9 research outputs found
Association between smoking cessation and alterations in forced expiratory volume in one second (FEV1). A Follow-Up Study from a Greek Tobacco Cessation Clinic
Background: Cigarette smoking is the most important preventable cause of several diseases such as malignancies, pulmonary and cardiovascular diseases. Smoking cessation is now supported by both behavioral counseling and medical pharmacotherapy and is the only effective approach for slowing down an accelerated decline in forced expiratory volume in one second (FEV1). Our study aims to examine changes in forced expiratory volume in one second (FEV1) after smoking cessation for smokers attending our smoking cessation clinic their correlation to smokers’ demographic characteristics.Methods: 114 smokers (48 males and 66 females), with a mean age of 48.36±10.49 years, were enrolled. They were classified in 4 groups, according to their age; 60 years (Group D) and underwent Spirometry on the 1st day of visit, one month (2nd visit) and, 3 months later (3rd visit).Findings: Statistically significant increase in FEV1 values at the 2nd and 3rd visit compared to the 1st visit was observed in smokers who quit smoking in Group Α, B and C (p<0.05). In addition, a statistically significant decrease in FEV1 values at the 2nd and 3rd visit compared to the 1st visit was noticed in smokers who continued smoking in Group B, C and D (p<0.05).Conclusion: Smoking cessation achieved through smoking cessation support led to the improvement of FEV1 values within 3 months. The greatest benefit was observed in smokers under the age of 60
A Challenging Cutaneous Lesion in a Patient With Chronic Idiopathic Neutropenia
Ecthyma gangrenosum (EG) is an uncommon necrotizing vasculitis that
affects mainly immunocompromised and burn patients, and it is frequently
associated with Pseudomonas aeruginosa bacteremia. However, cases of EG
with other related pathogens and cases of EG affecting immunocompetent
hosts have also been described in the literature. Besides, less common
cases of EG without bacteremia have been reported. Herein, we describe a
rare case of EG due to Pseudomonas aeruginosa without bacteremia in a
patient with chronic idiopathic neutropenia (CIN). Considering the high
mortality rate associated with EG, early diagnosis and appropriate
effective treatment are crucial
Solitary Fibrous Tumor of the Pleura as a Cause of Type II Respiratory Failure.
Solitary fibrous tumor of the pleura is a rare type of tumor originating from the mesenchyma of the pleura. It is traditionally a benign lesion. However, in some cases malignant features have been observed. The majority of solitary fibrous tumors of the pleura are noticed by accident on chest X-ray, while the main symptoms include cough, thoracic pain and dyspnea. When growing within the thoracic cavity, these tumors exert pressure on vital adjacent tissues and large vessels. In addition, these tumors can be accompanied with paraneoplastic syndromes that are completely resolved after tumor resection. Respiratory failure is a rare complication of this tumors, which is reported in a handful of cases. Herein, we report a rare case of a benign solitary fibrous tumors of the pleura in a 75-year-old woman complicated with type II respiratory failure
Firstcase of pneumonia-parapneumonic effusion due to Trichoderma longibrachiatum
Trichoderma longibrachiatum is a fungus belonging to the genus
Trichoderma. Trichoderma long-ibrachiatum is not thought as a pathogenic
for healthy individuals. However, it has the ability to produce toxic
peptides and extracellular proteases and has been described to cause
invasive infections in immunocompromised hosts. Trichoderma
longibrachiatum has been reported as the causative microorganism of lung
infections, skin infections, sinus infections, otitis, stomatitis
endocarditis, pericarditis, gastrointestinal infections, mediastinitis
and peritonitis. We report the first case of pneumonia with
parapneumonic effusion in an old woman with diabetes mellitus due to
Trichoderma longibrachiatum. (C) 2021 The Authors. Published by Elsevier
Ltd
Predictive Indicators of Survival in Patients With Surgically Resected Lung Carcinoid Tumors at a Greek Medical Center
Introduction
Lung carcinoid tumors are neuroendocrine neoplasms, less frequent than
other lung tumors. They are subdivided into typical carcinoids (TC) and
atypical carcinoids (AC), according to the rate of mitosis and the
presence of necrosis. Lung carcinoids are often asymptomatic and only
discovered incidentally. They may also present with cough, wheezing,
asthma, and chronic obstructive pulmonary disease, chest pain, and
hemoptysis depending on the location of the tumor and, less commonly,
present with carcinoid syndrome. In our study, we describe the clinical
and pathological features of patients with surgically resected lung
carcinoids at our institution over a period of 14 years. We also examine
if these features, including age, gender, tumor size, type of carcinoid,
stage, nodal involvement, and Ki-67 expression are associated with
patients' survival.
Materials and methods
We retrospectively reviewed patients that underwent surgery with a final
histologic diagnosis of a pulmonary carcinoid tumor from March 2005 to
March 2019. The evaluation included history, physical examination, chest
radiographs, computerized tomography of the chest, upper abdomen, and
brain, and bone scintiscan. All specimens resected during the surgical
procedures were sent for pathological examination, including mediastinal
and hilar lymph nodes. The patients' age, gender, tumor size, type of
carcinoid, nodal involvement, stage, and Ki-67 expression were recorded
and correlated to the patients' survival rates.
Results
The study included 108 patients - 52 males and 56 females - with a mean
age of 51.5 years (range 11-80 years). Atypical carcinoid was the
diagnosis in 28 patients (16 males and 12 females) and 80 patients had
the diagnosis of typical carcinoid (36 males and 44 females). Tumor size
was <= 3.7 cm in 84 patients (68 with TC and 16 with AC) and >3.7 cm in
22 patients (12 with TC and 10 with AC). Sixteen patients had nodal
deposits, 12 in N1 nodes and four in N2 nodes. Eighty patients were
classified in stage I, 18 patients in stage II, and 10 patients in stage
III. None of the patients had distant metastases. The Ki-67
proliferation index was examined in 84 specimens and Ki-67 was <2.5 in
50 patients and >= 2.5 in 34 patients. Of the 108 patients, eight died,
all with disease-related death. According to the Cox regression
univariate analysis, four factors were correlated to shorter survival:
atypical histology, tumor size >3.7 cm, nodal involvement, and advanced
stage
Conclusions
In conclusion, we found that histological type, tumor size, nodal
involvement, and stage are associated with survival in patients with
surgically resected lung carcinoids without distant metastases. Other
parameters, such as age at operation, gender, and Ki-67 index, did not
have a role in survival in these patients according to the Cox
regression univariate analysis
Pulmonary adverse events due to immune checkpoint inhibitors: A literature review.
Cancer immunotherapy aims to stimulate the immune system to fight against tumors, utilizing the presentation of molecules on the surface of the malignant cells that can be recognized by the antibodies of the immune system. Immune checkpoint inhibitors, a type of cancer immunotherapy, are broadly used in different types of cancer, improving patients' survival and quality of life. However, treatment with these agents causes immune-related toxicities affecting many organs. The most frequent pulmonary adverse event is pneumonitis representing a non-infective inflammation localized to the interstitium and alveoli. Other lung toxicities include airway disease, pulmonary vasculitis, sarcoid-like reactions, infections, pleural effusions, pulmonary nodules, diaphragm myositis and allergic bronchopulmonary aspergillosis. This review aims to summarize these pulmonary adverse events, underlining the significance of an optimal expeditious diagnosis and management
Exacerbation of bronchiectasis by Pseudomonas putida complicating COVID-19 disease: A case report
Novel coronavirus infection presents with greater severity in
individuals with comorbid chronic lung diseases. Bronchiectasis is an
illness characterized by permanent enlargement of the airways,
presenting with chronic cough and sputum production and vulnerability to
lung infections. Bronchiectasis is not a common comorbid disease in
patients with COVID-19 disease and bronchiectasis exacerbation rates
were decreased during the pandemic. However, COVID-19 disease is
associated with worse outcomes in patients with bronchiectasis and
patients with bronchiectasis are more susceptible to SARS-CoV-2
infection development. Pseudomonas putida is an opportunistic pathogen,
causing infections mostly in immunocompromised hosts and is not a
frequent bacterial colonizer in patients with bronchiectasis. This
present study reports a rare case of exacerbation of bronchiectasis by
Pseudomonas putida complicating COVID-19 disease in an immunocompetent
70-year-old woman. Clinicians should be aware that SARS-CoV-2 infection
is probably a precipitating factor of bronchiectasis exacerbation while
bronchiectasis is a risk factor for greater severity of SARS-CoV-2
infection
Evaluation of Immature Platelet Fraction in Lower Respiratory Tract Infections: A Retrospective Study
Introduction
Immature platelet fraction (IPF) is a parameter of an automated
hematologic analyzer and is related to platelet size and cytoplasmic RNA
content. It reflects thrombopoiesis and is often used as the marker of
platelet activity. IPF has been evaluated mostly in hematologic
disorders and has also been evaluated in patients with gestational
hypertension, sepsis, autoimmune diseases and in hospitalised patients
with neutrophilia. Platelets, asides from the maintenance of hemostasis,
release inflammatory mediators that can modify leukocyte and endothelial
responses to various inflammatory stimuli. Lower respiratory tract
infections are the leading cause of death from infections worldwide. The
role of platelets in lower respiratory tract infections has been
reported in many studies. IPF, which is related to platelet activation,
has not been evaluated in patients with lower respiratory tract
infections.
Methods
The study involved patients who fulfilled the criteria of
community-acquired pneumonia (CAP) and aspiration pneumonia (AP). In
addition, age and sex-matched healthy controls were involved. Whole
blood samples were collected from healthy controls and from the patients
on admission. The mean IPF% and C-reactive protein (CRP) levels were
measured in patients with CAP, in patients with AP and in healthy
controls. The mean IPF% values in patients with infection were compared
to mean IPF% values in healthy controls. The mean IPF% values were
compared to mean CRP levels in patients with infection. Additionally,
the mean IPF% values in patients that died in the first 14 days were
compared to the mean IPF% values in patients that were alive. The
statistical analysis of data was performed with the Statistical Package
for the Social Sciences (SPSS) for Windows, Version 13.0 (SPSS Inc,
Chicago, IL).
Results
The study population consisted of 45 patients (27 patients with CAP and
18 patients with AP), 27 males and 18 females, with a mean age of 72.11
+/- 16.4 years and 39 healthy controls, 22 males and 17 females with a
mean age of 64.2 +/- 14.8 years. The mean CRP levels in patients with
infection were 155.2 +/- 119.1 mg/dl. The mean IPF% value of patients
with infection was 2.76 +/- 2.27 and the mean IPF% value of controls
was 1.72 +/- 0.77 (p < 0.006). The IPF% value in patients with CAP was
2.55 +/- 2.02 and in patients with AP 3.07 +/- 2.64 (p = 0.595). The
mean IPF% value in patients with infection had no linear correlation
with CRP value in these patients (r = 0.076, p = 0.62). The mean IPF%
value in all patients that died in the first 14 days was 3.75 +/- 2.44
and the mean IPF% value in all patients alive was 2.35 +/- 2.11 (p =
0.06). The mean IPF% value in patients with CAP who died in the first
14 days of hospitalisation was 5.54 +/- 3.17 and in patients with CAP
who were alive was 1.87 +/- 0.72 (p = 0.06). The mean IPF% value in
patients with AP who died was 2.63 +/- 0.85 and in patients with AP who
were alive was 3.41 +/- 3.51 (p = 0.554).
Conclusions
Mean IPF% value is greater in patients with lower respiratory tract
infections, including CAP and AP, compared to healthy controls. There is
no linear correlation between IPF values and CRP values in patients with
lower respiratory tract infections. In addition, there is a difference
in mean IPF% value between patients who died in the first 14 days of
hospitalisation compared to those who were alive, but not statistically
significant
Prognostic value of the immunohistochemistry markers CD56, TTF-1, synaptophysin, CEA, EMA and NSE in surgically resected lung carcinoid tumors
Lung carcinoid tumor is a type of neuroendocrine tumor, which is
subdivided into typical carcinoid (TC) and atypical carcinoid (AT),
based on the rate of mitosis and the presence of necrosis. Several
prognostic factors for lung carcinoids have been reported in the
literature, including the type, Ki67 index, stage, chemotherapy and
radiation therapy. In the present study, 108 cases with resected
carcinoid lung tumors were enrolled and the expression of CD56, thyroid
transcription factor 1, synaptophysin, carcinoembryonic antigen,
epithelial membrane antigen and neuron-specific enolase (NSE) in the
resected tissue specimens was immunohistochemically analyzed. Patients
with positive staining for NSE had an unfavorable survival prognosis
compared with patients with negative staining for NSE (137.2 vs. 150.0
months, P=0.044). According to univariate analysis, none of the above
immunohistochemistry markers was associated with survival, and according
to multivariate analysis, NSE was an independent influencing factor for
survival inpatients with AT (P=0.046) and furthermore, the stage was an
independent factor of survival in patients with TC (P=0.005)