Laryngopharyngeal reflux (LPR) is defined as the movement of gastric content towards the larynx and the pharynx and it may cause respiratory symptoms or difficulty in their control. We aimed to find the frequency of LPR in chronic obstructive pulmonary disease (COPD) patients and to investigate its effect on COPD symptoms and the results of its treatment. At baseline 30 (20 male, 10 female, mean age: 65 +/- 10 years) COPD patients completed LPR and COPD symptom questionnaires and 13 (44%) were diagnosed with LPR based on laryngeal examination. Patients with LPR were given 2 months of PPI treatment, after which LPR and COPD symptom questionnaires, laryngeal examinations and pulmonary function tests were repeated. Following the treatment, significant improvements in COPD symptom index, LPR symptom index and laryngeal examination findings were observed in patients with LPR (P < 0.01, P < 0.01, P < 0.0001, respectively). Treatment of LPR resulted in a significant improvement in the symptoms of COPD.

Introduction: The novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the coronavirus disease 2019 (COVID-19). First COVID-19 case was detected in March, 10, 2020 in Turkey and as of May, 18, 2020 148,067 cases have been identified and 4096 citizens have died. Tuberculosis (TB) is a worldwide public health concern, incidence of tuberculosis (per 100,000 people) in Turkey was reported at 14, 1 in 2018. During pandemic COVID-19 was the main concern in every clinic and as we discuss here overlapping respiratory diseases may result in delaying of the diagnosis and treatment. Methodology: There were 4605 respiratory samples examined between March 23 and May 18 for COVID-19 and 185 samples for Mycobacterium tuberculosis in our laboratory. The Xpert Ultra assay was performed for the diagnosis of pulmonary tuberculosis; SARS-CoV-2 RNA was determined by real-time PCR (RT-PCR) analysis in combined nasopharyngeal and deep oropharyngeal swabs of suspected cases of COVID-19. Results: Both of SARS-CoV-2 and M. tuberculosis tests were requested on the clinical and radiological grounds in 30 patients. Here we discussed 2 patients who were both COVID-19 and TB positive. One patient already diagnosed with tuberculosis become COVID-19 positive during hospitalization and another patient suspected and treated for COVID-19 received the final diagnosis of pulmonary TB and Human Immunodeficiency Virus infection. Conclusions: We want to emphasize that while considering COVID-19 primarily during these pandemic days, we should not forget one of the “great imitators”, tuberculosis within differential diagnoses.

Objective:Chronic thromboembolic disease (CTED) is characterized by persistent pulmonary thromboembolic occlusions without pulmonary hypertension. Early surgical treatment by performing pulmonary endarterectomy (PEA) may improve symptoms. The goal of the study was to review our experience and early outcome of PEA in patients with CTED.Methods:Data were prospectively collected on all patients who underwent PEA between 2011 and 2015. Patients with CTED and a mean pulmonary artery pressure (mPAP) of <25 mm Hg were identified. All patients were in New York Heart Association (NYHA) functional class II or III. Measured outcomes were in-hospital complications, improvement in cardiac function and exercise capacity, and survival after PEA. Patients were reassessed at 6 months following surgery.Results:A total of 23 patients underwent surgery. There was no in-hospital mortality, but complications occurred in six patients (26%). At 6 months following surgery, 93% of the patients remained alive. Following PEA, the mPAP fell significantly from 21.0±2.7 mm Hg to 18.2±5.5 mm Hg (p<.001). Pulmonary vascular resistance also significantly decreased from 2.2±0.7 wood to 1.5±0.5 wood (p<.001). The 6-min walking distance significantly increased from 322.6±80.4 m to 379.9±68.2 m (p<.001). There was a significant symptomatic improvement in all survivors in NYHA functional classes I or II at 6 months following surgery (p=.001).Conclusion:PEA in selected patients with CTED resulted in significant improvement in symptoms. The selection of patients for undergoing PEA in the absence of pulmonary hypertension must be made based on patients’ expectations and their acceptance of the perioperative risk.

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OBJECTIVES:Sepsis is a disease with high mortality that is frequently observed in intensive care units. This study aimed to determine the risk factors affecting mortality of patients with sepsis who were followed up in the intensive care unit (ICU). We aimed to contribute to literature by evaluating the relationship between mortality and pro-brain natriuretic peptide (pro-BNP9), C-reactive protein (CRP), thrombocyte count, Acute Physiology and Chronic Health Evaluation (APACHE) II score, Sequential Organ Failure Assessment (SOFA) score, duration of hospitalization in the intensive care unit, and the presence of multidrug-resistant microorganism. MATERIAL AND METHODS:Patients hospitalized in ICU because of the diagnosis of sepsis and septic shock between December 2010 and June 2012 were included in this retrospective study. RESULTS:A total of 141 patients, including 74 male (52.5%) and 67 female (47.5%) patients, were involved in the study, and the median age was 66.8±17.9 years. Sixty-nine patients (48.9%) were discharged from the ICU; however, 72 patients (51.1%) were exitus. Multidrug-resistant microorganism was detected in 34 patients (24.1%). The patients' median SOFA score was 9.16±3.16, median APACHE-II score was 24.9±7.83, and median duration of hospitalization in the ICU was 8.44±11.61 days. It was found that mortality rate significantly increased in patients with the APACHE-II score of 24.5 and over, SOFA score of 8.5 and over, pro BNP value of 7241 ng/L and over, and CRP value of 96.5 mg/dL and over. Mortality rate was detected to be higher in patients undergoing invasive mechanical ventilation than in patients undergoing non-invasive mechanical ventilation. When thrombocyte count and mortality were associated with each other, it was found that the median value was 86000 mg/dL in exitus patients, whereas it was 185000 mg/dL in patients discharged from the ICU. CONCLUSION:It was revealed that increased APACHE-II score, increased SOFA score, increased pro BNP score, increased CRP, the presence of multidrug-resistant microorganism, and decreased thrombocyte count elevated the rate of mortality. However, no relationship was observed between the duration of hospitalization in the ICU and mortality.

Bu çalışmada bir hayvan modelinde bleomisin ile indüklenmiş enflamatuvar ve oksidatif akciğer hasarında montelukast kullanılarak sistenil lökotrien aktivitesinin farmakolojik inhibisyonunun erken ve geç dönem etkileri araştırıldı. Ça lış ma pla nı: Çalışmaya 48 erkek Wistar albino sıçan (ağırlık 250 g-300 g) dahil edildi. Sıçanlara intratrakeal bleomisin veya serum fizyolojik uygulandı ve sıçanlar montelukast veya serum fizyolojik alacak şekilde gruplara ayrıldı. Bleomisin uygulamasından dört ve 15 gün sonra bronkoalveolar lavaj sıvısı ve akciğer doku örnekleri alındı. Bul gu lar: Bleomisin tümör nekroz faktör-alfa düzeylerinde (kontrollerde 4.0±1.4 pg/mL'ye karşı erken dönemde 44.1±14.5 pg/mL, geç dönemde 30.3±5.7 pg/mL, sırasıyla, p<0.001 ve p<0.001), transforme edici büyüme faktörü-beta 1 düzeylerinde (28.6±6.6 pg/mL'ye karşı erken dönemde 82.3±14.1 pg/mL, geç dönemde 60.1±2.9 pg/mL, sırasıyla, p<0.001 ve p<0.001) ve fibrozis skorunda (erken dönemde 1.85±0.89'a karşı geç dönemde 5.60±1.14, sırasıyla, p<0.001 ve p<0.01) anlamlı artışlara yol açtı. Bleomisine maruz kalan sıçanlarda kolajen içeriği sadece geç dönemde arttı (kontrollerde 15.3±3.0 μg/mg'a karşı geç dönemde 29.6±9.1 μg/mg, p<0.001]. Montelukast tedavisi tüm bu biyokimyasal işaretlerle beraber bleomisinin indüklediği histopatolojik alterasyonları tersine çevirdi. So nuç: Montelukast, bleomisin ile indüklenmiş enflamatuvar ve oksidatif akciğer hasarını hafifletmekte ve kolajen depolanmasını ve fibrotik yanıtı azaltmaktadır. Dolayısıyla, sistenil lökotrien reseptör antagonistleri idyopatik pulmoner fibrozis için yeni teröpatik ajanlar olarak dikkate alınabilir. Anah tar söz cük ler: Bleomisin; kolajen; glutatyon; interstisyel akciğer hastalığı; malondialdehit; miyeloperoksidaz; transforme edici büyüme faktörü-beta 1; tümör nekroz faktör-alfa.

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