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Dursunoglu D.,Pamukkale University | Dursunoglu N.,Gogus Hastaliklari Anabilim Dali
Turk Kardiyoloji Dernegi Arsivi | Year: 2010

Sleep-disordered breathing is one of the important factors contributing to the development and/or progression of heart failure (HF). This condition is related to recurring attacks of apnea, hypopnea, and hyperpnea, sleep disruptions, arousals, intermittent hypoxemia, hypocapnia, and hypercapnia, and intrathoracic pressure changes. Obstructive sleep apnea (OSA) is characterized by recurrent upper airway obstruction (apnea and hypopnea), increased breathing effort against totally or partially occluded upper airway, and sleep disruptions. Cardiovascular consequences are the most serious complications of OSA and include acute myocardial infarction, heart failure, left/right ventricular dysfunction, arrhythmias, stroke, and systemic and pulmonary hypertension. Cheyne-Stokes respiration and central apneas may also occur in patients with HF. This article reviews the most recent information on the physiopathology, diagnosis, and treatment modalities of obstructive and central apneas in patients with HF.

Dogru S.,Gogus Hastaliklari Anabilim Dali | Kanat F.,Gogus Hastaliklari Anabilim Dali | Ozer F.,Gogus Hastaliklari Anabilim Dali | Maden E.,Gogus Hastaliklari Anabilim Dali | And 2 more authors.
Turk Toraks Dergisi | Year: 2013

OBJECTIVE: The characteristics of patients hospitalised for an asthma attack were evaluated to delineate the impact of age on sensitivity to risk factors for this condition. MATERIAL AND METHODS: Eighty patients hospitalised for an asthma attack were included in this cross-sectional study. Patients were divided into two age groups; younger than 65-years-old (52.5±7.6 years, n=36) and older than 65-years-old (72.5±5.2 years, n=44). A questionnaire was used to collect data on demographics, initial age and duration of asthma, atopy, atopic diseases, drug and food allergies, additional diseases, treatments during the previous 1 and 3 months, cause of attacks, duration of hospital stay, number of emergency visits and hospitalisation due to asthma over the last year, and all past hospital stays. Pulmonary function tests were performed upon admittance and discharge, and parameters of arterial blood gases were recorded. RESULTS: The severity of asthma attacks was greater in the older cohort of patients with risk factors including osteoporosis, positive skin test for mould, or theophylline use in the previous month. Independent of these variables, the severity of attacks was greater in patients over the age of 65. Irregular treatments in both age groups were noted over the previous one and three months. CONCLUSION: Theophylline use, mould sensitivity and biomass exposure in elderly patients with asthma should be questioned more carefully and protective measures taken to avoid these risks in keeping with the recommended guidelines. © 2013 by Turkish Thoracic Society.

OBJECTIVE: In this study, we aimed to test the preventive effects of intraperitoneally administered drotrecogin alpha which is derived from activated protein C (APC), on bleomycin-induced pulmonary fibrosis in rats, and to compare the effects of APC with the effects of methyl-prednisolone, a traditional therapy. MATERIAL AND METHODS: Thirty male Wistar albino rats were randomly allocated into four groups: 1. Saline alone (n=6); 2. Bleomycin+placebo (n=7); 3. Bleomycin+methyl-prednisolone (n=7); 4. Bleomycin+APC (n=10). The rats (except for the control group) were given intratracheal bleomycin (2.5 mg/kg). The bleomycin+APC group was given APC (100 μg/kg/day) and methyl-prednisolone treated rats were injected with 5mg/kg/day methyl-prednisolone intraperitoneally two days before the bleomycin injection; the drug was administered at the same dose for 16 days. All of the rats were killed 14 days after the intratracheal injection of bleomycin. Fibrotic changes in the lungs were demonstrated by analysing the cellular composition of bronchoalveolar lavage fluid, histological evaluation and lung hydroxyproline content. RESULTS: Fibrosis was experimentally induced in the lungs of rats using bleomycin. Fibrosis scores in the bleomycin+methyl-prednisolone and the bleomycin+APC groups were significantly lower than in the bleomycin+placebo group (p<0.05). The scores of the bleomycin+APC group and the bleomycin+methyl-prednisolone group were similar. The lung tissue hydroxyproline contents in the bleomycin+placebo and bleomycin+methyl-prednisolone groups were significantly higher than the control group (p<0.05), but the hydroxyproline content in the bleomycin+APC group was significantly lower than in the other groups (p<0.05). CONCLUSION: Drotrecogin alpha that is derived from recombinant APC has a protective effect on the pulmonary fibrosis induced by bleomycin. The protective effect seen with methyl-prednisolone is similar. © 2013 by Turkish Thoracic Society.

Fayda M.,Kocaeli University | Ilgazli A.,Gogus Hastaliklari Anabilim Dali | Arslan Z.,Gogus Hastaliklari Anabilim Dali | Aksu G.,Kocaeli University | Yildirim A.,Kocaeli University
Turkish Journal of Thoracic and Cardiovascular Surgery | Year: 2012

Three dimensional (3D) endobronchial brachytherapy planning with computed tomography (CT) guidance may help the accurate localization of the target where the prescription dose was administered in patients with lung cancer. In this article, we present a 60-year-old male case of T3N3 non-small cell lung cancer patient who was previously treated with chemotherapy and external beam radiotherapy and was admitted with the complaints of hemoptysis, hoarseness and dyspnea. In his first bronchoscopy, argon laser coagulation was used due to massive hemorrhage of endobronchial lesion obstructed almost totally the left upper and lower lobes. The 3-fraction of 5Gy/week high dose rate endobronchial brachytherapy was applied with CT guided 3 dimensional planning and the atelectasis was opened, while hemoptysis and dyspnea were improved.

Sarper A.,Akdeniz University | Ozbudak O.,Gogus Hastaliklari Anabilim Dali | Demircan A.,Akdeniz University
Turkish Journal of Thoracic and Cardiovascular Surgery | Year: 2012

Postintubation tracheal web is a rare, but serious problem. The symptoms, which depend on the degree of the stenosis, may begin in a few months and increase with the rapid progression of the stenosis. In this article, we present a case of postintubation tracheal web which leading to late symptoms despite a 75% obstruction of the lumen with slow progression.

Kilicgun A.,Abant Izzet Baysal University | Kurt B.,Gogus Hastaliklari Anabilim Dali | Boluk M.,Gogus Hastaliklari Anabilim Dali | Yilmaz F.,Patoloji Anabilim Dali
Turkish Journal of Thoracic and Cardiovascular Surgery | Year: 2012

Bronchocentric granulomatosis is a rare disease which shows no correlation between the clinical findings and radiological imaging. It is seen often in adults and is generally diagnosed by accident; however, a definitive diagnosis can be made with a lung biopsy. A necrotizing granulomatous reaction of the bronchi and bronchioles is generally observed. In this article, we present a 37-year-old male who was admitted for a detailed examination after a suspicious image was discovered on the chest X-ray. Many peripheral nodules were observed on computed tomography (CT) of the lung. Respiratory function tests revealed a mild obstruction, and a fiberoptic bronchoscopy showed no lesion. A nodule excision from the middle lobe in open lung biopsy was performed, and the result was found to be consistent with bronchocentric granulomatosis. We present this case due to its rare nature and believe it is a condition which should be investigated in terms of the etiology of multiple nodules.

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