Matrix metalloproteinase-9 decreased after chemotherapy in patients with non-small cell lung cancer

Aims and background. The aim of the study was to investigate the alteration in serum matrix metalloproteinase-9 (MMP-9) levels after chemotherapy and the association between the changes in serum levels of MMP-9 and response to chemotherapy in patients with advanced stage non-small cell lung cancer

The levels of serum vascular endothelial growth factor and Bcl-2 and association between them in stage IV non-small cell lung cancer

OBJECTIVE

Prospective cross-sectional multicenter study on domiciliary noninvasive ventilation in stable hypercapnic COPD patients

Taylan, Mahsuk/0000-0003-4072-2270; Durmus Kocak, Nagihan/0000-0003-4028-2797; Cosgun, Ibrahim Guven/0000-0001-7365-8098WOS: 000441176100001PubMed: 30127600Background: Domiciliary noninvasive ventilation (NIV) use in stable hypercarbic COPD is becoming increasingly widespread. However, treatment compliance criteria and factors related to compliance remain to be defined. Methods: This research was designed as a prospective, cross-sectional, multicenter real-life study. Chronic hypercapnic COPD patients who were using domiciliary NIV for at least 1 year and being followed up in 19 centers across Turkey were included in the study. The patients who used NIV regularly, night or daytime and >= 5 hours/d, were classified as "high-compliance group," and patients who used NIV irregularly and <5 hours/d as "low-compliance group." Results: Two hundred and sixty-six patients with a mean age of 64.5 +/- 10.3 years were enrolled, of whom 75.2% were males. They were using domiciliary NIV for 2.8 +/- 2 years. Spontaneous time mode (p<0.001) and night use (p<0.001) were more frequent in the high-compliance group (n=163). Also, mean inspiratory positive airway pressure values of the high-compliance group were significantly higher than the low-compliance group (n=103; p<0.001). Cardiac failure (p=0.049) and obesity (0.01) were significantly more frequent in the high-compliance group. There were no difference between 2 groups regarding hospitalization, emergency department and intensive care unit admissions within the last year, as well as modified Medical Research Council dyspnea and COPD Assessment Test scores. With regard to NIV-related side effects, only conjunctivitis was observed more frequently in the high-compliance group (p=0.002). Conclusion: Determination of the patients who have better compliance to domiciliary NIV in COPD may increase the success and effectiveness of treatment. This highly comprehensive study on this topic possesses importance as it suggests that patient and ventilator characteristics may be related to treatment compliance.Association of Lung Health and Intensive Care; Turkish Respiratory SocietyCOHOV Study Group: Firat Uygur, Fatma Merve Tepetam, Sinem Gungor, Sibel Arinc, Ulku Aka Akturk, Unal Sahin, Elif Tanriverdi, Serap Argun Baris, Talat Kilic, Emine Arguder, Dildar Duman, Aylin Ozsancak Ugurlu, Omer Tamer Dogan, Didem Gorgun Hattatoglu, Tugba Onyilmaz, Ayse Havan, Umran Toru, Ebru Cakir Edis, Ersin Gunay, Recep Isik, Emel Bulcun, Sibel Gunay, Murside Demirhan Uzun, Bulent Altinsoy, Muge Ozdemir, Ozgecan Karahan, Pinar Atagun Guney, Dilek Ernam, Demet Turan, Aziz Gumus, Mehmet Baran Balcan, Serdar Berk, Birsen Pinar Yildiz. The authors would like to thank The Association of Lung Health and Intensive Care for financial support in the publication of the article. The authors also gratefully acknowledge the support of Turkish Respiratory Society for help with the statistical analysis of this study

Chronic obstructive pulmonary disease phenotypes in Turkey: the COPET study-a national, multicenter cross-sectional observational study

Background/aim: While mortality rates decrease in many chronic diseases, it continues to increase in COPD. This situation has led to the need to develop new approaches such as phenotypes in the management of COPD. We aimed to investigate the distribution, characteristics and treatment preference of COPD phenotypes in Turkey. Materials and methods: The study was designed as a national, multicenter, observational and cross-sectional. A total of 1141 stable COPD patients were included in the analysis. Results: The phenotype distribution was as follows: 55.7% nonexacerbators (NON-AE), 25.6% frequent exacerbators without chronic bronchitis (AE NON-CB), 13.9% frequent exacerbators with chronic bronchitis (AE-CB), and 4.8% with asthma and COPD overlap (ACO). The FEV 1 values were significantly higher in the ACO and NON- AE than in the AE-CB and AE NON-CB (p < 0.001). The symptom scores, ADO (age, dyspnoea and FEV 1) index and the rates of exacerbations were significantly higher in the AE-CB and AE NON-CB phenotypes than in the ACO and NON-AE phenotypes (p < 0.001). Treatment preference in patients with COPD was statistically different among the phenotypes (p < 0.001). Subgroup analysis was performed in terms of emphysema, chronic bronchitis and ACO phenotypes of 1107 patients who had thoracic computed tomography. A total of 202 patients had more than one phenotypic trait, and 149 patients showed no features of a specific phenotype. Conclusion: Most of the phenotype models have tried to classify the patient into a certain phenotype so far. However, we observed that some of the patients with COPD had two or more phenotypes together. Therefore, rather than determining which phenotype the patients are classified in, searching for the phenotypic traits of each patient may enable more effective and individualized treatment

Effects of aspiration pneumonia on the intensive care requirements and in-hospital mortality of hospitalised patients with acute cerebrovascular disease

Introduction : In this study, we aimed to evaluate the effects of the development of aspiration pneumonia (AP) on the intensive care unit (ICU) requirements and in-hospital mortality of patients hospitalised in the neurology ward due to an acute cerebrovascular accident (CVA). Material and methods: Five hundred and three patients hospitalised in the neurology ward following an acute CVA were retrospectively analysed. The patients were divided into two groups: those with AP (group 1) and those without AP (group 2). Demographic characteristics and physical and radiological findings, including the localisation, lateralisation and aetiology of the infarction, in addition to ICU requirements and mortality, were evaluated. Results : Aspiration pneumonia was detected in 80 (15.9%) patients during the in-hospital stay. Transfer to the ICU for any reason was required in 37.5% of the patients in group 1 and 4.7% of those in group 2 (p < 0.001). In-hospital mortality occurred in 7.5% and 1.4% of the patients in group 1 and group 2, respectively (p = 0.006). The incidence of AP was highest in patients with an infarction of the medial cerebral artery (MCA) (p < 0.001). AP was associated with older age (p < 0.001), hypertension (p = 0.007), echocardiography findings (p = 0.032) and the modified Rankin Scale (mRS) score (p < 0.001). Conclusions : Our findings suggest that the requirement rate for transfer to the ICU and the mortality rate appear to be significantly higher in patients with a diagnosis of AP. Precautions should be taken, starting from the first day of hospitalisation, to decrease the incidence of AP in patients with acute CVA, focusing especially on older patients and those with a severe mRS score