Second Line Palliative Endobronchial Radiotherapy with HDR Ir 192 in Recurrent Lung Carcinoma

Purpose To observe the efficiency of reirradiation with high dose rate intraluminal brachytherapy in symptomatic palliation of recurrent endobronchial tumors. Materials and Methods Between January 1994 and June 1998, 21 patients diagnosed with recurrent endobronchial tumors following external beam radiotherapy were treated palliatively with high dose rate intraluminal irradiation at Hacettepe University Oncology Institute. A single fraction of 10 Gy was prescribed to the specified area in 9 patients and 15 Gy to 12. Results Endobronchial treatment improved the performance and reduced symptomatology in 17 (81%) patients. Ten dyspneic patients (10/14, 71%) recovered clinically with an accompanying radiological downstaging. The median symptomatic palliation was 45 days (range, 0 - 9 months), and the overall median survival was 5.5 months (range, 4 - 12 months). The palliative intrabronchial brachytherapy was well tolerated, with the exception of in one patient with a fatal hemorrhage, and another with medically salvaged bronchospasm and intrabronchial edema. Conclusion Recurrent patients with a history of previous thoracic external beam irradiation can be effectively palliated with high dose rate endobronchial reirradiation if the symptoms are directly related to the endobronchial tumor

Pulmonary Embolism Due To Metal Coil: Case Report

Radiological studies may sometimes reveal unexpected findings. A 42-year-old male patient was referred to our center because of metallic opacities observed on the chest X-ray. Physical examination was unremarkable except for macular lesions on both lower extremities. A detailed medical history revealed that the patient had a varicocele in the right testis which was obliterated with coil embolization 12 years ago. The metallic opacities observed on the chest X-ray were considered to result from the migration of the coils from testis to the lungs. Coil embolization is an effective and safe procedure in the treatment of varicocele. However, as presented in the case, the procedure may cause complications in a certain subgroup of patients. Migration of coils from the varicose testicular veins to the pulmonary vessels may be clinically insignificant; however, when found incidentally, it may pose a diagnostic problem that needs to be solved by the clinician.WoSScopu

Carbon monoxide poisoning related to the use of steam coal in poorly ventilated bucket stoves.

During the years 1986 to 1990, an increasing number of cases of acute carbon monoxide (CO) poisoning were encountered in the Emergency Department Hacettepe University Hospital in Ankara, Turkey. Between January 1 and March 31, 1991, all the patients presenting with complaints compatible with CO poisoning were evaluated; the diagnosis was confirmed in 55 of the 5795 people who attended the Emergency Department during this period. In all cases the source of CO intoxication was determined. Among these patients, nausea or vomiting and headaches were the most common complaints (occurring in 100% and 85%, respectively). At least transient impairment of alertness was observed in 29% of cases. The carboxyhaemoglobin levels ranged from 3.80 to 48.1% (median 14.2%). Two comatose patients who developed a non-cardiogenic pulmonary oedema required mechanical ventilation. One of them was discharged from the hospital with mild cerebral disability. Another patient developed an acute myocardial infarction. In all the cases in this series, the source of CO poisoning was identified as improper combustion of recently marketed steam coal in inadequately ventilated bucket stoves.Journal ArticleSCOPUS: ar.jinfo:eu-repo/semantics/publishe

Interest in technology-based and traditional smoking cessation programs among adult smokers in Ankara, Turkey

<p>Abstract</p> <p>Background</p> <p>Little is known about the demand for smoking cessation services in settings with high smoking prevalence rates. Furthermore, acceptability of text messaging and Internet as delivery mechanisms for smoking cessation programs in non-developed countries is under-reported. Given the cost effectiveness of technology-based programs, these may be more feasible to roll out in settings with limited public health resources relative to in-person programs.</p> <p>Findings</p> <p>148 adult smokers took part in a community-based survey in Ankara, Turkey. Two in five (43%) respondents reported typically smoking their first cigarette within 30 minutes of waking. Many participants expressed a desire to quit smoking: 27% reported seriously thinking about quitting in the next 30 days; 53% reported at least one quit attempt in the past year. Two in five smokers wanting to quit reported they were somewhat or extremely like to try a smoking cessation program if it were accessible via text messaging (45%) or online (43%).</p> <p>Conclusions</p> <p>Opportunities for low-cost, high-reach, technology-based smoking cessation programs are under-utilized. Findings support the development and testing of these types of interventions for adult smokers in Turkey.</p

Genetic Predisposition To Fiber Carcinogenesis Causes A Mesothelioma Epidemic In Turkey

Malignant mesothelioma in the western world is often associated with asbestos exposure. It is a relatively rare cancer that causes similar to 2,500 deaths yearly in the United States and 1,000 deaths yearly in the United Kingdom. In contrast, among people born in the Cappadocian (Turkey) villages of Tuzkoy, Karain, and "Old" Sarihidir, similar to 50% of deaths are caused by malignant mesothelioma. This epidemic has been attributed to erionite exposure, a type of fibrous zeolite mineral commonly found in this area of Turkey. In these three villages, malignant mesothelioma occurs in certain houses but not in others. The hypothesis was that a unique and more carcinogenic erionite was present in certain houses and caused malignant mesothelioma. We determined the X-ray diffraction pattern and the crystal structure of erionite from malignant mesothelioma villages and compared the results with the erionite samples from nearby non-malignant mesothelioma villages and from the United States. We found the same type of erionite in Cappadocian villages, with or without a malignant mesothelioma epidemic, in households with high or no incidence of malignant mesothelioma and in the United States. Pedigree studies of the three malignant mesothelioma villages showed that malignant mesothelioma was prevalent in certain families but not in others. When high-risk malignant mesothelioma family members married into families with no history of it, malignant mesothelioma appeared in the descendants. Genetically predisposed family members born and raised outside the malignant mesothelioma villages did not seem to develop malignant mesothelioma. In summary, pedigree and mineralogical studies indicate that the malignant mesothelioma epidemic is caused by erionite exposure in genetically predisposed individuals. This is the first time that genetics is shown to influence mineral fiber carcinogenesis.WoSScopu

Byssinosis and Copd Rates Among Factory Workers Manufacturing Hemp and Jute

Objectives: Prior studies have been performed on cotton textile plants throughout the world. This study was planned to identify the rate of byssinosis and chronic obstructive pulmonary disease (COPD) in hemp and jute workers and those who worked with both of them. Material and Methods: The study was realized in a factory which consecutively processed hemp and jute. The study enrollment included 266 people, 164 of whom were active workers and 102 were retired. A questionnaire, plain chest X-rays, physical examination and pulmonary function tests were performed. Dust levels were measured in various sections of the factory during 8 h work shifts. Endotoxin levels of various quality hemp fibers and dusts were measured. Results: The rate of byssinosis (28.2%) was higher among the workers that who exposed to both jute and hemp dust. The frequency of chronic bronchitis in retired workers who previously smoked was higher (20%) as compared to currently smoking workers (17%). High dust levels were measured in some parts of the factory (mean (M) = 2.69 mg/m(3)). Working in dense dust areas, active smoking, being older than 40 years of age, being an ex-smoker, and working in the factory for a period exceeding 15 years were significantly associated with bronchitis and emphysema development. High endotoxin levels were determined for fine hemp dust (605 EU/mg), coarse hemp dust (336 EU/mg) and poor quality hemp fibers (114 EU/mg), whereas in fresh hemp stalks the level of endotoxin was determined to be lower (0.27 EU/mg). Conclusions: Because of high exposures to jute and hemp dusts that are associated with high byssinosis rates, personal protection and environmental hygiene is crucial to prevention of byssinosis