appeared to be in group IIIb in accordance with TTS CAP Guideline, and that had a PSI score of 102.7 died. Average costs of medicine was 484.59 Euro, radiology costs were 65.38 Euro, laboratory costs were 329.38 Euro and the total cost was 1630.77 Euro. In group IIIb cases, costs of medicine and the total costs were higher than other groups. Radiological, laboratory and the total costs were not determined to be different among cases that did or did not conform to initial treatment guidelines (p> 0.05). There were no effect of gender and advanced age (>= 65 years) on total cost (p> 0.05). Existence of a comorbid disease was detected to have increased the total cost (p= 0.003). Total costs according to PSI scoring were 1274.60 Euro in low-risk group, and 1929.49 Euro in high-risk group (p= 0.04). Hospital mortality due to CAP was 2.6%

Etiology and Epidemiology of Community-Acquired Pneumonia in Turkey

OBJECTIVES: Due to its prevalence and mortality, Community Acquired Pneumonia (CAP) poses a significant health issue. Epidemiological data is crucial in deciding empirical treatment. Since sufficient knowledge of CAP epidemiology is not available in Turkey, this study has been planned

Microbiological results of bronchoalveolar lavage that was performed for opportunistic pulmonary infections

Between 2001-2002; in 62 cases, 33 (53%) male, 29 (47%) female, mean age 51.4 +/- 18.1 years) bronchoalveolar lavage (BAL) was performed for diagnosis of opportunistic pulmonary infection and specimens were evaluated for results of microbiological examinations. There was hematological malignancy in 18 (29%) and solid organ malignancy in 13 (21%) cases. Thirty-one (50%) cases were immuncompromised for reasons other than malignancy. By endoscopic evaluation endobronchial lesion was seen in 2 (3%) cases, indirect tumor signs were seen in 2 (3%) cases and signs of infection were seen in 11 (18%) cases. Fortyseven (76%) cases were endoscopically normal. Acid-fast bacilli (AFB) direct examination was positive in 3 (5%) cases. In 4 (6%) cases mycobacterial culture was positive, Mycobacterium tuberculosis-polymerase chain reaction (PCR) was also positive in these four cases. Examination of Gram-stained smears for bacteria was associated with infection in 14 (23%) cases. Bacteriologic cultures were positive for single potential pathogen in 10 (16%) cases, and for mixed pathogens in 7 (11%) cases for a total number of 17 (27%). Fungal cultures were positive in 3 (5%) cases all of which had hematological malignancy. As a result in 24 (39%) cases microbiological agent of infection is determined: in four mycobacteria, in 17 bacteria other than mycobacteria and in three fungi