Epidemiological features of Turkish patients with sarcoidosis.

Epidemiological characteristics of sarcoidosis differ according to geographical distribution. The aim of our study was to disclose epidemiological characteristics in our country. The data was collected from investigators, who sent information on newly-diagnosed patients via internet. In 2 years 198 female and 95 male patients were enrolled to the study (f/m:2.08). Mean age of patients was 44+/-13 years (17-90). Mean age of male patients was 38+/-12 while mean age of female patients was 48+/-13 (p<0.001). 73.4% of patients were nonsmokers (85.4% of females; 48.4% of males; (p<0.001)). About 50% of our 293 patients were housewives. Familial sarcoidosis was found in 3 patients' first degree relatives. Estimated annual incidence of sarcoidosis for Turkey was calculated as 4 per 100,000 person. According to our study, 2/3 of sarcoidosis patients were women; mean age of patients was 45 and the disease began 10 years later in female patients. 80% of patients were nonsmokers; negative relation between sarcoidosis and smoking was evident especially in women. Familial sarcoidosis frequency was lower compared to other studies in the literature. There was no occupational exposure history in our patients. Our incidence rate, is similar with the results of other European studies.

Peak expiratory flow monitoring to screen for asthma in patients with allergic rhinitis.

AIM: To investigate the benefit of using peak expiratory flow (PEF) monitoring to screen for asthma in allergic rhinitis patients. METHODS: Eighty-nine consecutive patients with allergic rhinitis but never assessed for asthma were included in this prospective study. Their allergic status was determined by skin prick tests. All of the subjects filled in a questionnaire on asthma-like symptoms. If they reported such symptoms, pulmonary function tests were carried out. Then, PEF was checked twice daily for 3 weeks. RESULTS: Thirty-six percent of our study group were male and 64% were female patients with a mean (SD) age of 36.3 (14.0) years. Skin prick tests were positive to grass mixture in 71 (79.8%) patients, to tree mixture in 51 (57.3%), to mite in 46 (51.7%), and to epidermal mix in 26 (29.2%) patients. Thirty-six patients (41%) reported 3 or more asthma symptoms. Lung function test results for these 36 patients showed obstruction for 11.1% (4 patients); the remaining patients (88.9%) had normal function parameters. The subjects who reported 3 or more asthma symptoms but had normal lung function monitored their PEF for 3 weeks. Sixteen (50%) patients from this group and the 4 patients with demonstrated airway obstruction had more than 20% diurnal variation in PEF. These 20 patients' asthma symptoms disappeared after they received 3 months of low-dose inhaled corticosteroid therapy. CONCLUSION: It is necessary to look for asthma in patients suffering from allergic rhinitis. PEF monitoring is a low-cost, objective approach to asthma diagnosis that can be performed by a patient with allergic rhinitis even if spirometry is normal. Knowledge of this technique is of utmost importance because delay in diagnosis will result in the unsatisfactory treatment of the disease.

[Functional results of surgical treatment of bronchiectasis in a developing country]. / Resultados funcionales del tratamiento quirúrgico de las bronquiectasias en un país en vías de desarrollo.

BACKGROUND: The prevalence of bronchiectasis has decreased significantly over recent decades in developed countries. However, resection for bronchiectasis still plays an important part in thoracic surgery practice in developing countries such as Turkey. This study was designed to evaluate the outcomes of surgical treatment for bronchiectasis, particularly in aspects related to the effects on functional well-being. PATIENTS AND METHOD: From January 1995 through December 2003, operations for bronchiectasis were performed in 81 patients. Demographic features, type of resection, and operative morbidity and mortality were evaluated. The outcomes related to overall "social" or nonpulmonary functional status were classified and compared according to a scale constructed to assess patients' well-being preoperatively and at the 6th postoperative month. RESULTS: The mean age was 24.4 years and 47 patients (58%) were male. Surgical treatment was lobectomy in 37 (45%), pneumonectomy in 10 (12%), segmentectomy in 13 (16%), and lobectomy plus segmentectomy in 22 (27%) of the operations. Complete resection of disease was achieved in 69 patients (85%). There was no operative mortality. The rate of morbidity was 18.3%. Improvement to a functional status of excellent was observed in 81.7% and improvement to a status of good was seen in 12.7% of patients; 5.6% experienced no change. The results of complete resection were significantly better than those of incomplete resection (P=.0015). CONCLUSION: Functional results of surgical treatment for bronchiectasis in this series suggest that the outcomes are favorable and promising, particularly in selected patients with sufficient pulmonary reserves and localized disease who are suitable for complete resection.

Resultados funcionales del tratamiento quirúrgico de las bronquiectasias en un país en vías de desarrollo / Functional results of surgical treatment of bronchiectasis in a developing country

Objetivo: La prevalencia de las bronquiectasias ha disminuido significativamente durante los últimos decenios en los países desarrollados. Sin embargo, la resección quirúrgica de las bronquiectasias desempeña todavía un papel importante en la práctica de la cirugía torácica en los países en vías de desarrollo como Turquía. El presente estudio se ha diseñado para evaluar los resultados obtenidos con el tratamiento quirúrgico de las bronquiectasias, especialmente en lo que se refiere a sus efectos sobre el bienestar funcional de los pacientes. Pacientes y método: Entre enero de 1995 y diciembre de 2003 recibieron tratamiento quirúrgico debido a bronquiectasias 81 pacientes. Se evaluaron las características demográficas, el tipo de resección quirúrgica y la morbilidad y mortalidad operatorias. Los resultados relativos al nivel funcional global "social" o extrapulmonar se clasificaron y compararon con una escala creada para determinar el grado de bienestar de los pacientes antes de la intervención y a los 6 meses. Resultados: La edad media de los pacientes era de 24,4 años y 47 (58%) eran de sexo masculino. El tratamiento quirúrgico consistió en lobectomía en 37 (45%), neumonectomía en 10 (12%), segmentectomía en 13 (16%) y la combinación de lobectomía y segmentectomía en 22 (27%) de las intervenciones quirúrgicas. La resección completa se llevó a cabo en 69 pacientes (85%). No se produjo ningún fallecimiento a consecuencia de la cirugía. La tasa de morbilidad fue del 18,3%. Se observó mejoría hasta un estado funcional excelente en el 81,7% de los pacientes, así como mejoría hasta un estado funcional bueno en el 12,7%; en el 5,6% no se observaron cambios. Los resultados obtenidos con la resección completa fueron significativamente mejores que los conseguidos con la resección incompleta (p = 0,0015). Conclusión: Los resultados funcionales del tratamiento quirúrgico de las bronquiectasias obtenidos en esta serie de pacientes son favorables y prometedores, especialmente en pacientes seleccionados con una reserva pulmonar suficiente y con un proceso patológico localizado en quienes es posible la resección completa

Background: The prevalence of bronchiectasis has decreased significantly over recent decades in developed countries. However, resection for bronchiectasis still plays an important part in thoracic surgery practice in developing countries such as Turkey. This study was designed to evaluate the outcomes of surgical treatment for bronchiectasis, particularly in aspects related to the effects on functional well-being. Patients and method: From January 1995 through December 2003, operations for bronchiectasis were performed in 81 patients. Demographic features, type of resection, and operative morbidity and mortality were evaluated. The outcomes related to overall "social" or nonpulmonary functional status were classified and compared according to a scale constructed to assess patients' well-being preoperatively and at the 6th postoperative month. Results: The mean age was 24.4 years and 47 patients (58%) were male. Surgical treatment was lobectomy in 37 (45%), pneumonectomy in 10 (12%), segmentectomy in 13 (16%), and lobectomy plus segmentectomy in 22 (27%) of the operations. Complete resection of disease was achieved in 69 patients (85%). There was no operative mortality. The rate of morbidity was 18.3%. Improvement to a functional status of excellent was observed in 81.7% and improvement to a status of good was seen in 12.7% of patients; 5.6% experienced no change. The results of complete resection were significantly better than those of incomplete resection (P=.0015). Conclusion: Functional results of surgical treatment for bronchiectasis in this series suggest that the outcomes are favorable and promising, particularly in selected patients with sufficient pulmonary reserves and localized disease who are suitable for complete resection

Tuberculosis in Nazilli District Prison, Turkey, 1997-2001.

SETTING: Nazilli District Prison, Turkey. OBJECTIVE: To evaluate the tuberculosis situation in a Turkish prison. DESIGN: Data obtained between 1997 and 2001 during the systematic annual tuberculosis screening programme undertaken in Nazilli District Prison were evaluated retrospectively. The screening programme consisted of yearly miniature chest radiography, and clinical and bacteriological evaluation of prisoners with abnormalities. Active tuberculosis cases among prisoners diagnosed passively at any time during the period were also studied. RESULTS: Over the 5-year period, 99.8% of the prisoners were screened. The mean point prevalence of tuberculosis in Nazilli District Prison was 341 per 100,000 prisoners. The total number of active tuberculosis cases was 13; five were symptomatic, of whom three were detected during screening. The remaining eight cases were determined only by screening. Treatment outcomes were treatment completion for six cases and cure for seven cases. CONCLUSION: Because tuberculosis prevalence is high among prisoners, it is necessary to continue screening for tuberculosis in prison in addition to passive case-finding activities. Treatment success is satisfactory in Nazilli District Prison. Screening of prison staff, contact examination and preventive approaches need further investigation.

Water-pipe smoking and pulmonary functions.

Water-pipe smoking is a type of smoking habit, widely encountered in Turkey and Arabic and Middle East countries. However there is limited data about the effects of water-pipe smoking. The aim of this study is to investigate this habit with regard to the duration and amount of smoking and to analyse its characteristics and effects on pulmonary function by the correlation of the results with those of cigarette smokers and non-smokers. All cafés in Izmir city were visited for this purpose. A total of 397 males were studied in four groups: water-pipe smokers, water-pipe smokers who used to smoke cigarettes, active cigarette smokers and non-smokers. After recording a detailed history of smoking, pulmonary function tests on each person were performed. There were statistically significant differences between cigarette smokers and non-smokers within most of the parameters. The results of recent study have shown that the detrimental effects on pulmonary function of water-pipe smoking are not as great as cigarette smoking (FEV1, FEV1/FVC parameters were higher in water-pipe smokers), especially on the parameters for small airways (FEF50, MMEF parameters were higher in water-pipe smokers) (P < 0.05). It is difficult to explain the reasons exactly without estimating possible mechanisms in detail, but the most likely mechanisms arise from the smoking technique itself which involves a water filter and a long spout through which the smoke passes before reaching the lungs.