Nafiye Yilmaz

Effectiveness of pharmacologic therapies on smoking cessation success: three years results of a smoking cessation clinic

BackgroundPharmacologic therapies have an important role in the success of interventions for smoking cessation. This study aims to determine the efficacy of several pharmacologic treatments in patients who applied to a smoking cessation clinic.MethodsThis retrospective study includes 422 patients who presented to our smoking cessation clinic between January 2010 and June 2013, used the pharmacologic treatment as prescribed and completed the one-year follow-up period. All patients were assessed using the Fagerström Test for Nicotine Dependence (FTND) and received both behavioral therapy and pharmacotherapy. Patients’ smoking status at one year was assessed by telephone interview.ResultsThe patients were 24.3% female (103/422) and 75.7% male (319/422) with a mean age of 38 ± 10 years. Patients were divided into three groups: varenicline (166 patients), bupropion (148 patients) and nicotine replacement therapy (108 patients).The smoking cessation rates of these groups were 32.5%, 23% and 52.8%, respectively, and were statistically significant (p > 0.001). The overall success rate was 35%. Further analysis revealed that pharmacologic therapy (p > 0.001) and gender (p = 0.01) were factors that showed statistically significant effects on smoking cessation rates. Males had higher success rates than females. The overall relapse rate was 21.6% and the bupropion group showed the highest relapse rate among treatment groups. Lack of determination emerged as the most important factor leading to relapse.ConclusionNicotine replacement therapy was found to be more effective at promoting abstinence from smoking than other pharmacologic therapies.

Is There a Relationship between Obstructive Sleep Apnea Syndrome Severity and Nesfatin-1?

Background: Obstructive sleep apnea syndrome (OSAS) and obesity frequently occur together. The relationship between increased appetite and obesity is well known; however, despite existing knowledge about the relationship between OSAS and obesity, it is not fully understood. Objectives: This study aimed to evaluate the relationship between OSAS and the appetite-suppressing hormone nesfatin-1 independent of body mass index (BMI). Methods: A total of 134 cases were included in the study; 102 with OSAS (OSAS group) and 32 healthy controls (control group). All cases underwent polysomnography, and nesfatin-1 levels were determined. Results: Nesfatin-1 levels were significantly lower in the OSAS group compared to the control group (3,776.5 ± 204.8 and 4,056.2 ± 101.5 pg/ml, respectively; p < 0.001). In addition, there was a statistically significant negative correlation between nesfatin-1 and the apnea hypopnea index (r = -0.543; p < 0.001). The statistically significant relationship persisted after adjusting for confounding intergroup factors such as age, gender and BMI (p < 0.001). In the OSAS group, there was a statistically significant correlation between nesfatin-1 and neck circumference (r = -0.304; p = 0.02) but not between nesfatin-1 and BMI and waist circumference. There was no statistically significant difference in nesfatin-1 levels between the sexes. Conclusion: OSAS patients have lower nesfatin-1 levels compared to controls, and a greater nesfatin-1 deficit corresponds to an increased severity of OSAS and an increased neck circumference. Replacement therapy may be a potential treatment for obese OSAS patients who have lower nesfatin-1 levels, which may have additional benefits through appetite suppression and weight loss.

Comparison of long-term outcomes of 50 and 100 mg rt-PA in the management of acute pulmonary thromboembolism

Pulmonary thromboembolism (PTE) is a life‐threatening disease. In this study, we aimed to evaluate long‐term outcomes of the use of 50 mg recombinant tissue‐type plasminogen activator (rt‐PA) in the management of PTE in terms of relapse, pulmonary hypertension (PH), mortality and hemorrhage and to compare with the use of 100 mg rt‐PA.

Prostate Cancer Metastasis Presenting as a Solitary Mass in the Lung: Case Report

To demonstrate a case with solitary lung and brain metastasis originating from prostate cancer without bone spread. A 72-year-old male who had previous surgery (radical prostatectomy) for prostate cancer was referred to us with cough, sputum production and chest pain. Radiological examinations showed a mass at the right lower lobe. On PET-CT the lesion confirmed and in addition to this lesion a left parietal lesion suggesting brain metastasis was seen. No lymph node or bone metastasis was detected. Transthoracic biopsy confirmed metastasis of prostate cancer. Without the usual pathway of metastasis, prostate cancer may spread to lung or brain without bone metastases.

Mycobacterium Tuberculosis and Nontuberculous Mycobacteria Coinfection of the Lungs

Tuberculosis is highly prevalent in our country and nontuberculous mycobacteria (NTM) are frequently found in respiratory specimens recently. A 65-year-old woman was admitted with complaints of fever, cough, weight loss, and hemoptysis. On the patients chest radiography an upper lobe cavity in both lungs and consolidation was detected. Acid-fast bacilli 4+ were observed in smear of sputum and culture results M. intracellulare and M. tuberculosis were observed together. The patients treatment was arranged. Through this case, we want to emphasize that tuberculosis and nontuberculous mycobacterial disease can coexist.

Predictive Value of Mean Platelet Volume for Pulmonary Embolism Recurrence

PurposeRecurrence is a major clinical problem in patients with pulmonary embolism and can affect mortality. The decision to discontinue treatment is important for recurrence and is based on patients’ clinical features as well as certain blood parameters. Our aim in this study was to evaluate whether mean platelet volume (MPV) and platelet distribution width (PDW) have utility as new predictive parameters for recurrence and mortality in pulmonary embolism.Materials and MethodsA total of 440 patients with pulmonary embolism underwent computed tomography, Doppler ultrasonography, and echocardiography before and at the conclusion of treatment. Thrombocyte count, MPV, PDW, and D-dimer parameters were also evaluated at the same time points.ResultsMPV and PDW were significantly higher in deceased patients (8.8xa0±xa01.2xa0fl and 17.4xa0±xa00.8) compared to surviving patients (7.7xa0±xa00.9xa0fl and 17xa0±xa00.9) (pxa0<xa00.0001). Initial MPV and PDW were also significantly higher in patients with recurrence (8.4xa0±xa00.7 vs 7.6xa0±xa00.8xa0fl, pxa0<xa00.0001 and 17.3xa0±xa00.8 vs 16.9xa0±xa00.9, pxa0=xa00.002, respectively) than in patients without recurrence. At the end of treatment, MPV was still higher in patients with recurrence compared to patients without recurrence (8.7xa0±xa00.5 and 7.5xa0±xa00.7xa0fl, respectively, pxa0<xa00.0001). MPV values over 8.05xa0fl at the end of treatment predicted recurrence with 91% sensitivity and 77% specificity.ConclusionMPV seems to be an indicator of recurrence in pulmonary embolism and may have utility in the prediction of recurrence. Elevated MPV can also be used to predict mortality in pulmonary embolism.

Recurrent Postpartum Eosinophilic Pneumonia Presenting as Acute Respiratory Distress Syndrome

Eosinophilic pneumonia (EP) is a rare disease of the lung. We aimed to present atypical course of two EP cases. They were admitted to our hospital because of acute respiratory distress syndrome (ARDS) in postpartum period. Eosinophilia was detected in bronchoscopic bronchoalveolar lavage and laboratory examination. In these cases, no spesific cause for eosinophilic pneumonia was determined and steroid treatment was started. After the treatment, the patients were in full recovery which were confirmed by clinical and radiological investigations, readmitted to our clinic with relapses of ARDS. The patients have received regular treatment for 1 year. Our cases were neither fitting the classic definitions of acute eosinophilic pneumonia nor chronic eosinophilic pneumonia. Therefore, we wanted to contribute additional data in the literature by sharing these interesting cases.