The role of oxidative stress and effect of alpha-lipoic acid in reexpansion pulmonary edema – an experimental study

Introduction: We investigated the role of oxidative stress in the pathogenesis of reexpansion pulmonary edema (RPE) and effect of alpha-lipoic acid (ALA) in the prevention of RPE

Pulmonary Rehabilitation Using Modified Threshold Inspiratory Muscle Trainer (IMT) in Patients with Tetraplegia

It is aimed to present the usefulness of inspiratory muscle trainer (IMT) in treatment of a 20-year-old male patient with diaphragmatic paralysis and tetraplegia due to spinal cord injury (SCI), and supporting effect of IMT in recovering from respiratory failure by rendering his diaphragm functions. The treatment was applied through the tracheostomy cannula by a modified IMT device. After applying IMT for three weeks, it was observed that the diaphragm recovered its functions in electromyography (EMG) test. As a result, in this study, we present a case where a patient could live without any respiratory device for the rest of his life with the help of modified IMT

Proanthocyanidin to prevent formation of the reexpansion pulmonary edema

<p>Abstract</p> <p>Background</p> <p>We aimed to investigate the preventive effect of Proanthocyanidine (PC) in the prevention of RPE formation.</p> <p>Methods</p> <p>Subjects were divided into four groups each containing 10 rats. In the Control Group (CG): RPE wasn't performed. Then subjects were followed up for three days and they were sacrificed after the follow up period. Samplings were made from tissues for measurement of biochemical and histopathologic parameters. In the Second Group (PCG): The same protocol as CG was applied, except the administration of PC to the subjects. In the third RPE Group (RPEG): Again the same protocol as CG was applied, but as a difference, RPE was performed. In the Treatment Group (TG): The same protocol as RPEG was applied except the administration of PC to the subjects.</p> <p>Results</p> <p>In RPEG group, the most important histopathological finding was severe pulmonary edema with alveolar damage and acute inflammatory cells. These findings were less in the TG group. RPE caused increased MDA levels, and decreased GPx, SOD and CAT activity significantly in lung tissue.</p> <p>Conclusion</p> <p>PC decreased MDA levels. Oxidative stress plays an important role in pathophysiology of RPE and PC treatment was shown to be useful to prevent formation of RPE.</p

Türkiye'de Bronkoskopi Uygulamaları: Bir Anket Çalışması

Derneği, Girişimsel Pulmonoloji Çalışma Grubu olarak ülkemizde bronkoskopi uygulaması yapan hekimlerin tutum ve davranışlarını bir anket ile ortaya koymayı amaçladık. Yöntemler: Tanısal ve girişimsel bronkoskopi uygulamalarına ilişkin 23 soru içeren web tabanlı ankete katılım için hazırlanan ve anket linkini içeren davet mektubu, göğüs hastalıkları, göğüs cerrahisi, anestezi ve reanimasyon uzmanlarının e-posta gruplarına gönderildi. Ankete katılan hekimlerin verdiği yanıtlar değerlendirildi. Anketten elde edilen sonuçlar genel olarak ve branş temelinde istatistiksel analizlerle değerlendirildi. Bulgular: Anketi 93 göğüs hastalıkları, 30 göğüs cerrahisi, 23 anesteziyoloji olmak üzere toplam 146 uzman hekim yanıtladı. Ankete katılan hekimlerin %73'ü üniversite veya eğitim araştırma hastanesinde çalışıyordu, katılımcıların %47'si yılda 100'den fazla bronkoskopi yapıyordu. Katılımcıların %36'sı yaptıkları bronkoskopilerin % 38'inde sedasyon yapmadıklarını belirttiler. Diğer taraftan, sedasyon için en fazla tercih edilen ilaç midazolam (%78) idi. Topikal anestezi yöntemi olarak lidokain nebülizasyonu göğüs hastalıkları uzmanlarının %77'si tarafından kullanılırken, göğüs cerrahisi ve anesteziyoloji uzmanlarında bu oran sırasıyla %13 ve %8 olarak saptandı (p<0,001).GH'lerin %38'i tanısal bronkoskopilerinin % 23'ünü genel anestezi altında yapıyordu. İşlem sırasında nabız oksimetresi takibi % 97, suplemental Oksijen kullanımı ise % 87 oranında bulundu. Göğüs hastalıkları uzmanlarının % 60'ı bronkoskopi eğitimi için, deneyimli bir uzman denetiminde en az 100 işlem yapılmasını, % 40'ı ise aynı sayının en az 50 olmasını yeterli görüyordu. Sonuç: Anket verileri ülkemizdeki bronkoskopi deneyimi hakkında bilgi vermektedir. Bu tür anketlerin soru çeşitliliğinin ve katılımcı sayı- sının arttırılarak tekrarlanmasının önemli bir veri kaynağı oluşturacağı düşüncesindeyiz.Objective: As in the rest of the world, there are differences in attitudes and behaviours among physicians in bronchoscopy applications in our country as well. The aim of this study was to put forward the attitudes and behaviours of bronchoscopists using a questionnaire as the Working Group of Interventional Pulmonology of Turkish Respiratory Society.Methods: The invitation letter prepared individuals for participation in the web-based questionnaire containing 23 questions on the implementation of diagnostic and interventional bronchoscopy; the link to the questionnaire was sent to the e-mail groups of pulmonologists, thoracic surgeons and anesthesia and intensive care specialists. The responses of the physicians participating to the questionnaire were evaluated. The results obtained from the questionnaire were evaluated generally and on the basis of medical branches by statistical analyses.Results: The questionnaire was answered by a total of 146 specialists including 93 pulmonologists, 30 thoracic surgeons and 23 anesthesiologists. In total, 73% of the physicians responding to the questionnaire were working at the University or Training and Research Hospital and 47% of the respondents were conducting more than 100 bronchoscopies per year. Here, 36% of the respondents stated that in the bronchoscopies that they carried out, they did not sedate their patients. On the other hand, the most commonly preferred medication for sedation was midazolam (78%). While 77% of the pulmonologists used nebulised lidocaine as a topical anesthetic, these rates were 12.5% and 8.3% respectively for thoracic surgeons and anaesthesiologists (p&lt;0.001). Also, 38% of pulmonologists were conducting 23% of the diagnostic bronchoscopies under general anesthesia. During bronchoscopy, the pulse oximetry follow-up was found to be 97%, and the supplemental oxygen administration was 87%. Overall, 60% of the pulmonologists thought that at least 100 procedures must be performed under the supervision of a specialist during bronchoscopy training and 40% of them were of the opinion that the number of procedures undertaken must be at least 50.Conclusion: The data of the survey give information about the practice of bronchoscopy in Turkey. It is suggested that the repetition of such questionnaires by increasing the variety of questions and the number of participants will provide an important data sourc

Acute Eosinophilic Pneumonia with Respiratory Failure Induced by Synthetic Cannabinoid Inhalation

Background: In recent days, synthetic cannabinoid derivatives have become life threatening for young people. Here, we want to share a case of acute eosinophilic pneumonia triggered by inhalation of synthetic cannabinoid, new side effects of which are being detected day by day. Case Report: A 21-year-old male, who had no history of pulmonary diseases, was admitted to the clinic with shortness of breath. His oxygen saturation was measured as 85-86% in room air. Common irregular ground-glass opacities were observed in thorax radiology. His peripheral blood eosinophil count was 1100 cell/mm³ with a leukocyte differential of 12%. Sputum eosinophilia was also observed. The patient was diagnosed with acute eosinophilic pneumonia in terms of current clinical, radiological and laboratory findings. Rapid remission was achieved with corticosteroid therapy. Conclusion: This is the first reported case of acute eosinophilic pneumonia induced by synthetic cannabinoid inhalation

Case Report Pulmonary Rehabilitation Using Modified Threshold Inspiratory Muscle Trainer (IMT) in Patients with Tetraplegia

It is aimed to present the usefulness of inspiratory muscle trainer (IMT) in treatment of a 20-year-old male patient with diaphragmatic paralysis and tetraplegia due to spinal cord injury (SCI), and supporting effect of IMT in recovering from respiratory failure by rendering his diaphragm functions. The treatment was applied through the tracheostomy cannula by a modified IMT device. After applying IMT for three weeks, it was observed that the diaphragm recovered its functions in electromyography (EMG) test. As a result, in this study, we present a case where a patient could live without any respiratory device for the rest of his life with the help of modified IMT