Massive Hemoptysis: Danger is Real, Promptness is Essential

WOS: 000436167400001PubMed ID: 2975580

The Effects of Smoking Properties and Demographic Properties on the Results of Smoking Cessation Therapy

We aimed to evaluate the effects of demographics and therapy modalities on the outcome of smoking cessation therapies in our clinic. 230 people filled a questionnaire via telephones interview. 68 persons who quitted smoking were defined as controls, and 101 subjects who couldn't quit were defined as the case group. There was no significant difference between case and control groups for age, gender and education. Presence of systemic and pulmonary disease did not affect quitting. Being married decreases the risk of not quitting by 0.4 times. At 6th month, 48.6% of those using bupropion, 35.9% of those using nicotine replacement therapy (NRT), 44,4% of those using combination therapy, and 17.6% of those having undergone only education program quitted. Eight of the bupropion, 18 of the NRT, 2 of the combination therapy, and 2 of the only education groups were not smoking at the end of the first year. The period of therapy was 4.71 +/- 6.43 weeks in case group and 6.64 +/- 3.14 weeks in control group. The difference was significiant. 55.6% of the cases and 86.2% of the controls had sufficient therapy (4 weeks) periods. It's shown that sufficient duration of therapy decreases the risk of not quitting about 0.2 times (OR 0.2, 95% CI 01-0.5, p=0.000). It was determined that the mean duration of restarting smoking was 2.4 +/- 1.9 months at the first attemp to stop smoking. Quitting rate can be increased by using therapies at least four weeks, and additional controls after six months are necessary to prevent recurrences

A case scenario study for the assessment of physician's behavior in the management of COPD: the WHY study

WOS: 000443757800002PubMed ID: 30233165Purpose: COPD diagnosis is mainly based on clinical judgment of physicians. Physicians do not also refer to COPD guidelines in their daily practice. This study aimed to assess attitudes of physicians regarding COPD diagnosis, treatment, and follow-up and to identify the factors influencing physicians' decisions in clinical practice. Patients and methods: Fifty physicians were selected from 12 EuroStat NUTS 2 regions and asked to assess seven fictitious case scenarios. The following five scenarios described patients with COPD: Case Global Initiative for Chronic Obstructive Lung Disease (GOLD) A-smoker and Case GOLD A-nonsmoker were previously undiagnosed patients presenting with dyspnea, Case GOLD D-smoker and GOLD B-exsmoker were COPD patients presenting with exacerbation, Case GOLD B-smoker was a previously diagnosed COPD patient with dyspnea in stable phase, Case asthma-COPD overlap syndrome, and Case obesity hypoventilation syndrome. Patients' history, physical examination findings, pulmonary function tests, and X-ray images were prepared before the study by an experts' committee and provided to the physicians upon their request, until they reached a final decision. The physicians completed a questionnaire including information about their clinical practices and institutions. Results: According to the GOLD 2015 recommendations, of the physicians, 44% performed guideline-concordant diagnosis in the first five scenarios, who were all COPD patients, and 6% performed guideline-concordant diagnosis in all cases. There was a negative correlation between high workload and making a guideline-concordant diagnosis (P=0.038, rho =-0.417). Even when the physicians made a guideline-concordant diagnosis of COPD, only a minority (10%-22%) used the GOLD classification. Logistic regression analysis revealed that working in a tertiary health care center was a significant factor in favor of establishing a guidelineconcordant diagnosis of COPD (P=0.029, OR = 6.139 [95% CI: 1.20-31.32]). Conclusion: Management of COPD patients in Turkey does not generally follow the GOLD criteria but is rather based on physicians' clinical experience. Heavy workload appears to adversely affect the correctness of clinical decisions.Novartis Pharmaceuticals, TurkeyWe thank Clinical Research Manager Clinical Research Organization who provided editorial support and performed statistical analysis funded by Novartis Pharmaceuticals, Turkey

Three atypical pulmonary hydatidosis lesions mimicking bronchial cancer from Turkey

WOS: 000266757500019PubMed ID: 19579706Hydatid disease is endemic in Turkey Echinococcus granulosus causes cystic echinococcosis mostly in the liver and lung. Although pulmonary hydatid cysts can be diagnosed by clinical and radiological findings, atypical or complicated lung lesions may be misdiagnosed. In the present study, three cases with hemoptysis and atypical lung lesions were diagnosed and treated as lung cancer or tuberculosis based on the clinical and laboratory findings along with the imaging data and fiberoptic bronchoscopy evaluation. Eventually pathological examination of the bronchoscopic biopsy material confirmed the definitive diagnosis as Pulmonary hydatidosis. The three patients presented herein emphasize the importance of considering pulmonary hydatid disease in the definitive diagnosis of atypical lung lesions Such as bronchial carcinoma in echinococcosis endemic areas

Gait speed as a functional capacity indicator in patients with chronic obstructive pulmonary disease

AIM: Walking distance is generally accepted as a functional capacity determinant in chronic obstructive pulmonary disease (COPD). However, the use of gait speed in COPD patients has not been directly investigated. Thus, the aim of our study was to assess the use of gait speed as a functional capacity indicator in COPD patients

Factors affecting treatment success in community-acquired pneumonia

WOS: 000389053000029PubMed ID: 27966314Background/aim: Treatment failure in hospitalized patients with community-acquired pneumonia is a major cause of mortality. The aim of this study was to evaluate the factors affecting treatment success in community-acquired pneumonia. Materials and methods: A total of 537 patients (mean age: 66.1 +/- 15.8 years, 365 males) registered to the Turkish Thoracic Society Pneumonia Database were analyzed. Of these, clinical improvement or cure, defined as treatment success, was achieved in 477, whereas 60 patients had treatment failure and/or died. Results: Lower numbers of neutrophils (5989.9 +/- 6237.3 vs. 8495.6 +/- 7279.5/mm(3)), higher blood urea levels (66.1 +/- 42.1 vs. 51.2 +/- 38.2 mg/dL), higher Pneumonia Severity Index (PSI) scores (123.3 +/- 42.6 vs. 96.3 +/- 32.9), higher CURB-65 scores (2.7 +/- 1.2 vs. 2.2 +/- 0.9), lower PaO2/FiO(2) ratios (216.3 +/- 86.8 vs. 269.9 +/- 65.6), and the presence of multilobar (33.3% vs. 16.4%) and bilateral (41.7% vs. 18.9%) radiologic infiltrates were related to treatment failure. The PSI score and PaO2/FiO(2) ratio were independent param-eters affecting treatment results in multivariate linear regression analysis (P < 0.001). Conclusion: The risk of treatment failure is high in patients with severe pneumonia and with respiratory failure. Effective treatment and close monitoring are required for these cases