The Importance of Red Cell Distribution width value in Obstructive Sleep Apnea

Background: Obstructive sleep apnea (OSA) is a very common condition among sleep disorders. The relationship between inflammation and OSA has been described and inflammation was found to have a role in the development of the disease. Hematologic parameters have been found as inflammatory biomarkers in various diseases. Aim: To evaluated the association of OSA and red blood cell distribution width (RDW) value, and the association of RDW value in OSA patients with hypertension (HT) and without HT. Method: A retrospective and cross-sectional evaluation of the complete records of 412 patients, who were presented to our sleep center and underwent polysomnography. Polysomnographic parameters and RDW-CV values for these patients were evaluated. Result: Total 372 patients with obstructive sleep apnea syndrome and 40 people as a control group were included in the study. There was no significant difference between the OSA and control group regarding the mean RDW value (p>0.05). No statistically significant association was detected between RDW and apnea hypopnea index (AHI) in the evaluation of the OSA group. There was a negatively significant correlation between RDW and minimum oxygen saturation and mean oxygen saturation values in the OSA patients (p=0.002; r=-0.159,p=0.004, r=-0.148;respectively). A statistically significant difference was found in the mean RDW value based on the presence of HT in all OSA groups (p=0.031). The mean RDW of the group with HT was higher than group without HT. Conclusion: RDW must be taken into consideration during follow-up in severe OSA, and in the presence of HT

Prognostic Value of Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio in Lung Cancer

Numerous studies determined that the neutrophil/lymphocyte (NLR) and platelet/lymphocyte ratios (PLR) had prognostic value in several cancer types. This study aimed to evaluate the relationship between NLR and PLR values with the survival time of lung cancer patients. Patients diagnosed with lung cancer between January 2014 and December 2016, were retrospectively evaluated. Demographic characteristics, disease stages, laboratory parameters recorded, and the relationship of NLR and PLR values with the survival time and the disease stage evaluated. NLR and PLR were categorized into two groups. SPSS 17.0 software package was used for the statistical analysis. ROC analysis, Student T-test, Chi-square, and Mann-Whitney U test were used. Mean age of 62±8 years were included in the study. In the NSCLC group, the average NLR and PLR values were 4±3.35 and 194.6±144.4 respectively. Regarding the NSCLC group, the overall survival time was shorter in the subgroup with an NLR >3.43 (13.1 months) compared to the subgroup with an NLR ≤3.43 (24.3 months). The mean survival time was shorter in the group with a PLR > 136.9 compared to the group with a PLR ≤136.9 (15.9 and 24.6 months respectively). Subgroups consisting of survivors and non-survivors in the NSCLC group showed a statistically significant difference considering neutrophil and lymphocyte count, CRP, NLR, and PLR values (

Creatinine Clearance in Patients with Obstructive Sleep Apnea

During an apnea, hemodynamic complications such as hypoxemia, a rise in systemic and pulmonary arterial pressure, and changes in heart rate occur in patients with obstructive sleep apnea (OSA). Potential mechanisms of OSA-associated renal dysfunction include renal hypoxia, hypertension, endothelial dysfunction. Hypertension is common in patients with OSA. This study aims to assess OSA patients' renal functions and investigate the creatinine clearance (CC) values across OSA patients with and without hypertension. The study included 530 individuals with OSA and 60 individuals with an apnea-hypopnea index (AHI) of 0.05). A statistically significant difference was detected in urea and creatinine levels between the OSA and control groups (p=0.005; p=0.012). Creatinine clearance decreases in patients with OSA in the presence of HT. Patients with OSA often experience cardiovascular disorders, and glomerular endothelial dysfunction occurs in OSA patients

Tru-cut biopsy in cryptogenic organizing pneumonia

Cryptogenic organizing pneumonia (COP) was first described by Davison and colleagues in 1983. Previously, it was called bronchiolitis obliterans organizing pneumonia (BOOB). The following are known causes of COP: toxic gas inhalation, chemotherapy, radiation therapy, aspiration, blood transfusion, upper respiratory tract infections, or it can be idiopathic. The clinical features of the patients resemble those of pneumonia or upper respiratory tract infection. In COP, imaging scans of the lungs reveal diffuse migrating patchy infiltrations which are in contact with the pleura. Corticosteroids are the first choice for treatment, but in some patients other immunosuppressive drugs are needed. Low doses may result in relapses. Transbronchial biopsy has a low yield in the diagnosis, instead tru-cut biopsy is the first choice for a definitive diagnosis. In this paper, we define our experience with two patients from whom we obtained a tru-cut lung biopsy in order to reach for a diagnosis

Determination of Factors Affecting Mortality of Patients with Sepsis in a Tertiary Intensive Care Unit

OBJECTIVES: Sepsis is a disease with high mortality that is frequently observed in intensive care units. This study aimed to determine the risk factors affecting mortality of patients with sepsis who were followed up in the intensive care unit (ICU). We aimed to contribute to literature by evaluating the relationship between mortality and pro-brain natriuretic peptide (pro-BNP9), C-reactive protein (CRP), thrombocyte count, Acute Physiology and Chronic Health Evaluation (APACHE) II score, Sequential Organ Failure Assessment (SOFA) score, duration of hospitalization in the intensive care unit, and the presence of multidrug-resistant microorganism. MATERIAL AND METHODS: Patients hospitalized in ICU because of the diagnosis of sepsis and septic shock between December 2010 and June 2012 were included in this retrospective study. RESULTS: A total of 141 patients, including 74 male (52.5%) and 67 female (47.5%) patients, were involved in the study, and the median age was 66.8 +/- 17.9 years. Sixty-nine patients (48.9%) were discharged from the ICU; however, 72 patients (51.1%) were exitus. Multi-drug-resistant microorganism was detected in 34 patients (24.1%). The patients' median SOFA score was 9.16 +/- 3.16, median APACHE-II score was 24.9 +/- 7.83, and median duration of hospitalization in the ICU was 8.44 +/- 11.61 days. It was found that mortality rate significantly increased in patients with the APACHE-II score of 24.5 and over, SOFA score of 8.5 and over, pro BNP value of 7241 ng/L and over, and CRP value of 96.5 mg/dL and over. Mortality rate was detected to be higher in patients undergoing invasive mechanical ventilation than in patients undergoing non-invasive mechanical ventilation. When thrombocyte count and mortality were associated with each other, it was found that the median value was 86000 mg/dL in exitus patients, whereas it was 185000 mg/dL in patients discharged from the ICU. CONCLUSION: It was revealed that increased APACHE-II score, increased SOFA score, increased pro BNP score, increased CRP, the presence of multidrug-resistant microorganism, and decreased thrombocyte count elevated the rate of mortality. However, no relationship was observed between the duration of hospitalization in the ICU and mortality

TÜRKIYE’DE YOĞUN BAKIM ÜNITELERINDE VENTILATÖR ILIŞKILI PNÖMONIYI ÖNLEMEK IÇIN ALINAN GÜNCEL ÖNLEMLER: TÜRK TORAKS DERNEĞI SOLUNUM YETMEZLIĞI VE YOĞUN BAKIM ÇALIŞMA GRUBU NOKTA PREVALANS ÇALIŞMASI

Objectives: The inadequate quality and nature of sleep is a commonly reported problem among hospitalized patients. The purpose of this study is to examine the effects of progressive muscle relaxation training program on sleep quality, sleep state, pain and life quality of patients who underwent pulmonary resection