Fahrettin Talay

Paranasal computed tomography results in asthma patients: association between sinus sites and allergen types.

Chronic rhinosinusitis (CRS) is a common comorbidity of asthma. The aim of this study was to investigate the relationships between the presence of rhinosinusitis, sinus site involvement, and total computed tomography (CT) sinus scores and the presence of allergy, allergen type, and severity of disease. Asthma patients (128 subjects), consisting of 57 allergic and 71 nonallergic patients, were included in the study. Presence of rhinosinusitis and sinus scores were evaluated by CT. CRS was determined in 45 (78.9%) allergic asthma patients and 44 (62.0%) nonallergic asthma patients (p<0.05). Ethmoid sinus involvement was higher among allergic asthma patients compared with nonallergic patients (68.4% versus 43.7%; p=0.005). House-dust mite allergy (71.4% versus 46.5%; p=0.008) and pollen allergy (73.5% versus 47.9%; p=0.01) showed positive correlations with ethmoid sinus involvement. No correlation was found between severity of disease and mean total CT sinus scores (p>0.05). The present study has shown the prevalence of chronic sinusitis to be higher in patients with allergic asthma, particularly in patients allergic to house-dust mites and pollens, with no correlation between severity of disease and presence of CRS. Investigating chronic sinusitis together with allergen sensitivity early in asthma diagnosis may contribute positively to patient treatment.

Prevalence and risk factors of asthma and allergic diseases among schoolchildren in Bolu, Turkey

Aim: In this study we aimed to detect the prevalence and risk factors of asthma and allergic diseases in children aged between 7 and 14 years old at rural and urban areas of Bolu, Turkey.

Effect of inhaled budesonide on oropharyngeal, Gram‐negative bacilli colonization in asthma patients

Background and Objective:  The effect of inhaled budesonide on oropharyngeal Gram‐negative bacilli colonization (OGNBC) in asthmatic patients was investigated.

The effect of triamcinolone acetonide aqueous nasal spray on the nasal carriage of Staphylococcus aureus.

Background In this study we aimed to investigate the effect of triamcinolone acetonide aqueous (TAA) intranasal spray that was used for 2 months to treat allergic rhinitis (AR) on the nasal carriage of Staphylococcus aureus (NCSA). Methods A total of 125 adult AR patients (study group) and 133 healthy individuals (control group) were enrolled for the study. The subjects were diagnosed with AR after a detailed history, physical examination, and prick testing. The AR subjects were administered TAA in a daily dosage of a 220-μg intranasal route. Nasal cultures were obtained on the 1st (baseline), 55th, and 60th days, and the subjects in the last two cultures of whom S. aureus was detected were accepted as NCSA. Results After all exclusion criteria were used, 110 AR and 114 control group subjects were enrolled in the study. Based on the culture results that were obtained on the 55th and 60th days, 10 (%9.1) patients from the study group and 18 (%15.7) individuals from the control group were defined to be NCSA (p > 0.05). Conclusion We conclude that the use of TAA treatment for AR does not increase the prevalence of NCSA. However, additional studies with a larger series are required to explain the effects of steroids on nasal colonization of S. aureus.

An unusual case of pulmonary nocardiosis in immunocompetent patient.

Pulmonary nocardiosis is a subacute or chronic necrotizing pneumonia caused by aerobic actinomycetes of the genus Nocardia and rare in immune-competent patients. A 35-year-old male, who had treated with antituberculosis drugs, presented with cough, dyspnea, and expectoration with episodes of hemoptysis with purulent sputum. The diagnosis of nocardiosis was made by microscopic examination of the surgically resected portion of the lung and revealed filamentous Gram-positive bacteria.

A New Diagnostic Marker For Acute Pulmonary Embolism In Emergency Department: Mean Platelet Volume

OBJECTIVE To investigate the diagnostic importance of mean platelet volume (MPV) on acute pulmonary embolism (APE) in the emergency Department (ED). METHODS Subjects were selected from patients admitted to ED with clinically suspected APE. Demographic, anthropometric and serologic data were collected for each patient. RESULTS A total of 315 consecutive patients were analyzed, including 150 patients (53.44 ± 15.14 y; 92 men/58 women) in APE group and 165 patients (49.80 ±13.76y; 94 men/71 women) in the control group. MPV in the APE group was significantly higher than in the control group (9.42±1.22 fl vs. 8.04±0.89 fl, p<0.0001). The best cut-off values for MPV when predicting APE in patients with clinically suspected APE presenting at the ED were 8.55 fl (sensitivity 82.2%; specificity 52.3%). CONCLUSIONS MPV is a helpful parameter for the diagnosis of APE in ED, for the first time in the literature.

Silicosis in Manufacture of Electric Cable: Report of Four Cases

Free silica (silicon dioxide) is naturally found in amorphous and crystalline forms in many rocks in the Earth . Inhaled silicon dioxide is usually crystalline and most often quartz which is the most important form. Silicosis is an irreversible disease 3) that results from workrelated exposures to dusts containing silica crystals, and is characterized by fibrotic tissue reaction caused by the presence of silica in the lungs . Crystalline silica exposure and silicosis have been associated with work in mining, quarrying, tunneling, sandblasting, masonry, foundry work, glass manufacture, ceramic and pottery production, cement and concrete production, and work with certain materials in dental laboratories. The diagnosis of silicosis is based on history of exposure to silica dust and multiple, bilateral pulmonary nodules and large opacities on chest radiography . Several studies have demonstrated that high resolution computed tomography (HRCT) is superior to conventional radiography for detection of silicotic lesions, confluence of nodules, and presence of emphysema . Most pneumoconiosis evolves slowly and changes in radiological findings take a long time, usually years, to occur. However, in rare instances, such as acute silicosis associated with exposure to a very large quantity of very fine silicaceous dust, radiological changes can show up within months . We present clinical and radiological findings of four cases working in the same department producing ‘silicone paste’ by mixing quartz dust (a synonym for silicon dioxide (SiO 2 ), sil ica or sil icon) with sil icone (polysiloxane ([R 2 SiO] n , a class-name for various synthetic plastic substances made of silicon, oxygen, carbon, germanium, and hydrogen), in an electric cable factory, for 5 to 8 yr. Up to now, this branch of industry has not been reported in the English literature as a cause of silicosis.

Evaluation of Pregnancy-Associated Plasma Protein-A Levels in Patients with Chronic Obstructive Pulmonary Disease and Associations with Disease Severity

Chronic obstructive pulmonary disease (COPD) represents a systemic disorder characterized by chronic airflow limitation and an increased inflammatory response of the airways. Comorbidities are frequent in COPD and it is crucial to predict these in early stage for adequate management of COPD. Recent studies have reported that elevated levels of pregnancy-associated plasma protein-A (PAPP-A), a zinc-binding metalloproteinase, detected in patients with asthma, lung cancer, and pulmonary embolism and independently associated with cardiovascular events. We aimed to assess serum PAPP-A levels in COPD and the associations between disease severity. The study population consisted of 75 COPD patients and 35 healthy subjects as a control group. PAPP-A levels were measured by using ultrasensitive enzyme-linked immunosorbent assay. Elevated levels of PAPP-A were observed in patients with COPD on comparison with the controls (p = 0.000). The levels in stage 1 (34.73 ± 22.97) and stage 2 (48.29 ± 53.35) were significantly higher than stage 3 (20.58 ± 22.98) and stage 4 (27.36 ± 21.46) (p = 0.049). Increased PAPP-A levels may be a useful marker in management of COPD that seeks to prevent the development of comorbidities such as adverse cardiovascular diseases.

Benefit of Metformin in COPD: An Effect on Autonomic Nervous System?

With great interest we read the recent article by Hitchings et al. on the safety of metformin in patients with type-2 diabetes mellitus and COPD (1). Th ey found that in patients at high risk for lactate accumulation, metformin therapy was associated with a minor elevation of lactate concentration of doubtful clinical signifi cance. An additional fi nding was that metformin was associated with a longer survival, which was diffi cult to interpret because of possible unmeasured confounders. We would like to propose a mechanism of metformin by which metformin may have a benefi cial eff ect in terms of survival of COPD patients. Studies have shown that alterations in autonomic nervous system are present in COPD, with or without arterial COPD (2–6), which may contribution to the severity of disease and survival. Metformin is an anti-diabetic agent that has been shown to reduce insulin resistance and hyperglycemia, and also reduce the incidence of diabetes (7). Studies have also shown that metformin has benefi cial eff ects on autonomic control (8,9) and can improve cardiac sympathovagal balance in obese patients with type-2 diabetes (8). We think it can be hypothesized that the preceding eff ects of metformin on the autonomic nervous system might have played a role in the survival data reported by Hitchings et al. (1).

Does the prevalence of nasal polyps increase in patients using statins

Several statins inhibit T-helper 1 development and induce T-helper 2 polarization and production of T-helper 2 cytokines that promote the activation and chemotaxis of eosinophils. Whether statins promote the development of nasal polyps has so far been uncertain. No studies have evaluated the frequency of the development of nasal polyps in patients using statins. To better define the relationship of statin use to the presence of nasal polyps, the investigators explored the frequency of the development of nasal polyps in patients who were using statins. A total of 200 patients who were using statins and 200 who were not using statins (400 cases) were investigated. All patients were examined for nasal polyps by anterior rhinoscopy or investigation with a fiberoptic endoscope. In addition, immunoglobulin E levels were measured, a skin prick test was performed, and the results from the 2 groups were compared. Nasal polyps were detected in 4 subjects who were using statins, whereas 5 nasal polyps were found in the control group; differences between the 2 groups were statistically insignificant (P> .05). When the atopy status of the 2 groups was compared, prick test positivity and serum immunoglobulin E levels were found to be 15% and 44±31 IU/mL in the statin group and 19% and 68±23 IU/mL in the control group (P> .05). These results show that nasal polyposis is a multifactorial disease with several different causes; however, the frequency of the development of nasal polyps does not increase in patients who use statins.