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Copyright of Turkiye Klinikleri Journal of Sports Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Despite advances in obstetric care, the prematurity rate is increasing all over the world with the use of assisted reproductive techniques. However, the survival rates of these babies have increased thanks to the developments in neonatal and perinatal care. The specific problems and complications seen in early prematurity, determine the long-term neurodevelopmental outcome. One of the most important determinants of neurodevelopmental outcome is intraventricular hemorrhage (IVH). In this study, risk factors that could cause IVH and severe IVH were investigated in premature infants. Materials and Methods: In this study, inpatient files in the neonatal intensive care unit of our hospital in a 10-year period were analyzed retrospectively. As the patient group, 40 patients with a gestational age below 37 weeks and diagnosed with IVH; the control group was selected from patients who were hospitalized on similar dates, did not have IVH, and whose body weight and gestational age were similar to the IVH group. Results: Prolonged mechanical ventilation, hypoxemia, hypercarbia and recurrent hypercarbia attacks, hypotension, recurrent surfactant need, erythrocyte transfusion, bicarbonate therapy, use of volume expander and pregnancy with assisted reproductive techniques were found to be risk factors for IVH. Mortality rate was significantly higher in IVH group and severe IVH (stage III-IV bleeding) group compared to the control group. In IVH group, periventricular leukomalacia was observed in 4 patients and hydrocephalus in 10 patients. Conclusion: IVH is a complication of prematurity that increases long-term morbidity and mortality. Use of blood transfusions, volume expanders and bicarbonate therapy which are identified as risk factors in this study should be minimized in neonatal intensive care. Since most important risk factor is prematurity, prevention of preterm birth should be main objective of medical care. [ABSTRACT FROM AUTHOR]

Hereditary methemoglobinemia is one of the rare causes of hypoxemia. Mutations in the CYB5R3 gene cause autosomal recessive hereditary methemoglobinemia. Mostly, symptoms such as shortness of breath, bruise and and fatique occur. It may not display any symptoms until adult ages. Our case was at the age of 18 and had sometimes recurring bruise in hands and lips, shortness of breath, palpitations and oxygen saturation (SaO2) was 85%. Methemoglobin (Methb) level was %20 (N;0-1.5) No cardiac or pulmonary cause could be detected, which could account for dyspnea and cyanosis, and due to low saturation and high Methb. levels, metheglobinemia was considered and high dose IV ascorbic acid was administered. In follow up period, saturation increased and Methb. level gradually decreased and with genetic tests, homozygous missense c.136C gt; T (p.R46W) mutation was detected with CYB5R3 gene sequence analysis. Patient was diagnosed with autosomal recessive hereditary methemoglobinemia type 1. This case is presented ın order to emphasize that hereditary methemoglobinemia should be kept in mind when shortness of breath, hypoxia and cyanosis, occur together and can not be attributed to pulmonary and cardiovascular causes.

The coronavirus disease (COVID-19), which emerged in the city of Wuhan in December 2019 and spread all over the world, especially infected the lungs. As the result of damage to the lungs, the patients most often apply with the complaint of shortness of breath (dyspnea) and are hospitalized in the presence of hypoxemia. The mechanism of hypoxemia, which also affects the prognosis of the disease and leads to mortality, and to whom, when, and how the oxygen therapy should be given, has been tried to be explained in this article. [ABSTRACT FROM AUTHOR]

Copyright of Istanbul Gelisim University Journal of Health Sciences / İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi is the property of Istanbul Gelisim Universitesi Saglik Bilimleri Yuksekokulu and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Negative pressure pulmonary edema is a condition that may develop after an acute obstruction in the upper respiratory tract, or may occur secondary to the elimination of a chronic obstruction. In this case study, we report on the successful management of the APRV mode for severe hypoxia developing after a negative pressure pulmonary edema that developed after an appendectomy. An appendectomy operation was planned by the general surgery clinic for a 33-year-old male patient weighing 85 kg with no known systemic disease history, due to a preliminary diagnosis of acute appendicitis. The patient underwent an appendectomy, after which severe laryngospasm and severe inspiratory effort developed. The patient, who developed a negative pressure pulmonary edema, was treated with the APRV mode and taken to the service on day 5 following the operation. We believe that the use of the APRV mode can dramatically improve hypoxia in cases where hypoxia cannot be corrected in invasive mechanical ventilation. [ABSTRACT FROM AUTHOR]

There is a strong cause-effect relationship between Obstructive Sleep Apnoea syndrome (OSAS) and many cardiovascular diseases. A high prevalence of cardiac arrhythmia has also been reported in patients with OSAS. Nocturnal intermittent hypoxia, increased negative intrathoracic pressure and increase in sympathovagal activity are defined as the pathophysiological mechanisms by which OSAS triggers and/or increases cardiac arrhythmogenesis. Herein, in the light of a case report, we aimed to review the relationship between OSAS and cardiac arrhythmia. [ABSTRACT FROM AUTHOR]

Background: Body mass index values ≥30 are defined as obesity. In obese, body surface area increases with weight; thus, the basal metabolic rate becomes higher compared to those at normal weight. Low-flow anesthesia (LFA) is an anesthetic method where fresh gas flow (FGF) is less than 1L /min. There are limited studies in the literature comparing the effects of different gas flows in obese patients undergoing laparoscopic surgery. The aim of this study was to investigate the efficacy and safety of LFA in obese patients. Materials and Methods: This randomized prospective study included 100 patients aged between 18-65 years undergoing laparoscopic cholecystectomy. Sealed envelope method was used for randomization. LFA was defined as the administration of FGF at 0.5 L/min, while normal flow anesthesia (NFA) was defined as FGF at 2 L/min. 100 patients were randomly divided into 4 groups. Group 1: normal patients with weight and LFA, Group 2: normal patients with weight and NFA, Group 3: obese patients and LFA, Group 4: obese patients with and NFA. Results: None of the patients had an inspiratory oxygen level (insO2) value below 35% after intubation. Therefore, hypoxia was not observed in any patient. However; when compared to group 2, group 1 had significantly longer anesthesia time and lower desflurane consumption. Similarly, when compared to group 4, group 3 had significantly longer anesthesia time and lower desflurane consumption. Conclusion: Our results suggest that LFA can be used safely in obese patients as well as in normal weight patients and it is an effective method to reduce the cost. [ABSTRACT FROM AUTHOR]

Objective: Obstructive Sleep Apnea syndrome (OSAS) is a chronic intermittent hypoxic process. In this study, we aimed to investigate electrophysiologically the changes in number of skeletal muscle motor unit due to chronic intermittent hypoxemia in cases followed up with the diagnosis of OSAS. Materials and Methods: According to the apnea-hypopnea index (AHI), patients divided into two groups (group 1: AHI <15 and group 2: AHI ≥15.0). Fifty-seven patients in group 1 and 62 patients in group 2 were included in the study. Motor and sensory distal latencies, conduction velocities and combined action potential amplitudes of nervus medianus and nervus ulnaris were evaluated in patients. After obtaining maximum M responses by submaximal stimulation in the patients, motor unit numbers (MUNE) were achieved with the program in Keypoint device. Results: There were no statistical differences between the two groups in terms of nervus medianus and nervus ulnaris motor and sensory nerve distal latencies, maximum M response amplitude and mean conduction velocity (p>0.5). Maximum M mean area of nerve medianus was 50.8±20.4 (16.1-121.7) in group 1 and 48.6±20.05 (10.5-111.4) in group 2 (p=0.55). The mean MUNE values were 155.3±41.17 (46.6251.7) in group 1 and 127.7±40.2 (22.8-235) in group 2 (p<0.00). Conclusion: The MUNE method demonstrates that chronic intermittent hypoxemia during sleep causes reduction of the motor unit number in OSAS patients and is an independent risk factor for subclinical polyneuropathy. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Ankara University Faculty of Medicine / Ankara Üniversitesi Tip Fakültesi Mecmuasi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Obstructive Sleep Apnea syndrome (OSAS) is a disease characterized by recurrent complete (apnea) or partial (hypopnea) upper respiratory tract obstructions episodes during sleep and often a decrease in blood oxygen saturation. Night hypoxias and sympathetic activity increase of arousals in OSAS are thought to stimulate that endothelial dysfunction and hypercoagulability. Materials and Methods: In this study, it was aimed to evaluate the relationship between the severity of the disease and the night hypoxia severity with hemogram parameters in patients diagnosed with OSAS who examined in our clinics. A total of 94 cases were included in the study, including 24 controls, 24 mild, 23 moderate, and 23 severe OSAS. Results: The mean and minimum oxygen saturation values in polisomnography with the number of neutrophils and neutrophil/lymphocyte (N/L) ratio were negatively correlated in the mild and severe OSAS groups. A negative correlation was observed between erythrocyte distribution width (EDW) and, mean oxygen saturation and minimum oxygen saturation in moderate and severe OSAS. When the mean and minimum oxygen saturation with regression analysis of EDW and N/L ratio were examined in each three groups; the 1 unit decrease in the minimum oxygen saturation increases the N/L ratio by 0.5-fold (p=0.02) in the mild OSAS, 0.5-fold (p=0.01) in the severe OSAS and it increases the EDW by ratio 0.5-fold (p=0.02) in the moderate OSAS. The 1 unit decrease in the mean oxygen saturation increases the N/L ratio by 0.4- fold (p=0.04) and the EDW by 0.8-fold (p=0.001) in the severe OSAS. Conclusion: As long as the OSAS severity increases, it is determined that the hematocrit values of patients increasing. However, as patients' sleep desaturation increase, we can see that EDW, the number of neutrophils, and N/L ratio also increasing. This situation suggests that the local inflammation caused by both mechanical stress and ischemiareperfusion cycles in the respiratory tract in OSAS is a consequence of spillage into the systemic circulation. [ABSTRACT FROM AUTHOR]

Objective: Chronic obstructive pulmonary disease (COPD) is characterized with air flow limitation. Cognitive problems can appear in advanced stage of COPD. There is relationship between COPD and levels of homocystein (hcy) and total antioxidant capacity (TAC). There is also relationship between cognitive dysfunction and levels of hcy and TAC. We aimed evaluation of cognitive functions in patients with COPD, and demonstration of the relationship between cognitive function and hcy and TAC. Methods: Twenty-eight hypoxic (group 1), 28 non-hypoxic COPD patients (group 2) and 25 healthy people (control group, group 3) were included to study. Hcy and TAC levels were measured in all subjects. Cognitive functions were evaluated in all subjects with standardized mini mental test (SMMT), clock drawing test (CDT), Blessed orientation memory concentration test (BOMCT), Benton's facial recognition test (BFRT) and clinical dementia rating scale (CDRS). Results: Hcy levels were high in group 1 (p=0.004), TAC levels were high in group 1 and 2 (p=0.04). SMMT (p=0.000) and CDT values were low in group1 (p=0.000), CDRS values were high in group1 and 2 (p=0.000), BFRT values were low in group1 and 2 (p=0.000), BOMCT values were high in group1 (p=0.000). There were a correlation between TAC and SMMT (r=0.582, p=0.001) and CDRS (r= -0.384, p=0.044). Conclusions: We demonstrated presence of cognitive dysfunction in COPD patients. Patients with hypoxic had more profound cognitive dysfunction. In addition, we demonstrated a relationship between TAC and cognitive dysfunction. [ABSTRACT FROM AUTHOR]

Respiratory diseases and respiratory failure are among the leading causes of death in children. In this review, practical points of mechanical ventilation are highlighted for physicians who are not pediatric intensivists but take care of critically ill patients on some occasions. Therefore, approaches to facilitate the use of mechanical ventilator in daily practice were adopted instead of discussing more complicated details. Common errors or difficulties were emphasized. The goal was to remove the anxiety against use of a mechanical ventilator and provide comfortable patient care. [ABSTRACT FROM AUTHOR]

Acute respiratory distress syndrome (ARDS) is characterized by pulmonary edema caused by sudden increase in alveolocapillary membrane permeability, hypoxemia, and bilateral lung infiltration. Despite improvement in ICU treatment modalities, the mortality rate among ARDS patients is still considerably high. In the treatment of ARDS, in addition to the treatment of underlying cause, low-tidal volume, lungprotective mechanical ventilation is recommended. However, in patients who cannot attain target oxygen level or develop high plateau pressure despite low-tidal volume ventilation and who cannot tolerate high carbon dioxide and low pH levels, extracorporeal membrane oxygenation (ECMO) may be considered as a good treatment option. In this article, cases of ARDS patients treated with ECMO in our clinic during 2013-14 have been retrospectively documented and discussed in line with the literature. [ABSTRACT FROM AUTHOR]

Obstructive sleep apnea syndrome (OSAS) can lead to many complications associated with cerebrovascular system. Pathophysiological mechanisms in the development of cerebrovascular pathology include hypoxia, inflammation, oxidative stress and hypercoagulability. Herein, we report a 31-year-old patient with OSAS which was associated with sinus venous thrombosis whose symptoms improved with positive airway pressure therapy. [ABSTRACT FROM AUTHOR]

Obstructive sleep apnea (OSA) is a common disorder which is associated with increased morbidity and mortality. There is growing evidence that patients with OSA have higher incidence of cancer, accelerated progression and cancer mortality. Intermittent hypoxia, oxidative stress and sleep fragmentation are hold responsible for cancer development. [ABSTRACT FROM AUTHOR]

Objective: Hypoxia, perfusion pressure changes, systemic hypertension, vasospasm, increase in blood viscosity and small vessels’ resistance may cause ischemia in Obstructive sleep apnea syndrome (OSAS). The aim of this study is to assess the effect of hypoxia on the eye (choroidal and corneal thicknesses) in patients with OSAS. Materials and Methods: In this observational study age and gendermatched 20 severe, 17 modarate, 16 mild OSAS patients without any comorbidity and a control group of 16 healthy subjects were examined with spectral-domain optic coherence tomography (OCT). The central corneal thickness (CCT), subfoveal, and temporal and nasal choroidal thicknesses of the patients were measured by OCT. Results: The mean age of OSAS patients was 52.3±10.6 and 48.8±12.1 in control subjects. Female and male patients made up 23.1% and 76.9%, respectively. The mean CCT of OSAS patients was 560.2±31.1/563.5±29.1 μm, whereas the mean CCT was 560.6±30.4/567.1±28.2 μm in control group (p=0.52/p=0.29). There were significant differences (p<0.001) in choroidal thickness (severe: 228.3±16.8/240.5±17.8; moderate: 236.0±21.6/232.4±18.5; mild: 241.3±23.6/242.6±20.9; control: 267.8±18.6/271.6±18,6 μm) between patients and control groups who were separated by their OSAS severity. Conclusion: In our study choroidal thickness became thinner with increasing OSAS severity. On the other hand, corneal thickness did not seem to be affected from OSAS. [ABSTRACT FROM AUTHOR]

Objective: Interstitial lung disease (ILD) may create sleep disturbances due to chronic disease-related stress, respiratory abnormalities and adverse effects of treatment. We aimed to determine the quality of sleep in ILD patients, and the incidence of Obstructive sleep apnea syndrome (OSAS) in these patients. Materials and Methods: Taken to this study were 52 patients who were followed up in our center due to ILD. Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI) were applied to the patients. Spirometry and diffusion test were performed. Polysomnography (PSG) was performed to 27 patients whose ESS were more than or equal to 10. Results: Demographic characteristics, body mass index, spirometry and diffusion measurements, PSQI global score and the sub-components of it didn’t show difference according to ESS daytime sleepiness. Sleep quality of 44% of the patients was determined to be poor by PSQI. PSQI global score and sub-components weren’t correlated with apnea-hypopnea index, stage 1 latency, sleep efficiency and nocturnal desaturation (p>0.05) in 27 patients who underwent PSG. We observed increased stage 1 sleep and decreased stage 2-3 and rapid eye movement sleep. As nocturnal hypoxemia was seen arousals (p=0.000, r=0.698) increased. OSAS was diagnosed in 19 (70%) of subjects. Conclusion: Although ILD patients don’t have daytime hypoxemia; they may have nocturnal hypoxemia and OSAS, which may effect their sleep quality. Therefore ILD patients should be evaluated for daytime sleepiness, and sleep-related breathing disorders. [ABSTRACT FROM AUTHOR]

Bone cement implantation syndrome is associated with hypoxia, hypotension, cardiac arrhythmias, increase in pulmonary vascular resistance and cardiac arrest and is a cause of mortality and morbidity in orthopedic patients when cement is used. Because it is rare and isn't well identified, literature is limited to case reports. In this article, bone cement implatation syndrome developed in a patient who had undergone surgery for hip replacement is reported with literature. [ABSTRACT FROM AUTHOR]

ARDS is an inflammatory process that can be life-threatening respiratory failure. ARDS can be a directly derived lung injury from infection or aspiration of gastric contents or an indirect injury that can be derived from an extrapulmonary process. Although more than 60 reasons have been defined, the most common cause of ARDS is sepsis. The incidence is between 28-32 cases per 100,000. Although intensive care management has evolved, mortality is still between 34%-58%. Refractory hypoxia in ARDS necessitates hypoxemic rescue therapy strategies. Patients with ARDS have two important primary physiologic problems. The first and most important problem is severe hypoxia stemming from alveolar collapse due to loss of alveolar surfactant. The other problem is the accumulation of protein-rich edematous fluid in the alveoli and interstitium and a significant decrease in respiratory system compliance because of loss of surfactant. Lung-protective ventilation strategies have been successful in such cases. Rescue therapies, such as iNO, prone positioning, recruitment maneuvers, titration of PEEP, and HFOV, which can be chosen due to the etiology and progress of the pathology, are promising. [ABSTRACT FROM AUTHOR]

Objective: Although the mechanism is still not so clear, ischemia modified albumin is produced as a result of the occurrence of changes in metal binding regions on the albumin with the production of reactive oxygen species. But it is not known whether this change is the cause or the result of different states. This study is designed to investigate the correlation between hypohemoglobinemia, hypoxemia due to blood loss and IMA. Methods: The research is carried out with 83 patients (28 Male, 55 Female; mean age: 51±22 year) and 19 subject as control group (7Male, 12 Female; mean age 35±18 year). Patients were divided into three sub-groups according to their hemoglobin levels (<8, 8-10, 10-12 g/dL). Additionally, same patients were divided into second sub-group according to their follow-up status as outpatient (40 male, 15 female, mean age: 48 ± 20 year), postoperative (8 male, 11 female, mean age: 49 ± 24 year) and intensive care unit (6 male, 5 female; mean age: 64±20 year) patients. To determine the IMA levels the measurement method based on albumin cobalt binding assay was used. Results: In IMA levels, no significant difference is found between the mild (Hb: 10-12 g/dL) [(n=47; 0,61±0,23 ABSU)], moderate (Hb: 8-10 g/dL) [(n=26; 0.58±0.24 ABSU)] and severe (Hb: <8 g/dL) [(n=9; 0.62±0.12 ABSU)] anemia groups. However, because of acute blood loss related acute hypoxemia; IMA levels of the postoperative patients are statistically higher as compared to control group. As compared to control groups, no statistically significant difference is observed in the levels of the serum IMA in the outpatient group who had minimally invasive surgery and in the intensive care patient group. Conclusion: Our results suggest that; if mycardial oxygenization is questioned in cases of acute and heavy blood loss, ischemia modified albumin is not a valuable test for the indicator of the myocardial ischemia. [ABSTRACT FROM AUTHOR]

Hypoxic pulmonary vasoconstriction (HPV) is an intrapulmonary adaptive mechanism that matches alveolar ventilation to perfusion. However during prolonged alveolar hypoxia HPV occurs with many pulmonary diseases. Despite intensive studies, cellular mechanisms of HPV are still not well defined. G proteins are a family of membrane-associated proteins believed to be involved in the transduction of various signals including the regulation of vascular tonus. In this study, we aimed to determine the contribution of G; and Gs proteins in hypoxic vasoconstriction of lamb isolated pulmonary artery rings. Pulmonary arteries were isolated from left lower lobe of freshly slaughtered lamb. Arteries suspended in an organ bath filled with Krebs-Henseleit solution and isometric contraction recorded continuously via an isometric transducer connected to a computerised polygraphy system. The solution aerated with 75% N2- 20% O2- 5% Co2 (normoxic) and 95% N2- 5% Co2 (hypoxic) pO2 of bathing medium was measured continuosly using an oxygen electrode. Pertussis toxin and cholera toxin were used to investigate the role of Gs and Gs proteins. In the present study, we observed that hypoxia had no effect on resting force in large artery rings, but it caused a further contraction (1.7±0.5 mN/mm2, n=10) in 3 \xM 5-HT precontracted pulmonary arteries rings. Hypoxic vasoconstriction was inhibited by preincubation with 2 [ABSTRACT FROM AUTHOR]

The primary function of the respiratory system is providing adequate oxygen for tissues. Clinical findings to indicate the need for oxygen treatment are generally unreliable. Thus, in pediatric emergency, oxygen treatment must be started until it is proven unnecessary, after which oxygen treatment indications may be assessed again based on artery blood gas analysis and pulse oximetry findings. The management of hypoxemia in critically ill patients is challenging. Since the dangers of tissue hypoxia and the possibility of harm from excess oxygen administration are well recognized, the approach to hypoxemia is very important. The introduction of pulse oximetry in clinical practice has allowed for simple, noninvasive and reasonably accurate estimation of arterial oxygen saturation. Pulse oximeters have become available for widespread application in pediatric care, and oxygen saturation has even been proposed as the fifth vital sign. However, the clinically relevant principles and the inherent limitations of pulse oximetry are not always well understood by health care professionals. [ABSTRACT FROM AUTHOR]

Copyright of Pamukkale Journal of Sport Sciences is the property of Pamukkale University School of Sport Sciences & Technology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives Carbon monoxide poisoning (COP) is one of the causes ofhypoxic encep-halopathy. The Mini-Mental Status Examination Scale (MMSES) is useful for evaluating the severity of hypoxic encephalopathy. The aim of this study was to investigate the relationship between the severity of poisoning, carboxyhemoglobin (CoHb) levels, and the MMSES among patients admitted to the emergency department with carbon monoxide poisoning. Methods Patients who were diagnosed with acute COP between February 2006 and February 2007 at Ondokuz Mayıs University Faculty of Medicine Emergency Department were evaluated prospectively. According to the severity of poisoning, patients were subdivided into three groups: mild, moderate, and severe. Results Fifty-one patients were included in our study. The ratio of females to males was 1.125. The average patient age at admission was 38.4± 16.5 years. The frequency of carbon monoxide poisoning among all admissions was 0.35%, and the frequency among all poisoning cases was 7.89%. Headache, nausea, dizziness, and weakness were the most frequent symptoms. Twenty of the patients (39.2%) had mild poisoning, 25 (49%) had moderate poisoning, and 6 (11.7%) had severe poisoning. While the relationship between severity of poisoning and COHb level was not significant, the relationships between MMSES and COHb level and between MMSES and poisoning severity were significant. Conclusions The MMSES scores of the patients admitted to the emergency department were negatively correlated with the severity of poisoning and CoHb levels. [ABSTRACT FROM AUTHOR]

Purpose: When chronic obstructive pulmonary disease (COPD) deteriorates, lipid metabolism may worsen and serum triglyceride levels decrease in response to hypoxia. It was aimed to evaluate the relationship between severity of disease, emphysema pattern and serum triglyceride level. Material and Methods: The patients with stable COPD who had not additional clinical problem that could be the reason of malnutrition were included in the study. Serum triglyceride levels, spirometric, anthropometric and demographic characteristics of cases were recorded and evaluated prospectively. Results: A hundred patients (81/19 M/F) with stable COPD were evaluated. Mean serum triglyceride level was 109.7±12.2mg/dl. It was observed that serum triglyceride level correlated with the duration of disease (r=0.298; p=0.003), the number of hospitalization (r=0.199 p=0.047), retrosternal distance (r=0.214; p=0.033) negatively and with %FEV1(r=0.247; p=0.013), FEV1/FVC (r=0.212; p=0.035) and distances of intersinusal line to dome of diaphragm(r=0.286; p=0.004) positively. In 29 cases serum triglyceride levels were in normal range, but in 71 cases not. The values of %FEV1 (p=0.049) and %PEF (p=0.001) were found significantly lower than others in cases that serum triglyceride levels were out of normal range. Conclusion: Serum triglyceride level correlated with spirometric findings positively. It was observed that lower serum triglyceride level, so frequent emphysema pattern was. We think that serum triglyceride level might be effective parameter for evaluating severity of disease, emphysema pattern and systemic impacts of hypoxia. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is determination of myocardial performance index (MPI/Tei index) using pulsed (PD) and tissue Doppler (TD) techniques to show cardiac response in newborns with hypoxic-ischemic encephalopathy (HIE) and healthy newborns and eventually evaluation of the differences between these two techniques. Methods: The study is a prospective observational study. Twenty term newborns diagnosed as perinatal asphyxia during postnatal 24 hours due to the defined criteria and fifty healthy term neonates as control group were included the study. Hypoxic group was divided into two groups with Sarnat stages, Sarnat Stage 1 and 2-3. MPIs (Tei indexes) were calculated with PD and TD echocardiographic techniques in all groups after the 24 hours of birth and one year later. The statistical differences between same techniques were calculated with Kruskal-Wallis test and Z score was used to compare the superiority of two techniques. Results: The MPI values calculated by PD (0.41±0.04, 0.51±0.02) and TD (0.59±0.04, 0.51±0.02) during the first day of life in Sarnat Stage 2-3 in both ventricles were significantly higher than the control group (p<0.01, p<0.02, p<0.03). While the Z score, calculated for MPI measured by PD and TD methods, were found similar in both ventricles in Sarnat Stage 1 and control groups, it was significantly different in other groups of Sarnat stages. Conclusion: The degree of cardiac response in neonates with HIE is associated with the severity of hypoxia. MPI values are not different from the controls in newborns received mild hypoxia while they are higher in the patients who were received moderate or severe hypoxia. Any advantage could not be found between two techniques according to the measurement values, but higher variability in the value of MPI, measured by TD method, calculated from moderate and severe hypoxia group was detected. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Nursing Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The evaluation of the relationships between the mortality and early period laboratory tests in the term infants diagnosed as hypoxic ischemic encephalopathy (HIE). Material and Methods: The newborns diagnosed as HIE between January 2004 and December 2008 were divided into two groups as the living and non-surviving groups. The two groups were evaluated prospectively. Results: Thirty two infants were included in the study. According to the Sarnat&Sarnat classification, 9 (28.1%), 14 (43.8%) and 9 infants (28.1%) were in stage 1, 2 and 3, respectively. Eight (25%) infants died. In the correlation evaluation of risk factors; lack of-follow-up at the antenatal period (r²=0.35) and having convulsions (r²=0.50) were positively associated with Sarnat stage. A positive relationship between Sarnat stage and the mortality rate was also determined (r²=0.57). CK-MB was strongly (r²=0.74), troponin-I moderately (r²=0.44), and pH weakly (r²=0.27) associated with mortality. In predicting mortality, the sensitivity and specificity for CK-MB was 100% and 91.6%, for Troponin I 100% and 70.8% and for pH 75% and 87.5%, respectively. Conclusion: This study demonstrates that in HIE, the relationship between the early period mortality rate and CK- MB values are strong, whereas for troponin-I and pH there is a moderate and weak association respectively. [ABSTRACT FROM AUTHOR]

Nowadays, situations associated with high altitude such as mountaineering, aviation increasingly draw the attention of people. Gas pressure decreases and hypoxia is encountered when climbing higher. Physiological and pathological responses of human body to different heights are different. Therefore, physiological and pathological changes that may occur together with height and to know the clinical outcomes of these are important . Acute mountain sickness caused by high altitude and high altitude cerebral edema are preventable diseases with appropriate precautions. Atmospheric oxygen decreasing with height, initiates many adaptive mechanisms. These adaptation mechanisms and acclimatization vary widely among individuals because of reasons such as environmental factors, exercise and cold. High altitude causes different changes in the cardiovascular system with various mechanisms. Although normal individuals easily adapt to these changes, this situation can lead to undesirable results in people with heart disease. For this reason, it should be known the effective evaluation of the people with known heart disease before traveling to high altitude and the complications due to the changes with height and the recommendations can be made to these patients. [ABSTRACT FROM AUTHOR]

Bronchopulmonary dysplasia (BPD) is one of the most important chronic morbidities of very low birth weight infants and is associated with significant comorbidities and high risk of mortality both in the neonatal intensive care unit (NICU) and long-term follow-up periods. In our country, there are few studies related with the characteristics of short- and long-term follow-up of infants with BPD. In this study, we aimed to define the demographic and clinical characteristics of infants with BPD in the last 10 years in our hospital, retrospectively. In the last 10 years, the incidence of BPD among very low birth weight infants was found to be 21.1% in our NICU. One hundred cases could be included in the study, and among them, 26 (26%) were mild BPD, 59 (59%) were moderate BPD and 15 (15%) were severe BPD according to the severity of the disease. The mean gestational age of the cases was 28.6±1.8 (25.4-34.8) weeks, while the mean birth weight was 1087±288 (600-2060) g. The number of male infants was higher than of females (61, 61%), and 85 (85%) cases were found to receive aggressive resuscitation at birth. On admission to NICU, 45% (n=45) of the cases were hypothermic and 76% (n=76) were hypotensive in the first 24 hours of life. During the NICU period, 69% (n=69) of the cases were found to develop respiratory distress syndrome, while 53% (n=53) developed pneumonia, 62% (n=62) patent ductus arteriosus, 33% (n=33) necrotizing enterocolitis, 67% (n=67) neonatal sepsis, 44% (n=44) intraventricular hemorrhage, and 34% (n=34) retinopathy of prematurity. Ten cases (10%) died during the NICU period. Home oxygen therapy was initiated in 69 (76.7%) of the discharged cases. Hypoxia, hypercarbia and hypocarbia in arterial blood gas analysis in the first three days of life were found to be the most important risk factors for the development of severe BPD. Fifty cases could be evaluated at corrected age of 12-24 months during the long-term follow-up. Of these, 11 (22%) had growth failure, 8 (16%) had cerebral palsy, 12 (24%) had severe retinopathy of prematurity, and 9 (18%) had hearing impairment. Rehospitalization rate was 47.8% (n=43) among discharged patients. The majority of the rehospitalized patients (18, 23.4%) had pneumonia, acute bronchiolitis (12, 15.6%) and sepsis (8, 10.4%). In conclusion, the short- and long-term management of BPD is complicated and requires a multidisciplinary approach. In our country, multicenter studies are needed to obtain comprehensive data about short- and long-term follow-up of infants with BPD. [ABSTRACT FROM AUTHOR]

Objective: Nucleated red blood cells (NRBCs) are not present in circulation of healthy adults and NRBCs in severe disease states are frequently correlated with poor prognosis and mortality. Here we aimed to investigate relationship between circulatory NRBCs and mortality retrospectively. Methods: NRBC counts were determined in 93833 samples from 39522 inpatients in a hospital along a year. Results of 757 inpatients of ICU of a hospital were analyzed retrospectively. NRBC, leukocyte, platelet counts and CRP levels of patients who died were compared with survivors'. Results: NRBC was determined in 4209 (4.49%) of 93833 samples, 2125 (5.38%) of 39522 inpatients. NRBC, leukocyte counts and CRP levels were found significantly higher and platelet count and hemoglobin levels were found significantly lower in the cases resulted with death compared with the survivors. Conclusion: Prognostic significance of NRBC detection of ICU patients is not understood yet. But its correlation with severe infections, hypoxia, acute and chronic anemia were reported. Our results support a relationship with NRBC detection and mortality. Further studies are needed to clarify the role of NRBC screening as an early mortality indicator determining the cases at high risk of dying. [ABSTRACT FROM AUTHOR]

Pulmonary hypertension often complicates the course of patients with advanced lung disease, and it is associated with a worse prognosis. In the recent classification of pulmonary hypertensive disorders, pulmonary hypertension due to lung disease is considered as a separate category within a group of disorders that were previously referred to as "secondary". The incidence and clinical course of pulmonary hypertension associated with chronic obstructive pulmonary disease is best known among the pulmonary hypertension associated with lung diseases. The pathophysiology and treatment of pulmonary hypertension seen in the course of advanced lung diseases are generally distinct from those of pulmonary arterial hypertension. Chronic hypoxia is the major mechanism implicated for the development of pulmonary hypertension in patients with lung diseases. This article focuses on the recent advances in our knowledge about the pulmonary hypertension due to lung diseases or hypoxia. [ABSTRACT FROM AUTHOR]

Forty-one year old man presented with dyspnea on exertion, had central and peripheral cyanosis, bilateral crepitan crackles and a systolic murmur on the mitral and aortic fields. Moderate hypoxemia and hypocapnia was detected in blood gas analysis. Thoracic CT revealed dilated and aneurismatic ascending aorta, hypoplastic pulmonary arteries and collateral vessels associated with descending aorta. Echocardiographically, aorta was found to be %50 dextropositioned and overriding, subaortic ventricular septal defect was present. Findings confirmed diagnosis of tetralogy of fallot with pulmonary atresia and the patient was put on long-term oxygen therapy. Tetralogy of fallot is the most common cyanotic congenital heart disease, which presents with severe symptoms in infancy or childhood. Rate of survival at 40 years without surgical correction is only 3%. However, fairly asymptomatic cases undiagnosed until adulthood are reported. Accordingly, congenital heart diseases should be considered in adults with hypoxemia and appropriate tests should be performed in advance. [ABSTRACT FROM AUTHOR]

Negative pressure pulmonary oedema is a rare condition associated with early postoperative hypoxia. Different etiological factors such as upper airway obstruction, forceful inspirium or relief of chronic airway obstruction were found to be associated with negative pressure pulmonary oedema. It appears after general anesthesia and commonly presents with hypoxic state requiring mechanical ventilation. Herein we want to present two cases of negative pressure pulmonary oedema. [ABSTRACT FROM AUTHOR]

Aim: Diffuse alveolar hemorrhage syndromes (DAHS) are a group of disease caused by immune and nonimmune disorders with a high morbidity and mortality. Therefore the factors affecting mortality in patients with DAHS are aimed to be evaluated retrospectively in this study. Material and Methods: Totally 24 DAHS cases (12 male, mean age 57.1 ± 18.9 yrs) diagnosed between 1998 and 2007 in our clinic were evaluated according to the patient data. Results: The diagnoses of the patients were ARDS due to DAHS (62.5%), community acquired pneumonia (20.8%) and pulmonary involvement of connective tissue disorders (16.7%). Nine patients had connective tissue disorder (mean disease duration 47.7 ± 54.7 months), 11 patients were on corticosteroid therapy and 5 patients had a history of cytostatic therapy. Only 10 patients (41.7%) had hemoptysis on admission. Hypoxemic respiratory failure was found in 70.8% of the patients and 58.3% of them required invasive mechanical ventilation. Sixteen cases received "pulse" corticosteroid therapy and 13 cases had blood transfusion. During the follow-up, 15 patients (62.5%) developed nosocomial pneumonia and 13 patients (54.2%) died. The patients with a baseline haemoglobin level of 10 gr/dl or less, had higher levels of CRP (20.7 ± 18.0 vs. 11.3 ± 8.0 mg/dl, p= 0.024). The patients died during the follow-up, had shorter duration of symptoms (13.6 ± 15.2 vs. 54.7 ± 81.7 days, p= 0.001) and higher baseline CRP levels (20.6 ± 14.5 vs. 8.6 ± 6.5 mg/dl, p= 0.020). Conclusion: The mortality rate was high in DAHS patients and the baseline CRP level is thought to be important for predicting mortality. [ABSTRACT FROM AUTHOR]

Objective: Traumatic brain injury is one of the most important causes of morbidity and mortality in developed countries. Head trauma can be observed in 75% of the traffic accidental deaths and in 80% of all multitrauma patients. In this article we summarize the most appropriate treatment strategies followed by the emergency doctors in trauma place and in emergency departments (EDs). Main findings: The pre-hospital approach in a head trauma patient should be made where the trauma happened; because hypoxia, arterial hypotension and the additive injuries increase morbidity and mortality in head trauma. The duties of EDs are maintaining the resusitation began in trauma place, preventing the table become worse up to systemic and cerebral injury complications. Conclusion: 50% of the severe head trauma patients mortal as soon as trauma happen, transportation duration or post-traumatic early period in EDs. We can understand that how urgent it is to early diagnose and treat in head trauma patients when we consider the effects of secondary injuries of mortality firstly caused hypotension, secondly hypoxia. [ABSTRACT FROM AUTHOR]

Fat embolism syndrome has been described following traumatic, surgical, and atraumatic conditions. Longbone fractures are probably the most common cause of this syndrome. Fat embolic events are often clinically insignificant and difficult to recognize since clinical manifestations vary and there is no routine laboratory or radiographic means of diagnosis. Propofol is widely used for the induction and maintenance of anesthesia. Addition of lidocaine to propofol may result in a coalescence of oil droplets, forming a separate layer. The risk of propofol and Iidocaine combination to cause fat embolism depends on the dose of lidocaine and the duration between its preparation and administration. We presented a patient who developed fat embolism following anesthesia induction during surgery for a lower extremity fracture due to a traffic accident. The occurrence of fat embolism was attributed to propofol-lidocaine use. The diagnosis of fat embolism was based on clinical manifestations, radiographic and laboratory findings, and elimination of other causes associated with arterial hypoxemia. [ABSTRACT FROM AUTHOR]

Objective: Postthoracotomy pain has long been recognized as a cause of postoperative morbidity, resulting in inadequate ventilation, coughing, atelectasis, hypoxia and pulmonary infection. Effective analgesia provides early mobilization after surgery and reduces morbidity. In this prospective clinical study we compared the effects of the three different analgesic agents on postthoracotomy pain. Method: Forty-five patients, ASA I-III, undergoing elective thoracotomy were randomized into four groups for intraoperative intercostal nerve blockade using 20% prilocaine (Group I, n=12), 0.5% bupivacaine (Group II, n=12), 0.75% ropivacaine (Group III, n=11) and none (Control Group, n=10). Postoperative pain was assessed by a visual analogue scale (VAS) at rest and cough and by Prince Henry Pain Scale (PHPS) at recovery room, 2., 4., 8., 12., 24., 48. hours. Mean arterial pressure, heart rate, respiratory rate and peripheral oxygen saturation were recorded. Food intake and analgesic consumption were investigated. Results: Demographic data, operation type and time were similar in all groups. There were no significant differences in all groups with respect to mean arterial pressure, heart rate, respiratory rate and peripheral oxygen saturation values. The VAS scores at rest and cough were lower in group III patients, particulary during the first 12 hours postoperatively. Food intake and analgesic consumption were not significantly different between groups. Conclusion: After thoracotomy, elimination of pain with an effective analgesic may accelerate recovery and reduce complication rates. Intercostal nerve blockade is an effective, safe and easy method in the treatment of postthoracotomy pain. [ABSTRACT FROM AUTHOR]

Growth failure is a well-recognized complication of congenital heart disease (CHD) and still an important problem for children with CHD. Growth failure in these children cause delay in surgical correction and increased risk of morbidity postoperatively. Inadequate caloric intake, increased energy requirements, malabsorption, severity of disease and hypoxia appears to be the most important factors in growth failure of CHD. However, underlying mechanisms of growth failure is still controversial. The role of endocrine factors has been evaluated recently and low serum insulin like growth factor-1 levels associated with growth delay have been reported in both cyanotic and acyanotic CHD. In the following rewiew, incidence, mechanisms of growth failure and recent methods of improving growth and catch-up growth in children with CHD are discussed. [ABSTRACT FROM AUTHOR]

Hanging is one of the methods that have the highest mortality rate among other suicide attempts. In the unsuccessful hanging attempts morbidity is usually severe. As a result of hanging, the cerebral blood flow is interrupted due to the acute occlusion of the vertebral arteries and, hypoxic encephalopathy develops due to the reduction in oxygen and glucose support of the brain parenchyma. Several psychiatric signs, primarily cognitive disorders, reveal with respect to the time of hypoxia and to the affected brain regions. In this article, we aimed to discuss a case with defect in the cognitive area have been developed after a suicide attempt by hanging and who did not abnormal brain imaging findings until the eighth month. [ABSTRACT FROM AUTHOR]

Tracheal bronchus is a congenital anomaly in which the right upper lobe bronchus originates from the lateral wall of the trachea. During conventional endotracheal intubation, the distal side of tracheal tube can obstruct the congenital bronchus. This may lead to right upper lobe atelectasis and/or hypoxemia. Tracheal bronchus has a prevalence of 0.4 % in bronchographic and bronchoscopic studies. We would like to share our one lung isolation experience in a patient which right lung couldn't be isolated with bronchial blocker (Cook® Cohen Tip) because of tracheal bronchus. [ABSTRACT FROM AUTHOR]

Pulmonary embolism is a common disease with high mortality and morbidity rates. Incidence of the disease is increasing associated with the development in the diagnostic methods. Anticoagulation is the standard treatment for pulmonary embolism. However, thrombolytic treatment is a significant alternative in acute massive pulmonary embolism as it provides rapid cloth resolution. Although a number of studies related with thrombolytic treatment and its indications are published recently, patterns and schemes of application are still remains as a debate. Herein, 72 year old patient with pulmonary embolism is presented. He was symptomatic with hypoxemia and hypotension. Diagnosis was made with spiral pulmonary angiography as "acute massive pulmonary embolism". He developed hemoptysis as a result of intravenous thrombolytic treatment (rt- PA: recombinant tissue plasminogen activator) and was successfully treated by local intravascular thrombolytic treatment (rt-PA). [ABSTRACT FROM AUTHOR]

Creatinine kinase (CK) is an enzyme that controls energy transfer in the cells. Serum CK levels is increased in some instances including muscle diseases, trauma, exercise, rhabdomyolysis, hypoxia, status epilepticus, acute psychosis and aggressive behaviours. An 8-year-old boy lost and confined for one day in a mountainous terrain was admitted to our hospital His medical and family history were unremarkable. Vital signs were stable on physical examination. Any abnormal finding apart from lethargy was not detected. In laboratory examination, glucosuria was found. Ketonemia was not observed. Hemoglobin, white blood cell and thrombocyte counts were 13.3 g/dL, 18.210 mm3 and 520.000 mm3, respectively. Serum electrolytes, calcium and phosphorus levels were within normal limits. Blood glucose level, CK, creatinine, aspartate aminotransferase and alanine aminotransferase levels were 183 mg/dL, 4779 U/L, 0.57 mg/dL, 169 U/L and 33 U/L, respectively. After a week, a control laboratory examination was performed. Blood glucose level, CK, aspartate aminotransferase and alanine aminotransferase levels were then 74 mg/dL, 118 U/L, 32 U/L and 10 U/L, respectively. In our case, we emphasize that high levels of serum CK and glucose may be related to stress, psychologic trauma, starvation and quivering. [ABSTRACT FROM AUTHOR]

Diabetic foot is an important public health problem. Hyperbaric oxygen therapy is one of the adjunctive methods used in the management of diabetic foot. Hyperbaric oxygen therapy excerts its beneficial effects by relieving wound hypoxia. Patients with ischemic wounds are potential candidates for hyperbaric oxygen therapy. [ABSTRACT FROM AUTHOR]