The Relationship of Hemogram Parameters and Night Desaturation in Patients Diagnosed with Obstructive Sleep Apnea Syndrome

Objective: Obstructive Sleep Apnea syndrome (OSAS) is a disease characterized by recurrent complete (apnea) or partial (hypopnea) upper respiratory tract obstructions episodes during sleep and often a decrease in blood oxygen saturation. Night hypoxias and sympathetic activity increase of arousals in OSAS are thought to stimulate that endothelial dysfunction and hypercoagulability. Materials and Methods: In this study, it was aimed to evaluate the relationship between the severity of the disease and the night hypoxia severity with hemogram parameters in patients diagnosed with OSAS who examined in our clinics. A total of 94 cases were included in the study, including 24 controls, 24 mild, 23 moderate, and 23 severe OSAS. Results: The mean and minimum oxygen saturation values in polisomnography with the number of neutrophils and neutrophil/lymphocyte (N/L) ratio were negatively correlated in the mild and severe OSAS groups. A negative correlation was observed between erythrocyte distribution width (EDW) and, mean oxygen saturation and minimum oxygen saturation in moderate and severe OSAS. When the mean and minimum oxygen saturation with regression analysis of EDW and N/L ratio were examined in each three groups; the 1 unit decrease in the minimum oxygen saturation increases the N/L ratio by 0.5-fold (p=0.02) in the mild OSAS, 0.5-fold (p=0.01) in the severe OSAS and it increases the EDW by ratio 0.5-fold (p=0.02) in the moderate OSAS. The 1 unit decrease in the mean oxygen saturation increases the N/L ratio by 0.4-fold (p=0.04) and the EDW by 0.8-fold (p=0.001) in the severe OSAS. Conclusion: As long as the OSAS severity increases, it is determined that the hematocrit values of patients increasing. However, as patients’ sleep desaturation increase, we can see that EDW, the number of neutrophils, and N/L ratio also increasing. This situation suggests that the local inflammation caused by both mechanical stress and ischemia-reperfusion cycles in the respiratory tract in OSAS is a consequence of spillage into the systemic circulation

Kronik Obstrüktif Akciğer Hastalığı Tanısı Olan Hastalarda Uyku Kalitesinin Değerlendirilmesi ve Uyku Bozukluklarının GOLD Evrelemesine Göre Karşılaştırması

Amaç: Bu çalışmada, Kronik Obstrüktif Akciğer Hastalığı (KOAH) hastalarında, Global Initiative for Chronic Obstructive Lung Disease (GOLD) A,B,C ve D evrelerine göre uyku kalitesinin saptanması, uyku bozukluklarının değerlendirilmesi ve evreler arası karşılaştırma yapılması amaçlanmıştır. Gereç ve Yöntem: Çalışmamıza, Ocak 2016-2017 tarihleri arasında Pamukkale Üniversitesi Tıp Fakültesi Hastanesi Göğüs Hastalıkları Polikliniği'ne başvuran, GOLD kriterlerine göre KOAH tanısı konulan, başvuru anında KOAH atağı geçirmeyen ve çalışmaya katılmayı kabul eden 94 hasta alınmıştır. Bulgular: KOAH hastalarında evreler arttıkça ortalama FEV1 değerlerinde azalma tespit edildi ve FEV1 değerleri azaldıkça gece boyunca ölçülen ortalama oksijen değerlerinin de azaldığı görüldü. Evrelere göre; total uyku süresi, uyku etkinliği, uyku latansı, REM uyku süresi ve non-REM uyku süresi arasında anlamlı farklılık saptanmadı. Polisomnografi sonuçlarına göre hastaların %40’ında apne-hipopne indeksi (AHI) <5 idi. AHI değerleriyle evreler arasında istatistiksel olarak anlamlı fark bulunmadı (p=0,581). KOAH evreleri ile AHI değerleri arasında istatistiksel anlamlı fark saptanmadı. Ancak KOAH evreleri arttıkça gece boyunca ölçülen ortalama oksijen satürasyonunda azalma tespit edildi. Sonuç: Nokturnal oksijen desatürasyonu, KOAH’ta görülen komorbiditelerin başlıca sebeplerinden biri olabilir. İleri evre KOAH hastalarında, gece desatürasyonları konusunda dikkatli olunmalı, komorbidite ve mortalitelerin önlenmesi için gerekli önlemler zaman kaybetmeden alınmalıdırObjective: We evaluated and compare sleep quality and disorders according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) A, B, C, D groups in patients with Chronic Obstructive Pulmonary Disease (COPD) and to determine sleep disorders. Materials and Methods: Our study included 94 patients who applied to Pamukkale University Medical Faculty Hospital Chest Diseases Polyclinic between January 2016 and January 2017, were diagnosed with COPD according to GOLD criteria, were not in a COPD attack at the time of admission and agreed to participate in the study. Results: In patients with COPD, as the severity of stages increased, a decrease in mean FEV1 values was detected and as the FEV1 values decreased, the mean oxygen values measured during the night decreased. According to the GOLD stage, there was no significant difference between total sleep periods, sleep activity, sleep latency, rapid eye movement (REM) sleep duration, and non-REM sleep duration. According to polysomnography results, apnea-hypopnea index (AHI) was found to be below 5 in 40% of the patients. There was no statistically significant difference between the AHI and COPD stages (p=0.581). Conclusion: No significant difference was found between the COPD stage and AHI severity. However, as COPD stages increased, a decrease in mean nocturnal oxygen saturation was detected. Nocturnal oxygen desaturation is the main cause of comorbidities observed in patients COPD. As a result, careful attention should be given to night desaturation in advanced patients with COPD, and the necessary procedures must be performed to prevent comorbidities

Dermal squamous cell carcinoma (avian keratoacanthoma) in parakeets

WOS: 000283619400011Tumor suspected operation materials obtained from eight parakeets are evaluated clinically, pathologically and immunohistochemically. The age of the parakeets varied from seven months to nine years old. Four were male, one was a female and the sexes of the rest three were not identified. Six of the operation materials were taken from the above the tail while the other two from beneath the wings. Evaluated tumors were observed to be hard in consistency and whitish color on cut surface. At histopathological examination; it is seen that hyperchromatic nucleated, big, ovoid shaped, pale eosinophilic cytoplasmated cells had formed groups in dermis. Keratinized horn pearl formations are identified in the centers of most of these cell groups. Within the horn pearl formations hyperkeratotic, parakeratotic changes and calcifications are found. In some cases inflammation areas consisting of heterophil leukocytes, lymphocytes and plasma cells in the dermis are observed. Also in histopathological examination of one case, tubercle formations made of coagulation necrosis in the center surrounded by heterophil leukocytes, macrophages, epithelioid cells, lymphocytes and foreign body giant cells are found as well as tumoral formations. Groups of cudgel shaped, red colored bacteria are found in Ziehl-Neelsen staining of the sections. Tissues are stained for proliferating cell nuclear antigen (PCNA) and p53 proteins immunohistochemically in order to interpret mitotic activity and malignancy of the tumor. TUNEL method is applied to the tissues to evaluate apoptosis

Investigation of the diagnostic value of serology, cytology and polymerase chain reaction in cat toxoplasmosis

Toksoplazmozis, Toxoplasma gondii tarafından meydana getirilen, çok sayıda memeli ve kanatlı hayvanda görülen, protozoer bir enfeksiyondur. Bu çalışmada; klinik belirti gösteren ya da T. gondii seropozitif bulunan kedilerde uygulanabilecek bronkoalveolar lavaj ve PZR tanı yöntemlerinin geçerliliği sorgulanarak, tanısal önemleri araştırıldı. Ayrıca, seropozitif bulunan kediler arasında sistemik toksoplazmozis görülme sıklığı ile dışkıda ookist varlığı muayene edildi. Çalışma materyalini, 102 kediden alınan kan, uygun olgularda ise bronkoalveolar lavaj, deri ve karaciğer biyopsileri oluşturdu. Bu kapsamda, kan serumlarında Sabin-Feldman boya testi ile T. gondii seropozitif bulunan kediler seçilerek; anestezi altında endotrakeyal kateter yardımıyla bronkoalveolar lavaj örneğinde sitolojik muayene yapıldı. PZR analizinde ise T. gondii B1 geni spesifik primerler ile konvansiyonel-PZR prosedürleri uygulandı. Çalışmada incelenen kedilerde T. gondii seroprevalansı 49/102 (%48.03) olarak belirlendi. Anti-Toxoplasma gondii antikor titreleri açısından incelendiğinde; bunlardan %40.19'unun (41/102) 1/16, %7.84'ünün (8/102) ise 1/64 titrede olduğu ortaya konuldu. Sonuç olarak, seroprevalans %48.03 olmasına rağmen sistemik toksoplazmozis oranının (49 seropozitif kediden biri, %0.98) oldukça düşükgerçekleştiği belirlendiToxoplasmosis is an infectious disease affecting most of the mammalian and aviary animals caused by Toxoplasma gondii. In this study, diagnostic values of bronchoalveolar lavage, biopsy and PCR and their practical implementation ways were questioned. The results of the each test were evaluated. Additionally, incidence of toxoplasmosis among seropositive cats were investigated by T. gondii and oocyst shedding screened in the stool samples, as well. The material of the study was constituted by blood, stool and bronchoalveoloar lavage samples taken from totally 102 cats. Bronchoalveolar lavage samples were evaluated for cytologic examination. In PCR analysis, T. gondii B1 primary sets were used and conventional-PCR procedure was applied. Antibodies to T. gondii were found in 49 (48,03%) of 102, with titers of 1/16 in 41 (40,19%), 1/64 in 8 (7,84%) cats. Only one cat exhibited systemic toxoplasmosis. In conclusion, although the seroprevalance was 48.03%, systemic toxoplasmosis rate was found 0.98% (1/49) with a lower percentag

Electrophysiological Assessment Of The Effects Of Obstructive Sleep Apnea On Cognition

We used electrophysiological measures to investigate the effects of obstructive sleep apnea on attention, learning, and memory. Thirty subjects (OSA group, n = 15, control group n = 15) participated in n-back tests, accompanied by P300 recordings, to investigate working memory and attention. The mirror-drawing test was used to study procedural memory, and the trail-making test (TMT) was used to evaluate divided attention and executive function. No significant group difference in reaction time was found in the 0-back and 1-back tests. In the 2-back test, reaction times of patients were longer than those of the control group. No P300 wave was obtained in the OSA group in any (0-, 1-, or 2-back) n-back test. In contrast, in the control group, significant P300 waves were recorded except for the 2-back test. The mirror-drawing scores were unaffected by sleep apnea. There was no difference between groups in the TMT-A test on any of the trials. Although no group difference was found in the first or second trials of the TMT-B test, OSA patients were less successful in learning on the third trial. According to our study results, OSA affects attention and executive function adversely however, we could not detect a significant effect on working or procedural memory.PubMedWoSScopu

Aortic stiffness, flow-mediated dilatation and carotid intima-media thickness in obstructive sleep apnea: Non-invasive indicators of atherosclerosis

Background and Objective: Obstructive sleep apnea (OSA) has a critical association with cardiovascular mortality and morbidity. Carotid intima-media thickness (IMT), flow-mediated dilatation (FMD) and aortic stiffness are early signs of atherosclerosis. The presence of subclinical atherosclerosis was assessed in OSA patients using these parameters. Methods: 40 patients with OSA showing an apnea-hypopnea index (AHI) ≥5 (mean age 51.3 ± 9 years, 32 males) and 24 controls (AHI &lt; 5, mean age 51.9 ± 5.2 years, 19 males) were enrolled in the study. In all subjects, polysomnographic examination and recordings were performed during sleep. IMT of the carotid artery, endothelium-dependent/-independent vasodilation of the brachial artery and aortic elastic parameters were investigated using high-resolution Doppler echocardiography. Results: The demographic data of the patients with OSA and controls were not significantly different. Subjects with OSA demonstrated higher values of aortic stiffness (7.1 ± 1.88 vs. 6.42 ± 1.56, respectively) and IMT (0.85 ± 0.13 vs. 0.63 ± 0.11 mm, p = 0.0001, respectively) but lower distensibility (9.47 ± 1.33 vs. 11.8 ± 3.36 cm2/dyn/106) and FMD (4.57 ± 1.3 vs. 6.34 ± 0.83%, p = 0.0001, respectively) than the controls. The respiratory disturbance index correlated positively with aortic stiffness and IMT and negatively with distensibility and FMD. Conclusion: We observed blunted endothelium-dependent dilatation, increased carotid IMT and aortic stiffness in patients with OSA compared with matched control subjects. This is evident in the absence of other diseases, suggesting that OSA is an independent cause of atherosclerosis. These simple and non-invasive methods help to detect subclinical atherosclerosis in OSA. Copyright © 2006 S. Karger AG

Serum biochemistry and native protein electrophoresis in diarrheic calves with arthritis

In this study, serum biochemistry and native protein electrophoresis in newborn calves with diarrhea and arthritis, were performed in order to evaluate the changes along with clinical findings for their possible application in the diagnosis and prognosis of disease. Based on clinical examination, animals were allotied into two groups comprising either diseased or healthy animals. Urea, creatinine, ALT, AST, LDH, albumin, total protein, glucose, total cholesterol, uric acid and iron levels were determined in the sera. Serum protein native polyacrilamide gel electrophoresis (nPAGE) was performed followed by protein band ratio estimation supported with densitometry at 596 nm. Differences between the average mean of healthy and diseased animals were compared statistically (Kruskal-Walley test). In this study a decrease in serum glucose and cholesterol values (p&lt;0.001), increase in urea, LDH levels and α1-and α2-globulin levels (p&lt;0.01 and p&lt;0.05 respectively) were found to be associated with the disease. As a result, the observed significant changes in biochemical parameters and clinical investigation in calves, suggesting acute inflammation causing the decrease in glucose and increase in α-globulins, may be of prognostic value

Subject characteristics.

<p>Values are presented as means ± SEM.</p><p>AHI = apnea–hypopnea index, REM = rapid eye movement, TST = total sleep time.</p><p>*Significantly different compared with control group, <i>P</i><0.05.</p