Moralespettersson9074

In patients with coils, the biopsy can lead to massive hemorrhages that are fatal.Transbronchial cryoprobe lung biopsy (TBCLB) have recently been introduced as a safe diagnostic tool in the diagnosis of interstitial lung diseases. While we do not enough evidence its role and place as a diagnostic procedure, the technique has been adopted by many centers. In spite of expanding body of literature, there are variations in patient selection and procedural aspect of the procedure. It has been established as a safe procedure if safety measures are practiced. Diagnosis of interstitial lung diseases continuous to be challenging. Surgical lung biopsy considered as gold standard but its morbidity and mortality limit its utilization in every case. Multidisciplinary medical decision is a validated team work effort when approaching patients with interstitial lung disease.The current understanding in severe asthma management is the targeted therapy approach with the evaluation of phenotypes and biomarkers. Therefore, personalized treatments are recently more prominent. Eosinophilic asthma with chronic rhinosinusitis/nasal polyps (CRSwNP) is one of the severe asthma phenotypes which needs a personalized treatment approach. Biological agents which specifically target type 2 (T2) high inflammation have been used in this severe asthma phenotype with a preferable safety profile. In the present review, biological agents in eosinophilic asthma with CRSwNP will be discussed.Introduction We aimed to evaluate the diagnosis of patients who applied on the first three years of our clinic, in order to contribute to the state of occupational diseases (OD) in Turkey. Materials and Methods The study is a cross-sectional study, between November 2013 and December 2016, 862 subjects were accepted for the evaluation. Gender, age, application ways, the reason of referral, workplace, exposure time and possible risks for the patients were evaluated through a file examination. Result Total of 708 (82.1%) was male and 154 (17.9%) were female. The mean age of the subjects was 38.3 ± 7.7 years; the mean term of employment was 126.6 ± 87.3 (1-420) months. The most common cause of referral was the suspicion of occupational pulmonary diseases (64.3%) with 554 workers. 435 workers (50,6%) were diagnosed to have an OD, 78 workers (9.0%) were diagnosed with work-related diseases. The most common diagnoses of OD; 169 (38.9%) pneumoconiosis, 71 (16.3%) occupational asthma, 38 (8.7%) cervical disc hernia, 24 (5.5%) lumbar disc hernia, 24 (5.5%) hearing loss, 19 (4.3%) cubital/carpal tunnel, and 15 (3.4%) workers have lead intoxication. Conclusions Dust, chemicals, ergonomic risks and noise still remain as important occupational health risks in Turkey. It is seen that the existing occupational diseases monitoring system is inadequate to identify and manage the health problems of the workers. CXCR antagonist An effective and comprehensive occupational disease monitoring system should be established and legal regulations should be planned.Introduction Tracheobronchial stents (TBS) are the principal modalities in the management of central airway obstruction with intrinsic tracheobronchial pathology and extrinsic airway compression. The aim of the study is to assess the indications, surveillance management, complications, and long-term outcomes of the TBS managed by rigid bronchoscopy (RB) in our 10-year experience. Materials and Methods The files of all patients who underwent stenting in two centers from November 2008 to September 2018 were reviewed for background data, type of disease, and indication for the placement of stents, symptoms, treatment, complications and outcome. Result 305 patients were stented with 342 TBS. TBS were placed in both malignant (n= 223) and benign airway diseases (n= 82). The median length of stent stay was 88 (34-280) days in patients with malignancies and 775 (228-2085) days in benign diseases. There was no stent-related mortality. Mucostasis (19%) and granulation tissue formation (17%) were the most common stentrelated complications. Benign nature of the disease, tumors metastatic to tracheobronchial tree, lenght of stent stay, and shape of stent were associated with the development of complications. Conclusions TBS offer a safe and effective therapy for patients with both benign and malign tracheobronchial pathologies.Introduction To investigate the relationship between body mass index (BMI) and the severity of obstructive sleep apnea (OSA) and to determine the BMI cut-off values for sleep-disordered breathing among adult population. Materials and Methods Data from 515 patients were evaluated retrospectively. These included demographic data, BMI, apnea-hypopnea index (AHI), oxygen saturation (SaO2) and oxygen desaturation index (ODI). The BMI cutoff value for sleep-disordered breathing was determined and comparisons were made between two groups of patients (BMI ≤ 33 and BMI > 33). Descriptive and comparative analyses were performed using SPSS, version 24. Result Higher BMI values were found to be correlated with diagnosis and severity of OSA and reduced sleep efficiency. Patients in the BMI > 33 group had significantly higher rates of co-morbid diseases than patients in the BMI ≤ 33 group. Patients with BMI ≤ 33 had significantly lower ODI values than patients with BMI > 33. In patients with BMI > 33, arousal index was significantly higher and SaO2 values were lower than those with BMI ≤ 33. In rapid eye movement (REM) sleep-related OSA, BMI values were higher than positional/classical OSA. Conclusions Patients with higher BMI experienced frequent nocturnal oxygen desaturation periods resulting in higher arousal indexes and decreased sleep efficiency. REM sleep-related OSA and high BMI values together may lead to increased nocturnal oxygen demand. We recommend the threshold values of BMI > 33 to be considered for screening OSA among adult population.Introduction Obesity has been considered to be one of the important risk factor for obstructive sleep apnea (OSA). We aimed to investigate the clinical and polysomnographic differences of obese and non-obese OSA patients and how these differences, if any, can be reflected in our daily clinical practice. Materials and Methods The polysomnographic data of 157 consecutive patients that underwent a sleep study were analyzed. Ninety-nine adult patients with a diagnosis of OSA [apnea-hypopnea index (AHI) ≥ 5/hour] were retrospectively assesed in two groups in respect of obese (BMI ≥ 30 kg/m2) or non-obese (BMI 0.05). While in the obese OSA patients the AHI and Epworth Sleepiness sclae were higher (respectively; p= 0.028, p= 0.01), average oxygen saturation at sleep was lower (p less then 0.001). While obese OSA patients had similar ratio of hypertension and atherosclerotic heart disease with non-obese OSA patients, whereas diabetes mellitus was higher in obese OSA group (p= 0.036). The use of antidepressant drug was more common in the non-obese patients than the obese patients (p= 0.011). Conclusions Although obese OSA patients have a more severe disease compared to nonobese OSA patients, there were no significant differences in clinical and polysomnographics findings between two groups. Should be noted that OSA may occur in non-obese patients.Introduction In this study, we aimed to determine the values of anthropometric measurements and rates used in the evaluation of obstructive sleep apnea syndrome (OSAS) in our country. Materials and Methods Twenty accredited sleep centers in thirteen provinces participated in this multicenter prospective study. OSAS symptoms and polysomnographic examination and apnea-hypopnea index (AHI) ≥ 5 cases OSAS study group; patients with AHI less then 5 and STOP-Bang less then 2 were included as control group. Demographic characteristics (age, sex, body mass index-BMI) and anthropometric measurements (neck, waist and hip circumference, waist/hip ratio) of the subjects were recorded. Result The study included 2684 patients (81.3% OSAS) with a mean age of 50.50 ± 0.21 years from 20 centers. The cases were taken from six geographical regions of the country (Mediterranean, Eastern Anatolia, Aegean, Central Anatolia, Black Sea and Marmara Region). Demographic characteristics and anthropometric measurements; age, neck, waist, hip circumference and waist/ hip ratios and BMI characteristics when compared with the control group; when compared according to regions, age, neck, waist, hip circumference and waist/hip ratios were found to be statistically different (p less then 0.001, p less then 0.001, p less then 0.05, respectively). When compared by sex, age, neck and hip circumference, waist/hip ratio, height, weight and BMI characteristics were statistically different (p less then 0.001, respectively). Neck circumference and waist/hip ratio were respectively 42.58 ± 0.10 cm, 0.99 ± 0.002, 39.24 ± 0.16 cm, 0.93 ± 0.004 were found in women. Conclusions The neck circumference was lower than the standard value in men, but higher in women. The waist/hip ratio was above the ideal measurements in both men and women. In this context, the determination of the country values will allow the identification of patients with the possibility of OSAS and referral to sleep centers for polysomnography.Introduction Dysnatremia is reported to have a prognostic effect in various diseases. A limited number of studies have been published on dysnatremiarelated parameters and clinical outcome in patients with pneumonia. The aim of the study is to analyze the factors related to baseline dysnatremia and to evaluate the clinical outcome of dysnatremia on hospital stay, 30-day and 1-year mortality in hospitalized patients with community-acquired pneumonia (CAP). Materials and Methods The study is a two-centre, retrospective, crosssectional study. According to the baseline corrected sodium values, hospitalized patients with CAP were grouped as hyponatremia ( 145 mmol/L). Result Of all the 471 patients included, 119 (25.3%) had hyponatremia and 25 (5.3%) had hypernatremia. Higher leucocytes and lower albumin values correlated with hyponatremia while female gender, higher leucocytes and urea levels correlated with hypernatremia. Baseline hyponatremia prolonged hospital stay (9.2 ± 5.6, vs. 7.5 ± 4.6, respectively, p= 0.001) and increased 1-year mortality. On the other hand, hypernatremia predicted 30-day (40%, vs. 10%, p less then 0.001) and independently predicted 1-year mortality (p less then 0.001). Conclusions In hospitalized patients with CAP, baseline hyponatremia prolongs hospital stay while hypernatremia signals a worse outcome both in the short term and long term.The N-methyl-D-aspartate receptor (NMDAr) system is critically involved in the pathogenesis and neurobehavioral sequelae of alcohol use disorder (AUD), and constitutes a potential pharmacotherapeutic target. Memantine (Namenda) is an FDA-approved NMDAr antagonist with suggested utility in AUD, however its safety and tolerability during long-term administration among recently-detoxified patients remains uncharacterized. This pilot study assessed safety, feasibility, and several secondary measures of interest, during a 4-week period of residential AUD treatment. Participants (N = 18) met diagnostic criteria for AUD. A double-blind, placebo-controlled, escalating-dose design was utilized. Assessments of medication side-effects were conducted weekly. At intake, week 2, and study completion, participants completed a battery assessing affective symptomatology, craving, and neurocognitive function. Medication groups reported equivalent side effects and severity. Medication compliance was high, and did not differ by group.