Chronic obstructive pulmonary disease may be one of the terminal end points of metabolic syndrome

We tried to understand presence of any effect of excess weight on respiratory system by means of excessive adipose tissue functioning as an endocrine organ and causing a pulmonary inflammation. Mild [stage 1], moderate [stage 2], and severe [stage 3 and 4] chronic obstructive pulmonary disease [COPD] patients were detected, and compared according to the metabolic parameters in between. There were 145, 56, and 34 patients in the mild, moderate, and severe COPD groups, respectively. The mean age increased gradually [52.4, 56.4, and 60.0 years] from the mild towards the severe COPD groups, respectively [p<0.05 nearly in all steps]. Similarly, the mean pack-years increased gradually and significantly [26.7, 34.8, and 36.8 pack-years] in the same direction [p<0.05 nearly in all steps]. Parallel to them, the mean body mass index increased up to the moderate COPD cases [28.2 versus 29.6 kg/m2, p= 0.039], and then decreased significantly [29.6 versus 26.8 kg/m2, p=0.006]. The metabolic syndrome includes some reversible indicators such as overweight, hyperbetalipoproteinemia, hypertriglyceridemia, dyslipidemia, impaired fasting glucose, impaired glucose tolerance, and white coat hypertension for the development of terminal diseases including obesity, hypertension, diabetes mellitus, peripheral artery disease, coronary heart disease, and stroke. In our opinion, COPD may be one of the terminal end points of the syndrome

Urine iodine excretion in patients with euthyroid nodular disease

Different nutritional and environmental factors are responsible for the pathogenesis of goiter, but iodine deficiency is the most important factor. However, little is known about the natural course of benign thyroid nodules in euthyroid patients over time. Few studies have used ultrasonographic evaluation to address this issue, especially in iodine-deficient areas. In this study, we present the long-term follow-up of benign thyroid nodules in a iodine-deficient area. Cross-sectional study at a tertiary referral center. This study included 62 randomly selected patients with benign euthyroid nodule. Thyroid volume and nodules were measured with sonography. Iodine intake was estimated by patient diet history and by measuring iodine excretion in spot urine samples. Patients were followed one year. Patients were divided into three groups according to level of urine iodine excretion: Group 1: <50 micro g/L [severe iodine deficiency group], Group 2: 50-100 micro g/L [mild iodine deficiency group], Group 3: >100 micro g/L [iodine sufficient group]. The presence of additional disease [hypertension, diabetes mellitus, coronary heart disease, chronic renal failure and a history of any medication for chronic disorder] and smoking rates were significantly higher in first group compared to the second and third group. Among groups, no significant difference was observed in either right or left thyroid lobe volume after one year. A clinically significant increase in nodule volume was observed in the first group, while there was a significant decrease in the second and third group. In this study, iodine deficiency was associated with an increase in thyroid nodule volumes. Smoking rates were higher in iodine deficient groups. It is thought that smoking impairs iodine intake or absorption consistent with a previous report

Recurrent and Massive Life Threatening Epistaxis due to Nasal Heroin Usage

Epistaxis, active bleeding from the nose, is a common ear nose and throat emergency, and can be severe or even fatal. We report a severe life threatening recurrent massive nasal bleeding caused by intranasal heroin use that has not hitherto been reported in the English literature. A 24-year-old male who took heroin several times nasally presented with massive nasal bleeding. A blood transfusion and an operation to halt nasal bleeding were required. The patient did not experience a bleeding attack 2 months following cessation of nasal heroin use.

Primary Effusion Lymphoma: An Untrivial Differential Diagnosis for Ascites

A primary effusion lymphoma is a rare type of non-Hodgkin's lymphoma where serous cavities are involved. That-cause peritoneal, pleural and pericardial effusions without any lymphadenopathy. They affect immunosuppressive patients with human herpes virus-8 being the suspected etiological agent. The prognosis is usually poor despite treatment. Herein, the case of an immunocompetent patient with ascites and pleural effusion diagnosed as primary effusion lymphoma is presented and discuss the case in the light of the current literature.