Diagnostic and clinical value of F-18 FDG PET/CT in thoracic carcinoid tumors

Aim: To assess the correlation between standard uptake values ​​(SUVmax, SUVmean) and Ki-67 in typical lung carcinoid (TC) tumors. Methods: Thirty-eight patients with thoracic masses sent for diagnosis and staging were included in the study. F-18 FDG PET / CT was applied to all patients before the operation. The patients were operated by thoracic surgery clinic. By determining different cut-off values ​​(2.5 and 0.5), SUVmean and SUVmax values ​​of the lesions from the curves drawn to the area of ​​interest were calculated. Results: Thirty-eight patients were included in the study (18 women, 20 men). The average age of our patients was 45. Pathological diagnoses of all patients were determined as typical carcinoids. Eight of our patients had parenchymal lesions and twenty of them had endobronchial lesions. The average of the Ki-67 index was about 3-4% (range 1-10%). No recurrence or death was detected after resection in the 5-year follow-up period. SUVmean1 and SUVmean2 values ​​were statistically significant when compared with SUVmax1 and SUVmax2 values ​​(p <0.05). Conclusion: We think that the SUVmean and Ki-67 index may be an important prognostic indicator that identifies high-risk subgroups. It is thought that Ki-67 indices may correlate well with SUVmean values, and low cut-off values ​​may be more suitable for diagnosis and prognosis in typical carcinoid tumors. SUVmean values ​​can be used for lung carcinoid tumors and F-18 FDG PET/CT imaging is useful in the approach to carcinoid tumors of the lung before thoracic surgery. &nbsp

Elderly patients in emergency department: Dyspnea and chest pain

INTRODUCTION: As in all countries, the rate of geriatric group in the population is increasing rapidly in parallel with the improvement of life style.. Geriatric patients frequently refer to ED with cardiopulmonary complaints. The aim of study was to investigate the diagnosis distributions of geriatric patients with chest pain- respiratory distress. METHODS: This retrospective study was performed with 1343 patients over 65 years of age who were admitted to ED with respiratory distress- chest pain evaluated with computed tomography - cardiac enzyme levels. RESULTS: A total of 1343 patients with respiratory distress and chest pain from the geriatric age group were included in the study. 531 patients who were admitted due to trauma and more than one admission to hospital with the same complaints were excluded from the study. Respiratory distress and chest pain were observed in 343 of 812 patients (42.24%) cause of pulmonary, 247 (30.41%) patients cardiac, and 222 (27.33%) had due to other causes. In patients with pulmonary-related respiratory distress and chest pain, the most common cause was pneumonia (39.06%);and in 51.41% of patients with cardiac causes, acute myocardial infarction was detected. DISCUSSION AND CONCLUSION: We believe that to known the etiology of respiratory distress and chest pain will provide better patient evaluation. Considering that the number of geriatric patients who applied for emergency services increases day by day, the fact that emergency workers have more knowledge about geriatrics is an important factor that will increase the success rate of emergency department treatment

Morphological study of the perireticular nucleus in human fetal brains

The perireticular nucleus consists of scattered neurons that are located in the internal capsule. The presence of perireticular neurons in the rat, ferret, cat and human has been described previously. Evidence suggests that the perireticular neurons in various species decrease in number with increasing gestation, but in humans this finding has not been supported by quantitative data. This study aimed to investigate (1) the morphology of the human fetal perireticular neurons, (2) the average number of perireticular neurons within the anterior and posterior crus of the internal capsule per unit area, and (3) the magnitude and the stage of neuronal loss in the human perireticular nucleus subsequent to maturation. Nissl-stained sections of the internal capsule of human fetal brains of 24, 26.5, 32, 35, 37 and 39 weeks of gestation showed a number of clearly distinguishable large perireticular and small microglia cells. A regular increase of both perireticular and microglial cells was observed up to 32 weeks of gestation, after which a dramatic reduction in the number of both perireticular and microglia cells was observed. The average number of perireticular and the microglia cells per unit area, located within the posterior crus, was more than in the anterior crus of the internal capsule. In the adult, no perireticular neurons were detected within the internal capsule. The results show that perireticular neurons are not restricted to the region lateral to the thalamus and medial to the globus pallidus (posterior crus) but are also present at the region lateral to the caudate nucleus and medial to the globus pallidus (anterior crus)

Lung cancer from suspicion to treatment: An indicator of healthcare access in Turkey

Background: Lung cancer is the leading cause of cancer-related deaths worldwide. Before beginning lung cancer treatment, it is necessary to complete procedures such as suspecting lung cancer, obtaining a pathologic diagnosis, and staging. This study aimed to investigate the processes from suspicion of lung cancer to diagnosis, staging, and treatment initiation. Metbods: The study was designed as a multicenter and cross-sectional study. Patients with lung cancer from various health institutions located in all geographic regions of Turkey were included in the study. The socio-demographic and clinical characteristics of the patients, the characteristics of the health institutions and geographic regions, and other variables of the lung cancer process were recorded. The time from suspicion of lung cancer to pathologic diagnosis, radiologic staging, and treatment initiation, as well as influencing factors, were investigated. Results: The study included 1410 patients from 29 different medical centers. The mean time from the initial suspicion of lung cancer to the pathologic diagnosis was 48.0 +/- 52.6 days, 39.0 +/- 52.7 days for radiologic staging, and 74.9 +/- 65.5 days for treatment initiation. The residential areas with the most suspected lung cancer cases were highly developed socioeconomic zones. Primary healthcare services accounted for only 0.4% of pa-tients with suspected lung cancer. The time to pathologic diagnosis was longer in the Marmara region, and the wait time for staging and treatment initiation was longer in Eastern and Southeastern Anatolia. Patients who presented to chest disease referral hospitals with peripheral lesions, those with early-stage disease, and those who were diagnosed surgically had significantly longer wait times. Conclusion: The time between pathologic diagnosis, staging, and treatment initiation in lung cancer was longer than expected. Increasing the role of primary healthcare services and distributing socioeconomic resources more equally will contribute to shortening the time to diagnosis and improve treatment processes for lung cancer

Lung cancer from suspicion to treatment: An indicator of healthcare access in Turkey

Background: Lung cancer is the leading cause of cancer-related deaths worldwide. Before beginning lung cancer treatment, it is necessary to complete procedures such as suspecting lung cancer, obtaining a pathologic diagnosis, and staging. This study aimed to investigate the processes from suspicion of lung cancer to diagnosis, staging, and treatment initiation. Methods: The study was designed as a multicenter and cross-sectional study. Patients with lung cancer from various health institutions located in all geographic regions of Turkey were included in the study. The sociodemographic and clinical characteristics of the patients, the characteristics of the health institutions and geographic regions, and other variables of the lung cancer process were recorded. The time from suspicion of lung cancer to pathologic diagnosis, radiologic staging, and treatment initiation, as well as influencing factors, were investigated. Results: The study included 1410 patients from 29 different medical centers. The mean time from the initial suspicion of lung cancer to the pathologic diagnosis was 48.0 ± 52.6 days, 39.0 ± 52.7 days for radiologic staging, and 74.9 ± 65.5 days for treatment initiation. The residential areas with the most suspected lung cancer cases were highly developed socioeconomic zones. Primary healthcare services accounted for only 0.4% of patients with suspected lung cancer. The time to pathologic diagnosis was longer in the Marmara region, and the wait time for staging and treatment initiation was longer in Eastern and Southeastern Anatolia. Patients who presented to chest disease referral hospitals with peripheral lesions, those with early-stage disease, and those who were diagnosed surgically had significantly longer wait times. Conclusion: The time between pathologic diagnosis, staging, and treatment initiation in lung cancer was longer than expected. Increasing the role of primary healthcare services and distributing socioeconomic resources more equally will contribute to shortening the time to diagnosis and improve treatment processes for lung cancer