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    Electrocardiographic changes in primary spontaneous pneumothorax
    (Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2014) Sevinc, Serpi; Kaya, Seyda Ors; Unsal, Saban; Koc, Sahbender; Alar, Timucin; Gunay, Samil; Boncu, Mehmet
    Background: This study aims to evaluate the electrocardiographic (ECG) changes in patients with primary spontaneous pneumothorax. Methods: A total of 48 patients (42 males, 6 females; mean age 29.7 +/- 12.5 years, range 15 to 58 years) with PSP were prospectively analyzed between November 2010 and November 2011. Pneumothorax size was calculated using the Rhea method. At least two standard 12-lead ECG were obtained for each patient (after the diagnosis of pneumothorax and prior to drain placement - ECG(pneumothorax), and after a complete re-expansion of the lung was achieved and confirmed radiologically - ECG(re-expanded)). P wave measurement, PR distance, QRS distance, QT interval and QT interval corrected for heart rate (QTc) were calculated. Heart rate (bpm), axis deviation measurement and the QRS amplitudes (QRSV1-6) in precordial leads were calculated. Results: There were 29 cases (60.4%) of left-sided and 19 cases (39.6%) of right-sided pneumothorax. The mean relative volume of pneumothorax was 43.0 +/- 21.5%. The most common symptoms included chest pain in 34 patients (70.8%) and dyspnea in 14 patients (29.2%). The pneumothorax duration was <= 24 hours in 30 patients (62.5%) and >24 hours in 18 patients (37.5%). There was a statistically significant difference between before and after the treatment for QT duration, axis deviation, heart rate, QRSV1, QRSV4, QRSV5 and QRSV6 (respectively; p=0.001, p=0.023, p=0.001, p=0.010, p=0.046, p=0.000, p=0.008). A total of seven patients had relevant QRS abnormalities including incomplete right bundle branch block in three patients, ST elevation in two patients and T-wave pointedness in one patient. Conclusion: Our study results suggest that left and right lung pneumothorax may cause axis variation, which is more pronounced in women, and that voltage increases after drainage in QRSV 4, 5 and 6 leads. In addition, pneumothorax may lead to specific ECG variations such as right bundle branch block and ST variations.
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    Öğe
    How does the type of thoracotomy affect the patient quality of life? A short form-36 health survey study
    (Springer, 2014) Alar, Timucin; Ceylan, Kenan Can; Kaya, Seyda Ors; Sevinc, Serpil; Sigirli, Deniz; Ozcelik, Cemal
    We evaluated whether the quality of life was affected in patients who had undergone various types of thoracotomy using the Short Form-36 Health Survey. The patients who had undergone thoracotomy for diagnosis or treatment between January and September 2011 in the Thoracic Surgery Department were investigated to determine the effect of the type of thoracotomy on the quality of life using the Short Form-36 Health Survey. The patients were classified into three groups. In Group I, the latissimus dorsi and the serratus anterior had both been preserved, and there was no muscle dissection, in Group II the latissimus dorsi muscle had been dissected and only the serratus anterior muscle has been preserved, and in Group III both muscles had been dissected, and the standard posterolateral muscle dissection had been performed. A total of 101 patients comprising 64 males (63.37 %) and 37 females (36.63 %), with a median age of 38 years, were included in this study. There were significant differences in all quality of life subscales between Groups I and III and between Groups II and III. The patients in Group I had the highest scores, while the patients in Group III had the lowest scores. There were no significant differences in five of the eight Short Form-36 subscales and one of the two summary scores values between Group I and Group II in females. We investigated the effect of the type of thoracotomy on the patient quality of life using the Short Form-36 Health Survey, and found that the standard posterolateral thoracotomy had a marked adverse effect on the quality of life compared to muscle-sparing thoracotomy. We also found that it is possible to use thoracotomy with serratus preservation rather than muscle-sparing thoracotomy in cases with benign diseases where a large field of view is required, such as for decortication and pulmonary hydatid cysts, without any significant decrease in the quality of life, especially in females.