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Introduction The results of standard chemotherapy in lung cancer are not very satisfactory, so it is important to identify genetic mutations that provide targeted therapies. Recent reports have suggested influences of racial difference on the frequency of mutation in lung cancer. We aimed to determine the frequency and regional distribution of genetic mutations of non-small cell lung cancer (NSCLC) in Turkey. Materials and Methods Regional distribution of genetic mutations in lung cancer in Turkey (REDIGMA) study was carried out as a prospective, cross-sectional, observational study in a large number of centers in which lung cancer patients were followed and could perform genetic mutation analysis on patients' biopsy materials. Result The 703 patients (77.7% male, mean age 63.3 ± 12.5 years) who were diagnosed as NSCLC from 25 different centers were included in the study. Tumor samples from patients were reported as 87.1% adenocarcinoma, 6.4% squamous cell carcinoma and 6.5% other. Mutation tests were found to be positive in 18.9% of these patients. The mutations were 69.9% EGFR, 26.3% ALK, 1.6% ROS and 2.2% PDL. Mutations were higher in women and non-smokers (p

WOS: 000462045500010, Introduction: Skeletal muscle weakness is a major systemic manifestation of chronic obstructive pulmonary disease (COPD). Loss of muscle mass contributes to impaired exercise capacity and peripheral muscle weakness and manifests as reduced fat-free mass in patients with COPD. This study aimed to examine the effects of fat-free mass, body mass index and airway obstruction severity on exercise capacity. Materials and Method: This study included 70 patients with COPD and 70 healthy individuals. Patients with COPD were divided into two groups: non-severe (GOLD Stage 1,2) and severe (GOLD Stage 2,3). Body mass index, fat-free mass, fat mass and percentage fat mass were measured, and pulmonary function tests were performed for all participants. The sixminute walk test was used as an index of exercise capacity. The Student's t-test, chi-square test and Pearson's correlation coefficient were used to compare study parameters. Results: The average fat mass, percentage fat mass and six-minute walk test were reduced in the COPD cohort. No significant correlations were found between the six-minute walk test and body mass index, fat-free mass, fat mass and percentage fat mass. A significant correlation was found between the six-minute walk test and forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1/FVC in patients with non-severe COPD. Conclusion: Exercise capacity is significantly reduced in patients with COPD.The significant relationship between the six-minute walk test score and pulmonary function test variables indicates that disease-related obstruction affects exercise capacity.

WOS: 000454539700011, PubMed ID: 30428648, Background/Aims: Many systems including the cardiovascular system (ischemic heart diseases, heart failure, and hypertension) may act as comorbidities that can be seen during the course of chronic obstructive pulmonary disease (COPD). Comorbidities affect the severity and prognosis of COPD negatively. Nearly 25% of patients with COPD die due to cardiovascular diseases. In this study, we aimed to evaluate the relationship between the blood pressure, inflammation, hypoxia, hypercapnia, and the severity of airway obstruction. Methods: We included 75 COPD patients in the study with 45 control cases. We evaluated age, sex, body mass index, smoking history, C-reactive protein levels, 24-hour ambulatory blood pressure Holter monitoring, arterial blood gas, and respiratory function tests of the patient and the control groups. Results: In COPD patients, the night time systolic, diastolic blood pressures and pulse per minute and the mean blood pressures readings were significantly elevated compared to the control group (p < 0.05). In the correlation analysis, night time systolic pressure was associated with all the parameters except forced expiratory volume in 1 second (FEV1%). Diastolic blood pressure was associated with pH and HCO3 levels. The mean night time, day time pulse pressures and 24-hour pulse per minute values were also associated with all the parameters except FEV1%. Conclusions: In this study we found that parameters of systolic and diastolic blood pressures and pulse pressures were significantly elevated in COPD patients compared to the control groups. Blood pressure was associated blood gas parameters and inflammation parameters in COPD patients. This, in turn, may cause understanding of the pathophysiology of COPD and its complications.

INTRODUCTION: Objective: Tuberculosis patients are stigmatized by the society, exposed to discrimination and in other words stigmatized. Our study was carried out to determine the level of stigmatization and the factors affecting the tuberculosis patients. METHODS: The sample of our study consisted of 95 patients with tuberculosis who were older than 18 years of age and had no communication problems by Tuberculosis Dispensary. The data were collected using Stigma Scale for Patients with Tuberculosis (SPTT) and sociodemographic questionnaire by face-to-face interview method. RESULTS: While the self-perception and internalized stigma levels of the patients who had no social security were higher in the female patients who participated in the study, the sensible stigma levels of the patients whose marital status was married and the average monthly income was below the minimum wage were significantly higher (p

The present study aimed to determine whether there is a relationship between intima-media thickness (IMT) changes in peripheral vessels (carotid and vertebral artery) and inflammatory mediators (C-reactive protein (CRP), leucocytes, etc.), artery blood gas changes and airway obstruction in COPD patients. This study included 60 patients with COPD and 40 healthy control subjects. We used the GOLD criteria for COPD diagnosis. The patient group differentiated according to arterial blood gas values and the presence or absence of pulmonary failure, and its type if any was present. In all patients and control group members, blood leucocytes and CRP values were measured. The carotid, vertebral artery thickness, and total cerebral blood flow were measured using a Doppler USG device and standardized 7 MHz linear transducer. There was no significant relationship between age, sex, body mase index (BMI) and intima-media thickness between the two groups. In the present study, we found out that the CRP levels were higher in COPD patients than in the control group. In progressive COPD patients, CRP levels were the highest. Furthermore, we found out the CIMT was higher in COPD patients compared to the control group. In conclusion, the CIMT and atherosclerosis risk increased in COPD patients. Systemic inflammation causes a higher carotid intima-media thickness in COPD patients. This finding was used as an early risk factor for cardiovascular disease. Doppler USG was used to identify a carotid artery pathology early. Systematic inflammation continuing during a stable period causes increased carotid artery intima-media thickness. This entity plays a role in atherosclerosis etiology.

cure, erkan/0000-0001-7807-135X; Cure, Medine Cumhur/0000-0001-9253-6459; Aydogan Baykara, Rabia/0000-0003-0542-266X WOS: 000399025700011 PubMed: 27431747 Behcet's disease (BD) is a systemic vasculitis characterized by cardiovascular complications. Early diagnosis of these complications can reduce morbidity and mortality. Carotid artery intima-media thickness (cIMT) and the logarithmic value of triglyceride to high density lipoprotein ratio (atherogenic index of plasma, AIP) are good markers of atherosclerosis. the purpose of this study was to investigate whether AIP is a predictive marker of subclinical atherosclerosis in BD patients. A total of 84 BD patients (60 male, 24 female) and 84 healthy control individuals (58 male, 26 female) were included in this study. cIMT measurements were made, and AIP values were calculated. cIMT (p < 0.001) and AIP (p < 0.001) values of the BD patients were higher than those of the control group. A strong independent relationship was found between the AIP value and cIMT (beta = 0.232, p = 0.018). in the subgroup analysis, the cIMT and AIP values of male BD patients were higher than those of female BD patients. Increased AIP and cIMT values can be a good marker for subclinical atherosclerosis in BD patients, especially in male BD patients.

28th International Congress of the European-Respiratory-Society (ERS) -- SEP 15-19, 2018 -- -- Paris, FRANCE, WOS: 000455567102422, …, European Respiratory Soc

WOS: 000322392300004, PubMed ID: 23645038, We hypothesized that solid tumors rarely occur in patients with hydatid disease. We obtained the serum of 14 patients diagnosed with hydatid disease, the serum of 10 patients who did not have a history of hydatid disease, and the hydatid cyst fluid from six patients. These sera and fluid samples were added at different concentrations to NCI-H209/An1 human lung small cell carcinoma cells and L929 mouse fibroblasts as a control group. Sera of patients with hydatid diseases had cytotoxic effects on NCI-H209/An1 cells, but they did not have cytotoxic effects on fibroblast cells. Sera from healthy subjects did not have a cytotoxic effect on the tumor cell line or control fibroblasts. Cyst fluid, also, did not have toxic effects on the NCI-H209/An1 cell line, but was toxic to fibroblasts up to a 1:32 dilution. Sera from patients with hydatid disease had cytotoxic effects on human small cell lung cancer cells in vitro.

Aim: In this study, we aimed to find out if there is an increase in the C-reactive protein (CRP) levels in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and in stable COPD (SCOPD) andto determine the correlation of a possible increase with other markers of inflammation. Material and Method: All patients with AECOPD were also categorized according to radiologic findings. Chest X-rays were evaluated and COPD patients who had new infiltrates, consolidation, air bronkogram were considered to have pneumonia (PCOPD). SCOPD patients without a history of exacerbation for the previous 2 months were recruited prospectively from our outpatient clinic. The pulmonary function test results and the values of arterial blood gas analyses, leukocytes, neutrophils, and CRP measured within 24 hour of admission were obtained from the records of the patients with COPD,. Results: The mean serum CRP level during AECOPD was significantly higher compared to those in the control group and SCOPD patients. The mean CRP level was higher in the SCOPD patients compared to the control group as well. The serum CRP levels were positively correlated with the PaCO2 levels that showed the severity of the attack and negatively correlated with the pH, FEV1 and FEV1/FVC values. Positive correlation between leukocyte count and CRP was detected in all groups except the control group. Discussion:We indicated that there was an association between serum CRP levels and severity of COPD. In COPD exacerbations, leukocyte count and serum CRP levels had a significant positive correlation.

Amaç: Bu çalışmadaki amacımız C-reaktif protein’nin (CRP) Akut eksezervasyonda kronik obstrüktif akciğer hastalığı (AEKOAH) ve stabil kronik obstrüktif akciğer hastalığında( SKOAH) artıp artmadığını tespit etmek, CRP deki artışın diğer inflamatuar markırlarla olan korelasyonunu belirlemektir. Gereç ve Yöntem: Anthonisen’in akut eksezervasyon kriterlerini taşıyan ve KOAH akut eksezervasyonu (AEKOAH) tanısı nedeniyle hastaneye yatan hastaların dosyaları retrospektif olarak tarandı. Tüm hastaların göğüs radyolografileri değerlendirildi. Göğüs radyografisinde yeni infiltrasyon, konsolidayon, hava bronkografi vb varsa pnömoni (PKOAH) olarak değerlendirildi. İki ay boyunca eksezervasyonu olmayan hastalar SKOAH olarak değerlendirildi. Aynı yaş ve cinsiyetten oluşan sağlıklı kontrol grubu oluşturuldu. Tüm hastaların İlk 24 saate yapılan solunum fonksiyon testi, arter kan gazı, venöz kan lökosit, nötrofil ve CRP ölçümleri kaydedildi. Bulgular: Ortalama CRP seviyesi akut ataktaki KOAH hastalarda kontrol grubuna ve SKOAH göre anlamlı derecede yüksekti (p, Aim: In this study, we aimed to find out if there is an increase in the C-reactive protein (CRP) levels in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and in stable COPD (SCOPD) and to determine the correlation of a possible increase with other markers of inflammation. Material and Method: All patients with AECOPD were also categorized according to radiologic findings. Chest X-rays were evaluated and COPD patients who had new infiltrates, consolidation, air bronkogram were considered to have pneumonia (PCOPD). SCOPD patients without a history of exacerbation for the previous 2 months were recruited prospectively from our outpatient clinic. The pulmonary function test results and the values of arterial blood gas analyses, leukocytes, neutrophils, and CRP measured within 24 hour of admission were obtained from the records of the patients with COPD,. Results: The mean serum CRP level during AECOPD was significantly higher compared to those in the control group and SCOPD patients. The mean CRP level was higher in the SCOPD patients compared to the control group as well. The serum CRP levels were positively correlated with the PaCO2 levels that showed the severity of the attack and negatively correlated with the pH, FEV1 and FEV1/FVC values. Positive correlation between leukocyte count and CRP was detected in all groups except the control group. Discussion: We indicated that there was an association between serum CRP levels and severity of COPD. In COPD exacerbations, leukocyte count and serum CRP levels had a significant positive correlation.

In the current study, we aimed to investigate the possible role of MCP-1 -2518 A>G and CC chemokine receptor 2 (CCR2) V64I polymorphisms in patients with lung cancer. Sixty-five patients with lung cancer (57 with NSCLC and 8 with SCLC) and 57 healthy controls were enrolled. Polymerase chain reactionrestriction fragment length polymorphism (PCR-RFLP) method was used. Genotype distribution of monocyte chemoattractant protein 1 (MCP-1) -2518 A>G polymorphism in lung cancer patients was as follows: 30 for AA, 30 for AG and 5 for GG genotype. Frequency of minor G allele in patients and controls were found as 30.8% and 23.7%, respectively. In patients, genotype distribution of CCR2 V64I polymorphism was as follows: 47 for GG, 16 for GA, and 2 for AA. Frequency of minor A allele was found in patients and controls as 15.4% and 19.2%, respectively. Genotype distribution and allele frequencies of MCP-1 and CCR2 polymorphism were not statistically different between patients and controls (p values >0.05 for both polymorphisms). In lung cancer patients, there was no significant association between smoking status and MCP-1 and CCR2 polymorphisms. Similarly, no significant association was found between distant organ metastasis and both gene polymorphisms. Our findings suggest that MCP1 -2518 A>G and CCR2 V64I polymorphisms are not associated with genetic susceptibility to lung cancer and lung cancer metastasis.

OBJETIVO: Avaliar radiografias de tórax de pacientes com tuberculose pulmonar e determinar se a extensão das lesões radiográficas correlaciona-se com os parâmetros bacteriológicos. MÉTODOS: Neste estudo descritivo e retrospectivo; foram avaliadas radiografias de tórax, baciloscopias para BAAR e culturas de escarro para Mycobacterium tuberculosis no momento basal e durante os dois primeiros meses de tratamento. A amostra foi composta por 800 pacientes masculinos internados entre 1995 até o presente em um hospital com 250 leitos no noroeste da Turquia. RESULTADOS: A VHS média inicial foi de 58 ± 37 mm/h. Inicialmente, a baciloscopia e as culturas de escarro tiveram resultado positivo em 83,8% e em 89,5% dos pacientes, respectivamente. Após o primeiro mês do tratamento, a proporção de culturas positivas foi maior nos pacientes com doença cavitária do que naqueles sem doença cavitária (53,7% vs. 37,7%; p < 0,001). Não houve correlação do número de zonas afetadas com idade, duração de sintomas, contato com paciente com tuberculose ativa, diabetes concomitante (p > 0.05 para todos), mas houve correlação positiva com VHS (r = 0,23, p < 0,001). Durante o primeiro e o segundo mês de tratamento, a negativação da baciloscopia foi menos frequente nos pacientes com comprometimento bilateral do que naqueles com comprometimento unilateral (p < 0,001 e p = 0,002 para os meses 1 e 2, respectivamente). A extensão da doença não se correlacionou com idade, duração dos sintomas, contato com paciente com tuberculose ativa e diabetes concomitante, mas sim com a recuperação bacteriológica atrasada. CONCLUSÕES: Radiografias de tórax e bacteriologia são ferramentas valiosas na avaliação de tuberculose pulmonar OBJECTIVE: To evaluate chest X-rays of patients with pulmonary tuberculosis and to determine whether the extent of radiographic lesions correlates with bacteriological parameters. METHODS: In this retrospective, descriptive study, we evaluated chest X-rays, as well as AFB detection by smear microscopy and culture for Mycobacterium tuberculosis, initially and during the first two months of treatment, in 800 male patients hospitalized between 1995 and the present at a 250-bed hospital in northwestern Turkey. RESULTS: The initial mean ESR was 58 ± 37 mm/h. Initial sputum smears and cultures were positive in 83.8% and 89.5% of the patients, respectively. After the first month of treatment, the proportion of patients with positive sputum culture was higher among those with cavitary tuberculosis than among those with non-cavitary tuberculosis (53.7% vs. 37.7%, p < 0.001). The number of affected zones was not correlated with age, symptom duration, contact with an active tuberculosis patient, or concomitant diabetes (p > 0.05 for all) but was positively correlated with the ESR (r = 0.23, p < 0.001). During the first and second months of treatment, conversion to smear-negative status was less common in patients with bilateral involvement than in those with unilateral involvement (p < 0.001 and p = 0.002 for months 1 and 2, respectively). Disease extent did not correlate with age, symptom duration, contact with an active tuberculosis patient, or concomitant diabetes but did correlate with delayed bacteriological recovery. CONCLUSIONS: Chest X-ray and bacteriology are valuable tools for the evaluation of pulmonary tuberculosis

WOS: 000290102100044, PubMed ID: 20165923, The Familial Mediterranean Fever (FMF) shows an autosomal recessive pattern of inheritance and affects certain ethnic groups. Disease is caused by mutations in MEFV gene and more than 180 mutations have been defined in affected individuals. Current study aimed to determine the frequency-type of the mutations for MEFV gene in Sivas-middle Anatolian city. The cohort was composed of 3340 patients. MEFV gene mutations were studied by multiplex PCR based reverse hybridization stripAssay method. Patients' clinical features were; family history: 68%, erysipelas-like erythema: 17.6%, fever: 89.9%, abdominal pain: 84.2%, peritonitis: 90.2%, arthritis: 33%, pleuritis: 14.2%, parental consanguinity: 21.2%. Current results revealed that M694V is the most frequent mutation (43.12%), followed by E148Q (20.18), M680I(G/C) (15.00%) and V726A (11.32%). The study population has a high rate of carriers and the E148Q mutation frequency was found to be highest when compared to the other regions of Turkey and other Mediterranean groups.

WOS: 000354771900018, PubMed ID: 25966729, Background: The aim of the study was to evaluate the antimicrobial activity of the-potassium-titanyl-phosphate - the KTP laser and ozone in of primary root canals. Materials and Methods: Sixty primary incisor teeth were selected. The specimens were inoculated with 10 mu L Enterococcus faecalis (E. faecalis). Groups: The KTP laser (1,5 W); gaseous ozone (150 s); sodium hypochlorite (NaOCl); saline group. Sterile paper points used to sample bacteria from the canals to tubes containing 5 mL of brain heart infusion broth. Then, 10 mu L suspension was incubated in culture media for 24 h. Data were analyzed statistically using Kruskal-Wallis and Mann-Whitney U-test. Results: There were statistically significant differences between all groups (P < 0.05). Complete sterilization was achieved in the 2.5% NaOCl group. The number of bacteria were significantly reduced in experimental groups in comparison to the saline group. Conclusion: The KTP laser and ozone application provided a significant antibacterial effect in primary root canals; however, 2.5% NaOCl was superior.

Fat embolism, generally serious trauma or surgery later, is to pass to the systemic circulation of the oil droplets released from the bone marrow or the soft tissues. It is developed after long bone fractures in the young, but also after hip fracture in the elderly. The clinical table occurred usually 24-48 hours after trauma may be such as light or can progress to respiratory failure and also death. In this case, the 84-year-old woman has been admitted to the hospital due to the traffic accident with complaint pains in the left arm and the left pelvic area. On orthopedic consultation, she was made the close reduction because of the left shoulder dislocation, the left supracondylar humerus fracture and the left ramus pubic fracture, and then, she was discharged to her house. She was reported as “dead” at the house after about three hours from accident. In autopsy of forensic case regarded as suspicious death, it was seen the hemorrhagic featured liquid out on the lung sections, the left shoulder dislocation, the left supracondylar humerus fracture and the left ramus pubic deplase fracture. In the postmortem histopathological examination, it was determined the stage IV of fat embolism in the interstitial capillary lumens in the lungs and the common bone marrow embolism in the medium-sized pulmonary vascular. According to the story of the event, the contents of the medical records, and the macroscopic-histopathological examination findings during autopsy; the death of the case occurred as a result of fat embolism in the lung together with extremity fractures depending on the general body trauma after the traffic accident.After post-traumatic bone fractures, early fixation and immobilization of the fractures is important to prevent the formation of fat embolism. Being careful follow-up and treatment of the cases is important in terms of prevention of the medical practice. Also, in the cases, the broken bones in the accident identified and evaluated as suspicious death; the contribution of the autopsy and the postmortem histopathological examination is clear on determining the diagnose.Key Words: Fat embolism, trauma, forensic medicine, autopsy, suspicious death.

Aim. Mycobacterium tuberculosis infection is a critical public health problem all over the world. T-helper 1 cells play an important role in the pathogenesis of tuberculosis. There is an increased activity of T-helper 1 in Familial Mediterranean Fever (FMF) patients and carriers. Based on immunity, we undertaken this study to evaluate a possible association of MEFV gene mutations with resistance to tuberculosis. Method. This study was performed with 51 patients (23 females, 28 males) applied to Cumhuriyet University Medical Faculty Chest Diseases Department between 2007 and 2009 and diagnosed with tuberculosis by physical examination, microbiological and radiologic analysis and 57 controls (26 females, 31 males). In these groups, 12 common MEFV gene mutations were researched using revers hybridisation FMF Strip Assay (ViennaLab Labordiagnostika, Vienna, Austria) technique. Results. A significant difference was not detected between patient and control groups in terms of distribution of MEFV mutations (p>0.05). There were 22 MEFV gene mutations (43.1%) in patient group. Homozygous mutation was not detected in this group. All mutations in patient group were heterozygous. There was also no homozygous mutation in control group and total 29 (50.8%) heterozygous mutations were detected. Conclusion. Our results suggested that the mutation frequency of MEFV gene in tuberculosis patients was not significantly different from healthy population. FMF mutations may effect the survive of tuberculosis but not sicken., ÖzetAmaç. Mycobacterium tuberculosis enfeksiyonu dünya üzerinde ciddi bir halk sağlığı sorunudur. T-helper 1 hücreleri tüberküloz patogenezinde önemli bir rol oynamaktadır. Ailesel Akdeniz Ateşi (FMF) hastaları ve taşıyıcılarında T-helper 1’in artmış aktivitesi söz konusudur. Bu çalışmayı, bağışıklık temelinde, MEFV gen mutasyonlarıyla tüberküloza karşı direnç arasında olası ilişkiyi değerlendirmek üzere yaptık. Yöntem. Bu çalışma 2007-2009 yılları arasında Cumhuriyet Üniversitesi Tıp Fakültesi Göğüs Hastalıkları Anabilim Dalı’na başvuran ve fizik muayene, mikrobiyolojik ve radyolojik tetkiklerle tüberküloz tanısı alan 51 hasta (23 kadın, 28 erkek) ve 57 kişilik kontrol grubuyla (26 kadın, 31 erkek) gerçekleştirilmiştir. Her iki grupta revers hibridizasyon FMF Strip Assay (ViennaLab Labordiagnostika, Vienna, Austria) tekniği kullanılarak 12 yaygın MEFV gen mutasyonu araştırılmıştır. Bulgular. MEFV mutasyonlarının dağılımı açısından hasta ve kontrol grupları arasında önemli bir fark saptanmamıştır (p>0,05). Hasta grubunda 22 MEFV gen mutasyonu (%43,1) vardı. Homozigot mutasyon tespit edilmedi. Hasta grubundaki mutasyonların tamamı heterozigottu. Kontrol grubunda da homozigot mutasyona rastlanmazken, toplam 29 (%50,8) heterozigot mutasyona rastlandı. Sonuç. Elde edilen veriler tüberküloz hastalarında MEFV geni mutasyon sıklığının sağlıklı populasyona oranla önemli bir farklılık göstermediğini düşündürmektedir. FMF mutasyonları tüberküloza yakalanmakta değil ama hastalığın seyrinde etkili olabilir.Anahtar sözcükler: FMF, tüberküloz, MEFV geni, mutasyon AbstractAim. Mycobacterium tuberculosis infection is a critical public health problem all over the world. T-helper 1 cells play an important role in the pathogenesis of tuberculosis. There is an increased activity of T-helper 1 in Familial Mediterranean Fever (FMF) patients and carriers. Based on immunity, we undertaken this study to evaluate a possible association of MEFV gene mutations with resistance to tuberculosis. Method. This study was performed with 51 patients (23 females, 28 males) applied to Cumhuriyet University Medical Faculty Chest Diseases Department between 2007 and 2009 and diagnosed with tuberculosis by physical examination, microbiological and radiologic analysis and 57 controls (26 females, 31 males). In these groups, 12 common MEFV gene mutations were researched using revers hybridisation FMF Strip Assay (ViennaLab Labordiagnostika, Vienna, Austria) technique. Results. A significant difference was not detected between patient and control groups in terms of distribution of MEFV mutations (p>0.05). There were 22 MEFV gene mutations (%43.1) in patient group. Homozygous mutation was not detected in this group. All mutations in patient group were heterozygous. There was also no homozygous mutation in control group and total 29 (%50.8) heterozygous mutations were detected. Conclusion. Our results suggested that the mutation frequency of MEFV gene in tuberculosis patients was not significantly different from healthy population. FMF mutations may effect the survive of tuberculosis but not sicken.Keywords: FMF, tuberculosis, MEFV gene, mutation

Background Clinical parameters, biomarkers and imaging-based risk stratification are widely accepted in pulmonary embolism(PE). The present study has investigated the prognostic role of simplified Pulmonary Embolism Severity Index (sPESI) score and the European Society of Cardiology (ESC) model. Methods This prospective cohort study included a total of 1078 patients from a multi-center registry, with objectively confirmed acute symptomatic PE. The primary endpoint was all-cause mortality during the first 30 days, and the secondary endpoint included all-cause mortality, nonfatal symptomatic recurrent PE, or nonfatal major bleeding. Results Of the 1078 study patients, 95 (8.8%) died within 30 days of diagnosis. There was no significant difference between non-low-risk patients ESC [12.2% (103 of 754;)] and high-risk patients as per the sPESI [11.6% (103 of 796)] for 30-day mortality. The nonfatal secondary endpoint occurred in 2.8% of patients in the the sPESI low-risk and 1.9% in the ESC low-risk group. Thirty-day mortality occurred in 2.2% of patients the sPESI low-risk and in 2.2% the ESC low-risk group (P = NS). In the present study, in the combination of the sPESI low-risk and ESC model low-risk mortality rate was 0%. Conclusions The sPESI and the ESC model showed a similar performance regarding 30-day mortality and secondary outcomes in the present study. However, the combination of these two models appears to be particularly valuable in PE. © 2014 Elsevier Ltd. All rights reserved.

WOS: 000346149200011, PubMed: 25491689, Background. Chronic obstructive pulmonary disease (COPD) is characterized by inhaled particles and gases inducing chronic inflammation of the airways accompanied by a not fully reversible airflow limitation. Systemic inflammation has an important role in the pathogenesis of COPD. In parallel, several comorbidites can be observed. Microalbuminuria is related to endothelial dysfunction. Microalbuminuria was increased in exacerbation periods of COPD. Objectives. The aim of the study was evaluate to the presence of microalbuminuria (MA) in patients with chronic obstructive pulmonary disease (COPD) and its relationship to inflammation, arterial blood gas parameters and 24-hour ambulatory blood pressure alterations. Material and Methods. Seventy COPD patients and 40 healthy volunteers were enrolled in the study. 24-h ambulatory blood pressure monitoring (ABPM) results, including pressure and pulse rates of the subjects were recorded and the cases were classified as "dipper" if a normal fall of more than 10% in blood pressure was observed at night and "non-dipper" if not. Routine renal function tests were performed, C-reactive protein (CRP) values were examined and urine samples were obtained to scrutinize the presence of MA. Patients were allocated into two groups, those with and without MA. The spirometry and arterial blood gas results of the patients were recorded. Results. The urinary albumin creatinin ratio (64.8 +/- 91.8), CRP (21 +/- 14.8), nocturnal systolic and diastolic blood pressure (118 +/- 14 and 72 +/- 10), nocturnal and diurnal pulse (87 +/- 17 and 90 +/- 14), nocturnal pulse pressure (49 +/- 11), mean pulse (89 +/- 15), mean pulse pressure (48 +/- 10) and the number of non-dipper subjects (65) were found significantly higher in the COPD group than in the control group (10.6 +/- 6, 5.4 +/- 2.4, 105 +/- 6 and 68 +/- 7, 70 +/- 10 and 78 +/- 11, 42 +/- 1, 75 +/- 11, 42 +/- 7 and 5, respectively); (p < 0.001, < 0.001, < 0.001 and 0.041, < 0.001 and < 0.001, < 0.001, < 0.001, < 0.001 and < 0.001, respectively). Nocturnal pulse (89 +/- 17) and CRP (23.5 +/- 14.8) were found to be significantly higher in COPD patients with MA than in COPD patients without MA (78 +/- 8 and 8.8 +/- 6.3, respectively); (p = 0.021 and < 0.001, respectively). Conclusions. The facts that CRP, a systemic inflammation marker, and mean nocturnal pulse pressure values were significantly higher in the group with MA among COPD patients, and that ambulatory blood pressure values did not differ between COPD patients with and without MA, suggest both a possible role of inflammation in MA development in COPD patients and a relationship between MA and increased heart rate.

WOS: 000328273000085, PubMed ID: 24175756, Background: A large variety of familiar and non-familiar lung carcinomas (LC) are caused by long term exposure to chemical carcinogens that are present in tobacco smoke. We aimed to investigate the prevalence of 5 thrombophilic germ-line mutations in patients with lung carcinomas. Materials and Methods: A total of 52 LC patients and 212 healthy controls from same population were analyzed for FV Leiden, factor V H1299R (R2), PAI-1, MTHFR C677T, MTHFR A1298C, ACE I/D, and Apo E genes and compared. Results: Overall, heterozygous and/or homozygous point mutations in FV Leiden Apo E2, PAI-1 and MTHFR C677T genes were associated with LC in the current cohort. There was no meaningful association between LC and ACE I/D gene markers. Conclusions: The current results showed that LC is related to combined thrombophilic gene mutations and individuals with homozygosity of 4G in PAI-1 and MTHFR C677T genes and heterozygosity of FV Leiden, Apo E4 genes have a germ-line risk for LC tumorigenesis.

Angioedema is characterized by swelling just below the surface of the skin and/or mucosa, caused by a sudden increase in endothelial permeability with extravasation of intravascular fluid into the interstitial tissues. A variety of mechanisms can trigger the process, causing angioedema to be classified into two main categories: hereditary and acquired angioedema. Unlike other forms of edema, angioedema is nonpitting, often asymmetric and has a tendency not to involve gravitationally dependent areas.

INTRODUCTION This study, to examine the outcomes of the respiratory disability assessment in our clinic. MATERIALS AND METHODS The reports of 136 patients who attended the chest diseases clinic between January 2010 and June 2011 for the assessment of the respiratory disability were examined retrospectively. RESULTS Of 10.457 patients who presented in 18 months, 136 (1.3%) requested the assessment of the respiratory disability. The patients' average age was 51 ± 12 years and 118 (87%) were male. Farmers constituted 19.8% of the patients and mine and foundry workers 10.7% of the patients. The most frequent symptoms were dyspnea (91.2%) and cough (76.5%). The most frequent radiological pattern was reticular and nodular opacities (38.2%). The workup led to a diagnosis of chronic obstructive pulmonary disease in 64 patients (47%) and of interstitial pulmonary disease/pneumoconiosis in 19 (14%) patients. No respiratory disease was found in 19 patients. Among 44 (32.4%) patients for whom disability rate was calculated, 8 (18.2%) had an incapacity rate of 60% or higher and 13 had 0%. The disability rates showed positive correlations with age, the duration of the respiratory symptoms and PaCO2 level (respectively r= 0.395, p= 0.008; r= 0.391, p= 0.009; r= 0.790, p< 0.001), and negative correlations with FVC, FEV1 and PaO2 levels (respectively r= -0.681, p< 0.001; r= -0.766, p< 0.001; r= -0.661, p= 0.003). Linear regression analysis showed that high PaCO2 value is a determinant for a high disability rate (r= 0.902, p= 0.014). Furthermore, smokers had higher disability rates than non-smokers (p< 0.001). CONCLUSION We believe that new evidence-based guidelines that will resolve the medicolegal and social obscurities are needed.

Giriş: Bu çalışmanın amacı, solunumsal maluliyetin değerlendirilmesi talebiyle kliniğimize başvuran hastaların sonuçları- nı irdelemektir. Materyal ve Metod: Çalışmada, Ocak 2010-Haziran 2011 tarihleri arasında göğüs hastalıkları polikliniğimize solunumsal maluliyetin değerlendirilmesi için başvuran ardışık 136 hastanın raporları retrospektif olarak incelendi. Bulgular: On sekiz aylık dönemde göğüs hastalıkları polikliniğimize başvuran 10.457 hastadan 136 (%1.3)’sının solunumsal maluliyetin değerlendirilmesi için başvurduğu belirlendi. Yaş ortalaması 51 ± 12 yıl olan hastaların 118 (%87)’i erkekti. Has- taların %19.8’inin çiftçilik, %10.7’sinin maden/döküm işçiliği yaptığı, en sık nefes darlığı (%91.2) ve öksürük (%76.5) yakın- malarının olduğu, radyolojik olarak en sık (%38.2) retiküler/nodüler opasitelerin saptandığı belirlendi. Yapılan tetkikler sonu- cu hastaların 64 (%47)’üne kronik obstrüktif akciğer hastalığı, 19 (%14)’una interstisyel akciğer hastalığı/pnömokonyoz tanı- sı konulurken, 19 hastada herhangi bir akciğer hastalığı saptanmadığı belirlendi. Hastalardan 98 (%72.1)’inin başka bölüm- lere de maluliyet değerlendirmesi için başvurduğu belirlendi. Maluliyet oranı hesaplanan 44 (%32.4) hastanın 8 (%18.2)’inin %60 ve üzeri, 13’ünün %0 iş göremez raporu aldığı belirlendi. Maluliyet oranlarıyla yaş, solunumsal semptom süreleri, PaCO2 değerleri arasında pozitif korelasyon (sırasıyla r= 0.395, p= 0.008; r= 0.391, p= 0.009; r= 0.790, p< 0.001), FVC, FEV1, PaO2, de- ğerleri arasında negatif korelasyon olduğu belirlendi (sırasıyla r= -0.681, p< 0.001; r= -0.766, p< 0.001; r= -0.661, p= 0.003). Li- neer regresyon analizinde yüksek PaCO2 değerlerinin yüksek maluliyet oranı hesaplanmasında belirleyici olduğu (r= 0.902, p= 0.014), ayrıca sigara içenlerde içmeyenlerden daha yüksek maluliyet oranı hesaplandığı saptandı (p< 0.001). Sonuç: Solunumsal maluliyet değerlendirmesindeki tıbbi, yasal ve sosyal belirsizliklerin giderileceği, hekime bilimsel yol göstericiliği olan yeni rehberlere gereksinim olduğu düşüncesindeyiz., Introduction: This study, to examine the outcomes of the respiratory disability assessment in our clinic. Materials and Methods: The reports of 136 patients who attended the chest diseases clinic between January 2010 and Ju- ne 2011 for the assessment of the respiratory disability were examined retrospectively. Results: Of 10.457 patients who presented in 18 months, 136 (1.3%) requested the assessment of the respiratory disa- bility. The patients’ average age was 51 ± 12 years and 118 (87%) were male. Farmers constituted 19.8% of the pati- ents and mine and foundry workers 10.7% of the patients. The most frequent symptoms were dyspnea (91.2%) and co- ugh (76.5%). The most frequent radiological pattern was reticular and nodular opacities (38.2%). The workup led to a diagnosis of chronic obstructive pulmonary disease in 64 patients (47%) and of interstitial pulmonary disease/pneumo- coniosis in 19 (14%) patients. No respiratory disease was found in 19 patients. Among 44 (32.4%) patients for whom disability rate was calculated, 8 (18.2%) had an incapacity rate of 60% or higher and 13 had 0%. The disability rates showed positive correlations with age, the duration of the respiratory symptoms and PaCO2 level (respectively r= 0.395, p= 0.008; r= 0.391, p= 0.009; r= 0.790, p< 0.001), and negative correlations with FVC, FEV1 and PaO2 levels (res- pectively r= -0.681, p< 0.001; r= -0.766, p< 0.001; r= -0.661, p= 0.003). Linear regression analysis showed that high Pa- CO2 value is a determinant for a high disability rate (r= 0.902, p= 0.014). Furthermore, smokers had higher disability rates than non-smokers (p< 0.001). Conclusion: We believe that new evidence-based guidelines that will resolve the medicolegal and social obscurities are needed.

WOS: 000449650902180, …

WOS: 000290351300015, PubMed ID: 21552671, INTRODUCTION: Rib fractures are the most common type of injury associated with trauma to the thorax. In this study, we investigated whether morbidity and mortality rates increased in correlation with the number of fractured ribs. MATERIALS AND METHODS: Data from 214 patients with rib fractures who applied or were referred to our clinic between January 2007 and December 2008 were retrospectively evaluated. The patients were allocated into three groups according to the number of fractures: 1) patients with an isolated rib fracture (RF1) (n = 50, 23.4%), 2) patients with two rib fractures (RF2) (n = 53, 24.8%), and 3) patients with more than two rib fractures (RF3) (n = 111, 51.9%). The patients were evaluated and compared according to the number of rib fractures, mean age, associated chest injuries (hemothorax, pneumothorax, and/or pulmonary contusion), and co-existing injuries to other systems. FINDINGS: The mean age of the patients was 51.5 years. The distribution of associated chest injuries was 30% in group RF1, 24.6% in group RF2, and 75.6% in group RF3 (p < 0.05). Co-existing injuries to other systems were 24% in group RF1, 23.2% in group RF2, and 52.6% in group RF3 (p < 0.05). Two patients (4%) in group RF1, 2 patients (3.8%) in group RF2, and 5 patients (4.5%) in group RF3 (total n = 9; 4.2%) died. CONCLUSION: Patients with any number of rib fractures should be carefully screened for co-existing injuries in other body systems and hospitalized to receive proper treatment.

Giriş: Bu çalışmadaki amacımız tanı konulan 65 yaş ve üzeri akciğer kanserli olgularla 65 yaş altı akciğer kanserli olguların klinikopatolojik karakteristik özelikleri arasındaki farklılıkları belirlemekti. Gereç ve Yöntem: Yüz altmış akciğer kanseri hastası retrospektif olarak çalışmaya dahil edildi. Hastaların yaşları, cinsiyetleri, tanı yöntemleri, performansları, eşlik eden hastalıkları ve histolojik tipleri ayrıntılı olarak incelendi. Hastalar 65 yaş ve üzeri yaşlı grup ve 65 yaş altı genç grup olmak üzere iki gruba ayrıldı. Her iki grup klinikopatolojik özeliklerine göre karşılaştırıldı. Bulgular: Genç grupta 124 hasta (13 kadın, 111 erkek), yaşlı grupta 36 hasta (üç kadın, 33 erkek) vardı. Medikal komorbidite durumu yaşlı hastalarda daha fazlaydı (p= 0.045). Öksürük-balgam çıkarma genç hastalarda istatistiksel olarak anlamlı derecede yüksekti (p=0.014). Yaşlılarda hemoptizi anlamlı olarak yüksekti (p=0.018). Kötü performans durumu yaşlılarda daha yüksekti (p=0.008). Akciğerin adenokarsinomu gençlerde (p=0.037), squamöz hücreli kanser yaşlılarda anlamlı derecede yüksekti (p=0.049). Sonuç: Bu çalışmada gençlerde öksürük-balgam semptomu, adenokarsinom histolojik tipi anlamlı derecede yüksek bulunurken, yaşlılarda hemoptizi, medikal komorbidite, kötü performans ve squamöz hücreli karsinom anlamlı derecede yüksek bulundu., Introduction: The aim of the present study was to determine the differences between the clinico-pathological characteristics of lung cancers among elder and young patients Materials and Method: 160 patients with lung cancer were included in the study retrospectively. Age, gender, diagnostic methods, performances, accompanying diseases and histological types of the cancer of patients were all investigated. Patients were divided into two groups; the younger group, under 65 years of age and the elderly group, over 65 years of age. Both groups were compared according to the clinico-pathological features. Results: There were 124 patients (13 female, 111 male) in the younger group, 36 patients (3 female, 33 male) in the elderly group. Medical comorbidity was significantly higher (p=0.045) in the elderly group. Coughing – expectoration rate was statistically higher (p=0.014) in the younger group. Hemoptysis was significantly higher (p=0.018) in the elderly group. Poor performances were significantly higher (p=0.008) in the elderly group. Adenocarcinoma of the lung was more frequent (p=.0.037) among the younger group whereas squamous cell cancer incidence was higher (p=0.049) in the elderly group. Conclusion: While coughing-expectoration symptoms and the lung adenocarcinoma were significantly higher in the younger group, hemoptysis, medical comorbidity, poor performance and the squamous cell carcinoma were sigficantly more frequent in the elderly group.

WOS: 000289257100023, PubMed ID: 21080081, Venous thrombosis is a significant cause of morbidity and mortality in patients with malignancies. We aimed to investigate the association between prothrombotic gene polymorphisms detected in lung cancer cases and deep venous thrombosis (DVT). Totally 66 patients with an established diagnosis of lung cancer, of which 33 developed DVT, were enrolled. Multiplex PCR technique and reverse hybridization strip assay were performed on DNA extracted from peripheral blood, in order to analyze prothrombin G20210A, factor V G1691A, methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C, angiotensin converting enzyme (ACE), plasminogen activator inhibitor-1 (PAI-1), and glycoprotein IIIa (Gp IIIa) gene mutations. Among prothrombotic gene polymorphisms investigated in this study, the commonest ones were PAI-1 4G/5G (56% heterozygous, 39% homozygous) and ACE gene mutations (58% heterozygous, 17% homozygous). The presence of homozygous MTHFR A1298C mutation was significantly associated with DVT (P = 0.020). Comparing the lung cancer patients with and without DVT, only MTHFR A1298C gene polymorphism differed significantly (P = 0.040). We determined a higher rate of prothrombotic gene mutations in lung cancer patients who developed DVT. However, statistical significance was achieved only for MTHFR A1298C gene mutation. Therefore, nongenetic factors for disturbance of hemostatic metabolism should also be considered in lung cancer patients.

To evaluate chest X-rays of patients with pulmonary tuberculosis and to determine whether the extent of radiographic lesions correlates with bacteriological parameters.In this retrospective, descriptive study, we evaluated chest X-rays, as well as AFB detection by smear microscopy and culture for Mycobacterium tuberculosis, initially and during the first two months of treatment, in 800 male patients hospitalized between 1995 and the present at a 250-bed hospital in northwestern Turkey.The initial mean ESR was 58 ± 37 mm/h. Initial sputum smears and cultures were positive in 83.8% and 89.5% of the patients, respectively. After the first month of treatment, the proportion of patients with positive sputum culture was higher among those with cavitary tuberculosis than among those with non-cavitary tuberculosis (53.7% vs. 37.7%, p0.001). The number of affected zones was not correlated with age, symptom duration, contact with an active tuberculosis patient, or concomitant diabetes (p0.05 for all) but was positively correlated with the ESR (r = 0.23, p0.001). During the first and second months of treatment, conversion to smear-negative status was less common in patients with bilateral involvement than in those with unilateral involvement (p0.001 and p = 0.002 for months 1 and 2, respectively). Disease extent did not correlate with age, symptom duration, contact with an active tuberculosis patient, or concomitant diabetes but did correlate with delayed bacteriological recovery.Chest X-ray and bacteriology are valuable tools for the evaluation of pulmonary tuberculosis.

WOS: 000286472600039, PubMed ID: 20532637, This study aimed to determine the relation between methylene-tetrahydrofolate reductase (MTHFR) gene polymorphism and lung cancer risk and the frequency of this polymorphism. The study involved 64 lung cancer patients (the study group) with definitive diagnosis and 61 noncancerous subjects (the control group). MTHFR C677T and A1298C mutation analysis was made using DNA isolated from peripheric blood and multiplex PCR and reverse hybridization strip test. Eighty-four percent of the patients were male. The age, gender, and history of alcohol use of the patients and control group were statistically similar. While MTHFR 677T and 677C allele frequency was 0.33 and 0.67 in the patients respectively, it was 0.29 and 0.71 in the control group. The frequencies of MTHFR 1298C and 1298A were 0.33 and 0.67 in the patients, and it was 0.31 and 0.69 in the control group respectively. When MTHFR 677TT and 677CT genotypes were compared with 677CC genotype, lung cancer risk was 2.4 times higher in the 677TT genotype. When MTHFR 1298AC and 1298CC genotypes were compared with 1298AA genotype, lung cancer risk was 1.5 times higher in 1298CC genotype. According to the results, allele frequency of homozygote T and C was high in lung cancer patients. It was 3.05 and 1.29 times higher in smokers than in non-smokers, and 3.05 and 1.64 times higher in males than in females; 3.0 and 2.44 times higher in those with non-small cell lung cancer than in those with small-cell lung cancer.

Churg-Strauss Sendromu (CSS); astım, eozinofili, küçük ve orta çaplı damarların inflamasyonu ile karakterize nadir görülen sistemik bir hastalıktır. Bu yazıda nefes darlığı, öksürük yakınmaları ile başvuran, astım, perikardiyal effüzyon ve eozinofili saptanan CSS olgusu sunulmuştur. 50 yaşında erkek hasta bir yıldır olan nefes darlığı, göğüs ağrısı, öksürük, balgam yakınması ile başvurdu. Hastanın solunum fonksiyon testlerinde orta derecede reversibl hava akımı obstr üksiyonu saptandı. Transtorasik ekokardiyografisinde perikardiyal effüzyon, periferik kanda ve bronş lavajında eozinofili saptandı. Akciğer grafisinde gezici infiltratlar izlendi. Bu bulgularla hastaya CSS tanısı kondu. Hastaya prednizolon tedavisi uygulandı. Tedavi ile belirgin klinik ve radyolojik iyileşme gözlendi., Churg-Strauss Syndrome (CSS) is a rare systemic disease characterized by asthma, eosinophilia and inflammation of small to medium sized blood vessels. This paper reports a patient who presented with dyspnea and cough, and who was diagnosed as asthma, pericardial effusion and eosinophilia. 50 year old male patient was admitted with dyspnea, chest pain, cough and sputum complaints for one year. Pulmonary function tests detected moderate reversible airflow obstruction. Transthoracic echocardiography revealed pericardial effusion. Eosinophilia was detected in both peripheric blood count and bronchial lavage. There were transient pulmonary infiltrates on chest X-ray. It was finally diagnosed as Churg-Strauss Syndrome with these findings. Corticosteroid therapy was performed. Clinical and radiological symptoms were improved with this treatment.

WOS: 000273363000007, PubMed ID: 20046000, Pulmonary alveolar microlithiasis (PAM) is a rare disease characterized by the presence of small calculi in the alveolar space. The SLC34A2 is thought to be responsible for the disease. We encountered three siblings of an inbred family who have PAM. We examined the family of the proband who was admitted with dyspnea on exertion and cough, and eventually was diagnosed with PAM. Genetic analysis revealed that both parents (a consanguineous marriage) of the proband were carriers with heterozygous mutation of SLC34A2 gene, and three of their children were diagnosed with PAM with homozygous mutation in the SLC34A2 gene. These findings suggest that impaired activity of the SLC34A2 gene may be responsible for familial PAM.

WOS: 000280143700006, PubMed ID: 20613935, BACKGROUND: Plasma D-dimer levels are directly related to the intra- and extra-vascular coagulation that occurs in acute and chronic lung damage in patients with community-acquired pneumonia (CAP). OBJECTIVES: This study examines the relationship between the severity of community-acquired pneumonia and D-dimer levels. In addition, the study examines the correlations among community-acquired pneumonia, the radiological extent of the disease and mortality. METHODS: The Pneumonia Severity Index was used to classify patients into five groups. Patients were treated at home or in the hospital according to the guidelines for community-acquired pneumonia. Blood samples were taken from the antecubital vein with an injector and placed into citrated tubes. After they were centrifuged, the samples were evaluated with the quantitative latex method. RESULTS: The study included 60 patients who had been diagnosed with community-acquired pneumonia (mean age 62.5 +/- 11.7) and 24 healthy controls (mean age 59.63 +/- 6.63). The average plasma D-dimer levels were 337.3 +/- 195.1ng/mL in the outpatient treatment group, 691.0 +/- 180.5 in the inpatient treatment group, 1363.2 +/- 331.5 ng/mL in the intensive care treatment group and 161.3 +/- 38.1ng/mL in the control group (p

Yirmi yedi yaşında bayan hasta ateş, öksürük, boğaz ağrısı, halsizlik ve nefes darlığı şikayetleriyle hastanemize başvurdu. Yüksek çözünürlüklü bilgisayarlı akciğer tomografisinde her iki akciğerde diffüz mikronodüler infiitrasyonlar, alveolar patern ve buzlu cam opasiteleri izlendi, hastanın takibi esnasında trombosit sayısı, hemoglobin ve hematokrit seviyeleri düştü, nazal sürün-tüden yapılan PCR testi sonucunda influenza A (H1N1) pozitif saptandı. Hasta bu bulgularla influenza A (H1N1) pnömonisi, diffüz alveolar hemorqji tanısı aldı ve oseltamivir, metilprednizolon, tedavisi uygulandı. Medikal tedavi ile semptomlarda ve akciğer grafisindeki infiltrasyonlarda belirgin düzelme gözlendi. Özet olarak influenza A (H1N1) virusu pnömoni, diffüz alveolar hemorqji ve solunum yetmezliğine neden olabilir. Erken tanı ve uygun tedavi ile bu komplikasyonlar düzelebilir., A 27-year-old woman presented to our hospital with fever, cough, sore throat, fatigue and shortness of breath. High resolution chest CT at admission showed diffuse micronodular infiltrations, alveolar pattern and ground-glass opacifications in both of the lungs. Platelet count, hemoglobin and hematocrit levels decreased during the follow-up of the patient. PCR test revealed positive result for novel influenza A (H1N1) in nasal and swab. According to these findings, she was diagnosed to have novel influenza A (H1N1) pneumonia and diffuse alveolar hemorrhage, and treated with oseltamivir and metilprednisolone. After the medical treatment, the symptoms and infiltrations on chest radiograph improved. To sum up, influenza A (H1N1) virus can cause pneumonia, diffuse alveolar hemorrhage and respiratory failure. Early diagnosis and appropriate therapy can treat these complications

Aim: In this study, we aimed to investigate the associations between comorbidity status and age, gender, stage and histopathological type of tumors in patients with lung cancer. Methods: Age, gender, smoking status, stage, accompanying diseases, and histological types of 148 patients were recorded. The Charlson comorbidity index was used for definition and grading of comorbidity. Results: In 44.6% of our patients, there was at least one comorbid disease. When associations between Charlson comorbidity index and demographic variables, smoking status, histological type and stage of the tumor were investigated, following results were found: 45.5 % of men, 46.7% of the smokers, 56.3 % of undifferentiated and 52.6% of patients with squamous cell carcinoma, 48.2% and 49.2 % of widespread and advanced stages of lung cancers, respectively, had medical comorbidities. Conclusions: In our study, medical comorbidity was more common in men than in women, in smoker than in non-smokers, in undifferentiated and squamous cell carcinomas than in the other histological types. The relationship between comorbidity status and stage of the tumor supports the hypothesis of camouflage. Keywords: Comorbidity, lung cancer, smoking Ozet Akciger kanserli hastalarin komorbidite durumu Amac: Bu calismada amacimiz akciger kanseri hastalarinda komorbiditenin yas, cinsiyet, evre ve histopatolojik tipi ile olan iliskisini incelemekti. Yontem: Yuz kirk sekiz akciger kanserli hastanin yaslari, cinsiyetleri, sigara icme durumlari, hastalik evreleri, eslik eden hastaliklari ve histolojik tipleri kaydedildi. Komorbiditenin tanim ve derecelendirilmesinde Charlson komorbidite indeksi kullanildi. Bulgular: Hastalarimizin %44,6'sinda en az bir komorbid hastaligi vardi. Charlson indeksine gore komorbidite derecesinin cinsiyet, sigara icme durumu, histolojik tip, evre ile olan iliskisi degerlendirildiginde erkeklerin %45,5'inde, sigara icme oykusu olanlarin %46,7'inde, squamoz hucreli karsinomlarin %52,6'sinda, tiplendirme yapilamayanlarin 56,3'unde, yaygin ve ileri evreye sahip akciger kanserli olgularin sirasiyla %48,2 ve % 49,2'sinde medikal komorbidite tespit edildi. Sonuclar: Bulgularimiza gore komorbidite, erkeklerde kadinlara gore, sigara icenlerde icmeyenlere gore, tiplendirilmeyen ve skuamoz hucreli karsinomu olanlarin diger histolojik tipleri olanlara gore daha fazladir. Hastalarimizin komorbidite ve evre iliskisi kamuflaj hipotezini desteklemektedir. Anahtar sozcukler: komorbidite, akciger kanseri, sigara icme

Aim. The aim of this study was to evaluate the patients hospitalized due to chronic obstructive pulmonary disease (COPD) at a pulmonary ward of a state hospital as a secondary care center. Methods. The retrospective analysis of 110 patients who were admitted to the department of chest diseases in Sivas State Hospital between March 2006-March 2007 for the diagnosis and the treatment of COPD was performed. The age, gender, smoking status, biomass exposure, occupation, the presence of any additional disease, the causes of the exacerbations, patients' symptoms, physical findings, pulmonary function test (PFT), direct chest radiography, and the outcome of hospitalization were recorded. Results. Of 110 patients included in this study, 88 (80%) were male and 22 (20%) were female. The mean age was 68.7 ± 7.9 years and the age range was between 42 and 82. We detected that the smoking rate was 82%, the rate of exposure to biomass was 44%, and the frequency of coexistence of smoking and biomass exposure was 31%. Dyspnea (100%), cough (78%), sputum production (66%), and chest pain (52%) were the most common symptoms. Rhonchi (86%) and inspiratory rales (74%) were the most common finding in physical examination of the patients. Chronic comorbidity was found in 40% of the cases, the most common being the cardiovascular diseases. Conclusions. Several risk factors were identified in patients hospitalized due to COPD. Intense exposure to biomass, especially in women, was found to be a significant risk factor for COPD in our region.Keywords: Chronic obstructive pulmonary disease, biomass, smokingÖzet Amaç. Bu araştırmanın amacı bir devlet hastanesi akciğer hastalıkları servisinde ikinci düzey bakım için yatırılan kronik obstrüktif akciğer hastalığı (KOAH) olgularının değerlendirilmesidir. Yöntem. Sivas Devlet Hastanesi Göğus Hastalıkları Servisinde Mart 2006-Mart 2007'de yatırılarak tedavi edilen 110 hastanın retrospektif analizi gerçekleştirildi. Yaş, cinsiyet, sigara kullanımı, biomas maruziyeti, iş, eşlik eden hastalık, atakların nedenleri, belirtiler, bulgular, akciğer fonksiyon testleri (AFT), direkt akciğer grafisi ve tedavi sonuçları kaydedildi. Bulgular. Çalışmaya alınan 110 olgunun 88'i (%80) erkek ve 22'si (%20) kadındı. Ortalama yaş 68,7 ± 7,9 (42-82) yıl bulundu. Sigara kullanım oranı %82, biomas maruziyeti %44 ve sigara ve biomas birlikte maruziyeti %31 olarak saptandı. Dispne (%100), öksürük (%78), balgam çıkarımı (%44) ve gögüs ağrısı (%52) olarak en sık görülen belirtilerdir. Ronkus (%86) ve inspiratuvar ral (%74) ile en sık saptanan muayene bulgularıydı. En fazla kardiyovasküler hastalık olmak üzere %40 olguda kronik komorbidite bulundu. Sonuçlar. KOAH nedeniyle yatarak tedavi edilen olgularda çeşitli risk faktörleri bulunmaktadır. Özellikle kadınlarda biomasın yoğun maruziyeti bölgemizde önemli bir risk faktörü olarak dikkati çekmektedir.Anahtar sözcükler: Kronik obstruktif akciğer hastalığı, biomas, sigara kullanımı, Amaç. Bu araştırmanın amacı bir devlet hastanesi akciğer hastalıkları servisinde ikinci düzey bakım için yatırılan kronik obstrüktif akciğer hastalığı (KOAH) olgularının değerlendirilmesidir. Yöntem. Sivas Devlet Hastanesi Göğus Hastalıkları Servisinde Mart 2006-Mart 2007’de yatırılarak tedavi edilen 110 hastanın retrospektif analizi gerçekleştirildi. Yaş, cinsiyet, sigara kullanımı, biomas maruziyeti, iş, eşlik eden hastalık, atakların nedenleri, belirtiler, bulgular, akciğer fonksiyon testleri (AFT), direkt akciğer grafisi ve tedavi sonuçları kaydedildi. Bulgular. Çalışmaya alınan 110 olgunun 88’i (%80) erkek ve 22’si (%20) kadındı. Ortalama yaş 68,7 ± 7,9 (42-82) yıl bulundu. Sigara kullanım oranı %82, biomas maruziyeti %44 ve sigara ve biomas birlikte maruziyeti %31 olarak saptandı. Dispne (%100), öksürük (%78), balgam çıkarımı (%44) ve gögüs ağrısı (%52) olarak en sık görülen belirtilerdir. Ronkus (%86) ve inspiratuvar ral (%74) ile en sık saptanan muayene bulgularıydı. En fazla kardiyovasküler hastalık olmak üzere %40 olguda kronik komorbidite bulundu. Sonuçlar. KOAH nedeniyle yatarak tedavi edilen olgularda çeşitli risk faktörleri bulunmaktadır. Özellikle kadınlarda biomasın yoğun maruziyeti bölgemizde önemli bir risk faktörü olarak dikkati çekmektedir.

Aim. The aim of this study was to evaluate the association between HCV and lung cancer. Methods. The study included 60 patients who admitted department of chest diseases our hospital for diagnosis of lung cancer. These patients were performed the blood test for HCV before to invasive procedures. Results: Of 60 patients included in this study, 58 (96.7%) were male and 2 (3.3%) were female. There was a statistically no significant difference between patients with Anti-HCV (+) and Anti-HCV (-) for gender and age (p>0.05). We found that anti-HCV antibodies were positive in 3 of 60 (5%) patients with lung cancer. Histologic types of lung cancer were 38.0 % squamous cell cancer, 30.0 % adenocarcinoma, 10.0% undifferentiated, and 21.7% small cell lung cancer. There was a statistically non-significant difference between patients with anti-HCV (+) and anti-HCV (-) for histological type of lung cancer (p>0.05). Conclusions: The development of lung cancer is a multifactorial process, including the environment factors, smoking, certain occupations, and genetic factors. HCV positivity alone may not be sufficient evidence for cause lung cancer. Therefore, there is a need studies that have large numbers of patients with HCV infection and lung cancer patients for this association.Keywords: Lung cancer, hepatitis C virusÖzetAkciğer kanserli hastalarda hepatit C virüs enfeksiyonun yeriAmaç: Bu çalışmanın amacı akciğer kanseri ile Hepatit C virüsü arasındaki ilişkiyi incelemektir. Yöntem: Hastanemiz göğüs hastalıkları bölümüne akciğer kanseri ön tanısıyla başvuran 60 hasta çalışmaya alındı. Hastalara tanısal invaziv girişimler yapmadan önce hepatit C için kan örnekleri alındı. Bulgular: Çalışmaya dahil edilen 60 hastanın 58'i (%96.7) erkek, 2'si (%3.3) kadındı. Altmış hastanın 3'ü (%5) anti HCV (+) idi. Anti-HCV (+) ve anti-HCV (-) gruplar arasında yaş ve cinsiyet bakımından anlamlı bir fark yoktu (p>0.05). Akciğer kanserli hastaların histolojik tipi olarak %38.0'ı squamöz hücreli kanser, % 30.0'ı adenokarsinoma, %10.0'ı tiplendirilemeyen ve % 21.7'si küçük hücreli akciğer kanseri idi. Anti-HCV (+) ve anti-HCV (-) gruplar arasında akciğer kanserinin histolojik tipi bakımından anlamlı bir fark yoktu (p>0.05). Sonuçlar: HCV pozitifliği akciğer kanserinin nedeni olarak göstermek için yeterli kanıt olmayabilir. Akciğer kanserinin gelişmesinde sigara, bazı meslekler, çevresel ve genetik faktörleri içeren multifaktöryel etkenler rol oynamaktadır. Akciğer kanseri ile HCV infeksiyonu arasındaki ilişki değerlendirmek için ileride daha geniş serili çalışmalara ihtiyaç vardır.Anahtar sözcükler: Akciğer kanseri, hepatit C virüsü

Objective: Non-small cell lung carcinoma is an aggressive phenomenon and the epigenetical alterations of some tumor supressor genes have been reported for the different tumor types. Case Presentation: It is presented a case report concerning a 43 years old male with NSCLC on the lower segment of the right lung. The patient underwent a diag-nostic excisional thin-needle biopsy and after the histological confirmation. We examined the promoter methylation status of some distinct tumor supressor genes in tumoral and blood tissues of the case after sodium bisulfite conversion and DNA amplification with methylation specific multiplex PCR technique. Both tissues were also searched for G to A transitions in codons 12 and 13 of the K-ras proto-oncogene. Results: Tumor specimen showed fully methyl pattern profiles for the SFRP2, p16, DAPK1 and partially hyper-methylated profile for the p53 and MGMT genes in this case with non-small lung carci-noma. Blood speicemen showed normal hypomethylated profiles for all studied TS genes. The K-ras proto-oncogene was in normal structure both in blood and tumoral spiecemens that examined. Conclusion: Results indicate that genes exhibit tumor suppressor activi-ties in blood, but exhibit epigenetic inactivation in carcinoma cell. These findings strongly support the hypothesis that epigenetic mechanisms may play an important role in the non-small cell lung carcinogenesis in human.