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    The diagnostic value of bronchoscopy in smear negative cases with pulmonary tuberculosis
    (Turkish Assoc Tuberculosis & Thorax, 2008) Araz, Omer; Akgun, Metin; Saglam, Leyla; Ozden, Kemalettin; Mirici, Arzu
    There are many studies showing usefulness of bronchoscopy in patients with suspected pulmonary tuberculosis (Tbc) and negative sputum smear. However, there is no enough data concerning that in which cases bronchoscopy is more useful. We aimed to investigate in which cases bronchoscopy is more diagnostic and also an in which cases presence of endobronchial involvement is more likely. A total of 60 smear negative patients undergoing bronchoscopy due to tuberculosis suspicion were evaluated. The characteristics of cases with or without positive diagnosis via bronchoscopy and also of the ones with or without endobronchial involvement were compared. Bronchoscopy provided positive result for Tbc in 29 (76%) of 38 cases with confirmed as Tbc later and 7 (18%) cases had endobronchial involvement. In the cases who are diagnosed as Tbc via bronchoscopy, the mean serum levels of C-reactive protein (CRP) were significantly higher than those of undiagnosed (p< 0.05). In the cases with endobronchial involvement, the duration of symptoms was significantly shorter (p= 0.01); the diameter of tuberculin skin test induration was significantly smaller (p< 0.05); and mean serum level of CRP was significantly higher (p< 0.05) than those of without endobronchial lesion. The results suggest that it is more likely to diagnose Tbc bronchoscopically in the cases who had increased serum levels of CRP, and possibility of endobronchial involvement may be increased among the cases in active and earlier period of the disease. However, further studies are required to support this hypothesis.
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    The incidence and severity of pulmonary hypertension in obstructive sleep apnea with hypothyroidism
    (Int Scientific Literature, Inc, 2013) Araz, Omer; Ucar, Elif Yilmazel; Yalcin, Aslihan; Pulur, Didem; Acemoglu, Hamit; Tas, Hakan; Saglam, Leyla
    Background: Hypothyroidism and obstructive sleep apnea (OSA) are both common health problems and can be seen together. Each of these 2 diseases can cause pulmonary hypertension (PH). We aimed to determine whether hypothyroidism with OSA has a significant effect on the frequency and severity of PH. Material/Methods: A total of 236 patients were included in the study. Patients were divided into 3 groups: Group I, Obstructive Sleep Apnea (n=149); Group II, Hypothyroidism (n=56); and Group III, Obstructive Sleep Apnea-Hypothyroidism (n=31). All patients underwent polysomnography and echocardiography and serum levels of thyroid-stimulating hormone (TSH) and free thyroxine 4 (FT4) were analyzed. Results: There were 167 male and 69 female participants, and the mean age was 47.8 +/- 11.5 (Group I: 81.9% male, 18.1% female; Group II: 44.6% male, 55.4% female; Group III: 64.6% male, 35.4% female). Distribution of mean pulmonary arterial pressure on echocardiography was statistically different among the 3 groups (x(2)=14.99, p=0.006). When adjusted according to the apnea-hypopnea index (AHI), age, and body mass index (BMI), a significant relation with PH was determined (p=0.002). Conclusions: The combination of hypothyroidism with OSA is associated with an increased frequency and severity of PH. When PH is found out of line with the severity of OSA, thyroid dysfunction should be investigated.