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Objectives: Chronic obstructive pulmonary disease (COPD) is a medical condition defined by persistent airflow limitation and respiratory symptoms caused by airway and/or alveolar abnormalities. Pulmonary hypertension (PH) is one of the cardiovascular comorbidities associated with COPD. We investigated the correlation of NLRC3 levels in patients with COPD with prognostic and surrogate parameters of PH on echocardiography and examined whether it could be used to predict PH in this patient population. Methods: A total of 80 patients diagnosed with COPD and 40 healthy volunteers as the control group were included in the study. The COPD group was further divided into two subgroups according to the systolic pulmonary artery pressure (sPAP) as follows: sPAP<35 mmHg and sPAP≥35 mmHg. The enzyme-linked immunosorbent assay (ELISA) method was used to determine the levels of NLRC3 in peripheral blood. Results: Patients with sPAP≥35 mmHg had a lower mean NLRC3 level than those with sPAP<35 mmHg (P=0.006). The NLRC3 levels showed a significant negative correlation with sPAP, tricuspid regurgitation velocity, right atrium, and pulmonary artery diameter. For NLRC3, the cut-off value was found to be 271,486 ng/L, with a sensitivity of 74%, and specificity of 63% in distinguishing patients with sPAP≥35 mmHg from all patients with sPAP<35 mmHg. Conclusion: Our study results suggest that NLRC3 levels measured from peripheral blood are predictive of PH in patients with COPD. Although the exact function of NLRC3 in the lungs, COPD, and PH have not been completely understood, we believe these findings will serve as a model for future studies. [ABSTRACT FROM AUTHOR]

Cystic fibrosis is the most common autosomal recessive hereditary disease in white populations. It is characterized by the formation of abnormal secretions in the exocrine glands located in the sweat and salivary glands, tracheobronchial tree, large intestine, and pancreas. The severity of the clinic depends on the type of "cystic fibrosis transmembrane regulatory protein" gene mutation. Although most cases are diagnosed in infancy or childhood, some patients are also diagnosed during adolescence and adulthood. We report a case a 19-yearold patient who was followed up with a diagnosis of asthma and bronchiectasis since childhood and diagnosed with cystic fibrosis. [ABSTRACT FROM AUTHOR]

Methemoglobinemia is a serious hematological disease characterized by the incapability of sufficient oxygen delivery to tissues and cyanosis when iron within hemoglobin in ferrous form (Fe+2) is oxidized to ferric form (Fe+3). Methemoglobinemia may be congenital or acquired. While prilocaine-induced methemoglobinemia can be seen in newborns and early pediatric ages, it is a rare condition in adults. We aimed to investigate prilocaine-induced adult methemoglobinemia with four cases. [ABSTRACT FROM AUTHOR]

Obstructive sleep apnea (OSA) is associated with increased cardiovascular (CV) morbidity and mortality. Endocan is a surrogate endothelial dysfunction marker that may be associated with CV risk factors. In this study, we tested whether serum endocan is a biomarker for OSA. Serum endocan levels were measured at baseline in 40 patients with OSA and 40 healthy controls and after 3 months of continuous positive airway pressure (CPAP) treatment in the patients with OSA. All participants were evaluated by full polysomnography. Flow-mediated dilatation (FMD) and carotid intima media thickness (cIMT) were measured in all participants. Endocan levels were significantly higher in patients with OSA than in healthy controls. After adjusting confounders, endocan was a good predictor of OSA. Endocan levels correlated with OSA severity (measured by the apnea–hypopnea index [AHI]). After 3 months of CPAP treatment, endocan levels significantly decreased. Endocan levels were significantly and independently correlated with cIMT and FMD after multiple adjustments. The cIMT and FMD also had significant and independent correlation with AHI. Endocan might be a useful marker for the predisposition of patients with OSA to premature vascular disease. [ABSTRACT FROM AUTHOR]

Background Epidemiological studies show that vitamin D deficiency and insufficiency are common worldwide and associated with many diseases including asthma. Our aim was to evaluate vitamin D insufficiency and its clinical consequences. Methods This cross-sectional study was carried out on 170 children consisted of 85 who were asthmatic and 85 who were not, aged 2 to 14 years in Tekirdag, Turkey, from September 2009 to May 2010. Children's basal serum D vitamin levels were determined, and their eating habits, vitamin D intake, exposure to sunlight and use of health services during the previous year were investigated. The severity of asthma and levels of asthma control were assessed according to the Global Initiative for Asthma guidelines. Results The difference between mean vitamin D levels in the asthmatic group (mean +/− SD) 16.6 +/− 8.5 ng/mL and the healthy control group (mean +/− SD) 28.2 +/− 19.5 ng/mL was found to be statistically significant (p < 0.001). Children in the asthma group had less exposure to sunlight and ate a diet less rich in vitamin D (p < 0.001). A significant difference was observed between the groups regarding the frequency of respiratory tract infections leading to emergency unit admissions and number of hospitalizations (p < 0.001). It was also shown that a decrease in vitamin D level increased the severity of asthma (p < 0.001) and decreased the frequency of controlled asthma (p = 0.010). Conclusion This study has demonstrated the correlation between plasma 25 (OH) D levels and childhood asthma. Evidently, this relationship being influenced by multiple factors other than vitamin D, further studies should be conducted to explore the interrelation between all such factors. [ABSTRACT FROM AUTHOR]

Sarcoidosis is a multisystemic, granulomatous disease with an unknown etiology. Although granulomas suggest an etiology related to infectious, and organic agents, their etiologies are still unknown. A 16 year-old girl referred with complaints of cough, malaise, and painful lesions on legs lasting for 4 months. On physical examination, no pathological sign was observed, except an erythema nodosum-like purple lesion, the largest one being 5 cm in diameter was detected on the tibial region. Erythrocyte sedimentation rate was 60/1 hour and CRP 15.66 mg/L. Angiotension converting enzyme level was elevated. High resolution thoracal CT results were reported as multiple mediastinal lymphadenopaties and micronodular parenchymal infiltrations at right middle and lower lobes. In biopsy, taken during bronchoscopy, granulamatous lesions were observed. Patient was suggestively diagnosed as sarcoidosis with these findings and followed up without treatment because of relatively lesser severity of these findings. Sarcoidosis is a rare disease of childhood, and can spontaneously resolve or become chronic. Follow-up of the patients with physical examination and respiratory function tests are necessary. Steroids or methotrexate can be used for the treatment according to the clinical severity of the disease, but results are controversial. Since it a rarely seen condition, we want to emphasize the importance of sarcoidosis and review the literature. [ABSTRACT FROM AUTHOR]

Sarcoidosis is a multisystemic, granulomatous disease with an unknown etiology. Although granulomas suggest an etiology related to infectious, and organic agents, their etiologies are still unknown. A 16 year-old girl referred with complaints of cough, malaise, and painful lesions on legs lasting for 4 months. On physical examination, no pathological sign was observed, except an erythema nodosum-like purple lesion, the largest one being 5 cm in diameter was detected on the tibial region. Erythrocyte sedimentation rate was 60/1 hour and CRP 15.66 mg/L. Angiotension converting enzyme level was elevated. High resolution thoracal CT results were reported as multiple mediastinal lymphadenopaties and micronodular parenchymal infiltrations at right middle and lower lobes. In biopsy, taken during bronchoscopy, granulamatous lesions were observed. Patient was suggestively diagnosed as sarcoidosis with these findings and followed up without treatment because of relatively lesser severity of these findings. Sarcoidosis is a rare disease of childhood, and can spontaneously resolve or become chronic. Follow-up of the patients with physical examination and respiratory function tests are necessary. Steroids or methotrexate can be used for the treatment according to the clinical severity of the disease, but results are controversial. Since it a rarely seen condition, we want to emphasize the importance of sarcoidosis and review the literature. [ABSTRACT FROM AUTHOR]

Introduction: Chronic obstructive pulmonary disease (COPD) is associated with increased cardiovascular morbidity and mortality. Carotid intima‐media thickness (CIMT) is a noninvasive method assessing atherosclerosis. Objective: It was aimed to determine relationship and survival between COPD and CIMT. Methods: CIMT was measured using Doppler ultrasound (USG) in 668 stable COPD patients at 24 centers. Patients were followed‐up for 2 years. Results: There were 610 patients who completed the study. There were 200 patients CIMT with <0.78 mm (group 1), and 410 with CIMT ≥ 0.78 mm (group 2). There was a significant difference at the parameters of age, gender, smoking load, biomass exposure, GOLD groups and degree of airway obstruction (FEV1) between groups 1 and 2. Our results revealed positive correlations between mean CIMT and age, smoking load (pack‐years), biomass exposure (years), exacerbation rate (last year), duration of hypertension (years) and cholesterol level; negative correlations between CIMT and FEV1 (P < 0.05). According to logistic regression model, compared with group A, risk of CIMT increase was 2.2‐fold in group B, 9.7‐fold in group C and 4.4‐fold in group D (P < 0.05). Risk of CIMT increase was also related with cholesterol level (P < 0.05). Compared with infrequent exacerbation, it was 2.8‐fold in the patients with frequent exacerbation (P < 0.05). The mean survival time was slightly higher in group 1, but not significant (23.9 vs 21.8 months) (P > 0.05). Conclusion: This study is the first regarding CIMT with combined GOLD assessment groups. It has revealed important findings supporting the increase in atherosclerosis risk in COPD patients. We recommend Doppler USG of the carotid artery in COPD patients at severe stages. [ABSTRACT FROM AUTHOR]

Desquamative interstitial pneumonia is a type of smoking-associated major idiopathic interstitial pneumonia, which is characterized by accumulation of alveolar macrophages in alveolar lumens and septa and develops secondary to mainly active or passive exposure to cigarette smoke. Desquamative interstitial pneumonia mostly occurs in male smokers in association with non-specific symptoms responsive to steroid therapy and has a better prognosis than usual interstitial pneumonia. To date, no large-scale clinical studies have been performed on desquamative interstitial pneumonia patients. Factors responsible for the scarcity of data on the clinical course of this condition include the retrospective nature of the available information as well as its rare occurrence. Despite this, a general consensus exists as to the nature of its symptoms, association with smoking, age and gender distribution, findings of respiratory function tests, steroid responsivity and mortality. The objective of the present review article was to report on desquamative interstitial pneumonia and to describe its etiology, risk factors and clinical features, as well as the laboratory, bronchoalveolar lavage, radiological and histopathological findings, and the treatment and prognosis of affected patients. [ABSTRACT FROM AUTHOR]

Increased carotid intima–media thickness (cIMT) and stiffness, reflecting subclinical atherosclerosis, are associated with obstructive sleep apnea syndrome (OSAS). The relationship between serum fetuin-A, which inhibits ectopic calcification, and atherosclerosis is unclear. Therefore, we investigated the association between serum fetuin-A levels and carotid artery stiffness and cIMT in patients with normotensive OSAS (n = 50) and non-OSAS controls (n = 38). Compared with controls, there were lower fetuin-A levels (59.4 ± 6.5 vs 68.2 ± 5.8 ng/mL, P = .029), higher mean cIMT (0.73 ± 0.2 vs 0.63 ± 0.3 mm, P < .001), and greater stiffness (β) index (7.45 ± 0.9 vs 5.2 ± 0.7, P = .001) in the OSAS group. The cIMT and stiffness (β) index were inversely correlated with fetuin-A levels (r = −.324, P = .033; r = −.466, P < .001, respectively) and positively correlated with apnea hypopnea index (r = .498, P < .001; r = .422, P = .001, respectively) in the OSAS group. Decreased serum fetuin-A levels were associated with subclinical carotid atherosclerosis in patients with normotensive OSAS. [ABSTRACT FROM PUBLISHER]

Abstract: Background: Although chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality and morbidity worldwide, epidemiological data on COPD is very limited. This study was designed to obtain some baseline data on COPD in the Malatya region of Turkey. Methods: Sixty clusters from urban and rural regions were randomly selected. Ten and seven consecutive households were included in the study from each urban and rural cluster, respectively. A validated questionnaire on the epidemiology of COPD was completed for each participant over 18 by a pulmonary physician. Each subject underwent standard spirometric measurement and early bronchodilation testing. Results: A total of 1160 participants completed the study (93%). Some 6.9% of the participants were found to have COPD (F/M=1/4). While the prevalence of COPD was 18.1% in current smokers over 40 years of age, the prevalence was 4.5% among younger smokers. Some 25.5% of the women and 57.2% of the men were current smokers. Biomass exposure, as a sole reason for COPD, was significantly common among female patients living in rural areas (54.5%). In the development of COPD, the relative risk ratio of cigarette smoke was found to be 3.4 and 3.3 times higher than biomass exposure and occupational exposure, respectively. Conclusions: Smoking rate and COPD prevalence were found to be unexpectedly high in the region, and biomass exposure is still an important cause of COPD, particularly among females living in rural areas. We think that national policies against smoking and biomass exposure should be implemented immediately. [Copyright &y& Elsevier]