Total kollaps spontan pnömotoraksın tedavi süreci için iyi bir işaret midir?

Aim: We aimed to investigate possible effects of total collapse on early reexpansion of lung, early cessation of air leak, chest tube withdrawal time and early discharge. Material and Method: A retrospective analysis of 74 consecutive patients treated for Spontaneous pneumothorax was evaluated. Patients' data including age, sex, localization and percentage of pneumothorax, presence of bullous lesions, duration of symptoms and time lengths for cessation of air leaks, lung re-expansion, chest tube withdrawal and discharge was collected and statistically analyzed. Results: There was a significantly shorter pneumothorax duration in total collapse patients (p<0.001). Following the treatment, significantly shorter time lengths were further observed in total collapse patients on lung expansion time (p<0.001), air leak cessation time (p<0.001), chest tube withdrawal time (p<0.001) and discharge time (p<0.001). Discussion: Our results have suggested that shorter duration of pneumothorax without pleural thickening may provide rapid re-expansion of the lungs in the spontaneous pneumothorax patients with total collapse. Severe lung tissue collapse and high intra-pleural air pressure together may result with closure of the perforated bullous lesion.Amaç: Biz bu çalışmamızda total kollapsın erken re ekspansiyona, hava kaçağının erken kesilmesine, göğüs tüpünün erken çekilmesine ve erken taburculuğa sebep olup olmadığını sunmayı amaçladık. Gereç ve Yöntem: 74 spontan pnömotorakslı olgu retrospektif olarak analiz edildi. Hastalar yaş, cinsiyet, pnömotoraks tarafı, pnömotoraks yüzdesi, büllöz lezyon varlığı, semptom süresi, hava kaçağının kesilme, akciğerin ekspanse olma, göğüs tüpünün çekilme ve taburculuk zamanı açısından istatistiksel olarak değerlendirildi. Bulgular: Total pnömotorakslı hastalarda pnömotoraks süresi anlamlı şekilde kısa idi (p<0.001). Tedavi sonrası akciğerin ekspansiyon süresi (p<0.001), hava kaçağının kesilme süresi (p<0.001), göğüs tüpünün çekilme zamanı (p<0.001) ve hastanın taburculuk zamanı (p<0.001) anlamlı şekilde kısa idi. Sonuç: Total kollapslı olgularda kısa pnömotoraks yaşı nedeniyle plevral kalınlaşma olmadan yapılan müdahale kolay re-ekspansiyona sebep olabilir, öte yandan ciddi akciğer kollapsı ve yüksek intraplevral hava basıncı perfore büllöz lezyonun kapanmasına sebep olabilmektedir

Traumatic First Rib Fractures

International audience1er juillet - 31 décembre 200

Nonkardiyak göğüs ağrılarının multidisipliner değerlendirilmesi

Amaç:Biz bu çalışma ile nonkardiyak göğüs ağrılarının sebeplerini, klinik değerlendirmesini ve tedavi seçeneklerini sunmayı amaçladık. Gereç ve Yöntem: Toplam 40 nonkardiyak göğüs ağrılı hasta değerlendirildi ve tedavi edildi. Olgular öncelikle anjina benzeri göğüs ağrısı ile kardiyoloji kliniğine başvurdular, myokard perfüzyon sintigrafisi ve koroner anjiyografi ile değerlendirildiler ve sonra fizik tedavi, psikiyatri, gastroenteroloji ve göğüs hastalıkları kliniklerine konsülte edildiler. Bulgular: Hastaların yaş ortalaması 41,35 ± 12,20 yıl (18-70 yaş), on iki’si (% 30) erkek, 28’i (% 70) kadın idi. Kas iskelet hastalıkları 9 (%22.5) olgu, emosyonel bozukluk 8 (%20) olgu, özofageal hastalık 14 (% 35) olgu ve göğüs hastalıkları 9 (%22.5) olgu şeklinde tespit edildi. Sonuç: Nonkardiyak göğüs ağrıları klinik uygulamada yaygın, pahalı, zor ve her zaman iyi huylu olmayan bir problemdir. Etyolojik faktörler kas iskelet, emosyonel, özofageal ve göğüs hastalıklarını ilgilendirebilir. Dikkatli değerlendirme, erken tanı ve uygun tedavi yaklaşımı sahip olduğu yüksek maliyet ve hayatı tehdit edici etyolojiler içermesi nedeniyle önemlidir.Aim:We aimed the report the reasons, clinical evaluation, and treatment options of noncardiac chest pain. Material and Method: A total 40 noncardiac chest pain patients had been evaluated and treated. They were applied with angina like chest pain to cardiac clinic firstly, the patients were evaluated with myocard perfusion scintigraphy or coronary angiography, and then all of the patients consulted with musculoskeletal, emotional, esophageal and chest diseases clinics. Results: The mean age of the patients was 41.35&plusmn;12.20 years (18-70 years), twelve (30%) were male and 28 (70%) were female. Musculoskeletal diseases were observed 9 (22.5%) patients, emotional diseases were observed 8 (20%) patients, esophageal diseases were observed 14 (35%) patients and chest diseases were observed 9 (22.5%) patients. Discussion: Noncardiac Chest Pain is a common, expensive, not always benign and difficult problem in clinical practice. The etiologies should be include musculoskeletal, emotional, esophageal and chest diseases. Carefully evaluation, early diagnosis and appropriate treatment approaches are important because of the high costs and contains the seriously life threating causes

Multisciplinary Evaluation of Noncardiac Chest PainNonkardiyak

Aim: We aimed the report the reasons, clinical evaluation, and treatment options of noncardiac chest pain. Material and Method: A total 40 noncardiac chest pain patients had been evaluated and treated. They were applied with angina like chest pain to cardiac clinic firstly, the patients were evaluated with myocard perfusion scintigraphy or coronary angiography, and then all of the patients consulted with musculoskeletal, emotional, esophageal and chestdiseases clinics. Results: The mean age of the patients was 41.35 +/- 12.20years (18-70 years), twelve (30%) were male and 28 (70%) were female.Musculoskeletal diseases were observed 9 (22.5%) patients, emotional diseases were observed 8 (20%) patients, esophageal diseases were observed14 (35%) patients and chest diseases were observed 9 (22.5%) patients.Discussion: Noncardiac Chest Pain is a common, expensive, not always benignand difficult problem in clinical practice. The etiologies should be includemusculoskeletal, emotional, esophageal and chest diseases. Carefully evaluation,early diagnosis and appropriate treatment approaches are importantbecause of the high costs and contains the seriously life threating causes