A Correlation Between Quantitative Measurement Parameters of Thorax Computed Tomography and Pulmonary Function Test: A Retrospective Study

Aim:Pulmonary functional and volumetric evaluation is routinely performed with pulmonary function test (PFT). However, volumetric evaluation is also possible in computed tomography (CT) imaging. The aim of this study is to examine the relationship between PFT and CT volumetric findings.Materials and Methods:Between April 2017 and May 2020, a total of 69 patients (34 males, 35 females) having thorax CT (without any parenchymal disease) and PFT were studied retrospectively. The images and PFT examinations with an optimum quality were enrolled. In CT, the volume and density of both lungs as well as total lung volume (TLV) and total lung density (TLD) were calculated. Forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio were recorded for the assessment with CT.Results:In a total of 69 patients (34 male, 49.3%; 35 female, 50.7%), the mean age was 55±14.56 years, FEV1=2.12±0.87, FVC=2.92±1.05, FEV1/FVC ratio=72.19±13.07, right lung volume=2118.06±662.36, right lung density=-806.8±68.16, left lung volume=1755.35±605.02, left lung density=-774.80±248.98, TLV=3820±1272.35 and TLD=-1597.17±295.70. FEV1, FVC and FEV1/FVC ratio showed a positive correlation with bilateral (right and left) lung volume and density (p<0.05).Conclusion:PFT provides important quantitative pulmonary functional data that can evaluate the severity and course of diseases causing respiratory symptoms. However, in cases where PFT cannot be performed (such as Coronavirus Disease-2019), CT quantitative pulmonary volumetric evaluation can be an alternative in the evaluation of main pulmonary functions

Acute Lung Toxicity Due to Nitrofurantoin Use: with a Case

5-nitrofuran türevi olan nitrofurantoin, kadın hastalarda komplikasyonsuz idrar yolu infeksiyonlarının tedavisinde ilk seçenektir. Kullanımında önemli yan etkiler bildirilmiştir ve bunlar arasında dozdan bağımsız olarak akciğer tutulumu da mevcuttur. Akut pulmoner reaksiyonlar genellikle nitrofurantoinin başlangıcından sonraki 3-8 gün içinde gelişir, ancak ilk dozdan birkaç saat ila 4 hafta sonra da ortaya çıkabilir. Bu olgu sunumunda, nitrofurantoin kullanımına bağlı, akut akciğer toksisitesi gelişen bir hasta sunulmuştur.Nitrofurantoin, a 5-nitrofuran derivative, is the first choice in the treatment of uncomplicated urinary tract infections in female patients. Significant side effects have been reported in its use, including lung involvement independent of dose. Acute pulmonary reactions usually develop within 3-8 days after start using nitrofurantoin. However, it can also occur a few hours to 4 weeks after the first dose. In this case report, a patient with acute lung toxicity due to nitrofurantoin use will be presented

Desquamative interstitial pneumonia: Risk factors, laboratory and bronchoalveolar lavage findings, radiological and histopathological examination, clinical features, treatment and prognosis

Desquamative interstitial pneumonia is a type of smoking-associated major idiopathic interstitial pneumonia, which is characterized by accumulation of alveolar macrophages in alveolar lumens and septa and develops secondary to mainly active or passive exposure to cigarette smoke. Desquamative interstitial pneumonia mostly occurs in male smokers in association with non-specific symptoms responsive to steroid therapy and has a better prognosis than usual interstitial pneumonia. To date, no large-scale clinical studies have been performed on desquamative interstitial pneumonia patients. Factors responsible for the scarcity of data on the clinical course of this condition include the retrospective nature of the available information as well as its rare occurrence. Despite this, a general consensus exists as to the nature of its symptoms, association with smoking, age and gender distribution, findings of respiratory function tests, steroid responsivity and mortality. The objective of the present review article was to report on desquamative interstitial pneumonia and to describe its etiology, risk factors and clinical features, as well as the laboratory, bronchoalveolar lavage, radiological and histopathological findings, and the treatment and prognosis of affected patients

Relationship between serum soluble endothelial protein C receptor level and COVID-19 findings

Coronavirus-related disease-2019 (COVID-19)-associated coagulopathy presents predominantly with thrombosis and leads to complications in close association with inflammatory process. Soluble endothelial protein C receptor (sEPCR), which is the soluble form of EPCR, reduces the anticoagulant and anti-inflammatory activity of activated protein C. The purpose of this study is to investigate the relationship between sEPCR and the laboratory parameters and thorax computed tomography (CT) findings in the course of COVID-19. Twenty-five laboratory-confirmed [reverse transcription-quantitative polimerase chain reaction (RT-qPCR) positive] and 24 clinically diagnosed (RT-qPCR negative) COVID-19 patients were enrolled in the study. Blood specimens were collected for sEPCR and haematological and biochemical parameter measurement. Thorax CT was performed to detect COVID-19 findings. These parameters from RT-qPCR positive and negative patients were then compared. Although there was no difference between the groups in terms of symptoms, the time between the onset of symptoms and the admission time was shorter in RT-qPCR positive group (P?=?0.000). sEPCR levels were significantly higher in the RT-qPCR positive group (P?=?0.011). Patients with ground-glass opacity and bilateral involvement on thorax CT have higher serum sEPCR levels (P?=?0.012 and 0.043, respectively). This study has shown for the first time that serum sEPCR levels, which is a member of coagulation cascade and has also been reported to be associated with inflammation, is higher in patients with positive RT-qPCR test and patients with GGO or bilateral involvement on thorax CT regardless of the PCR result. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved

Effect of CPAP on New Endothelial Dysfunction Marker, Endocan, in People With Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is associated with increased cardiovascular (CV) morbidity and mortality. Endocan is a surrogate endothelial dysfunction marker that may be associated with CV risk factors. In this study, we tested whether serum endocan is a biomarker for OSA. Serum endocan levels were measured at baseline in 40 patients with OSA and 40 healthy controls and after 3 months of continuous positive airway pressure (CPAP) treatment in the patients with OSA. All participants were evaluated by full polysomnography. Flow-mediated dilatation (FMD) and carotid intima media thickness (cIMT) were measured in all participants. Endocan levels were significantly higher in patients with OSA than in healthy controls. After adjusting confounders, endocan was a good predictor of OSA. Endocan levels correlated with OSA severity (measured by the apnea-hypopnea index [AHI]). After 3 months of CPAP treatment, endocan levels significantly decreased. Endocan levels were significantly and independently correlated with cIMT and FMD after multiple adjustments. The cIMT and FMD also had significant and independent correlation with AHI. Endocan might be a useful marker for the predisposition of patients with OSA to premature vascular disease.NHLBI NIH HHSUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Heart Lung & Blood Institute (NHLBI) [R01 HL085188, K24 HL093218, T32 HL134632, K24 HL132105] Funding Source: Medline; NATIONAL HEART, LUNG, AND BLOOD INSTITUTEUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Heart Lung & Blood Institute (NHLBI) [R01HL085188, K24HL093218, T32HL134632, K24HL132105] Funding Source: NIH RePORTE

Swyer-James (Macleod) syndrome: a case report

42 yaşında erkek hasta nefes darlığı ve öksürük şikayetleri ile başvurdu. Posterior Anterior (PA) akciğer grafisinde sol akciğerde belirgin havalanma artışı mevcut olan hastaya, ventilasyon- perfüzyon sintigrafisi, bilgisayarlı toraks tomografisi, toraks manyetik rezonans (MR) anjiyografi bulguları ile ‘Swyer-James (Macleod) sendromu’ tanısı konuldu. Nadir görülen bir sendrom olması nedeniyle son literatür bilgileri ışığında sunmayı uygun gördük.A fourty two-year old male patient applied wih complaints of cough and dispnea. As there was evident hyperinflation in left lung on posterior-anterior (PA) chest roentgenogram, the patients was diagnosed to have Swyer-James (Macleod) syndrome using the findings on ventilation/perfusion scintigraphy, computerised thorax tomography and magnetic resonans (MR) angiography of thorax. We presented the case with the latest literature update as it is a rarely encountered syndrome

Serum fetuin-A levels are associated with carotid intima–media thickness in patients with normotensive chronic obstructive pulmonary disease

Background: There are contradictory reports about the relationship between fetuin-A and atherosclerotic process. Coronary artery disease is the most important cause of mortality in patients with chronic obstructive pulmonary disease (COPD). We aimed to investigate the association of serum fetuin-A level with mean carotid intima–media thickness (cIMT) and ankle-brachial index (ABI) in COPD. Methods: We evaluated the association of serum fetuin-A level, mean cIMT and ABI in normotensive subjects with COPD (n = 65) and with non-COPD (n = 50). Results: Fetuin-A level was significantly lower (63.5 ± 19.8 ng/mL, 72.9 ± 16.2 ng/mL, p = 0.035) and C-reactive protein level higher (4 [1–10] vs. 3 [1–12] mg/dL, p = 0.034) in COPD patients than the control group. Compared to controls, fetuin-A level was significantly lower (63.5 ± 19.8 ng/mL, 72.9 ± 16.2 ng/mL, p = 0.035) and mean cIMT higher (0.69 [0.50–0.98] vs. 0.62 [0.44–0.98] mm, p = 0.034, respectively) in the COPD group. There was a significant negative correlation between mean cIMT and fetuin-A levels (r = –0.320, p = 0.032). Age (b ± SE: 0.002 ± 0.001, p = 0.008) and fetuin-A (b ± SE: –0.002 ± 0.001, p = 0.035) were decisive for the mean cIMT. Conclusions: There are increased cIMT values, decreased fetuin-A levels, but unchanged ABI values in patients with normotensive COPD. Age and fetuin-A were predictors for cIMT, while fetuin-A was negatively correlated with cIMT

Serum fetuin-A levels are associated with carotid intima-media thickness in patients with normotensive chronic obstructive pulmonary disease

Background: There are contradictory reports about the relationship between fetuin-A and atherosclerotic process. Coronary artery disease is the most important cause of mortality in patients with chronic obstructive pulmonary disease (COPD). We aimed to investigate the association of serum fetuin-A level with mean carotid intima-media thickness (cIMT) and ankle-brachial index (ABI) in COPD. Methods: We evaluated the association of serum fetuin-A level, mean cIMT and ABI in normotensive subjects with COPD (n = 65) and with non-COPD (n = 50). Results: Fetuin-A level was significantly lower (63.5 +/- 19.8 ng/mL, 72.9 +/- 16.2 ng/mL, p = 0.035) and C-reactive protein level higher (4 [1-10] vs. 3 [1-12] mg/dL, p = 0.034) in COPD patients than the control group. Compared to controls, fetuin-A level was significantly lower (63.5 +/- 19.8 ng/mL, 72.9 +/- 16.2 ng/mL, p = 0.035) and mean cIMT higher (0.69 [0.50-0.98] vs. 0.62 [0.44-0.98] mm, p = 0.034, respectively) in the COPD group. There was a significant negative correlation between mean cIMT and fetuin-A levels (r = -0.320, p = 0.032). Age (beta +/- SE: 0.002 +/- 0.001, p = 0.008) and fetuin-A (beta +/- SE: -0.002 +/- 0.001, p = 0.035) were decisive for the mean cIMT. Conclusions: There are increased cIMT values, decreased fetuin-A levels, but unchanged ABI values in patients with normotensive COPD. Age and fetuin-A were predictors for cIMT, while fetuin-A was negatively correlated with cIMT

Carotid intima‐media thickness in chronic obstructive pulmonary disease and survival: a multicenter prospective study

Introduction: Chronic obstructive pulmonary disease (COPD) is associated withincreased cardiovascular morbidity and mortality. Carotid intima-media thickness(CIMT) is a noninvasive method assessing atherosclerosis.Objective: It was aimed to determine relationship and survival between COPD andCIMT.Methods: CIMT was measured using Doppler ultrasound (USG) in 668 stable COPDpatients at 24 centers. Patients were followed-up for 2 years.Results: There were 610 patients who completed the study. There were 200 patientsCIMT with 0.05).Conclusion: This study is the first regarding CIMT with combined GOLD assessmentgroups. It has revealed important findings supporting the increase in atherosclerosisrisk in COPD patients. We recommend Doppler USG of the carotid artery inCOPD patients at severe stages

The Trend of Tuberculosis in Tekirdağ

AimThe incidence rate of tuberculosis (TB) is estimated by the World Health Organization as 128/100.000 worldwide. The main principles of TB control are early case detection and diagnosis, followed by directly observed treatment of patients. The aim of this study was to analyse the dynamics of TB between 2007 and 2011 in Tekirdağ.Material and MethodsData were obtained from TB dispensaries and separated into oneyear categories. Case notification rates were analysed by different age groups (0–14, 15–24, 25–44, 45–64, 65 and above). The patients were divided into two groups according to involved organs: pulmonary (smear/culture positive=PSP and smear/culture negative/unknown=PSN/U) and extrapulmonary. Antibiotic susceptibility tests to major antituberculosis drugs were performed on M. tuberculosis strains that were grown in culture and suspected of being resistant. Resistance to both INH and rifampicin were accepted as multiple drug resistance tuberculosis (MDR-TB).ResultsA total of 162.291 patients were examined, and out of this population, 1311 (0.8%) tuberculosis patients were evaluated. The distribution of case notification rates by year were 44.6%, 34.6%, 33.4%, 28.6%, and 27.6%from 2007 to 2011, respectively. Pulmonary and extrapulmonary TB rates were 74.5%(46.0%PSP and 28.5%PSN/U) and 25.5%, respectively. Extrapulmonary TB rates were 42.3% and 17.6% in men and women, respectively. Resistance rates against INH, rifampicin, ethambutol, and streptomycin were 21.6%, 8.8%, 1.6%, and 6.4%, respectively. The MDR-TB rate was 6.4%.ConclusionSystematic implementation of directly observed treatment programs plays an important role in decreasing TB incidence. Because the TB rates in our region are above the average for Turkey, screening and follow-up procedures must be conducted more stringently and regularly