A Single Imaging Modality in the Diagnosis, Severity, and Prognosis of Pulmonary Embolism

Introduction. This study aimed to investigate the currency of computerized tomography pulmonary angiography-based parameters as pulmonary artery obstruction index (PAOI), as well as right ventricular diameters for pulmonary embolism (PE) risk evaluation and prediction of mortality and intensive care unit (ICU) requirement. Materials and Methods. The study retrospectively enrolled 203 patients hospitalized with acute PE. PAOI was calculated according to Qanadli score. Results. Forty-three patients (23.9%) were hospitalized in the ICU. Nineteen patients (10.6%) died during the 30-day follow-up period. The optimal cutoff value of PAOI for PE 30th day mortality and ICU requirement were found as 36.5% in ROC curve analysis. The pulmonary artery systolic pressure had a significant positive correlation with right/left ventricular diameter ratio (r=0.531, P<0.001), PAOI (r=0.296, P<0.001), and pulmonary artery diameter (r=0.659, P<0.001). The patients with PAOI values higher than 36.5% have a 5.7-times increased risk of death. Conclusion. PAOI is a fast and promising parameter for risk assessment in patients with acute PE. With greater education of clinicians in this radiological scoring, a rapid assessment for diagnosis, clinical risk evaluation, and prognosis may be possible in emergency services without the need for echocardiography

Oxidative Status and Acute Phase Reactants in Patients with Environmental Asbestos Exposure and Mesothelioma

Background and Objectives. The aim of this study was to investigate inflammatory indicators and oxidative status in patients with asbestos exposure with and without mesothelioma and to compare results with data from healthy subjects. Methods. Eighty people with exposure to environmental asbestos and without any disease, 46 mesothelioma patients, and a control group of 50 people without exposure to environmental asbestos were enrolled in this prospective study. Serum total oxidant level (TOL), total antioxidant capacity (TAC), and oxidative stress index (OSI), CRP, transferrin, ceruloplasmin, α-1 antitrypsin, ferritin, and copper levels were measured. Results. Mesothelioma group exhibited higher TOL, OSI, α1-antitrypsin, ferritin and copper levels as compared to the other groups (P < 0.001, P = 0.007, P < 0.0001, P < 0.001, and P < 0.001, resp.). Transferrin was lower in the mesothelioma group than in the other two groups (P < 0.001). The asbestos group had higher TOL, TAC, α1-antitrypsin, and transferrin levels (P < 0.001, P < 0.001, P < 0.001, and P < 0.001, resp.), as well as lower OSI and ferritin levels as compared to the control group (P < 0.001 and P < 0.001). Conclusions. We believe that elevated acute phase reactants and oxidative stress markers (TOL and OSI) in the mesothelioma group can be used as predictive markers for the development of asbestos-related malignancy

Living obstructive, mixed and central apneas in the same epoch: an interesting OSAS case

24th Congress of the European-Sleep-Research-Society (ESRS) -- SEP 25-28, 2018 -- Basel, SWITZERLAND[Abstract Not Available]European Sleep Res So

The Relationship Between Inflammatory Marker Levels and Pulmonary Tuberculosis Severity

We aimed to investigate the correlation between red cell distribution width (RDW), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and other inflammatory markers with pulmonary tuberculosis (PTB) severity. Seventy patients with active pulmonary tuberculosis were compared with 50 age-matched and gender-matched healthy controls. The mean age of PTB patients was 50.4 +/- 21.8 years. There were no differences in terms of age, gender, and smoking history between PTB patients and controls. Patients with advanced PTB had a significantly higher white blood cell count, neutrophil count, RDW, NLR, and C-reactive protein when compared to patients with mild to moderate PTB. RDW (17.7 versus 15.7 %, p = 0.002) and NLR (4.7 versus 3.1, p = 0.009) values were higher in patients with advanced PTB as opposed to patients with mild to moderate PTB. NLR and RDW levels may be used as markers of inflammation to help clinically manage patients with TB and to determine disease severity

Congenital tuberculosis: presentation of a rare case

Congenital tuberculosis is a rare disease with a high mortality rate. Congenital tuberculosis is considered the result of mother-to-child transmission from the placenta to the fetus, through the ingestion of the amniotic fluid, or via transplacental transmission through the umbilical vein. Given the non-specific clinical signs of tuberculosis, it is usually difficult to diagnose it. The case of a 48-day-old male infant hospitalized due to weight loss, fever, cough, hemoptysis, and respiratory distress for the past 20 days, is presented. In this period, he had received broad spectrum antibiotics but with no improvement. A chest x-ray showed the presence of consolidation and a cavitary lesion in the upper and middle left lung fields. Mycobacterium tuberculosis was detected by polymerase chain reaction in a bronchoalveolar lavage specimen. Congenital tuberculosis was diagnosed based on this finding; hence, a tuberculostatic regimen was started accordingly. The patient died 13 days after treatment initiation. Congenital tuberculosis should be considered in infants with weight loss, fever, cough, hemoptysis and respiratory distress

Pulmonary Langerhans' Cell Histiocytosis and Diabetes Insipidus: On the occasion of two cases

Pulmoner langerhans hücreli histiyositozis (PLHH), etyolojisi bilinmeyen ve sigara içenlerde görülen, nadir bir interstisyel akciğer hastalığıdır. Hastalıkta genellikle izole akciğer tutulumu vardır ve santral sinir sistemi tutulumu nadirdir. Bu olgu sunumunda, birinde takip, diğerinde ise tanı sırasında santral diabetes insipidus (Dİ) saptanan iki olgu sunulmaktadır. Olgular, yaşları sırasıyla 24 ve 39 olan, sigara içme öyküsü olan erkek hastalardı. İki olgunun da yüksek rezolüsyonlu bilgisayarlı tomografilerinde (YRBT) yaygın kistik lezyonlar izlenmiş olup, video-yardımlı torakoskopik cerrahiyle (VATS) alınan biyopsilerinde PLHH saptandı. Takipte solunum fonksiyonlarının bozulmuş olduğu görülen birinci olguya 0,5 mg/kg metil prednisolon başlandı. Bir ay sonra yapılan kontrolde PLHH için kısmi düzelme gözlenmesi üzerine tedavi 6 aya uzatıldı, tedavi bitiminde tam remisyon saptanarak steroid tedavisi kesildi. İki hastaya da Dİ için oral 0,1 mg/gün desmopressin başlandı, bir ay sonra tam klinik düzelme gözlendi.Pulmonary Langerhans&amp;#8217; cell histiocytosis (PLCH) is an uncommon interstitial lung disease with an unknown etiology in smokers. Disease is usually seen with isolated lung involvement and central nervous system involvement is rare.Two PLCH cases, with central diabetes insipidus (DI) determined at diagnosis in one of the cases and during follow-up in the other, is being presented in this report. The patients&amp;#8217; ages were 39 and 24, respectively and they were both male patients with a history of smoking. Widely cystic lesions were viewed at high-resolution computed tomography scans (HRCT) and PLCH was detected at the biopsies obtained by video-assisted thoracoscopic surgery (VATS), in both two cases. Therapy was started with 0.5 mg/kg methyl prednisolone for latter case, because of impairment in pulmonary function tests during follow up. On control, after one month therapy, partial improvement was seen for PLCH and the therapy was continued up to 6 months. At the end of the therapy complete remission was seen and corticotherapy was stopped. Desmopressin was started for both cases at 0.1 mg/day, orally. After one month of treatment clinical improvement was observed during control

The results of OSAS patients in our clinic

28th International Congress of the European-Respiratory-Society (ERS) -- SEP 15-19, 2018 -- Paris, FRANCE[Abstract Not Available]European Respiratory So