Search

Objective: Previous studies showed that obstructive sleep apnea syndrome (OSAS) was associated with liver diseases such as elevated liver enzyme levels and hepatic steatosis. The aim of this study was to assess the relationship between serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels and OSAS and its severity. Methods: A total of 617 patients who underwent PSG (polysomnography) between January 2016 and May 2017 were evaluated in this study. AST, ALT, total cholesterol, triglyceride levels and body mass index were analyzed. The data were analyzed using the Student t-test, ANOVA, Chi-square test, and Pearson's correlation coefficient. Results: Five hundreds and thirty patients with OSAS and 60 healthy controls were included in the study. Of the patients in the OSAS group, 17.7% had an elevated ALT level and 7.9% had an elevated AST level. There was a statistically significant difference in ALT and AST levels between the OSAS and control groups (p < 0.001 and p < 0.001, respectively). In the OSAS group, there was a statistically significant positive relationship between serum ALT and AST levels and apnea-hypopnea index (AHI), apnea index, oxygen desaturation index. Both AST and ALT levels were statistically significantly higher in obese patients than in non-obese patients (p < 0.001 and p < 0.001, respectively). ALT level was statistically significantly higher in patients without hypertension than in patients with hypertension (p < 0.001). In OSAS patients without hypertension, there was a statistically significant relationship between serum ALT and AST levels and AHI (r = 0.223, p < 0.001 and r = 0.142, p = 0.007; respectively). Conclusion: OSAS is a risk factor for elevated liver enzyme levels. Hypoxia plays an important role on liver enzymes in OSAS patients.

Objective. The aim of this study was to determine the clinical presentation of tuberculosis cases from our center for the last nine years. Methods. This study was set as descriptive and retrospective. The data was obtained from the hospital records. Subjects who had been diagnosed as tuberculosis and received treatment in our center between the years 2007 and 2015 were included. The cases were classified as newly diagnosed, relapse, transferred, and returning after default. Results. There were 276 (171 males and 105 females) patients with a mean age of 41.5 ± 19.2 years. Pulmonary involvement is the most common presentation and seen in 155 (56.2%) patients. Lymph node and pleura are the most common extrapulmonary involvements those are seen in 53 (19.2%) and 23 (8.3%) patients, respectively. Number of the cases seems to decreased after 2012. Most (85.1%) of the patients were newly diagnosed. Among the subjects, 55.2% of them had bacteriologic diagnosis, 35.1% had histopathologic diagnosis. Two subjects died during the treatment period whereas 274 of them completed the treatment program. Conclusions. Our results show that tuberculosis is seen mainly in the adult age group. While pulmonary involvement is the most common presentation, lymph node and pleura involvements are the most common extrapulmonary presentations. Number of the tuberculosis seems to decrease for the recent years. Strict preventive measures and treatment strategies should be administered.

No abstract available.

Objective. We aimed to investigate iron metabolism and laboratory findings of anemia in children undergoing adenotonsillectomy for sleep disordered breathing. Methods. Consecutive children undergoing adenoidectomy/adenotonsillectomy for sleep disordered breathing between January 2013 and January 2015 were investigated. Routine preoperative blood tests including blood count and iron studies were analyzed. Subgroup analyses were performed addressing to the severity of sleep disordered breathing, age and duration of symptoms. Results were compared between subgroups and normal values. Results. The study included 171 children. The mean age was 5.44 ± 2.62 years. The mean hemoglobin level was 11.87 ± 1.125 gr/dL and 24 (14%) out of 171 patients had anemia (< 11 gr/dL). The mean ferritin levels were 23.23 ± 17.27 µg/L and 21.27 ± 15.44 µg/L in patients with anemia and non-anemic patients, respectively ( p = 0.572). Ferritin levels decreased in only 8 (33%) out of 24 patients with anemia. The mean age, body mass index, hematocrit, mean corpuscular volume, unsaturated iron binding capacity and serum iron levels decreased in patients with anemia. The rate of anemia significantly increased in children less than or equal to 3 years of age ( p = 0.020). There was no significant association between hemoglobin levels and sleep disordered breathing clinical score or duration of symptoms. Conclusion. The association between low iron status and sleep disordered breathing has previously published. Unfortunately, the type of anemia is still unclear. Our results supposed that the anemia of chronic disease secondary to chronic inflammatory process might play a role in pathogenesis of anemia in patients with sleep disordered breathing.

Objective. The aim of this study was to compare the effects of trospium chloride (TCL) and TCL + doxazosin (DXZ) combination to bladder capacity and residual urine volume (RUV) in spinal cord injury (SCI) patients with neurogenic bladder. Methods. The study included 120 patients with SCI. Urodynamic data of patients were reviewed retrospectively. Changes in maximum cystometric capacity (MCC) as well as RUV were determined in patients using 60-90 mg/day TCL (Group 1, n = 98) or 60-90 mg/day TCL + 4-6 mg/day DXZ (Group 2, n = 22). Results. There was statistically significant increase in both MCC and RUV values in both groups. There was no statistical difference in MCC and RUV values in Group 1 and Group 2 ( p = 0.111 and p = 0.664, respectively). There was a significant weak negative correlation between duration of injury and MCC values (r = 0.185; p = 0.043), meaning as the duration of injury increased, MCC decreased. There was no statistically significant correlation between medication usage duration with MCC and RUV (r = -0.129; p = 0.159 and r = -0.68; p = 0.462, respectively). Conclusions. Anticholinergic treatment is currently the mainstay conservative treatment of neurogenic detrusor overactivity. The impact of alfa blockers on neurogenic bladder has been less well evaluated. We consider that, adding DXZ to TCL has no additional benefit to increase bladder capacity and reduce RUV. Further studies are needed to determine the location of DXZ treatment in SCI patients with neurogenic bladder.

Cardiac myxoma associated with coronary artery disease is a rare pathology in an elderly patient. Herein we present an 81-year-old woman undergoing simultaneous surgical treatment for left atrial myxoma combined with coronary artery disease. The postoperative course of the patient was uneventful. The initial removal of mass should be performed to prevent systemic embolization of tumor fragments.

Objectives. M any studies have demonstrated a significant association between cardiovascular disease and neutrophil to lymphocyte ratio (NLR). To our knowledge, no study has been reported in patients with deep venous thrombosis (DVT) which affecting proximal or distal leg. In this study we analyzed proximal and distal DVT according to the NLR. Methods. This retrospective study was obtained from patients’ records of a tertiary university hospital between May 2011 to January 2014. A total of 57 patients with the diagnosis of acute primary DVT and 30 patients as control group included in the study. All of them were confirmed with lower extremity venous duplex examinations. Of these, 37 examinations with the diagnosis of proximal DVT were compared to 20 examinations with distal DVT. The groups compared regarding to complete blood counter values. Results. Mean eosinophil level was higher in the distal DVT group (0.28±0.24 vs. 0.12±0.01, p =0.001), whereas median NLR were higher in the proximal DVT group than the distal DVT group (3.5 [0.5-4.3] vs. 2.3 [1.2-9.7], respectively; p =0.002). In addition, median NLR, leukocyte and neutrophil counts were statistically lower in the control group than the others ( p =0.014, p =0.027 and p =0.004, respectively). Conclusion. NLR, an inexpensive and easily measurable laboratory variable, was independently and significantly associated with the presence and severity of DVT, especially acute proximal DVT.