Photodynamic treatment in solar keratosis [Solar keratozda fotodinamik tedavi]

Background and Design: Topical photodynamic treatment (PDT) with endogenous porphyrine consists of irradiation of a lesion with visible light after the local application of exogenous 5-aminolevulinic acid (ALA). In this study, the effectiveness and usefulness of the photodynamic treatment in solar keratosis were investigated. Materials and Methods: A total of 20 patients with 25 lesions (19 at the face, 4 on the scalp and 2 at the hands) received photodynamic treatment combined with 5-aminolevulinic acid (occlusive application of a 20% ALA emulsion for 6-8 h, irradiation with red light, 580-720 nm). Histological and clinical evaluation were performed both before treatment and 2 months after treatment. Results: In clinical evaluation, complete response was achieved in 84% of lesions. 64% of the histologic specimens showed complete improvement rate. No notable side effects were observed. Conclusion: Photodynamic treatment combined with ALA is an effective model in the treatment of solar keratosis. The potential advantages of PDT over conventional modalities include its non-invasiveness, the ability to treat multiple lesions at one sitting, the good patient acceptance and excellent cosmetic results

Smoking habit among the relatives of patients with serious smoking-related disorders

WOS: 000176733100003PubMed ID: 12065960Objective: To assess smoking habit and awareness of smoking as a potential cause of disease among relatives of patients with serious smoking-related disorders. Design and Setting:A survey using a face-to-face interview-assisted questionnaire at the Ege University Hospital between October 1998 and March 1999. Subjects: We interviewed 242 relatives of patients with serious smoking-related disorders, of whom 56.6% were female and 43.4% male. The mean age was 41.2 +/- 13.2 years (1575). One relative per patient completed the questionnaire and the chosen relative took care of the patient during his illness and accompanied him during hospital visits. Main Outcome Measures: We assessed the relationship between smoking habit and the perception of smoking as a potential cause of illness by the relatives. Statistical analysis was performed by chi(2) test. Results:The prevalence of smoking among relatives was 37.6% [49.5% males (n = 105) and 28.5% females (n = 137), p = 0.0003] and an additional 20.2% were ex-smokers. Of the relatives, 86.4% knew that the diseases were directly related to smoking, and 37.8% of these people were smokers and 21.5% ex-smokers. Only 7.2% reported that they had quit smoking after being influenced by the diseases of the patients. The decision to quit was statistically unrelated to the awareness of smoking as the cause of disease. Of all the relatives, 69.2% had tried to quit at least once, 86.8% considered quitting, and 89.0% considered using professional help for smoking cessation. Conclusion: The findings show that even though this group of smokers is aware of the harmful effects of smoking they cannot successfully quit smoking; however, the majority reconsider quitting and receiving professional help. Copyright (C) 2002 S, Karger AG, Basel

Topical photodynamic treatment in basal cell carcinoma [Bazal hucreli karsinomda topikal fotodinamik tedavi]

Background and Design: Basal cell carcinoma is the most common malign tumour on the skin. Photodynamic treatment is a novel method for the treatment of a variety of solid tumours. It has also been used for treatment of basal cell carcinoma. The purpose of this study was to determine the effectiveness of photodynamic treatment in the treatment of basal cell carcinoma. Material and methods: A total of 26 patients with 30 lesions (13 at the face, 8 on the nose, 4 on the scalp and finally 5 on the body) of basal cell carcinoma were included in this study. Clinically, of all the lesions, 14 lesions were superficial and 16 lesions had nodular pattern. Patients were administered topical 5-amino levulinic acid cream as photosensitizer agent. Six to eight hours after topical administration of 5- ALA, visible light irradiation was conducted with an incoherent light source. The combined red + infrared band was used during irradiation (respectively, 580-720 nm; 1250-1600 nm in wave length). Each lesion received a total dose of 100 J/cm2 at fluence rates of 100 to 120 mW/cm2. Histological and clinical evaluation were performed both before treatment and two months after treatment. Posttreatment examination were only clinically for three lesions, because second biopsy was unsuitable. In addition, each of the patients was examined clinically at two months interval. The average clinical follow-up was 6 months. Results: In clinical evaluation; complete response was achieved in 56.6% of lesions. Histologically, 62.9% of the specimens showed complete improvement rate. Clinically superficial BCC tumors were very responsive to PDT and the 14 superficial lesions treated showed a 92.8% complete response rate both clinically and histologically. 25% complete response was achieved in patients with nodular BCC lesions. The most significant side effects after treatment were moderate pain, redness and edema. The most common adverse effect during treatment was tolerable heat, itching and pain sensation. Conclusions: We can conclude that topical photodynamic therapy with ALA cream is a safe and effective modality in the treatment of superficial BCC

The effect of inhaled corticosteroids on bronchoalveolar lavage cells and IL-8 levels in stable COPD patients

WOS: 000234008000003PubMed ID: 15946834Chronic obstructive pulmonary disease (COPD) is characterised by a chronic inflammatory process in the large and small airways, as well as in the lung parenchyma. Although the rote of oral corticosteroids in the management of acute exacerbations of COPD is well documented, its rote in stable COPD is not clear. We examined the anti-inflammatory effect of inhaled budesonide on the percentage of neutrophils and on interleukin-8 (IL-8) levels in bronchoalveolar lavage (BAL) and their correlation with spirometry and symptom scores. Twenty-six patients with stable COPD were randomised, in a double-blinded, placebo-controlled trial with either 800 mu g of inhaled budesonide or placebo for a 6-month period. The budesonide-treated subjects had significant reductions in IL-8 levels in the BAL after therapy (mean +/- SEM, 1.53 +/- 0.72 at baseline vs. 0.70 +/- 0.48 ng/ml at 6 months, P = 0.004) and a reduction in the mean percentages of neutrophils (17.16 +/- 2.67% vs. 13.25 +/- 2.28% P = 0.002). The improvement in sputum production was of borderline (P = 0.058) significance but there was no improvement in lung function. In stable patients with COPD, treatment with inhaled budesonide for a period of 6 months has a positive effect on markers of lung inflammation, as assessed by reduction in percentage neutrophils and IL-8 concentration in BAL. (c) 2005 Elsevier Ltd. All rights reserved

Miliary tuberculosis with endometrial spread in a pregnant woman: A case report

WOS: 000185641600013PubMed ID: 1686839

Simple snoring: Not quite so simple after all?

Simple snoring (SS), in the absence of obstructive sleep apnoea (OSA), is a common problem, yet our understanding of its causes and consequences is incomplete. Our understanding is blurred by the lack of consistency in the definition of snoring, methods of assessment, and degree of concomitant complaints. Further, it remains contentious whether SS is independently associated with daytime sleepiness, or adverse health outcomes including cardiovascular disease and metabolic syndrome. Regardless of this lack of clarity, it is likely that SS exists on one end of a continuum, with OSA at its polar end. This possibility highlights the necessity of considering an otherwise ‘annoying’ complaint, as a serious risk factor for the development and progression of sleep apnoea, and consequent poor health outcomes. In this review, we: 1) highlight variation in prevalence estimates of snoring; 2) review the literature surrounding the distinctions between SS, upper airway resistance syndrome (UARS) and OSA; 3) present the risk factors for SS, in as far as it is distinguishable from UARS and OSA; and 4) describe common correlates of snoring, including cardiovascular disease, metabolic syndrome, and daytime sleepiness