CAN COUGH BE A SYMPTOM OF IMPORTANT DISEASES
Cough is one of the most common symptoms of respiratory diseases. 3-40% of patients apply to outpatient clinics with cough complaints. The vast majority of patients are women. A cough can be a symptom of a simple viral infection, or it can be a sign of a serious illness or life-threatening condition. However, most of the smokers who have coughs do not consult a doctor as they see it normal. Cough has both medical and social significance. Cough-related fainting can be fatal, especially for drivers. People who cough frequently avoid visits, social activities, and live isolated lives.
Cough is simply a reflex that clears the airways. Cough protects the lungs from aspiration and prevents the entry of foreign substances into the lower respiratory tract, allowing increased bronchial secretions to be expelled. It has negative effects such as the spread of infections in the community and causing significant health expenditures. Differential diagnosis is difficult as cough can occur for many reasons. Perhaps the most important step in the approach to the patient is to take a good history from the patient.
Acute cough is cough lasting less than 3 weeks. The most common cause is the common cold. The common cold is caused by viruses (most commonly rhinovirus, coronavirus, parainfluenza, RSV, adenovirus, and enterovirus). The common cold can heal on its own, often not requiring treatment. Rarely, it may be due to a life-threatening cause such as pneumonia, left heart failure, pulmonary embolism. A subacute cough is a cough that lasts between 3 and 8 weeks. The most common cause is infection. Asthma, sinusitis, ongoing allergen and irritant exposure are other common causes. A chronic cough is a cough that lasts longer than 8 weeks. Chronic cough is an important cause of morbidity (morbidity rate) and affects quality of life. Therefore, it is a clinical condition that needs to be treated. Its incidence in the adult age group is 3-40%. 10-38% of applications made to pulmonary diseases outpatient clinics are due to chronic cough.
Although most recurrent coughs in childhood are of viral origin, 10% of preschool and primary school children have a persistent cough that is not associated with the common cold and is not wheezing. The most important cause of childhood wheezing is indoor air pollution caused by parents' smoking. The prevalence of chronic cough reaches 50% in children under the age of 11 whose parents smoke. The most common cause of chronic cough in adults is "smoking". As the duration of smoking and the amount of cigarette consumed increase, the incidence of cough with phlegm also increases. The most common causes of chronic cough in non-smokers are the use of drugs in the angiotensin converting enzyme inhibitor (ACEI) group, which patients take in postnasal drip syndrome (PNDS), gastroesophageal reflux disease (GERD), asthma and hypertension.
Postnasal drip syndrome refers to the runny nose flowing from the nose to the throat, the need to clear the throat frequently, and often a runny nose or fullness around the nose. 20% of patients may not be aware of this situation. The cause of chronic cough in adults who do not smoke is associated with asthma in 24-29%. Wheezing, shortness of breath, chest tightness, and chronic coughing spells are the main symptoms. The cough is usually dry, occurring at night. Less common, cough variant asthma is considered asthma in which cough is the only symptom.
Gastroesophageal reflux (GER) refers to the reflux of stomach contents into the esophagus. The main symptoms of GER are burning in the chest, bitter water in the mouth, pronounced stomach complaints, chronic cough and hoarseness in the voice. GER is seen in 20% of the population. Angiotensin converting enzyme inhibitors (ACEI) are used in the treatment of heart failure, hypertension, myocardial infarction, etc. Chronic cough is seen in 19% of ACEI use. For treatment, discontinuation of the drug is sufficient. Sick Building Syndrome is one of the causes of chronic cough today. Ventilation of buildings and airborne pollutants, work stress, microorganisms in buildings and various organic compounds cause sick building syndrome. Although 9% of adults do not have a known respiratory system disease, chronic cough is seen.
Chronic psychogenic cough can be mentioned in these patients who are obese and have depressive symptoms. Other causes of chronic cough include allergic causes, occupational exposures, some irritant mechanisms, benign or malignant masses in the respiratory system, interstitial diseases of the lungs, some irritant mechanisms, etc. Be a non-smoker or smoker, if you have a cough, please consult a physician. Cough may be due to a simple, non-treatment requiring cause, or it may be a symptom of a serious disease that requires treatment and early diagnosis saves lives.
ALLERGIC ASTHMA
Asthma occurs as a result of narrowing of the airways due to the swelling of the mucous membranes that line the airways due to genetic and environmental triggers. Its frequency has been increasing in recent years. In Turkey, asthma is seen in 5% of children and 6% of adults.
For the diagnosis of asthma, first of all, a good history should be taken from the patient. Inhaled allergens and irritants cause seizures of wheezing and whistling, shortness of breath, chest tightness and coughing in people sensitive to these substances. Complaints occur at night and / or towards the morning, and completely or partially resolve spontaneously or with medications. Asthma is a lifelong disease. Complaints are usually associated with a particular season or environment. There may also be periods when patients are completely normal when there are no complaints.
It is not possible to completely eliminate asthma, but it can be kept under control. Patient education is very important in the treatment of asthma. Then, it is tried to be kept under control by removing the triggering factors from the environment, treating the accompanying diseases and finally by drug treatment.
COPD, Asthma, Bronchiectasis (Obstructive Pulmonary Diseases)
In many well-known novels and movies, people coughing while cigarettes in their hands, breathing difficultly, or covered in soot in mine-factory environments form a background somewhere in the novel or movie. You can easily find these people in the novels of Hüseyin Rahmi Gürpınar, Reşat Nuri Güntekin, Kemalettin Tuğcu, Charles Dickens or Cronin. They are usually poor people, they are used to coughing, and they may not even think that their condition is a disease. Today, this perception has been outdated and people do not want to live with shortness of breath, coughing and irritating phlegm. According to the overall health figures worldwide, COPD is the fifth leading cause of death. Looking at the prevalence of smoking, it would not be fortune telling to say that it will climb to higher ranks in the coming years.
The condition that used to be called chronic bronchitis is now called Chronic Obstructive Pulmonary Disease (COPD). Smoking is the main cause, but in certain special cases it is also seen in non-smokers. Poor working conditions, continuous breathing of smoke and being in a smoking environment, or smokes emitted while cooking and heating on hearths, poorly-designed cookers and stoves in our villages can lead to COPD. Coughing and producing sputum in at least three months of two consecutive years is the first episode of this disease. If you have quitted smoking, it can stop at that episode. But as long as you resume smoking or the living conditions that caused it, your symptoms will continue making progress. As a result, you will become someone who coughs, produces phlegm, and suffers from shortness of breath every day of the year. Always, the only intervention that will positively affect this situation is to stop smoking. The situation is sometimes much more difficult especially when the COPD is caused by your profession and working conditions.
The disease is usually seen after middle age, more often in men, but also in women in relation to their rural life. In the advanced period, heart failure develops, accompanied by frequent attacks of pneumonia and bronchitis.
BRONCHECTASIS
Although bronchiectasis, which can be defined as excessive enlargement of the bronchi, is almost as common as asthma and COPD, it has not been adequately studied. Currently, there is not enough information about which drugs can be effective.
In patients with bronchiectasis whose bronchi are more enlarged than normal, the main complaints are usually frequent coughing and sputum production. Some patients may produce sputum every day. In fact, the amount of sputum they produce in 24 hours may be more than a glass of water.
Blood in sputum is also a common complaint in patients with bronchiectasis. This bleeding can be in the form of a line in the sputum, or it can be in the form of an excessive amount of bleeding that is difficult to stop. Bronchiectasis is the most common cause of bleeding from the mouth among lung diseases.
If the disease progresses, patients may develop severe dyspnea. For this reason, it is necessary to regularly control the patients with pulmonary function tests by a Chest Diseases Specialist.
The most important issue in the treatment of bronchiectasis patients is to be treated with appropriate antibiotics when the patient has a bronchitis attack. In order to select the appropriate antibiotic, the Chest Diseases Specialist will benefit from previous sputum examinations.
Perhaps more important than the treatment of attacks is to try to prevent the patient from having frequent attacks. For this, patients must regularly apply respiratory physiotherapy techniques specially designed for them every day
Lung Cancer
Lung Cancer is an important health problem for our country as well as all over the world. When the disease is diagnosed, 75% of them are in the advanced stage. Only 10-15% of the patients are in the early stage, namely, they are suitable for surgery.
While there are around 34,000 new lung cancers diagnosed in 2013 in our country, the total number of cases is around 59,000. The number of patients who die from lung cancer annually is around 21,000. When we look at the figures in 2009, it is seen that there are 25,000 new cases, 50,000 total cases and 14,500 deaths due to lung cancer. In other words, there is a 40% increase in the number of patients diagnosed with lung cancer in 5 years. Deaths, on the other hand, increased by nearly 50%.
The rate of incidence is 70 per 100 thousand in men, while around 10 per 100 thousand in women. In other words, lung cancer affects men more. However, the major reason for this difference between men and women is that men in our country have a habit of smoking 3 times more than women. In recent years, rates have started to change due to the increase in smoking women.
While chemotherapy was applied to 53% of our lung cancer patients, radiotherapy (radiation therapy) was applied to 30%. The expenditure for lung cancer patients in our country reached 550 million TL in 2013.
As a result, 95% of lung cancer, which is perhaps the most important preventable disease, is caused by the use of tobacco and tobacco products. It is very important not to start smoking at all, to quit smoking and to have regular check-ups in order to prevent this still fatal disease, which both our patients go through a very difficult process and lead to very expensive treatments.
PNEUMONIA
It is an inflammation of the lung. It can be caused by various microbes such as bacteria, viruses, fungi. It is among the diseases that are most common, require medical attention, and having the most fatal consequences. It is more common especially in children, the elderly over 65 years of age, those with a chronic disease (such as kidney, diabetes, heart or lung disease), smokers, and the presence of a disease that suppresses the immune system or the use of drugs. Community-acquired pneumonia (CAP) is responsible for a significant portion of hospital admissions, treatment costs, lost work-school days, and deaths all over the world.
While deaths from infectious diseases are gradually decreasing due to the widespread use of antibiotics and effective immunization policies, pneumonia in the community is still a high cause of morbidity and mortality. Pneumonia is the 6th cause of death in the UK and the USA, and the 1st among deaths due to infections. While the mortality rate in outpatients is 1-5%, it reaches 12% in hospitalized patients and 40% in patients requiring intensive care support. In our country, lower respiratory tract infections are in the 5th place among the causes of death with 4.2%. Studies conducted in our country show that the mortality rate from pneumonia varies between 1% and 60% in relation to the severity of the disease, and the rate is significantly higher in hospital-treated pneumonia (10.3-60%).
Fluid Collection Between the Pulmonary Membranes (Pleurisy)
PLEURESIS
Pleuresis is defined as the accumulation of fluid in the potential space between two pleura, one of which surrounds the outer surface of the lung and the other that surrounds the inner surface of the chest wall and develops due to many pulmonary and extrapulmonary diseases. Normally, there is a very small amount of fluid between these 2 pleural sheets to provide lubrication. This fluid is released from the outer membrane of the lung and is reabsorbed mainly through the inner membrane covering the outer surface of the lung. In other words, although there is a continuous fluid movement in the pleural cavity, the amount of fluid remains constant at the level of approximately 20 milliliters (ml), since the released and reabsorbed fluid is in equilibrium. When an increase in the amount of fluid released or a blockage in reabsorption occurs due to many pulmonary and extrapulmonary diseases, this balance is disrupted and the amount of fluid in the pleural cavity increases and a clinical picture called pleurisy occurs.
Lung diseases causing pleurisy
Many lung diseases such as tuberculosis, lung and pleural cancer, pneumonia, pulmonary embolism, sarcoidosis, lung abscess often cause pleurisy.
In regions and countries where TB prevalence is high, like our country, the main cause of pleurisy is TB disease. Although pleurisy due to tuberculosis is seen in all age groups, it is mostly seen in young adults. Lung cancer is the main disease causing fluid accumulation in the pleura in elderly patients. In lung cancer, pleural disease, which occurs as a result of the invasion of the pleura by the cancer tissue directly through the neighborhood or the settlement of the cancer cells that have escaped into the bloodstream, to the pleura through the blood causes fluid accumulation.
Again, pleurisy may develop as a complication in pneumonia caused by bacteria and viruses.
In regions where contact with asbestos and some minerals found in nature is high - as the case in our country - pleural cancer that develops due to these substances often leads to fluid accumulation in the pleural cavity.
Tuberculosis (Tuberculosis)
What is Tuberculosis?
Tuberculosis is a contagious infectious disease that causes widespread inflammation, especially in the lungs, when the bacterium Mycobacterium tuberculosis enters the body through the respiratory tract. Patients with active pulmonary or laryngeal tuberculosis are seen as the source of the tuberculosis microbe, and the microbe is spread through the respiratory tract of sick people by exhaling, coughing or sneezing. Healthy people entering this environment inhale the microbe called Mycobacterium tuberculosis, making the disease continue to spread further.
What Are the Symptoms of Tuberculosis?
People who encounter the tuberculosis microbe can continue their healthy lives without showing any symptoms for months. During this period, the person's immune system tries to prevent the development of the disease by fighting the Mycobacterium tuberculosis bacteria. However, in cases where the immune system cannot show sufficient resistance, tuberculosis microbes become active and tuberculosis disease occurs. TB symptoms observed from the onset of the disease can be listed as follows:
- Complaints of cough lasting longer than 15 days,
- High fever, night sweats,
- Severe chest pain,
- Anorexia, rapid weight loss,
- Weakness, fatigue,
- Bloody sputum in the later stages.
What are the Causes of Tuberculosis?
According to World Health Organization, 2.5 percent of all diseases in the world and 26 percent of preventable deaths is made up by tuberculosis. Although most common in the South and East Asia and Africa, Tuberculosis is seen in all continents and all countries of the world, causing 9.2 million people to be exposed to TB disease annually.
Studies show that the increase in tuberculosis disease is driven by intense migration and the incidence of AIDS. While the increasing rate of immigration with industrialization facilitates the spread of the disease, the weakened immune system due to AIDS also reduces the person's defense against tuberculosis microbe. Sub-Saharan Africa, where the incidence of tuberculosis is highest in the world, is known as the continent where AIDS disease occurs most frequently. This proves that tuberculosis can occur due to health problems that affect the immune system, such as AIDS.
How Is TB Diagnosed?
The chest graph, which indicates tuberculosis together with the complaints of the patient, suggests tuberculosis, but sputum culture should be taken for a definitive diagnosis and analyzed to verify the presence of Mycobacterium tuberculosis. The sputum sample taken from the patient is analyzed in the laboratory and the definitive diagnosis can be made by observing the bacteria using a microscobe.
In particular, the fact that coughing is attributed to different causes such as smoking and colds delays the doctor visit for examination, leading to the disease to progress to a great extent. Since tuberculosis is a serious disease that affects the community as well as the individual and threatens public health, the community should be informed about tuberculosis, able to recognize the symptoms correctly and have information to be able to answer the question "What is Tuberculosis?". In order to make a correct diagnosis and effective treatment, the symptoms should be taken seriously from the first moment and examined in detail by a chest diseases specialist.
What are Tuberculosis Treatment Methods?
Drugs developed for the treatment of tuberculosis show a highly curative effect in the initial stage of the disease, allowing the person to regain his health quickly. There are four different types of drugs that offer the most effective treatment. With these drug applications, almost all of the patients are treated very successfully.
Although the period determined for drug treatment is at least six months, the duration of treatment may vary depending on the severity of the disease, its incidence in the community, the age of the person and other disease histories. In order to provide effective treatment, it is important to evaluate the symptoms correctly and to control the disease with early diagnosis. If you are showing signs of tuberculosis or you are frequently in crowded environments, you should absolutely follow up on symptoms and visit doctor in appropriate frequency.
Interstitial Lung Diseases
This group of diseases first attracted attention with the first case described by Hamman and Rich in 1935. Since then, many diseases with varying degrees of pulmonary stiffness have been described. Approximately 150 diseases are included in this disease group, which is named as interstitial lung disease.
In this disease, the lungs become stiffer and lose their flexibility. Therefore, patients develop shortness of breath. There is not much research on the frequency of interstitial lung diseases. According to the research published by the Turkish Thoracic Society in 2013, the annual incidence of this disease group in our country was found as 25.8 per hundred thousand. This research has been published in an international scientific journal (Clin Respir J 2014,8:55-62).
This group of patients can be divided into 4 subgroups, those with known causes (such as lung involvement of collagenoses, pneumoconioses), granulomatous diseases (such as sarcoidosis, hypersensitivity pneumonitis), idiopathic interstitial pneumonias and others that are rare.
Idioaptic pulmonary fibrosis (IPF) is the most common of the 7 diseases in the idiopathic interstitial pneumonias group. In the study of the Turkish Thoracic Society, approximately 20% of all diffuse parenchymal lung diseases in our country were found to be IPF. Unfortunately, there is no effective treatment in this disease, the cause of which is unknown. The average life expectancy in this disease has been reported to be about 2.8 years.
Pulmonary Embolism
The main task of the lungs is to ensure that the oxygen taken into the body passes into the blood and carbon dioxide in the blood is expelled. Clogging of the pulmonary artery and its branches with a blood clot is called “pulmonary thromboembolism” (PTE). The most common source of this clot is the deep veins in the leg.
In cases where the obstruction greatly hinders the pulmonary circulation, the blood pressure drops suddenly and the patient may enter a state of shock. This is not very common, but when it does occur it is life threatening.
The most common symptoms of the disease are sudden onset of shortness of breath, stabbing chest pain, bloody expectorate, palpitations, mild fever, and sometimes pain with swelling in the legs.
In the presence of certain risk factors, the probability of the occurrence of this disease increases,
• Genetic diseases that cause blood clots (the presence of such a disease in the family)
• Long-term bed rest (for example, bed rest due to herniated disc)
• Long-term travel
• Cancer disease
• One-two months after an surgical operation (especially orthopedic surgery)
• Trauma
• Use of birth control pills, hormone therapy in women
• Pregnancy
• Obesity
• Those with chronic heart or lung disease
• Those with strokes
In this disease, which is seen in one of 1000 people every year, and probability of mortality can reach up to 30% if not treated, it may be life-saving for those with the above-mentioned risk factors to visit the nearest emergency service where a chest diseases specialist is present, especially when they have sudden shortness of breath and sudden chest pain.
• Snoring and Sleep Apnea Syndrome
SLEEP APNEA:
Snoring is seen in approximately 40% of adult people. The vibrations of the air passing through the narrowed upper airways cause snoring. Sometimes respiratory arrest occurs due to complete obstruction of the airways. Breathing that is stopped for more than 10 seconds during sleep is defined as apnea. The presence of apnea in the patient is usually noticed by the partner, and most patients are not aware that they have snoring and/or apnea. Excessive daytime sleepiness develops due to diminished deep sleep at night due to apneas. During apnea, the oxygen pressure in the blood begins to drop and the amount of oxygen carried to the tissues declines.
Sleep apnea syndrome is characterized by recurrent apneas during sleep, often seen with a decrease in blood oxygen level.
Sleep apnea syndrome adversely affects almost all systems in our body, leading to very serious health problems. It causes the most heart and circulatory system problems. It can cause hypertension, ischemic heart disease and myocardial infarction, heart failure, heart rhythm disorders and sudden death.
It causes constant fatigue and weakness, difficulty in concentration, memory loss, decreased attention, morning headaches, frequent urination at night, night sweats, decreased performance in school and work life, sexual dysfunction in male patients, and a tendency to gain weight continuously.
The definitive diagnosis can be easily made by performing a sleep polysomnographic examination (PSG: sleep test). In mild cases, the problem can be solved by taking general measures such as weight loss, using oral tools or surgical treatment. However, in moderate and severe cases, the use of a device called CPAP or BIPAP is required.
• Sleep Laboratory (Polysomnography)
POLYSOMNOGRAPHY (SLEEP TEST)
Polysomnography is a test for the diagnosis of sleep disorders. Although it is often used to investigate the presence of respiratory disorders during sleep, such as sleep apnea and snoring, it is also used to detect rarer conditions such as sleep movement disorders, sleep terror, sleep paralysis, narcolepsy, and parasomnia. If the pulmonologist suspects that you have sleep apnea syndrome, he/she will request polysomnography.
Polysomnography (sleep follow-up test) should not be applied to those with severe psychiatric disorders, intellectual disabilities and high fever. This test measures your breathing, brain waves, heart rate, body movements, snoring, and oxygen level in the blood during the night. For this, electrodes must be placed in some parts of your body. Small sensors are placed on your head, mouth and nose, chest, neck, fingertips, and legs. This is a painless procedure. After the sensors are placed, you will be expected to lie in your bed and sleep according to your normal sleep time.
Rooms should be prepared in a way that ensures the comfort of the patient. In order to facilitate the placement of the electrodes, patients should take a shower before visiting, and men should shave. The connecting cables are adjusted in such a way that they do not disturb the patients so that the patients can sleep comfortably. No medicine is given to you to facilitate sleep. A sleep technician will monitor you and all your recordings throughout the night. Therefore, in case of any need, the technician will come to your room and assist you.
When you wake up in the morning, all plugs will be removed so you can return to your home or work. Then your doctor will review your records and prepare a polysomnography report. The necessary treatment method will be determined according to the test result. If you have sleep problems and your doctor has recommended you to have polysomnography, you can find out the cause of your sleep disorder by taking this test and have a healthy sleep by undergoing a timely treatment. A healthy sleep means a healthy life.
• Bronchoscopy Procedures
Bronchoscopy is a type of endoscopy method used to examine the airways and lungs, other than the larynx, and to perform some procedures and interventions for diagnosis and treatment. Endo means inside, scope means looking, so it means looking inside the body. The word broncho means airways, therefore, bronchoscopy means looking inside the airways.
Bronchoscopy is performed for two main purposes. The first is diagnostic bronchoscopy, the second is therapeutic bronchoscopy. Sometimes minor treatment procedures can be performed during diagnostic bronchoscopy, and other times diagnostic samples may be taken during therapeutic bronchoscopy. Bronchoscopy is mainly performed for the diagnosis and treatment of diseases involving the respiratory tract and lungs. Bronchoscopy is performed in the presence of respiratory tract and lung diseases that cannot be definitively diagnosed by other diagnostic methods, and in the presence of respiratory complaints such as chronic cough, bloody sputum, hoarseness that cannot be explained by other methods.
Bronchoscopy can be performed in an emergency, life-saving or non-emergency, elective setting. If there is no life-threatening situation, at least 4-6 hours of full fasting is a must. If there is no emergency, the physician may want to perform the procedure at the most appropriate time for many reasons. Bronchoscopy can be performed under local anesthesia and/or conscious sedation or general anesthesia depending on the interventions, the disease and the condition of the patient. No pain is felt during the procedure. The main difficulty experienced by the patient is cough and shortness of breath, which can be easily suppressed with drugs, and most patients do not recall these difficulties. Bronchoscopy is performed with a set of medical devices called bronchoscopes, which are sent through the nose or mouth while the person is sitting or lying down.
• Pulmonary Function Tests
The causes of shortness of breath can be understood by performing PFT to a patient with dyspnea complaint. The most common and well-known of these reasons are asthma and COPD. In these diseases, because the airways are narrow, there is a problem while air, which have entered the lungs, is going out. While the patient is breathing out, sounds such as whistling may occur.
In another group of diseases, the air intake capacity of the lung decreases. The most common of these diseases, which go with stiffness and shrinkage (fibrosis) in the lung, are diseases such as sarcoidosis, idiopathic pulmonary fibrosis (IPF). In addition, rheumatic diseases, some drugs and occupational diseases can also affect the lungs and cause stiffness, causing shortness of breath. In these patients, the amount of air entering the lungs is reduced and they are out of breath when they try to do a work.
In diseases such as polymyositis, Gullian-Barre, myasthenia gravis, which cause shortness of breath by weakening the muscles that allow us to breathe, sufficient air cannot enter the lungs. It is possible to distinguish these diseases from each other by performing pulmonary function tests.
• Thoracentesis
THORACENTESIS (SAMPLING WATER FROM LUNG)
Thoracentesis is the process of taking samples from the fluid accumulated between the two membrane layers surrounding the lung for diagnostic and/or therapeutic purposes.
Some of the causes of fluid accumulation between the lung membranes are as follows:
-Pneumonia, and pulmonary tuberculosis, etc. infections
-Heart failure,
-Lung cancer or cancers that spread to the lungs,
-Kidney diseases
-Liver diseases
-Rheumatic diseases
In the above-mentioned cases, if deems it necessary, your doctor can take a sample of the fluid accumulated between the lung membranes via the thoracentesis.
How is thoracentesis done?
Before the procedure, you should absolutely inform your doctor if you have diseases, drugs you use, and known allergies. Your doctor will provide you information about how the procedure is done. You do not need to be hungry for this procedure.
The patient sits on a chair or examination chair with his back to the physician and leans against a pillow or chair with both arms raised. After the side to be sampled is determined by the physician, it is wiped with sterile gauze and antiseptic solution. After applying local anesthesia with a needle to the side where the liquid will be taken, the liquid is taken with a sterile needle. The patient may feel a slight pain at this time. This takes 10-15 minutes. However, it may take longer if it is for discharge purposes. The patient should not move during thoracentesis. After the procedure, pressure is applied with sterile gauze and the plaster is adhered. After 24 hours at the latest, the plaster and gauze are removed. It is appropriate not to take a bath during this time.
• Allergy Tests
Skin Prick Test (SPT):
It is a test applied in cases whose complaints suggest the presence of a respiratory or food allergy. The test is administered directly ("fresh prick") with respiratory tract and food allergies, latex, or food. The method is based on the principle that after the antigen is dripped onto the skin, it is gently lifted and released with a lancet. Evaluation of the test is done after 15 minutes. You should inform your doctor if you have or have not received antihistamine treatment for 1 week before the test, and systemic steroid treatment for 1 month.
Patch test:
It is a test to determine whether eczema is allergic and if it is an allergen, which allergen substances it develops against. Non-allergic tapes containing suspicious substances are adhered to the skin. It is re-evaluated by the doctor after 72 hours (3 days). During this period, you absolutely have to avoid bathing, sunbathing, and/or activities that cause excessive sweating, and do not have to tamper with the bands. If you are allergic to a substance, symptoms such as redness, swelling, and blistering develop in that area. During the test, cortisone drugs and antihistamines that relieve itching have not to be used. Similarly, cortisone creams and pills must not have been used for two weeks before the test.
Intradermal Drug skin test:
After using certain drugs, some individuals may develop conditions such as shortness of breath and wheezing, chest tightness, cough, itching in the eyes, itching in the nose and throat, sneezing, nasal congestion or discharge, redness and itching of the skin, swelling of the lips and eyelids, low blood pressure, and allergic conditions such as allergic shock. This condition limits the drug administration for these individuals. These tests are applied to the skin of patients who are allergenic to drugs, in order to find a suitable drug option that they can use according to their needs or to confirm drug allergy. Allergy and Clinical Immunology specialist physicians decide the necessity and apply it.
If your doctor thinks you have a drug allergy and thinks you are in need of medication due to the conditions you are in, he will perform these tests in order to find an effective and safe drug option for you or to confirm your diagnosis of drug allergy.
Although it is low probability, there is still risk of developing allergy because of using these drugs, therefore, they should absolutely be recommended by testing.
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