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

Behçet hastalığı ve kanser ilişkisi: Retrospektif analiz tek merkez deneyimi

Amaç: Behçet Hastalığı vaskülitik bir hastalıktır. Behçet Hastalığı ile kanser birlikteliği çok sık değildir. Biz çalışmamızda Behçet Hastalığı kanser ilşkisini araştırdık. Materyal ve Metod: 2005-2010 yılları arasında takip edilmiş 105 Behçet Hastası çalışmaya alındı. Histopatolojik olarak konfirme edilmiş malignensisi olan hastalar belirlendi. Bulgular: Bu takip süresinde klavuzlara uygun olarak düzenli taramaları yapılan hastalardan sadece birinde malignensi gözlendi. Bu hasta 55 yaşında meme kanseri tanısı aldı ve 16 yıl kolşisin kullanımı mevcuttu. Meme kanserine yönelik olarak modifiye radikal mastektomi ve 4 kür doksorubisin; siklofosfamid kombinasyonu uygulandıktan sonra tedaviye Tamoksifen ve LHRH anologu ile devam edildi. Sonuç: Bazı romatolojik hastalıklar kanser gelişimine predispozisyon yaratabilir. Hastalığın natürü ve kullanılan immunsupresif ilaçlar bundan sorumlu olabilir. Bizim çalışmamızda direk böyle bir ilişki gösterilemedi. Ama diğer bir yandan önemle vurgulanması gereken Behçet Hastalığı ile malignensi birlikteliğinde her 2 hastalığın birlikte dikkatlice yönetimidir.Purpose: BehÇet's disease (BD) is a vasculitis of unknown origin. In autoimmune and vasculitic disorders the risk of malignancies has been extensively studied. In BD patients more than hundred cases associated with malignancies have been published. However, the direct relationship with BD has not been proved. We aimed to to investigate the incidence of malignancies in BD patients Material and Methods: Here in we assessed 105 cases retrospectively between 2005-2010 with BD diagnosed according to International Study Criteria (ISG) . The patient's data were reviewed for development of histopathologically confirmed malignancy Results: One of our 105 patients with BD was found to have solid tumor in the rate of 0.9 %. The remaining 104 patients with BD were in follow up without any malignancy in this period. The malignancy that we reported was invasive right breast carcinoma in a 55-year-old woman with BD. A radically modified right mastectomy and axillary lymphadenectomy were performed and postoperative doxorubicin, cyclophosphamide therapy for four cycles and hormonal therapy with tamoxifen and leuprolide acetate was administered as adjuvant therapy. This patient had a history of 16 years colchicine usage as medication for BD. Conclusion: The rheumatologic diseases can predispose malignancy, the autoimmune nature of BD or the immunosupressive medicines could be possible causes of this carcinoma. However, in our study only one patient had malignancy. The another point of view; management and also prevention of cancer with BD is important entity

An implementation on the social cost of hospital acquired infections

WOS: 000355307300172PubMed: 26064367Hospital Acquired Infections (HAIs) are defined as infections developing in relation to health services at inpatient treatment facilities in general. Although health services improve, HAIs continue to be seen both in underdeveloped and developed countries. HAIs result in a range of negative externalities. Negative externalities include factors such as an increase in morbidity and mortality, extension of the hospitalization duration, impaired quality of life, loss of working power and performance. HAIs pose a big burden regarding population and community health care. This study aims to calculate the financial burden of HAIs by evaluating it within the scope of negative externality. The communal costs of HAIs patients were calculated by using a genuine approach with reference to samples obtained from the Duzce University Research and Application Hospital. This approach includes 4 stages and the results of each stage is sorted according to the data of 2013 as follows: (i) HAIs expenditure undertaken by the Social Security Institution is 5,832,167 TL, (ii) the monetary value of the work power loss of the HAIs patients who are at a working age is 126,154 TL, (iii) the relative cost of HAIs patients compared to a group of normal patients is 21,507 TL and (iv) HAIs patients' communal cost is 6,013,101 TL. Based on the received results, the annual communal cost of the estimated HAIs patients in Turkey is predicted to be 3,640,442,057 TL. In addition to these findings, HAIs patients experience 14 times longer in-patient stay at the hospitals as compared to normal patients, and their treatment expenditures are 23 times higher than the normal patients. In the conclusion part of the study, regarding the preventability (internalization) of HAIs, which was evaluated as part of negative externality, alternative applicable political suggestions are presented for the use of policymakers

Carbon monoxide poisoning cases presenting with non-specific symptoms

KARA, ISMAIL HAMDI/0000-0003-2022-1882WOS: 000394362200017PubMed: 27495248Carbon monoxide (CO) is a colourless and odourless gas appearing as a result of incomplete combustion of carbon-containing fuels. Many domestic or occupational poisonings are caused by CO exposure. Malfunctioning heating systems, improperly ventilated motor vehicles, generators, grills, stoves and residential fires may be listed in the common sources of CO exposure. The aim of this study was to emphasize the significance of early diagnosis of CO poisoning with non-invasive measurement of CO levels of the patients with nonspecific symptoms using a pulse oximeter device in the triage. Our study was a cross-sectional study. Patients who presented to the emergency department (ED)due to non-specific symptoms and had a Canadian Triage and Acuity scale level of 4 or 5 were included in the study; 106 (5.9%) of 1788 patients admitted during the study period were diagnosed with CO poisoning. Patients with CO poisoning and the other patients had statistically significant differences in terms of presenting symptoms, namely, headache, dizziness, nausea, and vomiting. More CO poisoning cases were admitted in the fall and winter compared to the spring and summer. The number of CO poisoning victims can be decreased if preventive measures like CO monitoring systems and well-designed ventilation systems are generalized at homes and workplaces. Measurement of carboxyhaemoglobin levels of patients presenting to ED due to non-specific symptoms like headache and dizziness during cold seasons and winter months using a pulse CO-oximeter should be a part of the routine of emergency medicine triage

Nosocomial Acinetobacter Infections

The number of nosocomial infections caused by Acinetobacter spp. has increased in recent years. In this study, we evaluated 80 patients (male 70% and, mean age of all patients 38.8 ± 12) with nosocomial acinetobacter infections. Fifty three (66.3%) of 80 strains identified by Sceptor were found to be as Acinetobacter baumannii and 27 (33.7%) strains to be as A. lwoffii. All Acinetobacter spp. were multidrug resistant. Quinolone and carbapenem resistance were 60.4% and 15.1% for A. baumannii, and 44.4% and 22.2% for A. lwoffii, respectively. Nosocomial Acinetobacter infections occurred after a mean (± SD) hospitalization of 14 ± 8.8 days. Most of infections (61.3%) were acquired in an intensive care and oncology ward. Of all patients, 76 (95%) had multiple risk factors. Nosocomial infections were as follows: pneumonia in 32 (40.8%), urinary tract infection in 16 (20%), wound infection in 14 (17.5%), bacteremia in 8 (10%), meningitis in 5 (6.3%), catheter infection in 3 (3.8%) and peritonitis in 2 (2.5%) of the patients. Acinetobacter infections caused or contributed to death of 13 (16.3%) patients

Safety and efficacy of regorafenib in patients with treatment-refractory metastatic colorectal cancer in Turkey: the single-arm, open-label REGARD study

Objectives Regorafenib improved overall survival in patients with metastatic colorectal cancer (mCRC) refractory to standard therapies in two randomised, phase III trials, but has not been evaluated in Turkey. REGARD evaluated the safety and efficacy of regorafenib in Turkish patients with treatment-refractory mCRC