Noninfectious causes of diffuse pulmonary infiltrations in chronic renal failure: metastatic pulmonary calsification

Metastatic pulmonary calsification (MPC) is a metabolic lung disease characterized by the deposition of calcium in pulmonaryparenchyma. It may occur due to many bening or malign pathologies. Especially it is most commonly seen in patients with endstage chronic renal failure received renal replacement treatment. The case we report here involved a history of renal transplantationabout 22 months ago. His thorax computed tomography had demonstrated bilateral disseminated infiltrations with ground-glass densities predominantly in the upper lobes and it was seen partially preserved subpleural areas and basal zones. Thehistopathological results in transbronchial lung biopsy indicated metastatic pulmonary calsification. We wanted to discuss patientwith the accompaniment of literature

The Role of First-Pass Perfusion Computed Tomography in the Differentiation of Centrally Located Lung Cancer and Distal Atelectasis

Our aim in this study was to differentiate postobstructive consolidation from lung cancer by means of first-pass perfusion CT in centrally located malignancies. We studied 20 patients (18 males and 2 females) diagnosed as lung cancer with untreated central masses and distal postobstructive atelectasis. In order to localize the slice position showing the appropriate mass-consolidation area to be included in contrast-enhanced dynamic imaging, we first performed scout and baseline acquisition without contrast media, followed by dynamic acquisition after intravenous contrast media injection. Three different ROIs were placed on the central mass while avoiding the peripheral regions as much as possible and on the peripheral locations of distal consolidation using dynamic contrast-enhanced images. The BV, BF, TTP and MTT perfusion parameters were automatically calculated in the ROI locations. We were able to differentiate the central masses from distal consolidations by means of statistical differences in the first-pass BV and BF parameters between the mass and distal consolidation areas. The mean values of parameters that were calculated in the mass and consolidation areas were BV:7.69±4.28 ml/100g, BF:48.87±25.54 ml/100g/min, TTP:27.94±7.32 sec., MTT:9.56±3.47 sec. and BV:11.83±5.34 ml/100g, BF:78.75±39.41 ml/100g/min, TTP:29.72±6.05 sec., MTT:11.44±4.93 sec., respectively. We concluded that first-pass perfusion CT may be used as a functional imaging method to differentiate central lung cancer from distal consolidation and could be useful in reducing the target cancer volume in patients who are candidates for radiation therapy. [Med-Science 2016; 5(2.000): 432-47

N-acetylcysteine in patients with COPD exacerbations associated with increased sputum

WOS: 000354549100004PubMed ID: 25595117Background N-acetylcysteine (NAC) has been shown not to alter the clinical outcome in chronic obstructive pulmonary disease (COPD) exacerbations. However, NAC may improve symptoms through its mucolytic effect in the subgroup of patients with increased sputum production. The aims of this study were to determine whether NAC improves symptoms and pulmonary function in patients with COPD exacerbation and increased sputum production. Methods This was a placebo-controlled study, where patients with severe COPD and increased sputum production, who were hospitalized for an exacerbation, were included. They were randomized to receive either NAC 200 mg tid or placebo in addition to the usual treatment. Results Forty-two patients were included and were equally distributed to NAC and placebo groups. The symptoms, namely, ease of sputum production and dyspnea at rest and on exertion significantly improved in both groups; but there was no difference in improvement between NAC and placebo groups (p = 0.96, 0.62, 0.31, respectively). Similarly, forced expiratory volume-one second (FEV1) and PaO2 levels improved significantly in NAC (964 +/- 599-1239 +/- 543 ml, p < 0.001, and 57.5 +/- 14.5-70.5 +/- 16.0 mmHg, p < 0.001, respectively) and placebo groups (981 +/- 514-1180 +/- 535 ml, p < 0.001 and 57.9 +/- 14.3-68.7 +/- 19.0 mmHg, p < 0.001, respectively), without any difference between the two groups (p = 0.52 and 0.57). There was no difference in the number of exacerbations during the 6-month follow-up period. Conclusion NAC does not have any beneficial effect on clinical outcomes in patients with severe COPD exacerbation associated with increased and/or viscous mucus production

Orta ve ağır astımlı olgularda alerjik bronkopulmoner aspergilloz

Introduction: Allergic bronchopulmonary aspergillosis (ABPA), which is predominantly a disease of severe asthmatic patients, is caused by hypersensitivity to aspergillus antigens. The prevalence of ABPA is speculative, as the few studies that were performed adopted widely different diagnostic criteria. Material and Method: In this study, we aimed to evaluate the prevalence of ABPA in patients with moderate and severe asthma. ABPA-Central bronchiectasis (ABPA-SB) was diagnosed if a patient had asthma, central bronchiectasis, positive Aspergillus fumigatus skin test or positive serum aspergillus sIgE. ABPA-Seropositive (ABPA-S) was diagnosed if a patient had asthma, elevated total IgE level, positive Aspergillus fumigatus skin test and positive serum aspergillus sIgE. Results: Of the sixty four patients, 71.9% had moderate asthma and 28.2% severe asthma. Positive Aspergillus sIgE was present in 2 patients (3.1%). Sensitivity to A. fumigatus with skin test was shown in a total of 4 (7.8%) patients. Central bronchiectasis was seen on HRCT in seven of the patients (14.6%) and central mucus impaction was seen in one patient (2%). In this study, ABPA was diagnosed in 2 (3.1%) patients. Two (3.1%) patients were evaluated as aspergillus-sensitive asthma. Conclusion: Patients with ABPA had severe asthma. Therefore, ABPA should be considered in patients with poorly controlled severe asthmaGiriş: Allerjik bronkopulmoner aspergilloz (ABPA), ağır astımlı olgularda görülmektedir ve aspergillus antijenlerine aşırı duyarlılık nedeni ile oluşmaktadır. ABPA sıklığına dair bilgiler, farklı tanısal kriterlerin kullanıldığı az sayıda çalışma nedeniyle tahmine dayalıdır. Gereç ve Yöntem: Bu çalışmada; orta ve ağır persistan astımlı olgularda ABPA sıklığı araştırılmıştır. ABPA-Santral bronşektazi (ABPA-SB) tanısı; astım, santral bronşektazi, Aspergillus fumigatus deri testi pozitifliği veya serumda aspergillus sIgE pozitifliği; ABPA-Seropozitif (ABPA-S) tanısı; astım, yüksek total IgE düzeyi, Aspergillus fumigatus deri testi pozitifliği ve serumda aspergillus sIgE saptanması ile konmuştur. Bulgular: Altmış dört olgunun %71.9'u orta, %28.2'si ağır persistan astımdır. Aspergillus sIgE, 2 (%3.1) olguda pozitiftir. Deri testlerinde A. fumigatus pozitifliği toplam 4 olguda (%7.8) gösterilmiştir. YRBT ile 7 (%14.6) olguda santral bronşektazi ve 1 (%2) olguda santral yerleşimli mukus tıkacı saptanmıştır. Çalışmamızda 2 (%3.1) olgu ABPA-SB tanısı almıştır. İki (%3.1) olgu ise aspergillus duyarlı astım olarak değerlendirilmiştir. Sonuç: ABPA'lı olgular, ağır persistan astımlı olgulardır. Bu nedenle kontrolü güç ağır astım olgularında ABPA düşünülmelidir

The affecting factors and prevalence rate of sick building syndrome in healthcare workers

Sick building syndrome (SBS) is defined as symptoms that occur while living or working in a certain building but disappear after moving away from the environment. In this study, we aimed to determine the effects of indoor air pollutants on the health of employees, the prevalence of SBS in healthcare workers at the university hospital, its relationship with environmental and personal factors and the respiratory system. A questionnaire was applied to 951 healthcare workers who agreed to participate in the study. Having at least one general, one mucosal and one skin symptom every week in the last 3 months was accepted as SBS. Temperature, CO and CO2 levels and relative humidity were measured in different areas of the hospital. The prevalence of SBS was 62.1%. There was a statistically significant relationship between SBS and having a chronic disease (p [Med-Science 2023; 12(1.000): 87-93

Intensive Clinic Intervention Plus Psychodrama in Smoking Cessation and Effects on Cessation Outcome

Objective: Psychodrama is a therapeutic discipline, which uses action methods, role training, and group dynamics to facilitate a constructive change in the lives of participants. This study was run to assess the effectiveness of psychodrama on intensive clinic intervention for smoking cessation. Material and Methods: The process and outcome of smoking cessation program using intensive cognitive-behavioral therapy (CBT) and pharmacotherapy (PT) or CBT and PT plus psychodrama was studied on 113 participants. Sixty-one participants were randomized in CBT and PT plus psychodrama group, and 52 participants were randomised in CBT and PT group. Success rate of smoking cessation was assessed at the end of the first, third and sixth months. Results: At the end of the first and third months, the rates of smoking cessation were 80.3% and 63.9% in study group, and 59.6% and 46.2% in control group (p=0.014 and p=0.044, respectively). In the sixth month, the rate of smoking cessation was 50.8% in the study group and 38.5% in the control group (p=0.130). Conclusion: In this study, we concluded that the intensive clinic intervention plus psychodrama increased the success rate of smoking cessation in the early period

Smoking status of pulmonologists who are members of Turkish thoracic society and factors related to their being a smoker = Türk toraks derneǧi üyesi göǧüs hastalıkları hekimlerinin sigara i̇çme durumu ve i̇lişkili faktörler

Objective: If smoking habit among physicians in a country is common as it is in the general population, it is a particular problem for national tobacco control studies. The study aimed to investigate the smoking status of pulmonologists who are members of the Turkish Thoracic Society (TTS), and factors related with being a smoker. Material and Methods: Web-questionnaires were e-mailed to members of TTS by the TTS secretary from June 2010-February 2011. Only pulmonologists were included in the study. To analyse possible predictors of smoking smokers were categorized as ever smokers and never smokers. Possible predictors were sex, being graduated before/after 2004, urban/suburban working place, being academician or not, having education on smoking cessation help, experienced in smoking cessation outpatient clinic or not. Results: Web questionnaires of 699 pulmonologists were reviewed. Of the participants, 65.2% were female and the mean age was 39.4±9.0 (25-72); 69% were non-smokers, 21.1% were ex-smokers, and 9.9% were current smokers. Never smokers were mostly included in the group of pulmonologists younger than 40 years old (p=0.001). The number of never smokers with experience in smoking cessation outpatient clinic was higher than the number without any experience (72.1% and 67.1%, respectively; p=0.03). Smoking was 1.8-fold more likely among males (95% confidence interval-CI 1.2-2.5) and 1.8-fold more likely among those graduated before 2004 (95% CI 1.1-3.1); 66.7% of current smokers were in the contemplation stage. The number of cases in contemplation stage were mostly among regular smokers (p=0.001). Conclusion: The results of this study suggesting relatively low prevalence of smoking among pulmonologists are important for tobacco control