The characteristics of smoking habit among patients evaluated at our outpatient clinic

To determine the prevalence of cigarette smoking, to examine the risk factors affecting smoking amongst adults and to assess the opinion of patients about quitting smoking who were evaluated at our outpatient clinic. Six hundred fifty-nine patients who were evaluated at our outpatient clinic between June 2005 and June 2006 were included in the study. This is a cross-sectional study that evaluates prevalence of smoking. Data gathered by applying face to face questionnaires. The mean age of 659 participants [417 (63.3%) males and 242 (36.7%) females] was 53.1 ± 16.2 years. The prevalences were; 33% (n= 218) smokers, 39% (n= 258) ex-smokers and 28% (n= 183) non-smokers. Smoking prevalence under age of 50 was significantly higher (p= 0.0001). There was a positive significant relation between education and smoking amongst women, but this relationship was not significant amongst men. The most common reason for beginning smoking was because of friends (72%). 86% wanted to quit smoking. 48.9% tried to quit smoking but couln't be successful. The prevalence of active smoking and quit smoking among patients who applied to pulmonary medicine outpatient clinic were 33% and 28%, respectively. The ratio of smoking and smoking pack-years was higher among men. Eighty-six percent of patients wanted to quit, 25% tried to quit but could not be successful, and 49% quit smoking but began smoking again. According to these findings, patients who were smoking wanted to quit but couln't be successful without a professional help. We planned to found a smoking cessation outpatient clinic at our department

An old woman with weight loss and chest pain

Pulmonary sarcomas constitute only 0.1-0.5% of all primary lung malignancies. These tumors may derive from the lung parenchyma, bronchial tree or pulmonary arteries. The most important entity in the differential diagnosis is metastatic synovial sarcoma. A 76-years-old woman was admitted for investigation of a fever, productive cough, dyspnea, weight loss and left-sided chest pain which had been present for one month. A chest computerised tomography showed enlarged mediastinal lymph nodes were observed, as well as a left-sided pleural effusion. Thoracentesis revealed hemorrhagic pleural effusion which was exudate and lymphocyte predominant, closed pleural biopsy showed chronic inflammation. Left sided thoracoscopy was performed under local anesthesia, total collapse of left lung and multiple pleural nodules were observed on the visceral pleura multiple biopsies were obtained from those nodules. Pathologic examinations revealed "synovial sarcoma". As skeleton single photon emission tomography was unremarkable, primary pleuropulmonary synovial sarcoma was decided as diagnosis and chemotheraphy was planned for the patient. Primary pleuropulmonary synovial sarcoma is a rare neoplasm of lung and pleura but it is rare entity

Clinical presentations and diagnostic work-up in sarcoidosis: A series of Turkish cases (clinics and diagnosis of sarcoidosis)

Sarcoidosis 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

obstruction (2007 : 7b)

Imaging findings were reported in an unusual case of endobronchial lipomatous hamartoma obstructing the left mainstem bronchus. Computed tomography readily demonstrated the presence of fat density within the lesion narrowing the differential diagnosis to endobronchial lipoma or lipomatous hamartoma

Stress fracture of the fifth metatarsophalangeal sesamoid bone: a case report

There is a paucity of published literature on the injuries of the lesser toe sesamoids of the foot. A fifty-six-year-old male patient without a major trauma history was diagnosed as having a stress fracture of the fifth metatarsophalangeal joint medial sesamoid bone. Conservative treatment was employed and the patient was followed-up for 25 months without any complaints. The sesamoid bone injury of the fifth toe should be included in the differential diagnosis of lateral forefoot pain

A new technique for creating an abdominal window in a hip spica cast.

Opening an abdominal window in a hip spica type of cast can be a troubling maneuver for both orthopaedic surgeon and patient. We present a simple device to create an abdominal window more easily

Hamstring shortening in healthy adults

Hamstring shortening (HS) causes changes in the posture and walking ability in spastic children, however, there are no studies defining the abnormalities in patellar alignment in individuals with HS.Twenty-five patients with a primary complaint of anterior knee pain, having HS detected at physical examination, and 11 healthy individuals without any HS or knee discomfort as a control group are included in this study. Serial x-rays of the spine, pelvis and knee are taken and knee x-rays are evaluated for the position of the patella in both groups.In patients with Knee Extension Deficit (KED) greater than or equal to 60degrees, the Blackburne-Peel ratio is lower and the Insall-Salvati ratio is higher than the other groups, denoting a cephalic location of the patella (p < 0.05). There are no changes in the congruency and sulcus angles between the HS and control groups. Vertebral and pelvic changes correlate well with the literature, confirming that significant alterations occur after 60degrees of KED in adults.The extensor mechanism of the knee is affected and patella is located higher than normal in patients with severe HS, which may be a cause for knee discomfort. In the light of these findings, a routine knee extension deficit examination can be suggested in the initial evaluation of knee discomfort