Isolated Hepatic Tuberculosis Presenting as Cystic-Like and Tumour-Like Mass Lesions

Hepatic tuberculosis is a rare manifestation of extra-pulmonary tuberculosis. Hepatic tuberculous lesions are especially mimicking tumour-like mass or cystic lesions in the liver and so can be misdiagnosed with several diseases. Histopathological examination of the specimen is essential in the diagnosis for hepatic tuberculosis. In this report, two cases with hepatic tuberculosis having cystic solid mass and abscess liver lesions are described

Evaluation of patients with fibrotic interstitial lung disease: Preliminary results from the Turk-UIP study

OBJECTIVE: Differential diagnosis of idiopathic pulmonary fibrosis (IPF) is important among fibrotic interstitial lung diseases (ILD). This study aimed to evaluate the rate of IPF in patients with fibrotic ILD and to determine the clinical-laboratory features of patients with and without IPF that would provide the differential diagnosis of IPF. MATERIAL AND METHODS: The study included the patients with the usual interstitial pneumonia (UIP) pattern or possible UIP pattern on thorax high-resolution computed tomography, and/or UIP pattern, probable UIP or possible UIP pattern at lung biopsy according to the 2011 ATS/ERSARS/ALAT guidelines. Demographics and clinical and radiological data of the patients were recorded. All data recorded by researchers was evaluated by radiology and the clinical decision board. RESULTS: A total of 336 patients (253 men, 83 women, age 65.8 +/- 9.0 years) were evaluated. Of the patients with sufficient data for diag-nosis (n=300), the diagnosis was IPF in 121 (40.3%), unclassified idiopathic interstitial pneumonia in 50 (16.7%), combined pulmonary fibrosis and emphysema (CPFE) in 40 (13.3%), and lung involvement of connective tissue disease (CTD) in 16 (5.3%). When 29 patients with definite IPF features were added to the patients with CPFE, the total number of IPF patients reached 150 (50%). Rate of male sex (p<0.001), smoking history (p<0.001), and the presence of clubbing (p=0.001) were significantly high in patients with IPE None of the women <50 years and none of the men <50 years of age without a smoking history were diagnosed with IPE Presence of at least 1 of the symptoms suggestive of CTD, erythrocyte sedimentation rate (ESR), and antinuclear antibody (FANA) positivity rates were significantly higher in the non-IPF group (p<0.001, p=0.029, p=0.009, respectively). CONCLUSION: The rate of IPF among patients with fibrotic ILD was 50%. In the differential diagnosis of IPF, sex, smoking habits, and the presence of clubbing are important. The presence of symptoms related to CTD, ESR elevation, and EANA positivity reduce the likelihood of IPF

Association of respiratory symptoms and lung function with occupation in the multinational Burden of Obstructive Lung Disease (BOLD) study

Background Chronic obstructive pulmonary disease has been associated with exposures in the workplace. We aimed to assess the association of respiratory symptoms and lung function with occupation in the Burden of Obstructive Lung Disease study. Methods We analysed cross-sectional data from 28 823 adults (≥40 years) in 34 countries. We considered 11 occupations and grouped them by likelihood of exposure to organic dusts, inorganic dusts and fumes. The association of chronic cough, chronic phlegm, wheeze, dyspnoea, forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1)/FVC with occupation was assessed, per study site, using multivariable regression. These estimates were then meta-analysed. Sensitivity analyses explored differences between sexes and gross national income. Results Overall, working in settings with potentially high exposure to dusts or fumes was associated with respiratory symptoms but not lung function differences. The most common occupation was farming. Compared to people not working in any of the 11 considered occupations, those who were farmers for ≥20 years were more likely to have chronic cough (OR 1.52, 95% CI 1.19–1.94), wheeze (OR 1.37, 95% CI 1.16–1.63) and dyspnoea (OR 1.83, 95% CI 1.53–2.20), but not lower FVC (β=0.02 L, 95% CI −0.02–0.06 L) or lower FEV1/FVC (β=0.04%, 95% CI −0.49–0.58%). Some findings differed by sex and gross national income. Conclusion At a population level, the occupational exposures considered in this study do not appear to be major determinants of differences in lung function, although they are associated with more respiratory symptoms. Because not all work settings were included in this study, respiratory surveillance should still be encouraged among high-risk dusty and fume job workers, especially in low- and middle-income countries.publishedVersio

Cohort Profile: Burden of Obstructive Lung Disease (BOLD) study

The Burden of Obstructive Lung Disease (BOLD) study was established to assess the prevalence of chronic airflow obstruction, a key characteristic of chronic obstructive pulmonary disease, and its risk factors in adults (≥40 years) from general populations across the world. The baseline study was conducted between 2003 and 2016, in 41 sites across Africa, Asia, Europe, North America, the Caribbean and Oceania, and collected high-quality pre- and post-bronchodilator spirometry from 28 828 participants. The follow-up study was conducted between 2019 and 2021, in 18 sites across Africa, Asia, Europe and the Caribbean. At baseline, there were in these sites 12 502 participants with high-quality spirometry. A total of 6452 were followed up, with 5936 completing the study core questionnaire. Of these, 4044 also provided high-quality pre- and post-bronchodilator spirometry. On both occasions, the core questionnaire covered information on respiratory symptoms, doctor diagnoses, health care use, medication use and ealth status, as well as potential risk factors. Information on occupation, environmental exposures and diet was also collected

Riociguat treatment in patients with chronic thromboembolic pulmonary hypertension: Final safety data from the EXPERT registry

Objective: The soluble guanylate cyclase stimulator riociguat is approved for the treatment of adult patients with pulmonary arterial hypertension (PAH) and inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH) following Phase

A rare pleural effusion: Pseudochylothorax: Differential diagnosis

WOS: 000254582600027Pseudochylothorax is an odorless and milky pleural effusion with high levels of cholesterol and/or cholesterol crystals. Lipids in the effusion are suggested to accumulate in the pleural fluid as a result of pleural thickening and calcification due to chronic pleurisy. Tuberculous pleurisy, chronic romatoid pleurisy and theurapetic pneumothorax are the common causes of pseudochylothorax. The differential diagnosis of pseudochylothorax and chylothorax, which have completely different etiologies, pathogeneses and treatments, should be made and patients should be followed closely for tuberculosis reactivation. In this article, we presented a 70 years old man with pseudochylothorax in whose pleural fluid culture

Spontaneous hydropneumothorax: An unusual presentation of malignant pleural mesothelioma

We report a case of malignant pleural mesothelioma in a patient who presented with spontaneous hydropneumothorax. This is the third case of malignant pleural mesothelioma reported to have this pattern of radiographical presentation in medical publications in English. The patient was a 52-year-old woman who had environmental asbestos exposure. The hydropneumothorax did not recur after the chest drainage, but the pleural tumour showed progression. Thus, spontaneous hydropneumothorax may be included among the presenting symptoms of malignant pleural mesothelioma, particularly in patients who have a history of environmental exposure.We report a case of malignant pleural mesothelioma in a patient who presented with spontaneous hydropneumothorax. This is the third case of malignant pleural mesothelioma reported to have this pattern of radiographical presentation in medical publications in English. The patient was a 52-year-old woman who had environmental asbestos exposure. The hydropneumothorax did not recur after the chest drainage, but the pleural tumour showed progression. Thus, spontaneous hydropneumothorax may be included among the presenting symptoms of malignant pleural mesothelioma, particularly in patients who have a history of environmental exposure

The Effectiveness, Safety, and Tolerability of Pirfenidone in Idiopathic Pulmonary Fibrosis: A Retrospective Study

IntroductionIn this study we aimed to investigate the effectiveness and safety profile of pirfenidone for the treatment of idiopathic pulmonary fibrosis (IPF) in a real-life setting.MethodsClinical records of patients diagnosed with mild-to-moderate IPF and receiving pirfenidone treatment across three centers in Turkey between January and September 2017 were retrospectively collected. Pulmonary function measurements, including percentage of forced vital capacity (FVC%) and percentage of diffusion capacity (DLCO%) were analyzed in patients who received pirfenidone treatment for at least 6months. Decline in lung function, defined as an absolute decline of at least 10% in FVC from baseline, or death at 6months was also analyzed. Safety data were included for all follow-up visits.ResultsIn the pooled cohort (n=60), patients were mostly men (73.4%) and current or former smokers (61.7%). Average baseline FVC% and DLCO% were 68.4% and 48.7%, respectively. Forty-seven patients (78.3%) had a high-resolution computed tomography scan with a definite interstitial pneumonia (UIP) pattern, and 18 patients (30%) had a surgically proven UIP pattern. Forty-six (76.7%) patients with IPF remained stable and 14 (23.3%) patients had progressed according to decline in FVC of at least 10% during the therapy course. After 6months of therapy, cough decreased in 58.3% of patients. At least one side effect due to therapy was encountered in 33 (55.0%) IPF patients. Dyspepsia (36.4%), nausea (27.3%), and rash/photosensitivity (24.2%) were the most frequent side effects in our cohort. Sixteen patients (26.7%) needed dose adjustment, one patient (1.7%) discontinued therapy, and one patient (1.7%) died in the study period.ConclusionsThis study shows that pirfenidone seems to be an effective treatment for IPF and also had tolerable and relatively acceptable side effects.FundingRoche

Huge bilaterally cavitary and nodulary lung lesions: Pulmonary lenfomatoid granulomatosis

WOS: 000209370403867

The characteristics of patients with stable and exacerbated chronic obstructive pulmonary disease (COPD) admitted to our hospital

AMAÇ: Bu çalışmada, hastanemize başvuran stabil ve alevlenme önemindeki KOAH'lı hastaların karakteristik özelliklerini belirlemek amaçlanmıştır. YÖNTEM: Aralık 1999-Ocak 2001 tarihleri arasında Çukurova Üniversitesi Tıp Fakültesi Göğüs Hastalıkları kliniğine başvuran 113 stabil ve 31 alevlenme dönemindeki KOAH hastası çalışmaya alınmıştır. Bu hastaların sosyodemografik özellikleri, sigara alışkanlıkları, solunum fonksiyon testleri ve arteriyel kan gazı parametreleri incelenmiştir. Sonuçlar: Stabil KOAH'lı hasta grubunun yaş ortalaması ile [62.6±8.2 (yıl±SS)], KOAH alevlenme grubunun yaş ortalaması [64.2±7.3 (yıl±SS)] arasında belirgin bir fark yoktu. KOAH alevlenme grubunun ortalama FEVi değerinin [37.1 ±19.7 (%beklenen)], stabil KOAH'lı hastaların ortalama FEVi değerinden [53.2±20.3 (%beklenen)] daha düşük olduğu görülmüştür (p-0.02). Arteriyel kan gazı incelemelerinde, alevlenme dönemdeki KOAH'lı hastaların PaÖ2, ve O2 saturasyon değerlerinin, stabil KOAH'lı hastalara göre daha düşük olduğu, PaCO^nin ise yüksek olduğu saptanmıştır (p<0.05). Stabil KOAH grubunun %17.7'si eğitimsiz iken KOAH alevlenme grubunda bu oran %22.6 idi. Stabil KOAH'lı hastaların %55.8'nin aylık geliri 250 $(400 milyon TL) altında, KOAH alevlenme grubunda bu oran$ (400 millions TL) in stable COPD group was 55.8%, this percentage in exacerbated COPD group was 80.6% (p=0.01). Cigarette smoking intensity was significantly higher in patients with exacerbated COPD (47.0±18.5 [pack-years±SD]) than in patients with stable COPD (39.4±14.6 [pack-years±SD]) (p=0.004)