Background/aim: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality. In COPD patients, various inflammatory markers such as cytokines and acute phase proteins, which show systemic inflammation in the circulation, increase during exacerbations. In our study, we aimed to determine the relationship between serum SP-D levels and exacerbation severity, clinical course of the disease, and early mortality after discharge. Materials and methods: Fifty hospitalized patients with COPD acute exacerbation (46 male and 4 female) were recruited in this study. Thirty-three of the subjects (31 male and 2 female) were reevaluated after discharge. Venous blood samples were taken from all patients and followed up for exacerbation frequency, hospital admission, and mortality for 12 months. Results: Serum SP-D levels in the stable period of the patients were lower than exacerbation (P < 0.001). The median exacerbation period SP-D level of the patients admitted to emergency department in the first month was statistically significantly higher than that of the patients who were not admitted (P < 0.05) after discharge. There was a correlation between the rate of emergency admission and serum SP-D levels during the 12-month period after discharge (P = 0.04 (r = 0.29)). Conclusion: Our study showed that serum SP-D was found to be a useful biomarker in predicting emergency admission and predictor of the health status of COPD patients but did not predict early mortality after the exacerbation.
BackgroundChronic deposition of monosodium urate crystals, in case of hyperuricemia, is the main cause of the gout.1 Furthermore, lowering uric acid to the targeted levels is the main therapeutic objective in chronic gout treatment. Uric acid lowering treatment (ULT) has three main arms: Practicing lifestyle modifications, pharmacologic ULT and targeting co-morbid illnesses.2 Thus, patients’ medical and therapeutic properties may have a role in successful ULT.ObjectivesWe evaluated the demographic and therapeutic properties; co-illnesses and disease features of the patients that would relate with the success of ULT. Then, we compared these parameters between the gout patients with successful ULT and inadequate ULT.Methods66 gout patients on pharmacologic ULT were enrolled to the study. Non-adherence to pharmacologic ULT was accepted an exclusion criteria. Demographic and therapeutic features; co-illnesses and disease features of the patients were obtained during the study. Then, we compared these parameters between the patients with successful ULT and inadequate ULT.ResultsAdherence to diet was found different between groups (OR, 7.00; CL%95 2.27–21.56). All other features including maximum allopurinol dosage were similar. Only one patient from sucessful ULT group and none of the patients in inadequate group had an drinking habit.Abstract AB1039 – Table 1Demographic properties, therapeutic features and laboratory values of the patientsSuccessful ULT n=32Inadequate ULT n=34p Gender (M/F)29/328/60.47Age60.3±13.155.8±11.80.14Body mass index27.2±9.827.8±8.90.32Diabetes mellitus n(%)7 (21.9)11 (32.4)0.24Hypertension n(%)19 (59.4)18 (52.8)0.39Chronic cardiac disease* n(%)9 (28.1)6 (17.6)0.23Hyperlipidemia n(%)1 (3.1)2 (5.9)0.52Chronic kidney disease n(%)6 (18.8)3 (8.8)0.20ACE inhibitors/AT II blockers n(%)18 (56.3)13 (38.2)0.14Beta-blockers n(%)5 (15.6)4 (11.8)0.72Diuretics n(%)5 (15.6)5 (14.7)0.91Acetylsalicylic acid n(%)5 (15.6)3 (8.8)0.46Abstract AB1039 – Table 2Disease and treatment features of the patientsSuccessful ULT n=32Inadequate ULT n=34p Pretreatment SUA (mg/dL)9.47±1.68.8±1.60.18Maximum allopurinol dosage (mg)290.6±92.8313.8±134.80.75Adherence to diet n(%)26 (81.2)13 (38.2)<0001Chronic gout arthritis n(%)8 (25.0)11 (32.3)0.56Tophus n(%)5 (15.6)2 (5.8)0.25Erosion n(%)7 (21.8)7 (20.5)1.00ConclusionsWe found that diet was the only factor that relate with success of ULT while patients were on pharmacologic ULT. So, clinicians should emphasise the importance of all part of ULT including diet with informing patients about the nature of disease and benefits of ULT during visits.References[1] Dalbeth N, Merriman TR, Stamp LK. Gout. Lancet2016; 388: 2039–52.[2] Khanna D, Fitzgerald JD, Khanna PP, Bae S, Singh MK, Neogi T, et al. 2012American College of Rheumatology guidelines for management of gout. Part 1: systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia. Arthritis Care Res (Hoboken)2012; 64: 1431–46.AcknowledgementsNoneDisclosure of InterestNone declared
BackgroundFamilial Mediterranean fever (FMF) is characterized by recurrent attacks of polyserositis. Delay in treatment may lead to recurrent attacks and amyloidosis.ObjectivesIn this study, we aimed to evaluate clinical features of patients diagnosed early and compared to those diagnosed lateMethodsWe enrolled 143 FMF patients over the age of 18 who met Tel-Hashomer Criterias into the study. Demographic features of the patients, duration of education, smoking habits, family history of FMF disease and amyloidosis,; features, duration and frequency of FMF attacks; age at first FMF attack; age at first admittance to a specialist, time between first FMF attack to first admittance to a specialist and which medical specialities patients admitted for their symptoms were recorded with face to face survey method. Else, MEFV gene mutations of the patients, time between first admittance to a specialist to diagnosis, clinical decision and judgement of the specialists at the time of diagnosis were obtained from hospital's medical recording system. Early diagnosis was defined as within three years after the first symptom.ResultsMean diagnostic delay was 12.03±10.43 years. Age at first FMF attack (p=0.020), time between first FMF attack to first admittance to a specialist (p=0.003) and first admittance to a specialist after year 2000 (p=0.001) were found statistically important related with early diagnosis in a regression model. MEFV mutation was the only method that had an influence on the decision making of doctors in the diagnosis of FMF especially after year 2000.ConclusionsInstead of demographic, clinical and genetic differences, early diagnosis may related with increased patient awareness about the disease. Furthermore, availability of MEFV mutation may influence doctors' decision making positively for facilitating early diagnosis of FMF and may replace clinical features. But, this may lead to failures in diagnosis in gene-negative FMF cases.ReferencesBen-Chetrit, E. M. Levy (1998) Familial Mediterranean fever.Lancet 351:659–64Livneh, A., P. Langevitz, D. Zemer, N. Zaks, S. Kees, T. Lidar, A. Migdal, S. PadehM. Pras (1997) Criteria for the diagnosis of familial Mediterranean fever.Arthritis Rheum 40:1879–85Disclosure of InterestNone declared
Non-specific interstitial pneumonia (NSIP) is a form of idiopathic interstitial pneumonia with a specific histological pattern involving varying degrees of alveolar wall inflammation or fibrosis, and with a temporal uniformity of lesions. The organized component can be found at different degrees, and the presence of a histologically organized component does not exclude a diagnosis of NSIP. Acute respiratory failure is rare in NSIP. A female patient who presented to our clinic with radiological findings of widespread consolidation and acute respiratory failure was diagnosed with NSIP with organized pneumonia through a surgical lung biopsy. The patient responded rapidly to steroid therapy, and the clinical findings improved dramatically. We present our case in order to emphasize the importance of treatment in the event of respiratory failure in idiopathic NSIP with organized pneumonia, and recommend rapid diagnosis and treatment.
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