Obstructive sleep apnea syndrome (OSAS) is a common health problem, and associated with obesity, metabolic syndrome (MetS), and diabetes. Growing evidence shows that 25-hydroxyvitamin-D3 (25-OH-D) insufficiency and high parathyroid hormone (PTH) levels may be correlated to glucose intolerance, MetS, obesity, and cardiovascular abnormalities similar to OSAS. Bisphenol A (BPA) is an endocrine disruptor agent which exerts a wide variety of metabolic effects. It has estrogenic activity and its exposure may contribute to weight gain, obesity, impaired glucose metabolism, and the development of diabetes, also similar to OSAS. The aim of this study is to investigate the relationships between OSAS and serum BPA, 25-OH-D, and PTH levels. This study enrolled 128 subjects, with all of the OSAS patients having been diagnosed by polysomnography. The 128 subjects were divided into three groups: a control (n = 43), a moderate OSAS (n = 23) (AHI = 15-30), and a severe OSAS groups (n = 62) (AHI > 30). The serum BPA, 25-OH-D, and PTH levels for each subject were analyzed. 25-OH-D was lower in both OSAS groups, and PTH was higher in the OSAS groups than in the control subjects. The BPA levels were higher in the severe OSAS group than the moderate OSAS and control. There was a positive correlation between the BPA and body mass index, and a negative correlation between the 25-OH-D and BPA levels in all of the individuals. OSAS is related to high BPA and PTH levels, and low vitamin D levels. There is a positive association between BPA levels and OSAS, and the severity of OSAS. These results suggest that the BPA levels may have a role in the pathogenesis of OSAS.

Background: Psoriasis is associated with chronic obstructive pulmonary disease. There is no study on the spirometric pulmonary function testing in patients with psoriasis. Objective: The aim of this study was to compare the spirometric parameters in patients with psoriasis and controls. Methods: Ninety-six patients with psoriasis and 60 sex- and age-matched control subjects were included in this study. Spirometric pulmonary function testing, including percent forced vital capacity (FVC%), percent forced expiratory volume in the 1st second (FEV₁%), forced expiratory flow at 25-75% of FVC (FEF_25-75%), and FEV₁/FVC ratio, was performed in all study subjects. Results: The mean FEV₁/FVC ratio and FEF_25-75% were significantly lower in the psoriasis patients than in the controls (82.4 ± 6.3 vs. 90.7 ± 10.7, p < 0.001, and 86.7 ± 24.2 vs. 94.8 ± 23.0, p = 0.04, respectively). Both FEV₁/FVC ratio and FEF_25-75% were significantly associated with the presence of psoriasis (p < 0.001 and p = 0.029, respectively). Conclusion: Psoriasis patients had lower mean FEV₁/FVC ratios and FEF_25-75%, compared with the control subjects. FEV₁/FVC and FEF_25-75% are independently associated with the presence of psoriasis.

Objective Balance and cognitive problems may develop in COPD. Studies investigating cognitive functions are mostly in elderly patients, and the number of studies on balance impairment is less than studies about cognitive dysfunction in COPD. We aimed to evaluate both balance and cognitive functions in patients with COPD under 65 years. Methods A total of 60 COPD patients and 60 healthy control group were enrolled. The patients with COPD were divided into two groups due to dyspnea severity. Demographic data and dyspnea scores of all patients were recorded. BECK depression scale, standardized Mini Mental Test (MMT), and BERG balance scale were applied to the individuals. Factors affecting BERG balance scale were evaluated. Results BERG balance scale and MMT values were found to be significantly lower in patients with COPD compared with the control group (p = 0.009). It was observed that the mean values of BERG balance scale and MMT were significantly low in the severe dyspnea group. BERG scale had significant correlations with MMT (rho = 0.331, p = 0.001), BECK (rho = −0.222, p = 0.016), age (rho = −0.318, p = 0.018), MMRC (rho = −0.368, p < 0.001), CAT (rho = −0.338, p = 0.008), FEV1% (rho = 0.307, p = 0.017), SpO2 (rho = 0.448, p < 0.001), and number of hospitalization per year (rho = −0.316, p = 0.014). According to the results of multiple linear regression analysis, the effect of oxygen saturation on BERG was found to be statistically significant (B = 0.512, p = 0.008). Conclusions Balance tests in patients with COPD under the age of 65 are significantly low when compared with healthy controls at the same age. Balance and cognitive functions are significantly associated with each other. It may be beneficial to perform balance and cognitive function tests earlier even at the beginning of the treatment period of COPD, and strategies should be planned to prevent the progression of functional losses.

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.

Purpose To evaluate the association of Obstructive Sleep Apnea Syndrome (OSAS) with Retinal Nerve Fiber Layer (RNFL), Ganglion Cell Complex (GCC) and choroidal tissue thickness (CCT). Methods: This cross-sectional study included 50 patients with OSAS and 50 controls between July 2014-January 2015). OSAS severity was classified by using the apnea-hypopnea index (AHI). RNFL thickness, GCC thickness and CCT analyses were performed by optic coherence tomography (OCT). Statistical analysis was performed using SPSS for Windows version 21 software. Results: The mean intraocular pressure (IOP) of the patients with OSAS 16.1±1.37, the cup/disc (C/D) ratio was 0.45±0.17 and vertical C/D ratio was 0.43±0.16. The control group mean IOP was 15.2±1.03, the C/D ratio was 0.36±0.20 and vertical C/D ratio was 0.34±0.19. These are all important measurements in glaucome and statisticallay significant (p=0.00, 0.022, 0.012). Althought the differences between the mean values of all quadrants RNFL thickness were similarly lower in OSAS group, this significance was not statistically different. Similarly the average GCC, minimum GCC and subfoveal CCT values between groups were not significant (p=0.79, 0.53, 0.9).Conclusion: In summary we found that peripapillary RNFL, GCC, CCT did not change with OSAS patients or the severity of OSAS. Further more we found that IOP, C/D ratio and vertical C/D ratio of patients were all significantly higher than control group. However multicenter longterm cohort studies are still needed to assess the definite changes of RNFL thickness, GCC and CCT in OSAS patients.

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.

© Tür k Uyku Tıbbi Der gi si, Ga le nos Ya yı ne vi ta ra fın dan ba sıl mış tır. / © Journal of Turkish Sleep Me di ci ne, Pub lis hed by Ga le nos Pub lis hing.

Background Ankylosing spondylitis (AS) is a chronic inflammatory disease. AS causes restrictive respiratory disorder by limiting the expansion of the chest. Objectives Our study was planned to evaluate the effect of physiotherapy programme on pulmonary function tests and quality of life in Ankylosing spondylitis patients Methods Fourty AS patients (16 F,24 M) were enrolled in this study. The disease duration, morning stiffness, Schober tests, chest expansion, Erythrocyte Sedimentation Rate (ESR) and C Reactive Protein(CRP) were analyzed and recorded. On the first month of the study, a physiotherapy program was applied in the therapy unite 2 days in every week. A home program including range of motion strenghtening posture and, respiratory exercises 20-30 minutes in every day was prescribed. All the patients received an education and brochure about home exercise programme during the second and the thirth months. The pain was evaluated using visual analog scale (VAS). Disease activity was evaluated by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Pulmonary function tests (FEV1, FEV1/FVC, FVC) were performed with spirometry. Quality of life was evaluated by Health Asssesment Questionnaire Spondyloarthropaties (HAQS). Results The mean disease duration of the patients was 5.83±5.88. Pre and post exercise scores were calculated and compared for each parameter. VAS and BASDAI values significantly decreased after exercises (p=0.012, p=0.020 respectively), while Schober, FEV1 and FEV1/FVC values significantly increased after exercises (p=0.019, p=0.025, p=0.010 respectively). There was an improve in HAQS scores after the physiotherapy programme, however it was not statistically significant. Conclusions Our study showed that physiotherapy programme can be effective for the management of pain, disease activity and respiratory functions. References Karapolat H, Akkoc Y, Sari I, Eyigor S, Akar S, Kirazli Y, Akkoc N,Comparison of group-based exercise versus home-based exercise in patients with ankylosing spondylitis: effects on Bath Ankylosing Spondylitis Indices, quality of life and depression. Clin Rheumatol.2008 Jun;27(6):695-700. Lubrano E, D’Angelo S, Parsons WJ, Corbi G, Ferrara N, Rengo F, Olivieri IEffectiveness of rehabilitation in active ankylosing spondylitis assessed by the ASAS response criteria. Rheumatology (Oxford), 2007 Nov;46(11):1672-5. Analay Y, Ozcan E, Karan A, Diracoglu D, Aydin R. The effectiveness of intensive group exercise on patients with ankylosing spondylitis. Clin Rehabil, 2003 Sep;17(6):631 Fernández-de-Las-Peñas C, Alonso-Blanco C, Alguacil-Diego IM, Miangolarra-Page JCOne-year follow-up of two exercise interventions for the management of patients with ankylosing spondylitis: a randomized controlled trial. Am. J. Phys.Med.Rehabil, 2006 Jul;85(7):559-67. Disclosure of Interest None Declared