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Taha Toros Arşivi, Dosya Adı: Müzisyenlerİstanbul Kalkınma Ajansı (TR10/14/YEN/0033) İstanbul Development Agency (TR10/14/YEN/0033

Ahmet Haşimle Yahya Kemal'in dargın olduğu senelerde

Taha Toros Arşivi, Dosya No: 182-Yahya Kemal Beyatlıİstanbul Kalkınma Ajansı (TR10/14/YEN/0033) İstanbul Development Agency (TR10/14/YEN/0033

Gaseous Air Pollutants and Hospitalization for Respiratory Disease in the Neonatal Period

OBJECTIVE: Current levels of ambient air pollution are associated with morbidity and mortality in the general population. To determine the influence of gaseous air pollutants on neonatal respiratory morbidity, we tested the association between daily respiratory hospitalizations and daily concentrations of ambient air pollution gases: ozone, carbon monoxide, sulfur dioxide, and nitrogen dioxide, in 11 large Canadian cities. STUDY DESIGN: Daily time-series analyses were employed and results were adjusted for day of the week, temperature, barometric pressure, and relative humidity. RESULTS: The percent increases in hospitalization associated with an increase in air pollution equivalent to its interquartile range were 3.35 [95% confidence interval (CI), 1.73–4.77] for O(3), 2.85 (95% CI, 1.68–4.02) for NO(2), 1.66 (95% CI, 0.63–2.69) for SO(2), and 1.75 (95% CI, 0.48–3.02) for CO. The independent effect of all pollutants combined was 9.61% (95% CI, 4.52–14.7%). CONCLUSION: Our results suggest that neonates are experiencing adverse effects of air pollution at current levels in Canada, and that accounts for a significant proportion of hospitalizations in this subgroup

Probing Delta structure with pion electromagnetic production

The Dubna-Mainz-Taipei dynamical model for pion electromagnetic production, which can describe well the existing data from threshold up to 1 GeV photon lab energy, is presented and used to analyze the recent precision data in the $\Delta$ region. We find that, within our model, the bare Delta is almost spherical while the physical Delta is oblate. The deformation is almost saturated by the pion cloud effects. We further find that up to Q^2 = 4.0 (GeV/c)^2, the extracted helicity amplitude A_{3/2} and A_{1/2} remain comparable with each other, implying that hadronic helicity is not conserved at this range of Q^2. The ratio E_{1+}/M_{1+} obtained show, starting from a small and negative value at the real photon point, a clear tendency to cross zero, and to become positive with increasing Q^2. This is a possible indication of a very slow approach toward the pQCD region. Finally, we find that the bare helicity amplitude A_{1/2} and S_{1/2}, but not A_{3/2}, starts exhibiting the scaling behavior at about Q^2 \ge 2.5 (GeV/c)^2.Comment: Invited talk presented at the 2nd Asia-Pacific Conference on Few-Body Problems in Physics, Shanghai, P.R. China, 2002 (10 pages LATEX including 1 table and 5 figures

Sub-clinical left and right ventricular dysfunction in patients with COPD

SummaryBackgroundCardiovascular manifestations in COPD include increased arterial stiffness, ischaemic heart disease, chronic heart failure and cor pulmonale. We hypothesised that sub-clinical right (RV) and left ventricular (LV) dysfunction occurs in patients with COPD, related to the severity of airflow obstruction, arterial stiffness and systemic inflammation.MethodsThirty six patients and 14 controls, all free of overt cardiovascular disease underwent tissue Doppler echocardiography, spirometry, measurement of aortic pulse wave velocity (PWV) and venous sampling for inflammatory markers.ResultsMean LV myocardial strain and strain rate were less in patients than controls, p<0.05. LV isovolumic relaxation time (IVRT) was prolonged in patients (125±15.2ms) compared with controls (98.2±21.1ms), p<0.01, indicating LV diastolic dysfunction. The RV free wall strain and strain rate were less in patients than controls, both p<0.05, indicating RV systolic dysfunction. Patients had sub-clinical pulmonary arterial hypertension with a greater RV myocardial relaxation time and Tei index, both p<0.01. Patients with mild airways obstruction had LV and RV dysfunction and evidence of increased RV afterload compared with controls. In multivariate analyses aortic PWV predicted LV IVRT, p<0.01, while FEV1 predicted RV Tei index and myocardial relaxation time, both p<0.01.ConclusionsPatients with COPD have sub-clinical left ventricular dysfunction related to arterial stiffness, and right ventricular dysfunction related to airways obstruction. Both right and left ventricular dysfunction are present in patients with mild airways obstruction suggesting that cardiac co-morbidities commence early in the development of COPD

Effect of octanoic acid-rich formula on plasma ghrelin levels in cachectic patients with chronic respiratory disease

<p>Abstract</p> <p>Background</p> <p>For cachectic patients with chronic respiratory disease (CRD), conventional enteral nutrition formula is an optional treatment to maintain energy balance. The molecular mechanisms by which enteral nutrition formula controls appetite and weight remain unknown. We examined whether enteral nutrition formula rich in octanoic acids would increase plasma levels of ghrelin, an appetite-stimulating hormone produced in the stomach, in cachectic patients with CRD.</p> <p>Methods</p> <p>Plasma ghrelin profiles in cachectic patients with CRD were assessed and compared with those in age- and sex-matched controls. Plasma levels of acyl-ghrelin, an active ghrelin modified by octanoic acids, and desacyl-ghrelin were measured separately. We examined changes in 24-h plasma ghrelin profiles before and after single administration of the formula. We also evaluated the effects of 2-week administration of the formula on plasma ghrelin levels and nutritional status in patients.</p> <p>Results</p> <p>The ratio of acyl-ghrelin to desacyl-ghrelin in plasma was lower in patients than in controls. Single administration of the formula did not change plasma desacyl-ghrelin levels, but induced an increase in acyl-ghrelin levels. Two-week treatment with the formula was effective in increasing weight and acyl-ghrelin, along with improving nutritional status in patients.</p> <p>Conclusion</p> <p>These results show that the formula contributes to increased weight, which may be associated with induction of acyl-ghrelin production in cachectic patients with CRD.</p

Chronic Obstructive Pulmonary Disease: Effects beyond the Lungs

Peter Barnes discusses the growing epidemic of chronic obstructive pulmonary disease (COPD), especially in developing countries and among nonsmokers

How do COPD patients respond to exacerbations?

<p>Abstract</p> <p>Background</p> <p>Although timely treatment of COPD exacerbations seems clinically important, nearly half of these exacerbations remain unreported and subsequently untreated. Recent studies have investigated incidence and impact of failure to seek medical treatment during exacerbations. Yet, little is known about type and timing of other self-management actions in periods of symptom deterioration. The current prospective study aims at determining the relative incidence, timing and determinants of three types of patient responses.</p> <p>Methods</p> <p>In a multicentre observational study, 121 patients (age 67 ± 11 years, FEV₁pred. 48 ± 19) were followed for 6 weeks by daily diary symptom recording. Three types of action were assessed daily: planning periods of rest, breathing techniques and/or sputum clearing (type-A), increased bronchodilator use (type-B) and contacting a healthcare provider (type-C).</p> <p>Results</p> <p>Type-A action was taken in 70.7%, type-B in 62.7% and type C in 17.3% of exacerbations (n = 75). Smokers were less likely to take type-A and B actions. Type-C actions were associated with more severe airflow limitation and increased number of hospital admissions in the last year.</p> <p>Conclusions</p> <p>Our study shows that most patients are willing to take timely self-management actions during exacerbations. Future research is needed to determine whether the low incidence of contacting a healthcare provider is due to a lack of self-management or healthcare accessibility.</p

The recording and characteristics of pulmonary rehabilitation in patients with COPD using The Health Information Network (THIN) primary care database

Pulmonary rehabilitation is recommended for patients with COPD to improve physical function, breathlessness and quality of life. Using The Health Information Network (THIN) primary care database in UK, we compared the demographic and clinical parameters of patients with COPD in relation to coding of pulmonary rehabilitation, and to investigate whether there is a survival benefit from pulmonary rehabilitation. We identified patients with COPD, diagnosed from 2004 and extracted information on demographics, pulmonary rehabilitation and clinical parameters using the relevant Read codes. Thirty six thousand one hundred and eighty nine patients diagnosed with COPD were included with a mean (SD) age of 67 (11) years, 53% were male and only 9.8% had a code related to either being assessed, referred, or completing pulmonary rehabilitation ever. Younger age at diagnosis, better socioeconomic status, worse dyspnoea score, current smoking, and higher comorbidities level are more likely to have a record of pulmonary rehabilitation. Of those with a recorded MRC of 3 or worse, only 2057 (21%) had a code of pulmonary rehabilitation. Survival analysis revealed that patients with coding for pulmonary rehabilitation were 22% (95% CI 0.69–0.88) less likely to die than those who had no coding. In UK THIN records, a substantial proportion of eligible patients with COPD have not had a coded pulmonary rehabilitation record. Survival was improved in those with PR record but coding for other COPD treatments were also better in this group. GP practices need to improve the coding for PR to highlight any unmet need locally