The pure effects of obstructive sleep apnea syndrome on cardiac autonomic functions: heart rate turbulence analysis.

OBJECTIVES: To demonstrate the pure effect of obstructive sleep apnea syndrome (OSAS) on cardiac autonomic function (CAF) using heart rate turbulence (HRT) parameters. PATIENTS AND METHODS: A total of 64 patients with OSAS and 30 age- and gender-matched healthy subjects were enrolled. All subjects had normal coronary arteries and were free from diabetes mellitus (DM) and hypertension (HT). The HRT parameters (TO, turbulence onset; TS, turbulence slope) were obtained from 24-h ambulatory electrocardiogram (ECG) recordings. HRT parameters were compared between groups, and the relationship between HRT and the apnea-hypopnea index (AHI) was examined. RESULTS: No between-group differences were found in age or gender. Mean TO was significantly higher in the OSAS group than in healthy controls (0.89 ± 0.5, -0.08 ± 0.26; p < 0.001; respectively). The mean TS did not differ between the two groups (2.81 ± 3.06 versus 3.14 ± 2.33; p = 0.212). The AHI was positively correlated with TO (r = 0.845, p < 0.001). The multiple logistic regression analysis revealed that after adjustment for other variables, TO was a significant and independent predictor of AHI, OR 2.394 (95% CI: 1.596-3.591). CONCLUSIONS: HRT (TO in particular) is correlated with AHI. Thus, impaired HRT may be an important factor underlying the occurrence of arrhythmia and sudden cardiac death in patients with OSAS.

Another advantage of nasal septal suturing: pulmonary function unaffected.

BACKGROUND: Nasal packing (NP) after septoplasty has some negative aspects. The nasal septal suture (NSS) is therefore becoming increasingly preferred. OBJECTIVE: The aim of this study was to analyze the effects of NSS and NP on pulmonary function tests. METHODS: Sixty patients who suffered from nasal blockage resulting from nasal septal deviation and who were otherwise healthy were included. Patients were randomized into two groups, NP or NSS. Pre-operative spirometry was performed for all patients. The NP group received a finger glove packing for two days after septoplasty, whereas no additional dressing was used for the NSS group. Narcotic analgesics were not used for pain relief after septoplasty in either group. Spirometry was performed post-operatively on the third day for all patients and before removal of the NP for the NP group. RESULTS: We observed statistically significant differences between pre-operative and post-operative values of forced vital capacity (FVC; p = 0.008), forced expiratory volume in the first second (FEV1; p = 0.006), and forced expiratory flow ((FEF)25-75%; p = 0.011) in the NP group. In comparison, pre-operative and post-operative values did not differ for FVC, FEV1, FEV1/FVC%, and FEF25-75% in the NSS group. CONCLUSION: NP negatively influenced pulmonary function based on spirometric parameters, while NSS did not.

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.

Are official reports sufficient? Official registration rates of patients with tuberculosis in Sivas, Middle Anatolia.

PURPOSE: The main goal of this retrospective study was to re-evaluate all available records of clinical and laboratory data of patients with tuberculosis (TB) in Sivas province, Middle Anatolia, Turkey. METHODS: TB registration data held at health institutions in Sivas province were compared and matched with data obtained from the local official TB registries from January 2000 to December 2001. RESULTS: Of the 536 TB cases found in 2000 and 2001, 255 (47.6%) were officially registered. Of the 127 cases with smear-positive pulmonary TB (PTB), only nine cases labelled as smear-positive were registered in local dispensaries. The incidence of unregistered cases with smear-positive PTB found by this study was approximately 40-fold and eightfold greater than the incidence of registered cases for 2000 and 2001, respectively. CONCLUSION: There were many more unofficially recorded TB patients compared with officially recorded cases in Sivas province between 2000 and 2001. The results of this study are disappointing and alarming for Turkey's national TB control programme, at least for its regional applications.