Comparison of trace elements in peripheral blood and bone marrow of newly diagnosed multiple myeloma patients.

Trace elements are essential micronutrients for the human body. Their roles are indispensable, as they are involved in a wide range of vital biological processes. In this study, we aimed to evaluate alterations in trace elements in the blood and bone marrow serum of patients with newly diagnosed multiple myeloma (NMM). The levels of zinc (Zn), copper (Cu), iron (Fe), manganese (Mn), magnesium (Mg), selenium (Se), arsenic (As), boron (B), nickel (Ni), silicon (Si) and chromium (Cr) were analyzed in the venous blood samples of the patient group comprising 70 patients with NMM (41 males and 29 females) and compared to those in the control group comprising 30 individuals (18 males and 12 females). In addition, trace element levels were analyzed in bone marrow samples from the patient group. Blood and bone marrow serum levels were quantified using inductively coupled plasma optical emission spectrometry. When the blood samples of the patient and control groups were compared: Zn (p = 0.011), Fe (p = 0.008), Mn (p = 0.046), Se (p < 0.001), As (p < 0.001), Ni (p < 0.001) and Cr (p < 0.001) levels were significantly higher in the patient group than in the control group. Higher Zn, Fe, Mn, Se, As, Ni and Cr levels in the NMM patients suggest that alterations of trace elements could be predisposing factor that initiates the malignant process. The relationship between malignancies and trace elements is crucial for the development of adjuvant therapy strategies and preventive medicine and as biomarkers for cancer diagnosis. Therefore, there is a need for studies examining the relationship between hematological malignancies and trace elements.

Endobronchial coil lung volume reduction performed on patients with emphysema dominant COPD: Long term follow-up results.

Introduction: Chronic obstructive pulmonary disease (COPD) is a commonly seen, preventable, and treatable disease with permanent respiratory symptoms and air entrapment that is caused by particle exposure. In case of limited response to traditional treatment protocols, lung volume reduction may be performed in patients with emphysema dominant patterns. In this study, long term follow-up results of the patients who had been operated on by minimal invasive bronchoscopic lung volume reduction surgery by coil placement were reported. Materials and Methods: Records of the patients operated on by coil placement were retrospectively investigated, and pulmonary function test (PFT), echocardiography (ECHO), six-minute walking test (6MWT), tomography images, ventilation scintigraphy, and clinical summaries were evaluated. Out of 34 initial candidates, 18 patients were included in the study. Wilcoxon signed-rank test and Spearman's rho were utilized to compare interventions and follow-up testing. Result: The average age of 18 patients was 62 (50-74) years, and except for one patient, all were males (n= 17). Fifteen patients were operated bilaterally, and the rest were unilaterally operated, with an average of 10 coils placed per coil placement. An average of 90 days was between bronchoscopic coil placement, with a follow-up duration of 45 days in between. Mean total follow-up duration was 794 (± 424) days. Pneumonia and pneumonitis were seen in 33% of patients within the first month. Mortality from respiratory causes was found to be 11%, while mortality from all causes was found to be 22%. Statistical difference was observed regarding 6MWT after bronchoscopic volume reduction when compared the initial preoperative values. However, this difference was later lost statistically at the second follow-up performed after the completion of both sides. A benefit in improved resting saturation was observed after the second procedure, which was not evident after unilateral intervention. However, similiar to 6MWT, this benefit was lost at the second follow-up, with resting saturation instead being effected negatively. No difference was observed in PFT results; however, a correlation was seen between FEV1 and walking distance. No specific correlation had been seen in the ECHO evaluation. Conclusions: Benefits regarding 6MWT and resting saturation were observed in patients undergoing minimal invasive bronchoscopic lung volume reduction surgery with coils. This benefit was evident in the short term but was lost as the follow-up duration increased. A relatively high morbidity and mortality rate was also present, further stating the risky nature of pulmonary intervention, even minimally invasive procedures, on patients with COPD.

Multiple Myeloma from the Perspective of Pro- and Anti-Oxidative Parameters: Potential for Diagnostic and/or Follow-Up Purposes?

BACKGROUND: Multiple myeloma is a hematological malignancy characterized by anemia, antibodies causing kidney damage, and damage to multiple organs, which come together to cause morbidity. Although oxidative stress is not a core pathological aspect of multiple myeloma, reactive oxygen species (ROS) and antioxidant balance have been shown to play a role in the disease process and are considered in its management. In the presented study, we aim to assess the reliability of specific oxidant and antioxidant variables as potential biomarkers for multiple myeloma and to determine which of these variables might exhibit higher sensitivity in predicting multiple myeloma. METHODS: This case-control study was conducted between March 2023 and August 2023. A total of 30 multiple myeloma patients, newly diagnosed according to the multiple myeloma diagnostic criteria revised by the International Myeloma Study Group in 2014, and a total of 30 volunteers without multiple myeloma were included in this study. Serum glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) and catalase (CAT), and malondialdehyde (MDA) and nitric oxide (NO) levels were measured with the first blood samples taken after inclusion. RESULTS: The groups had similar age (p = 0.623) and sex distribution (p = 1.000). MDA (cut-off: >4.35, p < 0.001), GSH-Px (<59.8, p < 0.001), CAT (<67.2, p < 0.001), SOD (<21.2, p = 0.001), and NO (>38.5, p < 0.001) could significantly detect multiple myeloma. Multivariate logistic regression revealed that increased MDA (p = 0.003) and NO (p = 0.001) levels and decreased GSH-Px (p = 0.001), CAT (p = 0.001), and SOD levels were independently associated with multiple myeloma disease. CONCLUSIONS: The presence of increased antioxidant levels and decreased antioxidant levels in patients with multiple myeloma is the clearest indicator of increased oxidative stress. These parameters may help to identify potential therapeutic targets and develop strategies to control disease progression.

The Role of Glycogen Synthase Kinase-3ß in the Zinc-Mediated Neuroprotective Effect of Metformin in Rats with Glutamate Neurotoxicity.

Metformin has been suggested to have protective effects on the central nervous system, but the mechanism is unknown. The similarity between the effects of metformin and the inhibition of glycogen synthase kinase (GSK)-3ß suggests that metformin may inhibit GSK-3ß. In addition, zinc is an important element that inhibits GSK-3ß by phosphorylation. In this study, we investigated whether the effects of metformin on neuroprotection and neuronal survival were mediated by zinc-dependent inhibition of GSK-3ß in rats with glutamate-induced neurotoxicity. Forty adult male rats were divided into 5 groups: control, glutamate, metformin + glutamate, zinc deficiency + glutamate, and zinc deficiency + metformin + glutamate. Zinc deficiency was induced with a zinc-poor pellet. Metformin was orally administered for 35 days. D-glutamic acid was intraperitoneally administered on the 35th day. On the 38th day, neurodegeneration was examined histopathologically, and the effects on neuronal protection and survival were evaluated via intracellular S-100ß immunohistochemical staining. The findings were examined in relation to nonphosphorylated (active) GSK-3ß levels and oxidative stress parameters in brain tissue and blood. Neurodegeneration was increased (p < 0.05) in rats fed a zinc-deficient diet. Active GSK-3ß levels were increased in groups with neurodegeneration (p < 0.01). Decreased neurodegeneration, increased neuronal survival (p < 0.01), decreased active GSK-3ß (p < 0.01) levels and oxidative stress parameters, and increased antioxidant parameters were observed in groups treated with metformin (p < 0.01). Metformin had fewer protective effects on rats fed a zinc-deficient diet. Metformin may exert neuroprotective effects and increase S-100ß-mediated neuronal survival by zinc-dependent inhibition of GSK-3ß during glutamate neurotoxicity.

Hughes-Stovin Syndrome: A Rare Cause of Thrombosis and Pulmonary Artery Aneurysm.

Hughes-Stovin Syndrome (HSS) is a rare clinical condition characterized by thrombophlebitis as well as multiple pulmonary and bronchial aneurysms. It commonly presents with coughing, dyspnea, fever, chest pain, and hemoptysis, and its management usually consists of surgical and medical approaches. In this report, we discuss a case of a patient with HSS. A 30-year-old male patient was admitted to the pulmonary medicine ward for hemoptysis. After evaluation with chest CT, bilateral pulmonary embolism and pulmonary aneurysms were observed. Due to a history of aphthous lesions, Behçet's disease (BD) was considered the initial diagnosis; however, the patient did not fit the criteria and was later diagnosed with HSS. Intravenous methylprednisolone was initiated, along with a maintenance treatment with cyclophosphamide. Treatment response was observed in the fourth month; however, due to the persistence of hemoptysis, additional cycles of cyclophosphamide were later required, under which the patient's condition has been stable. HSS currently lacks clear diagnostic criteria, and further studies are needed to investigate genetic backgrounds, familial transmissions, and treatment alternatives.

Selenium Heals the Chlorpyrifos-Induced Oxidative Damage and Antioxidant Enzyme Levels in the Rat Tissues.

Chlorpyrifos (CPF), mainly exposed by oral, dermal, or inhalation, is a broad-spectrum organophosphate pesticide used in pest control, increasing agricultural productivity, and being considered toxic to living things. Selenium (Se), an essential component of selenoenzymes and selenoproteins, is an essential element that protects cells from oxidative stress and has antioxidant properties. The study aimed to examine the oxidative stress caused by different doses of CPF exposure in brain, liver, and kidney tissues while observing the healing effect of Se application on tissue damage and antioxidant levels. A total of 56 rats were divided into seven different groups: 1st group control (water); 2nd group sham (corn oil); the 3rd group was CPF-L (5.4 mg/kg CPF); the 4th group was CPF-H (13.5 mg/kg CPF); the 5th group was Se (3 mg/kg Se); 6th group was CPF-L + Se (5.4 mg/kg CPF + 3 mg/kg Se); the 7th group was CPF-H + Se (13.5 mg/kg CPF + 3 mg/kg Se). The brain, liver, and kidney tissues were obtained from rats sacrificed 6 weeks later. Acetylcholinesterase (AChE), oxidant, and antioxidant parameters were examined in the tissues. The results suggest that CPF causes neurotoxicity, hepatotoxicity, and renal toxicity by altering AChE levels, inducing lipid peroxidation, and decreasing antioxidant systems. Se treatment increased the activities of AChE and, antioxidant defense system and reduced the malondialdehyde (MDA) levels in the brain, liver, and kidney tissues of rats. Se was found to heal and also protect these tissues against these changes resulting from CPF exposure.

Trace Element Status and Postoperative Morbidity After On-pump Coronary Artery Bypass Surgery.

Trace elements are essential micronutrients that take part in most antioxidant reactions in the body. In this study, we evaluated the levels of copper, chromium, manganese, selenium, magnesium, zinc, iron, and silicon in adult patients who undergone isolated on-pump coronary artery bypass with the occurrence of postoperative atrial fibrillation, transient renal injury, transient liver injury, and rate of wound infection; 51 adult patients (41 men, 10 women) underwent isolated coronary artery bypass grafting (CABG) under cardiopulmonary bypass. The mean age was 61,9 ± 8,0 years (range 45-82 years). Blood samples were collected preoperatively, postoperative first hour, postoperative first day, and fifth postoperative day for element analysis. Serum levels were determined by an Inductive Coupled Plasma Optical Emission Spectrometer (ICAP 6000). Serum copper, zinc, and selenium values, typically known as strong antioxidant elements in the body, decreased significantly during the first hour and first day of postoperative period compared to the preoperative period (p < 0.05). Also, postoperative atrial fibrillation, transient renal injury, transient liver injury, and rate of wound infection were observed to increase with the decrease in levels of trace elements (p < 0.05). The levels of these elements were observed to return to normal levels during the fifth postoperative day. The levels of trace elements decrease significantly after on-pump coronary artery bypass surgery. Our study results suggest that this could be one of the predisposing factors for increased postoperative atrial fibrillation, transient kidney injury, transient renal injury, and increased rate of wound infections for patients undergoing on-pump coronary artery bypass grafting.

Coronavirus Disease 2019 Pneumonia Scoring System Comparison and Risk Factors.

OBJECTIVE: Coronavirus disease 2019 is a disease caused by severe acute respiratory syndrome coronavirus 2, a novel type of coronavi- rus, which causes pneumonia in some hosts. No specific scoring method exists for mortality evaluation in novel coronavirus pneumonia. The aim of this study was to investigate factors affecting coronavirus disease 2019 mortality and comparison of pneumonia scoring sys- tems, pneumonia severity index, CURB-65, and MuLBSTA. MATERIAL AND METHODS: In this single-center clinical study, 151 patients who had been diagnosed with coronavirus disease 2019 infection and pneumonia between March 11 and May 31, 2020, were evaluated retrospectively. Correlation between patients' symptoms, comorbidities, drugs in use, radiological findings, and mortality was investigated. Parameters were also evaluated regarding their contribution to additional treatment requirements and days of fever response. RESULTS: A correlation between mortality and higher scores of pneumonia severity index, CURB-65, and MuLBSTA was found. When parameters were investigated separately, elevated glucose and urea levels, presence of diabetes, renal failure, hypertension, chronic obstructive pulmonary disease, cerebrovascular events and known malignancies, lymphocyte count, smoking history, radiological find- ings, and age correlated with mortality. In addition to these parameters, elevated calcium, potassium, brain natriuretic peptide, troponin, d-dimer, C-reactive protein, HC03, and lactate dehydrogenase levels were found significant regarding mortality. These parameters were not found statistically relevant regarding additional treatment requirement, fever response day, and total treatment duration. CONCLUSION: A modified version of present pneumonia scoring systems will be required to rigorously evaluate the severity of a patient's condition. A new scoring system that uses components of the present ones may prove useful and with further studies, a similar follow-up algorithm may be created.

Effect of Pulmonary Functions on Survival in Patients with Operable Non-small Cell Lung Cancer.

OBJECTIVE: To investigate the prognostic importance of pulmonary functions and their effect on survival in patients with operable non-small cell lung cancer (NSCLC), who underwent surgical resection and/or received medical treatment. STUDY DESIGN: Cohort study. PLACE AND DURATION OF STUDY: University of Health Sciences, Diskapi Training and Research Hospital, Ankara, Turkey, between June 2013 and March 2020. METHODOLOGY: The study included a total of 70 patients diagnosed with non-small cell lung cancer (NSCLC), comprising 35 who underwent surgical treatment and 35 who were treated medically. The effects of age, gender, additional comorbidities, smoking status, complications after surgery and/or radiotherapy, and pulmonary function test values ​​on survival were investigated. RESULTS:  The median overall survival time of the patients was 1973±769.1 (466-3.480) days. According to the univariate Cox regression analysis, the preoperative and postoperative values of the forced expiratory volume in 1 second were not important risk factors affecting survival (p=0.752 and p=0.878) respectively. A statistically significant difference was observed in survival probability between the patients with and without coronary artery disease (CAD) (p=0.005). There was also a statistically significant difference between the Eastern Cooperative Oncology Group (ECOG) performance groups in terms of survival probability (p<0.001). CONCLUSION: There was no relationship between pulmonary functions and survival in patients with operable NSCLC, but this evaluation should be undertaken in larger patient groups. This study demonstrated the importance of patients' performance status and comorbidities, such as CAD in survival. KEY WORDS: Non-small cell lung cancer, Survival, Respiratory function test.

Frequency of Direct Oral Anticoagulants Usage in Acute Pulmonary Thromboembolism Treatment in Turkey (TUPEDO).

Background: Direct oral anticoagulants (DOACs) have been used in acute pulmonary thromboembolism as an alternative to warfarin due to drug interactions, narrow therapeutic range, and necessary close International Normalized Ratio (INR) monitoring. Phase 3 study results have reported that these drugs are at least as effective as warfarin and beneficial in terms of bleeding; however, studies that present up-to-date life data are necessary. Aims: To evaluate the frequency of using DOACs, which are prescribed with a limited number of indications in our country, and real-life data results. Study Design: Cross-sectional study. Methods: This cross-sectional survey collected the clinical data (history, current treatment, treatment duration, etc.) of patients with pulmonary thromboembolism and who applied to the physician for follow-up between October 15, 2019, and March 15, 2020. The researchers kept the patient records sequentially. Results: Data from 836 patients with acute pulmonary thromboembolism from 25 centers were collected, and DOAC was used in 320 (38.5%) of them. The most preferred DOAC was rivaroxaban (n = 294, 91.9%). DOAC was mostly preferred because it could not provide an effective INR level with warfarin (n=133, 41.6%). Bleeding was observed in 13 (4%) patients. Conclusion: The use of direct oral anticoagulants is becoming almost as widespread as conventional therapy. Real-life data results are important for their contribution to clinical practice.

Investigation of the Protective Role of Selenium in the Changes Caused by Chlorpyrifos in Trace Elements, Biochemical and Hematological Parameters in Rats.

Organophosphate compounds are the most widely employed insecticides in countries with high agriculture activity. On average, organophosphates cause 3 million people to poison and 200 000 deaths per year due to food chain or occupational, accidental, or suicidal exposure. Our study aimed to research selenium's protective role against the toxic action of CPF, one of the most commonly used organophosphates, with an experimental model formed with rats. A total of 56 male SD rats were distributed into seven groups as follows: control (tap water), sham (corn oil), group I (5.4 mg/kg CPF), group II (13.5 mg/kg CPF), group III (3 mg/kg Se), group IV (5.4 mg/kg CPF+Se), and group V (13.5 mg/kg CPF+Se). Following 6 weeks of oral exposure, there were significant changes in AChE activity, biochemical and hematological parameters, and trace element levels in CPF-treated rats. In the high-dose CPF group, RBC values, Hb, and Hct decreased, and values of WBC, AST, ALT, ALP increased (p < 0.001) significantly compared to control, sham, and Se groups. While there was no significant change in zinc level, the copper and selenium levels were significantly higher in group IV than in control (p < 0.001) and sham (p < 0.05, p < 0.01, respectively) groups. Moreover, max. O.R.L. was found statistically more elevated in the high-dose CPF group compared to control, sham, and Se groups (p < 0.05, p < 0.05, and p < 0.01, respectively). All results indicated that Se is an antioxidant that reduces the toxic effects caused by CPF. Employing combinations of chlorpyrifos and selenium appeared greatly in restoring the harmful effects of CPF exposure.

Correlation of the Radiological Emphysema Score of Chronic Obstructive Pulmonary Disease Patients with Clinic Parameters.

OBJECTIVE: To evaluate the association between the degree of emphysema on computed tomography (CT) images and disease severity, in order to predict the clinical characteristics of patients with chronic obstructive pulmonary disease (COPD). STUDY DESIGN: Cross-sectional, observational study. PLACE AND DURATION OF STUDY: University of Health Sciences, Diskapi Training and Research Hospital, Ankara, Turkey between January 2016 and January 2017. The analysis of the medical records of patients was performed in December 2020. METHODOLOGY: Clinically diagnosed COPD patients were included in this study. Based on emphysema severity on CT, the patients were classified into three groups as group I (n=59), group II (n=37), and group III (n=20), and emphysema was not present in the remaining 15 patients. The associations between emphysema severity and the GOLD stage, mMRC dyspnea score and exacerbation frequency were analysed with Chi-square test. RESULTS: In 131 patients, the severity and presence of emphysema was found to be significantly associated with smoking history (p=0.034). However, no significant differences were observed between emphysema severity and exacerbation frequency (p=0.512) and mMRC dyspnea scores (p=0.110). The severity of emphysema was related with the GOLD stage (p=0.001). There was also a significant association between BMI and severity of emphysema, with the severe emphysema cases tending to be underweight (p=0.001). CONCLUSION: CT-emphysema severity can be used to classify COPD to assist in the clinical characterisation of patients. This type of classification is important to determine the underlying pathophysiology and genomic profile of COPD.     Key Words: Chronic obstructive pulmonary disease, Computed tomography, Emphysema.

Comparison of trace element levels after cardiopulmonary bypass between cyanotic and acyanotic patients.

Trace elements are essential micronutrients for the human body. In this study, we evaluated the alterations in copper, chromium, manganese, selenium, magnesium, zinc, iron, arsenic, boron, and silicon levels in children with cyanotic and acyanotic CHD who underwent cardiac surgery with cardiopulmonary bypass. Participants were divided into the following three groups: patients acyanotic CHDs (n=34), patients with cyanotic CHDs (n=30), and healthy controls (n=30). Blood samples were collected before the surgery and 1 hour after the sternum was closed. Serum trace elements were determined by Inductively Coupled Plasma Optical Emission Spectrometer-ICAP 6000. The baseline serum arsenic, manganese, and zinc levels of both patient groups were lower compared with controls, but there was no significant difference between baseline serum trace element levels of cyanotic and acyanotic patients. In both the patient groups, there was a significant decrease in postoperative serum arsenic, boron, copper, and zinc levels, and a significant increase in postoperative serum iron and magnesium levels. Silicon levels increased in cyanotic patients. Alterations in trace element levels were in the same direction in cyanotic and acyanotic patients. Copper, zinc, and manganase replacement may be needed after on-pump cardiac surgery.

Integration of multi-scale molecular modeling approaches with experiments for the in silico guided design and discovery of novel hERG-Neutral antihypertensive oxazalone and imidazolone derivatives and analysis of their potential restrictive effects on cell proliferation.

AT1 antagonists is the most recent drug class of molecules against hypertension and they mediate their actions through blocking detrimental effects of angiotensin II (A-II) when acts on type I (AT1) A-II receptor. The effects of AT1 antagonists are not limited to cardiovascular diseases. AT1 receptor blockers may be used as potential anti-cancer agents - due to the inhibition of cell proliferation stimulated by A-II. Therefore, AT1 receptors and the A-II biosynthesis mechanisms are targets for the development of new synthetic drugs and therapeutic treatment of various cardiovascular and other diseases. In this work, multi-scale molecular modeling approaches were performed and it is found that oxazolone and imidazolone derivatives reveal similar/better interaction energy profiles compared to the FDA approved sartan molecules at the binding site of the AT1 receptor. In silico-guided designed hit molecules were then synthesized and tested for their binding affinities to human AT1 receptor in radioligand binding studies, using [125I-Sar1-Ile8] AngII. Among the compounds tested, 19d and 9j molecules bound to receptor in a dose response manner and with relatively high affinities. Next, cytotoxicity and wound healing assays were performed for these hit molecules. Since hit molecule 19d led to deceleration of cell motility in all three cell lines (NIH3T3, A549, and H358) tested in this study, this molecule is investigated in further tests. In two cell lines (HUVEC and MCF-7) tested, 19d induced G2/M cell cycle arrest in a concentration dependent manner. Adherent cells detached from the plates and underwent cell death possibly due to apoptosis at 19d concentrations that induced cell cycle arrest.

Intermediate to long-term follow-up results of INH chemoprophylaxis prior to anti-TNF-alpha therapy in a high-risk area for tuberculosis.

BACKGROUND: The use of anti-TNF drugs for rheumatic diseases has increased in recent years. Several studies have reported an increased risk of reactivation of tuberculosis (TB) with anti-TNF agents. OBJECTIVES: The aim of this study was to present the follow-up results of a single center from Turkey, a country with a high rate of active and latent tuberculosis infection (LTBI), for INH chemoprophylaxis in patients receiving anti-TNF-α therapy for rheumatic diseases infection. METHODS: In this prospective observational study, consenting patients who were to be administered an anti-TNF agent for a rheumatic disease were evaluated for the presence of active infection or LTBI by a chest X-ray and a tuberculin skin test. Patients with LTBI were given chemoprophylaxis 1 month prior to commencement of anti-TNF treatment. All patients were followed-up bimonthly for any signs of pulmonary or extrapulmonary TB. RESULTS: A total of 73 patients, 23 female (31.5 %) and 50 male (68.5 %), with a mean age of 41.0 ± 13.1 years (18-78) were enrolled in the study. Overall, 44 patients (60.3 %) had ankylosing spondylitis, 18 (24.7 %) had rheumatoid arthritis, 7 (9.6 %) had juvenile rheumatoid arthritis, and 3 (4.1 %) had psoriatic arthritis. LTBI was identified in 58 patients all of whom received chemoprophylaxis for 9 months. None of the patients in the study developed any signs of tuberculosis reactivation during follow-up. CONCLUSIONS: TST is a reliable and cost-effective method for the diagnosis of LTBI in patients prior to anti-TNF therapy. Moreover, chemoprophylaxis with INH seems to be effective for the prevention of TB reactivation in individuals with LTBI.

[Could plasma D-dimer levels be a predictive marker for prognosis in lung cancer?]. / Plazma D-dimer düzeyleri akciger kanserinde prognoz için bir belirteç olabilir mi?

INTRODUCTION: Plasma concentrations of circulatory markers of hemostatic activation which may be associated with tumor growth and dissemination have been shown to predict prognosis in malignancy. The present study was designed to investigate the prognostic value of plasma D-dimer level in lung cancer. MATERIALS AND METHODS: Plasma levels of the D-dimer in 138 lung cancer patients [98 non-small cell lung cancer (NSCLC), 40 small cell lung cancer (SCLC)] were measured before the initiation of any therapy and each chemotherapy. RESULTS: There were 124 (89.9%) men and 14 (10.1%) women with a mean age of 62.8 years (range 38-84). There were no statistically significant differences among the histopathologic types for NSCLC patients. Stage IIIA NSCLC group had statistically significant higher D-dimer level than stages I-II and IV. D-dimer levels were increased significantly after 4 cycles of chemotherapy in progressive disease. The median survival times in NSCLC patients were 26.6 months (95% CI, 17.6-35.6) and 15.9 months (95% CI, 4.2-27.7; p= 0.037) respectively, for patients with a low D-dimer level (≤ 1.2 ng/L) and a high D-dimer level (> 1.2 ng/L).With the cox-regression analysis, the plasma level of D-dimer and tumour stage were identified as independent predictive factors of the survival. CONCLUSION: These results suggest that plasmalevel of D-dimer can act as a predictive factor of decreased survival and a poor response to the treatment in lung cancer.

[Interstitial lung disease associated with connective tissue diseases: diagnosis and treatment approaches]. / Bag dokusu hastaliklarina bagli gelisen interstisyel akciger hastaligi: Tani ve tedavi yaklasimlari

Connective tissue diseases are a diverse group of immunologically mediated systemic disorders that often lead to thoracic changes. There are huge differences between epidemiological studies depending upon method of ascertainment and selection criteria regarding the incidence of respiratory involvement due to connective tissue diseases. However, increased mortality and morbidity develops pulmonary involvement due to connective tissue diseases. Interstitial lung disease constitute an important group in this respect and it is estimated that the overall incidence of 15%. Today, still diagnosis, treatment, follow-up, prognosis of IInterstitial lung disease due to Connective tissue diseases (CTD-ILD) related clinical problems have been experienced. The diagnostic methods of disease include clinical approach, pulmonary function tests, high-resolution computed tomography, bronchoalveolar lavage and surgical lung biopsy. Treatment and selection of drugs are still controversial. In this review, a CTD-ILD, separately for each diagnosis, pulmonary function tests and radiological features, prognosis and treatment approaches were evaluated.

The diagnostic role of capnography in pulmonary embolism.

The aim of this study was to evaluate the diagnostic contribution of alveolar dead space fraction (AVDSf) measured using capnography in patients admitted with suspected pulmonary embolism (PE). A total of 58 patients who were admitted to our hospital with suspected PE between October 2006 and January 2008 were included in this study. All patients were assessed using the Wells clinical score, capnography, computed tomographic pulmonary angiography, D-dimer measurement, lower-extremity venous Doppler ultrasonography, and V/Q scintigraphy. Forty patients (69%) had PE based on computed tomographic pulmonary angiography findings. The AVDSf value with the highest sensitivity and specificity, which was at the same time statistically significant, was 0.09. This value was consistent with the AVDSf value obtained using receiver operating characteristic analysis. In our study, the sensitivity of capnography was 70%, with a specificity of 61.1%, positive predictive value of 80%, and negative predictive value of 47.8%. The use of AVDSf in combination with any of the several scoring systems that evaluate clinical likelihood of PE and D-dimer levels resulted in higher sensitivity and specificity rates for the diagnosis of PE.

Paranasal computed tomography results in asthma patients: association between sinus sites and allergen types.

Chronic rhinosinusitis (CRS) is a common comorbidity of asthma. The aim of this study was to investigate the relationships between the presence of rhinosinusitis, sinus site involvement, and total computed tomography (CT) sinus scores and the presence of allergy, allergen type, and severity of disease. Asthma patients (128 subjects), consisting of 57 allergic and 71 nonallergic patients, were included in the study. Presence of rhinosinusitis and sinus scores were evaluated by CT. CRS was determined in 45 (78.9%) allergic asthma patients and 44 (62.0%) nonallergic asthma patients (p<0.05). Ethmoid sinus involvement was higher among allergic asthma patients compared with nonallergic patients (68.4% versus 43.7%; p=0.005). House-dust mite allergy (71.4% versus 46.5%; p=0.008) and pollen allergy (73.5% versus 47.9%; p=0.01) showed positive correlations with ethmoid sinus involvement. No correlation was found between severity of disease and mean total CT sinus scores (p>0.05). The present study has shown the prevalence of chronic sinusitis to be higher in patients with allergic asthma, particularly in patients allergic to house-dust mites and pollens, with no correlation between severity of disease and presence of CRS. Investigating chronic sinusitis together with allergen sensitivity early in asthma diagnosis may contribute positively to patient treatment.

[Smoking habits of the elementary school teacher students in education faculty and related factors]. / Egitim fakültesi sinif ögretmenligi ögrencilerinde sigara içme aliskanliklari ve iliskili faktörler.

In this study we aimed to determine the smoking habits of the elementary school teacher students and to examine the factors affecting smoking. The prepared questionnaires were applied to 3rd and 4th year students by selecting randomly. The ratio of the students smoking regularly and occasionally was 45.8%. The smoking frequency was higher in male and fourth year students [63 (53.8%) of males, 85 (41.3%) of females (p< 0.05); 102 (52.3%) students in 4th year and 46 (35.9%) students in 3rd year (p< 0.01)]. The most common reason of not smoking was the harmful effect of smoking to life (45.8%), the most common reason of initiating smoking was to decrease their stress (43.1%) and the most common reason to keep on smoking was difficulty of quitting (56.7%). When compared to nonsmokers, the smoking frequency of mothers, brothers, all family members and close friends of smoker students were higher (p< 0.05). There was significant difference between depression symptom scores of the students who were smoking and the ones who were nonsmokers (14.9 +/- 7.6 in smokers, 9.8 +/- 6.3 in nonsmokers; p< 0.05). The smoking frequency among school teacher students was very high. The smoking habits of close friends, regular alcohol intake, and presence of depressive symptoms were increasing the risk of smoking. It will be beneficial for public health to plan and apply appropriate education program for students who will be the first teachers of the primary school students, not to start smoking.