Evaluation of Quality of Life with the Chronic Obstructive Pulmonary Disease Assessment Test in Chronic Obstructive Pulmonary Disease and the Effect of Dyspnea on Disease-Specific Quality of Life in These Patients

PURPOSE: The chronic obstructive pulmonary disease (COPD) assessment test (CAT) was recently introduced for use in assessing disease-specific quality of life and follow-up of patients with COPD. The purpose of this study was to evaluate the effect of the dyspnea on disease-specific quality of life detected by CAT score in patients with COPD. MATERIALS AND METHODS: In this study, 90 stable patients with COPD as defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria were included. The level of dyspnea was assessed with the Medical Research Council (MRC) dyspnea scale, and disease-specific quality of life was assessed with CAT score. RESULTS: The mean+/-SD age was 68.5+/-10.9 (range 41-97) years. A significant relationship was established between CAT score, MRC dyspnea scale score and GOLD stage in patients with COPD. There was also a positive correlation between dyspnea scale scores and GOLD stage in the patients (p<0.001), as well as positive correlation between CAT score and dyspnea scale score (p<0.001). CAT score showed a significant correlation with hospitalization and exacerbations (p<0.05). CONCLUSION: Dyspnea is an important symptom that may impact quality of life in patients with COPD. CAT was shown to be a simple, fast and intelligible measurement of disease-specific quality of life, and was correlated with levels of dyspnea in patients with COPD.

Giant hamatroma originating from the chest wall in an adult

Hamartomas of the chest wall are rare benign lesions usually appear in infancy. We report an adult with giant hamartoma of the chest wall. A 21-year-old man was admitted to the hospital with swelling on his scapular region. An erythematous, swollen, and wide plaque formed mass lesion of 250 x 180 on the left scapular region was found in his physical examination. Thorax CT revealed a tumoral lesion in left hemithorax wall with destruction of the 3rd rib, and formation of the new bone growing and asymmetry in thorax by infiltrating surrounding soft tissues, and decreased left lung volume. Pathological findings referred to soft tissue hamartoma. After the diagnosed, the patient underwent to thoracotomy

Diagnostic Contribution of Gastric and Bronchial Lavage Examinations in Cases Suggestive of Pulmonary Tuberculosis

We assessed whether acid fast bacilli (AFB) determination in gastric lavage (GL) and bronchial lavage (BL) contributes to diagnosis in cases radiologically suggestive of pulmonary tuberculosis but with either negative AFB in sputum or the inability to expectorate sputum. Of 129 cases recruited for the study, 22 were excluded due to evaluation as inactive disease or non-tuberculosis disease. The remaining 107 cases were evaluated in 2 groups. Group A consisted of 49 patients that could not expectorate sputum and from whom GL was obtained. In group B, BL was performed in 58 patients that had negative sputum smear. Smear positivity was 61.2% (30/49) and culture positivity was 30.6% (15/49) in group A, 51.7% (30/58) and 81% (47/58), respectively, in group B. Thirteen cases, in whom AFB could not be detected microbiologically but who were radiologically strongly suggestive of tuberculosis, were regarded as tuberculosis according to 'from treatment to diagnosis' criteria. In conclusion, detection of AFB positivity in the diagnosis of tuberculosis is important in terms of early initiation of treatment and detection of resistant bacilli. Therefore, we suggest that it would be helpful to obtain GL in cases where the patient is unable to expectorate sputum, and perform BL in cases with negative sputum smear.

Dental Technician's Pneumoconiosis: Mineralogical Analysis of Two Cases

Pneumoconiosis was diagnosed by open lung biopsy in two dental technicians who had interstitial lung disease. Mineralogical analysis was performed to investigate the origin of the dust that had been inhaled. A marked accumulation of silicon and phosphorus was found in both cases. The hard metals chromium and cobalt were also found. Dental technician's pneumoconiosis is a complex pneumoconiosis in which such dust and hard metals may play a role.

Deaths in patients with pulmonary tuberculosis: an analysis of a chest diseases hospital in Istanbul, Turkey

To evaluate the medical records of patients with pulmonary tuberculosis in order to determine the inhospital mortality rate. Materials and Medical records of 22,651 patients with pulmonary tuberculosis admitted to Gulhane Military Medical Academia, Camlica Chest Diseases Hospital, Istanbul, Turkey from 1977 to 1999 were examined. Of the 22,651 patients, 133 [0.58%] died: 117 male and 16 female, mean age 41.5 +/- 20.7 years. The mean length of hospital stay was 15.8 ' 25.9 days and it increased yearly [p = 0.004]. There was no significant difference in hospital mortality rate of tuberculosis within years. Forty-nine patients had chronic and/or far advanced tuberculosis, 36 of them had concomitant diseases. Thirteen patients had miliary and/or tuberculous meningitis, 3 multi drug-resistant tuberculosis, another 3 had pneumothorax, and 2 empyema. These patients had significantly lower prognostic nutritional index than those patients who recovered from pulmonary tuberculosis [p = 0.025]. Inhospital mortality rate of tuberculosis did not change in the last 23 years. We suggest that pulmonary tuberculosis will continue to be a significant cause of death and therefore important health care problem for Turkey in the 21st century

Primary antituberculosis drug resistance at Turkish Military Chest Diseases Hospital in Istanbul

The aim of this study was to investigate the prevalence of primary drug resistance to tuberculosis. We evaluated the clinical data, radiological features and sputum samples from 365 newly diagnosed patients with a positive culture of pulmonary tuberculosis at the Turkish Military Chest Diseases Hospital, Istanbul, Turkey. No patients had taken antituberculosis drugs previously. The Bactec method was used to perform drug susceptibility testing for isoniazid, rifampicin, ethambutol, and streptomycin. Primary resistance to one or more drugs was detected in 87 [23.8%] patients; resistance to isoniazid was most common [54 patients] followed by resistance to ethambutol [n = 39], rifampicin [n = 11], and streptomycin [n = 9]. One-drug resistance was detected in 69 patients; two-drug resistance in 11, three-drug resistance in 6, and four-drug resistance in 1. Multidrug resistance [resistance to at least isoniazid and rifampicin] was detected in 10 patients. In logistic-regression analysis, primary drug resistance was associated with radiological advanced tuberculosis [p < 0.001]. Primary resistance to one or more drugs used in treating tuberculosis is relatively high. It is necessary to regularly screen for and treat drug resistance among those who live in close quarters, such as army barracks, school dormitories and prisons. Regular surveillance of drug sensitivity patterns should be maintained to determine appropriate alternate drug regimens and detect the spread of resistant stains in the population