Makale Arama

The aim of our study was to determine serum asymmetric dimethylarginine (ADMA), nitric oxide (NO) and arginine levels in patients with acute attack, stable and cor pulmonale Chronic Obstuctive Pulmonary disease (COPD). Twenty five acute attack of COPD, twenty five stable of COPD, twenty five cor pulmonale subjects partipicated in this study. To be selected patients had to have no other diseases. The control group was formed by twenty five appearentely healthy people. ADMA and arginine levels were measured by high performance liquid chromatoghraphy with fluorecence detection. Serum nitrite/nitrate concentrations were determined using a commercial colorimetric assay. Patients of acute (p

A retrospective study was performed to investigate the mortality among the patients hospitalized in department of chest diseases Dicle University medical school clinic. The patients passed out in this clinic in the period from January 2004 to May 2009 were evaluated. It was determined that totally 4417 patients were hospitalized (8892 hospitalization) in this period and 384 (8.6%) of them resulted in death. The mean age of the patients was 66.8±15.3 and 92 (33%) were women and 187 (67%) were men. The principal causes of their mortality were pneumonia in 92 patients (33.1%), chronic obstructive pulmonary disease (COPD) in 87 (31.2%) patients, pulmonary cancer in 52 (18.6%) patients, tuberculosis (TB) in 18 (6.5%) patients, pulmonary thromboembolism (PE) in 18 (6.5%) patients and another diseases in 12 (4,2%). When the accompanying diseases were evaluated, no additional diseases were determined in 130 (46.6%) patients; 41 patients (14.7%) had cardiac disorders, 22 patients (7.9%) had cancers outside the lungs, 18 patients (6.5%) had cor pulmonale, 17 patients (6.1%) had neurologic disorders, 15 patients (5.4%) had renal diseases, 10 patients (3.6%) had diabetes mellitus (DM), 9 patients (3.1%) had TB and 17 patients (6.1) had unclassified disorders. In conclusion, we think that the knowledge about their mortality rates and the causes of mortality is useful for every clinic for their approach to the patients and considering the accompanying diseases is helpful to decrease the mortality

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. For many patients, maximal therapy for COPD produces only modest or incomplete relief of disabling symptoms and these symptoms result in a significantly reduced quality of life. Despite the high morbidity and mortality associated with severe COPD, many patients receive inadequate palliative care. There are several reasons for this. First, patient– physician communication about palliative and end-of-life care is infrequent and often of poor quality. Secondly, the uncertainty in predicting prognosis for patients with COPD makes communication about end-of life care more difficult. Consequently, patients and their families frequently do not understand that severe COPD is often a progressive and terminal illness. The purpose of the present review is to give knowledge regarding palliative and end-of-life care for patients with COPD. Recent studies provide insight and guidance into ways to improve communication about end-of-life care and thereby improve the quality of palliative and end-of-life care the patients receive. Two areas that may influence the quality of care are also highlighted: 1) the role of anxiety and depression, common problems for patients with COPD; and 2) the importance of advance care planning. Improving communication represents an important opportunity for the improvement of the quality of palliative and endof-life care received by these patients.

Those who am working in the mercury proces-sing plant and suffcring from chronic obstructive pulmonery diseasc (COPD) were studicd for possible mercury toxicity. The study reveals that about 23.95 % of the total workes were COPD patients and their problems were bccause of the cigaret smoking rather that' the toxicity from the exposure. In addition to this study we found that the workes had poor oral hygenic care.

Chest pain is the most common reason of emergency service visits and is analysed in two subdivisions as cardiac and non-cardiac. Pain of cardiac origin is well understood but pathophysiology of non-cardiac chest pain is complex and poorly understood. In this study, we aimed to assess the characteristics of patients and final diagnoses of patienets admitted to pulmonary clinic with chest pain. In our study, we prospectively analyzed 97 male and 103 female in a total 200 patients who admitted to pulmonary clinic with chest pain. Demographic, clinic characteristics, medical and family histories were noted. After their consultation with the relevant clinic within indications their final diagnosis were recorded. According to the results, pain with musculoskeletal origin was the most common, gastrooesophageal reflux the second, chronic obstructive pulmonary disease, asthma and acute bronchitis related chest pain was the third most common reason. In conclusion majority of patients admitted to pulmonary clinics with chest pain mostly are related to musculoskeletal reasons. On the other hand, patients with chronic obstructive pulmonary disease, asthma and acute bronchitis patients especially who are not diagnosed yet may define shortnes of breath and chest tightness as chest pain.

It was reported that there is relationship between high brain natriuretic peptide (BNP) levels and mortality in chronic obstructive pulmonary disease (COPD). In this study, we investigated effect of NIV to the BNP and troponin. Fifty eight cases with COPD were enrolled to this study. The patients were divided into two groups as cases receiving NIV (n:41) and cases not receiving NIV (n:17). In both groups pretreatment and posttreatment pro BNP and troponin levels were measured. Initially, in NIV group both pro-BNP (2013.95 pg/ml) and troponin (0.17 ng/ml) levels were significantly higher than those of control group (328.9 pg/ml and 0.02 ng/ml, respectively) (p0.05). In conclusion, in severe COPD acute exacerbations that develop respiratory failure, both pro-BNP and troponin levels increase significantly. This increase suggests that in COPD exacerbations, depending on severity of exacerbation right ventricle load and pulmonary hypertension may be more prominent and myocardial injury may accompany this. In COPD exacerbations, NIV treatment could safely decrease the increased pro-BNP levels without increasing the myocardial injury.

\r\n A decrease in retinal nerve fiber layer thickness can be secondary to glaucoma, several neurologic diseases, optic nerve diseases other than glaucoma, retinal diseases, toxic, nutritional or vascular causes such as shock optic neuropathy. Glaucoma, which is among the commonest causes of blindness worldwide, is a progressive optic neuropathy characterized by a decrease in retinal nerve fiber layer thickness secondary to retinal ganglion cell death, cupping of optic nerve head and visual field loss. Although the best known risk factor associated with glaucoma is high intraocular pressure, it is thought that systemic vascular disorders, which are among the risk factors of glaucoma, play role especially in the pathogenesis of normotensive glaucoma where intraocular pressure is low. In our study, we described a patient with decreased retinal nerve fiber layer thickness and thought normotensive glaucoma as the most probable diagnosis, who also had multiple systemic vascular diseases. 

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Aim: In this study, we aimed to discuss our experience and results of non-operating room anesthesia.

Materials and Methods: Anesthesia records of patients older than 18 years who underwent sedo-analgesia outside the operating room for diagnosis and treatment between May 2017 and December 2017 were retrospectively screened. The records were examined in terms of demographic data, applied procedure, duration of the procedure, sedation grade, medications used, developing minor and major complications, chronic obstructive pulmonary disease story and intensive care need. Relationships between complications with demographic data and categorical variables were analyzed.

Results: Totally 2562 patients underwent sedo-analgesia. 1428 (55.7%) of these cases were female and 1134 (44.3%) of them were male. The average age of patients was 53.08±16.55. 268 (10.5%) of the cases were ASA I, 1683 (65.7%) were ASA II, 598 (23.3%) were ASA III and 13 (0.5%) were ASA IV. 519 (20.3%) patients were minimally sedated, 1541 (60.1%) were moderate sedated and 502 (19.6%) deep sedated. The longest procedure time in endoscopic retrograde cholangiopancreatography was 28.7 ± 16.3 min, and the shortest procedure time in endoscopy was 10.3 ± 3.1 min. The most commonly performed procedure was colonoscopy with 31%. The most commonly used drug combination was midazolam + propofol + fentanyl applied to 1231 patients (48%). 148 (5.76%) patients had minor complication, and 10 (0.37%) patients had major complication. A total of 15 (0.58%) patients underwent intensive care after the procedure. Desaturation was statistically significantly higher in patients with ASA III and above, in procedures take longer than 15 minutes, in patients older than 65 years, and in the presence of chronic obstructive pulmonary disease. The intensive care need after the procedure was also significantly higher in these patient groups.

Conclusion: The incidence of non-operating room anesthesia is increasing steadily. The risks associated with these practices are similar to the anesthesia in the operating room. In order to increase patient safety and reduce complications, it is important to carry out a thorough evaluation before the procedure, to provide proper monitored anesthesia care in appropriate physical conditions, and to establish healthy communication between the teams.

Abstract

Aim: We aimed to assess the changes in retinal nerve fiber layer (RNFL) and optic nerve head (ONH) in patients with chronic obstructive pulmonary disease (COPD).

Patients and Methods: Thirty patients having severe COPD and 29 age and sex-matched healthy subjects were enrolled in the study. After a detailed ophthalmic examination, the ONH and RNFL thickness measurements were taken by an optical coherence tomography (OCT) (Stratus OCT-3). Arterial blood gases (pO₂ and PCO₂) were measured and respiratory functional tests were performed for the staging of COPD patients. The OCT parameters were compared difference between the 2 groups using independent t test, while Pearson correlation analysis was performed to assess the correlations between respiratory functional tests, arterial blood gases and RNFL thickness parameters. A p value less than 0.05 was accepted as statistically significant.

Results: There were no significant differences in optic disc area, cup area and rim area between COPD and healthy subjects (p>0.05). Parameters of mean and superior quadrant RNFL thickness were found to be significantly thicker in COPD subjects (114.52±7.7 µm and 141.07 ±18.2 µm, respectively) compared to the control subjects (107.9±5.4 µm and 131.31±13.6 µm, respectively) (p<0.05). No correlation was found between pO₂ and RNFL thickness (r=-0.22, p=0.33). There was a moderate correlation between pCO₂ and superior quadrant RNFL (r= 0.53 and p=0.017), and a high negative correlation between FEV₁/FVC and superior quadrant RNFL (r=-0.76, p=0.003).

Conclusions: The increase in pCO2 and the decrease in FEV1 / FVC indicate increased hypoxia. Peripapillary RNFL loss associated with RGC death can be masked by hypoxia / ischemia-induced retinal and optic disc edema. Increased mean RNFL thickness in COPD patients was thought to be due to retinal edema associated with increased hypoxia.