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In recent times, monocyte/high-density lipoprotein cholesterol (HDL) ratios (MHR) surfaced as novel markers of inflammation and oxidative stress. This study aims to investigate the short -term prognostic role of the MHR ratios in patients who suffer from acute pulmonary embolism (PE). Two hundred patients who suffered from pulmonary embolism were included ret rospectively in the current study. The demographic data along with the laboratory parameters of the patients were obtained from the digital archive system of the facility. Mortality was seen in 42 (21%) of 200 patients with PE. It was determined that the mean age, mean troponin level, pulmonary artery pressure, monocyte value, and MHR ratios were statistically higher in exitus group compared to the survivor group. The mean MHR value was higher in patients with exitus in 1st month than patients with exitus between 1-6 months (p=0.009). 132 (66%) patients with acute PE had sPESI =1, while mean MHR was statistically higher in high -risk patients compared to low-risk PE patients (17.95±12.67, 11.54±5.66, p= 0.001, respectively). For the MHR ratio, when the cut-off value was considered 16.03 in the prediction of PE cases for survival, the sensitivity was 81% and the specificity was 62% (AUC=0.793, p=0.001, CI%= 0.722-0.865) The fact that MHR was higher in exitus group, in high-risk patients and in those patients with exitus in the first 1 month suggested that it may be an important factor in predicting mortality in patients with PE. [ABSTRACT FROM AUTHOR]

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OBJECTIVES: Asthma is a global problem and chronic condition that persists through patient's entire life, during which the possibility of a surgical procedure is common. An accurate clinical and functional evaluation of respiratory functions and asthma control is needed in patients undergoing surgical procedures and requiring general anesthesia. The aim of this study was to disclose any possible relation between postoperative complications and some pre- and postoperative factors. MATERIALS AND METHODS: In this prospective cross-sectional study, randomly selected 111 asthmatic patients who presented to 10 different tertiary centers were included. The patients were evaluated at three different periods; any day between 1-7 days before surgery, and postoperative third and seventh to tenth days. RESULTS: Among the patients included in the study, 86 (77.5%) were women and mean age was 52.2±13.8 years. General anesthesia was the most common anesthesia type (89.2%), and 33.3% of patients had had a thoracoabdominal surgery. There was a statistically significant difference between pre- and postoperative third-day values, including ACT scores (22.2±3.16 and 21.59±3.84, respectively; p<0.001); forced expiratory volume during the first second (84.92±19.12 and 78.26±18.47, respectively; p<0.001); peak flow rate (79.51±21.12 and 70.01±19.72, respectively; p<0.001); and SaO2 (96.95±1.82 and 95.8±3.32, respectively; p<0.001). Bronchospasm and pain were the most common complications during the postoperative period. CONCLUSION: Controlled asthma under treatment steps 1-2-3 does not cause any serious postoperative pulmonary complications (PPCs). Therefore, achieving an optimal control level of asthma during the preoperative period must be considered the "gold standard" to reduce the risk of PPCs in asthmatic patients. [ABSTRACT FROM AUTHOR]

A 70-year-old woman who had experienced progressive dyspnea for 1 month was admitted to the emergency department. A physical examination revealed bilateral axillary lymphadenopathy and it was determined that she had undergone chemotherapy due to chronic lymphocytic leukemia (CLL) in the previous year. A hypodense lesion was observed on a thorax computed tomography image. The result of the investigation was a determination of pulmonary involvement (lymphocytic infiltration) of CLL. The case is presented in the context of a literature discussion due to the low incidence. [ABSTRACT FROM AUTHOR]

Abstract: Background and aims: Asymmetric dimethylarginine (ADMA) decreases the levels of nitric oxide by inhibiting nitric oxide synthases. In this study, the possible role of ADMA in determining pulmonary hypertension (PH) in chronic obstructive pulmonary disease (COPD) patients was investigated. Methods: Stable COPD patients who were admitted to pulmonology outpatient clinic were involved in the study. Forty healthy volunteers, with similar ages and sexes, were accepted as the control group. COPD patients were divided into two groups: 40 patients without PH (COPD group) and 40 COPD‐related PH patients (COPD‐PH group). Pulmonary function test, echocardiography and arterial blood analyses of all patients were performed. Results: The mean age of patients was 69.21 ± 10.62, and 15 of these patients were females. There was no significant difference between the two COPD groups in terms of age and sex (P > .05). There was no difference in PaO2, SaO2, FEV1 and FEV1/FVC values between the two COPD groups (P > .05). Serum ADMA levels were similar in the control and the COPD group (0.42 ± 0.13 vs 0.43 ± 0.15), but it was significantly higher in the COPD‐PH group compared to the control and the COPD group (0.49 ± 0.14). A negative correlation was determined between serum ADMA levels and SaO2 levels (r = –.247, P = .028). A significant positive correlation observed between ADMA and systolic pulmonary artery pressure values (r = .627, P < .001) Conclusions: In conclusion, high levels of serum ADMA levels may be able to determine the presence of PH. [ABSTRACT FROM AUTHOR]

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The article offers information on the different important aspects of an accurate preoperative evaluation. Topics covered include the anesthesia-tied changes in pulmonary functions, and the risk factors associated with surgical intervention. Also mentioned are the patient-related risk factors including obstructive sleep apnea, obesity, and chronic obstructive pulmonary disease.

Primary isolated tracheobronchial amyloidosis is an uncommon disease. It manifests in symptoms such as progressive dyspnea, cough, and haemoptysis. Airway obstruction can cause atelectasis and recurrent bronchopulmonary infections. A 47-year old man was admitted with the complaint of dyspnea upon exertion of 15 years duration. It is learned that he had a productive cough in winter, and received treatment for bronchial asthma, but had no recovery. Hemoptysis added to his complaints for 10 days, and he had a smoking history of 30 packet/year. Upon physical examination, he had prolonged expirium, and other system signs were normal. Laboratory findings; WBC: 7.100, Hb: 14, Hct: 42.6%, Plt: 479.000, ESR: 80 mm/sec, biochemical parameters were within the normal range. The posteroanterior radiogram of the chest revealed bilateral hilar fullness, and double contour on the right diaphragm. Results of pulmonary function tests were as follows; FEV1/FVC: 44%, FEV1: 47%, FVC: 84%. A computed tomographys can of the chest showed clear emphysemal areas in lung parenchyma, and diffuse thickening on the wall of the trachea, bilateral main bronchii, and segmental bronchii. Fiberoptic bronchoscopy revealed multiple endobronchial lesions on the walls of trachea,and subsegmental bronchii, and mucosal infiltration. A biopsy from these lesions revealed pink-purple amyloid accumulation on mucosal connective tissue, mucosal gland wall, and mucosal vascules after painting with crystal violet and Kongo red. The patient was diagnosed as tracheobronchial amyloidosis, and argon plasma coagulation applied under general anesthesia first to the left main bronchus, and then the right main bronchus and trachea during 2 sessions. After coagulation, mechanical resection was applied.Cryotherapy was applied to the remaining tissue. After treatment, his symptoms were significantly improved. Although spontaneousresolution has been reported in the tracheobronchial amyloidosis, most cases require multiple therapeutic interventions in order to control progressive respiratory symptoms. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Thoracic Journal / Turk Toraks Dergisi is the property of Aves Yayincilik 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.)

Objective: Determining right ventricle dysfunction (RVD) in pulmonary thromboembolism (PTE) is very important for prognosis and treatment options. RVD is usually diagnosed by echocardiographic findings. Recent studies have suggested that the measurement of cardiac troponin I (cTnI), and brain natriuretic peptide (BNP) serum levels can define RVD. The aim of this study is to evaluate the diagnostic value of BNP and cTnI serum levels for determining RVD in patients with submassive PTE. Material and Methods: Fifty patients with a definitive diagnosis of PTE were included into the study. For determining a probable RVD, all patients underwent an echocardiography, and serum levels of BNP, and cTnI were measured during their admission. A control group was created with 19 healthy volunteer whose age was similar to the patients. Results: Right ventricle dysfunction is detected by echocardiography in 52% of patients included into the study. High levels of BNP were found in 73% of patients with RVD (+), and in 12% of patients with RVD (-). When cTnI levels were examined; it was determined that 12% of patients with RVD (+), and 8% of patients with RVD (-) had high cTnI levels. BNP levels were significantly high in patients with RVD (+) when compared with RVD (-), and control groups (p<0.001). When cTnI levels of groups were compared, no significant difference was observed between the three groups. Conclusion: It is suggested that high levels of BNP can be a marker for RVD, patients who have high levels of BNP must be followed closely, and may be assessed for thrombolytic therapy. (Turk Toraks Derg 2012; 13: 163-8) [ABSTRACT FROM AUTHOR]

Objective: Determining right ventricle dysfunction (RVD) in pulmonary thromboembolism (PTE) is very important for prognosis and treatment options. RVD is usually diagnosed by echocardiographic findings. Recent studies have suggested that the measurement of cardiac troponin I (cTnI), and brain natriuretic peptide (BNP) serum levels can define RVD. The aim of this study is to evaluate the diagnostic value of BNP and cTnI serum levels for determining RVD in patients with submassive PTE. Material and Methods: Fifty patients with a definitive diagnosis of PTE were included into the study. For determining a probable RVD, all patients underwent an echocardiography, and serum levels of BNP, and cTnI were measured during their admission. A control group was created with 19 healthy volunteer whose age was similar to the patients. Results: Right ventricle dysfunction is detected by echocardiography in 52% of patients included into the study. High levels of BNP were found in 73% of patients with RVD (+), and in 12% of patients with RVD (-). When cTnI levels were examined; it was determined that 12% of patients with RVD (+), and 8% of patients with RVD (-) had high cTnI levels. BNP levels were significantly high in patients with RVD (+) when compared with RVD (-), and control groups (p<0.001). When cTnI levels of groups were compared, no significant difference was observed between the three groups. Conclusion: It is suggested that high levels of BNP can be a marker for RVD, patients who have high levels of BNP must be followed closely, and may be assessed for thrombolytic therapy. (Turk Toraks Derg 2012; 13: 163-8) [ABSTRACT FROM AUTHOR]

Objective: An imbalance in the oxidant-antioxidant system has been recognised as one of the first events that ultimately lead to inflammatory reactions in chronic obstructive lung disease (COPD). Lycopene, an antioxidant carotenoid, is associated with prevention of some human chronic diseases. This study was designed to investigate the effect of lycopene on oxidant stress and pulmonary function tests (PFT) in patients with COPD. Material and Method: Thirty clinically stable COPD patients, and 15 healthy non-smoker subjects were enrolled on the study. Fifteen COPD patients received oral placebo and 15 patients received 20 mg lycopene daily for 4 months in addition to their standardized therapy. Their baseline spirometer, plasma malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), interleukin (ID-6, IL-1β, and tumor necrosis factor alpha (TNF-α levels) were measured in serum. All parameters were measured again after supplementation. Results: The mean MDA, IL-6, IL- lβ, and TNF-α levels in the COPD group at baseline were higher than controls, while SOD and CAT levels were lower in the patients compared to controls. Four months qf lycopene supplementation produced significant increase in mean SOD, and CAT levels (both p

Bochdalek hernia is a type of congenital diaphragmatic hernia (CDH) that typically presents in childhood, but may rarely be detected in adults. Most cases are asymptomatic and diagnosed incidentally. Hernias are often located on the leftside, while bilateral location is rare. We present a 75-year-old man in whom bilaterally Bochdalek hernia was detected incidentally. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to evaluate the B group vitamin levels in patients with COPD and to determine the relationship between vitamin levels and pulmonary functions. Material and Method: Fifty four patients with COPD, who were initially diagnosed during the admission to the outpatient clinic, were studied. Pulmonary function tests and assays of vitamins of COPD patients, healthy subjects were evaluated. Results: All the B group vitamin levels were lower in the COPD group. B1, B2, B12 vitamin levels correlated with smoking (pack/year) (r=-0.33, r=-0.265, r=-0.483, respectively, p<0.05 for all values), forced expiratory volume in one second (FEV1) (r=0.372, r=0.474, r=0.777 respectively, p<0.05 for all values), and FEV1/forced vital capacity (FVC) (r=0.418, r=0.430, r=0.787 respectively, p<0.05 for all values). B6 vitamin levels correlated with FEV1/FVC values (r=0.290, p<0.05). Conclusion: This study confirms a decreased level of B group vitamins in patients with COPD. It may be suggested that B group vitamin supplementation may have a beneficial effect on oxidant/antioxidant imbalance in such patients. Future work is needed to explore the possible relationship between the intake of B group vitamins, systemic and local pulmonary assessment of antioxidant capacity/antioxidant molecules, and lung function. [ABSTRACT FROM AUTHOR]

Background and objective: To evaluate the potential role of anti-tumour necrosis factor (TNF)-α mAb (infliximab) on the inflammatory response in a mouse model of acute asthma. Methods: BALB/c mice received intraperitoneal (i.p.) ovalbumin (OVA) on days 0 and 14, 100 μg of OVA intranasally on day 14 and 50 μg of OVA intranasally on days 25, 26 and 27. The low-dose (2.5 mg/kg) and high-dose (6.25 mg/kg) infliximab groups received i.p. infliximab before each i.p. sensitization and on challenge days 1, 6, 13, 20 and 27. The control group received i.p. injections of normal saline with alum on days 0 and 14 and normal saline without alum on days 14, 25, 26 and 27. Results: There were statistically significant decreases in the numbers of BAL fluid (BALF) neutrophils, eosinophils, as well as lung eosinophils in both the low- and high-dose infliximab groups when compared with the control OVA sensitized/challenged group. The lower dose of infliximab did not alter lung neutrophil counts, but a marked decrease was seen with the high dose of infliximab. After treatment with low and high doses of infliximab, BALF levels of regulated on activation normal T cell expressed and secreted (RANTES), granulocyte macrophage-colony stimulating factor (GM-CSF), TNF-α, IL-6, macrophage inflammatory protein (MIP)-2, and levels of RANTES, IL-4, GM-CSF, TNF-α, IL-6 and MIP-2 in lung tissue were significantly decreased when compared with the control OVA sensitized/challenged group. There was a significant decrease in BALF IL-4 only in the high-dose infliximab group. Conclusions: These results show that an anti-TNF-α mAb has a considerable anti-inflammatory effect on allergen-induced lung inflammation in an animal model of acute asthma. [ABSTRACT FROM AUTHOR]

Introduction: The most common cause of tracheal stenosis (TS) continues to be traumas according to the intubation and tracheostomy. Bronchoscopy is considered the gold standard for the detection and diagnosis of tracheobronchial pathology. There are several treatment options. We aimed to discuss our tracheal stenosis patients' treatment options, and their follow-up period., Materials and Methods: Consecutive referred patients between 2009 and 2018 presenting with TS were reviewed for the study. Demographic characteristics, localization, length and degree of stenosis, treatment techniques, postoperative complications, and survival were recorded for all patients., Result: A total of 110 patients included. The mean age was 53.7 ± 16.7 (16-98 years) years. Of 110 patients, 54 (49.1%) were female. Most common type of stenosis was complex stenosis (74.5%). Mechanical dilatation was applied to all patients. Stenotic regions of 22 (20%) patients were cut with bronchoscopic scissor. Tracheal stents were inserted into trachea of 49 (44.5%) patients. During follow-up period; 36 of 110 (32.7%) patients had surgical resection. Six of 36 (16.7%) patients died during follow-up period (one of them died during surgery), 17 (47.2%) patients had total recovery after surgery. Thirteen of 36 (36.1%) patients had restenosis after surgery., Conclusions: Tracheal stenosis is a process seen after postintubation or posttracheostomy frequently and it has a wide range of management modalities. Although, it is believed that surgery is the most efficient technique in cases without medical contraindications, we determined that endoscopic interventions can be alternative therapeutic options for inoperable patients. Patients must be followed-up after interventional therapies because complications, and restenosis can usually be seen.

Introduction: Sleep quality is known to be associated with the distressing symptoms of cancer. The purpose of this study was to analyze the impact of cancer symptoms on insomnia and the prevalence of sleep-related problems reported by the patients with lung cancer in Turkey., Materials and Methods: Assesment of Palliative Care in Lung Cancer in Turkey (ASPECT) study, a prospective multicenter study conducted in Turkey with the participation of 26 centers and included all patients with lung cancer, was re-evaluated in terms of sleep problems, insomnia and possible association with the cancer symptoms. Demographic characteristics of patients and information about disease were recorded for each patient by physicians via face-to-face interviews, and using hospital records. Patients who have difficulty initiating or maintaining sleep (DIMS) is associated with daytime sleepiness/fatigue were diagnosed as having insomnia. Daytime sleepiness, fatigue and lung cancer symptoms were recorded and graded using the Edmonton Symptom Assessment Scale., Result: Among 1245 cases, 48.4% reported DIMS, 60.8% reported daytime sleepiness and 82.1% reported fatigue. The prevalence of insomnia was 44.7%. Female gender, patients with stage 3-4 disease, patients with metastases, with comorbidities, and with weight loss > 5 kg had higher rates of insomnia. Also, patients with insomnia had significantly higher rates of pain, nausea, dyspnea, and anxiety. Multivariate logistic regression analysis showed that patients with moderate to severe pain and dyspnea and severe anxiety had 2-3 times higher rates of insomnia., Conclusions: In conclusion, our results showed a clear association between sleep disturbances and cancer symptoms. Because of that, adequate symptom control is essential to maintain sleep quality in patients with lung cancer.

Introduction: The importance of the evaluation of health status in chronic obstructive pulmonary disease (COPD) is recently highlighted in many studies. In this study, we aimed to test the validity and reliability of the Turkish version of St. George Respiratory Questionnaire (SGRQ)., Materials and Methods: The study was conducted in seven centers in Turkey. Three hundred and twenty one COPD patients (40-75 years) were included to the study. Turkish versions of breathlessness, Cough, and Sputum Scale (BCSS), mMRC (Modified Medical Research Council) dyspnea scale, SGRQ, COPD assessment test (CAT) and Short Form Health Survey (SF-36) were carried out to the patients. The statistical analysis of SGRQ was performed by using the coefficient of internal consistency, discriminative analysis for different stages and the correlation with the other scales., Results: The mean age was 62.4 ± 8.9 years and the mean FEV1 was 51.9 ± 19.2% pred. The coefficient of internal consistency (Cronbach alpha) was 0.8815. The correlation between the total score measured initially and that obtained two weeks later was found to be highly significant (r= 0.90, p< 0.0001). According the results of validation of both total score and the components of SGRQ, the correlation between the total score of SGRQ and CAT was 0.782 (p< 0.0001), SGRQ and SF-36 was between -0.481 ile -0.819 (p< 0.0001). The total and component scores were able to discriminate different disease stages and a significant correlation was found to be with pulmonary function tests., Conclusion: SGRQ Turkish version is a reliable and valid assessment tool for COPD patients in clinical practice.

Unlabelled: Unilateral pulmonary artery agenesis without any cardiovascular malformation is a rare anomaly. We present the imaging findings of a patient who was diagnosed as isolated left pulmonary artery agenesis. A 27-year-old female patient was admitted to our hospital due to dyspnea during exercise for five years. Chest X-ray revealed minimally small left pulmonary hilum and left lung. She was admitted to our clinic with the suspicion of pulmonary artery pathology. Absent perfusion of the left lung with normal ventilation was visualized on scintigraphy. MDCT angiography of pulmonary arteries showed absent left main pulmonary artery with systemic collaterals around left hemithorax. Pulmonary artery agenesis can be asymptomatic and isolated until adulthood. Both scintigraphy and CT angiography images of pulmonary artery agenesis of a patient are rare in the literature. Pulmonary ventilation-perfusion scintigraphy can be used not only for pulmonary embolism but also pathologies involving pulmonary artery and its branches., Conflict of Interest: None declared.

Introduction: This study, we aimed to investigate the protective effect of lycopene in lung injury rat model., Materials and Methods: Twenty eight Wistar rats were enrolled into the study. Control group (n= 7) were applied PBS + ethanol (9/1). A single dose of 100 mg/kg oleic acid (OA) intravenously was administrated to OA group (n= 7). One mL of corn oil was given daily to corn oil + OA group (n= 7) by gavage for five weeks. Lycopene was given by gavage to lycopene + OA group (n= 7) for five weeks. At the end of the 5th weeks, OA were given. Four hour after OA administration, lung tissue, blood samples were taken. Malondialdehyde, superoxide dismutase, glutathione-peroxidase, catalase levels were determined., Results: Malondialdehyde levels of serum, lung tissues were increased in OA, corn oil + OA groups than control, where as decreased to controls levels in lycopene + OA group (p< 0.05). Superoxide dismutase, glutathione-peroxidase activities of serum, tissue increased moderetaly or they were closed with control values. There was significant increase in lycopene + OA group values. Histopathological examination of control group was normal. OA, cornoil + OA groups had perivascular, alveolar edema, hemorrage, prominent neutrophil infiltration, destruction in alveolar structure. Lycopene + OA group had less neutrophilic infiltration, perivascular, alveolar edema., Conclusion: Lycopene rich diet may have an important role preventing damages in lungs.

Introduction: This study is aimed to evaluate the reliability and validity of the Turkish version of chronic obstructive pulmonary disease (COPD) Assessment Test (CAT) in seven centers., Materials and Methods: 321 patients between 4-75 years of age, diagnosed and staged by Global Initiative for Obstructive Lung Disease (GOLD) 2011 criteria were included. The Breathlessness, Cough, Sputum scale (BCSS), mMRC (Modified Medical Research Council ) dyspnea index, St. George Respiratory Questionnaire (SGRQ), CAT and Short Form-36 (SF-36) were used concurrently. In the statistical analyses, internal consistency, item-total score correlation, explorative factor analysis, correlation with other scales were calculated., Results: The mean age was 62.4 ± 8.9 years and 89.7% of the patients were male (n= 288). Mean FEV1% was 51.9 ± 19.2 and most of the patients were in Stage 3. CAT total score was 17.8 ± 9.5. In the internal consistency, Cronbach alpha coefficient was found as 0.9116 and item-total score correlation coefficients were between 0.62-0.79 and all were statistically significant (p< 0.0001). The correlation of the test-retest score calculated after two weeks with the initial score was 0.96 (p< 0.0001). In the structural validity, factor analysis with principle component analysis and varimax rotation was performed. One factor solution was achieved with eigenvalue of 4.956 and it represented 61.9% of the total variance. All the items were contained in the factor and the factor loads were between 0.71-0.85. The correlation coefficients of CAT with other indexes were moderate to good. The discrimination of CAT among disease stages has been shown to be significant (p< 0.0001) and a significant correlation was found with pulmonary function tests (p< 0.0001)., Conclusion: It is demonstrated The Turkish version of COPD Assessment Tool is reliable and valid.