The costs of hospitalization in patients with acute exacerbation of chronic obstructive pulmonary disease

Sevket Ozkaya1, Serhat Findik2, Atilla Guven Atici21Rize University, Department of Pulmonary Medicine, Rize, Turkey; 2Ondokuz Mayis University, Department of Pulmonary Medicine, Atakum, Samsun, TurkeyIntroduction: Chronic obstructive pulmonary disease (COPD) is a major public health problem. It imparts a substantial economic burden on individuals and society. Acute exacerbations are the main cause of hospital admissions and hospitalizations in patients with COPD in Turkey.Objectives: We aimed to determine the costs of hospitalization in patients with acute exacerbations of COPD (AECOPD).Results: A total of 7832 (1556 women, 6276 men) patients were hospitalized due to acute exacerbations of COPD between 2005–2009 in the Samsun Chest Diseases and Thoracic Surgery Hospital, northern Turkey. The mean age was 64.6 ± 19.8 years old and median length of hospital stay was 14.8 ± 9.5 days. The mean cost per admission was US$718 ± 364. Drug costs accounted for the largest portion (53.5%) of the mean cost, followed by bed cost (19.6%). One hundred seventy-four (2.2%) of the total hospitalized patients with AECOPD died in hospital.Conclusion: AECOPD continues to have both significant economic burden and high mortality rate.Keywords: COPD, acute exacerbation, hospitalization, cost

Comparison of Vinorelbine-Cisplatin with Gemcitabine-Cisplatin in Patients with Advanced Non-Small Cell Lung Cancer

Purpose The objective of this trial was to compare cisplatin-plus-vinorelbine regimen with cisplatin-plus-gemcitabine regimen in patients with stage IIIB-IV non-small cell lung cancer (NSCLC). Patients and Methods Chemonaive patients with stage IIIB-IV NSCLC received either vinoelbine 30 mg/m 2 (days 1 and 8) plus cisplatin 80 mg/m 2 (day 1) every 21 days (VC arm) or gemcitabine 1250 mg/m 2 (days 1 and 8) plus cisplatin 80 mg/m 2 (day 1) every 21 days (GC arm). Results One hundred thirtyfour patients (67 VC and 67 GC) were included to the study. Overall response rates for the VC arm (31.2%) were not significantly different from that of the GC arm (34.3%). There were no differences in overall survival and one-year survival rates. Median survival and one-year survival rates for the VC and GC groups were 10.6 and 11.5 months, 45% and 46.8%, respectively. Grade 3-4 thrombocytopenia was significantly higher on the GC arm (VC 1.4% v GC 8.9%, p < 0.05), as was febrile neutropenia on the VC arm (VC 8.9% v GC 1.4%, p < 0.05). Conclusion VC and GC demonstrated similar efficacy but there were differences in toxicity profiles

Asymptomatic double aortic arch

Muzaffer Sariaydin1, Serhat Findik1, Atilla Guven Atici1, Sevket Ozkaya2, Aziz Uluisik11Department of Pulmonary Medicine, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey; 2Department of Pulmonary Medicine, Faculty of Medicine, Rize University, Rize, TurkeyAbstract: A 51-year-old male patient with a past history of lung tuberculosis was referred to our clinic for routine control. The patient reported no complaints and chest X-ray was normal. Three-dimensional thoracic computed tomography revealed a balanced-type double aortic arch with no compression of trachea or esophagus.Keywords: double aortic arch, asymptomatic, adult, three dimensional computed tomograph

Mean platelet volume and mean platelet volume/platelet count ratio in risk stratification of pulmonary embolism

Background and objective: Recently, some of the hemogram parameters were reported to predict early death in acute pulmonary embolism (PE). The aim of this study was to investigate the role of mean platelet volume (MPV) and MPV/platelet count ratio (MPV/P), WBC and red cell distribution width (RDW) in risk stratification of patients with acute PE. Materials and methods: We retrospectively reviewed the medical records of patients with acute PE admitted to the Emergency Department. In addition to the clinical evaluation, the hemogram parameters were measured on admission. Results: A total of 152 patients were included. Patients with RV dysfunction had significantly higher MPV levels and MPV/P than patients without RV dysfunction. Receiver operating characteristic curve analysis revealed that a MPV cut-off of 7.85 fL provided a sensitivity of 53.3% and a specificity of 68.5%, and a MPV/P cut-off of 0.0339 fL/(109/L) provided a sensitivity of 69.6% and a specificity of 65% for the prediction of RV dysfunction. There was a positive correlation between MPV and systolic pulmonary artery pressure (SPAP) and between MPV and RV diameter. There was a positive correlation between MPV/P and SPAP and between MPV/P and RV diameter. The low-risk PE group had lower MPV and MPV/P than the massive PE and submassive PE groups. Conclusions: MPV and MPV/P were found to be associated with RV dysfunction and clinical severity in acute PE. Low MPV and MPV/P levels may be an indicator of low risk and, high WBC levels may be an indicator of high risk in patients with acute PE. RDW levels may not reflect severity of acute PE