[Sarcoidal reaction in lung adenocarcinoma in 50-years old man]. / Reakcja sarkoidalna wokól gruczolakoraka pluca lewego u 50-letniego chorego.

A 50-year old patient was admitted to the hospital with hoarseness persisting for two weeks. Chest computed tomography revealed enlargement of lymph nodes in the aortopulmonary window. The bronchoscopy did not show any abnormalities, in transbronchial fine needle aspiration biopsy no diagnostic material was obtained. In the biopsies collected during mediastinoscopy the sarcoid granulomas were recognized. In the follow-up the computed tomography revealed a tumor mass and diagnostic thoracotomy was performed in which pulmonary adenocarcinoma was recognized. After radiotherapy the total regression was achieved. In this case sarcoid-like reaction in the course of lung cancer and the diagnostic difficulties were described.

[Exposure to passive smoking among current smokers and non-smokers]. / Narazenie na palenie bierne wsród czynnych palaczy tytoniu i osób niepalacych.

INTRODUCTION: Few studies have evaluated exposure to passive smoking among current smokers. The aim of our study was to assess environmental tobacco smoke (ETS) in current smokers, as well as attitudes towards smoking. MATERIAL AND METHODS: We used a questionnaire containing questions about epidemiological information and the history of smoking, including exposure to ETS. The study was conducted in a group of 114 healthy individuals (mean age 29.7 years). RESULTS: 57 of the participants (50%) declared to be daily smokers, 32 (28%) had never smoked, 11 (9.6%) were ex-smokers, and 14 (12%) defined themselves as occasional-smokers. The total exposure to ETS of the entire group was 89.47% (current smokers 87.72%, never-smokers 93%). No significant difference in the range of exposure to ETS according to the place of exposure was found. Symptoms occurring most often during exposure to ETS in the group of smokers were: sputum production 42.1%, cough 31%, lacrymation 24.6%, wheezing 21.0%. Never-smokers suffered mainly from cough 50%, dyspnea 46.9%, lacrymation 46.9%. Wheezes occurred significantly more often in the group of current smokers than in never-smokers (21% v. 3.2%), while dyspnea was significantly more frequent in never-smokers than current smokers (48.4% v. 13.7%). Smokers were less in favor of introducing a smoking ban than never-smokers (public places 77.6% v. 100%, friends' houses 39.6% v. 86.7%, pubs and discos 41.1% v. 84.4%). Over 66% of smokers declared their wish to quit smoking. Seventy percent of subjects who had been exposed to ETS in childhood started smoking significantly earlier than those who had not been exposed. CONCLUSIONS: Our study showed the problem of 'double' exposure to tobacco smoke. Current smokers are in favor of a smoking ban in public places.

[Evaluation of the indication of carbon monoxide in exhaled air]. / Ocena przydatnosci oznaczania stezenia tlenku wegla w powietrzu wydychanym.

In spite of intensified antitobacco campaigns and decrease in social acceptance for smoking it is still an important issue. In prevention there is a need to make smokers and non-smoking people aware of a level of exposure to tobacco smoke. One of the objective methods to evaluate this exposition is to measure a concentration of the carbon monoxide in exhaled air. The aim of our study was to evaluate the indication of carbon monoxide in exhaled air. The research was based on examination of 67 patients admitted to admission room in SP CSK, Warsaw. The level of carbon monoxide was measured with Smokerlyzer device in 56 cases (34 women, 22 men). Everyone in this group answered questions concerning a reason of admission to hospital, concomitant diseases, and addiction to smoking and ways of fight against the addiction as far as smokers are concerned. Current smokers answered also questions about their attitude to smoking and filled in Fagerström and Schneider tests. In a group of 67 patients 11 were not able to proceed the test with Smokerlyzer, 5 (45.5%) due to dyspnea, 4 (36.4%) due to lack of a verbal contact. In the group of 56 investigated patients 20 (35.7%) have never smoked, 32 (57.1%) were ex-smokers and 4 (7.1%) were current smokers. 3 (75%) of the smokers have tried to give up smoking 3 times on average. In the Fagerström test their mean came to 3.5 points, what indicates a low level of addiction. The Schneider test averaged out 8 points, what indicates a good motivation to give up smoking. The average of concentration of carbon monoxide in exhaled air came to 8 ppm (1.87% Hb) in this group. In the group of non-smoking patients the level of carbon monoxide came to 1.4 ppm (0.67%Hb). In the group of nonsmoking patients exposed to the tobacco smoke, the level of carbon monoxide came to 3 ppm (1.15%), but the difference was not statistically significant (p > 0.05). The increased CO level in exhaled air is usually caused by smoking cigarettes and exposure to ETS. All the smokers acknowledged the addiction. Routine use of Smokerlyzer in the admission room is limited, mainly by the dyspnea. Despite the practicality of CO level measurement, taking medical history of smoking is still the most important.