Evaluation of patients with fibrotic interstitial lung disease: Preliminary results from the Turk-UIP study

OBJECTIVE: Differential diagnosis of idiopathic pulmonary fibrosis (IPF) is important among fibrotic interstitial lung diseases (ILD). This study aimed to evaluate the rate of IPF in patients with fibrotic ILD and to determine the clinical-laboratory features of patients with and without IPF that would provide the differential diagnosis of IPF. MATERIAL AND METHODS: The study included the patients with the usual interstitial pneumonia (UIP) pattern or possible UIP pattern on thorax high-resolution computed tomography, and/or UIP pattern, probable UIP or possible UIP pattern at lung biopsy according to the 2011 ATS/ERSARS/ALAT guidelines. Demographics and clinical and radiological data of the patients were recorded. All data recorded by researchers was evaluated by radiology and the clinical decision board. RESULTS: A total of 336 patients (253 men, 83 women, age 65.8 +/- 9.0 years) were evaluated. Of the patients with sufficient data for diag-nosis (n=300), the diagnosis was IPF in 121 (40.3%), unclassified idiopathic interstitial pneumonia in 50 (16.7%), combined pulmonary fibrosis and emphysema (CPFE) in 40 (13.3%), and lung involvement of connective tissue disease (CTD) in 16 (5.3%). When 29 patients with definite IPF features were added to the patients with CPFE, the total number of IPF patients reached 150 (50%). Rate of male sex (p<0.001), smoking history (p<0.001), and the presence of clubbing (p=0.001) were significantly high in patients with IPE None of the women <50 years and none of the men <50 years of age without a smoking history were diagnosed with IPE Presence of at least 1 of the symptoms suggestive of CTD, erythrocyte sedimentation rate (ESR), and antinuclear antibody (FANA) positivity rates were significantly higher in the non-IPF group (p<0.001, p=0.029, p=0.009, respectively). CONCLUSION: The rate of IPF among patients with fibrotic ILD was 50%. In the differential diagnosis of IPF, sex, smoking habits, and the presence of clubbing are important. The presence of symptoms related to CTD, ESR elevation, and EANA positivity reduce the likelihood of IPF

Atopy and allergic diseases frequency in stable sarcoidosis patients

Bu çalışma, 03-06, Aralık 2015 tarihlerinde Kuala Lumpur[Malezya]’da düzenlenen Asian Pacific Society of Respirology 20th Congress Kongresi‘nde bildiri olarak sunulmuştur

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

The value of coronary artery calcium score in the early diagnosis of coronary artery disease in patients with stable chronic obstructive pulmonary disease

Context view, showing the west elevation of Red Square; The trapezoidal building features an interesting combination of elements of Russian medieval architecture and a steel framework and glass roof, a similar style to the great Victorian train stations of London. Each arcade is on three levels, linked by walkways of reinforced concrete. Shukhov was the inventor of a new family of doubly-curved structural forms. These forms, based on non-Euclidean hyperbolic geometry, are known today as hyperboloids of revolution. Shukhov developed not only many varieties of light-weight hyperboloid towers and roof systems, but also the mathematics for their analysis. It is still open today, and is a popular tourist destination for those visiting Moscow. Source: Wikipedia; http://en.wikipedia.org/wiki/Main_Page (accessed 6/22/2009