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OBJECTIVE: Alectinib has a much better central nervous system transmission than crizotinib in patients diagnosed with anaplastic lymphoma kinase mutation-positive nonsmall cell lung carcinoma. We aimed to investigate alectinib's efficacy in the treatment and its place in the first-line treatment and report our real-life data. MATERIAL AND METHODS: The data of 38 patients who were diagnosed with anaplastic lymphoma kinase-positive nonsmall cell lung carcinoma in our clinic between 2016 and 2021, who did not receive any treatment before were retrospectively analyzed. RESULTS: Of the 19 patients who received alectinib, 14 had multiple, and 6 had pretreatment brain metastases. No newly emerging brain metastases were detected during the treatment period. The progression-free survival of patients was 23.5 ± 4.2 months, and overall survival was 24.6 ± 4.1 months. Progression was observed in 10 (52.6%) patients. Of the 19 patients who received crizotinib, 7 had multiple metastases, and brain metastases were detected in 1 patient before treatment and 6 patients during the treatment period. Progression-free survival of crizotinib patients was 17.1 ± 4.8 months and their overall survival was 26.5 ± 6.1 months. Progression was observed in 17 (89.5%) patients. The second line of alectinib could be given to 8 of these patients. Overall survival after second-line treatment of alectinib was 18.2 ± 7.0 months. Overall survival of the patients who could not receive second-line treatment of alectinib was 4.0 ± 2.0 months. CONCLUSION: The progression rate was lower in alectinib than the crizotinib patients, although there were more patients with multiple metastases and brain metastases in the alectinib arm. [ABSTRACT FROM AUTHOR]

BACKGROUND AND AIM: Thyroid transcription factor-1 (TTF-1) is a good prognostic factor and is also thought to be associated with driver mutations in lung cancer. This study aimed to evaluate the relationship between TTF-1 expression and prognosis and driver mutations in lung adenocarcinomas. METHODS: We analyzed the data of 307 patients who were diagnosed with lung adenocarcinoma and underwent TTF-1 testing in two centers between January 2018 and January 2021. RESULTS: Of the 307 patients included in the study, 231 were TTF-1 positive, 23 were weakly positive, and 53 were negative. There was no statistically significant relationship between TTF-1 positivity and progression-free survival (PFS) (p=0.492). However, overall survival (OS) was significantly longer in TTF-1 positive patients (p=0.005). Both PFS and OS were significantly longer in TTF-1 positive patients with multiple metastates (p=0.001, p=0.013). Of the 199 patients who underwent epidermal growth factor receptor (EGFR) mutation analysis, EGFR positivity was detected in 62 of them, and 58 patients were found to be in the TTF-1 positive group (p=0.022). CONCLUSIONS: Thyroid transcription factor-1 positivity in lung adenocarcinomas is a good prognostic factor that often accompanies EGFR positivity. [ABSTRACT FROM AUTHOR]

BACKGROUND AND AIM: Various markers are used to determine the prognosis of many types of cancer. We investigated the relationship of nutritional status, immunity, and inflammation markers with progression-free survival (PFS) and overall survival (OS) to predict the prognosis of patients diagnosed with small cell lung cancer (SCLC) at the time of the diagnosis. METHODS: We retrospectively reviewed 149 patients who were diagnosed with SCLC, treated, and followed up by our clinic between 2010 and 2012. We examined the relationship between the complete blood count of patients, lactate dehydrogenase (LDH), c-reactive protein (CRP), albumin, and protein parameters, as well as neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio, lymphocyte-monocyte ratio, modified Glasgow prognostic score (mGPS), prognostic nutritional index (PNI), and systemic immune-inflammation index (SII) values, before treatment with PFS and OS. RESULTS: We found a strong prognostic relationship between PFS and serum albumin, protein, CRP, leukocyte, neutrophil, NLR, PNI, SII, mGPS, and PNI score. Also, there was a prognostic relationship between OS and albumin, protein, LDH, CRP, neutrophil, NLR, PNI, SII, mGPS, and PNI score. CONCLUSIONS: We determined that simple and easily accessible parameters representing nutritional status, inflammation, and immunity are good prognostic markers in SCLC. Predicting prognosis with these tests can guide clinicians in treatment modalities. [ABSTRACT FROM AUTHOR]

BACKGROUND AND AIM: The long-term outcome of Coronavirus disease 2019 (COVID-19) patients discharged from the intensive care unit (ICU) is unclear. We investigated the effect of COVID-19 on lung structure, pulmonary function, exercise capacity, and quality of life in patients discharged from ICU and medical wards. METHODS: A prospective single-center study was conducted on COVID-19 patients discharged from University of Health Sciences, Dr. Suat Seren Chest Disease and Thoracic Surgery Training and Research Hospital between March 19 and September 1, 2020. Patients who were followed up for more than 48 h in ICU and more than 72 h in medical wards were included in the study. Computed tomography (CT) scores, pulmonary function tests, 6-min walking distance, and health-related quality of life were compared between ICU and medical ward patients 6 months after discharge. RESULTS: A total of 70 patients were included in the final analyses, and 31 of them were discharged from ICU. ICU patients had higher CT scores than non-ICU patients at admission (17 vs 11) and follow-up visits (6 vs 0). Two-thirds of ICU patients had at least one abnormal finding on a follow-up CT. Advanced age (OR 1.08, 95% CI 1.02-1.15) and higher CT score at admission (OR 1.13, 95% CI 1.01-1.27) were risk factors for having radiological abnormalities on the follow-up CT. Of the patients discharged from ICU, 90% had at least one persistent symptom. CONCLUSIONS: Many COVID-19 survivors, especially those with severe diseases, could not fully recover even after 6 months after their discharge from the hospital. [ABSTRACT FROM AUTHOR]

Objective: Thrombolytic and anticoagulation therapy modalities are the possible treatment for submassive pulmonary embolism (PE). However, the indications are still the subject of debate. The aim of the present study was to compare the efficacies of thrombolytic and standard anticoagulation treatment modalities on mortality and also to determine the safety of thrombolytic treatment in subjects with submassive PE. Materials and Methods: Subjects with submassive PE were recruited from the intensive care unit (ICU). Demographic data, comorbidity, bedside echocardiography (ECHO) findings, treatment procedure, treatment-related side effects, and total length of stay in the hospital and ICU were collected. Control ECHO was performed 48 h after the initiation of treatment. Short-term and 1-year mortality rates were recorded. The correlation between the increased risk for major bleeding and thrombolytic treatment was assessed. Results: A total of 54 subjects were enrolled during the study period. The median age of the subjects was 66 (54-73) years. Of the 54 subjects, 18 (33.3%) underwent thrombolytic treatment, and 36 (66.7%) received standard anticoagulation therapy. Short-term and 1-year mortality rates were statistically lower in subjects who received thrombolytic therapy (p=0.02 and p=0.04, respectively). The reduction in mean pulmonary arterial pressure was significantly higher in the thrombolytic treatment group (p<0.001). Risk for major bleeding was similar between the two. Conclusion: Thrombolytic therapy may reduce the mortality rates in subjects with submassive PE without an increase in the risk of major bleeding. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Intensive Care is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cukurova Medical Journal / Çukurova Üniversitesi Tip Fakültesi Dergisi is the property of Cukurova University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: When unplanned extubation (UE) occurs in intensive care patients, mechanical ventilation is negatively affected. In this study, we aimed to investigate the characteristics of UE patients, the duration of extubation, and the characteristics of reintubated patients. Material and Methods: In this retrospective cohort study of UE patients between May 1, 2010 and December 31, 2012, reintubated patients were included in Group 1 (n=12) and patients who did not require reintubation were included in Group 2 (n=12). The demographic features, mechanical ventilation mode, UE cause (patient/staff), APACHE II score, presence of ventilator-associated pneumonia, extubation time, sedation requirement, NIV requirement after extubation, and need of reintubation were recorded. Patients in groups 1 and 2 were compared in terms of risk factors for reintubation. Results: Twenty-four patients (23 males) were included. Their median age was 75 years (range, 56-81 years) [Group 1=79 years (range, 74-81 years) and Group 2=62 years (range, 56-76 years)]. The APACHE II score was significantly higher in Group 1 patients than in Group 2 patients (27 vs. 23, p=0.03). The pH was significantly lower in Group 1 (7.26 vs. 7.35, p=0.008). Weaning was significantly lower and mortality was significantly higher in Group 1 patients than in Group 2 patients (1/12 vs. 8/12, p=0.003 and 11/12 vs. 1/12, p=0.0001, respectively). The number of patients with ventilator-associated pneumonia was higher in Group 1 than in Group 2 (7/12 vs 2/12, p = 0.035). NIV was applied to all patients except one. Conclusion: Unplanned extubation is an undesirable condition in intensive care. Patients with advanced age and high APACHE II scores may be at a high risk of reintubation and mortality. [ABSTRACT FROM AUTHOR]

Background/aim: Sex-related differences have not been thoroughly explored in chronic obstructive pulmonary disease (COPD). We aimed to evaluate possible sex-related differences in COPD Assessment Test (CAT) scores of COPD patients with or without significant anxiety and/or depression. Materials and methods: Stable COPD patients were prospectively enrolled in the study between July 2013 and April 2014. Levels of anxiety, depression, dyspnea, and health-related quality of life parameters were assessed using specific questionnaires, including the CAT and others. Demographic and clinical data were recorded and physiological tests were performed. All the data were compared to determine any sex-related differences. Results: A total of 128 COPD patients (86 men, 42 women, mean age: 60.5 ± 9.3 years) were included. The women were significantly younger and had lower pack-years of cigarette smoking, and higher biomass smoke exposure, but displayed similarly severe COPD as compared to men. Beck anxiety (13.5-11) and Beck depression (15-11) inventory results were significantly higher in women than men (P = 0.04, P = 0.01). No statistically significant difference was found between the sexes in terms of CAT score, Modified Medical Research Council score, or COPD stage parameters (P > 0.05). Conclusion: Female patients have higher levels of depression and anxiety scores but present the same CAT scores related to COPD severity as compared to men. [ABSTRACT FROM AUTHOR]

Drugs are well-known causes of eosinophilic lung disease and patients with drug-induced eosinophilic lung disease can have variable clinical presentations. Clinical features may range from asymptomatic eosinophilic infiltrates to acute eosinophilic pneumonia (AEP)-like syndrome leading to acute respiratory failure. This report describes the first case of clomipramine-induced AEP-like syndrome causing acute hypoxemic respiratory failure which was treated successfully. Considering the increasing usage of tricyclic antidepressants, physicians should be aware of this very rare and life-threatening complication of clomipramine. [ABSTRACT FROM AUTHOR]

The widespread emergence of extensively drug-resistant tuberculosis is an increasing global health care problem and affects young adults, including women of childbearing age. The treatment of extensively drug-resistant tuberculosis during pregnancy is still controversial and therapeutic abortions were previously recommended for pregnant patients. We describe herein a severe case of extensively drug-resistant tuberculosis that was successfully treated during pregnancy. The patient delivered a healthy baby and had no signs of relapse eight months after completing the treatment. In conclusion, extensively drug-resistant tuberculosis can be treated successfully during gestation and pregnant women should have the option to continue their pregnancy. [ABSTRACT FROM AUTHOR]

Copyright of Respiratory Case Reports is the property of LookUs Scientific and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pulmonary Langerhans cell histiocytosis is a rare idiopathic disorder mostly seen in young adult smokers. A 36-year-old female patient referred to our clinic with the complaints of cough and sputum production for the last four months. She had a smoking history of 7 packets per year (current smoker). In high resolution computed tomography, cystic appearances, which were more marked in upper lobes, ground glass opacities near the cystic lesions, and millimetric nodules around them were observed. A surgical biopsy showed a lymphocytic lung infiltrate with Langerhans cells immune staining with CD1a antigen positivity. [ABSTRACT FROM AUTHOR]

Peripartum cardiomyopathy (PPCM) is a rare, life-threatening heart disease of unknown etiology and occurs during the peripartum period in previously healthy women. When a female patient in peripartum has respiratory and cardiac failure, the physicians should be alert about this disease because the complaints are nonspecific. Herein, we present a previously healthy 29-year-old case of PPCM who showed nonspecific respiratory symptoms leading to a preliminary diagnosis of pulmonary thromboembolism (PTE). Echocardiography was an important tool for establishing the eventual diagnosis of PPCM with a consistent history and clinical background. The diagnosis, clinical course, and treatment of PPCM were reviewed in the light of pertinent literature. (Yoğun Bakım Derg 2013; 4: 18-20) [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Medical & Surgical Intensive Care Medicine / Dahili ve Cerrahi Yoğun Bakım Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Alectinib has a much better central nervous system transmission than crizotinib in patients diagnosed with anaplastic lymphoma kinase mutation-positive nonsmall cell lung carcinoma. We aimed to investigate alectinib's efficacy in the treatment and its place in the first-line treatment and report our real-life data., Material and Methods: The data of 38 patients who were diagnosed with anaplastic lymphoma kinase-positive nonsmall cell lung carcinoma in our clinic between 2016 and 2021, who did not receive any treatment before were retrospectively analyzed., Results: Of the 19 patients who received alectinib, 14 had multiple, and 6 had pretreatment brain metastases. No newly emerging brain metastases were detected during the treatment period. The progression-free survival of patients was 23.5 ± 4.2 months, and overall survival was 24.6 ± 4.1 months. Progression was observed in 10 (52.6%) patients. Of the 19 patients who received crizotinib, 7 had multiple metastases, and brain metastases were detected in 1 patient before treatment and 6 patients during the treatment period. Progression-free survival of crizotinib patients was 17.1 ± 4.8 months and their overall survival was 26.5 ± 6.1 months. Progression was observed in 17 (89.5%) patients. The second line of alectinib could be given to 8 of these patients. Overall survival after second-line treatment of alectinib was 18.2 ± 7.0 months. Overall survival of the patients who could not receive second-line treatment of alectinib was 4.0 ± 2.0 months., Conclusion: The progression rate was lower in alectinib than the crizotinib patients, although there were more patients with multiple metastases and brain metastases in the alectinib arm.

Introduction: Chronic thromboembolic pulmonary hypertension (CTEPH) is a curable and partially preventable complication, with a substantial incidence, leading to severe morbidity and mortality. The aim of the present study was to find out the incidence of CTEPH secondary to acute pulmonary thromboembolism (PTE) using non-invasive procedures such as ventilation/perfusion (V/Q) scintigraphy and pulmonary multidetector CT (MDCT) angiography in determining the diagnosis of CTEPH., Materials and Methods: The study included a total of 99 patients diagnosed with initial PTE between January 2010 and December 2012. The patients who received anticoagulant therapy at least for three months underwent transthoracic echocardiography (TTE) (n= 85). Thirty one patients with a SPAP value > 30 mmHg and/or an evidence of right ventricular dysfunction in TTE underwent MDCT pulmonary angiography and V/Q scintigraphy. The patients with an evidence of residual chronic thromboembolic signs in MDCT pulmonary angiography and/or segmental perfusion defect(s) in V/Q scintigraphy underwent right heart catheterization (RHC) (n= 7). The mean PAP was measured, and a vasoreactivity test was performed. During RHC, a non-contrast medium was delivered to the pulmonary arteries for pulmonary arteriography imaging., Results: Among patients diagnosed with PTE, 44 were male and 55 were female. The mean age was 60 ± 17 years. Of these patients, 63.6% had history of at least one additional disease and at least one risk factor for PTE. During diagnosis, 24 subjects were considered having massive, 61 submassive and 14 non-massive PTE. Nineteen (19.1%) patients received thrombolythic therapy. Other 80 (80.8%) patients received standard anticoagulant therapy with an INR value within the therapeutic range. In 79.8% of patients, thromboembolism was bilateral, and it was unilateral in 21.8%. After a minimum of 1 year, and maximum of 2 years follow up five subjects (5.5%) were diagnosed with CTEPH. The univariate analysis showed no association between the development of CTEPH and factors like; age, etiologic risk factors for PTE, receiving thrombolytic treatment, prevalence and type of PTE., Conclusion: Potentially preventabl complication of pulmonary embolism; CTEPH, had a substantial incidence during follow-up.