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Objective To investigate the factors affecting compliance with positive airway pressure (PAP) therapy and establish the relationship between compliance and pulmonary function tests (PFT) in patients with OSA. Material and methods In this prospective study, patients with OSA using PAP devices were questioned about the complaints related to the device. Depression and anxiety scales along with PFT parameters were also assessed. Results Of 98 participants, 63% were men. The mean age was 52.0 +/- 9.6 years. Sixty-seven percent of the patients were compliant with their devices. A significant difference was observed between the proportion of the participants compliant or non-compliant with the device, based on OSA severity (p < 0.05). Beck depression inventory (BDI) and Beck anxiety inventory (BAI) scores of the compliant patients were significantly lower than those of the non-compliant patients (p < 0.001, p = 0.044, respectively). No statistically significant difference was detected between the groups regarding individual pulmonary function tests (p > 0.05). The rates of nasal mask use, not having difficulty in tolerating CPAP, falling asleep, absence of abdominal distension, no facial sores, no air leakage, patients benefiting from the device, reduction in daytime sleepiness, and the belief that they are receiving appropriate therapy in participants compliant with the device were higher than those in non-compliant participants (p < 0.05). The rates of claustrophobia and discomfort due to pressure were significantly lower in patients compliant with the device than in the non-compliant patients (p < 0.05). Conclusion While no relationship was detected between PFT parameters and PAP therapy compliance, significant factors affecting the device compliance were detected. WOS:000679638200001 2-s2.0-85111554942 PubMed: 34328605

WOS: 000518179400017 PubMed: 32158320 Objective: The aim of this study was to investigate the relationship between bacteriological case definitions and indoor and outdoor air quality parameters in tuberculosis (TB). Materials and Methods: A total of 200 patients with TB diagnosed and treated in our hospital during 2012-2018 were included to this study. The air monitoring measurement parameters of the National Air Quality Network [particulate matter 10 (PM10), sulfur dioxide (SO2), air temperature, air pressure, and relative humidity] for the same time period were obtained from the web page http://laboratory.cevre.gov.tr/Default. ltr.aspx. Results: Of the 200 patients, 62.5% (125) were males and 37.5% (75) were females. The rate of diagnosis based on culture and smear positivity was 48.4% (31), which was significantly higher than that in the clinic [10.9% (7)] among patients who used stove for warming. The rate of diagnosis based on culture and smear positivity [52.1% (25)] was significantly higher than that in the clinic [8.3% (4)] among patients who were exposed to biomass. The univariate analysis revealed no significant independent effect of warming and biomass use on case definition. According to the case definitions, the mean values of PM10, SO2, and temperature in the diagnosed month showed no statistically significant difference. The humidity level in the month was significantly higher, during which cases diagnosed using smear and culture positivity were compared with cases diagnosed using only culture positivity (p=0.023). Conclusion: This study indicates that biomass used as a cooking fuel is a risk factor for pulmonary TB, implying that TB occurrence can be reduced significantly by lowering or preventing the exposure to cooking smoke emitted from biomass fuel.

Background: There are few studies showing that the increase in particulate matters less than 10 mu m (PM10) values increases the apnea-hypopnea index (AHI). We aimed to investigate relationship between air quality parameters and the seasons with the AHI. Methods: This was a retrospective study that included 500 adults. Polysomnography (PSG) was performed on all patients. Oxygen saturation, air temperature, relative humidity, and PM10 values were recorded in Duzce for every year. The parameters of the national air quality network and sleep parameters of 500 individuals hospitalized between 2015 and 2017 were checked. Results: A total of 500 patients were included in the study, of whom 316 (63.2%) were male and 184 (36.8%) were female. While the AHI value of patients who presented during 2016 was 27.5, it had significantly declined to 20.2 in 2017 (p = .024). A significant decline was observed in AHI values of OSA patients from 2016 to 2017 (p = .043). A significant positive correlation was observed between REM-related AHI and relative humidity (r = 0.183, p = .002). Conclusions: This study showed a clear relationship between AHI and PM10 during winter when air pollution parameters are high in the region. PM10 emerged as a parameter that substantially increases the relative risk for OSA. WOS:000483191800001 2-s2.0-85071006139 PubMed: 31441672

Pneumocystis jirovecii pneumonia (commonly called Pneumocystis pneumonia or PCP) is an opportunistic infection that occurs in immunocompromised individuals. 26 year-old male patient admitted to nephrology department for hypervolemic hyponatremia and consulted to our clinic because desaturation developed. He has been diagnosed with collapsing glomerulonephritis (GN) and he was using cyclosporine and prednisolone. Postero-anterior chest X-ray showed that; left cardiodiaphragmatic sinus was blunt. In the arterial blood gas, Ph:7,42 PO2:53 mmHg PCO2:35,4 mmHg, HCO3:23,6 mEql/L. The the alveolar arterial gradient was elevated (52,75). Antibiotic and because of hypervolemia diuretic therapy was recommended to the patient. After ten days the patient's hypoxia deepened.Repeated chest X-ray showed bilateral perihilar heterogeneous opacity. Flexible bronchoscopy was performed. Pneumocystis jirovecii was detected in lavage culture. The patient treated with Trimethoprim- Sulfamethoxazole (TMP-SMZ) (3 x 7.5 mg / kg) dose. Hypoxemia improved on the 7th day of treatment and the patient was discharged. TMP-SMZ treatment was completed in 21 days. Pneumocystis developing secondary to cyclosporin toxicity Jirovecii pneumonia is a rare case.

Aim: Obstructive sleep apnea syndrome (OSAS) patients show multiple physiological deficits and several neuropsychological comorbidities. The aim of this study was to investigate the eating attitudes in OSAS patients. Material and methods: Polysomnography records of 157 were performed. Eating Attitudes Test (EAT), Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI) were applied to all participants. Results: The mean age of the 157 individuals included in the study was 47.2 +/- 11.4 (18-76) years and 36% (n = 56) of the individuals were female and 64% (n = 101) were male. When the patients were ranked according to the severity of OSAS, 38.2% (n = 60) were severe, 20.4% (n = 32) were moderate, 24.2% (n = 38) were mild, and 17.2% (n = 27) were OSAS negative. There was a significant difference in terms of the age-and-BMI-adjusted EAT score according to OSAS severity (p = .042). There was a significant difference in the age-and-BMI-adjusted value of the EAT according to the presence of OSAS (p = .011). After controlling age and BMI, no significant correlation was found between the EAT and the BDI (r = 0.012, p = .890) in patients with OSAS while there was a significant positive correlation EAT and the BAI (r = 0.177, p = .046). Conclusions: Considering the association of OSAS with psychiatric disorders, the presence of eating disorders (EDs) becomes an important and special topic. Treatment of patients with OSAS should not only aim to improve the patient's sleep apnea, but also to improve the patient's quality of life by evaluating the patient's psychological and physical functions. WOS:000513593400001 2-s2.0-85079397133 PubMed: 32048528

As coronavirus disease 2019 (COVID-19) spreads across the world, the ongoing clinical trials are leading to a big race worldwide to develop a treatment that will help control the pandemic. Unfortunately, COVID-19 does not have any known effective treatment with reliable study results yet. In this pandemic, there is not a lot of time to develop a new specific agent because of the rapid spread of the disease. The process of developing a vaccine is long and requires hard work. Although the pathophysiology of the disease is not fully understood, some of the proposed treatment alternatives are based on old evidence and some have been used with the idea that they might work owing to their mechanism of action. The efficacy, reliability, and safety of the currently available treatment alternatives are therefore a matter of debate. Currently, the main therapies used in the treatment of COVID-19 are antiviral drugs and chloroquine/hydroxychloroquine. Other proposed options include tocilizumab, convalescent plasma, and steroids, but the mainstay of the treatment in intensive care units remains supportive therapies. WOS:000600070300012 2-s2.0-85103141655

Amaç:Obstrüktif uyku apne (OUA) üst hava yollarının uyku sırasında daralması ilekarakterizedir ve bu durum oksijen desaturasyonu, sempatik aktivasyon,tekrarlayan arousallara neden olur. Uyku problemi yaşayan insanlar kendileriniagresif eğilimleri olan ve dürtüselliklerini daha az kontrol edebilen kişilerolarak düşünürler. Bu çalışmanın amacı OUA ve gündüz uykululuk halinin, şiddetiçeren ya da içermeyen davranışlar üzerine etkilerini araştırmaktır.Gereçve Yöntemler: Düzce Üniversitesi Tıp FakültesiHastanesi Göğüs Hastalıkları Polikliniğine uyku bozuklukları nedeniyle başvuran150 kişi çalışmaya dâhil edildi. Tüm hastalara polisomnografi (PSG) yapıldı.Tüm diğer testler [Beck depresyon ölçeği (BDÖ), Beck anksiyete ölçeği (BAÖ),Epworth uykululuk skalası (EUS) ve Şiddet içeren ve içermeyen suç davranışlarıölçeği (ŞİSDÖ)] katılımcılarla yüz yüzegörüşme ile yapıldı.Bulgular:Bu çalışmada OUA hastalarında ŞİSDÖ ile apne-hipopneindeksi (AHI) arasında anlamlı bir ilişki saptanmadı. OUA’li hastalarda toplamŞİSDÖ skoru ile EUS arasında anlamlı bir ilişki bulundu (r=0,267 p=0,003). EUSile BDÖ skoru (r=0,314 p, Aim: Obstructivesleep apnea (OSA) characterized by repetitive collapse of the upper airwayduring sleep and this condition leading to oxygen desaturation, sympatheticactivation, and recurrent arousals. Patients who experience sleep problemsconsider themselves, less able to control impulsive, aggressive tendencies. Theaim of this study was to investigate the effect of OSA and daytime sleepinesson violent and non-violent behaviors.Material and Methods: Hundred fifty individuals who were admitted to the Chest DiseasePolyclinic for Sleep Disorders of Duzce University, School of Medicine Hospitalwere included in the study. All patients underwent polysomnography (PSG). Alltests [Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), EpworthSleepiness Scale (ESS) and Nonviolent and Violent Offending Behavior Scale(NVOBS)] were applied to all participants by face to face interview.Results: In thisstudy, no significant relationship was found between NVOBS and AHI in OSApatients. Patients with OSA; There was a significant relationship between totalscore of NVOBS and ESS (r=0.267 p=0.003). There was a significant relationshipbetween the ESS score and the BDI score (r=0.314 p

Aim: This study examined the effects of monocyte/high-density lipoprotein cholesterol (HDL-C) ratio (MHR) and other inflammatory markers in patients with sarcoidosis not receiving treatment. To our knowledge, this is the first study on the relationship between sarcoidosis and MHR.Material and Methods: This study included 53 patients with sarcoidosis who were followed at a single, outpatient tertiary-care centre. Data on patient demographics (age and gender), disease characteristics (duration of disease, radiographic stage, treatments); pulmonary function tests (% predicted values for forced vital capacity [FVC], forced expiratory volume at 1 second [FEV1], diffusing capacity of the lungs for carbon monoxide [DLCO], alveolar volume [VA], forced expiratory flow [25–75% and at 50%; FEF] [FEF25-75]), blood biochemistry and hemogram findings were retrieved from hospital records.Results: Mean ± SD patient age was 51.13 ±1 1.94 years. Of the 53 patients, 42 were female and 11 were male. When compared with MHR ratio and pulmonary function test parameters, there was a negative correlation with FEV1% (P = 0.043, r = −0.279) and DLCO% (P = 0.009, r = –0.360). There was no significant correlation between FVC, FEV25-75 or VA. No significant correlation was found between blood calcium, urinary calcium, SACE (serum angiotensin converting enzyme) values and MHO ratio.Conclusions: Large-scale prospective studies are needed to determine if the use of MHR as an indicator of inflammation and activation would be helpful in the diagnosis and monitoring of patients with sarcoidosis.

Background Chronic obstructive pulmonary disease (COPD) is not fully reversible disease that is characterized by progressive restricting airflow. Non-invasive mechanical ventilation (NIMV) treatment can be used in COPD patients who had type 2 respiratory failure. This study aimed to determine the effect of BPAP S/T and AVAPS modes on intraocular pressure (IOP), central corneal thickness (CCT) in 40 type 2 respiratory failure patients with COPD. Methods Forty patients with type 2 respiratory failure who were hospitalized between June and December 2018 with the diagnosis of COPD exacerbations were included to the study. Patients followed up without NIMV for 12 hours after the end of exacerbations treatments end. After IOP, visual acuity and CCT were measured in all patients at the same time (11.00 am), same NIMV treatment was applied to the patients for 4 hours (AVAPS-BPAP S/T). Then the measurements were repeated. The effects of these NIMV modes on IOP were evaluated. Results After NIMV treatment, it was observed that the mean IOP increased statistically significantly (13.3 vs 12.3 mm Hg; P = 0.001). After treatment with NIMV, there was a decrease for CCT close to statistical significance (P = 0.057) Conclusion As a result; increased IOP and thinning of CCT after NIMV treatment has been shown. The type of NIMV and the level of inspiratory pressure needed in hypercapnic respiratory failure seem to affect IOP and it should be cautiously used to increase IOP. WOS:000503149800001 2-s2.0-85076765609 PubMed: 31799789

Kartegener sendromu bronşiektazi, kronik sinüzit ve situs inversus triadı ile karakterize olanotozomal resesif geçişli, yaklaşık 30000 canlı doğumda bir görülen nadir bir hastalıktır.Elektron mikroskopik görüntülemede görülen en sık bozukluk, epitelyal silyalarda dyneinkollarının yokluğudur. Bu hastalıkta siliyal aktivitenin bozulması nedeniyle aşırı balgambirikmesi görülür. Hastalığın tedavisi semptomlara yöneliktir. İnfertilite ve sağırlık görülebilir.Kartagener sendromunun uyku kalitesini düşürdüğü de görülmüştür. Hastalarınenfeksiyonlardan korunması için göğüs fizyoterapisi, influenza ve pnömokok aşılarınınyapılması önerilir. Bu hastaların toz, duman gibi partikül içeren gazlardan uzak durmalarıgerekmektedir. Bu çalışmada, sık hastane başvurusuna rağmen geç tanı konulan, obstrüktifuyku apne sendromu ile birliktelik gösteren 33 yaşında erkek olgu klinik ve radyolojik bulgularile sunuldu. Kartagener syndrome is a rare autosomal recessive disorder seen about in one per 30000 live births and characterized by bronchiectasis, chronic sinusitis and situs inversus triad. Absence of dynein arms in epithelial cilia is the most common defect in electron microscopic examination. Extreme sputum retention is seen due to cilial disfunction in this disease. Treatment of the disease is directed to symptoms. Infertility and deafness can be seen. It has been also observed that Kartagener syndrome decreases sleep quality. In order to protect the patients from infections, chest physiotherapy, influenza and pneumococcal vaccines are recommended. These patients should stay away from particulate included gases such as dust and smoke. In this study, a 33 year old male patient diagnosed late despite frequent hospital admissions, coexistence with obstructive sleep apnea syndrome was presented with clinical and radiological findings.