Henri Temianka Correspondence; (spivakovsky)

https://digitalcommons.chapman.edu/temianka_correspondence/2868/thumbnail.jp

THE RELATIONSHIP BETWEEN SERUM URIC ACID LEVELS AND EARLY MORTALITY IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE CASES DURING EXACERBATION

Aim: In this study, it was aimed to compare the levels of serum uric acid and uric acid/creatinine ratios in patients with COPD during an attack or in stable COPD, and to show whether serum uric acid and uric acid/creatinine ratios are associated with early mortality in COPD patients during an acute attack. Materials and Methods: In this study, COPD acute attack (n=155) and stable COPD (n=30) patients were evaluated. The data of these patients were obtained from patient files and computer records. COPD diagnosis and severity assessment were made according to the GOLD 2006 guideline. Participants??? age, gender, body mass index, pulmonary function test, arterial blood gas, uric acid, creatinine values and comorbidity information were recorded in the previously prepared Case Data Form. In 2012, when we conducted this study, gold 2006 was taken as the guideline for spirometry measurement, but spirometric measurements determined with reference values determined according to age, height and gender, and FEV1/FVC measurement 7 mg/dl for men) and uric acid/ creatinine ratio (median value 7.10). Since the upper limit of the uric acid value measured in the blood is 6 mg/dl in women and 7-8 mg/dl in men, the cut-off points for uric acid (>6 mg/dl for women and >7 mg/dl for men) were determined in our study. According to this categorization, it was determined that there was no statistically significant relationship between uric acid level (odds ratio 2.985 [95% confidence interval 0.61814,151]) and early mortality risk. Conclusion: The results of this study showed that the uric acid and uric acid/ creatinine levels in the attack group were higher than the levels in the stable group, but these parameters were not associated with early mortality

The outcome of tuberculosis in patients on chronic hemodialysis

Aim: In patients on regular hemodialysis, the incidence of tuberculosis is high. Material: We present 18 (6.08%) tuberculosis patients among 296 patients on regular hemodialysis between 1980 and 1996. Results: Pulmonary tuberculosis was seen in 11 (61%) patients, 7 (38%) of whom presented with pleural effusion. Tuberculosis was extra-pulmonary in 7 (38%) patients. There were 4 (22.2%) patients with tuberculous lymphadenitis, 2 (11.1%) with tuberculous peritonitis, 1 (5.5%) with urinary tuberculosis. Intermittent fever, malasia and dyspnea were the most common symptoms. The mean duration on hemodialysis before diagnosis of tuberculosis were 22.22 ± 7.19 months and the mean duration of symptoms prior to treatment were 34.16 ± 3.36 days. Tuberculosis was diagnosed in 10 (55.5%) patients within the first 4 months of dialysis and in 8 (44.4%) between the 1st and the 8th year of hemodialysis treatment. Our patients were treated with isoniazid, rifampicin, morfazinamid and ethambutol. Four patients died within the first 4 months of the antituberculosis therapy, in all of whom tuberculosis was diagnosed within the 4 months of dialysis. In patients who died, duration of symptoms ranged from 30 days to 60 days, mean 42 days. Overall mortality was 22.2% and correlated with the duration of symptoms prior to initiation of antituberculosis and hemodialysis therapy. Fourteen patients (77.7%) who survived longer than one year were clinically cured. Conclusion: Our results suggest that the mortality of tuberculosis is high in patients in the early phase of maintenance dialysis and delay in the disease treatment of tuberculosis. Because of their generally poor state of nutrition, and depressed cellular immunity, the mortality is high in patients in the early stage of maintenance hemodialysis. Therefore, if the diagnosis is delayed, mortality is higher. Tuberculosis should be considered strongly and treated promptly if suspected

Respiratory functions in fiberoptic cable workers Fi̇beropti̇k kablo i̇şçi̇leri̇nde solunum fonksi̇yonlari

Purpose: During fiberoptic cable production gases such as chlorine, helium and freon are mainly used, and when gas leakage occurs, the workers are exposed to these gases. Chlorine inhalation causes chest thightness and dyspnea. Depending on the intensity of exposure, this can lead to different conditions varying from slight bronchial irritation to obvious pulmonary edema. We aimed to search the effects of gas leakage on the workers pulmonary function (PF) at the Fiberoptic Cable Factory. Material and Methods: The study was performed on a total of 43 workers who answered an inquiry with regard to their respiratory symptoms. In all the workers physical examinations were carried out and their chest radiography were obtained and the pulmonary function (PF) of 27 cases (Group-I), who could have been exposed to gas inhalation along with the PF of 16 control cases (Group-II; without any exposure) were evaluated. Results: Mean age of the workers was 29.7±5.0 years. In Group-I, there was chest tightness in three of the workers after exposure to the chlorine gas; in one after smoking; in two after returning to work from their vacation. When the chlorine gas amount inside the factory was 0.4 ppm, mean PF in Group-I was lower than that of Group-II; the difference was not statistically significant (FEV1/ FVC in Group I and II was %83±14 and % 88±12 respectively, p>0.05). In 30% of all cases studied, symptoms related to chronic bronchitis were positive. The ratio of smoking in both groups was similarly high (Group-I 77.8%, Group-II 56.3%). Conclusion: These findings strongly suggested that smoking was the primarily responsible agent for the symptoms in the labourers. However, in Group-I the low FEV1/ FVC ratio may also be due to the exposure to chlorine gas. Since long term damage caused by chlorine gas exposure also increases by cigarette smoking, a special effort should be undertaken to encourage the labours to quit smoking in similar factories

Gemcitabine induced pulmonary toxicity with late onset

Gemcitabine is a nucleoside analog that has been increasingly used in the chemotherapy of solide tumors, including breast, pancreas ovary and non small cell lung cancer. It is generally well tolerated and has few side effects. Gemcitabine induced pulmonary complications range from mild dyspnea to death from ARDS. A 57- year- old man was treated with six cycles of gemcitabine because of pancreatic carcinoma in July, 2004.The patient had self limiting weakness, lack of appetite, nausea and no dyspnea in treatment period. One year later, he was admitted to a local hospital with exercises induced dyspnea. He had been given levofloxacin for 14 days. On admission to our hospital, his complaint kept on. A few inspiratory crackles were present at right base. CXR demonstrated interstitial infiltrations in the right lung lower zone. HRCT showed grand glass opacity and mild reticular patterns in right lung middle and lower lobes. Bronchoscopy was performed. Transbronchial biopsy revealed nonspecific interstitial pneumonia. Following the administration of oral corticosteroid, he had complete resolution of all signs and symptoms of gemcitabine toxicity