Hikmet Çoban

The relationship between allergy and asthma control, quality of life, and emotional status in patients with asthma: a cross-sectional study.

BackgroundPsychiatric comorbidities are prevalent in patients with chronic somatic disorders such as asthma. But, there is no clear evidence regarding the effect of atopic status and the type of sensitized allergen on emotional status. The aim of the present study was to investigate the effects of house dust mites and pollen allergies on emotional status, asthma control and the quality of life in patients with atopic asthma.MethodsThe study included 174 consecutive patients who were diagnosed with asthma accoring to the GINA criteria and who did not receive therapy for their allergy. All patients underwent a skin prick test. The asthma control, quality of life, and emotional status were evaluated using the ACT (asthma control test), AQLQ (asthma-specific quality of life questionnaire), and HAD (hospital anxiety depression questionnaire).ResultsAtopy was detected in 134 (78.7%) patients. Of those patients: 58 (33.3%) had anxiety and 83 (47.7%) had depression. There was no relationship between emotional status, atopic status, and the type of indoor/outdoor allergen. Furthermore, there was no relationship between atopy and asthma severity, asthma control, and the quality of life. The anxiety and depression scores were significantly higher and the quality of life scores lower in the uncontrolled asthma group. The ACT and AQLQ scores were also lower in the anxiety and depression groups.ConclusionsIt was concluded that anxiety and depression are prevalent in patients with uncontrolled asthma, and atopic status did not affect the scores in ACT, AQLQ, and emotional status tests.

Consider Behcet's disease in young patients with deep vein thrombosis

Behcets disease is a multi-systemic and chronic inflammatory vasculitis of unknown etiology characterized by recurrent oral and genital ulcers, uveitis, arthritis, arterial aneurysms, venous thrombosis, skin lesions and GIS lesions. Although pulmonary artery aneurysms are rare, it is a critical condition due to high risk of rupture. Venous involvement of Behcets disease primarily occurs in the lower extremities. In the presence of deep vein thrombosis(DVT) and pulmonary embolism, the mainstay of treatment in Behcets disease is immunosuppressant therapy. Anticoagulants can be used only after initiation of immunosuppressant therapy and suppression of the disease. Anticoagulant therapy alone may lead to fatal hemoptysis. We report the case of a 24 year-old patient who presented to the emergency service with complaints of shortness of breath, general condition disorder and hemoptyhis while using warfarin for DVT and whose thoracic CT angiography showed pulmonary embolism and pulmonary artery aneurysm and diagnosed with Behcets disease.

Lung cancer in patients diagnosed with silicosis should be investigated.

Silicosis is an interstitial lung disease developing as a result of inhalation of inorganic silica particles. In silicosis cases developing as a result of environmental and occupational exposure, an increase is observed in Turkey especially depending upon denim sandblasting. We present a 35-year-old female case who was applied to our hospital due to complaint of progressive dyspnea, had a history of working in denim sandblasting for 18 months, were diagnosed with silicosis as a result of high resolution computed tomography (HRCT) and diagnosed with lung adenocarcinoma as a result of transbronchial lung biopsy made due to clinical deterioration and radiological progression within three months. The purpose of this report was to point out that lung cancer can develop in patients followed up with diagnosis of silicosis or radiologic findings in silicosis can be confused with lung cancer.

Evaluation of TNF-alpha gene (G308A) and MBL2 gene codon 54 polymorphisms in Turkish patients with tuberculosis.

OBJECTIVE MBL acts as a binding protein that enables uptake of mycobacteria into macrophages. And, TNF-alpha is an important cytokine that is involved in control of mycobacterial infections both in-vivo and in-vitro. A large number of genetic factors exerting susceptibility to tuberculosis has been identified, among which mannose-binding lectin and tumor necrosis factor-alpha call attention. The objective of this study is to compare the frequency of TNF-alpha and MBL gene polymorphisms between patients diagnosed with tuberculosis and healthy volunteers in Turkey, and determine the association between tuberculosis and TNF-alpha gene (G308A) and MBL2 gene codon 54 polymorphisms. MATERIAL AND METHODS The study included 69 patients who were diagnosed with tuberculosis and 70 control subjects. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used to detect TNF-alpha (G308A) gene and MBL2 gene codon 54 polymorphisms. For statistical analysis, the significance level was determined as p<0.05. RESULTS A comparison between patient and control groups in TNF-alpha (G308A) gene and MBL2 gene codon 54 polymorphisms showed no statistically significant difference (p>0.05). However, a comparison of mean body mass index (BMI) and smoking status showed a statistically significant difference between the tuberculosis and control groups (p=0.01 and p=0.009, respectively). CONCLUSION Our results suggest that the MBL2 gene Codon 54 and TNF-alpha gene G308A polymorphisms are not associated with an increased risk for development of tuberculosis in our patients. Further studies are required including more cases of tuberculosis patients and other potentially relevant gene polymorphisms.

Is There a Correlation between New Scoring Systems and Systemic Inflammation in Stable Bronchiectasis

Aim The present study aimed to investigate the relation between FACED and BSI scores, which were developed to measure the severity of bronchiectasis, and systemic inflammation in patients with stable bronchiectasis. Methods FACED and BSI scores of 117 patients with stable bronchiectasis were calculated. The correlations between mean scores and CRP levels, leukocyte count, and neutrophil/lymphocyte ratio were investigated. Findings Mean BSI and FACED scores were 7.2 ± 5.2 and 2.1 ± 1.8, respectively. The severity of bronchiectasis as determined based on BSI and FACED increased significantly with increasing levels of CRP in patients with stable bronchiectasis (p=0.001 and p=0.027, resp.). No significant changes were found in leukocyte count (p=0.72 and p=0.09, resp.) and N/L ratio (p=0.45 and p=0.71, resp.). BSI and FACED scores were significantly correlated with CRP but not with leukocyte count or N/L ratio. Conclusion In patients with stable bronchiectasis who are evaluated based on FACED and BSI scores, CRP can be a useful biomarker as a direct indicator of the severity of systemic inflammation.

The relationship between restless legs syndrome and bronchial asthma

Restless legs syndrome (RLS) is associated with sleep disorders. However, although sleep disturbance is prevalent in people with asthma, an insufficient number of studies have investigated the relationship between asthma and RLS.

Hypersensitivity pneumonitis caused by the broom grass (Calluna vulgaris)

Hypersensitivity pneumonitis (HP), is an inflammatory disease that represents one possible response of the interstitial and parenchymal tissue to the intensive and repeated inhalation of organic dusts or reactive chemicals substances. In this case report, for the first time in the literature as we know, acute hypersensitivity pneumonitis in a patient who working in broom grass manufacturing were presented. Broom manufacturer employee 35 years old female patient was admitted with dyspnea, fever and cough, beginning the three months before. Physical examination, there were bilateral basal crackles. On Thorax CT bilateral diffuse ground-glass opacity and mosaic perfusion were observed. Patient was hospitalized, IV prednisolone therapy was started. Almost complete clinical improvement was achieved. We would like to emphasize that detailed occupational history should be questioned; because; diagnosis of acute HP, due to the mixing with the viral infection or atypical pneumonia, easily skipped.

Respiratory arrest due to nitrofurantoin treatment in the absence of pulmonary pathology.

In the case we present, an elderly female patient developed respiratory arrest in the absence of pulmonary pathology after using nitrofurantoin (NF). To our current knowledge, this case is the first in the literature. The patient was monitored on mechanical ventilation, and her condition improved only after discontinuing NF treatment.

Angiotensin-Converting Enzyme Gene Insertion/Deletion Polymorphism in Patients with Pulmonary Thromboembolism

Abstract The aim of the present study is to investigate the relationship between angiotensin-converting enzyme (ACE) gene polymorphism and pulmonary embolism by comparing the frequency of ACE gene polymorphism between cases diagnosed with pulmonary embolism with that of the control group. The study included 73 patients and 73 healthy subjects as the control group. Isolated DNAs were genotyped using the polymerase chain reaction (PCR) method for the identification of the ACE insertion/deletion (I/D) polymorphism. The genotypes were determined according to the bands observed in the agarose gel electrophoresis. The frequency of ID genotype was 39.7 percent, the frequency of insertion/insertion (II) genotype was 17.8 percent, and the frequency of the deletion/deletion (DD) genotype was 42.5 percent in the patient group. In the control group, the frequency of the II genotype was 21.9 percent, the frequency of the ID genotype was 38.4 percent, and the frequency of the DD genotype was 39.7 percent. There were no statistically significant differences between the patient group and the control group in terms of the frequencies of II, ID, and DD genotypes (p > 0.05). The findings of the present study showed no association between ACE gene polymorphism and the risk of developing the pulmonary embolism. Due to the limited number of patients however, these results must be confirmed by further studies incorporating larger series of patients.

Concurrent acute interstitial pneumonia and pulmonary embolism during treatment with peginterferon alpha-2a and ribavirin in a patient with hepatitis C

The case presented is the first patient with concurrent acute interstitial pneumonia and pulmonary embolism associated with combined treatment of peginterferon and ribavirin for hepatitis C.