Dual Energy CT Evaluation of the Severity of Pulmonary Thromboembolism: Correlation of Pulmonary Perfusion Score with CT

Bozdag, Mustafa/0000-0002-0741-587XWOS: 000567599300005Background: Pulmonary thromboembolism (PTE) is an important cause of morbidity and mortality in hospitalized patients and computed tomographic angiography (CTA) has become the gold standard diagnostic examination for suspected PTE. Dual energy computed tomography (DECT) not only detects thromboembolic filling defects but also provides functional perfusion information by generating iodine distribution maps. Objectives: the objective of the study is to determine the value of perfusion defect score (P score) in detection of the severity of acute PTE and to correlate it with pulmonary obstruction score (Qanadli score), other CTA parameters and clinical findings. Patients and Methods: Fifty five patients, with acute PTE who underwent DECT were reviewed. We calculated P score, Qanadli score, ratio of the right ventricle diameter to the left ventricle (RV/LV ratio) and the main pulmonaryartery(PA) diameter by using the dual energy CTA images. the correlation between CTA parameters and clinical- echocardiographic data was investigated. Results: Correlation analysis showed a significant positive correlation between the P score and Qanadli score (r= 0.748, P < 0.001). There was also a significant positive correlation between P score and RV/LV ratio (r = 0.432, P = 0.001) and between Qanadli score and RV/LV ratio (r = 0.424 P = 0.001). Echocardiographic data was present in 39 patients (70.9 %). P score was significantly higher in patients with RV dilatation (P = 0.022) and RV dysfunction (P = 0.001) on echocardiography. Likewise, similar interaction was present between Qanadli score and RV dilatation (P = 0.023) and RV dysfunction (P = 0.003). No correlation was present between P score and blood gas analysis [partial pressure of oxygen in arterial blood (PaO2), partial pressure of arterial carbon dioxide (PaCO2),(PaO2)/fraction of inspired oxygen (FiO(2)), oxygen saturation] and hemodynamic data (blood pressure and pulse). Conclusion: P score is seen as a good adjunctive tool to other CTA parameters and echocardiography in detection of PTE severity. Addition of perfusion changes to clinical risk assessment will help in the management of patients

Examining the relationship between symptoms watched in lung cancer patients and illness perception

Objective: To examine the relationship between the symptom experience of lung cancer patients and their illness perception of the disease. Methods: The descriptive and cross-sectional study was conducted from April to September 2015 at the Chemotherapy Treatment Centre of the Medicine Chest Diseases Clinic at the Ege University, Izmir, Turkey, and comprised lung cancer patients of either gender aged >18 years. Data was collected using a predesigned Patient Questionnaire as well as the standard Lung Cancer Symptom Scale, Illness Perception Questionnaire and Karnofsky Performance Scale. The patients' sociodemographic characteristics and data on their illness, the symptoms they experienced and the numerical and percentage distribution of the items on the illness perception scale, mean and standard deviation values were examined. Pearson Correlation analysis was used to examine the correlation between illness perception and Karnofsky Performance Scale scores and other variables. Results: Of the 105 patients, 86(81.9%) were males, 86(81.9%) were married, 49(46.7%) were elementary school graduates, 101(96.2%) were unemployed, and 95(90.5%) were receiving chemotherapy. The overall mean age of the sample was 61.43 +/- 8.24 years, the period since diagnosis was 11.38 +/- 17.84 months, and the duration of chemotherapy was 4.28 +/- 2.37 months. The mean symptom burden score was 22.75 +/- 10.85 and the Lung Cancer Symptom Scale score was 22.75 +/- 10.85. The mean score of the type of illness domain was 5.53 +/- 2.12. The overall mean global quality of life score was 64.30 +/- 12.60. Conclusions: As the symptom burden experienced by the lung cancer patients increased, their perception of the illness became more negative, and the longer the cyclical periods and the period of diagnosis, the patients' control over their illness decreased

Hypersensitivity to chemotherapeutics: a cross sectional study with 35 desensitisations

WOS: 000352616900023PubMed ID: 25056643Chemotherapy is one of the main treatments for lung cancer, and in these patients, discontinuation of treatment due to uncontrollable hypersensitivity reactions (HSRs) is an important problem. To determine the frequency of HSRs during chemotherapy and to review current approaches. We did a cross sectional study in patients undergoing chemotherapy for lung cancer in a reference chemotherapy unit from January 2012 to January 2013. Patients who developed immediate-HSRs or delayed-HSRs to chemotherapeutics and gave consent were included into study. The effectiveness of a standardised 12-step "rapid drug desensitisation" (RDD) procedure was investigated in patients with immediate-HSRs. In total, 1,099 cycles of chemotherapy were administered to 292 patients in 1 year. We observed ten HSRs, during ten cycles in ten patients (similar to 3 % of the patients). Two HSRs were delayed-type, eight were immediate-type at grade 1-3. Of those with immediate-type HSR, five patients with grade 2-3, and additional two referred patients with grade 4 HSRs were successfully given their culprit drug in 35 cycles of chemotherapy with 12-step or modified 20-step RDD protocol. HSRs to chemotherapeutics are not so rare. Premedication alone does not prevent such reactions. The results of RDD treatment look promising for continuing treatment with the culprit chemotherapeutic agent

Salivary Lipids of Patients with Non-Small Cell Lung Cancer Show Perturbation with Respect to Plasma

A comprehensive lipid profile was analyzed in patients with non-small cell lung cancer (NSCLC) using nanoflow ultrahigh-performance liquid chromatography–electrospray ionization–tandem mass spectrometry. This study investigated 297 and 202 lipids in saliva and plasma samples, respectively, comparing NSCLC patients to healthy controls. Lipids with significant changes (>2-fold, p 2–3-fold) in plasma and saliva samples. Three specific TGs (50:2, 52:5, and 54:6) were significantly increased in NSCLC for both sample types. A common ceramide species (d18:1/24:0) and phosphatidylinositol 38:4 decreased in both plasma and saliva by approximately two-fold. Phosphatidylserine 36:1 was selectively detected in saliva and showed a subsequent decrease, making it a potential biomarker for predicting lung cancer. We identified 27 salivary and 10 plasma lipids as candidate markers for NSCLC through statistical evaluations. Moreover, this study highlights the potential of saliva in understanding changes in lipid metabolism associated with NSCLC

Smoke-free Ege: An attempt for an integrative prevention strategy for tobacco control at a University setting

Introduction Ege University is a pioneering university at Ege region with its 70 000 students and approximately 3000 academic staff. Tobacco control policies, parallel to the current regulations in the country, are an important issue for Ege University too, yet it bares important opportunities as well as barriers for an integrative approach for tobacco control on University Campus. Aim This study aims to explain the construction of Smoke-Free Ege Working Group, its formal initiation at the World No Tobacco Day (May 31st) and its subsequent action plan structured in the light of MPOWER. Methods Since 1999, smoking cessation outpatient service delivery points have been the main units of motivation for tobacco control policies at Ege University. Although Turkey is moving well about tobacco regulations, adherence to regulations is deficient and high prevalence of smoking among university staff and students remains as a major concern throughout the years. In March 2018, the administrative bodies of Medical School, have dealt their concerns to the units serving care for cessation and have gathered them at a first meeting. The Dean and Medical Manager of Medical Faculty, with a non-smoker administrative team, mentored and facilitated these efforts. Starting at this point, with regular meetings, the representatives determined their objectives, current barriers and opportunities. The construction of Smoke-Free Ege Working Group has rooted from these consecutive meetings. In the light of MPOWER, specific objectives at University Campus were listed. The major aim of the group was recognized as “changing the norms and culture for smoking”. This needed a good promotion strategy as well as collaboration with staff, students and administrative units. The efforts were collaborated with the Communications Unit of the University. A logo was created, brochures to raise awareness for the Smoke Free issue and the Working group, were prepared. The formal presentation of the Working Group was planned as a colorful activity on World No Tobacco Day, May 31st. To gather more visibility at the social media and press, representatives from three major opponent sports teams of Izmir city were invited. Results The Working Group was introduced to the media in the presence of the Rector, Dean, Medical managerl and all administrative units of the Medical School. Staff who succeeded to stop smoking, at the cessation service of the University, were awarded with certificates. The media showed great interest in the activity as it was put as “the famous sportsmen are supporting the efforts for a Smoke-free university”. Students and staff attended and shared the activity in social media as the entrance of the meeting was also colorfully designed for such promotion. Conclusions The Working Group has achieved to attract attention of staff, students and responsible bodies of the University and now moving forward for Smoke –Free Councils with students and staff representatives. Barriers and opportunities will be discussed, actions in the light of MPOWER, will be planned at these Councils. Smoke –Free Unit certifications and awards, designing smoking points outside of education and hospital settings and changing the “norm” are targeted