Azithromycin in the treatment of adults with mild to moderate community-acquired pneumonia: a study of efficacy and tolerability

Amaç: Bu çalışma, erişkin yaş grubundaki ağır olmayan toplum kökenli pnömoni olgularının ayaktan tedavisinde, Azitromisin.in (3 gün süreyle günde tek doz 500 mg) etkinlik ve güvenilirliğini araştırmak üzere tasarlanmıştır. Yöntem: Polikliniğe başvurusunda ağır olmayan toplum kökenli pnömoni tanısı konan 11 hasta çalışmaya alındı. Tanı klinik ve radyolojik bulgulara dayanılarak kondu. Bu hastalar azitromisin ile tedavi sırasında yan etki açısından ve bir aylık süre içinde klinik ve radyolojik olarak kontrol edildi. Değerlendirmeler, düzelme, tam iyileşme, başarısızlık ve nüks olarak belirtildi. Sonuçlar, toplam hasta sayısına oranlanarak yüzde cinsinden hesaplandı. Bulgular: Tedavi sonundaki etkinlik değerlendirmesinde, 11 hastanın 10.unda (%91) tam iyileşme olduğu belirlendi. Yalnızca bir hastada nüks gelişti (%9). ıki hastada tedaviye bağlı yan etki gözlendi (%18). Hastaların tedaviye uyumu yüksekti (%91). Sonuç: Bu çalışma, 3 gün-günde tek doz 500 mg azitromisin tedavisinin, ayaktan tedavi kararı verilmiş ağır olmayan toplum kökenli pnömoni tedavisinde etkin ve güvenli olduğunu göstermektedir. Ayrıca, kısa süreli bir tedavi rejimi hasta uyumunu da arttırmaktadır.Objective: This study was designed to investigate the efficacy and tolerability of azithromycin (500 mg once daily for 3 days) in the treatment of adults with mild to moderate community-acquired pneumonia. Methods: Eleven patients with mild to moderate pneumonia were enrolled in the study. The diagnosis was based on clinical and radiographical findings. The patients were treated with azithromycin and they were assessed for side effects, during one-month-of, follow up. Post treatment evalution was categorized on either a cure, improvement, failure or relapse. The results were expressed as a percentage of the total number of patients. Results: The efficacy was recorded at the end of treatment as a cure in 10 of 11 patients (91%). Only one patient had relapsed (9%). The rate of treatment-related adverse events was (18%). Conclusion: This study shows that a 3-day, once-daily course of azithromycin is clinically effective and well tolerated in the treatment of mild to moderate community-acquired pneumonia. Furthermore, the patient compliance to treatment is improved with such a short regimen

Diafragma laserasyonu ve bronşektaziye yol açan bronşial web ile birlikteki kostal ekzositoz

Thoracic complications belong to exostosis with the other abnormality are extremely rare. A 40 year-old man presented with right-sided pleuritic chest pain. Computed tomographic scan of the chest revealed exostosis length 2.5 cm pushing pleura and diaphragm and compressing adjacent to lung and liver. Middle and lower lobe bronchiectasis was also identified. There were a web lesion in bronchial lumen at the level of middle lobe at bronchoscopy. In operation, diaphragm laceration was repaired with sutures. Bilobectomy inferior was performed and 10th costa was partially resected together with exostosis. Exostosis cases which lead to diaphragm laceration and bronchiectasis in addition with bronchial web as we present in this case are quite rare

Thoracoscopy under local anesthesia for patients with a high cardiopulmonary risk index

Background: In this study, we aimed to investigate the efficacy of thoracoscopy performed under local anesthesia and sedation for the diagnosis and treatment of patients with a high cardiopulmonary risk index. Methods: Between January 2007 and October 2010, 32 patients (22 males, 10 females; mean age 63.6 years; range 36 to 89 years) with a high cardiopulmonary risk index who underwent thoracoscopy under local anesthesia and sedation at Pamukkale University, School of Medicine, Department of Thoracic Surgery were included. Risk assessment was performed using the cardiopulmonary risk index. All procedures were performed in the operating room. Results: The cardiopulmonary risk index points of the patients ranged from 7 to 37 (mean 13.6). None of the patients underwent general anesthesia, indotracheal intubation, or epidural or intercostal blockage. Pleural biopsy/effusion drainage, either with or without talc pleurodesis, was performed in fifteen patients, six had drainage and debridement of empyema, and four had a biopsy of a mediastinal lymph node. In addition, three patients had a partial pleurectomy for secondary pneumothorax, one underwent a biopsy of a mediastinal mass, and one had a hematoma removed. Furthermore, a foreign body was extracted from one patient, and a wedge resection for the diagnosis of multiple lung nodules was performed on another. None of the patients required a thoracotomy. Morbidity was observed in three patients (9%), but no mortality was seen. Conclusion: Thoracoscopy performed under local anesthesia and sedation is a safe and effective, even for patients in poor general condition

Occupational exposure and thoracic malignancies, Is there a relationship?

The aim of this study was to evaluate the effect of occupational exposure in the occurrence of lung cancer. Method: Three-hundred lung cancer cases diagnosed between September 1, 1999, and September 31, 2007, and 300 healthy controls were enrolled in this case-control study. Life-long occupational history, gender, age, exposure to asbestos, comorbidities, and smoking status were collected. Results: The mean age of the 300 lung cancer cases was 60.3 ± 9.9 year (91.7% male and 8.3% female), and the mean age of healthy control group was 60.4 ± 10.5 year (95.0% male and 5.0% female). The most frequent histological types were squamous (172, 57.3%), adeno (69, 23.1%), and small cell (37, 12.3%). There was an increased risk of lung cancer occurrence among agriculture workers (OR=1.89, 95% Cl=1.17-2.98) (p=0.009). Inorganic dust exposure (OR=1.81, 95% Cl=1.0-3.25) (p=0.049) and organic dust exposure (OR=1.89, 95% Cl=1.0-3.59) (p=0.05) were found to be related with high frequency of having lung cancer. Conclusion: Workers who had occupational exposure to organic and inorganic dust, especially in the agricultural field, had higher risk of lung cancer occurrence when compared with office workers

Sarkoidozlu olgularda klinik görünüm ve tanısal yaklaşım: Türk olgu serisi (sarkoidoz klini?i ve tanı yaklaşımları)

PubMed ID: 22087521Sarcoidosis 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