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1.
Cureus ; 16(1): e51458, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38298278

ABSTRACT

With the onset of the pandemic in 2020, COVID-19 pneumonia has become a common cause for hospitalization and is associated with high mortality rates. Inflammatory biomarkers play a crucial role in understanding and monitoring the progression of various diseases, including COVID-19. The objective of this study was to assess the significance of sequentially monitored standard laboratory tests, including complete blood cell count, D-dimer, fibrinogen, ferritin, albumin, C-reactive protein (CRP), as well as newly calculated inflammatory biomarkers in predicting the severity and prognosis of COVID-19 pneumonia. This single-center retrospective study included 194 patients hospitalized due to COVID-19 pneumonia. Patients were grouped based on the severity of their clinical symptoms, with 134 categorized as severe disease and 60 as mild-moderate disease. The patients' demographic data and laboratory values at hospital admission and on the third day of hospitalization were comparatively evaluated. In the severe illness group, there were more complaints about shortness of breath and a significant drop in the SPO2 value was observed at the time of application (p =0.005 and p<0.001, respectively). The overall mortality rate in all patients was 9% (18/194), and all deaths occurred within the severe disease group. All laboratory parameters, with the exception of platelet count and ferritin levels, were significantly associated and correlated with the severity of the disease during the hospitalization period. Among the biomarkers, there was no significant difference in neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) on the first day, a significant increase was observed on the third day of hospitalization in the severe disease group (p=0.050 vs. 0.003 and p=0.073 vs. 0.020, respectively). No significant difference was observed only in the PNR (platelet/neutrophil ratio) value among the inflammatory biomarkers (p=0.090 vs. p=0.354). In conclusion, the SPO2 level of COVID-19 patients at admission and the subsequent laboratory parameters examined show a significant relationship with the severity of the disease. In addition, simple inflammation biomarkers derived from laboratory values have shown a very significant relationship and correlation in the diagnosis and follow-up of the disease. In both admission and follow-up evaluation, a more significant association was observed with CRP-related biomarkers such as CRP/albumin ratio and CRP/lymphocyte ratio rather than NLR and PLR, which are widely used in the literature, in showing the severity of COVID-19. In patients with pneumonia, the laboratory assessment made on the third day of hospitalization reflects the severity of the disease more clearly than on the first day.

2.
Genes Immun ; 25(1): 14-42, 2024 02.
Article in English | MEDLINE | ID: mdl-38123822

ABSTRACT

The COVID-19 pandemic remains a significant public health concern despite the new vaccines and therapeutics. The clinical course of acute SARS-CoV-2 infection is highly variable and influenced by several factors related to the virus and the host. Numerous genetic studies, including candidate gene, exome, and genome sequencing studies, genome-wide association studies, and other omics efforts, have proposed various Mendelian and non-Mendelian associations with COVID-19 course. In this study, we conducted whole-exome sequencing on 90 unvaccinated patients from Turkey with no known comorbidities associated with severe COVID-19. Of these patients, 30 had severe, 30 had moderate, and 30 had mild/asymptomatic disease. We identified rare variants in genes associated with SARS-CoV-2 susceptibility and pathogenesis, with an emphasis on genes related to the regulation of inflammation, and discussed these in the context of the clinical course of the patients. In addition, we compared the frequencies of common variants between each group. Even though no variant remained statistically significant after correction for multiple testing, we observed that certain previously associated genes and variants showed significant associations before correction. Our study contributes to the existing literature regarding the genetic susceptibility to SARS-CoV-2. Future studies would be beneficial characterizing the host genetic properties in different populations.


Subject(s)
COVID-19 , Humans , COVID-19/genetics , SARS-CoV-2 , Exome Sequencing , Genome-Wide Association Study , Pandemics , Disease Progression
3.
Tuberk Toraks ; 71(4): 428-432, 2023 Dec.
Article in English | MEDLINE | ID: mdl-38152013

ABSTRACT

Sevoflurane is a commonly used inhalational anesthetic agent for inducing and maintaining general anesthesia. However, it has been associated with a rare but serious pulmonary condition known as diffuse alveolar hemorrhage (DAH). DAH is characterized by decreased hemoglobin levels, diffuse pulmonary infiltration, and respiratory failure with hypoxemia. We present a case of DAH in a healthy young adult who experienced this condition following general anesthesia with inhaled sevoflurane during an uncomplicated orthopedic procedure. Notably, there were no other risk factors or known causes that could account for the development of DAH in this patient.


Subject(s)
Anesthesia , Lung Diseases , Young Adult , Humans , Sevoflurane/adverse effects , Pulmonary Alveoli , Hemorrhage/chemically induced , Lung Diseases/complications , Anesthesia/adverse effects
4.
Sarcoidosis Vasc Diffuse Lung Dis ; 40(4): e2023044, 2023 Dec 20.
Article in English | MEDLINE | ID: mdl-38126501

ABSTRACT

Interstitial lung disease (ILD) is a common complication that can develop during the course of systemic sclerosis (SSc). Nindetanib is an antifibrotic drug approved for the treatment of systemic sclerosis-associated interstitial lung disease. Although there is an insufficient data on the development of pneumothorax, the safety of Nintedanib treatment is also uncertain. We observed recurrent resistant pneumothorax under nintedanib treatment in a patient with systemic sclerosis-associated interstitial lung disease. Nintedanib use may increase the risk of developing refractory pneumothorax. Ssc patients who are started on nintedanib should be followed carefully for pneumothorax.

5.
Nucl Med Commun ; 44(12): 1067-1073, 2023 Dec 01.
Article in English | MEDLINE | ID: mdl-37779448

ABSTRACT

OBJECTIVE: The aim of this study is to analyze the frequency of lung injury and the sensitivity of the diethylenetriamine penta-acetic acid (DTPA) clearance test in detecting lung injury in patients undergoing radiotherapy (RT) to the thorax. MATERIAL AND METHOD: Twenty individuals scheduled for RT for lung cancer were included as the patient group. The healthy control group consisted of 20 age and gender-matched individuals who were nonsmokers with no history of comorbidities. We conducted follow-up with patients at 0-1-6 months, performing carbon monoxide diffusion test (DLCO), DTPA clearance test (excluding the first month), and high-resolution computed tomography of the thorax. The control group was followed up with DLCO between the baseline and 6th months. RESULTS: Ninety percent of the patient group was male, and the median age was 62 years. Seventy percent of the patients had squamous cell carcinoma and adenocarcinoma. Pneumonitis was detected in the patient group in the first month (100%) and fibrosis in the sixth month (%100) Both at the beginning and in the sixth month, the DLCO values of patients who received RT were lower than those of the control group ( P  = 0.001 and P  < 0.001, respectively). While DTPA clearance was similar between irradiated and non-radiated lungs at the beginning, there was a substantial decrease in the irradiated lung in the sixth month( P  = 0.001). There was no significant correlation between malignancy type, RT dose, and tumor size( P  > 0.05). CONCLUSION: The DTPA clearance test could be an alternative method for demonstrating radiation injury in patients receiving RT.


Subject(s)
Lung Injury , Lung Neoplasms , Pulmonary Fibrosis , Radiation Injuries , Humans , Male , Middle Aged , Lung Neoplasms/complications , Lung Neoplasms/radiotherapy , Lung Neoplasms/drug therapy , Pulmonary Fibrosis/pathology , Lung Injury/pathology , Lung/pathology , Technetium Tc 99m Pentetate
6.
Tuberk Toraks ; 71(1): 34-40, 2023 Mar.
Article in English | MEDLINE | ID: mdl-36912407

ABSTRACT

Introduction: The genetic risk factors for Coronavirus disease-2019 (COVID19)-associated pulmonary fibrosis (CAPF) are not clearly defined. Mutations in the genes encoding telomerase reverse transcriptase (TERT) and mucin 5B (MUC5B) are well-known genetic risk factors for pulmonary fibrosis. In this study, we aimed to show whether the most common proven mutations of pulmonary fibrosis affect the development of CAPF. Materials and Methods: Forty-eight patients who were matched for age, gender, COVID-19 disease severity, and respiratory support type and needed high flow nasal cannula, non-invasive mechanical ventilator, or invasive mechanical ventilator due to COVID-19 were followed up prospectively. Eighteen patients were excluded from the follow-up due to known structural lung disease, collagen tissue disease, and occupational exposure to fibrosis. The patients were called for follow-up three months after discharge, and CT was performed. Those with fibrosis (n= 15) in the third-month follow-up CT were included in the CAPF group, and those with complete resolution (n= 15) were included in the control group. Blood samples were taken for genetic analysis. Result: TERT gene study revealed that six (40%) of the fibrosis group was normal, while five were heterozygous (33.3%). MUC5B polymorphism was not detected in 10 (66.7%) of the fibrosis group. Conclusions: Individuals with TERT mutations may be at a higher risk for CAPF. Further studies are needed to clarify the genetic risk factors for CAPF.


Subject(s)
COVID-19 , Mucin-5B , Pulmonary Fibrosis , Telomerase , Mucin-5B/genetics , Telomerase/genetics , Humans , COVID-19/complications , COVID-19/genetics , COVID-19/pathology , Pulmonary Fibrosis/genetics , Middle Aged , Male , Female
7.
J Vasc Nurs ; 41(1): 22-26, 2023 03.
Article in English | MEDLINE | ID: mdl-36898801

ABSTRACT

BACKGROUND AND AIM: Subcutaneous administration may result in complications such as bruising and pain at the injection site. This study was performed as in order to determine the effect of cold application and compression on pain and bruising in subcutaneous heparin injection. METHODS: The study was a randomized controlled trial. 72 patients were included in the study. Each patient in the sample was both experimental (cold and compression) and control groups and 3 different parts of abdomen were used for injection of each patient. The data of the research were collected by using Patient Identification Form, Subcutaneous Heparin Observation Form and Visual Analog Scale (VAS). RESULTS: In the study, it was observed that after heparin injection, ecchymosis developed in 16.4%, 28.8%, and 54.8% of the patients, respectively, and pain was experienced during injection in 12.3%, 43.5%, and 44.2% of the patients, respectively, on the pressure, cold application, and control site groups, and this difference was statistically significant (p<0.001). CONCLUSION: In the study, it was found that bruising size of the compression group was smaller in contrast with the other groups. When the VAS mean was examined for the groups, it was found that the patients in the compression group had lower pain than the other groups. In order to prevent complications that may arise in nurses' subcutaneous heparin injections and to increase the quality of patient care, it may be recommended to transfer the 60-second compression application after subcutaneous heparin applications to clinical applications and to conduct studies comparing compression and cold application with other applications for future studies.


Subject(s)
Contusions , Heparin , Pressure , Heparin/administration & dosage , Injections, Subcutaneous , Pain/etiology , Contusions/complications , Contusions/prevention & control
8.
Holist Nurs Pract ; 37(1): E14-E23, 2023.
Article in English | MEDLINE | ID: mdl-36378093

ABSTRACT

Dyspnea is a common symptom and anxiety is a common comorbidity of chronic obstructive pulmonary disease (COPD). They affect individuals with COPD in a multifaceted way, causing many disabilities. Progressive relaxation exercises (PREs) are an important intervention in reducing symptoms and comorbidity. The aim of this study was to determine the effects of PREs on dyspnea and anxiety levels in individuals with COPD. A pretest-posttest randomized controlled trial was conducted at the chest diseases clinic of a university hospital in Turkey. Forty-four patients with COPD who met the inclusion criteria for participation in the study were assigned either to an intervention or a control group, with 22 patients in each group. In the intervention group, the patients performed PREs once a day for 4 weeks in addition to the standard treatment. The patients in the control group received the standard treatment. In the data collection stage of the study, questionnaire forms, namely, the Modified Borg Scale (MBS), Modified British Medical Research Council Dyspnea Scale, COPD Assessment Test (CAT), and Beck Anxiety Inventory (BAI), were used. Data were collected before (the first follow-up) and after the intervention (the second follow-up). In the second follow-up, the MBS, BAI, and CAT scores decreased significantly in the intervention group (P < .05) but showed no significant changes in the control group (P > .05). This study demonstrates that PREs can reduce dyspnea and anxiety levels in individuals with COPD.


Subject(s)
Autogenic Training , Pulmonary Disease, Chronic Obstructive , Humans , Dyspnea/etiology , Dyspnea/therapy , Pulmonary Disease, Chronic Obstructive/complications , Pulmonary Disease, Chronic Obstructive/therapy , Comorbidity , Anxiety/etiology , Anxiety/therapy , Quality of Life
9.
Turk J Med Sci ; 53(5): 1301-1311, 2023.
Article in English | MEDLINE | ID: mdl-38812999

ABSTRACT

Background/aim: It is known that the correlation of pulmonary function tests (PFT) with muscle dysfunction is insufficient. Here, we aimed to evaluate the diaphragm functions in individuals with Friedreich's ataxia (FRDA) and to examine its relationship with respiratory parameters and disease severity. Materials and methods: This prospective study, conducted between November and December 2022, at Erciyes University, included 14 individuals with genetically confirmed FRDA and an age- and gender-matched healthy control group of eight individuals. We examined pulmonary functions with spirometric methods and evaluated diaphragm excursion, and diaphragm thickness-expiratory (Tde) and - end of inspiration (Tdi) with ultrasonography during calm breathing. Thickening fraction (TF) calculated. Also, we examined PaCO2 at rest. The neurological status of individuals was assessed using the Scale for the Assessment and Rating of Ataxia (SARA). Results: The mean values of FEV1(lt), FEV1(%), FVC (lt), and FVC (%) were higher in the control group (p; <0.001, 0.013, <0.001, and 0.009, respectively). Also, mean Tdi, Tde, excursion and TF were lower in the FRDA group compared to the control group (p = 0.005, 0.294,0.005, and 0.019, respectively). The mean excursion value was 1.13 ± 0.54cm in the FRDA group and 1.71 ± 0.49cm in the control group. There is a strong, negative, and statistically significant correlation between SARA total score with excursion and TF (r = -0.7432, p = 0.002; r = -0.697, p = 0.008). There is no statistically significant relationship between excursion and BMI, standing-to-supine decrease in FVC, FEV1, and PaCO2. Also, the relationship between maximal inspiratory pressure (PImax) and excursion was moderate. Conclusion: Diaphragm ultrasound may reveal respiratory dysfunction better than PFT. Diaphragm excursion and TF are associated with disease scores in individuals with FDRA. Further studies are needed regarding the detection of alveolar hypoventilation.


Subject(s)
Diaphragm , Friedreich Ataxia , Respiratory Function Tests , Ultrasonography , Humans , Friedreich Ataxia/physiopathology , Friedreich Ataxia/diagnostic imaging , Diaphragm/physiopathology , Diaphragm/diagnostic imaging , Male , Female , Ultrasonography/methods , Prospective Studies , Adult , Young Adult , Spirometry , Case-Control Studies
11.
Sarcoidosis Vasc Diffuse Lung Dis ; 39(1): e2022006, 2022.
Article in English | MEDLINE | ID: mdl-35494165

ABSTRACT

Introduction: The aim of our study is to investigate the etiological distribution of ILD in Turkey by stratifying the epidemiological characteristics of ILD cases, and the direct cost of initial diagnosis of the diagnosed patients. Material-Method: The study was conducted as a multicenter, prospective, cross-sectional, clinical observation study. Patients over the age of 18 and who accepted to participate to the study were included and evaluated as considered to be ILD. The findings of diagnosis, examination and treatment carried out by the centers in accordance with routine diagnostic procedures were recorded observationally. Results: In total,1070 patients were included in this study. 567 (53%) of the patients were male and 503 (47%) were female. The most frequently diagnosed disease was IPF (30.5%). Dyspnea (75.9%) was the highest incidence among the presenting symptoms. Physical examination found bibasilar inspiratory crackles in 56.2 % and radiological findings included reticular opacities and interlobular septal thickenings in 55.9 % of the cases. It was observed that clinical and radiological findings were used most frequently (74.9%) as a diagnostic tool. While the most common treatment approaches were the use of systemic steroids and antifibrotic drugs with a rate of 30.7% and 85.6%, respectively. The total median cost from the patient's admission to diagnosis was 540 Turkish Lira. Conclusion: We believe that our findings compared with data from other countries will be useful in showing the current situation of ILD in our country to discuss this problem and making plans for a solution.

12.
Balkan Med J ; 39(2): 148-152, 2022 03 14.
Article in English | MEDLINE | ID: mdl-35330566

ABSTRACT

Background: Direct oral anticoagulants (DOACs) have been used in acute pulmonary thromboembolism as an alternative to warfarin due to drug interactions, narrow therapeutic range, and necessary close International Normalized Ratio (INR) monitoring. Phase 3 study results have reported that these drugs are at least as effective as warfarin and beneficial in terms of bleeding; however, studies that present up-to-date life data are necessary. Aims: To evaluate the frequency of using DOACs, which are prescribed with a limited number of indications in our country, and real-life data results. Study Design: Cross-sectional study. Methods: This cross-sectional survey collected the clinical data (history, current treatment, treatment duration, etc.) of patients with pulmonary thromboembolism and who applied to the physician for follow-up between October 15, 2019, and March 15, 2020. The researchers kept the patient records sequentially. Results: Data from 836 patients with acute pulmonary thromboembolism from 25 centers were collected, and DOAC was used in 320 (38.5%) of them. The most preferred DOAC was rivaroxaban (n = 294, 91.9%). DOAC was mostly preferred because it could not provide an effective INR level with warfarin (n=133, 41.6%). Bleeding was observed in 13 (4%) patients. Conclusion: The use of direct oral anticoagulants is becoming almost as widespread as conventional therapy. Real-life data results are important for their contribution to clinical practice.


Subject(s)
Anticoagulants , Pulmonary Embolism , Acute Disease , Administration, Oral , Anticoagulants/administration & dosage , Anticoagulants/adverse effects , Cross-Sectional Studies , Hemorrhage/chemically induced , Hemorrhage/epidemiology , Humans , Pulmonary Embolism/drug therapy , Pyrazoles/therapeutic use , Retrospective Studies , Turkey , Warfarin/administration & dosage , Warfarin/adverse effects
13.
Tuberk Toraks ; 69(4): 477-485, 2021 Dec.
Article in English | MEDLINE | ID: mdl-34957741

ABSTRACT

INTRODUCTION: This study aimed to compare two groups of patients with Chronic Obstructive Lung Disease (COPD) and blood eosinophil values of ≥300 cells/ µL. The patients were followed up for one year in two groups, one receiving inhaled corticosteroids (ICS) and the other not receiving ICS in terms of exacerbation rates, the incidence of pneumonia, mortality rates, FEV1, FVC and FEF25-75 changes, the COPD Assessment Test (CAT) and modified Medical Research Council (mMRC) dyspnea scores. MATERIALS AND METHODS: Stable patients, who presented to the University Medical Faculty Chest diseases outpatient clinic and diagnosed with COPD according to pulmonary function test results and GOLD stages 2-4 according to the 2017 GOLD criteria and with blood eosinophil counts of ≥ 300 cells/ µL were included in the study. RESULT: 85 patients were included in the study, of which 76.5% (n= 65) were males. There were no significant differences between the 38 patients receiving ICS and the 47 patients not receiving ICS regarding baseline FEV1, FVC, FEF25- 75 absolute values and percentages, and FEV1, FVC values controlled at month six and month 12, and FEF25-75 absolute values and percentages at month six (p> 0.05). However, the difference between the baseline and month 12 absolute values and percentages of FEF25-75 was statistically significant, and the decrease from baseline was greater in the group receiving ICS (p< 0.05). The difference in CAT and mMRC scores were statistically significant at month six and month nine in favor of the group receiving ICS (p< 0.05). The median number of moderate and severe exacerbations were both one (min: 0, max:3) in the group receiving ICS (n= 38) and in the one not receiving ICS (n= 47). The difference of exacerbation rates in both groups were not statistically significant (p> 0.05). CONCLUSIONS: In this study, it was determined that exacerbation rates of eosinophilic COPD patients did not differ depending on the use of ICS in a one-year period. Nevertheless, the 12-month FEF25-75 values of patients not using ICS were lower to a lesser extent, while the CAT and mMRC scores improved in favor of ICS users at different months in the one-year follow-up.


Subject(s)
Eosinophilia , Pulmonary Disease, Chronic Obstructive , Administration, Inhalation , Adrenal Cortex Hormones/therapeutic use , Humans , Male , Pulmonary Disease, Chronic Obstructive/drug therapy , Pulmonary Disease, Chronic Obstructive/epidemiology , Treatment Outcome
14.
Turk J Med Sci ; 51(6): 3001-3007, 2021 12 13.
Article in English | MEDLINE | ID: mdl-34773691

ABSTRACT

Background/aim: There is limited information about peripheral blood eosinophilia (PBE) and airway obstruction in sarcoidosis. Since pulmonary sarcoidosis affects the airways, it is often confused with asthma. The aims of the study are to investigate airway obstruction and PBE in sarcoidosis patients and to examine the similarity of clinical presentation with asthma. Materials and methods: The patients matching the ATS/ERS/WASOG diagnosis criteria and were between 18 and 80 years of age were included consecutively between 2018 and 2020. Other diseases causing granulomas were excluded. Results: A total of 84 patients were included of which 26 (31%) had a PBE level of ≥300 µL with no significant difference seen between sarcoidosis stage and PBE (p > 0.05). A significant (p < 0.05) decrease was only seen in FEV1 as the stage of sarcoidosis progressed. Respectively 31 (36.9%), 12 (14.3%) and 4 (4.8%) patients had an obstructive, restrictive and mixed respiratory function disorder. Twenty-four (28.6%) subjects with sarcoidosis had history of asthma. Spring fever, eczema, and skin/nose allergy were noticed in 17 (20.2%) of the patients. Conclusion: Mild PBE may be seen in sarcoidosis. Patients applying with PBE, airway obstruction, bronchial hyperreactivity along with spring fever, eczema, skin/nose allergy, wheezing, chest tightness, shortness of breath and cough may be also evaluated in terms of sarcoidosis.


Subject(s)
Airway Obstruction/etiology , Eosinophilia/epidemiology , Pulmonary Disease, Chronic Obstructive/epidemiology , Sarcoidosis/complications , Adolescent , Adult , Aged , Aged, 80 and over , Airway Obstruction/epidemiology , Asthma/complications , Asthma/epidemiology , Eczema , Eosinophilia/complications , Female , Humans , Male , Middle Aged , Respiratory Function Tests , Sarcoidosis/epidemiology
15.
Turk J Med Sci ; 51(4): 1953-1959, 2021 08 30.
Article in English | MEDLINE | ID: mdl-33932968

ABSTRACT

Background/aim: The efficacy of mepolizumab has been largely demonstrated in clinical trials in patients with severe eosinophilic asthma (SEA). However, reports on experience with mepolizumab in a real-life cohort are limited. Moreover, data about the effectiveness of mepolizumab on small airways is scarce. This study evaluated the effectiveness of mepolizumab therapy on symptoms, asthma exacerbations, blood eosinophils, steroid dependence, and small airways in a real-life cohort of patients with SEA. Materials and methods: We retrospectively analyzed patients with SEA who were receiving fixed-dose mepolizumab. The effects of mepolizumab on clinical, laboratory, functional parameters were evaluated at 12th, 24th, and 52nd weeks. Small airways were assessed with the FEF 25-75. Results: A total of 41 patients were enrolled in the study. Mepolizumab significantly reduced asthma exacerbation rates, reduced mOCS dose, and improved asthma control test (ACT) scores at 12th, 24th, and 52nd weeks. However, we found no significant changes in FEV1 and FEF25-75 values at baseline, 12th, 24th, and 52nd weeks (78.9 ± 23.3%, 82.9 ± 23.4%, 81.9 ± 23.9%, and 78.9 ± 23.5% for FEV1; 45.1 ± 23.1%, 48.8 ± 23.5%, 48.7 ± 23.1%, and 41.0 ± 20.1% for FEF25-75, respectively) Conclusion: In this study, mepolizumab significantly improved all outcomes (symptom scores, asthma exacerbations, OCS sparing, and blood eosinophils) except functional parameters. Still, despite the dose reduction in mOCS dosage, no significant deterioration was observed in FEV1 and FEF25-75 values.


Subject(s)
Antibodies, Monoclonal, Humanized/therapeutic use , Asthma/drug therapy , Steroids/therapeutic use , Adult , Antibodies, Monoclonal, Humanized/administration & dosage , Female , Humans , Male , Middle Aged , Respiratory Function Tests , Retrospective Studies , Steroids/administration & dosage
16.
Turk J Med Sci ; 51(6): 3001-3007, 2021 Dec.
Article in English | MEDLINE | ID: mdl-36161645

ABSTRACT

BACKGROUND: There is limited information about peripheral blood eosinophilia (PBE) and airway obstruction in sarcoidosis. Since pulmonary sarcoidosis affects the airways, it is often confused with asthma. The aims of the study are to investigate airway obstruction and PBE in sarcoidosis patients and to examine the similarity of clinical presentation with asthma. METHODS: The patients matching the ATS/ERS/WASOG diagnosis criteria and were between 18 and 80 years of age were included consecutively between 2018 and 2020. Other diseases causing granulomas were excluded. RESULTS: A total of 84 patients were included of which 26 (31%) had a PBE level of ≥300 µL with no significant difference seen between sarcoidosis stage and PBE (p > 0.05). A significant (p < 0.05) decrease was only seen in FEV1 as the stage of sarcoidosis progressed. Respectively 31 (36.9%), 12 (14.3%) and 4 (4.8%) patients had an obstructive, restrictive and mixed respiratory function disorder. Twenty-four (28.6%) subjects with sarcoidosis had history of asthma. Spring fever, eczema, and skin/nose allergy were noticed in 17 (20.2%) of the patients. DISCUSSION: Mild PBE may be seen in sarcoidosis. Patients applying with PBE, airway obstruction, bronchial hyperreactivity along with spring fever, eczema, skin/nose allergy, wheezing, chest tightness, shortness of breath and cough may be also evaluated in terms of sarcoidosis.


Subject(s)
Airway Obstruction , Asthma , Eczema , Eosinophilia , Pulmonary Disease, Chronic Obstructive , Sarcoidosis , Airway Obstruction/complications , Airway Obstruction/epidemiology , Asthma/complications , Asthma/epidemiology , Eczema/complications , Eosinophilia/complications , Eosinophilia/epidemiology , Humans , Pulmonary Disease, Chronic Obstructive/complications , Pulmonary Disease, Chronic Obstructive/epidemiology , Sarcoidosis/complications , Sarcoidosis/epidemiology
17.
Cureus ; 12(8): e9989, 2020 Aug 24.
Article in English | MEDLINE | ID: mdl-32983689

ABSTRACT

While the definitive diagnosis of the coronavirus disease 19 (COVID-19) is mainly made by the polymerase chain reaction (PCR), some PCR-negative cases are diagnosed typically by a computed tomography (CT) scan's radiology. However, there are many different infectious and non-infectious diseases that have radiology like COVID-19. We are presenting a case of a patient having symptoms and a CT scan radiology comparable to that of COVID-19 and also having eosinophilia. The patient was initially diagnosed and treated as a COVID-19 patient. The patient stated that she had always complained of having dyspnea and cough, but it had increased even more in the past few days. Her thorax CT revealed bilateral ground-glass opacities with upper lobe predominance, which was reported as highly compatible with COVID-19 by radiologists. COVID-19 PCR result was negative twice. In laboratory results, eosinophil count was 2,850/mm3 and total Ig was 768 IU/mL. However, when the laboratory values and the radiological findings were combined with the patient's history, COVID-19 was excluded and the chronic eosinophilic pneumonia was accepted as a diagnosis. Clinicians more focused on COVID-19 while questioning the patients and while evaluating the laboratory and the radiological findings make it easier to miss other infectious and non-infectious diseases. Assessing the complete blood count result, focusing on the lymphocyte value, also makes it easy to skip eosinophilia.

19.
Turk J Med Sci ; 50(4): 910-916, 2020 06 23.
Article in English | MEDLINE | ID: mdl-32394685

ABSTRACT

Background/aim: Sensitivity and symptoms related to animal proteins have been investigated in various occupational groups. However, data from horse farm workers are limited. We aimed to determine horse allergen sensitivity in the horse farm workers, and to evaluate its relationship with respiratory symptoms and functional parameters. Materials and methods: A total of 110 subjects were enrolled in the study. The study group consisted of 80 horse farm workers. Face-to-face surveys, skin prick tests (SPT), and pulmonary function tests (PFT) were performed in the study group. Control group consisted of 30 healthy subjects. SPT and PFTs were also performed for control group. The SPT test results of the horse farm workers were compared with the SPT results provided from the medical records of 1376 subjects who admitted to the outpatient clinic with respiratory symptoms. Results: Atopy rate was significantly higher in horse farm workers than in healthy subjects (41% and 13%, respectively; P = 0.008). Horse allergen sensitivity was positive 8/80 (10%) in horse farm workers, 0/30 in healthy subjects, and 32/1376 (2%) in medical records of subjects who were admitted to the outpatient clinic with respiratory symptoms. (P = 0.07, P = 0.001, respectively). There was no statistically significant relationship between respiratory symptoms and horse allergen sensitivity in horse farm workers (P = 0.67). However, mean FEV1 ratios were lower in horse farm workers with horse allergen sensitivity than healthy subjects (88.6% ± 17.9, 103.7 ± 10, P = 0.031, respectively). Conclusion: Atopy and animal allergen sensitization were significantly higher in horse farm workers, suggesting the relationship between the intensity of specific allergen exposure and the sensitization to this specific allergen.


Subject(s)
Allergens/immunology , Animal Husbandry , Horses , Hypersensitivity/immunology , Occupational Diseases/immunology , Symptom Assessment , Adult , Animals , Case-Control Studies , Female , Humans , Male , Respiratory Function Tests , Skin Tests
20.
Turk J Med Sci ; 50(2): 433-441, 2020 04 09.
Article in English | MEDLINE | ID: mdl-32093447

ABSTRACT

Background/aim: Oral corticosteroid (OCS)-dependent severe eosinophilic asthma with chronic rhinosinusitis with nasal polyps (SEA-CRSwNP) would be a suitable phenotype for mepolizumab treatment. This study evaluated the short-term efficacy of mepolizumab treatment in OCS-dependent SEA-CRSwNP. Materials and methods: Baseline and 24th week results [daily OCS doses, asthma exacerbation frequency, asthma control test (ACT) scores, blood eosinophil levels, FEV1 values, and numerical analog scale (NAS) of CRSwNP symptoms] of patients who were treated for at least 24 weeks with mepolizumab were retrospectively evaluated and compared. Results: A total of 16 patients were enrolled in the study. Mepolizumab was discontinued in one patient due to side effects. The daily OCS dosage was reduced from baseline in all patients, and at week 24 OCS was discontinued in 40% of the patients (baseline mean steroid dose: 9.2 ± 5.2 mg, 24th week: 1.3 ± 1.4 mg; P < 0.001). The number of asthma exacerbations within 24 weeks significantly decreased after beginning mepolizumab treatment (2.1 ± 2.7 vs. 0.07 ± 0.26; P = 0.012), and a significant increase in ACT scores (baseline mean ACT: 18 ± 5.7; 24th week mean ACT: 23.3 ± 3; P = 0.006) was observed despite the decrease in daily OCS dosages. There was no significant difference in FEV1 values between baseline and week 24. Evaluation of the general symptoms of CRSwNP, as per NAS, revealed that the baseline mean NAS was 5.6 ± 4.4, and the 24th week mean NAS was 3.2 ± 3.2 (P = 0.021). Conclusion: This is the first real-life study evaluating the short-term efficacy of mepolizumab treatment on OCS-dependent SEA-CRSwNP. This study demonstrates that mepolizumab is an effective and safe biologic for the treatment of this severe asthma subphenotype.


Subject(s)
Adrenal Cortex Hormones/therapeutic use , Antibodies, Monoclonal, Humanized/therapeutic use , Asthma/drug therapy , Eosinophilia/drug therapy , Nose Diseases/complications , Adult , Asthma/complications , Chronic Disease , Eosinophilia/complications , Female , Humans , Male , Middle Aged , Retrospective Studies , Treatment Outcome
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