Pleural Effusions in Lung Cancer: Detection and Treatment

In all cell types of lung cancer, pleural effusion is a possible complication of disease. Paramalignant pleural effusions [PMPE] are not a consequence of malignant disease spreading to pleura. The probability that an effusion is paramalignant is higher if the effusion is a transudative or parapneumonic effusion. Differentiating between paramalignant and malignant effusions has both therapeutic and prognostic significance. MPEs are a sign of metastatic dissemination of neoplastic disease. In pleural fluid or tissue, there are malignant cells. In PMPE, lung cancer had been previously diagnosed. Bronchoopstruction, atelectasis, infection, pulmonary emboli, air therapy, and heliotherapy result in effusion development. PMPEs equally appear in all pathohistological types of lung cancer, as MPEs are the most common in lung adenocarcinoma. Also, there are biochemical properties of PMPE and MPE. Therapeutic procedures depend on the presence of respiratory distress, biochemical properties of pleural fluid, type of primary tumour, and expected response to the therapy

Desquamative interstitial pneumonia with clinical, radiological and histologic correlation

Respiratory bronchiolitis-associated interstitial lung disease (ILD), desquamative interstitial pneumonia (DIP), and pulmonary Langerhans cell histiocytosis are entities of smoking-related ILD. While clinically regarded as 2 separate forms of idiopathic interstitial pneumonia, DIP, and respiratory bronchiolitis-associated ILD are thought to be representing ends of a continuous spectrum of disease that primarily affects tobacco smokers. This case report presents a 53-year-old female patient who has 58 pack-year smoking history who has been experiencing a dry cough and epigastric pains for 2 years. Open-lung biopsy is performed and histopathology indicated smoking-related interstitial fibrosis. The patient did not stop smoking, which after a year leads to significant clinical deterioration with a notable decrease in diffusion for carbon monoxide capacity. Upon smoking cessation and treatment with corticosteroids, a significant clinical improvement is achieved. In smokers complaining of cough and reduced exercise tolerance and in whom evidence of interstitial fibrosis is demonstrated radiologically, DIP should be considered as a differential diagnosis. Smoking is the exclusive etiologic factor of pathogenesis of DIP. Keywords: Respiratory bronchiolitis-associated interstitial lung disease, Desquamative interstitial pneumonia, Idiopathic interstitial pneumonia, Smokin

Changing trends in incidence of lung cancer by histological type in Montenegro

Introduction: Lung cancer is one of the most common malignant neoplasms, as well as the most common cause of death cancer. Most lung cancers are squamous cell carcinomas, small cell carcinomas or adenocarcinomas. Objective: Examining changes in trends of lung cancer incidence in Montenegro by histological type during a 15-year period, from 1997 to 2011. Methods: During the study period, histopathological confirmation was obtained for all primary lung cancer cases in the only hospital for lung diseases in the country. Based on the data from medical records, patients were classified by time period, sex, age groups and smoking history. Descriptive method was used. Results: Ratio between incidences of adenocarcinoma and squamous cell carcinoma changes in males, with a significant increase in the incidence rate of adenocarcinoma and drop in the rate of squamous cell carcinoma (p&lt;0.001). In addition, statistically significant (p&lt;0.05) decrease in the incidence of NSCLC (non-small cell lung cancer) and an increase in the incidence of SCLC (small cell lung cancer) was found. A statistically significant increase in linear trend in the incidence of small cell carcinoma was noted in females (p&lt;0.005). Conclusion: Incidence rates of adenocarcinoma and small cell carcinoma have increased during the study period.</p

Factors associated with patient and health system delays in diagnosis and treatment of tuberculosis in Montenegro, 2015–2016

<div><p>Background</p><p>Fundamental measures of control of tuberculosis are early detection and timely treatment of the affected. The aim of this study was to identify factors associated with patient-related and health system-related delays among patients with tuberculosis in the Republic of Montenegro.</p><p>Methods</p><p>A cross-sectional study included 130 tuberculosis patients older than 15 years of age. The inclusion criteria were diagnosis of tuberculosis based on clinical, pathohistological and microbiological findings. Patient delay referred to the number of days between the onset of symptoms and the first consultation with general practitioner (GP). Health system delay represented the number of days between the first consultation with GP and the initiation of tuberculosis treatment.We classified delays longer than median delay length as 'prolonged delays'. Delays greater than 75^th percentile of the maximum length of delay were classified as 'extreme delays'.</p><p>Results</p><p>Distribution of patient and health system delay in the overall delay was apprioximately equal (49% vs. 51%). Being married (OR = 2.54, p = 0.026) and having more negative attitudes towards tuberculosis (OR = 4.00, p = 0.045) were associated with extreme patient delay. Greater knowledge on tuberculosis was associated with lower likelihood of prolonged (OR = 0.24, p = 0.031) and extreme (OR = 0.30, p = 0.012) patient delay. Persons with negative sputum smear were more likely to experience prolonged (OR = 7.01, p<0.001) and extreme (OR = 4.40, p = 0.032) health system delay. Persons older than 47 years of age were more likely to experience prolonged health system delay (OR = 2.61, p = 0.042). Specialist consultation delay was associated with prolonged (OR = 1.08, p = 0.001) and extreme (OR = 1.05, p<0.001) health system delay.</p><p>Conclusion</p><p>Contribution to overall delay is equally distributed between the patients and the health care system. Improvement of knowledge in the general population and continuing medical education of the health care workers on tuberculosis could lead to reduction in patient and health system delays in treatment of tuberculosis.</p></div

Factors associated with prolonged and extreme health system delay: Results of logistic regression analysis.

<p>Factors associated with prolonged and extreme health system delay: Results of logistic regression analysis.</p

Factors associated with prolonged and extreme patient delay: Results of logistic regression analysis.

<p>Factors associated with prolonged and extreme patient delay: Results of logistic regression analysis.</p

Characteristics of TB patients.

<p>Characteristics of TB patients.</p