Objective: Chronic obstructive pulmonary disease (COPD) is an important public health problem and it is associated with systemic inflammation. Mean platelet volume (MPV) is one of the markers indicating platelet activation, and it was found to be high in many diseases related to inflammation. In previous studies reported different results evaluating of MPV in COPD. In this study, we aimed to evaluate of C-reactive protein (CRP), white blood cell (WBC), and MPV in acute exacerbation of COPD and stable COPD patients. Methods:In this retrospective study, data of 40 patients with acute exacerbation of COPD, 43 stable COPD patients and 40 healthy subjects were evaluated. Results:The mean MPV, CRP and WBC were found in control, stable COPD and acute exacerbation of COPD groups, 7.9±1.1; 8.2±1.3 and 8.7±1.6 fL; 3.4±1.2; 5.2±3.5 and 27.5±23.6 mg/L; 7.8±1.6; 8.1±2.1 and 11.4±4.5 x10 3 / ϻL, respectively. The mean WBC and CRP in the acute exacerbation of COPD group were significantly higher than the other groups (for both values p ˂0.001). The mean MPV in the acute exacerbation of COPD group was found higher than in the other groups. The mean MPV values were significantly higher in patients of acute exacerbation than control subjects (p=0.030). Conclusion:The results of this study suggest that the increased MPV may be a marker for the evaluation acute exacerbation of COPD as well as the classic acute phase reactant CRP.
Prior radiation exposure is the best known risk factor for thyroid cancers, and papillary thyroid carcinoma (PTC) may arise from dyshormonogenetic goiter. A 17-year-old female patient was admitted to the department of chest diseases with respiratory symptoms. The patient had undergone a thyroid surgery for goiter at the age of 9. A bilateral nodular opacity was detected by radiological examination. The histopathologic examination of the specimen obtained from computed tomography guided trucut biopsy was diagnosed as PTC. We present a very rare case of PTC with lung metastasis that had undergone subtotal thyroidectomy due to dyshormonogenetic goiter eight years ago.
Pulmonary sequestration is a rare anomaly, which does not have a connection with the bronchial system and gets its blood supply, generally, from the aorta or its branches. Anatomically, two different forms were described: intralobar and extralobar. Although 74% of intralobar pulmonary sequestrations get their blood supply from the descending thoracic aorta, they may get their blood supply from different arteries. Furthermore, there is more than one arterial anomaly in 14.8% of cases. We report an intralobar pulmonary sequestration, in which arterial blood supply is from two different origins (Arcus aorta and celiac trunk). To the best of our knowledge, this is the first case in the literature.Keywords: congenital abnormalities, bronchopulmonary sequestration, pneumonectomy questration shares the same pleura with normal lung tissue, but the extralobar form is separated from normal lung tissue with its own pleura. Intralobar pulmonary sequestration is more common than the extralobar form, and it affects the posterior basal segments of lower lobes and involves the left lung inferior lobe more frequently. Venous drainage in pulmonary sequestration is provided by pulmonary veins, in 95% of the cases. It gets its arterial blood supply from the descending thoracic artery, in 74%, and from the abdominal aorta, in 19%, of cases. It may rarely receive its blood supply from intercostal, subclavian, innominate, internal thoracic, pericardiophrenic, celiac, splenic arteries. Furthermore in 14,8% of cases arterial anomaly is more than one.
Objective: Obstructive sleep apnea syndrome (OSAS) is characterized by recurrent upper airway obstruction and intermittent hypoxia during sleep. Intermittent hypoxia and increased inflammatory activity plays a role in increased risk of cardiovascular disease in the OSAS. OSAS is an important cause of morbidity and mortality and cardiovascular disorders are the most important complications of OSAS. Mean platelet volume (MPV) is a marker of platelet activation and function, and increased platelet volume is associated with increased platelet activity. Different diseases related with inflammation, hypoxia, vascular injury, thrombosis and atherosclerosis were found to be associated with MPV. In this study, we aimed to investigate the relationship between OSAS and MPV. Methods:In this retrospective study, data of sex and age matched 33 patients with moderate OSAS, 34 patients with severe OSAS and 30 healthy subjects were evaluated. Results:The mean MPV was found in control, moderate OSAS and severe OSAS groups as 7.83±1.00, 8.26±1.40 and 8.94±1.20 (fL) respectively. The mean MPV value was significantly higher in severe OSAS group than control subjects (p=0.001). In correlation analysis, there were positive correlation between MPV with apnea-hypopnea index and total sleep time, and negative correlation between MPV with platelet count and minimum oxygen saturation (Respectively, p=0.003 / R=0.295, p=0.030 / R=0.221, p=0.011 / R= -0.257, p=0.019 / R= -0.238). Conclusion:In this study, the increased MPV was associated with severe OSAS and the results of this study suggest that the platelet activation is increased in OSAS. Hypoxia caused by OSAS, due to the activated platelets, may play a role in the development of cardiovascular diseases which is an important cause of morbidity and mortality in OSAS.
Aim: We aimed to examine the diagnostic power of chest computerized tomography (CT) comparing with ‘Clinical Decision’ and RT-PCR results among the patients admitted to the hospital with COVID-19 disease suspicion. Material and Method: This study included 162 patients who applied to the pandemic outpatient clinic between March 11 and April 11, 2020, suspected of new coronavirus infection, and had chest CT and RT-PCR tests at the same time. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy and positive odds ratio of RT-PCR and chest CT imaging are investigated for the diagnosis of COVID-19. Results: It was found that 56.8% (92 patients) of chest CT scans taken at admission were compatible with viral pneumonia. With the ‘Clinical Decision’, which we accept as the gold standard diagnostic method, 61.1% of the patients (99 patients) were evaluated as COVID-19 positive and treatment was started. According to clinical decision, sensitivity of chest CT was 92.9%. Conclusion: COVID-19 pneumonia is a serious life-threatening condition. Rapid diagnosis and early treatment are very important in terms of reducing mortality and morbidity. The chest CT might create an early diagnosis and treatment opportunity.
Amaç: İdiyopatik pulmoner fibrozis (İPF) etyolojisi bilinmeyen, progresif seyirli, etkili bir tedavi seçeneği olmayan bir İnterstisyel Akciğer Hastalığı' dır. Bleomisin (BLM) ile oluşturulan akciğer fibrozis modeli, insanlardaki İPF'nin değerlendirilmesi için kullanılan en önemli modeldir. Erdostein (ERD) ve N-asetilsistein (NAC) sülfhidril içeren antioksidanlardır. Bu çalışmada bu ajanların BLM ile oluşturulan fibrozis üzerine etkinliğinin araştırılması amaçlanmıştır.Gereç ve Yöntem: Çalışmaya alınan ratlar 5 gruba ayrıldı. Kontrol grubuna (n=7), 0. günde intratrakeal (i.t.) salin, BLM-I (n=5), BLM-II (n=6), ERD (n=6), ve NAC (n=7), gruplarına 0. günde 7,5 Ü/kg BLM i.t. verildi. 14. günden 29. güne kadar BLM-II grubuna distile su, ERD grubuna ERD (10 mg/kg/gün) ve NAC grubuna NAC (3 mmol/kg/ gün) peroral verildi. BLM-I grubu için 14. günde, diğerleri için 29. günde çalışma sonlandırıldı. Bronkoalveoler lavajda (BAL) Malondialdehit (MDA), inflamatuvar hücre sayımı, serumda Total Antioxidant Status (TAS), Total Oxidant Status (TOS), Tumor Necrosis Factor Alfa (TNFα), Transforming Growth Factor Beta 1 (TGFβ1), Makrofaj İnflamatuar Protein 2 (MİP 2), Matrix Metalloproteinase 1 (MMP 1), MMP 7 çalışıldı. Akciğer dokusunda hidroksiprolin ölçümü ve histopatolojik inceleme yapıldı.Bulgular: Nötrofil düzeyleri, ERD grubunda BLM I, BLM II, NAC gruplarına göre anlamlı düşük bulundu (Sırasıyla; p=0,004, p=0,015, p=0,022). Lenfosit düzeyleri, ERD, NAC gruplarında BLM I' e göre anlamlı düşük bulundu (Sırasıyla; p=0,030, p=0,010). Akciğer dokusu fibrozis derecesi, ERD grubunda BLM I, BLM II, NAC gruplarına göre anlamlı düşük bulundu (p<0,001). TAS düzeyleri, ERD grubunda BLM I-II, NAC gruplarına göre anlamlı yüksek bulundu (BLM II için p=0,002, diğerleri için p<0,001). TOS düzeyleri, ERD grubunda BLM I-II, NAC gruplarına göre anlamlı düşük bulundu (Sırasıyla; p<0,001, p=0,009, p=0,025). MİP 2 düzeyleri, ERD grubunda BLM I grubuna göre anlamlı düşük bulundu (p=0,004). MMP 1 düzeyleri, ERD grubunda BLM I-II gruplarına göre anlamlı düşük bulundu (Sırasıyla; p=0,007, p=0,022). MDA düzeyleri, ERD grubunda BLM I grubuna göre anlamlı düşük bulundu (p=0,026). Hidroksiprolin düzeyleri, ERD, NAC gruplarında BLM I grubuna göre anlamlı düşük bulundu (Sırasıyla; p=0,001, p=0,003).Sonuç: Bu çalışmanın sonuçları ERD'in BLM ile oluşturulan fibrozis üzerine tedavi edici etkisinin olduğunu göstermektedir. Bu etkiyi akciğerde çeşitli kemokin ve kollagenaz düzeylerini ve inflamatuvar hücre birikimini azaltarak, oksidan/antioksidan dengesini düzenleyerek gösterebilir.
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