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Aim: Inflammation is an important mechanism in the development of pulmonary arterial hypertension (PAH) in patients with COPD. In this study, we investigated the relationship of disease severity parameters and inflammation with PAP in COPD patients. Material and Methods: A patient group consisting of 80 patients with stable COPD including who were obtaining treatment at the outpatient clinic of Kırıkkale University Faculty of Medicine Department of Pulmonary Medicine were included in the study along with a control group of 46 individuals who were compatible with the patient group in terms of age and gender and did not have any airway obstruction. Spirometry measurements were performed (FEV1, FVC, FEV1/FVC, MEF and PEF). Systolic pulmonary artery pressure (sPAP) measurements and standard doppler echocardiography were performed at the outpatient clinic of the department of cardiology. Results: CRP was found to be significantly higher in patients with stable COPD compared to the control group. sPAP values of COPD patients were significantly higher than those of the control group. A statistically significant positive relationship was observed between the sPAP value and age (p = 0.006). There was no statistically significant relationship between sPAP and MCIRS score (p = 0.700). A statistically weak negative relationship was observed between sPAP and FVC% (p = 0.053) Conclusion: Development of PAH increases morbidity and mortality. Therefore, patients with advanced stages of COPD should be screened using echocardiography, which is an easy-to-use, fast and repeatable measurement method to check for PAH development.

INTRODUCTION Psychological distress of patients with asthma may be reduced when they learned to live with their illness. Asthma can change the psychological and personality characteristics. We aim to investigate the psychological and personality characteristics of patients with asthma using MMPI (Minnesota Multiphasic Personality Inventory). METHODS Thirty-three adult patients with asthma (23 female and 10 male) and 20 healthy controls (14 females and 6 males) were enrolled in this study. Psychometric evaluation was made with the Turkish version of the MMPI. The patients were separated into two groups according to the duration of symptoms (recent-onset asthma

WOS: 000364365600012 PubMed: 26221045 BACKGROUND: Bronchiectasis may change cognitive function. The mechanism responsible for cognitive dysfunction in COPD may be neuronal damage caused by hypoxia. Cognitive function in patients with bronchiectasis is also likely to be affected by similar mechanisms. The goal of this study was to determine the frequency and determinants of low cognitive ability in subjects with stable bronchiectasis. METHODS: Thirty subjects with stable bronchiectasis and 25 healthy volunteers underwent a cognitive ability assessment using the Wechsler Adult Intelligence Scale. Bronchiectasis was diagnosed by high-resolution computed tomography of the chest. Age, body mass index, the Hospital Anxiety and Depression Scale, and pulmonary function were assessed. Perceived intensity of dyspnea after exercise (after climbing 3 flights of stairs) was estimated using a modified Borg scale. RESULTS: Mean scores on the verbal and performance tests and full-scale IQ scores were significantly lower in subjects with bronchiectasis than in healthy volunteers. Low cognitive ability in subjects with bronchiectasis was associated with higher depression scores, lower oxygen saturation, and poor lung function after adjusting for potential confounders in multivariate analysis. Borg scores after exercise in subjects with bronchiectasis and low cognitive ability were higher than those in subjects with bronchiectasis and high cognitive ability, despite similar P-aO2 and FEV1 in both groups. CONCLUSIONS: Low cognitive ability in subjects with bronchiectasis may be associated with reduced lung function, more serious hypoxemia, and higher depressive symptoms. Subjects with bronchiectasis and low cognitive ability feel more intense dyspnea than do those with high cognitive ability.

WOS: 000364365600013 PubMed: 26199452 BACKGROUND: Bronchiectasis can adversely affect quality of life. However, the tests examining quality of life in bronchiectasis are not sufficient. We examined the validity of a measure designed for COPD, the Seattle Obstructive Lung Disease Questionnaire (SOLQ), in bronchiectasis. In addition, we aimed to compare the quality of life of subjects with bronchiectasis and bronchial hyper-responsiveness with that of those without to identify the effective factors. METHODS: We studied 78 subjects with clinically stable bronchiectasis and 41 healthy controls matched for age and sex. Subjects were assessed by the SOLQ. A detailed history, physical examination, the Medical Outcomes Study 36-Item Short Form questionnaire, the Hospital Anxiety and Depression Scale, and spirometric measurements were obtained. RESULTS: Cronbach alpha coefficients, which reflected internal consistency, were >0.70 for all SOLQ components except for treatment satisfaction. SOLQ component scores correlated with all of the component scores of the Medical Outcomes Study 36-Item Short Form questionnaire and the Hospital Anxiety and Depression Scale, confirming their concurrent validity. All SOLQ scores correlated positively with percent-of-predicted FEV1, whereas the physical function, treatment satisfaction, and emotional function correlated negatively with the exacerbation frequency in Pearson analysis. Emotional and physical functions were positively associated with percent-of-predicted FEV1 in linear regression analysis. Compared with subjects without bronchial hyper-responsiveness, those with bronchial hyper-responsiveness had lower FEV1/FVC and more exacerbations/y. Compared with bronchiectasis subjects without bronchial hyper-responsiveness, those with bronchial hyper-responsiveness had significantly lower SOLQ, physical function, and coping skills scores but not emotional function and treatment satisfaction. CONCLUSIONS: The SOLQ is a valid instrument for determining quality of life in subjects with bronchiectasis. Subjects with bronchiectasis and bronchial hyper-responsiveness had a poorer quality of life, lower baseline spirometric values, and more frequent exacerbations, suggesting more severe disease.

KISA, Ucler/0000-0002-8131-6810 WOS: 000365744500011 PubMed: 25778945 Objectives Microalbuminuria is an important risk factor for cardiovascular diseases. Microalbuminuria may be seen due to intermittent hypoxemia in patients with obstructive sleep apnea syndrome (OSAS). In this study, we investigated the prevalence and relationship of microalbuminuria with clinical and physiological parameters in patients with OSAS. Method Ninety-eight patients with OSAS and 26 nonapneic snoring subjects upon polysomnography were included in this study. The urinary albumin-to-creatinine ratio (UACR) was calculated according to a previously described formula. The severity index of chronic diseases was evaluated by using the modified cumulative illness rating scale (MCIRS). Insulin resistance (IR) method was analyzed by homeostasis assessment model (HOMA-IR). Subjective sleepiness was assessed using the Epworth sleepiness scale (ESS). Results Body mass index (BMI), MCIRS, and UACR were higher in patients with OSAS than nonapneic snoring subjects. In linear regression model, there was a negative relationship between UACR and minimal O-2, and there was a significantly positive relationship between UACR and desaturation index. Conclusion Microalbuminuria may be seen in patients with OSAS, depending on the severity of disease and hypoxemia. Microalbuminuria in patients with OSAS should be examined in regular periods for risk of cardiovascular morbidity or mortality.

Background and Aims Round pneumonia (RP) is a rare radiological presentation of a subtype of lobar pneumonia that arises because of a developmental defect in connective tissues (pores of Kohn and channels of Lambert). The round appearance on chest X-ray (CXR) is thought to occur from an infectious process that spreads from small peripheral alveoli centrifugally through interalveolar channels via the pores of Kohn and the canals of Lambert. This explains the nonsegmental distribution and shape of RP. The pathogenesis of RP is unknown. An alternative theory holds that RP in children occurs because of underdeveloped pores of Kohn and the absence of canals of Lambert, limiting the spread of the organism and resulting in a focal, round mass seen on radiographs. As a result of this developmental defect, dissemination of infection remains in a limited area. While this is a well-known entity in childhood, it has been described infrequently in adults. Lesions of RP are not necessarily round; oval lesions can also be seen. It is a radiological subtype of the pneumonia subtype and presents as a solitary nodule or a mass lesion in CXR. Methods We presented two cases of RP. One mimicked and was mistaken for pulmonary infarction because of triangular pleural-based density and the other mimicked pulmonary malignancy because of a homogeneous triangular opacity based on the pleura on the posteroanterior radiography and computed tomography. Conclusion These cases were presented because of RP's importance, and RP should be considered a part of differential diagnosis of pulmonary infarct and lung tumor.

WOS: 000361324100010 Aim: To investigate the personality traits of patients with polycystic ovary syndrome (PCOS). Methods: Forty-nine patients with PCOS and 34 healthy controls were enrolled in the study. Psychometric evaluation was made with the Minnesota Multiphasic Personality Inventory. Additionally, Short Form-36 (SF-36) and Hospital Anxiety and Depression Scale (HADS) were also performed. Results: Polycystic ovary syndrome patients had significantly higher absolute and clinical elevation scores on depression, hysteria, psychasthenia and hypomania compared with the controls. Patients with PCOS had lower SF-36 physical and mental health summary scores and higher HADS anxiety and depression subscale scores. Conclusion: Polycystic ovary syndrome patients seem to have depressive, hysterical, psychasthenic and hypomanic personality traits.

KISA, Ucler/0000-0002-8131-6810 WOS: 000316954500010 PubMed: 23547630 Background: Microalbuminuria is an important risk factor for cardiovascular diseases. Microalbuminuria may be seen due to hypoxemia in patients with chronic obstructive pulmonary disease (COPD). Objectives: In this study, we investigated prevalence and relationship of microalbuminuria with clinical and physiological parameters in patients with COPD. Method: During the research, 66 consecutive patients with COPD and 40 cases smokers with normal spirometry were included. The urinary albumin creatinin ratio (UACR) was calculated according to previously described formula. The presence of microalbuminuria was defined as UACR being >= 20 in men and >= 30 in women. The severity index of chronic diseases was evaluated by using MCIRS. Results: The rate of presence of microalbuminuria and UACR were higher in patients with COPD than smokers with normal spirometry. Pearson correlation analysis showed a significant inverse relationship between UACR and PaO2, FEV1%, FVC%. On the other hand, there was a positive relationship between UACR and BODE index. There was a significant relationship between the presence of microalbuminuria with PaO2 and BODE index. In the linear regression model, there was a negative relationship between UARC and PaO2 yet there was a significantly positive relationship between UARC and MCIRS score, BODE index. In the logistic regression model, the presence of microalbuminuria showed significant associations with PaO2, BODE index. Conclusion: Microalbuminuria may be seen in patients with COPD, depending on the severity of disease and hypoxemia. Microalbuminuria in patients with severe COPD should be examined in regular periods for risk of cardiovascular morbidity or mortality.

Pulmoner langerhans hucreli histiositozis (PLHH) X langerhans hucreli histiositozisin alt grubu olup akcigerlerde langerhans hucre infiltrasyonunun goruldugu nedeni bilinmeyen bir interstisiyel akciger hastaligidir. Klinik spektrumu non-produktif oksuruk, nefes darligindan spontan pnomotoraksa kadar cok genis olup olgularin % 90'indan fazlasi sigara icicisidir. Yuksek cozunurluklu bilgisayar tomografide (YCBT) ust ve orta zonlarda retikulonoduler ve kistik gorunumlerin olmasi karakteristiktir. PLHH nadir gorulen bir hastaliktir, genc, sigara icen ve spontan pnomotoraks nedeniyle basvuran hastalarda akla gelmelidir. Nadir gorulen bir hastalik olmasi nedeniyle takip ettigimiz 4 olguyu literature katki yapmak amaciyla sunduk.

WOS: 000382381800008 PubMed: 26932385 BACKGROUND: The aim of this study was to assess the association between cognitive function and age, pulmonary function, comorbidity index, and the 6-min walk distance in subjects with COPD as well as to compare the Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) in terms of their ability to identify cognitive dysfunction in subjects with COPD. METHODS: A total of 52 individuals with stable COPD were included in this study. Cognitive function was assessed using MMSE and MoCA. Age, body mass index, the Modified Cumulative Illness Rating Scale, 6-min walk distance, arterial blood gases, and pulmonary function tests were assessed and recorded. RESULTS: The range and SD of scores in subjects with COPD were larger with MoCA than with MMSE. MMSE and MoCA scores are associated with 6-min walk distance and comorbidity index in subjects with COPD. General cognitive function measured by MoCA was negatively correlated with the comorbidity index but was positively associated with 6-min walk distance in subjects with COPD after controlling for possible confounding factors in the multivariate model. However, general cognitive function measured by MMSE was not correlated with the comorbidity index and 6-min walk distance in subjects with COPD, after controlling for possible confounding factors in the multivariate model. CONCLUSIONS: MoCA may be a more reliable screening test than MMSE in detecting cognitive impairment in subjects with COPD. The addition of cognitive tests on assessment of subjects with COPD can provide further benefit.

Summary Objective: Insulin resistance (IR) and disorders of glucose metabolism (DGM) are risk factors for cardiovascular diseases. There are different reasons for development of DGM in patients with obstructive sleep apnoea syndrome (OSAS) and this association is controversial. We investigated the frequency of DGM and IR in patients with OSAS and determining factors for these disorders. Method: One hundred and twelve untreated patients with OSAS and 19 non-apnoeic snoring subjects upon polysomnography were included in this study. Oral glucose tolerance test (OGTT) was performed in all subjects who had fasting blood glucose

WOS: 000209656300002 PubMed: 21708053 Exacerbations occur commonly in patients with asthma but factors affecting perception of dyspnea during exacerbation are not well known. This investigation was designed to determine the effects of negative mood on perception of dyspnea during exacerbation. A total of 47 patient aged 28-78 years (mean age, 52.5 years) admitted with acute asthma had recordings of blood gas pressure, negative mood score, forced expiratory volume in 1 second (FEV1), and dyspnea score at admission and at the 72nd hour. Perceived intensity of dyspnea was estimated using a modified Borg scale. The negative mood was assessed with an overall of six mood adjectives (nervous-anxious, sad-blue, and tired-drowsy). High negative mood score was defined as the score above the cutoff point (median score, >7). Borg sore of patients with a high negative mood score was higher than that of patients with a low negative mood score (6.3 +/- 2.5 versus 4.4 +/- 2.4; p +/- 0.01). The high Borg sore of asthmatic patients with high negative mood persisted even at the 72nd hour (1.6 +/- 0.9 versus 1.0 +/- 0.7; p +/- 0.01). FEV1 values of both groups at admission were similar. The negative mood score (beta = 0.68; p = 0.0001) and initial FEV1 (beta = -0.42; p = 0.01) were the important determinants of Borg score at admission in all patients with multivariate analysis but not arterial oxygen pressure, arterial carbon dioxide pressure, asthma duration, and female sex. This study indicated that emotional factors, as well as the level of airways obstruction, predicted the magnitude of dyspnea at exacerbation of asthmatic patients. Thus, the emotional factors should be taken into account in the treatment of dyspnea at exacerbation.

WOS: 000271143000012 PubMed: 19552600 Purpose: To investigate the respiratory and cardiovascular effects of switching therapy from topical timolol 0.5% to latanoprost 0.005% in elderly patients with glaucoma. Methods: Twenty-five patients with primary open-angle glaucoma (POAG) who were treated with topical timolol 0.5% were included in the study. The beta-blocker treatment was ended due to insufficient intraocular pressure (IOP) and systemic or local side effects. The treatment then switched to latanoprost in these patients. All recruited patients underwent a full ocular, cardiovascular, and respiratory examination including spirometry, pulse rate, and blood pressure. All measurements were made 1 day before the beta-blocker treatment was ended and 30 days after the latanoprost treatment was started. Results: Timolol treatment was associated with numerically but not statistically significant lowered pulse rates, systemic blood pressure, diastolic blood pressure, and reductions in the spirometry measurements. The change to latanoprost treatment was associated with numerical improvement in mean values of spirometric test results. There were no significant differences in changes in mean values of spirometry, pulse rate, or blood pressure. Histamine challenge test was determined to be positive in 16 of 25 patients for timolol, of whom 10 were positive for latanoprost. This was statistically significant (P < 0.05). Conclusions: Although all the results presented were statistically insignificant, switching to latanoprost treatment may offer some advantages in respiratory and cardiovascular function for elderly people with glaucoma over beta-blocker drugs. Spirometry and the measurement of pulse rate and blood pressure are advised in all patients receiving topical beta-blocker therapy.

A case of hypersensitivity pneumonitis with symptoms of dyspnea and cough, with normal PA chest radiography and with the anamnesis of pigeon exposure was presented here. 66 years old male patient had complaints of dyspnea and cough since 3 months. His respiratory sounds were normal. He did not have other environmental, occupational or drug exposure history. In thorax high resolution computed tomography (HRCT), there were centriacinar nodules in the middle and lower lobes. When his anamnesis was reevaluated, we learned that he was cleaning up pigeon droppings from roof every week. The patient was instructed to stop having direct and indirect contact with pigeons. One month after, the patient was reevaluated. His cough and dyspnea were improved. In his followup thorax HRCT, centriacinar nodules were disappeared. We should always consider hypersensitivity pneumonitis in the patients with the complaints of dyspnea, cough, even if the PA radiography is normal; we should take the exposure history comprehensively. Key words: Hypersensitivity pneumonia, centriacinar nodules, tomography, Nefes darlığı, öksürük semptomları ile gelen PA akciğer grafisi doğal olan ancak detaylı anamnezle güvercin maruziyeti öyküsü tarifleyen ve hipersensitivite pnömonisi tanısı alan olguyu sunduk. 66 yaşında erkek hasta üç aydır olan nefes darlığı, öksürük şikayetleri ile polikliniğine başvurdu. Fizik muayenesinde solunum sesleri doğaldı. Çevresel, mesleksel maruziyet ve özellikli bir ilaç kullanım öyküsü yoktu. PA akciğer grafisi normaldi. Toraks yüksek çözünürlüklü bilgisayarlı tomografi (YÇBT)’de orta ve alt loblarda daha belirgin olan yaygın buzlu cam dansitesinde sentriasiner nodüller izlendi. Hastanın evin çatısındaki güvercinlere ait atık ürünlerini haftalık temizlediği öğrenilmesi üzerine güvercinlerle direk ve dolaylı maruziyetinin kesilmesi önerildi. Bir ay sonraki kontrolünde öksürük ve nefes darlığı semptomlarında gerileme olduğu öğrenildi. Kontrol toraks YÇBT’de her iki akciğerde izlenen yaygın sentriasiner nodüllerin kaybolduğu görüldü. Nefes darlığı, öksürük gibi semptomlarla başvuran hastalarda akciğer grafisi normal bile olsa hipersensitivite pnömonisinin de olabileceği göz önünde bulundurulmalı ve hastaların maruziyet öyküsü detaylı olarak sorgulanmalıdır.Anahtar kelimeler: Hipersensitivite pnömonisi, sentriasiner nodüller, tomografi

Batislam, Ertan/0000-0002-7493-4573 WOS: 000245566500003 PubMed: 17382135 OBJECTIVES To assess the relationship among the sexual, hormonal, physical, and psychological status of women with bronchial asthma (BA) compared with that of healthy volunteers. METHODS Thirty-eight women with BA were enrolled in the study. The patients were asked to complete the Female Sexual Function Index, General Health Questionnaire, and Medical Outcomes Study Short Form 36-item Health Survey (SF-36). Using the answers on the SF-36, the mental and physical component summary scores were calculated. A total of 20 healthy women were enrolled in the study as the control group. The same questionnaires were given to this group as well. Statistical analysis was performed using the Mann-Whitney U test and Pearson correlation tests. RESULTS At the end of the study, statistically significant differences were observed for all questionnaire scores (P

Psychological distress of patients with asthma may be reduced when they learned to live with their illness. Asthma can change the psychological and personality characteristics. We aim to investigate the psychological and personality characteristics of patients with asthma using MMPI (Minnesota Multiphasic Personality Inventory).Thirty-three adult patients with asthma (23 female and 10 male) and 20 healthy controls (14 females and 6 males) were enrolled in this study. Psychometric evaluation was made with the Turkish version of the MMPI. The patients were separated into two groups according to the duration of symptoms (recent-onset asthma 10 years, long-standing asthma ≥10 years).Patients with asthma compared with control group had significantly higher the rate of clinical elevation on depression, hysteria, psychasthenia and social introversion. Patients with recent-onset asthma compared with long-standing asthma have significantly higher the rate of clinical elevation on depression, hysteria, psychopathic deviate, psychasthenia and social introversion. MMPI mean t score in patients with recent-onset asthma was higher than patients with long-standing asthma. MMPI mean t score in patients with asthma was negatively associated with the symptom duration in multivariate model.Patients with asthma have relatively more inactivity, anergia, guilt, pessimism, nonspecific physical complaints, irrational fears and introvert. Patients with long-standing asthma have less psychological distress, suggesting that learned to cope with his illness.

WOS: 000237857400014 PubMed: 16729784 Background: Numerous studies have been performed concerning the perception of dyspnea during changes in airway caliber provoked in the laboratory setting, but studies of asthma exacerbation are scarce. Objective: To investigate whether the perception of dyspnea during histamine-induced bronchoconstriction might be used to identify patients with asthma who sense dyspnea poorly during exacerbation. Methods: The perception of dyspnea in 50 patients (45 female, 5 male) with asthma was evaluated at admission with exacerbation and during a stable period. Perceived intensity of dyspnea was estimated using a modified Borg scale. The perception of dyspnea in the stable period 4 to 6 weeks after exacerbation was measured with the histamine challenge test. Perception parameters were defined as the change in Borg score divided by the change in forced expiratory volume in 1 second (FEV1) as a percentage of the baseline FEV1 (Delta Borg/Delta FEV1) and as the Borg score at 20% decrease (PS20Histamine) or increase (PS20Exacerbation) in FEV1. Results: The perception of dyspnea during asthma exacerbation was unrelated to the perception of dyspnea during histamine-induced bronchoconstriction (for Delta Borg/Delta FEV1, beta = .08, P = .50; for PS20, beta = -.11, P = .40). The K value for the agreement of poor perceivers at exacerbation and during the stable period was -0.21 (P = .10). However, the intensity of dyspnea caused by histamine-induced bronchoconstriction was lower than that caused by asthma exacerbation (PS20: 1.6 +/- 1.1 vs 2.8 +/- 2.5. respectively. P = .004; Delta Borg/Delta FEV1: 0.08 +/- 0.05 vs 0.21 +/- 0.28, respectively, P = .001). Conclusion: The perception of dyspnea during asthma exacerbation is not correlated with the perception of dyspnea during histamine-induced bronchoconstriction. Therefore, the perception of dyspnea during histamine-induced bronchoconstriction cannot be used to identify the asthmatic patients who perceive dyspnea poorly.

Objective: The goal of this study was to determine preferences and expectation of COPD patients about their drugs used. Method: 46 patients with COPD were involved to the study. Preferences of patients relevant to the drugs they use for COPD and their expectations from this therapy were assessed under 6 categories. 16 alternative therapy forms were established for these groups by utilizing conjoint analysis. Patients sorted 16 types of therapy per order of preference. Results: During the Conjoint analysis the major expectation of patients from the drugs they use was the choice of number of day without complaints is to be maximum (more than 20 days). 2nd major choice of patients’ for their therapy was the choice of therapy cost to be minimum. Other choices of patients relevant to the drugs they use for therapy was respectively as follows; rapid commencing of effective period of drugs they use for reliever therapy, effective period of drugs they use for reliever therapy to be long, combined using of long term effective bronchodilator and inhaler steroid rather than seperate form. In addition, the first choice of patients for inhaler for maintenance and acute symptoms was long acting-bronchodilatator. Conclusion: The major expectation and choice of COPD patients from their drug treatment were that the number of days without complaints was to be maximum with therapy. Other choices relevant to the drug therapy was combined forms rather than seperate and long acting bronchodilatator for maintenance treatment. Taking account of patient preferences when selecting COPD treatment may help to improve compliance with treatment.

Objectives: Published data on gender differences in the effect of smoking on pulmonary function have been controversial. The study was designed to investigate the gender differences in effects of smoking on pulmonary function. Methods: Female smokers were chosen among individuals older than 40 yrs, living in home for the aged. Male smokers were chosen from among office workers older than 40 yrs in MCI (machine chemical industry). Total 215 female smokers and 283 male smokers included the study. The individuals were interrogated with a questionnaire concerning respiratory symptoms, smoking status and other characteristics. Chronic airway obstruction was defined by FEV1/FVC

Introduction The relationship between obstructive sleep apnea syndrome (OSAS) and bronchial hyperresponsiveness (BHR) is not well known. In this study, we investigated the association between BHR and disease severity in patients with OSAS. Materials and methods Fourty seven (37 male/10 female) OSAS patients admitted with polysomnography enrolled to the study. Histamine bronchial challenge test was performed and body mass index (BMI, kg/m2) was calculated. Presence of BHR was diagnosed as positivity of bronchial provocative test (BPT) (PD values ≤ 16 mg/mL). Patients were questioned with Epworth sleepiness scale (ESS). Results Histamine bronchial challenge test was positive in 21 of 47 patients. There were significant negative correlations between PD 20 value and AHI (r= -0.47, p= 0.03), BMI (r= -0.45, p= 0.03), and ESS score (r= -0.45, p= 0.03) in the patients with BHR. In addition, AHI (p= 0.03), BMI (p= 0.02), ESS scores (p= 0.03) were higher in patients with BHR (21 patients) than in patients not having BHR (26 patients). Significant negative relation was found between PD 20 value and AHI (b=-0.45, p= 0.03) and significant positive relation was found between presence of BHR and AHI (p= 0.04), BMI (p= 0.03) independently of age and sex in multiple regression analysis. Conclusion BHR is common in patients with OSAS. As severity of OSAS increased, severity of BHR increased. In addition, obesity may trigger presence of BHR in patients with OSAS.

Round pneumonia (RP) is a rare radiological presentation of a subtype of lobar pneumonia that arises because of a developmental defect in connective tissues (pores of Köhn and channels of Lambert). The round appearance on chest X-ray (CXR) is thought to occur from an infectious process that spreads from small peripheral alveoli centrifugally through interalveolar channels via the pores of Kohn and the canals of Lambert. This explains the nonsegmental distribution and shape of RP. The pathogenesis of RP is unknown. An alternative theory holds that RP in children occurs because of underdeveloped pores of Kohn and the absence of canals of Lambert, limiting the spread of the organism and resulting in a focal, round mass seen on radiographs. As a result of this developmental defect, dissemination of infection remains in a limited area. While this is a well-known entity in childhood, it has been described infrequently in adults. Lesions of RP are not necessarily round; oval lesions can also be seen. It is a radiological subtype of the pneumonia subtype and presents as a solitary nodule or a mass lesion in CXR.We presented two cases of RP. One mimicked and was mistaken for pulmonary infarction because of triangular pleural-based density and the other mimicked pulmonary malignancy because of a homogeneous triangular opacity based on the pleura on the posteroanterior radiography and computed tomography.These cases were presented because of RP's importance, and RP should be considered a part of differential diagnosis of pulmonary infarct and lung tumor.

WOS: 000302966500008 PubMed: 22469102 Purpose: Quality of life (QoL) may be poor in patients with sleep apnea depending on multifactorial reasons. In this observational study, we examined the factors determining QoL in patients with obstructive sleep apnea (OSA) and nonapneic snoring subjects. Methods: Complete assessments were obtained on 111 subjects who diagnosed OSA and 18 nonapneic snoring subjects. Fasting blood samples of all of subjects were taken to determine insulin resistance (IR) and oral glucose tolerance tests were performed to diagnose disorders of glucose metabolism (DGM). Quality of life, with short form (SF)-36, and excessive daytime sleepiness, with epwort sleepness scale (ESS), were evaluated. Results: The mean age of the patients with OSA was higher than that of the nonapneic snoring subjects (48.4 +/- 9.6 years and 43.0 +/- 11.8 years, respectively; p=0.03). BMI was also significantly higher in the patients with OSA than in the nonapneic snorers (31.0 +/- 4.5 and 27.1 +/- 4.0, respectively; p=0.001). The mental health component in the patients with OSA was slightly but not significantly lower than the nonapneic snoring subjects (p=0.05). A negative correlation among most domains of quality of life with scores of ESS, body mass index (BMI), presence of hypertension (HT) and DGM was found. Only physicial functioning was negatively correlated with apnea hypopnea index (AHI). In linear regression analysis, there were negative associations among physical functioning with BMI, presence of HT and DGM while there was no association between physicial functioning and AHI. In addition, there were negative correlations between mental health component with BMI and presence of HT in the multivariate analysis. Obese patients with OSA had lower physicial and mental components compared with nonobese patients with OSA. Conclusion: The impact of OSA on quality of life can be attributed to excessive daytime sleepiness. Obesity and metabolic disorders in patients with OSA may also negatively affect the quality of life.

To investigate the effects of septoplasty on pulmonary function tests (PFTs) and bronchial hyperresponsiveness (BHR) in patients who had no previous pulmonary diseases.Prospective, controlled clinical trial.Fourteen patients with nasal septal deviation (NSD) and 20 controls were enrolled in the study.All patients were evaluated with anterior rhinoscopy, nasal endoscopy, acoustic rhinometry (AR), visual analogue scale (VAS), PFTs, and bronchoprovocation test (BPT) on the day before surgery and 8 to 12 weeks after surgery.The postoperative values of forced expiratory volume in 1 second, forced vital capacity, and peak expiratory flow percentages were higher than preoperative ones, and these results were statistically significant (p = .007, p = .04, and p = .007, respectively). Nine patients had preoperative BHR, and three of them had negative BPT postoperatively. When compared with the preoperative values, there was a borderline decrease in the rate of BHR in six patients. There were significant improvements in the symptoms of left and right nasal congestion, headache, postnasal drip, and olfactory function after surgery. We found important improvement in the values of AR at right minimal cross-sectional area 1 (p = .02), left distance 1 (p = .04), and left distance 2 (p = .04) postoperatively.An improvement in both nasal symptoms and PFT values was seen after surgical treatment for NSD. We concluded that septoplasty may be considered as having favourable effects on BHR.

Ekici, Arif B/0000-0001-6099-7066 WOS: 000242662400003 PubMed: 17199838 Background: The purpose of this study was to clarify the correlations between the presence of comorbidities and psychological distress and health-related quality of life (HRQL). This was a population-based cross-sectional study. Methods: Parents and grandparents of students from seven randomly selected primary schools in the city centre were asked to answer questionnaires sent by their children. All subjects were questioned for somatic diseases, psychological distress and HRQL by Health Questionnaire, Hospital Anxiety and Depression scale and short-form-12 health survey, respectively. Results: Out of 5024 parents and grandparents (mean age 52.3 +/- 14.3 years, range 20-104 years) of primary school students 4605 returned the questionnaires, a figure that corresponds to the overall response rate of 91.6%. Chronic diseases substantially reduced HRQL and this effect did not differ markedly with the type of chronic disease. Association of comorbidities with psychological distress further impaired HRQL. As the number of chronic diseases was increased, HRQL and physical and mental functioning declined. The worst HRQL was observed in subjects who had five or more comorbidities associated with psychological distress. Conclusion: The present study indicates significant adverse effects of chronic diseases and psychological distress on HRQL in adults, the effect of psychological distress being the most important. Our results lead us to suggest that in the management of comorbidities, the detection of the presence and severity of associated psychological distress and its treatment, besides the specific treatment of comorbidities, may provide dramatic improvement in HRQL of the patients.

PubMed: 17693789 OBJECTIVE: We investigated whether long-term, low-level exposures to solvents had adverse longitudinal effects on pulmonary functions. METHODS: The study was performed on 1091 workers 5 years ago and then on 697 workers 5 years later. Chronic respiratory symptoms were recorded using a questionnaire on respiratory symptoms. RESULTS: The annual decrease in forced expiratory volume in 1 second in the workers exposed to solvents was not significantly different from that of the unexposed workers (69.7 ± 89.9 vs 75.8 ± 87.6 mL/yr, P = 0.5, respectively). In 453 workers who were exposed to solvents 5 years ago, the prevalence rate of asthma was 1.1%. Five years later, it was 3.6% in 193 workers from the same group. The difference was statistically significant (P = 0.03). CONCLUSIONS: Longitudinally, the chronic exposure to low doses of solvents does not adversely affect the pulmonary functions, whereas it increases the asthma prevalence. ©2007The American College of Occupational and Environmental Medicine.

Background: Respiratory disorders in childhood may predispose to pulmonary disease in late adult life. Objectives: The aim of this study was to evaluate the relationship between their effects in adult life and the characteristics of the respiratory system in childhood. Methods: A total of 10,224 parents and grandparents of students from 14 randomly selected primary schools in the city center were asked to answer questionnaires given to their children. 9,853 of 10,224 persons (the overall response rate was 96.3%) were eligible for analysis. In the questionnaire subjects were asked about respiratory system-related symptoms and characteristics. Results: Chronic cough [14.3 vs. 4.7%, OR 3.4 (2.6–4.4), p < 0.001], chronic bronchitis [35.3 vs. 11.8%, OR 4.0 (3.4–4.8), p < 0.001] and asthma [34.2 vs. 5.1%, OR 9.6 (8.0–11.5), p < 0.001] in the childhood respiratory infection group were more common than in the control group. Childhood respiratory infections were associated with an increased risk of asthma (OR 5.6, p < 0.001), chronic bronchitis (OR 2.3, p < 0.001) and chronic cough (OR 1.5, p < 0.001), after adjusting for possible confounding factors. In addition, the presence of dampness or visible mould, wall-to-wall carpets, pets at home and parents’ smoking during childhood were associated with an increased risk of frequent childhood respiratory infections. Conclusion: These results indicated that frequentrespiratory infections during childhood might play an important role in the occurrence of chronic airway diseases in adult life. The removing of risk factors for frequent childhood respiratory infections may reduce the subsequent risk of chronic airway disease in late adult life.