Purpose
The objective of this study is to investigate the effects of laparoscopic sleeve gastrectomy (LSG) on the polysomnographic parameters related to OSAS.
Materials and Methods
We conducted this ...3-year prospective cohort study in a tertiary care center between December 2016 and December 2019. In total, we enrolled 31 patients with severe obesity who underwent full-night polysomnography (PSG) before LSG. Later, the patients were re-evaluated by full-night PSG 12 months after the surgery.
Results
The mean age of the patients was 44.1 ± 9.6 years. The mean body mass index (BMI) decreased significantly from a mean value of 49.8 ± 8.5 kg/m
2
at baseline to 33.2 ± 8.2 kg/m
2
and a percent BMI (%BMI) reduction of 33.8 ± 10.4% and a percent total weight loss (%TWL) of 35.4 ± 10.8% was achieved on the same day of the postsurgical PSG (
p
< 0.001). There was a remarkable improvement in the AHI (baseline: 36.1 ± 27.1, 12 months after the surgery: 10.3 ± 11.8; difference: 25.8 ± 22.8 events per hour) (
p
< 0.001). Importantly, there was a decrease in the percentage of non-rapid eye movement (NREM) 2 (
p
< 0.001), whereas NREM 3 and REM stages witnessed a significant increase (
p
= 0.001 and
p
< 0.001, respectively) after the surgery.
Conclusion
The results of this study showed that weight loss after LSG yields improvement not only in AHI but also in many polysomnographic parameters such as sleep quality and desaturation indices.
Caregiver Burden in Pulmonary Patients Yılmaz Kara, Bilge; Toprak, Derya; Kara, Ekrem ...
Journal of gerontological social work,
04/2023, Letnik:
66, Številka:
3
Journal Article
Recenzirano
Caregiving has become an increasingly important medical and social issue in recent decades. We performed a cross-sectional study on pulmonary patients and accompanying informal caregivers who were ...hospitalized in the chest disease ward of a tertiary center in Turkey between January 2020 and April 2021. Informal caregivers were asked to complete the Zarit Caregiver Burden Interview. A total of 141 inpatients (39% female, mean age: 76.8 ± 10.2 years) and their informal caregivers (77% female, mean age: 54 ± 11.9 years) were evaluated. The caregivers were classified as light to medium burden (group 1, burden score ≤40) and medium to heavy burden (group 2, burden score >40). The mean burden score was 35.7 ± 13.3 points. The number of female caregivers was higher in group 2 (p = 0.025). There was a positive correlation between the burden score and female gender (p = 0.002) and the number of chronic diseases of caregivers (p = 0.020). Statistical analysis revealed a negative correlation between the burden score and the level of education (r = > −0.174, p = 0.040). Caregiver burden is related to the characteristics of the caregiver rather than those of the patient being cared for. Female caregivers with lower education and more than one chronic disease perceive a higher caregiver burden.
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUSTBNA) is a minimally invasive diagnostic tool used for the evaluation of mediastinal lymphadenopathy. It is a safe procedure, but ...complications such as bleeding and infection may occur. We report a case of a patient who developed a subcutaneous abscess abscess and mediastinitis after EBUSTBNA. A 75-year-old male with a history of right nephrectomy due to renal cell carcinoma and lung adenocarcinoma history underwent EBUS-TBNA for the evaluation of a right upper paratracheal lymph node. Two weeks after the procedure, the patient presented to the emergency department with skin induration and erythema on the right clavicular area. A non-contrast neck and thorax CT scan was performed, which revealed an extensive subcutaneous abscess on the right clavicular area, extending to the supraclavicular region. The patient was hospitalized, and empirical intravenous antibiotics were initiated due to deep neck infection. Repeated drainage of the subcutaneous abscess was performed. Bacteriologic examination revealed Streptococcus mitis. The patient showed improvement with antibiotic treatment, and a follow-up ultrasound showed a decrease in the size of the abscess and was discharged approximately four weeks after hospitalization. Although very rare, serious infectious complications may develop after EBUSTBNA, and our case report is an important example regarding its management process.
It is difficult to distinguish coronavirus disease‐2019 (COVID‐19) from other viral respiratory tract infections owing to the similarities in clinical and radiological findings. This study aims to ...determine the clinical importance of platelet count and platelet indices in the differentiation of COVID‐19 from influenza and the value of these parameters in the differential diagnosis of COVID‐19. The medical records of the patients and the electronic patient monitoring system were retrospectively analyzed. Demographic characteristics, admission symptoms, laboratory findings, radiological involvement, comorbidities, and mortality of the patients were recorded. Forty‐three patients diagnosed with influenza and 54 diagnosed with COVID‐19 were included in the study. The average age of the COVID‐19 patients was lower than that of the influenza patients (influenza: 60.5 years, COVID‐19: 52.4 years; pp = 0.024),.024), and the male gender was predominant in the COVID‐19 group (influenza: 42%, COVID‐19: 56%). According to laboratory findings, the mean platelet volume (MPV) and MPV/platelet ratio were statistically significantly lower, whereas the eosinophil count and platelet distribution width levels were significantly higher (p < 0.05) in the COVID‐19 group. It was found that the most common symptom in both groups was dyspnea and that the symptom was more prevalent among influenza patients. In the diagnosis of COVID‐19, the platelet count and platelet indices are easily accessible, inexpensive, and important parameters in terms of differential diagnosis and can help in the differentiation of COVID‐19 from influenza during seasonal outbreaks of the latter.
High-dose and long-term use of inhaled corticosteroids may cause systemic and local side effects such as opportunistic infections. Here we report a patient with asthma who developed a giant cavity in ...the lung while using inhaled salmeterol plus fluticasone propionate.
A 57-year-old female patient presented with a three-week history of cough, hemoptysis, and dyspnea. She had a diagnosis of asthma for 4 years and was using an inhaled salmeterol plus fluticasone treatment intermittently for 2 years. A giant cavity was detected in the patient's chest X-ray. As a result of further investigations, three different microorganisms were isolated from the samples of sputum, bronchial lavage and lung biopsy.
was the first microorganism that was isolated from the sputum and the bronchial lavage. Afterwards,
was detected in both the bronchial lavage fluid and the histologic examination of the tissue samples obtained by percutaneous lung biopsy. Appropriate antibiotics and antifungals were prescribed. Moderate clinical and radiological response to the treatment was obtained. During the outpatient follow-up,
growth which was sensitive to all of the major anti-tuberculosis drugs was reported in the mycobacterial culture, and the patient was started on anti-tuberculosis treatment.
Tuberculosis and other opportunistic infections are a potential consequences of inhaled corticosteroids. Clinicians overseeing such patients need to be vigilant about the need for timely investigations about tuberculosis before and during prescribing medications containing inhaled corticosteroids.
Effect of coronaphobia on smoking habits Ozcelik, Neslihan; Yilmaz Kara, Bilge
Journal of addictive diseases,
2021 Apr-Jun, Letnik:
39, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Coronavirus disease 2019 (COVID-19) epidemic had exhibited negative effects on patients with a nicotine use disorder because of social stress situations. The objective of this study is to investigate ...the changes that occurred in the smoking habits of the patients who applied to our smoking cessation clinic because of the COVID-19 outbreak's effect (coronaphobia) on their mental health.
In this study, we included the patients who applied to our smoking cessation clinic between January 1 and June 30, 2020. We conducted telephonic and face-to-face interviews with the patients during the outbreak, and inquired about the changes in their smoking habits.
In total, 114 volunteers (mean age: 41.2 years min-max: 18-82 years, M/F: 70/44 61.4/38.6%) who registered in the smoking cessation clinic of Chest Diseases Clinic were included in the study. The number of people with and without coronaphobia was 64 (56.1%) and 50 (43.9%), respectively. The analyses of the changes in smoking behaviors because of coronaphobia demonstrated that people with coronaphobia exhibited a significantly higher decrease or cessation of smoking as compared to no change in smoking behavior or increase in the number of cigarettes (p: .006).
Success in smoking cessation can be increased with the accurate analyses of the anxiety effects caused by coronaphobia after COVID-19 outbreak on the desire of smoking cessation. This resolution depends on the solution-oriented strategies that will increase the awareness of physicians and patients, a close follow-up of patients with tools such as telemedicine, and a quick determination of their needs.
Healthcare workers (HCWs) possess a high risk for both latent tuberculosis infection (LTBI) and active disease. This study aimed to investigate tuberculosis (TB) disease history in hospital staff ...working in healthcare institutions in the Eastern Black Sea Region of Turkey.
This study included 460 HCWs employed in 5 hospitals in the Eastern Black Sea Region of Turkey. Between May 01 and July 31, 2016, the participants were asked to answer a questionnaire, including data about TB history. The data about family TB history, Bacilli Calmette-Guerin (BCG) vaccination, or tuberculin skin test (TST) application before starting work were also evaluated.
Of the 460 participants, 69.3% were women (n=319) and 30.7% (n=141) were men. The mean age was 32 (17-63) years. A total of 8 participants (1.7 %) had TB history. There was no statistically significant relationship between TB history and age, sex, body mass index (BMI), smoking habits, or presence of comorbidities (p>0.05 for all variables); family history of TB (p<0.001) and TST positivity (p<0.001) were significantly higher in participants with a TB history. Each participant was checked for the presence of both BCG scar and TST positivity. No difference was noted between positive TB history and negative HCWs (p>0.05). The duration of work (years) was higher in participants with a TB history. The p value was very close but did not reach the limits of significance (p=0.059).
In this study, the rate of TB among HCWs was 1.7% (8 of 460 HCWs). Family history of TB and TST positivity are strong predictors of TB in HCWs.
Background
Three-dimensional (3D) printing is a method applied to build a 3D object of any shape from a digital model, and it provides crucial advantages especially for transferring patient-specific ...designs to clinical settings. The main purpose of this study is to introduce the newly designed complex airway stent models that are created through mathematical functions and manufactured with 3D printing for implementation in real life.
Methods
A mathematical modeling software (MathMod) was used to design five different airway stents. The highly porous structures with designated scales were fabricated by utilizing a stereolithography-based 3D printing technology. The fine details in the microstructure of 3D printed parts were observed by a scanning electron microscope (SEM). The mechanical properties of airway stents with various designs and porosity were compared by compression test.
Results
The outputs of the mathematical modeling software were successfully converted into 3D printable files and airway stents with a porosity of more than 85% were 3D printed. SEM images revealed the layered topography of high-resolution 3D printed parts. Compression tests have shown that the mathematical function-based design offers the opportunity to adjust the mechanical strength of airway stents without changing the material or manufacturing method.
Conclusions
A novel approach, which includes mathematical function-based design and 3D printing technology, is proposed in this study for the fabrication of airway stents as a promising tool for future treatments of central airway pathologies.
Lipoid pneumonia (LP) is defined as the sum of clinical and radiological abnormalities due to aspiration of oil based foreign materials. There are two kinds of LP defined in the literature. Exogenous ...LP is associated with aspiration of oily materials into the airways and the lung parenchyma consciously or accidentally as in fire-eater’s lung. Endogenous LP is a more complicated situation that occurs when an endogenous lipoid material fills the alveolar space without a history of aspiration. It is associated with certain conditions like bacterial pneumonia. The pathogenesis is similar to alveolar proteinosis. We report a case of non-resolving pneumonia finally diagnosed as exogenous LP caused by aspiration of a liquid laxative.
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