Spirometry testing among the homeless.

BACKGROUND: Many literature reports have indicated the fact that the percentage of active smokers among the homeless is high, often several times higher than that of the general population. The homeless are known to have worse spirometric parameters than the general population. OBJECTIVES: The question of what the principal and exclusive cause of airway obstruction among the homeless is remains unanswered. Verification of the above-mentioned hypothesis is possible by comparing the spirometric parameters in homeless people with those in the general population, based on the data related to subgroups with similar tobacco smoke exposure, which are homogenous in terms of sex, race and age. MATERIAL AND METHODS: The spirometric parameters in 58 homeless male smokers were compared with those in 55 male smokers living normal lives. Neither group differed in age, duration of smoking or the number of pack-years. All of the subjects were Caucasian. RESULTS: The mean values of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/ FVC, both corrected and expressed as absolute figures, were lower amongst the smoking homeless men than amongst men living normal lives. In 27.59% of the homeless subjests not receiving treatment for lung diseases, airway obstruction was identified. CONCLUSIONS: Our results suggest that smoking is not the only cause of the worse spirometric parameters found among the homeless.

Multiple primary lung cancer: A literature review.

Nowadays, lung cancer is a leading cause of death in both men and women worldwide. There is no clear explanation for its mortality rate. However, it is already known that genetic and environmental factors as well as oncological treatment are involved. As the incidence of lung cancer soars, the number of patients diagnosed with multiple primary lung cancers (MPLC) is also rising. While differentiating between MPLC and intrapulmonary metastasis of lung cancer is important for treatment strategy and prognosis, it is also quite complicated, particularly in the cases with similar histologies. It is also important not to delay the diagnosis. The aim of this paper was to discuss MPLC in general, and the differentiation between MPLC and intrapulmonary lung cancer metastasis in particular. Based on a review of statistical data and the current literature, we discuss the diagnostic criteria and the molecular, genetic and radiographic methods used to distinguish between MPLC and intrapulmonary metastases.