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Objective:The objective of this study is to find the relationship between incidence rate and mortality of acute pulmonary thromboembolism (PTE), and seasonal and meteorological factors. Materials and methods: The data from 234 patients who were hospitalized due to acute PTE in the emergency service or policlinics between 2001 and 2008 were investigated retrospectively. Cases that developed APE (acute pulmonary embolism) in the hospital were excluded. Seasons and months in which acute PTE was diagnosed were recorded. Mortality rates by months and seasons were evaluated. The mean pressure, temperature and humidity values were evaluated for periods of three days, seven days and one month before the day of presentation. The effects of meteorological factors on the severity (massive or non-massive) and mortality of APE were investigated. Results: The incidence rate of acute APE showed a significant difference according to seasons (p=0.000). APE was diagnosed most commonly in spring and winter. The mean pressure values for three days, seven days and one month and the mean humidity values for three days for the dead patients were found to be significantly lower than those of the survived ones (p

Selcuk ZT, Demir AU, Tabakoglu E, Caglar T. Prevalence of asthma and allergic diseases in primary school children in Edirne, Turkey, two surveys 10 years apart. Pediatr Allergy Immunol 2010: 21: e711–e717. © 2010 John Wiley & Sons A/S To assess change in prevalence and risk factors of asthma and allergic diseases among primary school children in rural and urban parts of Edirne, Turkey, a series of cross-sectional studies were conducted in 1994 and 2004. A questionnaire was administered to the parents of primary school children aged 7–12, in urban and rural parts of Edirne, Turkey (5412 in 1994 and 5735 in 2004). Response rates in 1994 and 2004 were 84% and 82.5%, respectively. There were significant differences between the age distribution, urban habitation (1994: 70.1%, 2004: 75.8%, p

An elevated plasma D-dimer level indicates the activation of coagulation and fibrinolysis. In the present study, we investigated the association of pre-treatment haemostatic parameters (D-dimer, fibrinogen and prothrombin fragment 1+2) with clinicopathological parameters and outcome in patients with lung cancer.Plasma levels of D-dimer and other parameters were measured in 78 evaluable patients with lung cancer (60 non-small cell lung cancers, 18 small cell lung cancers). At diagnosis, 35 patients (44.9%) were locally advanced stage (IIIA/B) and 43 patients (55.1%) had metastatic disease (IV). Multivariate statistical analysis was carried out using Cox's proportional hazards model. The receiver operating characteristic curve was used to determine the cut-off values for D-dimer, fibrinogen and prothrombin fragment 1+2.The median survival for all patients was 264 days (95% confidence interval 200-328 days). A significant association between the plasma levels of D-dimer and the response to chemotherapy was observed (P=0.03). With the univariate analysis, tumour stage, pre-treatment plasma levels of D-dimer, fibrinogen, platelet count, lactate dehydrogenase concentration and Karnofsky performance status were predictive for survival. With the multivariate analysis (Por =0.1), the plasma level of D-dimer (P0.001), tumour stage (P=0.01) and Karnofsky performance status (P=0.02) were identified as independent predictive factors. The median survival times were 405 days (95% confidence interval 165-644 days) and 207 days (95% confidence interval 146-267 days, P0.001), respectively, for patients with a low D-dimer level (or =0.65 microg/ml) and a high D-dimer level (0.65 microg/ml).Elevated plasma levels of D-dimer in patients with lung cancer are associated with decreased survival and a poor response to treatment. Pre-treatment for the D-dimer level may be useful in the prediction of survival and the response to treatment.

Primary spontaneous pneumothorax (PSP) occurs subsequent to a disruption in the continuity of visceral pleura and escape of air into the pleural space. The cause of PSP is most often the rupture of subpleural blebs or bullae. It is usually difficult to detect evidence of pulmonary pathology. The purposes of the present study were (1) to investigate the changes of pulmonary alveolar epithelial permeability in patients with PSP as determined by Tc-99m DTPA aerosol lung scintigraphy, (2) to assess whether or not some differences exist between apical and basal parts of the lungs, and (3) to determine the relationship between the clearance rate of Tc-99m DTPA and the PFT results, the recurrence rate of PSP, and the percentage of pneumothorax in affected lung.Thirteen PSP patients (two females, 11 males; mean age 32.5 +/- 11.8 years) with normal chest X-ray were studied. Thirteen healthy non-smoking volunteers (1 female, 12 males; mean age, 35.8 +/- 10 years) were selected as a control group. Tc-99m DTPA aerosol lung scintigraphy and PFT were performed in all patients and controls. Clearance rates (%/min) of Tc-99m DTPA aerosol in right and left lung field, and apical and basal parts of each lung were calculated from dynamic images for 15 min.There was no significant difference (p0.05) between patients and controls, or between apical and basal parts of each lung. No correlation was found between the clearance rate of Tc-99m DTPA and PFT results, the recurrence rate of PSP, or the percentage of pneumothorax.This study demonstrates that pulmonary epithelial permeability is not altered in PSP patients; the clearance rate of Tc-99m DTPA shows no difference between apical and basal parts of each lung.

Massive pulmonary embolism (MPE) is a life threatening disease, thrombolytic treatment could save lives. The aims of this study are to identify early and late mortality rates in patients with MPE who received thrombolytic treatment, and mortality related risk factors. All the hospital records for the MPE patients who received thrombolytic treatment between 1998 and 2006 were retrospectively investigated. Pulmonary embolism was diagnosed through computed tomografi scan and V/P scintigraphy. Due to MPE, 21 women total 41 patients who undergo tPA or streptokinase were included in the study. Kaplan-Meier for the survival analysis and cox regression analysis for determining the mortality related independent risk factors were used. Dying while staying in hospital was accepted as early or hospital mortality, after discharge from hospital as late mortality. Out of 41 patients, 12 of them died while they are hospitalized (hospital mortality; 29%) 6 of them died after they were discharged (late mortality; 21%). The average survival time among discharged patients was 2304 days (95% confidence interval: 1725-2884). Among those patients who took streptokinase or tPA, late or early mortality rates (p0.05) and survival time did not show significant difference (p= 0.8908). The presence of arrhythmia [p= 0.01; odds rate (OR): 6.25] and jugular vein distention (JVD) (p= 0.03; OR: 6.25) for hospital mortality and multiple ongoing health problems for the late mortality were identified as the independent risk factors. For the hospital mortality, the presence of JVD or arrhythmia, for prognostic sensitivity, specificity, positive predictive value and negative predictive value were recorded as 75%, 79%, 60% and 88% respectively. In conclusion, the presence of arrhythmia and/or JVD on a patient with MPE is a negative prognostic factor for hospital mortality. The presence of other ongoing health problems influences the survival time of the discharged patients.

Objective: The Turkish anti-tobacco law was accepted and effectuated in 1996. All forms of cigarette advertising, the sale of tobacco products to persons under the age of 18 and smoking in public institutions were all restricted. In this paper, we aimed to evaluate the influence of the Turkish antitobacco law on children for the periods before the law, after three years and after 10 years. Material and Methods: A self-completed questionnaire was distributed among primary school children. This included questions about the children's smoking habits, their opinions of parents' and teachers' smoking habits, tobacco use in public places and the recognition rate of 16 food, drink, cigarette and toothpaste logos and brand names. The first, second and third applications of the questionnaire were performed with students who attended the same classes in the same primary schools, accounting for 772 children in June 1996, 1,157 children in February 1999 and 719 children in June 2006. Results: When these three periods were evaluated, it could be seen that the prevalence of having smoked significantly decreased (13.9%, 4%, 2.2%, p

Özet Amaç: İşyeri ortam havasında bulunan SO2, çalışanların özellikle solunum sistemini etkileyen bir gazdır. Bu araştırma, Edirne’de süpürge üretiminde çalışanların, islemede kullanılan SO2 den etkilenme durumlarını değerlendirmek amaçlanmıştır. Yöntem: Araştırma 2012 Ocak-Şubat aylarında Edirne’de gerçekleştirilmiştir. Oluşturulan veri toplama formu ile süpürgeciler sitesinde çalışan 25 kişiden ve konfeksiyon işinde çalışan 25 kişiden veri toplanmıştır. Demografik bilgiler, solunum sistemi öykü-fizik muayeneleri ve solunum fonksiyon testleri sonucunda elde edilen veriler araştırmacılar tarafından hazırlanan veri formuna kaydedilmiştir. Kükürt dioksit kullanılarak, isleme ve sarartma işleminin yapıldığı odaların iç ortam havasında ise, GasAlertMicro 5 marka cihaz ile SO2 düzeyi ölçülmüştür. Bulgular: SO2’ye maruz kalan ve kalmayan grupların yaş ortalamaları (sırasıyla 47.6±1.2, 45.2±3.4) ve sigara kullanma oranları (%64, %64) benzer idi (p>0.05). SO2’ye maruz kalanlarda balgam (%32 ve %16, p0.05) ve patolojik solunum sesi varlığı (% 12 ve % 12, p>0.05) benzer bulunmuştur. Çalışanlarda, solunum fonksiyon testlerinden FEV1, FVC, FEV1/FVC, MEF (FEF25-75%) değerleri, kontrol grubuna göre anlamlı olarak düşük bulunmuştur (hepsi için pSonuç: İsleme odalarında ölçülen SO2 düzeyi DSÖ ve NIOSH standartlarına göre yüksek bulunmuştur. İşyeri ortam havasında izin verilen değerlerin üzerinde bulunan SO2, çalışanların sağlığını, öncelikle de solunum sistemini etkilemektedir. Çalışanlar, bu risk etmeni konusunda bilgilendirilmeli ve korunma yöntemlerine ilişkin olarak eğitilmelidir. SO2’nin yoğun olduğu isleme bölümünde, havalandırma sistemlerinin iyileştirilmesinin yanı sıra, bu bölümde çalışma sırasında, kişisel koruyucu maske kullanılmalıdır. Anahtar kelimeler: İç ortam havası, SO2, süpürge işçileri, solunum fonksiyon testi Abstract Objective: Sulphur dioxide (SO2,)which is encountered in the ambient air of the working rooms used for making brooms, is a gas that primarily affects the respiratory system of the staff. Method: This study was conducted to investigate the exposure to SO2 which is used in the production process in broom-making in Edirne between January-February of 2012. A questionnaire was applied to 25 broom-makers and to 25 other individuals. The study included demographic data, a history and a physical examination of the respiratory system, and the results of spirometry. The amount of SO2 in the rooms used for the industrial processes were measure by a Gas Alert Micro 5 brand device. Results: The average age of the workers affected by SO2 and of the non exposured group were (47.6±1.2, 45.2±3.4 respectively) and the rates of smoking were (64%, 64%) similar (p>0.05). Differences in sputum levels (32% and 16%, p0.05) and pathological respiratory sounds ratios (12% and 12%, p>0.05) were similar. Spirometry findings including FEV1, FVC, FEV1/FVC and MEF (FEF25-75%) were significantly lower for the workers than the control group (pConclusion: SO2 room gas amounts were higher than both WHO and National Institute for Occupational Safety and Health (NIOSH) standards. SO2 gas amounts higher than the standards are harmful especially for the respiratory system of the workers. Workers in this industry should be warned of the potential risks and should be educated. Workers of the complex using SO2 should use masks during working hours and rooms should have efficient air-conditioning. Key Words: Indoor air, SO2, sweeper workers, pulmonary function test

The study was prospectively designed to assess the correlation between a new clinical model empirically developed for acute pulmonary embolism (PE) and ventilation/perfusion (V/P) scan results. One hundred sixty consecutive patients with suspected acute PE underwent clinical evaluation before V/P scintigraphy. The clinical probability of PE was categorized according to a structured clinical model empirically developed as low, intermediate, or high, and the results were compared with those of V/P scintigraphy. Forty, 61, and 59 patients were classified as low, intermediate, and high clinical probability, respectively. Seventy-five percent (30/40) of the patients with low clinical probability were also of low scintigraphic probability or had a normal result (rs: 0.39, p=0.000); 28% (17/61) of the patients with intermediate clinical probability demonstrated intermediate scintigraphic probability (rs: 0.20, p=0.012); and 68% (40/59) of the patients with high clinical probability were also of high scintigraphic probability (rs: 0.43, p=0.000). Overall, the correlation of two scoring systems was statistically significant (rs: 0.39, p=0.000). Unilateral leg swelling (p=0.027), syncope or near syncope (p=0.002), amputation of a hilar artery (p=0.007), and electrocardiographic signs of right ventricular overload (p=0.000) prevailed in patients with high scintigraphic probability. “Syncope-near syncope or hemodynamic collapse” PLUS “electrocardiographic signs of right ventricular overload or hypoxemia” combination had the most significant correlation with a high scintigraphic probability (rs: 0.31; p=0.000). In conclusion, the new clinical model empirically developed was significantly successful to provide comparable results with V/P scan. This consistency was particularly prominent in patients with low or high clinical probability for PE.

The occurrence of clinically symptomatic intraocular metastases as an initial manifestation of primary neoplasm is rare event. The recognition of metastatic ocular tumors is important since they indicate a poor prognosis. Prompt diagnosis and treatment can significantly improve the quality of life for these patients. We report the case of a 48-year-old man presenting with a two-week history of left sided intraocular pain with blurring of vision and headache, which are the first signs of small-cell lung carcinoma.

Objective: Cisplatin-gemcitabine (PG) and cisplatin-etoposide (PE) combinations are active regimens for non-small cell lung cancer (NSCLC). The present study aimed to compare PG with PE in the treatment of patients with stage IIIB and IV NSCLC. Methodology: We conducted a prospective, multicentre trial. A total of 166 patients were enrolled into the study and received either gemcitabine (1000 mg/m2) on days 1, 8 and 15 plus cisplatin (80 mg/m2) on day 2 every 4 weeks, or etoposide (100 mg/m2) on days 1, 2 and 3 plus cisplatin (80 mg/m2) on day 1 every 3 weeks. Results: The overall response rate was superior in the PG group (54.8%vs 39.0%, P = 0.045). There was no significant difference in survival between the two groups, with respective median and 1-year survival of 38 weeks and 33.3% for the PG group, and 34 weeks and 23.2% for the PE group. There was also no statistical difference for time to progression between the two groups. Neutropenia and thrombocytopenia were seen more frequently in the PG group (grade 3 neutropenia, 33.3%vs 15.9%, P = 0.012; grade 3 thrombocytopenia, 27.4%vs 3.7%, P

Purpose: Isocyanates are highly reactive chemicals used in a number of industries including paints. Therefore, house painters are known to be at risk for occupational exposure to isocyanates. Our objectives in this study were: (1) to investigate the possible effects of isocyanate exposition on the bronchoalveolar epithelial permeability in house painters by using Tc-99m DTPA radioaerosol lung scintigraphy; (2) to assess whether or not some differences exist between asthmatic and non-asthmatic house painters, and (3) to determine the relationship between Tc-99m DTPA radioaerosol lung scintigraphy and the spirometric measurements, and the work duration of house painters.Materials and Methods: Ten non-smoking house painters (28.8±8.8 yrs) and ten healthy volunteers underwent Tc-99m DTPA radioaerosol lung scintigraphy. Following inhalation of radiotracer through a nebulizer for 5 minutes, dynamic scintigrams (1 frame/min, up to 10 min) were taken from both lungs. ROI's were drawn over the both lung area, and time-activity curves were obtained, from which the half-time (T1/2) of Tc-99m DTPA clearance was calculated. Spirometric lung function test was measured in all house painters.Results: Mean T1/2 values (min±SD) were 93.74±32.79 for house painters, and 90.96±40.02 for control subjects. There was no significant difference in T1/2 values of Tc-99m DTPA clearance between house painters and controls, and between asthmatic and non-asthmatic house painters as well. No correlation was observed between T1/2 values of Tc-99m DTPA clearance and spirometric measurements. In house painters, there was a positive correlation between T1/2 values of Tc-99m DTPA clearance and work duration (r=0.73, p=0.016).Conclusions: Our findings indicate that in house painters, occupational exposure to isocyanates has no effect on bronchoal veolar epithelial permeability, and the rate of Tc-99m DTPA clearance shows no difference between asthmatic and non-asthmatic house painters. The positive correlation between the rate of Tc-99m DTPA clearance and work duration needs to be confirmed in larger cohorts.

An 18-year-old woman presented with primary pulmonary hypertension (PPH) and was hospitalized because of hemoptysis and was referred to our department for a differential diagnosis pulmonary thromboembolism. Doppler ultrasonography of the lower extremities was normal. Echocardiography and cardiac catheterization showed right ventricular dilatation and increased pulmonary artery pressure without anatomic (intracardiac) shunt. The mean pulmonary arterial pressure was 110 mm Hg. Tc-99m MAA lung perfusion scans showed nonsegmental patchy defects. Extrapulmonary renal uptake and increased systemic deposition of radiotracer were seen in the MAA scintigraphy. It could be related to a functional intrapulmonary shunt resulting in increasing pressure in the pulmonary artery in PPH.