Akciğer kanserli hastalarda kemoterapinin yaşam kalitesi üzerine etkisi

Bu çalışmada akciğer kanserli hastalarda kemoterapinin yaşam kalitesi üzerine etkilerinin belirlenmesi amaçlanmıştır. Araştırmaya Ocak 2006 ile Ocak 2007 yılları arasında kemoterapi tedavisi gören 50 hasta alındı. Veri toplama aracı olarak Avrupa Kanser Araştırma ve Tedavi Organizasyonu (EORTC) Yaşam Kalitesi Anketi (QLQ C-30) ve akciğer kanseri modülü (LC-13) ile görsel analog ölçeği (VAS) kullanıldı. Kemoterapi tedavisi ile birlikte sosyal fonksiyonda azalma ve dispne, konstipasyon, alopeside artma ve öksürükte azalma saptandı. Olguların ekonomik durumları da birinci kemoterapi dönemindekine göre daha kötü bulundu (p<0.05). Kemoterapi tedavisi ile birlikte küçük hücre dışı akciğer kanserli hastalarda fiziksel fonksiyon ve sosyal fonksiyon alanları azalmış, yorgunluk, bulantı, uykusuzluk, konstipasyon da artmıştır. Metastaz varlığı ile yaşam kalitesi arasında istatistiksel olarak anlamlı bir farklılık yoktu. Ağrı yaşam kalitesinin bütün alanlarını negatif yönde etkilemektedir. Yaş, eğitim durumu gibi sosyodemografik özelliklerle yaşam kalitesi arasında ilişki olmamakla birlikte, cinsiyet yaşam kalitesini etkilemektedir ve erkeklerde yaşam kalitesi rol fonksiyon, emosyonel fonksiyon ve kognitif fonksiyon alanları kadınlara göre daha iyidir. Akciğer kanserli hastalarda yaşam kalitesinin değerlendirilmesinde sosyodemografik özelliklerin anlamlı bir etkisi yoktur. Ağrı yaşam kalitesinin bütün alanlarını negatif yönde etkilemektedir ve olgularda ağrı arttıkça yaşam kaliteleri düşmektedir.The aim of the present study was to determine the effect of chemotherapy on the quality of life of patients with lung carcinoma. Fifty patients who were receiving chemotherapy between January 2006 and January 2007 were included in the study. The quality of life questionnaire (QLQ C-30), lung cancer specific module (LC-13) of the European Organization for Research and Treatment of Cancer (EORTC), and visual analog scale (VAS) were used in data collection. Chemotherapy resulted in worsening of social functioning, as well as dyspnea, constipation, and alopecia, whereas coughing improved. The economic status of the patients became worse compared to the first chemotherapy period (p&lt;0.05). Chemotherapy led to a decrease in physical and social functioning in the patients with non-small cell lung cancer, and an increase in fatigue, nausea, insomnia, and constipation. No statistical significance was observed between the presence of metastases and quality of life. Pain negatively affected all subscales of the quality of life. Although no relationship was observed between the quality of life and sociodemographic characteristics, such as age and educational status, gender affected the quality of life, and the role, emotional, and cognitive functioning of the quality of life were worse in females compared to males. Sociodemographic characteristics had no significant impact on the quality of life of the patients with lung cancer. Pain negatively affected all areas of quality of life; indeed, the quality of life of the patients decreased as pain increased

Ongoing Symptoms, Formation of Interstitial Lung Disease and Follow-up Process in PostCOVID-19

Aralık 2019’da Çin’in Wuhan eyaletinden severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)’ye bağlı ciddi akut solunum hastalıkları bildirildi. Koronavirüs hastalığı- 2019 (COVID-19) ilişkili semptomlar hafif üst solunum yolu infeksiyonundan akut solunum sıkıntısı sendromu (ARDS)’na kadar çeşitli klinik farklılık gösterir. Taburculuk sonrası bazı hastalarda semptomların ve radyolojik bulguların devam ettiği görülmüştür. Hipertansiyon ve diyabet gibi komorbiditeler, erkek cinsiyet ve ileri yaş gibi risk faktörleri ciddi COVID-19 ve idiopatik pulmoner fibrosis (İPF) için ortak risk faktörleridir. Bununla birlikte, SARS-CoV-2 infeksiyonuna yakalanan İPF hastalarında, antifibrotik tedavinin rolü ve bunların devamı veya kesilmesi için bilimsel mantık tam olarak tanımlanmamıştır. COVID-19 pandemisinden edinilen veriler ile şiddetli akut solunum sendromu (SARS) ve Ortadoğu solunum sendromu (MERS) gibi önceki koronavirüs infeksiyonlarından elde edilen veriler, SARS-CoV-2 infeksiyonunu takiben önemli fibrotik değişiklikler olabileceğini düşündürmektedir. Bu makalede, COVID-19 pnömonisi sonrası devam eden semptomların sıklığı ve ortaya çıkabilecek interstisyel akciğer hastalığı sıklığından söz edildi. Ayrıca başta pulmoner fibrosis olmak üzere akciğerde meydana gelen interstisyel değişikliklerin önlenmesi ve solunum fonksiyonlarında azalma literatür ışığında tartışılmıştır.n December 2019, severe acute respiratory diseases due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) were reported from Wuhan province of China. The symptoms associated with Coronavirus Disease-2019 (COVID-19) range from mild upper respiratory tract infection to acute respiratory distress syndrome (ARDS). It was observed that symptoms and radiological findings continued in some patients after discharge. Comorbidities such as hypertension and diabetes, risk factors such as male gender and advanced age are common risk factors for severe COVID-19 and idiopathic pulmonary fibrosis (IPF). However, the role of anti fibrotictherapy and the scientific rationale for their continuation or discontinuation in IPF patients infected with SARS-CoV-2 have not been fully defined. Data from the COVID-19 pandemic and previous coronavirus infections such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) suggest that there may be significant fibrotic changes following SARS-CoV-2 infection. In this article, the frequency of on going symptoms after COVID-19 pneumonia and the frequency of interstitial lung disease that may ocur were discussed. Inaddition, the prevention of interstitial changes in the lung, especially pulmonary fibrosis, and the decrease in respiratory functions are discussed in the light of the literature

İdiyopatik Pulmoner Fibrozis Hastalarında Tanı ve Tedaviye Yaklaşım: Bir Anket Çalışması

Objective: As Turkish Respiratory Society Diffuse Parenchymal Lung Diseases-Pulmonary Vascular Diseases Study Group (TRS DPLD-PVD SG), we aimed to demonstrate the approaches of physicians with a questionnaire toward the patients with IPF in our country.Methods: An invitation letter including a questionnaire with 24 questions to assess the approaches they prefer in the patients with IPF and the capabilities of the departments they work at and a link for the questionnaire was directed to the mail groups of chest diseases and thoracic surgery specialists. Responses of the physicians who participated in the questionnaire were reviewed.Results: Thirty percent of the participants saw less than 5 patients with IPF in a year and 16.8% of them saw more than 21. 66.3% of partici-pants stated that anamnesis, symptoms and clinical findings along with typical radiologic findings would be sufficient for the diagnosis, while 27.7% suggested that pathological findings should indicate IPF along with clinic and radiologic ones.When the methods used for tissue samp-ling were viewed; application rates of bronchoscopic transbronchial biopsy, thoracoscopic biopsy and open lung biopsy were found very close to one another.In the patients with the suspected disease of IPF, the fields in which the hesitation was the most problematic were respectively pathological examination of biopsies (73.2%) and interpretation of radiologic findings (49.5%). 37.6% of the patients with diagnosis of IPF were directed to experienced centers; medical treatment and drugless follow-up rates were respectively 33.6% and 14.8%. Among the participants, 29.7% suggested lung transplantation for all cases while 48.5% only preferred this operation in particular onesObjective: As Turkish Respiratory Society Diffuse Parenchymal Lung Diseases-Pulmonary Vascular Diseases Study Group (TRS DPLD-PVD SG), we aimed to demonstrate the approaches of physicians with a questionnaire toward the patients with IPF in our country.Methods: An invitation letter including a questionnaire with 24 questions to assess the approaches they prefer in the patients with IPF and the capabilities of the departments they work at and a link for the questionnaire was directed to the mail groups of chest diseases and thoracic surgery specialists. Responses of the physicians who participated in the questionnaire were reviewed.Results: Thirty percent of the participants saw less than 5 patients with IPF in a year and 16.8% of them saw more than 21. 66.3% of participants stated that anamnesis, symptoms and clinical findings along with typical radiologic findings would be sufficient for the diagnosis, while 27.7% suggested that pathological findings should indicate IPF along with clinic and radiologic ones.When the methods used for tissue sampling were viewed; application rates of bronchoscopic transbronchial biopsy, thoracoscopic biopsy and open lung biopsy were found very close to one another.In the patients with the suspected disease of IPF, the fields in which the hesitation was the most problematic were respectively pathological examination of biopsies (73.2%) and interpretation of radiologic findings (49.5%). 37.6% of the patients with diagnosis of IPF were directed to experienced centers; medical treatment and drugless follow-up rates were respectively 33.6% and 14.8%. Among the participants, 29.7% suggested lung transplantation for all cases while 48.5% only preferred this operation in particular ones.Conclusion: Some of the results of our study is compatible with the guidelines of IPF, is to show that the quality of debate and confusion still continued in this regar

Approaches in Diagnosis and Treatment of Patients with Idiopathic Pulmonary Fibrosis: A Questionnaire Study

Objective: As Turkish Respiratory Society Diffuse Parenchymal Lung Diseases-Pulmonary Vascular Diseases Study Group (TRS DPLD-PVD SG), we aimed to demonstrate the approaches of physicians with a questionnaire toward the patients with IPF in our country. Methods: An invitation letter including a questionnaire with 24 questions to assess the approaches they prefer in the patients with IPF and the capabilities of the departments they work at and a link for the questionnaire was directed to the mail groups of chest diseases and thoracic surgery specialists. Responses of the physicians who participated in the questionnaire were reviewed. Results: Thirty percent of the participants saw less than 5 patients with IPF in a year and 16.8% of them saw more than 21. 66.3% of participants stated that anamnesis, symptoms and clinical findings along with typical radiologic findings would be sufficient for the diagnosis, while 27.7% suggested that pathological findings should indicate IPF along with clinic and radiologic ones.When the methods used for tissue sampling were viewed; application rates of bronchoscopic transbronchial biopsy, thoracoscopic biopsy and open lung biopsy were found very close to one another.In the patients with the suspected disease of IPF, the fields in which the hesitation was the most problematic were respectively pathological examination of biopsies (73.2%) and interpretation of radiologic findings (49.5%). 37.6% of the patients with diagnosis of IPF were directed to experienced centers; medical treatment and drugless follow-up rates were respectively 33.6% and 14.8%. Among the participants, 29.7% suggested lung transplantation for all cases while 48.5% only preferred this operation in particular ones. Conclusion: Some of the results of our study is compatible with the guidelines of IPF, is to show that the quality of debate and confusion still continued in this regard

Approaches of Physicians for the Diagnosis and Treatment of Pulmonary Thromboembolism: A Questionnaire Study

Objective: We aimed to demonstrate the approaches of physicians with a questionnaire toward the patients with pulmonary thromboembolism (PTE) in our country.Methods: An invitation letter including a questionnaire with 28 questions to assess the approaches they prefer in the patients with PTE and the capabilities of the departments they work at and a link for the questionnaire was directed to the mail groups of chest diseases specialists. Responses of the physicians who participated in the questionnaire were reviewed. Results: The examinations used to diagnose PTE such as D-dimer, troponin, echocardiographic Doppler ultrasonography and multidetector computed tomography (CT) have been performed in 94% of the institutions, ventilation/perfusion scintigraphy, MRI and pulmonary angiography examinations were performed in 50% of the instututions. While D-dimer test was performed in 73.2% of the institutions by quantitative ELISA; in 15.7% of them it was semiquantitative and in 11.6% of the instutitions it was performed by latex agglutination. 81% of physicians were seen to be using clinical probability scoring systems and most commonly used scoring method was seen to be Wells scoring with a rate of 90%. According to the simplified PESI score, 61.5% of the physicians reported to prefer outpatient treatment. In non-massive and submassive pulmonary thromboemboli patients, 86.2% of the physicians reported to prefer thr low molecular weight heparin (LMWH) treatment; vitamin K antagonist in maintenance treatment was also the most commonly resorted drug with a percentage of 84.9. Conclusion: The absence of the examinations used in the diagnosis and treatment of PTE in most institutions and difficulty to reach the available examinations at all hours of the day were significant facts. Especially; lack of access to high-sensitivity D-dimer test, bedside echocardiography used to assess right ventricular dysfunction, troponin and NT-proBNP makes us think about low adaptation to guidelinesObjective: We aimed to demonstrate the approaches of physicians with a questionnaire toward the patients with pulmonary thromboembolism (PTE) in our country.Methods: An invitation letter including a questionnaire with 28 questions to assess the approaches they prefer in the patients with PTE and the capabilities of the departments they work at and a link for the questionnaire was directed to the mail groups of chest diseases specialists. Responses of the physicians who participated in the questionnaire were reviewed. Results: The examinations used to diagnose PTE such as D-dimer, troponin, echocardiographic Doppler ultrasonography and multidetector computed tomography (CT) have been performed in 94% of the institutions, ventilation/perfusion scintigraphy, MRI and pulmonary angiography examinations were performed in 50% of the instututions. While D-dimer test was performed in 73.2% of the institutions by quantitative ELISA; in 15.7% of them it was semiquantitative and in 11.6% of the instutitions it was performed by latex agglutination. 81% of physicians were seen to be using clinical probability scoring systems and most commonly used scoring method was seen to be Wells scoring with a rate of 90%. According to the simplified PESI score, 61.5% of the physicians reported to prefer outpatient treatment. In non-massive and submassive pulmonary thromboemboli patients, 86.2% of the physicians reported to prefer thr low molecular weight heparin (LMWH) treatment; vitamin K antagonist in maintenance treatment was also the most commonly resorted drug with a percentage of 84.9. Conclusion: The absence of the examinations used in the diagnosis and treatment of PTE in most institutions and difficulty to reach the available examinations at all hours of the day were significant facts. Especially; lack of access to high-sensitivity D-dimer test, bedside echocardiography used to assess right ventricular dysfunction, troponin and NT-proBNP makes us think about low adaptation to guideline

Assessment of osteoporosis using the FRAX method and the importance of vitamin D levels in COPD patients

Abstract Background The aim of this paper was to evaluate the availability of FRAX for assessing osteoporosis risk, and to demonstrate the importance of vitamin D levels in COPD patients. Methods Fourty-six males who fulfilled the COPD diagnostic criteria defined by GOLD were included. Age, race, BMI, physical activity frequency, smoking and dietary habits, age at COPD diagnosis, disease duration, fractures history, and medications use were determined. Levels of 25(OH)D were detected. BMD was measured by DXA at lumbar spine, femoral neck, and entire femur, and classified according to ISCD. FRAX score was calculated. Control group was composed of 40 non-smoker individuals without previous history of pulmonary diseases. Results 25(OH)D levels were significantly different between patients and controls. In the COPD group, a statistically significant difference in vitamin D levels was detected among the A, B, C, and D grades, while no such significant differences in FRAX scores were detected. 25(OH)D levels were significantly low in COPD patients with disease exacerbations and hospitalizations in the previous one year. No correlation was detected between vitamin D levels and the FRAX score. A positive correlation was observed between vitamin D levels and T-score. FRAX scores were higher and vitamin D levels were lower in osteoporotic COPD patients than in non-osteoporotic COPD patients. Conclusion Using FRAX for assessing osteoporosis in COPD can reduce fracture risk and allow adequate treatment. Since vitamin D levels are related to exacerbations and hospitalizations, vitamin D supplementation may be needed in COPD patients, especially in those with high FRAX scores

Akciğere metastaz yapan nadir bir karsinom: Sertoli-leydig hücreli tümör

The lung is the most common site of metastasis for many malignancies. Especially the gastrointestinal system, gynecological malignancies and osteosarcomas frequently metastasize to the lung. It accounts for less than 0.5% of all ovarian neoplasms. The frequency of recurrence and metastasis is less than 5%. In most cases, they are stage I tumors, limited to the ovary and carry a good prognosis. Here, while investigating the nodules in the lung that were detected incidentally at the age of 64, the rare Sertoli-leydig cell tumor of the lung is discussed clinically, radiologically and pathologically in the presence of a 64-year-old patient who was found to have undergone ovarian surgery 9 years ago. Since imaging methods and tumor markers did not yield significant results in terms of primary malignancy, wedge resection was performed from the left lung nodules. The histology of the lung nodule was the same as the poorly differentiated foci of the ovarian tumor. The immunohistochemical profiles of the two tumors were also similar. As a result of the evaluation of the patient's old materials belonging to the ovary and the samples taken from the lung together; The diagnosis was reached by obtaining similar results with the primary tumor in the immunohistochemical examination performed for the metastatic focus. Sex cord stromal tumors of the ovary, which rarely cause lung metastasis and have a tendency to recur and metastasis in a very long time after the first diagnosis, should also be kept in mind in the elderly woman and the patient with a gynecological history

Does anthracosis reported in endobronchial ultrasound-guided transbronchial needle aspiration exclude metastasis?

OBJECTIVES: In some studies, it has been hypothesized that anthracotic pigmentation in mediastinal lymph nodes is a sign of benign conditions and excludes metastasis from thoracic and extrathoracic malignancies. The aim of this study was to evaluate the clinical significance of mediastinal lymph node anthracosis in cancer patients who underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). MATERIALS AND METHODS: In this study, medical data of patients with lung cancer or extrathoracic cancer who underwent EBUS-TBNA for investigation of mediastinal lymph node metastasis were evaluated retrospectively. EBUS-TBNA cytology reported as anthracotic pigmentation was included in this study. Patients were excluded from the study if cytology of aspirated lymph nodes reported as “benign,” “malignancy,” or “granulomatous inflammation.” RESULTS: There were 50 eligible patients. Thirty-one (62%) patients underwent EBUS-TBNA for lung cancer staging and 19 (38%) for evaluation of extrathoracic metastasis. A total of 120 lymph nodes were sampled. The most sampled station was subcarinal. EBUS-TBNA was false negative in eight of 31 (25.8%) lung cancer patients and one of 19 (5.2%) extrathoracic malignancy patients. CONCLUSIONS: Anthracotic pigmentation of lymph nodes in EBUS-TBNA cannot exclude metastasis in lung cancer patients and mediastinoscopy should be performed before surgery in this group. In patients with extrathoracic malignancy, anthracotic pigmentation is associated with benign conditions. However, further investigation with larger cohort is needed

Seroepidemiology of Respiratory Syncitial Virus and Influenza Viruses in Cases with Severe Chronic Obstructive Pulmonary Disease

Introduction: This study aimed to detect encountering rates of influenza and respiratory syncitial virus (RSV) viruses in patients with severe chronic obstructive pulmonary diseases. Materials and Methods: Fifty-seven severe COPD patients applied to our hospital between the autumn-winter season of 2006- 2007 were included into the study. Influenza A, influenza B, and RSV specific IgA and IgG antibodies were studied by ELISA method. Results: Seropositivity rates of IgG and IgA for influenza A, influenza B and RSV were found 100% (n= 57), 75.4% (n= 43), 94.7% (n= 54) and 21% (n= 12), 17.5% (n= 10), 19.3% (n= 11), respectively. Conclusion: Seroprevalance of influenza and RSV were found high in patients with COPD. Vaccination for Influenza A and B and protection from respiratory infections are important for the prevention of acute exacerbations of COPD

Carboplatin and etoposide followed by once-daily thoracic radiotherapy in limited-disease small-cell lung cancer

49th Annual Meeting of the American-Society-of-Clinical-Oncology (ASCO) -- MAY 31-JUN 04, 2013 -- Chicago, ILWOS: 000335419604520Amer Soc Clin Onco