Obstructive sleep apnea as a risk factor for cardiovascular diseases

Obstructive sleep apnea (OSA) is a common medical condition that occurs in approximately 5% to 15% of the population. It is usually associated with an increased risk of cardiovascular disease. Diagnosis of OSA is based on polysomnography, and its severity is measured with an apnea-hypopnea index. Most of the adverse effects of OSA on the cardiovascular system are reversible with treatment. In addition to continous positive airway pressure therapy, precautions such as weight loss, avoidance of central nervous system depressants, treatment of nasal congestion and sleeping in the lateral position may help to treat OSA. (Cardiol J 2007; 14: 534-537)

Obturacyjny bezdech senny jako czynnik ryzyka rozwoju chorób układu sercowo-naczyniowego

Obturacyjny bezdech senny jest stosunkowo często występującym schorzeniem, które dotyka około 5-15% populacji. Zaburzenie to zazwyczaj ściśle wiąże się ze zwiększonym ryzykiem rozwoju chorób układu sercowo-naczyniowego. Diagnostyka obturacyjnego bezdechu sennego opiera się na badaniu polisomnograficznym, a jego nasilenie mierzy się za pomocą wskaźnika bezdechów i spłyceń oddychania. Większość działań niepożądanych wywoływanych przez obturacyjny bezdech senny w odniesieniu do układu sercowo-naczyniowego ma, w toku włączonego leczenia, charakter odwracalny. Oprócz terapii za pomocą wentylacji w trybie ciągle dodatniego ciśnienia w drogach oddechowych w celu kompleksowego leczenia obturacyjnego bezdechu sennego zaleca się również zmniejszenie masy ciała, unikanie leków o depresyjnym wpływie na centralny układ nerwowy, leczenie niedrożności jamy nosowej, a także spanie w pozycji bocznej. (Folia Cardiologica Excerpta 2008; 3: 74-78

Heart rate variability and heart rate turbulence in patients with chronic obstructive pulmonary disease

Background: In chronic obstructive pulmonary disease (COPD) patients, functional and structural changes of the respiratory system greatly influence cardiovascular autonomic functions. Determining autonomic balance may be important in understanding the pathophysiology of COPD and useful clinically in the treatment of COPD patients. Heart rate variability (HRV) and heart rate turbulence (HRT) are useful tools in assessing the autonomic neurovegetative function. Our aim in this study was to evaluate the HRV and HRT variables in COPD patients. Twenty five moderate to severe COPD patients and 25 healthy subjects were included in this study. Methods: Pulmonary function tests and echocardiographic examination, arterial blood gases analysis were performed, HRV and HRT analysis were assessed from a 24-hour Holter recording. Results: When HRV and HRT parameters were compared, COPD patients had significantly decreased sNN50 total, pNN50, SDANN, SDNN, SDNNI, rMSDD in time domain HRV parameters, and the values of the HRT onset was significantly less negative in COPD patients. Although the values of the HRT slope were lower in COPD patients, there was no significant difference between the two groups. We also found a correlation between HRT and HRV parameters. Conclusions: In addition to HRV parameters, HRT onset was significantly different in COPD patients. In our opinion, the combination of HRV variables and HRT onset may be simple and elegant ways of evaluating cardiac autonomic functions. New investigations of HRT and HRV in COPD patients have a potential importance for improving risk stratification and therapeutic approaches, and understanding the autonomic outcomes of the disease process

The results of a questionnaire on smoking in high school teachers of Eyüp district in İstanbul

Bu çalışma ile en etkin meslek gruplarından biri olan öğretmenlerin sigara içme oranları, sigaraya karşı tutumları, sigara ile ilişkili hastalıklar ve sigara içiminin kontrolünde yasal önlemler konusundaki düşüncelerinin belirlenmesi amaçlandı. Bu doğrultuda İstanbul Eyüp ilçesindeki 350 lise öğretmenine anket uygulandı ( %64 erkek, %36 kadın, yaş ortalaması 33.8 8.8 yıl). Öğretmenlerin 160 (%45.7)’ının sigara içtiği saptandı. Kadınlarda sigara içme sıklığı (%50) erkeklere göre (%43.3) daha fazla idi. Sözel branş öğretmenlerinde sigara içme oranı yüksek (%57), yabancı dil öğretmenlerinde ise düşük (%24) bulundu. Sigara içmeye başlama nedenleri arasında en sık neden, özenti ve merak (%36.1) idi. Öğretmenlerin %50.3’ü sigara içmeye 14-22 yaşları arasında başlamıştı. Alışkanlık (%50.3) halen sigara içme nedenleri arasında ilk sırada idi. Sigara içen öğretmenlerin %68’i sigarayı bırakmayı düşünüyordu. Sigara içimini bırakmayı düşünme nedenleri arasında sağlığı korumak (%76.4) ilk sırayı alıyordu. Çalışma grubu sigara ile ilişkili hastalıklar konusunda genel olarak bilgi sahibi idi. Ancak mesane kanseri ve ölü doğum konusunda bilgi oranları düşüktü. Sigara ile ilgili yasal önlemler, sigara bağımlılığı ve sigaraya karşı eğitim konusundaki düşüncelerde içen ve içmeyenler arasında belirgin farklılıklar vardı. Sonuç olarak; sigara içimini önleme ve bıraktırma çalışmalarının bir aşaması olarak öncelikle sigara içmeye başlanmasında en duyarlı ve riskli dönemde olan orta-lise öğrencilerinin eğitimini yapan öğretmenlerin sigaranın zararları, sigara bağımlılığı ve bıraktırmada izlenecek yöntemler konusunda eğitilmeleri ve bilgilendirilmeleri gerektiği görüşündeyiz.This study is aimed to investigate the rate of smoking, reactions against it, the knowledge about smoking-related disorders, and legal restrictions against smoking in teachers who are among the very active professions. A questionnaire was applied to 350 high school teachers in Eyup district of Istanbul (male 64%, female 36%, mean age 33.8 ± 8.8 years). One hundred sixty (45.7%) of them were found to be smokers. Smoking rate was higher in females (50%) than males (43.3%). Smoking rate was higher in teachers of verbal branches (57%) and lower in those of foreign languages (24%). The leading causes of beginning to smoke were affectation and curiosity (36.1%). 50.3% began to smoke when they were 14-22 years-old. Being accustomed is the main (50.3%) reason to continue smoking currently. Sixty eight percent of the teachers who were active smokers were planning to stop smoking. The main reason to plan stopping (76.4%) was considering health. The study group had an acceptable level of knowledge about smoking-related disorders. However, those about urinary bladder cancer and missed abortion were insufficient. The thoughts about legal restrictions against smoking, smoking dependence, and education against smoking were significantly different between smokers and non-smokers. In conclusion; as an important step in stopping and preventing smoking, high school teachers who educate the people most vulnerable to begin smoking should be educated and informed about the hazards of smoking, smoking dependence and the ways to stop it

The demographic clinical radyological and bacteriological characteristic of cases with pulmonary tuberculosis in İstanbul Eyüp tuberculosis struggle dispansery

Amaç: Bu çalışmada akciğer tüberkülozlu olgularımızın demografik, klinik, radyolojik ve bakteriyolojik özelliklerini ve radyolojik, bakteriyolojik özellikleri etkileyen faktörleri belirlemeyi amaçladık. Gereç ve Yöntem: istanbul Eyüp Verem Savaş Dispanseri'nde 2001-2002 yıllarında takip edilen 199 akciğer tüberkülozu olgusu bu amaçla değerlendirildi. Sonuçlar: Olgularımızın 152 (%76)'si erkek, 47 (%24)'si kadın, yaş ortalaması 33.7 14.0 yıl idi. ilkokul mezunu 117 (%59), sosyal güvencesi olmayan 101 (%51), yeni olgu 160 (%80.4), ferdi başvurudan tedaviye alınan 138 (%69) kişiy- di. Halen sigara içiciliği %59, düzenli alkol alımı %17, hastanede yatış oranı %55 idi. En sık yakınmalar öksürük (%88) ve halsizlikti (%87). Akciğer grafilerinde 56 (%28)'sında lezyonlar yaygın, 116 (%58.3)'sında kavite vardı. Tedavi öncesi 151 (%76) aside dirençli basil pozitifti. Sigara içen, hastaneye yatan, kavitesi bulunan ve lezyonları yaygın olan olgularda yayma pozitifliği daha fazla idi (p 0.05).Yorum: Sonuç olarak, eski, temaslı muayenesinden, bulunan ve yayma pozitif olgu oranlarımız önceki araştırmalara göre fazla idi ve sigara içenlerde yayma pozitiflik oranı artmaktaydı.Aim: To evaluate the demographic, clinical, radiological and bacteriological characteristics of our cases with pulmonary tuberculosis and the factors affecting the radiological and bacteriological characteristics of these cases. Material and Methods: We evaluated 199 cases with pulmonary tuberculosis followed in İstanbul Eyüp Tuberculosis Dispensary between 2001 and 2002. Results: Our cases consisted of 152 (76%) male and 47 (24%) female patients (mean age: 33.7 ± T4.0 years). Of these cases 117 (59%) were graduated from primary school, 101 (51 %) had no social security, 160 (80.4%) were new ca- ses and 138 (69%) were self attended cases. Fifty nine percent were still smoking, 17% had regular alcohol intake and the hospitalization rate was 55%. The most frequent complaints were cough (88%) and fatigue (87%). In chest roent- gens, the lesions were extensive in 56 (28%) of the cases and cavity was present in 116 (58%) of them. Before treatment acidoresistant bacile smear was positive in 151 (76%) cases. Smear positivity was more frequent in cases who was hospitalized, smoker, having cavity and extensive lesion (p< 0.05). Conclusion: As a result, the rate of former patients and patients diagnosed by examination of contacts were higher in our study than those of previous studies as well as the number of smear positive patients which was found have a ten- dency to increase with smoking

Ophthalmic Pathologies In Female Subjects With Bilateral Congenital Sensorineural Hearing Loss

Background/aim: The high prevalence of ophthalmologic pathologies in hearing-disabled subjects necessitates early screening of other sensory deficits, especially visual function. The aim of this study is to determine the frequency and clinical characteristics of ophthalmic pathologies in patients with congenital bilateral sensorineural hearing loss (SNHL). Materials and methods: This descriptive study is a prospective analysis of 78 young female SNHL subjects who were examined at a tertiary care university hospital with a detailed ophthalmic examination, including electroretinography (ERG) and visual field tests as needed. Results: The mean age was 19.00 +/- 1.69 years (range: 15 to 24 years). A total of 39 cases (50%) had at least one ocular pathology. Refractive errors were the leading problem, found in 35 patients (44.9%). Anterior segment examination revealed heterochromia iridis or Waardenburg syndrome in 2 cases (2.56%). Dilated fundus examination revealed retinal pathologies in 15 cases (19.23%), including retinitis pigmentosa or Usher's syndrome in 8 cases (10.25%). Most of the Usher's syndrome cases (87.5%) had consanguinity. Conclusion: Screening for congenital SNHL in the early years of life and routine yearly follow-ups are essential for maximizing the rehabilitation of this disabled group. The high rate of visually debilitating syndromic ocular pathologies associated with high frequency of consanguinity doubles the importance

General characteristics and therapeutic options in lung cancer in Turkey

[No Abstract Available

An Unusual Case of Pulmonary Nocardiosis in Immunocompetent Patient

Pulmonary nocardiosis is a subacute or chronic necrotizing pneumonia caused by aerobic actinomycetes of the genus Nocardia and rare in immune-competent patients. A 35-year-old male, who had treated with antituberculosis drugs, presented with cough, dyspnea, and expectoration with episodes of hemoptysis with purulent sputum. The diagnosis of nocardiosis was made by microscopic examination of the surgically resected portion of the lung and revealed filamentous Gram-positive bacteria