Cenk Babayiğit

Right ventricular and pulmonary function in sickle cell disease patients with pulmonary hypertension

The effects of sickle cell disease (SCD) on right ventricular (RV) and pulmonary function in SCD patients with pulmonary hypertension is not well-known. The aim of this study was to investigate RV and pulmonary functions in patients suffering from SCD with or without pulmonary hypertension using color tissue Doppler imaging and spirometry. We evaluated 48 asymptomatic patients with SCD. All patients underwent echocardiography with tissue Doppler imaging and pulmonary function test. Patients were divided into two groups: Group 1 consisted of 27 patients (age, 18.1 ± 7.1 years) with normal pulmonary artery pressure, and group 2 consisted of 21 patients (age, 21.4 ± 7.4 years) with pulmonary hypertension. Both groups were compared with a sex- and age-matched control group including 24 normal healthy subjects (age, 19.8 ± 9.2 years). Tricuspid lateral annular systolic (Sm) and early diastolic velocity (Em) were higher in group 1 than group 2 and the control group (p < 0.05). Tricuspid lateral annular late diastolic velocities (Am), isovolumetric contraction time, and myocardial performance index (MPI) were higher and the Em/Am ratio was lower in group 2 than group 1 and the control group (p < 0.05). However, no differences were found in the tricuspid lateral annular Em deceleration time, ejection time, and isovolumetric relaxation time between group 1, group 2, and the control group. Tricuspid lateral annular Sm and Em were similar in group 2 and the control group. Forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and the diffusion capacity of the lung for carbon monoxide were decreased in both groups of patients compared to the control group (p < 0.05). However, there was no difference in respiratory rate, FEV1/FVC ratio, peak expiratory flow, and total lung capacity between group 1, group 2, and the control group. There were no differences in any indices of lung function between the two groups of patients. MPI is useful index to evaluate RV function in patients with SCD. RV diastolic function was disturbed in only SCD patients with pulmonary hypertension. On the other hand, the restrictive pattern of pulmonary function abnormalities had developed in both groups of patients.

A different type of congenital lumbar hernia associated with the lumbocostovertebral syndrome.

Congenital lumbar hernia is rare in infancy and childhood, and its association with the lumbocostovertebral syndrome is even more unusual. Only 20 cases have been reported in the English literature. We present the case of a child with multiple costovertebral anomalies, undescended testis, and lateral abdominal wall hernia that is not within the anatomical boundaries of traditional lumbar hernias.

High Prevalence of Pulmonary Hypertension in Homozygous Sickle Cell Patients with Leg Ulceration

Pulmonary hypertension is a common complication and is a risk factor for death in adult patients with sickle cell disease. Chronic leg ulceration is a major cause of morbidity in homozygous sickle cell disease. We aimed to determine prevalence of pulmonary hypertension in homozygous sickle cell patients and if there is any relation of pulmonary hypertension with leg ulceration. A total of 88 patients, asymptomatic for pulmonary hypertension, were enrolled in the study. Doppler echocardiography was performed on homozygous sickle cell patients with and without leg ulceration. 12 patients (10 male, 2 female) had active ulcer or healed scar (group I) and 76 patients (40 male, 36 female) had no active leg ulcer or history of (group II). The prevalence of pulmonary hypertension in group I and group II were 91.6% (n = 11) and 31.6% (n = 24), respectively (p = 0.0001). Patients with leg ulceration had increased left atrium and right ventricular diameters at diastole and also had increased left ventricular end-diastolic and end-systolic diameters. We determined an increased prevalence of pulmonary hypertension in patients with leg ulceration. Patients with homozygous sickle cell disease, especially those with leg ulcers should be screened for pulmonary hypertension, since pulmonary hypertension is a frequent and generally asymptomatic complication and a risk factor of mortality.

Performance of QuantiFERON-TB Gold In-Tube test and Tuberculin Skin Test for diagnosis of latent tuberculosis infection in BCG vaccinated health care workers.

Background Tuberculin skin test (TST) has been used for years as an aid in diagnosing latent tuberculosis infection (LTBI) but it suffers from a number of well-documented performance and logistic problems. Quantiferon-TB Gold In Tube test (QFT-GIT) has been reported to have better sensitivity and specifity than TST. In this study, it was aimed to compare the performance of a commercial IFN-γ release assay (QFT-GIT) with TST in the diagnosis of HCWs at risk for latent TB infection in BCG vaccinated population. Material/Methods Hundred healthy volunteer health care workers were enrolled. All were subjected to TST and QFT-GIT. Results were compared among Health Care Workers (HCWs) groups in terms of profession, workplace, working duration. Results TST is affected by previous BCG vaccinations and number of cases with QFT-GIT positivity is increased in accordance with the TST induration diameter range. QFT-GIT result was negative in 17 of 32 TST positive (≥15 mm) cases and positive in 4 of 61 cases whose TST diameters are between 6–14 mm, that is attritutable to previous BCG vaccination(s). It was negative in all cases with TST diameters between 0–5 mm. HCWs with positive QFT-GIT results were significantly older than the ones with negative results. Furthermore duration of work was significantly longer in QFT-GIT positive than in negative HCWs. Conclusions There was a moderate concordance between QFT-GIT and TST, when TST result was defined as positive with a ≥15 mm diameter of induration. We suggest that QFT-GIT can be used as an alternative to TST for detection of LTBI, especially in groups with high risk of LTBI and in population with routine BCG vaccination program.

Papillary thyroid carcinoma with lung metastasis arising from dyshormonogenetic goiter: a case report.

Prior radiation exposure is the best known risk factor for thyroid cancers, and papillary thyroid carcinoma (PTC) may arise from dyshormonogenetic goiter. A 17-year-old female patient was admitted to the department of chest diseases with respiratory symptoms. The patient had undergone a thyroid surgery for goiter at the age of 9. A bilateral nodular opacity was detected by radiological examination. The histopathologic examination of the specimen obtained from computed tomography guided trucut biopsy was diagnosed as PTC. We present a very rare case of PTC with lung metastasis that had undergone subtotal thyroidectomy due to dyshormonogenetic goiter eight years ago.

The Relationship between Patient Age and Sensitivity to Known Risk Factors for Asthma Attacks

Geliş Tarihi/Received: 19.09.2012 Kabul Tarihi/Accepted: 06.02.2013 Çevrimiçi Yayın Tarihi/Available Online Date: 07.05.2013 Turk Toraks Derg 2013; 14: 141-8 DOI: 10.5152/ttd.2013.33