Bronchial Anthracofibrosis Case with Endobronchial Tuberculosis

<p>We reported a case with bronchial anthracofibrosis and endobronchial tuberculosis. Our case demonstrated this possible correlation between anthracofibrosis and endobronchial tuberculosis. We showed this correlation visually and microbiologically.</p

Orthostatic hypotension and heart rate variability as indicators of cardiac autonomic neuropathy in diabetes mellitus

Aim: The aim of this study was to emphasize two different points in our work: 1) The well known importance of (subclinical) postural hypotension and reduced heart rate variability as (early) markers of autonomic neuropathy; 2) and the more controversial influence of diabetic control in their worsening. Methods: Two standard cardiovascular response tests (heart rate variability by respiration and orthostatic blood pressure changes) were carried out on 93 diabetic patients with prolonged QT interval in order to determine cardiac dysautonomy. QT segment duration was measured on electrocardiography recordings. Patients with HbA1c levels below 7 were considered as well-controlled diabetics. A cut off of 5 years was selected for the known duration of diabetes. The relations between cardiac autonomic neuropathy and diabetic control and the known duration of diabetes were determined. Results: The mean values for the known duration of diabetes and HbA1c level were 10±7.23 years and 9.5±2.3 mg/dl respectively. Median QTc differences, postural change in the systolic blood pressure, and changes of heart rate by respiration were 0.62 sec, 20 mmHg, and 6 beat/min, respectively. There was no difference in QTc values with respect to diabetes control but QTc values were significantly different with regard to the known duration of diabetes. Blood pressure variations with standing were significantly related to control as well as the known duration of diabetes. Variability of hearth rate with respiration on the other hand was significantly related to the duration but not to the control of diabetes. QTc showed a significant correlation with the known duration of diabetes, postural blood pressure changes, and heart rate variability with respiration. Conclusion: Clinician's should be more alert for the signs of autonomic neuropathy, especially in patients with a history of diabetes for more than five years. Special attention should be given to postural blood pressure changes and heart rate variability with respiration

Factors affecting the success of weaning in patients with chronic obstructive pulmonary disease

Objectives: Weaning failure rate was higher in patients with chronic obstructive pulmonary disease (COPD) and many factors affect it. The aim of this study was to investigate the factors affecting the success of weaning in COPD patients receiving invasive mechanical ventilation (IMV).Materials and methods: Totally 43 COPD patients who received IMV in intensive care unit were included. Clinical and laboratory results and Acute Physiology Assessment and Chronic Health Evaluation (APACHE II) scores were recorded and affecting factors on weaning success were investigated.Results: In 43 patients, 25 had successful weaning (58.1%). Patients with high APACHE II score prior to intubation was found as associated with weaning failure. High Glasgow coma scale (GCS) scores before entubation and weaning are associated with weaning success. Pre-weaning anxiety, positive endotracheal aspirate culture, pulmonary arterial pressure value, enteral feeding, pre-weaning tachycardia, pre-weaning cuff leaking and FiO2 values were found to be associated with weaning failure. Pre-weaning cortisol levels were associated with weaning success. In successful weaning group, measured NIF and VT in spontaneous mode were found as higher and f/VT ratio was lower compared with unsuccessful group. T-tube during the 15th and 30th minutes of the symptoms of fatigue (sweating assets) were associated with weaning failure. IMV duration and longer extubation duration of weaning, and more number of t-tube insertion attempts were found as associated with failure of weaning.Conclusions: Infection in patients with COPD, the presence of anxiety, and hemodynamic and respiratory instability significantly increases the weaning failure

The Effect Of Telithromycin On Inflammatory Markers In Chronic Obstructive Pulmonary Diseases

Aim : To evaluate the anti-inflammatory effect of telithromycin on sputum interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α), myeloperoxidase (MPO) levels in patient with chronic obstructive pulmonary diseases (COPD). Methods : Thirty four patients with mild to moderate COPD were enrolled in this prospective, single center, double-blind, placebo controlled study. Subjects received either telithromycin or placebo for 10 days. Before and after treatment period spirometric tests, arterial blood gas analyses were performed, sputum samples were taken for measurement of sputum inflammatory markers, and spu-tum was induced. Results : There was no statistical difference in baseline clinical or laboratory parameters between groups. After the treatment, the induced sputum IL-8, TNF-α, , MPO levels is similar compared with pretreatment levels. Conclusion : In this study, anti-inflammatory effects of telithro-mycin in stable COPD patients were not demonstrated. Further studies are needed to determine the clinical significance of these findings

G����S Duvar�N�N T�Berk�Loz Absesi

Chest wall is a rare involvement localization of tuberculosis, though uncommon are frequently seen in countries endemic to the disease. In this report, a tuberculosis case with chest wall involvement is presented.Hastalığın endemic olarak görüldüğü yerlerde bile göğüs duvarı tutulumu sık değildir, nadir tüberkuloz tutulum lokalizasyonudur. Bu bildiride, göğüs duvarı tutulumu olan bir vaka sunulmuştur

The relationship between patient age and sensitivity to known risk factors for asthma attacks

AMAÇ: Astım atağı nedeniyle yatırılarak tedavi edilen hastaların çeşitli risk faktörlerinin yaş gruplarına göre atak ağırlığındaki belir- leyiciliği ve ilişkisi araştırıldı.GEREÇ VE YÖNTEMLER: Astım atağı tanısıyla hastaneye yatırılan 80 hasta çalışmaya dâhil edildi. Olgular 65 yaş altı (n=36; 52,5±7,6) ve üstü (n=44; 72,5±5,2) olmak üzere 2 gruba ayrılarak değerlendirildi. Hastaların demografik özellikleri, astım başlangıç yaşı ve astım süresi, astım ağırlık derecesi, atak şiddeti, atopi, atopik hastalıklar, ilaç ve besin alerjisi, ek hastalıklar, son 1 ay ve 3 ay içindeki tedavi durumu, atak nedeni, yatış süresi, astım nedeniyle son 1 yıl içinde acil servis ve hastaneye yatış sayısı, astım nede- niyle yaşamı boyunca toplam hastaneye yatış sayısı kaydedildi. Hastaların yatış ve çıkışta solunum fonksiyon testleri ve arter kan gazları alındı. BULGULAR: Altmış beş yaş üstü hastalarda osteoporoz varlığı, küf mantarı için cilt testi pozitifliği, son 1 aydaki teofilin kullanımının atak ağırlığını artırdığı tespit edildi. 65 yaş üstünde astım ağırlığın- dan bağımsız olarak atak şiddetinin daha ağır olduğu tespit edildi. Son 1 ay ve son 3 ayda her iki yaş grubundaki hastaların düzensiz tedavi aldığı belirlendi. SONUÇ: Yaşlı astım hastalarında teofilin kullanımı, küf mantarı duyarlılığı, biomas maruziyeti gelecekteki astım ataklarını önle- mek için daha dikkatli sorgulanmalı ve rehberler doğrultusunda gerekli koruyucu önlemler önerilmelidir.OBJECTIVE: The characteristics of patients hospitalised for an asth- ma attack were evaluated to delineate the impact of age on sensitiv- ity to risk factors for this condition. MATERIAL AND METHODS: Eighty patients hospitalised for an asthma attack were included in this cross-sectional study. Patients were divided into two age groups; younger than 65-years-old (52.5&plusmn;7.6 years, n=36) and older than 65-years-old (72.5&plusmn;5.2 years, n=44). A questionnaire was used to collect data on demographics, initial age and duration of asthma, atopy, atopic diseases, drug and food allergies, additional diseases, treatments during the previous 1 and 3 months, cause of attacks, duration of hospital stay, number of emergency visits and hospitalisation due to asthma over the last year, and all past hospital stays. Pulmonary function tests were per- formed upon admittance and discharge, and parameters of arterial blood gases were recorded.RESULTS: The severity of asthma attacks was greater in the older cohort of patients with risk factors including osteoporosis, positive skin test for mould, or theophylline use in the previous month. In- dependent of these variables, the severity of attacks was greater in patients over the age of 65. Irregular treatments in both age groups were noted over the previous one and three months. CONCLUSION: Theophylline use, mould sensitivity and biomass exposure in elderly patients with asthma should be questioned more carefully and protective measures taken to avoid these risks in keep- ing with the recommended guidelines