Increased platelet activation and aggregation which are closely related to cardiovascular complications have been reported in patients with obstructive sleep apnea (OSA). The aim of this study was to assess the mean platelet volume (MPV), an indicator of platelet activation in patients with OSA. The 95 subjects referred for evaluation of OSA underwent overnight polysomnography. Blood samples were taken for MPV determination. According to the apnea-hypopnea index (AHI), subjects were divided into three groups; group 1: control subjects without OSA (AHI < 5, n = 24), group 2: patients with mild to moderate OSA (AHI: 5-30, n = 42), and group 3: severe OSA (AHI > 30, n = 29). Body mass index (BMI) of patients with severe OSA was significantly higher than control subjects (31.5 ± 4.0 vs. 28.2 ± 5.0; p = 0.02). The MPV was significantly higher in patients with severe OSA than in the control group (8.9 ± 1.0 vs. 8.2 ± 0.7 fl; p = 0.01). Correlation analysis within 71 patients with OSA indicated that MPV was correlated with AHI (p < 0.001, r = 0.44) and DI (p = 0.001, r = 0.37). In multivariate regression analysis, when MPV was taken as independent with other study variables which are potential confounders such as age, gender and BMI, MPV was independently correlated with both AHI (β = 0.44, p < 0.001) and DI (β = 0.38, p < 0.001). We have shown that MPV was significantly higher in patients with severe OSA when compared with control subjects and MPV was correlated with AHI and DI.

Previous studies have reported increased platelet activation and aggregation in patients with obstructive sleep apnea (OSA). Continuous positive airway pressure (CPAP) treatment has been shown to decrease platelet activation. We aimed to study the effects of nasal CPAP therapy has on MPV values in patients with severe OSA. Thirty-one patients (21 men; mean age 53.8 ± 9.2 years) with severe OSA (AHI > 30 events/hour) constituted the study group. An age, gender and body mass index (BMI) matched control group was composed 25 subjects (14 men; mean age 49.6 ± 8.5 years) without OSA (AHI < 5 events/hour). We measured MPV values in patients with severe OSA and control subjects and we measured MPV values after 6 months of CPAP therapy in severe OS patients. The median (IQR) MPV values were significantly higher in patients with severe OSA than in control group (8.5 [8.3-9.1] vs. 8.3 [7.5-8.8] fL; p = 0.03). The platelet counts were significantly lower in patients with severe OSA than in control group (217.8 ± 45.9 vs. 265.4 ± 64.0 × 10⁹/L; p = 0.002). The six months of CPAP therapy caused significant reductions in median (IQR) MPV values in patients with severe OSA (8.5 [8.3-9.1] to 7.9 [7.4-8.2] fL; p < 0.001). Six months of CPAP therapy caused significant increase in platelet counts when compared with baseline values (217.8 ± 45.9 to 233.7 ± 60.6 × 10⁹/L; p < 0.001). We have found that the MPV values of patients with severe OSA were significantly higher than those of the control subjects and 6 months CPAP therapy caused significant reductions in the MPV values in patients with severe OSA.

OBJECTIVES:This study was performed on Suleyman Demirel University medical students to determine the quality of sleep and to investigate factors that affect of sleep quality. MATERIAL AND METHODS:Suleyman Demirel University Medical students at 1, 2, 3, 4, 5 and 6 classes included to this crosssectional analytical study (n= 720). Refused to fill to the survey (188), and students were not come to faculty (195), applied survey to 337 students (46.8%). Epworth sleepiness scale (ESS), Pittsburgh (PSQI) and Berlin sleep questionnaires, and 13 pieces closed and open-ended socio-demographic questions were conduct a questionnare under observation. The collected data were analyzed by using descriptive statistics, chi-square, two independent groups t test, Pearson and Spearman's correlation, Mann-Whitney U, Kruskal-Wallis and ANOVA tests. RESULTS:337 students participated in the study, 42.1% were male, 57.9% were female, mean age was 21.3 ± 2.1 years. Depending on Body mass index (BMI) 31 were poor, 212 normal, 53 overweight, and 4 obese students. In 118 students (35.3%), and these students have a chronic disease associated with 15.6% used the drug because of illness and 38 percent of students (11.6%) were smokers. 18.1 ± 16.1 min for pupils in times of falling asleep, sleep duration per night. 6.6 ± 1.3h, the mean departure time was 7.7 ± 1.8. Scale with a total score of Pittsburgh class (p= 0.000), age (p= 0.003), BMI (p= 0.015) had a significant correlation between. Pittsburgh PUKI scores and without a significant difference in gender (p= 0.054), the use of stimulant substances (p= 0.032), weight (p= 0.021) and snoring (p= 0.002) with no significant difference were found. ESS total score and gender (p= 0.025), drug use (p= 0.035) and sports activities (p= 0.038). Ten students had snoring (3.0%), 5 students (1.5%) had witnessed apnea. Snoring 17.2% to in ESS > 10 points on it. Pittsburgh, the mean scores of those who witnessed apnea (14.0 ± 5.3), witnessed apnea, according to non-students (10.2 ± 6.4) were higher (p= 0.191).The effects PSQI and ESS results on the term were statistically significant by the multivariate regression analysis [F(10.602)= 4.56; p< 0.05; Wilkis Lamda 0.864, partial n 2 = 0.07]. To estimate of the value of PSQI by the stepwise regression analysis was performed; age and fall asleep properties has been included of the model (R2= 89%, p< 0.05). To estimate of the value of PSQI by the stepwise regression analysis was performed; fall asleep property has been included of the model in the the male gender (R2= 80%, p< 0.05). To estimate of the value of ESS by the stepwise regression analysis was performed; term property has been included of the model (R2= 65%, p< 0.05). CONCLUSION:Medical school students participating in our study, although female-male ratio close to each other, we found that higher ESS and Pittsburgh scores in female more than male. In this case may be related to physiological, genetic, environmental, cultural and psychological differences.

OBJECTIVES:Effects of air pollution parameters of sulfur dioxide (SO2) and particulate matter (PM10) values on the respiratory system were investigated. MATERIAL AND METHODS:Data of SO 2 and PM10 were obtained daily for air pollution and classified into two groups: Group I (2006Group I ( -2007, coal burning years and Group II (2008II ( -2009, natural gas+ coal burning. Groups I and II were divided into two subgroups according to the months of combustion as combustible (November-April) and noncombustible (May-October). The number of patients with asthma and chronic obstructive pulmonary disorder (COPD) was recorded between 2006 and 2009. RESULTS:There was no statistically significant difference between Groups I and II for PM10 and SO 2 (p>0.05). Within the years, the values of SO 2 and PM10 were statistically different between the groups defined by month (p<0.01). The number of patients in the combustible and noncombustible subgroups were found to be different for every 4 years, and the numbers of patients with COPD or asthma were not changed through the years. There was a strong correlation between PM10 and COPD (r=0.59, p<0.01) and a weak correlation between PM10 and asthma (r=0.25, p>0.05). A correlation was found between SO 2 and COPD (p<0.01) but not between SO 2 and asthma (p>0.05). The number of visits for COPD and asthma was statistically different between combustible and noncombustible subgroups (X2:58.61, p=0.000; X2:34.55, p=0.000, respectively). The r2 values for SO 2 and PM10 for COPD patients were 17% and 24%, respectively, in contrast to 8% and 5%, respectivley for asthma patients. CONCLUSION:Air pollution is known to increase respiratory disease occurrences. With decrease in the usage of solid fuel, air pollution could be reduced and may be effective in preventing respiratory diseases. KEYWORDS:Air pollution, respiratory system disease, PM10, SO 2 , asthma, COPD INTRODUCTIONInhalation of toxic particles and gases increases epithelial permeability, which is one of natural defense mechanisms of the lungs; decreases mucociliary activity; and depresses macrophage functions. These substances render toxic effects in healthy or unhealthy individuals and can be a component of molecular events that commonly develop [1]. In vitro experimental studies conducted on humans and animals showed that the damages caused increased inflammatory cellular activation (e.g., neutrophils, T lymphocytes, macrophages, and mast cells), increased production of inflammatory cell proteins (cytokines and chemokines), increased oxidative stress with free radical formation [2] (superoxide, hydrogen peroxide, and hydroxyl radicals), and decreased antioxidant enzyme levels (glutathione transferase and superoxide dismutase) [3].Several studies have shown that particulate matter (PM) in the air affect short-and long-term health. In many studies, there is evidence of effects of PM10 and PM2.5 (PM diameter of 10 or 2.5 µm) on asthma and chronic obstructive pulmonary disease (COPD) and on the increased rate of hospitalization [4]. Stud...

Background There are limited studies on the effects of asthma on cardiac function. Right ventricular dysfunction and pulmonary hypertension are cardiovascular complications that may be seen in advanced stages of the disease. Pulmonary artery stiffness (PAS), is a promising, relatively new echocardiographic index that has been reported to increase in right ventricular failure, providing information about pulmonary vascular bed. Aim In this study, we aimed to evaluate PAS, a marker of pulmonary artery elasticity, in adult‐onset asthma. Methods Ninety‐nine nonsmokers who had a new asthma diagnosis between the ages of 18 and 65 years and 97 healthy controls with similar age and sex distribution were included in the study. PAS was calculated by dividing the maximal frequency shift of pulmonary flow (MFS) in pulmonary acceleration time (PAT). Results Clinical and demographic characteristics of both groups were similar (P ˃ 0.05). PAS values were higher in the asthma group than in the control group (25.2 ± 4.5 vs 22.4 ± 4.1, P ˂0.001). TAPSE was lower in the case group (24.9 ± 2.0 vs 25.5 ± 2.1, P = 0.043), while RV MPI was higher (0.36 ± 0.07 vs 0.32 ± 0.06, P ˂0.001). In the multivariate linear regression analysis, RV MPI, RV Em, and TAPSE variables were independent predictors of PAS. Conclusion In our study, PAS values were higher in patients with newly diagnosed adult asthma and we found a significant weak correlation between PAS values and subclinical right ventricular dysfunction.

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