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BBF (bronchobiliary fistula) is a very rare entity, characterised with passage between bronchial and biliary system. Our case, 56 years old woman was complaining about yellow juicy sputum, cough, wheesing since 1,5 years, after a cholesistectomy operation. There was a consolidation area in the right middle lobe at thorax CT. In spite of treatment with antibiotics there wasn't any clinical or radiological healing. We determined the correct diagnosis by magnetic resonance cholangiopancreatography (MRCP) and cholescintigraphy after determining oropharynx and airways covered by alkaline, yellow secretion at fiberoptic bronchoscope. The patient underwent minimally invasive treatment choices first by our follow up. Now this is 4 th months of patient with her last biliary stent and without complaint. We present our case to emphasize that BBF is a very rare situation, diagnosis of BBF is difficult but possible when a clinical sign is suspicious and its treatment chooses are variable for each patiente's condition. [ABSTRACT FROM AUTHOR]

To determine the prevalence of cigarette smoking, to examine the risk factors affecting smoking amongst adults and to assess the opinion of patients about quitting smoking who were evaluated at our outpatient clinic. Six hundred fifty-nine patients who were evaluated at our outpatient clinic between June 2005 and June 2006 were included in the study. This is a cross-sectional study that evaluates prevalence of smoking. Data gathered by applying face to face questionnaires. The mean age of 659 participants [417 (63.3%) males and 242 (36.7%) females] was 53.1 +/- 16.2 years. The prevalences were; 33% (n= 218) smokers, 39% (n= 258) ex-smokers and 28% (n= 183) non-smokers. Smoking prevalence under age of 50 was significantly higher (p= 0.0001). There was a positive significant relation between education and smoking amongst women, but this relationship was not significant amongst men. The most common reason for beginning smoking was because of friends (72%). 86% wanted to quit smoking. 48.9% tried to quit smoking but couldn't be successful. The prevalence of active smoking and quit smoking among patients who applied to pulmonary medicine outpatient clinic were 33% and 28%, respectively. The ratio of smoking and smoking pack-years was higher among men. Eighty-six percent of patients wanted to quit, 25% tried to quit but could not be successful, and 49% quit smoking but began smoking again. According to these findings, patients who were smoking wanted to quit but couldn't be successful without a professional help. We planned to found a smoking cessation outpatient clinic at our department.

Pulmonary embolism (PE) could not be diagnosed correctly in 2/3 of patients saving of that pathology, and unfortunately mortality in them could be as high as 30%. In the present study, we aimed to investigate the gender differences in clinical, electrocardiography (ECG) and laboratory findings of PE patients diagnosed with contrast-enhanced helical computerized tomography of thorax. 31 patients (18 females, 58% and 13 males, 42%) were included into the study. Symptoms, risk factors, ECG and arterial blood gases were evaluated, and then Wells, Geneva and ECG scores were obtained in each subject. Alveolo-arterial (A-a) oxygen gradient was calculated as P(A-a)O2= 150-(PCO2/0.8)-PO2. Mean pulmonary artery pressure (PAP) was measured by echocardiography. In female and male patients, Wells score (4.8 +/- 1.9 and 3.2 +/- 2.2, p= 0.017); ECG score (5.9 +/- 3.6 and 3.1 +/- 1.8, p= 0.036) and mean PAP (33.5 +/- 12.3 mmHg and 23.2 +/- 10.0 mmHg, p= 0.017) were significantly different. However, between female and male patients Geneva score (4.8 +/- 1.7 and 5.0 +/- 1.6), A-a gradient (35.2 +/- 17.3 and 42.9 +/- 12.3) and PaCO2 (33.5 +/- 15.1 and 29.8 +/- 5.4) did not differ significantly (p> 0.05). Immobilization and surgical interventions as risk factors for PE were established significantly higher in females than males (50%-30.8%, p= 0.02 and 50%-23.1%, p= 0.01). In female patients with PE, Wells and ECG scores, immobilization, surgical interventions and mean PAP are significantly higher than male patients. So, in the clinical practice, these parameters may help to diagnose acute PE especially in females.

Objective: To evaluate Nazilli Tuberculosis Dispensary activities executed between 1st June, 1996- 31st May, 2000 and to compare differences among 12-month-periods., Design: Retrospective analyses of data., Settings: People living in the villages under responsibility of Nazilli Tuberculosis Dispensary., Population: People examined in out-patient clinic as symptomatic cases, for health report or during contact examination, number of mycobacteriological and radiological examinations, and tuberculosis cases detected in each year., Main Results: Average number of newly diagnosed tuberculosis patient in every 12-month-period was 105. The average rate for new tuberculosis cases finding was 52.5%. Pulmonary tuberculosis was in 74.8% of all tuberculosis cases. The range of smear positive pulmonary tuberculosis cases in all tuberculosis cases differed from 49% to 71% and a decrease in the rate of cases with no sputum smear from 18% to 3% were observed. The average of bacteriological conversion rate at the end of second therapy month was 70.5%. The average of cure rate in new smear positive patients was 82%. According to drug susceptibility test results, 13 of new smear positive cases and 5 of old cases were multi-drug resistant tuberculosis., Conclusion: Although the treatment success of either new smear positive or old smear positive tuberculosis cases were high, it is necessary to plan strategies for increasing the new case finding rate to 70%, the rate suggested by World Health Organization. The data obtained by this study showed that hopeful results may be achieved by stable staff and team-work in tuberculosis dispensary.