Incıdence Of Anemıa In Cases Wıth Lung Cancer At The Tıme Of Dıagnosıs And Relatıon Between Cancer Types

INTRODUCTION: Anemia is a condition seen over 10% of geriatric population, frequency of which increases with age, and negatively affects the quality of life. Anemia is often encountered both during the course of cancer disease, and as a result of the cancer treatments applied. However, there is small number of epidemiologic research about incidence of anemia in cancer patients.The aim of the study is to investigate incidence of anemia in patients diagnosed with lung cancer and its relationship with histopathologicaly diagnosed types of cancer. METHODS: In this cross-sectional study, we evaluated database of patients with lung cancer who applied to oncology polyclinics between June 2012 and December 2012. RESULTS: Newly diagnosed 74 lung cancer patients with age of 65 years and older, were enrolled to the study. According to WHO criteria; females with hemoglobin (Hb)<12 g/dl, hematocrit (Htc)<36%; males, Hb<13 g/dl, Htc<39% were considered to be anemic.The mean age of 74 patients was 71.4+-7,711 (min: 65 max: 85). 63 (85.1%) of cases were male, and 11% (14.9) were female. Mean hb was found as 12.75+-1,666 and mean corpuscular volume (MCV) was found as 87,14 +- 7,711. The histopathological types of cancer were 43.2% (n=32) squamous cell carcinoma, 27% (n=20) small cell lung cancer, 23% (n=17) adenocarcinoma and 6.8% (n=5) other type. There was no statistically significant relationship between histopathologic cancer type and frequency of anemia and MCV. Frequency of macrocytic and microcytic anemia in females was significantly higher than males (p=0.04). DISCUSSION AND CONCLUSION: In conclusion; anemia in elderly patients with lung cancer is a condition that negatively effects both the overall quality of life, prognosis of the disease, and treatment response. It is suggested that before treatment of lung cancer, all patients should be evaluated in terms of anemia and administration of necessary treatment is recommended

Association between Emergency Visits with Acute Exacerbation and Exercise Performance in Chronic Obstructive Pulmonary Disease

Objective: The relationship between acute exacerbation and exercise performance in chronic obstructive pulmonary disease (COPD) is unclear. The aim of this study was to compare exercise performance between patients with COPD who visited and did not visit an emergency department in the last year; we also aimed to investigate the correlation between frequency of emergency visits and exercise performance. Methods: We recorded the number of emergency department visits of 206 COPD patients. The six-minute walk test, the modified Medical Research Council Dyspnea Scale, body plethysmographs, carbon monoxide diffusion tests, and arterial blood gas analysis were practiced. Results: We had one hundred twenty seven participants visited an emergency department at least once in the last year. Exercise performance, dyspnea, pulmonary functions, and oxygenation were significantly poorer in those patients (p<0.05). The number of emergency department visits was correlated with exercise performance, dyspnea, oxygenation, forced expiratory volume in one second forced expiratory volume in one second/forced vital capacity, and carbon monoxide diffusion capacity (p<0.05). Conclusion: Exercise performance was poor and negatively related to the frequency of emergency department visits in COPD patients. We concluded that exercise performance-enhancing implementations may contribute to reduce the frequency of emergency department visits

Ratio And Regional Distribution Of Genetic Mutation In Lung Cancer In Turkey (REDIGMA)

28th International Congress of the European-Respiratory-Society (ERS) -- SEP 15-19, 2018 -- Paris, FRANCEWOS: 000455567103370…European Respiratory So

Türkiye’de akciğer kanserinde genetik mutasyonların bölgesel dağılımı (REDIGMA)

Introduction: The results of standard chemotherapy in lung cancer are not very satisfactory, so it is important to identify genetic mutations that provide targeted therapies. Recent reports have suggested influences of racial difference on the frequency of mutation in lung cancer. We aimed to determine the frequency and regional distribution of genetic mutations of non-small cell lung cancer (NSCLC) in Turkey. Materials and Methods: Regional distribution of genetic mutations in lung cancer in Turkey (REDIGMA) study was carried out as a prospective, cross-sectional, observational study in a large number of centers in which lung cancer patients were followed and could perform genetic mutation analysis on patients’ biopsy materials. Results: The 703 patients (77.7% male, mean age 63.3 ± 12.5 years) who were diagnosed as NSCLC from 25 different centers were included in the study. Tumor samples from patients were reported as 87.1% adenocarcinoma, 6.4% squamous cell carcinoma and 6.5% other. Mutation tests were found to be positive in 18.9% of these patients. The mutations were 69.9% EGFR, 26.3% ALK, 1.6% ROS and 2.2% PDL. Mutations were higher in women and non-smokers (p< 0.000, p< 0.001). Again, the frequency of mutations in adenocarcinoma was higher in metastatic disease. There was no difference between the patient’s age, area of residence, comorbidity and clinical stage and mutation frequency. Conclusion: Our study revealed that the EGFR mutation rate in Turkey with NSCLC was similar to East European, African–American and Caucasian patients, and was lower than in East Asia.Giriş: Akciğer kanserinde standart kemoterapinin sonuçları çok tatmin edici değildir, bu nedenle hedefe yönelik tedavileri sağlayan genetik mutasyonları belirlemek önemlidir. Son raporlar, ırksal farklılığın ve bölgesel değişikliğin akciğer kanserinde mutasyon sıklığı üzerindeki etkilerini göstermiştir. Çalışmamızda küçük hücreli dışı akciğer kanseri (KHDAK)'nde genetik mutasyonların Türkiye'deki sıklığını ve bölgesel dağılımını belirlemeyi amaçladık. Materyal ve Metod: Türkiye'de akciğer kanserinde genetik mutasyonların bölgesel dağılımı (REDIGMA) çalışması, akciğer kanseri hastalarının takip edildiği ve hastaların biyopsisinde genetik mutasyon analizi yapılabilecek çok sayıda merkezde prospektif, kesitsel ve gözlemsel bir çalışma olarak gerçekleştirildi. Bulgular: Çalışmaya 25 farklı merkezden KHDAK tanısı konan 703 hasta (%77.7 erkek, ortalama yaş 63.3 ± 12.5 yıl) alındı. Hastalardan alınan tümör örnekleri %87.1 adenokarsinom, %6.4 skuamöz hücreli karsinom ve %6.5 diğer olarak bildirildi. Mutasyon testleri bu hastaların %18.9'unda pozitif bulundu. Mutasyonlar %69.9 EGFR, %26.3 ALK, %1.6 ROS ve %2.2 PDL idi. Mutasyonlar kadınlarda ve sigara içmeyenlerde istatistiksel olarak daha yüksek tespit edildi (p< 0.000, p< 0.001). Yine, adenokarsinomdaki mutasyonların sıklığı metastatik hastalıkta daha yüksekti. Hastanın yaşı, ikamet alanı, komorbiditesi, klinik evresi ve mutasyon sıklığı arasında farklılık saptanmamıştır. Sonuç: Çalışmamızın sonucunda Türkiye geneli mutasyon pozitifliği literatür ile karşılaştırıldığında Türkiye’de KHDAK'lı hastalarda EGFR mutasyon oranının Doğu Avrupa, Afrikalı-Amerikalı ve Kafkasyalı hastalara benzer ve Doğu Asya'dan daha düşük olduğu ortaya koyulmuştu

Do the Amount of Fluid, Histopathology, Radiology and Pleurodesis Status Affect the Survival in Malignant Pleural Effusions?

INTRODUCTION: The primary objective of this study was to identify the most common pleural malignancies leading to malign pleural effusion (MPE). The secondary objective was to evaluate the relationship between the amount of fluid and radiological findings, etiologies, treatment methods and survival. METHODS: We retrospectively included cases of MPE with a tissue diagnosis. RESULTS: The most common causes of MPE were lung cancer (73%), breast cancer (8.3%) and mesothelioma (7%). In patients who were offered chemical pleurodesis, pleurodesis was successful in nearly 31.1%. No relation wasfound between the amount of pleural fluid and cell type,survival, pulmonary, extrapulmonary malignancy and mesothelioma, Patients live longer if pleurodesis was successful (p = 0.005). Median survival of patients with MPE due to pulmonary, extrapulmonary and mesothelioma, ORCID: 0000-0002-8939-336X respectively were 77 ± 12.8, 150 ± 48.4 and 365 ± 0 days. The survival of the patients with mesothelioma was significantly longer than others (P: 0.000). DISCUSSION AND CONCLUSION: The main cause of MPE was lung cancer, followed by breast cancer, unknown primary and mesothelioma. Chemical pleurodesis was a viable palliative measure for MPE. Successful pleurodesis had a significant contribution to the survival

Pulmonary Strongyloides stercoralis infection

The 17-year-old male patient presented with fever, weakness, dyspnea and weight loss. His chest radiography demonstrated diffuse reticulonodular density, and high-resolution lung tomography indicated diffuse micronodules and prevalent ground-glass pattern. The findings were consistent with miliary involvement. The patient underwent examinations for rheumatology, immunology, cytology and infectious conditions. His immune system was normal and had no comorbidities or any history of immunosuppressive treatment. Strongyloides stercoralis larvae were noted upon direct inspection of the feces. Clinical and radiological improvement was achieved with albendazole 400 mg/day. This case is being presented since miliary involvement in the lungs caused by S. stercoralis infection in an individual with intact immune system is rare and difficult to diagnosis

The relation between distant metastasis and genetic change type in stage IV lung adenocarcinoma patients at diagnosis

Introduction Brain metastasis prevalence is higher in patients with positive epidermal growth factor receptor (EGFR) mutation, anaplastic lymphoma kinase (ALK) and C-ROS oncogene 1 (ROS-1) fusion change in lung adenocarcinoma. Objectives The purpose of our study is to investigate the relation between the genetic change type and the initial distant metastasis in stage IV lung adenocarcinoma patients with genetic changes. Methods The study was conducted between January 2007 and December 2018 in a retrospective fashion with patients who had lung cancer diagnosed as stage IV adenocarcinoma. The relation between genetic mutation change (EGFR, ALK or ROS-1) and distant metastasis was analysed. Results A total of 845 patients were included in the study. The median age was 62 (28-88). It was determined that lung and pleura metastases were more frequent at a significant level in patients with positive EGFR mutation (P = 0.032,P = 0.004, respectively). In patients with positive ALK fusion change, pleura metastasis was determined to be more frequent (P = 0.001). Multiple metastases were determined to be significantly more in patients with positive ALK fusion change than single metastasis (P = 0.02). Conclusion In patients with EGFR mutant lung adenocarcinoma, lung and pleura metastasis is more frequent and pleura metastasis is more frequent in ALK positive adenocarcinoma. Additionally, multiple organ metastases are higher in ALK positive lung adenocarcinoma

The Relationship between COVID-19 Severity and Bacillus Calmette-Guerin (BCG)/ Mycobacterium tuberculosis exposure history in healthcare workers: a multi-center study

The COVID-19 pandemic has brought countries' health services into sharp focus. It was drawn to our group's attention that healthcare workers (HCWs) had a lower mortality rate against higher COVID-19 incidence compared to the general population in Turkey. Since risk of exposure to tuberculosis bacillus among healthcare workers are higher than the population, we aimed to investigate if there is a relationship between BCG and Mycobacterium tuberculosis exposure history with COVID-19 severity in infected HCWs. This study was conducted with 465 infected HCWs from thirty-three hospitals to assess the relationship between COVID-19 severity (according to their hospitalization status and the presence of radiological pneumonia) and BCG and Mycobacterium tuberculosis exposure history. HCWs who required hospital admission had significantly higher rates of chronic diseases, radiological pneumonia, and longer working hours in the clinics. Higher rates of history of contact and care to tuberculosis patients, history of tuberculosis, and BCG vaccine were observed in hospitalized HCWs. HCWs who had radiological pneumonia had a significantly increased ratio of history of care to tuberculosis patients and a higher family history of tuberculosis. The findings from our study suggest that the lower mortality rate despite the more severe disease course seen in infected HCWs might be due to frequent exposure to tuberculosis bacillus and the mortality-reducing effects of the BCG vaccine

Frequency of Direct Oral Anticoagulants Usage in Acute Pulmonary Thromboembolism Treatment in Turkey (TUPEDO)

Background: Direct oral anticoagulants (DOACs) have been used in acute pulmonary thromboembolism as an alternative to warfarin due to drug interactions, narrow therapeutic range, and necessary close International Normalized Ratio (INR) monitoring. Phase 3 study results have reported that these drugs are at least as effective as warfarin and beneficial in terms of bleeding; however, studies that present up-to-date life data are necessary. Aims: To evaluate the frequency of using DOACs, which are prescribed with a limited number of indications in our country, and real-life data results. Study Design: Cross-sectional study Methods: This cross-sectional survey collected the clinical data (history, current treatment, treatment duration, etc.) of patients with pulmonary thromboembolism and who applied to the physician for follow-up between October 15, 2019, and March 15, 2020. The researchers kept the patient records sequentially. Results: Data from 836 patients with acute pulmonary thromboembolism from 25 centers were collected, and DOAC was used in 320 (38.5%) of them. The most preferred DOAC was rivaroxaban (n = 294, 91.9%). DOAC was mostly preferred because it could not provide an effective INR level with warfarin (n=133, 41.6%). Bleeding was observed in 13 (4%) patients. Conclusion: The use of direct oral anticoagulants is becoming almost as widespread as conventional therapy. Real-life data results are important for their contribution to clinical practice