Asthma and asthma symptom prevalences in the students of Konya Selcuk University

Bu çalışma, Selçuk Üniversitesi öğrencilerinde, astım ve astım benzeri semptomların yaygınlığının ve astım gelişimini etkileyen risk faktörlerinin belirlenmesi amacıyla bir anket çalışması olarak gerçekleştirilmiştir. Çalışma, 2003-2004 eğitim-öğretim yılında Konya kent merkezindeki fakülte ve 4 yıllık yüksekokulların 1, sınıfında öğrenim gören 8110 öğrencinin 4504'üne 2003 Kasım- Aralık aylarında, ECRHS protokolüne dayanılarak hazırlanan yazılı anket uygulaması ile yapıldı. Çalışmaya alınan 4433 öğrencinin %52.4'ü erkek, %47.6'sı kız ve genel yaş ortalaması 19.2±1.5 idi. Çalışmada: current astım %1.6, kümülatif astım %2.7, astım benzeri semptom %38 olarak bulunmuştur. Son 12 aydaki vizing, vizing ile birlikte nefes darlığı ve nezle-grip olmadan olan vizing prevaiansiarı sırasıyla %20.5, %9.5, %7.8 olarak bulunurken gece uykudan göğüste sıkışma hissi, nefes darlığı, öksürük atağı ile uyanma oranları ise sırasıyla %1 1.1, %8.5 ve %19 olarak bulunmuştur. Son 12 ayda astım atağı geçirme ve halen astım İçin tedavi kullanma oranları ise %1.3 ve %0.8 bulunmuştur. Allerjik rinit oranı ise %1 1 bulunmuştur. Bu çalışmada, cinsiyet, allerjik rinit, ailesel atopi, yaşanılan bölge ve sigara gibi risk faktörlerinin astım prevalansı üzerine etkileri de araştırılmıştır. Önceki çalışmalarla uyumlu olarak ailesel atopi, allerjik rinit ve sigara faktörlerinin astım gelişiminde risk faktörleri olarak rol oynayabileceği belirlenmiştir. Cinsiyetin ise astım gelişimine fazla etkisinin olmadığı tespit edilmiştir. Sonuç olarak çalışmamız, Türkiye'de erişkin populasyonda bildirilen oranlarla karşılaştırıldığında üniversite öğrencilerinde astım sıklığının daha düşük olduğunu göstermiştir. Öte yandan bu çalışmada saptanan bulguların ülkemiz üniversite öğrencilerinde yapılan diğer çalışmalarda bildirilen verilerle uyumlu olduğu gözlenmiştir.his study was performed in the students of Selçuk University, for the purpose of determining the prevalence of asthma and asthma like symptoms and the effect of risk factors on the development of asthma. The data were collected through the application of the ECRHS questionnaire to 4504 subjects from the selected 8110 students registering at various faculties in the city of Konya, in the academic year 2003-2004. The survey was conducted in November-December 2003. Of the 4433 students enrolled in the study, 52.4% were males and 47.6% were females. Mean age was 19.2±1.5 years. The prevalence of current asthma was 1.6%, prevalence of cumulative asthma was 2.7% and prevalence of asthma like symptoms was 38% in this study. Prevalences of wheezing, wheezing associated with shortness of breath and wheezing without cold in the last 12 months were found to be 20.5%, 9.5% and 7.8%, respectively. Prevalences awakening with the feeiing at chest tightness, with shorthness of breath and with cough attack were reported 11.1%, 8.5% and 19% in the last 12 months, respectively. Asthma attack within previous 12 months and use of medicine for asthma rates were found to be 1.3% and 0.8%. Aiiergic rhinitis rate was 11%. In this study, risk factors affecting asthma prevalence were also investigated and in accordance with the previous studies, it is found that the family history of atopy, allergic rhinitis, smoking and the geographical region may piay role as risk factors for developing asthma. Sex was not a significant risk factor for developing asthma. In conclusion, our study has showed that the prevalence of asthma in the university students is less than the ratios reported fort he adult population in Turkey. However the findings of this study are concordant with the previous findings reported in some studies performed in the other university students of our country

Şiddetli Astım Akut Alevlenmelerinde Noninvaziv Ventilasyon

WOS:000360001300008Astım, bronşial düz kas kontraksiyonu, hava yolu inflamasyonu ve sekresyonlarda artış sonucu oluşan reverzibıl hava yolu obstrüksiyonu ile karakterize kronik bir hastalıktır. Astım hastalarının çoğunda ataklar medikal tedavi ile kolayca kontrol altına alınabilir. Ancak çok küçük bir hasta grubunda astım atakları ölümcül olabilmektedir. Bu hasta grubunda şiddetli astım atakları standart tedaviye dirençlidir ve bu hastaların bir kısmında mekanik ventilasyon tedavisine ihtiyaç olmaktadır. Astımlı hastalar invaziv mekanik ventilasyonun olağan komplikasyonlarına ilave olarak başka komplikasyonlar için de risk altındadırlar. Bu hastalarda yeterli ventilasyonu sağlamak yüksek inspiratuar basınçlarda dahi zor olabilmekte ve sıklıkla hasta-ventilator asenkronisi gelişmektedir. Noninvaziv ventilasyon (NIV) son 20 yıldır akut solunum yetmezliği tedavisinde giderek artan bir şekilde kullanılmaktadır. Günümüzde NIV'in KOAH alevlenmesi ve akut akciğer ödeminin standart ilk seçenek tedavisi olduğu kabul edilmektedir. Bilgi ve tecrübelerdeki artış NIV'in daha önce kontrendike olduğu düşünülen astımda da kullanılabileceği konusunu gündeme getirmiştir. Bu derlemede şiddetli akut astım ataklarında NIV'nin kullanımı ile ilgili güncel bilgileri gözden geçirilmesi amaçlanmıştır. Günümüzde şiddetli astım ataklarında NIV kullanımını tavsiye etmek için yeterli veriler olmamakla birlikte bazı ilginç ve ümit verici sonuçlar vardır. Sonuç olarak çelişkileri ortadan kaldırabilmek için respiratuar asidozu ve hiperkapnisi olan hastaların dâhil edildiği iyi dizayn edilmiş yeni çalışmalara ihtiyaç vardır.Asthma is a chronic disease characterized by reversible airway obstruction caused by bronchial smooth muscle contraction, airway inflammation, and increased secretion. In most patients, control of disease activity is easily achieved with medical therapy. However, in a small minority, asthmatic attacks may be fatal. Some patients with severe asthmatic attacks are refractory to standard treatment, and a few of these patients have a history of severe asthmatic attacks that necessitated mechanical ventilation. In addition to the usual complications of mechanical ventilation, invasive mechanical ventilation in asthmatic patients is associated with other risks. These patients are often difficult to ventilate, have low compliance with high inspiratory pressures, and have frequent patient-ventilator asynchrony. Noninvasive ventilation (NIV) has been increasingly used to treat acute respiratory failure in the past two decades. It is now considered as standard first-line therapy in chronic obstructive pulmonary disease exacerbations and acute pulmonary edema. The increase in knowledge and experience has revived the use of NIV in asthma, which has previously been thought to be contraindicated. The purpose of this article is to review the up-to-date information on the use of NIV during severe acute asthmatic attacks. Nowadays, although sufficient data are not present to recommend the use of NIV in severe asthmatic attacks, there are some interesting and promising results about NIV. In conclusion, new well-designed studies including cases with respiratory acidosis and hypercapnia are necessary to eliminate the controversy

Factors affecting the success of weaning in patients with chronic obstructive pulmonary disease

Objectives: Weaning failure rate was higher in patients with chronic obstructive pulmonary disease (COPD) and many factors affect it. The aim of this study was to investigate the factors affecting the success of weaning in COPD patients receiving invasive mechanical ventilation (IMV).Materials and methods: Totally 43 COPD patients who received IMV in intensive care unit were included. Clinical and laboratory results and Acute Physiology Assessment and Chronic Health Evaluation (APACHE II) scores were recorded and affecting factors on weaning success were investigated.Results: In 43 patients, 25 had successful weaning (58.1%). Patients with high APACHE II score prior to intubation was found as associated with weaning failure. High Glasgow coma scale (GCS) scores before entubation and weaning are associated with weaning success. Pre-weaning anxiety, positive endotracheal aspirate culture, pulmonary arterial pressure value, enteral feeding, pre-weaning tachycardia, pre-weaning cuff leaking and FiO2 values were found to be associated with weaning failure. Pre-weaning cortisol levels were associated with weaning success. In successful weaning group, measured NIF and VT in spontaneous mode were found as higher and f/VT ratio was lower compared with unsuccessful group. T-tube during the 15th and 30th minutes of the symptoms of fatigue (sweating assets) were associated with weaning failure. IMV duration and longer extubation duration of weaning, and more number of t-tube insertion attempts were found as associated with failure of weaning.Conclusions: Infection in patients with COPD, the presence of anxiety, and hemodynamic and respiratory instability significantly increases the weaning failure

The Effect Of Telithromycin On Inflammatory Markers In Chronic Obstructive Pulmonary Diseases

Aim : To evaluate the anti-inflammatory effect of telithromycin on sputum interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α), myeloperoxidase (MPO) levels in patient with chronic obstructive pulmonary diseases (COPD). Methods : Thirty four patients with mild to moderate COPD were enrolled in this prospective, single center, double-blind, placebo controlled study. Subjects received either telithromycin or placebo for 10 days. Before and after treatment period spirometric tests, arterial blood gas analyses were performed, sputum samples were taken for measurement of sputum inflammatory markers, and spu-tum was induced. Results : There was no statistical difference in baseline clinical or laboratory parameters between groups. After the treatment, the induced sputum IL-8, TNF-α, , MPO levels is similar compared with pretreatment levels. Conclusion : In this study, anti-inflammatory effects of telithro-mycin in stable COPD patients were not demonstrated. Further studies are needed to determine the clinical significance of these findings

Myasthenia gravis with acute respiratory failure in the emergency department

Acute respiratory failure (ARF) is defined as a sudden malfunction in the ability of respiratory system to maintain adequate gas exchange. Acute hypercapnic respiratory failure develops as a result of ventilation deficiency and it is defined as an increase of PaCO2 above 45 mmHg. Myasthenia Gravis (MG) is a sporadically developing auto-immune deficiency where the neuro-muscular transmission is affected and it is one of the important reasons for neurologically-induced respiratory distress. Here, we report a case of a 75-year-old male patient previously undiagnosed MG, who presented with ARF. MG is not a common entity that we encounter daily. Patients on occasions may present to the emergency department because of acute exacerbation. Though most of them were known cases, we should be aware of some unrecognized cases and should consider MG as a differential diagnosis for patients with acute respiratory failure. Keywords: Acute respiratory failure, Myasthenia graves, Emergency medicin

Computed Tomography Findings in Pulmonary İnvolvement of Wegener's Granulomatosis: Pictorial Review

Wegener granülomatozis, akciğerde en iyi bilgisayarlı tomografide tanımlanan, değişik bulgularla ortaya çıkabilen nekrotizan granülomatöz bir vaskülittir. Görüntüleme bulguları kaviteleşebilen nodül veya kitleler; konsolidasyon ve buzlu cam yoğunluklarıdır. Wegener granülomatozis pnömoni, malignite ve infeksiyon dışı inflamatuvar hastalıkları taklit edebilir. Bu resimli derlemenin amacı Wegener granülomatozisin akciğer tutulumunda karakteristik bilgisayarlı tomografi bulgularını göstermektir.Wegener's granulomatosis is a necrotising granulomatous vasculitis which has a variable manifestations in the chest that are best described on computed tomography. Imaging findings may include masses or nodules, which may cavitate; consolidations and ground-glass opacities. Wegener's granulomatosis can mimic pneumonia, malignancy, and noninfectious inflammatory diseases. The purpose of this pictorial essay is to demonstrate the characteristic computed tomography findings of pulmonary Wegener's granulomatosis