Tüberküloz ve toraks
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Tüberküloz ve toraks · Jan 2011
Comparative Study[The comparison of patients with hospitalized health-care-associated pneumonia to community-acquired pneumonia].
Health-care-associated pneumonia (HCAP) is defined as pneumonia that develops in patients with a history of recent hospitalization, hemodialysis as an outpatient, residence in a nursing home, outpatient intravenous therapy and home wound care. We aimed to compare the initial demographic characteristics, causative agents and prognosis between hospitalized HCAP and community-acquired pneumonia (CAP) patients. HCAP and CAP patients hospitalized between 01 September 2008-01 September 2009 were evaluated retrospectively. ⋯ The duration of hospitalization (14.4 ± 11.4 vs. 10.7 ± 7.9 days, p= 0.011) and mortality rate (34.7% vs. 9.0%, p< 0.001) were higher in HCAP compared with CAP patients. As HCAP is different than CAP in terms of patients' characteristics, causative microorganisms and prognosis, it should be considered in all patients hospitalized as CAP. Potentially drug-resistant microorganisms should be taken into consideration in the empirical antibiotic treatment of these patients.
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Tüberküloz ve toraks · Jan 2011
Case Reports[Fondaparinux treatment in heparin induced thrombocytopenia:a case report].
Heparin induced thrombocytopenia is a serious complication of heparin therapy that has a high levels of morbidity and mortality due to thrombotic complications. Heparin induced thrombocytopenia usually develops between days 5 and 14 (inclusive) following initiation of heparin. ⋯ In this manuscript, we presented a case diagnosis with heparin induced thrombocytopenia who was given low molecular weight heparin for prophylaxis. We tried to make an overview of new treatment choices along with current literature.
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Tüberküloz ve toraks · Jan 2011
Review Case ReportsAn unusual case of foreign body aspiration and review of the literature.
Tracheobronchial foreign body aspiration is a health problem that can be seen in all age groups, and it requires urgent diagnosis and intervention. We report a case of an unusual foreign body aspiration in a laryngectomized patient and we aim to discuss this situation according to the literature. A 72-year-old man, who underwent total laryngectomy 7 years ago for a squamous cell carcinoma of the larynx, was reported with complaint of aspiration of a silicone tracheostomy canula. ⋯ Treatment timing and methods are important to prevent the complications. Flexible bronchoscopy can be used for the diagnose and is preferential to remove small and fit foreign bodies. For children, for complicated cases and in order to remove penetrating or amorph-shaped bodies rigit bronchoscopy should be preferred.
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Tüberküloz ve toraks · Jan 2011
Multicenter StudyA cross-sectional observational study to investigate daily symptom variability, effects of symptom on morning activities and therapeutic expectations of patients and physicians in COPD-SUNRISE study.
Chronic obstructive pulmonary disease (COPD) is a lung disease characterized with limitation of airflow that is not completely reversible, progressive deterioration of airways and systemic inflammation. This study has been planned to determine daily symptom variability of patients, expectations of patient and physicians from treatment and patient profiles. A total of 514 patients with COPD from 25 centers were included in this national, multicenter, cross-sectional observational study. ⋯ Major treatment expectations of patients were greater symptomatic relief (82.3%) and greater mobility (70.0%), faster symptomatic relief (61.1%) and improvement in morning activities (59.3%); while major treatment expectations of physicians included increased quality of life (100.0%) and decreased morbidity (96.0%). Quitting smoking was the most commonly recommended (88.3%) and implemented (67.9%) non-drug protective approach aimed at decreasing the frequency of exacerbations. Consequently, our results demonstrate that COPD is not a disease of only the elderly, is an important healthcare issue that often disrupt daily living of the patients due to inadequate disease awareness leading to overlooking of the symptoms by patient and physicians, and that a patient-centered approach based on the living standards, life expectancies and preferences of patients was crucial in patient management.
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Tüberküloz ve toraks · Jan 2011
Randomized Controlled TrialConventional vs. endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of mediastinal lymphadenopathies.
The aim of this study was to determine whether or not radial probe endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) is superior to conventional TBNA in the diagnosis of mediastinal lymphadenopathies in routine clinical practice. Consecutive patients, who were referred for TBNA, were randomized to conventional TBNA and EBUS-guided TBNA groups. Patients were also grouped according to the anatomic location of the pathologic lymph nodes to evaluate if there was a difference in the diagnostic yield with respect to lymph node station. ⋯ In patients with mediastinal lymph nodes other than subcarinal lymph nodes, EBUS-TBNA had a significantly higher yield compared to conventional TBNA [33.3% (6/18) vs. 68.2% (15/22) for conventional and EBUS-TBNA groups, respectively; p= 0.028]. In conclusion, the diagnostic yield of EBUS-TBNA was superior to the yield of conventional TBNA at stations other than subcarinal region. We suggest that EBUS is a useful tool to guide TBNA in the evaluation of mediastinal lymph nodes.