Postoperative psychiatric disorders (PPDs) may complicate the post-surgical outcome. We analysed the types, incidences, risk factors and outcomes of the PPDs in non-cardiac thoracic surgery patients. All patients (n=100) undergoing major non-cardiac thoracic surgery from January 2004 to March 2005 were investigated prospectively. The diagnosis of PPD was made based on the Diagnosis and Statistical Manual of Mental Disorders. The patients were grouped into two according to the presence (group I) or absence (group II) of PPD. Data on pre-, per- and postoperative factors, and the adverse outcomes were analysed. Eighteen patients (18%) developed PPD, including delirium in 44%, adjustment disorders in 22%, panic attack in 17%, minor depression in 11% and psychosis in 6%. The patients who developed PPD were older (58+/-17 vs 50+/-15 years, p=0.05), had a longer operation time (6+/-1 vs 5+/-2h, p=0.015) and hospital stay (13+/-9 vs 8+/-5 days, p=0.019). The morbidity and mortality rates were not significantly different between the groups (67% vs 46%; 11% vs 1%, respectively). The causative factors in the development of PPD were older age, longer operation time, abnormal serum chemistry values of sodium, potassium, calcium and glucose, hypoalbuminaemia, the presence of the postoperative respiratory distress and infection and blood transfusion (p<0.05). PPDs are associated with adverse outcomes including a longer hospital stay, and increased morbidity and mortality rates. The identification, detection and elimination of these risk factors are recommended.

Although links between meteorological conditions and spontaneous pneumothorax (SP) have been proposed, the reports are controversial. In this study ozone levels, which are known to have some adverse effects on lung tissues, were investigated as a potential triggering factor of SP. At present there is not sufficient information about the effects of ozone on SP. Of a total 79 pneumothorax patients recruited for the study, 21 secondary pneumothorax cases were excluded. In the remaining 58 SP patients, meteorological data at the time of SP occurrence were recorded. The number of SP patients was higher in spring than in the other seasons (p < 0.05). There was an association between the SP frequency and the average ozone level at different seasons (F 3,52 = 19.45, p = 0.001). The average ozone level was higher in spring (363 ± 25 Dobson) than during the other seasons (autumn 296 ± 18 Dobson; summer 321 ± 26 Dobson; winter 324 ± 32 Dobson) (p = 0.001). There was a positive correlation between SP frequency and the average ozone values for each season (r = 0.301, p = 0.024). There was no significant correlation between the severity of SP and ozone level (r = 0.236, p = 0.16). The number of SP patients increases in spring when ozone levels are highest. Ozone is known to affect alveolar cells and cause interstitial edema. Ozone causes damage to the lung interstitium by way of oxidative stress. Rupture of unrecognized underlying blebs/bullae has been proposed as a cause of SP. Increased levels of ozone may be a triggering factor for these ruptures.

Giriş ve Amaç: En yaygın olarak görülen anterior göğüs duvarı deformiteleri, pektus ekskavatum (PE) ve pektus karinatum (PK)’dır. Hastalarda, ek sorun olarak postür bozuklukları görülebilmektedir. Mevcut çalışmada PE ve PK’lı hastaların postür bozukluklarını tanımlamak ve bu postür bozukluklarının klinik semptomlarla olan ilişkisini araştırmak amaçlanmaktadır. Gereç ve Yöntemler: Çalışmaya 11-45 yaş arası 526 hasta [PE (n=346) ve PK (n=180)] retrospektif olarak alınmıştır. Hastaların özgeçmişi, soy geçmişi, sırt ile göğüs ağrısı bulgusu, dinlenirken ve egzersiz sırasında nefes darlığı yaşayıp yaşamadığı gibi klinik semptomlar var/yok olarak not edilmiştir. Hastaların önden-yandan-arkadan çekilen fotoğraflarının yardımı ile New York Postür Değerlendirme Yöntemi (NYPDY) analizleri yapılmıştır. Ek olarak postür bozukluğu belirteçleri var/yok olarak kaydedilmiştir. İstatiksel olarak p