A neglected etiology of bronchiectasis: External compression due to hiatal hernia.

AIM: To investigate the incidence of bronchiectasis supposed to be made by the external compression of hiatal hernia (HH) to bronchi. MATERIALS AND METHODS: The thorax computed tomography (CT) scans of patients which were carried out in Duzce University Hospital between February 2014 and August 2015 were retrospectively evaluated. The repeated scans in the same patient were excluded. RESULTS: A total of 4388 patients were included in the study. A total of 98 HH cases were detected of which 58 (59.2%) were female. The mean age was 73.30 ± 9.14 (45-90). The rate of HH according to small, moderate and large size was 45 (45.9%), 9 (9.2%), 44 (44.9%), respectively. The rate of hiatal hernia accompanied by bronchiectasis were similar in both males and females (P = 0.078). The prevalence of bronchiectasis was significantly high in large hernias with 81.4% rate (P = 0.009). Bronchiectasis rate was 12.343 times (OR: 12.343, 95% CI: 1.479-103.027, P = 0.009) higher in the large HH group compared to small and moderate HH groups. Hiatal hernia accompanied by bronchiectasis was 88.1% anatomically near to HH. CONCLUSIONS: Thus, hiatal hernia may cause bronchiectasis due to external compression rather than lymphadenopathy or the tumor as an etiology of bronchiectasis and should be considered in the differential diagnosis.

Mean platelet volume is associated with glycaemic control and retinopathy in patients with type 2 diabetes mellitus.

OBJECTIVES: To investigate the relationship between mean platelet volume (MPV) and glycometabolic indices, to compare MPV according to HbA1c levels, and to analyse the difference in MPV between patients with and without microvascular complications. METHODS: This retrospective study was conducted on 60 Type 2 diabetic patients and 50 age- and sex-matched non-diabetic controls. We obtained demographic, clinical and laboratory data including MPV, platelet count, fasting and postprandial blood glucose (FBG and PBG), haemoglobin A1c (HbA1c), lipid profile, creatinine, systolic and diastolic blood pressure (BP) in patient and control groups, and diabetic microvascular complications including nephropathy, neuropathy, and retinopathy in the patient group. All analyses were performed using SPSS version 15.0 for Windows. RESULTS: Mean platelet volume in the diabetic group was higher than in the control group (p = 0.001). Mean platelet volume was positively correlated with FBG and HbA1c levels (p = 0.03 and p < 0.001, respectively). It was also negatively related to platelet count (p < 0.001). Mean platelet volume in patients with HbA1c > 7% was significantly higher than those with HbA1c ≤ 7% (p < 0.001). Mean platelet volume was significantly increased in patients with retinopathy compared to those without retinopathy (p = 0.04). CONCLUSION: This study has shown that an increased MPV is closely associated with poor glycaemic control, which may be a risk factor for diabetic retinopathy. Nonetheless, further prospective studies are needed to assess the relationship between MPV, glycaemic indices and microvascular complications.

Comparison of serum CA 19.9, CA 125 and CEA levels with severity of chronic obstructive pulmonary disease.

OBJECTIVE: To investigate serum levels of CA 19.9, CA 125 and carcinoembryonic antigen (CEA) in patients with different stages of chronic obstructive pulmonary disease (COPD). PATIENTS AND METHODS: Fifty-three consecutive patients (50 males, 3 females, mean age 67.6 +/- 10.1 years) with COPD were included in this study. Serum levels of CA 19.9, CA 25 and CEA were determined by the chemiluminescent immunometric method. Based on values obtained from pulmonary function tests, the patients were divided into 3 groups: moderate (21), severe (18) and very severe (14). Data were analyzed with a Kruskal-Wallis one-way analysis of variance test and Mann-Whitney U test. RESULTS: The mean serum levels of CA 125 and CA 19.9 were significantly higher in patients with very severe COPD (p = 0.013 and p = 0.017, respectively) than in patients with severe and moderate COPD (p < 0.05). Patients with cor pulmonale had significantly high mean serum levels of CEA, CA 19.9 and CA 125 (p < 0.05). Patients using a long-acting beta-agonist and theophylline showed significantly higher mean serum levels of CA 125 than patients who were not (p < 0.05). CONCLUSION: Data showed that the increased serum tumor markers in patients with COPD might be due to the severity of COPD, medication and cor pulmonale.

Epidemiological features of Turkish patients with sarcoidosis.

Epidemiological characteristics of sarcoidosis differ according to geographical distribution. The aim of our study was to disclose epidemiological characteristics in our country. The data was collected from investigators, who sent information on newly-diagnosed patients via internet. In 2 years 198 female and 95 male patients were enrolled to the study (f/m:2.08). Mean age of patients was 44+/-13 years (17-90). Mean age of male patients was 38+/-12 while mean age of female patients was 48+/-13 (p<0.001). 73.4% of patients were nonsmokers (85.4% of females; 48.4% of males; (p<0.001)). About 50% of our 293 patients were housewives. Familial sarcoidosis was found in 3 patients' first degree relatives. Estimated annual incidence of sarcoidosis for Turkey was calculated as 4 per 100,000 person. According to our study, 2/3 of sarcoidosis patients were women; mean age of patients was 45 and the disease began 10 years later in female patients. 80% of patients were nonsmokers; negative relation between sarcoidosis and smoking was evident especially in women. Familial sarcoidosis frequency was lower compared to other studies in the literature. There was no occupational exposure history in our patients. Our incidence rate, is similar with the results of other European studies.

Comparison of the tuberculin skin test and the quantiferon test for latent Mycobacterium tuberculosis infections in health care workers in Turkey.

The aim of this study was to compare the efficacy of the tuberculin skin test (TST) and the quantiferon test (QFT) for detecting latent tuberculosis infection (LTBI) in health care workers (HCWs). Seventy-six participants who were working in Duzce University Hospital, where tuberculosis patients were being treated, were included in the study. TST was performed according to the Mantoux technique. QFT was performed in accordance with the manufacturer's instructions. A positive TST result was defined as an induration diameter of > or = 15 mm. TSTs were positive in 41 of 76 participants (53.9%) and QFT was positive in 65 of 76 participants (85.5%). There was a significant difference between the numbers of QFT-positive and TST-positive cases (P=0.02). When the induration diameter of TST was > or = 20 mm, QFT positivity was 100%. Multivariate analysis revealed that there was a significant correlation between the percentage of patients with QFT positivity and the induration diameter of TST (P=0.009). QFT thus seems to be more effective for LTBI diagnosis than TST. However, large-scale trials including quantitative measurement of QFT in subgroups taking into account the division where HCWs are employed and the different results of TST might clarify the usefulness of QFT in LTBI diagnosis.

Persistent serpentine supravenous hyperpigmented eruption associated with docetaxel.

Various mucocutaneous reactions have been reported with the use of systemic docetaxel. We describe a 47-year-old man who developed a persistent serpentine supravenous hyperpigmented eruption (PSSHE), beginning at the site of docetaxel injection and spreading along the superficial venous network in the anterior aspect of the right forearm and distal arm. The eruption occurred after the first infusion of docetaxel following insufficient venous washing. A second infusion was administered through a vein in the other forearm, but this time, abundant venous washing was performed and a similar eruption did not occur. To our knowledge, this is the second report of docetaxel-induced supravenous discoloration and we discussed the terminology and mechanism of this unique reaction.