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1.
Saudi Med J ; 44(12): 1248-1253, 2023 Dec.
Article in English | MEDLINE | ID: mdl-38016753

ABSTRACT

OBJECTIVES: To examine the possible association of obstructive sleep apnea (OSA) and depression on sleep quality in people living with human immunodeficiency virus (PWLHIV). METHODS: Adult PWLHIV were included in this prospective, cross-sectional, case-control study. Our study was completed with 99 patients and 80 control subjects. To investigate sleep quality, the Pittsburgh Sleep Quality Scale and Stanford Sleepiness Scale were used; to determine the risk of OSA, the Berlin and STOP-BANG questionnaires were used; and to evaluate the existence and degree of depression, the Beck Depression Inventory was applied. RESULTS: Patients had significantly higher daytime sleepiness (p=0.002) and absent-mindedness (p=0.004). The rate of being able to concentrate on one's work was significantly higher in the control group compared with the patient group (p=0.000). More participants in the patient group had poor sleep quality (57% versus [vs.] 47.5%). The sleep quality score was significantly higher in the patient group (6.32 vs 5.23; p=0.032). Daytime dysfunction was significantly higher in the patient group (p=0.004). The rate of OSA risk was similar between the patient group and the control group on both the Berlin and STOP-BANG questionnaires (p=0.443 and p=0.581). Rates and numbers of depression the patient group were significantly higher (p=0.007). CONCLUSION: The results suggest that depression may be the most likely cause of sleep disorders in PWLHIV, regardless of OSA.


Subject(s)
Depression , Sleep Apnea, Obstructive , Adult , Humans , Depression/complications , HIV , Cross-Sectional Studies , Prospective Studies , Case-Control Studies , Sleep Apnea, Obstructive/complications , Surveys and Questionnaires , Sleep Quality
2.
South Med J ; 116(1): 26-32, 2023 01.
Article in English | MEDLINE | ID: mdl-36578114

ABSTRACT

OBJECTIVES: Pulmonary hypertension (PH) is common in obstructive sleep apnea syndrome (OSAS). This study aimed to evaluate the effect of PH on kidney functions in patients with OSAS. METHODS: The data of patients who were diagnosed as having OSAS after referral to the sleep center in the Gaziantep University Medical Faculty between January 2005 and June 2017 were evaluated. The estimated glomerular filtration rate was calculated with the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Renal functions of the subjects who had data after 5 years were included for long-term analysis. RESULTS: A total of 2152 patients with OSAS (n = 1540), PH (n = 49), OSAS and PH coexistence (n = 359), and the control group (n = 204) were included in the study. Pulmonary arterial pressure (PAP) was 44.51 ± 23.73 in the PH group; it was 37.1 ± 13.14 in the group with OSAS + PH (P = 0.001) Urea and uric acid were found to be higher in the association of OSAS + PH. CKD-EPI was lower in the presence of PH or OSAS + PH than in the presence of OSAS. PH was present in 16.06% of males and 25.10% of females (P = 0.000), and PAP was detected as 35.80 ± 13.23 and 40.96 ± 16.65, respectively (P = 0.001). PH was present in 15.99% of males and 25.84% of females with OSAS (P = 0.000). The PAP of males with OSAS was 36.03 ± 13.46, and the PAP of females was 38.68 ± 12.55 (P = 0062). Urea, creatinine, and uric acid were higher and CKD-EPI was lower in male subjects in the presence of OSAS and PH, whereas the same scenario also was present in the presence of PH alone in female subjects. Long-term comparisons (n = 343) revealed significant decreases in the CKD-EPI in those with OSAS and OSAS + PH and these decrease were more pronounced in the presence of OSAS and PH. The regression analysis revealed that female patients had lower CKD-EPI in the presence of PH, although the presence of PH had no effect on CKD-EPI in males. CONCLUSIONS: PH is a risk factor for the deterioration of renal function in OSAS and more prominent in the long term.


Subject(s)
Hypertension, Pulmonary , Renal Insufficiency, Chronic , Sleep Apnea, Obstructive , Humans , Male , Female , Hypertension, Pulmonary/complications , Uric Acid , Sleep Apnea, Obstructive/complications , Sleep Apnea, Obstructive/epidemiology , Sleep Apnea, Obstructive/diagnosis , Glomerular Filtration Rate , Renal Insufficiency, Chronic/complications , Kidney/physiology
3.
Sleep Breath ; 21(4): 1049, 2017 12.
Article in English | MEDLINE | ID: mdl-28160131
4.
Med Princ Pract ; 26(2): 179-181, 2017.
Article in English | MEDLINE | ID: mdl-28068652

ABSTRACT

OBJECTIVE: To emphasize the importance of a careful clinical evaluation to prevent unnecessary interventions and treatments. CLINICAL PRESENTATION AND INTERVENTION: A 76-year-old female patient had been diagnosed with asthma during previous admissions to different hospitals. She had also undergone fiberoptic bronchoscopy (FOB) on 2 occasions for evaluation of right middle lobe atelectasis observed on computed tomography. A repeated FOB revealed tracheobronchomalacia and nodular bronchial amyloidosis. A silicone Y stent was inserted, but the dyspnea increased. Excessive granulation tissue developed, and the patient died despite ventilatory support. CONCLUSION: The stenting technique used did not prevent the development of respiratory failure and death in this patient. Hence, a surgical procedure could be considered as an alternative to stenting in such cases.


Subject(s)
Dyspnea/etiology , Tracheobronchomalacia/complications , Tracheobronchomalacia/diagnosis , Aged , Asthma/diagnosis , Bronchoscopy , Chronic Disease , Diagnosis, Differential , Female , Humans , Tomography, X-Ray Computed , Tracheobronchomalacia/surgery
5.
Sleep Breath ; 21(2): 475-478, 2017 May.
Article in English | MEDLINE | ID: mdl-27995436

ABSTRACT

PURPOSE: The purpose of this study was to investigate the prevalence of obstructive sleep apnea (OSA) in patients with hemoptysis. METHODS: Files of patients who had undergone bronchial arterial embolization due to hemoptysis between 1 December 2009 and 2015 were evaluated and interviews of patients were conducted until 1 June 2016. Pittsburgh Sleep Quality Index (PSQI), STOP and STOP-BANG surveys were administered. OSA risk was determined with Berlin Questionnaire. RESULTS: Study group consisted of 53 patients and 58 control subjects. Mean age was 46.94 ± 14.36 and 41.97 ± 12.92 in patient and control group, respectively. Of these patients, seven had re-embolization procedure because of recurrence of hemoptysis. High OSA risk was more common among patients with hemoptysis (24.5%, n = 13) than the control group (8.6%, n = 5) (p = 0.023). Percentage of high risk OSA patients with massive hemoptysis, nonmassive hemoptysis, and control subjects was 29.7% (n = 11), 12.5% (n = 2), and 8.6% (n = 5), respectively (p = 0.022). There were more high OSA risk subjects among patients with idiopathic hemoptysis 44.4% (four out of nine), while 20.5% (nine out of 53) patients with a known etiology had high risk (p = 0.127). The number of patients with high OSA risk was also higher in patients who required a second embolization procedure (four out of seven, 57.1%), while 19.6% of patients without need for re-embolization had high risk (p = 0.031). CONCLUSIONS: OSA is found to be a risk factor for hemoptysis and also may provoke massive hemoptysis. It seems reasonable to consider OSA as an underlying condition in idiopathic hemoptysis. OSA may contribute to embolization failure.


Subject(s)
Hemoptysis/etiology , Sleep Apnea, Obstructive/complications , Adult , Aged , Bronchial Arteries , Cross-Sectional Studies , Embolization, Therapeutic , Female , Hemoptysis/epidemiology , Hemoptysis/therapy , Humans , Male , Middle Aged , Risk Factors , Sleep Apnea, Obstructive/epidemiology , Sleep Apnea, Obstructive/therapy
6.
Surg Radiol Anat ; 39(3): 345-348, 2017 Mar.
Article in English | MEDLINE | ID: mdl-27506828

ABSTRACT

In this case report, we present an unexpected, extramediastinal course of aortic arch through an accessory fissure of left upper lobe of the lung in a 19-year-old healthy man.


Subject(s)
Anatomic Variation , Aorta, Thoracic/abnormalities , Lung/abnormalities , Vascular Malformations/diagnostic imaging , Adult , Aorta, Thoracic/diagnostic imaging , Humans , Imaging, Three-Dimensional , Lung/diagnostic imaging , Male , Radiography , Tomography, X-Ray Computed , Young Adult
7.
Am J Orthod Dentofacial Orthop ; 150(6): 945-949, 2016 Dec.
Article in English | MEDLINE | ID: mdl-27894543

ABSTRACT

INTRODUCTION: The objective of this study was to compare the head posture of patients with obstructive sleep apnea (OSA) having different levels of severity with that of control subjects. METHODS: One hundred subjects participated in this study. Seventy-five subjects underwent overnight polysomnography in a sleep laboratory and were allocated into "mild," "moderate," or "severe" OSA groups, and 25 subjects with no complaints regarding OSA were allocated into 1 group and served as the controls. Cephalometric radiographs were obtained from all participants in natural head position. Craniocervical, craniovertical, and cervicovertical angles were measured in the groups. Data were analyzed using the least significant difference. RESULTS: The results showed significant differences between the OSA groups and the control group, and among the test groups, in all craniocervical, craniovertical, and cervicovertical angles (P <0.05), except for 1 craniovertical measurement (P >0.05). There were no significant differences in this measurement among the test groups and in any measurement between the mild and moderate OSA groups (P >0.05). CONCLUSIONS: Head posture showed significant differences in patients with OSA. In general, the more severe the OSA, the more extended the natural head position as indicated by increases in the craniocervical angles. The cervical posture parameters may indicate existing OSA.


Subject(s)
Head/physiopathology , Posture/physiology , Sleep Apnea, Obstructive/etiology , Adult , Case-Control Studies , Cephalometry , Female , Humans , Male , Middle Aged , Severity of Illness Index , Sleep Apnea, Obstructive/physiopathology
8.
Postgrad Med J ; 92(1091): 540-4, 2016 Sep.
Article in English | MEDLINE | ID: mdl-27317753

ABSTRACT

Obstructive sleep apnoea syndrome is an important health problem which may cause or worsen systemic diseases. Chronic intermittent hypoxia during repetitive airflow cessations may cause endothelial dysfunction. Sleep apnoea is also shown to be associated with hypercoagulability which may be due to decreased nitric oxide levels and impaired vasodilatation. Endothelial dysfunction, increased systemic inflammation, sympathetic nervous system activation, increased oxidative stress and dysglycaemia may all contribute to cardiovascular processes such as hypertension, arrhythmia, stroke, heart failure and coronary artery disease in patients with obstructive sleep apnoea. Treatment approaches in patients with obstructive sleep apnoea mainly focus on maintaining upper airway patency either with positive airway pressure devices or upper airway appliances. Strategies involving positive airway pressure therapy are associated with decreased morbidity and mortality. Obstructive sleep apnoea should be suspected as an underlying mechanism in patients with cardiovascular disease and warrants appropriate treatment.


Subject(s)
Cardiovascular Diseases/physiopathology , Inflammation/physiopathology , Oxidative Stress , Sleep Apnea, Obstructive/physiopathology , Thrombophilia/physiopathology , Arrhythmias, Cardiac/complications , Arrhythmias, Cardiac/physiopathology , Cardiovascular Diseases/complications , Continuous Positive Airway Pressure , Coronary Artery Disease/complications , Coronary Artery Disease/physiopathology , Endothelium, Vascular/physiopathology , Equipment and Supplies , Heart Failure/complications , Heart Failure/physiopathology , Humans , Hypertension/complications , Hypertension/physiopathology , Inflammation/complications , Sleep Apnea, Obstructive/complications , Sleep Apnea, Obstructive/therapy , Stroke/complications , Stroke/physiopathology , Sympathetic Nervous System/physiopathology , Thrombophilia/complications
9.
Sleep Breath ; 20(1): 191-5, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26084412

ABSTRACT

PURPOSE: The aim of this study is to investigate possible factors influencing glomerular filtration rate (GFR) in obstructive sleep apnea (OSA). METHODS: Data of OSA patients admitted to Gaziantep University sleep clinic from January 2005 to January 2010 were retrospectively evaluated. GFR is calculated with the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Patients younger than 18 years old were excluded. RESULTS: The mean age of OSA (n = 634) and control group (n = 62) were 51.13 ± 11.61 and 50.69 ± 13.88 years, respectively (p = 0.81). The mean estimated GFR (eGFR) was 90.73 ± 19.59 ml/min/1.73 m(2) in OSA patients and 94.14 ± 18.81 ml/min/1.73 m(2) in control subjects (p = 0.19). GFR was 84.25 ± 20.87 ml/min/1.73 m(2) in patients with left ventricular hypertrophy (LVH) while it was 93.94 ± 18.44 ml/min/1.73 m(2) in patients without LVH (p = 0.00). GFR of male subjects was 92.1 ± 19.23 in OSA and 95.84 ± 20.08 ml/min/1.73 m(2) in controls (p = 0.33). GFR of female and male patients in the OSA were 87.45 ± 20.10 and 92.91 ± 18.02 ml/min/1.73 m(2), respectively (p = 0.13). Serum creatinine was higher in OSA patients compared to controls (p = 0.01). GFR was 92.30 ± 19.27 in male and 88.33 ± 19.84 ml/min/1.73 m(2) in female subjects (p = 0.01). GFR was 84.86 ± 19.95 in hypertensive patients while it was 95.11 ± 18.20 ml/min/1.73 m(2) in normotensive subjects (p = 0.00). GFR was 89.30 ± 19.96 in patients with metabolic syndrome (MetS) and it was 93.46 ± 18.68 ml/min/1.73 m(2) in patients without MetS (p = 0.00). CONCLUSIONS: GFR values were lower in sleep apneic patients with MetS as well as in patients with hypertension and LVH.


Subject(s)
Glomerular Filtration Rate/physiology , Sleep Apnea, Obstructive/diagnosis , Sleep Apnea, Obstructive/physiopathology , Adult , Aged , Creatinine/blood , Female , Humans , Hypertension/diagnosis , Hypertension/physiopathology , Hypertrophy, Left Ventricular/diagnosis , Hypertrophy, Left Ventricular/physiopathology , Male , Metabolic Syndrome/diagnosis , Metabolic Syndrome/physiopathology , Middle Aged , Polysomnography , Reference Values , Retrospective Studies , Sex Factors , Turkey
10.
J Oral Sci ; 57(3): 269-71, 2015 Sep.
Article in English | MEDLINE | ID: mdl-26369493

ABSTRACT

A 47-year-old man was referred for assessment of bilateral lymph node enlargement identified on a routine chest radiograph. Positron emission tomography showed high standardized uptake values (SUVmax: 20.5) in right supraclavicular, right intercostal, and multiple mediastinal lymph nodes. Biopsy samples obtained from the right upper and left lower paratracheal nodes by mediastinoscopy revealed granulomatous inflammation. Clinical and laboratory findings indicated a diagnosis of dental technician pneumoconiosis. The patient is alive and well 3 years after diagnosis. This case highlights the importance of obtaining an occupational history.


Subject(s)
Lung Neoplasms/diagnostic imaging , Pneumoconiosis/diagnostic imaging , Dental Technicians , Humans , Lung Neoplasms/diagnosis , Lymph Nodes/diagnostic imaging , Male , Middle Aged , Pneumoconiosis/diagnosis , Positron-Emission Tomography
11.
Scott Med J ; 60(1): e8-10, 2015 Feb.
Article in English | MEDLINE | ID: mdl-25468366

ABSTRACT

Inflammatory myofibroblastic tumour (IMT) is a rare benign mesenchymal tumour. However, IMT may arise from a wide variety of tissues and is very rare in the elderly. IMT may mimic the mass in which it originates. Although IMT has been defined as uncertain behaviour, it is treated surgically. We present a-65-year old man whose mass was diagnosed as IMT extending from scrotum to pelvis. The mass was independent of any surrounding anatomic structures. According to our best knowledge this is the first case in the literature that pelvic IMT was diagnosed in an elderly man and successfully treated surgically with a long term follow-up period. Aetiology of IMT is still unknown, and more studies are needed for exact continuum of IMT.


Subject(s)
Granuloma, Plasma Cell/diagnosis , Neoplasms, Muscle Tissue/diagnosis , Pelvic Neoplasms/diagnosis , Pelvis/pathology , Scrotum/pathology , Testicular Diseases/diagnosis , Aged , Diagnosis, Differential , Granuloma, Plasma Cell/pathology , Humans , Inflammation/diagnosis , Male , Neoplasms, Muscle Tissue/pathology , Neoplasms, Muscle Tissue/surgery , Pelvic Neoplasms/pathology , Pelvic Neoplasms/surgery , Rare Diseases , Testicular Diseases/pathology , Treatment Outcome
12.
Ann Saudi Med ; 34(4): 302-7, 2014.
Article in English | MEDLINE | ID: mdl-25811202

ABSTRACT

BACKGROUND AND OBJECTIVES: Obstructive sleep apnea (OSA) is common in adult population and may cause many adverse clinical results. We aimed to investigate possible changes in cardiopulmonary exercise capacity in OSA patients after positive airway pressure treatment. DESIGN AND SETTINGS: Patients who were admitted to Gaziantep University Pulmonary Diseases Sleep Center and diagnosed OSA were included. Studies carried out between May 2010 and July 2011. Sixty-five consecutive patients were included in this prospective study. PATIENTS AND METHODS: Sixty-five adult sleep clinic patients diagnosed with OSA by polysomnography and in whom continuous positive airway pressure (CPAP) ventilation therapy was indicated were included. Cardiopulmonary exercise capacity was assessed by bicycle ergometry during diagnostic workup and at least 4 weeks later. RESULTS: There were 57 (87.7%) males. The mean age was 45.29 (10.57) years, apnea-hypopnea index 38.02 (23.19 events/h, body mass index 31.72 (4.87) kg/m2. Patients were grouped with respect to compliance with CPAP. The peak oxygen consumption (VO2) did not change in the CPAP compliant group (n=33) (22.52 [6.62] mL/[min.kg] to 21.32 [5.26] mL/[min.kg]; P=.111), and decreased from 21.31 (5.66) mL/(min.kg) to 19.92 (5.40) mL/(min.kg) (P=.05) in the CPAP noncompliant group. Work rate increased from 84.0% to 85.0% in the CPAP compliant group and decreased from 79.6% to 77.1% in the noncompliant group (P=.041). In the group that used the device, ventilation (VE)/VCO2 at anaerobic threshold (AT) declined from 28.42 to 27.36; however, it increased from 27.41 to 27.81 in the group that did not use the device (P=.033). CONCLUSIONS: Decline in the exercise capacity was prevented in patients with OSA after 4 weeks of CPAP therapy. The changes in VE/VCO2 at AT suggest the reversal of pathophysiologic changes in OSA with the CPAP therapy that may improve cardiac function and cause more efficient ventilation.


Subject(s)
Continuous Positive Airway Pressure , Exercise Tolerance/physiology , Exercise/physiology , Sleep Apnea, Obstructive/therapy , Adult , Anaerobic Threshold , Exercise Test , Female , Humans , Male , Middle Aged , Patient Compliance , Prospective Studies , Pulmonary Ventilation , Severity of Illness Index
13.
Clin Invest Med ; 36(6): E277-81, 2013 Dec 01.
Article in English | MEDLINE | ID: mdl-24309223

ABSTRACT

PURPOSE: Obstructive sleep apnea (OSA) syndrome causes systemic consequences due to hypoxia and endothelial dysfunction. The purpose of this study was to investigate whether OSA is more common in subjects with pulmonary embolism (PE). METHODS: This prospective study was conducted between November 2009 and December 2010 in the Department of Pulmonary Medicine of Gaziantep University. Twenty-eight patients with PE were included in the study group along with forty-five subjects with OSA as the control group. The control group was selected from among subjects who were referred to the sleep clinic. Full night polysomnography was performed for each subject. RESULTS: Mean apnea-hypopnea index (AHI) was found to be higher in the PE group compared with the control group (p=0.010). Severe OSA was detected in 21.4% of the PE group but in no controls (p=0.015). Sleep stage 2 was longer in control group whereas stage 1 and rapid eye movement (REM) sleep was longer in the PE group. Snoring and excessive daytime sleepiness were more common in the control group compared with the study group. AHI severity and thrombus localization were not significantly different between the groups (p=0.350). CONCLUSION: Our study findings suggest that OSA is more prevalent and severe in subjects with PE compared with control subjects. The clinical significance of less prevalent excessive daytime sleepiness and snoring in subjects with PE should be evaluated in further studies.


Subject(s)
Pulmonary Embolism , Sleep Apnea, Obstructive , Adult , Aged , Female , Humans , Male , Middle Aged , Polysomnography/methods , Prevalence , Pulmonary Embolism/complications , Pulmonary Embolism/epidemiology , Pulmonary Embolism/physiopathology , Sleep Apnea, Obstructive/epidemiology , Sleep Apnea, Obstructive/etiology , Sleep Apnea, Obstructive/physiopathology
14.
Eur J Ophthalmol ; 23(3): 303-8, 2013.
Article in English | MEDLINE | ID: mdl-23335315

ABSTRACT

PURPOSE: To explore the interrelationships of histopathologic characteristics of pterygium and postoperative recurrence. METHODS: Consecutive patients with primary pterygium or recurrent pterygium treated in our tertiary center between January 2007 and January 2010 were included in the study. All the patients were surgically treated by limbal-conjunctival autograft transplantation and postoperatively followed up for at least 1 year. Histopathologic changes were classified as inflammation intensity, degree of vascularization, and fibrinoid change. The results of examination of histopathologic and clinical characteristics of pterygium were comparatively analyzed. A total of 101 consecutive patients were included in the study. Ninety eyes of 90 patients who had primary pterygium (PP group) were compared with 11 eyes of 11 patients who had recurrent pterygium (RP group). In the PP group, 7 of the 90 (7.8%) patients had evidence of recurrence, while in the RP group, 2 of the 11 (18.2%) patients had evidence of recurrence (p=0.254). RESULTS: No significant difference was found in inflammation intensity, degree of vascularization, and fibrinoid change between PP and RP groups (p>0.05). In the PP group, no significant difference was found for inflammation intensity, degree of vascularization, and fibrinoid change between patients with (7/90) and without recurrences (83/90) (p>0.05). In the RP group, no significant difference was detected for inflammation intensity, degree of vascularization, and fibrinoid change between patients with (2/11) and without recurrences (9/11) (p>0.05).
 CONCLUSIONS: No significant correlation between the histology of pterygium and recurrence rate could be established.


Subject(s)
Postoperative Complications/diagnosis , Pterygium/pathology , Pterygium/surgery , Adult , Conjunctiva/transplantation , Female , Follow-Up Studies , Humans , Male , Middle Aged , Recurrence , Transplantation, Autologous
15.
Sleep Breath ; 17(2): 647-51, 2013 May.
Article in English | MEDLINE | ID: mdl-22729826

ABSTRACT

PURPOSE: The aim of this study is to compare metabolic syndrome with syndrome Z growing epidemic in terms of risk factors, demographic variables, and gender differences in our large cohort at southeastern area in Turkey. METHODS: Data of patients admitted to sleep clinic in University of Gaziantep from January 2006 to January 2011 were retrospectively evaluated. ATP III and JNC 7 were used for defining metabolic syndrome and hypertension. RESULTS: Data of 761 patients were evaluated. Hypertension, diabetes mellitus, coronary artery disease, pulmonary hypertension, and left ventricular hypertrophy were more common in patients with syndrome Z than in patients without metabolic syndrome. Age, waist/neck circumferences, BMI, triglyceride, glucose, and Epworth sleepiness scale score were detected higher, whereas the minimum oxygen saturation during sleep was lower in patients with syndrome Z. Metabolic syndrome was more common in sleep apneic subjects than in controls (58 versus 30 %). Female sleep apneics showed higher rate of metabolic syndrome than those of males (74 versus 52 %). Hypertension, diabetes mellitus, coronary artery disease, and left ventricular hypertrophy were detected higher in males with syndrome Z than in males without metabolic syndrome. Snoring and excessive daytime sleepiness were detected higher in females with syndrome Z than in females without metabolic syndrome. Systemic/pulmonary hypertension, diabetes mellitus, and left ventricular hypertrophy were more common in females with syndrome Z than in females without metabolic syndrome. Complaints of headache and systemic/pulmonary hypertension were more common among females than males with syndrome Z. Female syndrome Z patients had lower minimum oxygen saturation than male patients with syndrome Z. CONCLUSIONS: Metabolic syndrome in sleep apneic patients is more prevalent than in controls. All metabolic syndrome parameters were significantly different among obstructive sleep apneic patients with respect to gender with more severe coronary risk factors in males.


Subject(s)
Developing Countries , Epidemics , Metabolic Syndrome/epidemiology , Sleep Apnea, Obstructive/epidemiology , Comorbidity , Cross-Sectional Studies , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/etiology , Disorders of Excessive Somnolence/diagnosis , Disorders of Excessive Somnolence/epidemiology , Female , Humans , Hypertension, Pulmonary/epidemiology , Hypertension, Pulmonary/etiology , Hypertrophy, Left Ventricular/diagnosis , Hypertrophy, Left Ventricular/epidemiology , Male , Metabolic Syndrome/etiology , Oxygen/blood , Risk Factors , Sex Factors , Sleep Apnea, Obstructive/etiology , Snoring/diagnosis , Snoring/epidemiology , Syndrome , Turkey
16.
Tuberk Toraks ; 60(1): 47-51, 2012.
Article in English | MEDLINE | ID: mdl-22554366

ABSTRACT

INTRODUCTION: Positive pressure ventilation is considered first line therapy in obstructive sleep apnea syndrome however compliance is limited by various factors. We aimed to investigate possible factors influencing compliance. MATERIALS AND METHODS: One hundred and forty patients were prescribed positive pressure ventilation for obstructive sleep apnea during June 2006-June 2008. Of these patients, 77% (n= 108) were reached by telephone and a questionnaire was administered regarding factors influencing treatment compliance. Airway passage was measured with C2 vertebrae level and narrowest airway passage on lateral skull radiographs. RESULTS: The mean age was 52.2 ± 12.3 years. Seventy one percent (n= 77) of subjects obtained the prescribed device. There was no difference in sex, age, marital status, educational level, symptoms, co-morbid conditions, and social security coverage between the subjects who have received the prescribed devices and who have not (p> 0.05). No difference was detected between these two groups of patients in view of Epworth sleepiness scale (ESS) and apnea hypopnea index (AHI). Mean duration of device usage was 6.3 ± 2.3 hours. The device use compliance was not affected by any of the following factors: age, gender, level of education, co-morbid diseases, ESS score, AHI, airway passage measurements, application of humidification and education concerning the device (p> 0.05). Patient (p= 0.057) and bed partners (p= 0.001) satisfaction about the device yielded higher compliance rates. CONCLUSION: Factors influencing compliance rates in obstructive sleep apnea syndrome seems to be related to satisfaction about the device use however upper airway morphology measured with C2 vertebrae level and narrowest airway passage has no impact on treatment compliance.


Subject(s)
Continuous Positive Airway Pressure/methods , Patient Compliance , Patient Satisfaction , Sleep Apnea, Obstructive/therapy , Female , Humans , Male , Middle Aged , Radiography , Skull/diagnostic imaging , Surveys and Questionnaires
17.
Tuberk Toraks ; 60(1): 56-8, 2012.
Article in English | MEDLINE | ID: mdl-22554368

ABSTRACT

A young male with complaints of cough, dyspnea and hemoptysis was admitted. He was using fluticasone propionate and salmeterol for two years for his asthma. Leukotriene receptor antagonist was prescribed two weeks prior to his admission and no reduction of his inhaled steroid therapy was performed. Eosinophil count was detected as 1460/mm³ (15%) and immunoglobulin E level was 547 IU/mL. Thorax computerized tomography revealed patchy infiltration. Increased eosinophilic inflammation were detected in bronchoalveolar lavage fluid and transbronchial biopsy. He received prednisolone treatment for Churg-Strauss syndrome. Improvement was observed on three months follow up period. He has no complaint in his follow up.


Subject(s)
Acetates/adverse effects , Anti-Asthmatic Agents/adverse effects , Churg-Strauss Syndrome/chemically induced , Quinolines/adverse effects , Acetates/therapeutic use , Adolescent , Asthma/drug therapy , Churg-Strauss Syndrome/diagnosis , Cough/chemically induced , Cough/diagnosis , Cyclopropanes , Dyspnea/chemically induced , Dyspnea/diagnosis , Hemoptysis/chemically induced , Hemoptysis/diagnosis , Humans , Leukotriene Antagonists/adverse effects , Leukotriene Antagonists/therapeutic use , Male , Quinolines/therapeutic use , Sulfides
18.
South Med J ; 104(7): 495-8, 2011 Jul.
Article in English | MEDLINE | ID: mdl-21886048

ABSTRACT

OBJECTIVES: Psychiatric disorders are common in obstructive sleep apnea syndrome (OSAS); however, interrelating factors influencing psychiatric comorbidity (PC) in OSAS are unclear. The aim of this study is to investigate gender related differences with PC in OSAS. METHODS: Data of patients diagnosed as OSAS in University of Gaziantep from January 2006 to January 2010 were retrospectively evaluated. Polysomnographic data were recorded with Viasys Sleep Screen (Viasys Healthcare, Germany). Patients younger than 18 years old were excluded. RESULTS: PC was present in 53.1% of OSAS patients. The rate of male subjects with PC was 42.6%; however, 76.26% of females had PC (P = 0.00). Age (P = 0.00) and body mass index (BMI) (P = 0.00) were higher in patients with PC. Ferritin levels were lower in patients with PC (P = 0.00). Male subjects with PC were older and had lower sleep efficiency and longer rapid eye movement latency than males without PC. BMI was the only contributory factor to PC in female subjects. CONCLUSION: PC in OSAS is common, especially in females. Apnea hypopnea index does not seem to influence probability of PC.


Subject(s)
Mental Disorders/complications , Sleep Apnea, Obstructive/psychology , Adult , Age Factors , Aged , Body Mass Index , Female , Humans , Male , Middle Aged , Retrospective Studies , Sex Factors , Sleep, REM
20.
Tuberk Toraks ; 59(1): 8-17, 2011.
Article in Turkish | MEDLINE | ID: mdl-21554225

ABSTRACT

There is currently no national data on the effects of polyvinyl chloride (PVC) exposure on pulmonary function. In this study we recruited workers and administrative staff from two PVC plants between July 2008 and July 2009. A questionnaire, pulmonary function tests, carbon monoxide diffusion capacity, and peak flows were recorded. Particulate matter analyses were performed by the Adana Central Laboratory of the Directorate of Occupational Health and Safety. Data were analyzed with SPSS 13.0 software. Nine of the 147 subjects were female. The incidence of a cough was more common in the administrative group. Of the study population, 59.1% were smokers. Tobacco addiction significantly increased cough and dyspnea [OR= 1.10 (1.00-1.20, 95% CI) p= 0.007 and OR= 1.08 (1.02-1.14, 95% CI), p= 0.008, respectively]. Dust exposure was correlated with the incidence of a cough [OR= 0.20 (0.04-0.80, 95% CI) p= 0.008]. The period of work correlated with sputum production [OR= 1.00 (1.00-1.02, 95% CI) p= 0.044]. The FVC% was significantly higher in the administrative group, and FEV1/FVC and DLCO were higher in the exposed group. Tobacco addiction increased the risk of airflow limitation, as evaluated by FEV1/FVC < 70% and FEF25-75 < 50% [OR= 1.15 (1.06-1.25, 95% CI) p= 0.001 and OR= 1.09 (1.02-1.17, 95% CI) p= 0.010, respectively]. Tobacco addiction and increasing duration of work had a negative influence on DLCO in the exposed group (r= -0.270, p= 0.025 and r= -0.210, p= 0.037). In the exposed group PEF variability was significantly greater on workdays, compared with rest days. This study shows that tobacco consumption has a greater affect on the airways than PVC dust exposure. A median of 36 months exposure to PVC dust had no significant impact on pulmonary function parameters, except for DLCO and PEF variability.


Subject(s)
Lung Diseases/chemically induced , Occupational Diseases/chemically induced , Occupational Exposure/adverse effects , Polyvinyl Chloride/adverse effects , Adult , Carbon Monoxide/metabolism , Cough/chemically induced , Cough/epidemiology , Diffusion , Dust , Dyspnea/chemically induced , Dyspnea/epidemiology , Female , Humans , Incidence , Lung Diseases/epidemiology , Lung Diseases/physiopathology , Male , Middle Aged , Occupational Diseases/epidemiology , Occupational Diseases/physiopathology , Particulate Matter/analysis , Peak Expiratory Flow Rate , Respiratory Function Tests , Smoking/adverse effects , Smoking/epidemiology , Surveys and Questionnaires , Tobacco Use Disorder/complications , Tobacco Use Disorder/epidemiology , Turkey/epidemiology , Young Adult
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