The characteristics of smoking habit among patients evaluated at our outpatient clinic

To determine the prevalence of cigarette smoking, to examine the risk factors affecting smoking amongst adults and to assess the opinion of patients about quitting smoking who were evaluated at our outpatient clinic. Six hundred fifty-nine patients who were evaluated at our outpatient clinic between June 2005 and June 2006 were included in the study. This is a cross-sectional study that evaluates prevalence of smoking. Data gathered by applying face to face questionnaires. The mean age of 659 participants [417 (63.3%) males and 242 (36.7%) females] was 53.1 ± 16.2 years. The prevalences were; 33% (n= 218) smokers, 39% (n= 258) ex-smokers and 28% (n= 183) non-smokers. Smoking prevalence under age of 50 was significantly higher (p= 0.0001). There was a positive significant relation between education and smoking amongst women, but this relationship was not significant amongst men. The most common reason for beginning smoking was because of friends (72%). 86% wanted to quit smoking. 48.9% tried to quit smoking but couln't be successful. The prevalence of active smoking and quit smoking among patients who applied to pulmonary medicine outpatient clinic were 33% and 28%, respectively. The ratio of smoking and smoking pack-years was higher among men. Eighty-six percent of patients wanted to quit, 25% tried to quit but could not be successful, and 49% quit smoking but began smoking again. According to these findings, patients who were smoking wanted to quit but couln't be successful without a professional help. We planned to found a smoking cessation outpatient clinic at our department

An old woman with weight loss and chest pain

Pulmonary sarcomas constitute only 0.1-0.5% of all primary lung malignancies. These tumors may derive from the lung parenchyma, bronchial tree or pulmonary arteries. The most important entity in the differential diagnosis is metastatic synovial sarcoma. A 76-years-old woman was admitted for investigation of a fever, productive cough, dyspnea, weight loss and left-sided chest pain which had been present for one month. A chest computerised tomography showed enlarged mediastinal lymph nodes were observed, as well as a left-sided pleural effusion. Thoracentesis revealed hemorrhagic pleural effusion which was exudate and lymphocyte predominant, closed pleural biopsy showed chronic inflammation. Left sided thoracoscopy was performed under local anesthesia, total collapse of left lung and multiple pleural nodules were observed on the visceral pleura multiple biopsies were obtained from those nodules. Pathologic examinations revealed "synovial sarcoma". As skeleton single photon emission tomography was unremarkable, primary pleuropulmonary synovial sarcoma was decided as diagnosis and chemotheraphy was planned for the patient. Primary pleuropulmonary synovial sarcoma is a rare neoplasm of lung and pleura but it is rare entity

Clinical presentations and diagnostic work-up in sarcoidosis: A series of Turkish cases (clinics and diagnosis of sarcoidosis)

Sarcoidosis is an idiopathic granulomatous disease. It usually affects the lung. The diagnosis may be problematic since the known causes of granulomatous inflammation must be excluded. This multicenter study aimed to evaluate the clinical presentations and diagnostic approaches of sarcoidosis. The study protocol was sent via internet, and the participants were asked to send the information (clinical, radiological and diagnostic) on newly diagnosed sarcoidosis cases. 293 patients were enrolled within two years. Pulmonary symptoms were found in 73.3% of the patients, and cough was the most common one (53.2%), followed by dyspnea (40.3%). Constitutional symptoms were occured in half of the patients. The most common one was fatigue (38.6%). The most common physical sign was eritema nodosum (17.1%). The most common chest radiograhical sign was bilateral hilar lymphadenomegaly (78.8%). Staging according to chest X-ray has revealed that most of the patients were in Stage I and Stage II (51.9% and 31.7%, respectively). Sarcoidosis was confirmed histopathologically in 265 (90.4%) patients. Although one-third of the bronchoscopy was revealed normal, mucosal hyperemi (19.8%) and external compression of the bronchial wall (16.8%) were common abnormal findings. The 100% success rate was obtained in mediastinoscopy among the frequently used sampling methods. Transbronchial biopsy was the most frequently used method with 48.8% success rate. Considering sarcoidosis with its most common and also rare findings in the differential diagnosis, organizing the related procedures according to the possibly effected areas, and the expertise of the team would favor multimodality diagnosis

Rib deformity in scoliosis

Rib deformity in scoliosis is of interest because it may help in the diagnosis, and also, in some pronounced cases, it may need correction by costoplasty. There are, however, debates about its use in diagnosis, because some authors think that rib deformity is not closely related to either the magnitude or the extent of rotation of the curve. In order to define the relation between rib deformity and scoliosis, 11 patients were recruited who were to undergo scoliosis surgery and thoracoplasty, and anteroposterior (AP) T1-S1 standing radiographs, computerized tomography (CT) scans, and three-dimensional (3D) reconstructions were obtained. From the radiographs, the most rotated vertebra, the Cobb angle, the apex and the type of the curve were determined. From the CT scans and 3D reconstructions, the exact level of the rib deformity measured was matched with the corresponding vertebral level. In this way, the most rotated vertebra and the most prominent part of the rib cage deformity were identified. The most rotated vertebra was found to be at the same level in both radiographs and CT scans in only five patients. In the rest of the patients, CT scans showed it either one level higher or lower than it appeared on the radiograph. The most prominent part of the rib cage deformity was at the same level as the most rotated vertebra in two patients, and in the rest of the patients it was one, two or three vertebral levels lower. There was no association between the Cobb angle, vertebral rotation and rib deformity. ACT scan is necessary preoperatively in patients who will undergo a costoplasty, to determine the exact levels of the prominence. However, a scanogram or a 3D reconstruction is required for exactly matching the most prominent part of the rib cage deformity to the corresponding vertebral level

obstruction (2007 : 7b)

Imaging findings were reported in an unusual case of endobronchial lipomatous hamartoma obstructing the left mainstem bronchus. Computed tomography readily demonstrated the presence of fat density within the lesion narrowing the differential diagnosis to endobronchial lipoma or lipomatous hamartoma

Endobronchial lipomatous hamartoma: an unusual cause of bronchial obstruction (2007: 7b).

Imaging findings were reported in an unusual case of endobronchial lipomatous hamartoma obstructing the left mainstem bronchus. Computed tomography readily demonstrated the presence of fat density within the lesion narrowing the differential diagnosis to endobronchial lipoma or lipomatous hamartoma

Stress fracture of the fifth metatarsophalangeal sesamoid bone: a case report

There is a paucity of published literature on the injuries of the lesser toe sesamoids of the foot. A fifty-six-year-old male patient without a major trauma history was diagnosed as having a stress fracture of the fifth metatarsophalangeal joint medial sesamoid bone. Conservative treatment was employed and the patient was followed-up for 25 months without any complaints. The sesamoid bone injury of the fifth toe should be included in the differential diagnosis of lateral forefoot pain