Asymptomatic solitary pons metastasis in small cell lung cancer: a case report

Akciğer kanserli olguların %10-14'unda tanı esnasında merkezi sinir sistemi metastazı bulunmakta ve %80-85 supratentoriyel yerlesim göstermektedir. Merkezi sinir sistemi metastazlarında en sık semptom basagrısıdır ancak daha nadir olarak hemiparezi gibi fokal nörolojik bulgular, epilepsi, serebellar fonksiyonlarda bozulma saptanabilmektedir. Beyin metastazlarının gelistigi akciger tümörleri radyolojik olarak sıklıkla apikal ve periferik yerlesimlidir. Beyin metastazı taramalarında ve evrelendirmede beyin BT ve/veya MRG kullanılmaktadır. Ancak beyin BT bazen beyin sapındaki lezyonları çok iyi görüntüleyemeyebilir. Kontrastlı beyin MRG'si küçük metastatik lezyonları göstermede BT'den daha duyarlıdır. Bu yazıda küçük hücreli akciger kanseri tanısı alan ve herhangi bir klinik semptom göstermeyen 47 yasındaki bir erkek olguda nadir metastaz bölgesi olarak saptanan pons yerlesimli bir beyin metastazı sunulmaktadır.Central nervous system metastasis is seen 10-14% in lung cancers at initial diagnosis and usually located at supratentorial localisation. In central nervous system metastases, the most common symptom is headache, whilst focal neurological deficits like hemiparesia, epilepsy, and deterioration in cerebellar functions may also be seen. Lung cancers with brain metastasis is usually located at apex and periferal regions radiographically. In scanning and staging of brain metastases, brain CT and/or MRI is used. Lesions located at brain stem may not be seen by brain CT. Brain MRI with gadolinum is more sensitive than CT to detect small metastatic lesions. In this case report, we present a 47 years old man with small cell lung cancer who had no neurologic symptoms and with rarely seen pons metastasis of brain

Characteristics of asthma in an older adult population according to sex and control level: why are asthma symptoms in older women not well-controlled?

ObjectiveThe older adult population in Turkey has increased by 22.6% in the last 5 years, and the characteristics of such patients with asthma remain uninvestigated. Therefore, we aimed to evaluate the characteristics of older adults with asthma according to sex and asthma control status to provide an in-depth overview of asthma in this population in Turkey.MethodsThe data of older adults (age 65 years and over) with asthma were obtained from a multicenter, cross-sectional asthma database registry (Turkish Adult Asthma Registry, TAAR) funded by the Turkish Thoracic Society. Comparisons were made based on sex and asthma control levels using the Global Initiative for Asthma (GINA) Asthma Symptom Control Questionnaire.ResultsOf the 2053 (11.5%) patients registered with the TAAR, 227 were older adults (median age, 69 (8), women, 75.8% (n = 172)). Of these, 46.5% (n = 101) had obesity to some degree. Compared with men, women had lower education, income levels, and employment rates. Additionally, women exhibited a higher prevalence of obesity, hypertension, and thyroid gland disease than men. Being female (OR: 2.99; 95% CI: 1.307-6.880), the presence of gastroesophageal reflux disease (OR: 2.855; 95% CI: 1.330-6.130), and a predicted forced expiratory volume in the first-second value lower than 80% (OR: 2.938; 95% CI: 1.451-5.948) were associated with poorly controlled asthma.ConclusionsHerein, older adults comprised 11.5% of adult patients with asthma. Being female poses a disadvantage in terms of both asthma prevalence and control in the older adult asthmatic population owing to the prevalence of comorbidities and socioeconomic sex-related distinguishing factors