Turkish Thoracic Journal最新文献

Objective: The objective of this study is to present the concrete impact of air pollution and tobacco use on lung disease by using a data engineering approach and acquired datasets.

Material and methods: To demonstrate the relationship between the air pollution and the tobacco use with the lung diseases, various relevant datasets are acquired. These datasets present not only Turkey but also worldwide situation. Datasets used in this study present the population, industrial growth, number of motor vehicles, forest area size, tobacco use rate, air pollution, number of death due to asthma, lung disease, tobacco use and air pollution. In total, 10 different datasets are gathered to prove our objective. To achieve our objective with the acquired materials, a data engineering approach is adopted. From a data engineering point of view, each dataset represents a variable for the calculation. With the data science engineering techniques used in this study, existing relations between these variables are clearly stated. Besides, with this information, a cause-consequence matching is achieved as well. In this study, covariance, correlation analyses are executed on the datasets. Moreover, multi-linear regression is performed for the forecasting.

Results: Relations between the various datasets are explored and results are divided into 3 clusters based on the relations. Among the explored relations, the most significant relation is discovered between the tobacco use rate and its effects on death rates. This relation is measured around 93-94%, which can be considered as a high risk.

Conclusion: Results show the concrete impacts of deforestation on air pollution, increase in tobacco use especially in easy ages causes lung disease in worldwide. These results indicate a global warning about various senses: the importance of the forest area size to balance the air quality, regulations about the number of motor vehicles, and the tobacco selling to young people are highly required.

Objective: Cystic fibrosis (CF) is the commonest life-limiting inherited illness in the Caucasian population but is uncommon in the Middle East, and so the genotypes and clinical course of disease in this population is not well known.

Material and methods: In this retrospective observational study, we collected and reviewed the data on CF mutations, body mass index (BMI), lung function, microbiology, and the demographics in adult CF patients in the United Arab Emirates (UAE).

Results: Data was reviewed for 39 adult CF patients. The median age of adult CF patients presenting to our clinic was 25 years (interquartile range (IQR) 22-31), the median BMI was 19 (IQR 17-22), and the median percentage predicted forced expiratory volume at 1 second (FEV1) was 49.5% (IQR 38.5-62.5). S549R was the commonest mutation (n = 11, 28%) followed by ∆F508 (n = 9, 23%). Only 5 (13%) out of 39 patients were heterozygote for CF mutations which reflects the high level of consanguinity in the region. Twelve (30%) patients were diagnosed after the age of 16, and in total, 19 (48%) were diagnosed after the age of 10. Thirty-two (82%) of patients are pseudomonas colonized, and 31% had 3 or more exacerbations in the last 12 months.

Conclusion: The CF mutation patterns in the UAE are different from western populations with low ∆F508 prevalence, with the presence of rare mutations more specific to this region and a high rate of homozygosity. Late diagnosis, high pseudomonas colonization rate, and exacerbation frequency remain a problem in this region and lead to poor long-term outcomes.

The novel coronavirus disease (COVID-19) is similar to connective tissue disease-associated interstitial lung diseases (CTD-ILD) in many aspects. However, patients with CTD-ILD have required particular attention during the pandemic since they are at high risk due to -immunosuppressive treatments. Thus, prompt decisions for diagnosis and treatment initiation have become more important than earlier for these patients during the pandemic. Radiological perspectives have become inevitable for the differential diagnosis of this group ¬during the pandemic, particularly to obtain rapid and accurate results that allow the physicians to start treatment immediately. However, in addition to radiological images, a definitive diagnosis also requires access to extensive information regarding patient history, including characteristics of comorbidities, and clinical and serological findings. Consequently, the differential diagnosis of COVID-19 and CTD-ILD can yield accurate treatment regimens that differ greatly between the 2 diseases, and also prevent the spread of the outbreak with COVID-19 patients treated under isolation.

Objective: This study evaluated the relationship between end-tidal carbon dioxide (EtCO2) measured with a portable capnometer and PaCO2 in respiratory disease patients.

Material and methods: We retrospectively reviewed patients whose EtCO2, measured with a portable capnometer using a mouthpiece, and PaCO2 were simultaneously assessed at a single center from August 2017 to September 2018. The primary outcome was the relationship between EtCO2 and PaCO2. We conducted subgroup analyses in patients with interstitial lung disease (ILD), with and without O2 supplementation. The relationship between EtCO2 and PaCO2 was analyzed using Spearman's rank test and Bland-Altman analysis.

Results: A total of 100 patients were registered in this study. There was a moderate correlation between EtCO2 and PaCO2 (rho = 0.41). The Bland-Altman plot showed that the mean bias was 0.32 mmHg (95% CI: -1.28 to 1.92), the limits of agreement (LOA) were -15.48 and 16.13 mmHg, and the percent error was 38.49%. The LOA in patients with ILD were -15.12 and 13.75 mmHg. In patients with O2 supplementation, the mean bias was greater, and the LOA were wider than in those without O2 supplementation (mean bias: 7.17 vs. -1.18 mmHg, respectively; LOA: -14.29 and 28.62 mmHg vs. -13.82 and 11.46 mmHg, respectively).

Conclusion: In the clinical setting, the relationship between EtCO2 and PaCO2 was poor in patients with respiratory disease, especially in those receiving O2 supplementation, compared with that reported in previous studies. It may be difficult to precisely estimate PaCO2 in patients with respiratory disease based on measurements of EtCO2.

Objective: Despite the negative aspects of cigarette use on pregnant, the level of smoking is extremely high among low-income women during pregnancy.

Material and methods: This study which has been conducted using an in-depth individual interview method, qualitatively explores and describes the characteristics of smoking behavior among poor pregnant women in Izmir, Turkey. A conventional content analysis method was used in the data analysis. Twelve pregnant women who smoked at least 1 cigarette a day and had $4 daily income were chosen as participants in this study. Interviews were recorded using a voice recorder, and the average duration of the interviews was 31 min.

Results: The smoking behavior of poor pregnant women is classified under 2 themes: "Individual attitudes and behavior" and "Interpersonal factors."

Conclusion: Public health nurses should include smoking/non-smoking criteria in their routine check-ups and follow up with pregnant women while undertaking the role of educator and counseling regarding smoking cessation.

Pectus Excavatum (PE) or "funnel chest," the most common deformity of the anterior chest wall characterized by sternal depression, can be repaired via either operative or non-invasive techniques. Vacuum Bell (VB) device is the most widespread of the latter one which can be applied either intraoperatively or as monotherapy. The present narrative review examines the efficacy of that innovative method. A thorough search of the literature resulted in 13 English-written articles concerning VB therapy from its first description to February 2019. The studies included patients with mild to moderate PE, mainly evaluated via Haller-Index and/or sternum depth prior to and following treatment. Concerning depth-improvement, 37-90% showed amelioration while 10-40% of them an excellent correction to normal. In 42%, Haller-Index also improved with a median decrease of 0.3 after VB application. A correlation was attempted to be found between the efficacy of VB and factors such as the frequency and duration of VB application, patient age, gender, PE severity and type, and differential pressure of the suction cup. Complications may be frequent yet mild and temporary. Intraoperatively, VB widows Minimally Invasive Repair of Pectus Excavatum (MIRPE) operation a safer procedure with greater results. VB as conservative treatment is an effective and well-tolerated alternative therapeutic option for selected patients with PE who meet specific criteria. It also constitutes a device of significant efficacy, appropriate for intraoperative use during MIRPE procedure.

Historically snake, scorpion, and hymenoptera venom have been used to treat various diseases. It is well known that alternative and/or complementary treatment options are widely used, especially among cancer patients. The case we describe here has lung carcinoma and received blue scorpion venom as an alternative therapy. A 86 years old male patient was admitted complaining of dyspnea. Thorax computed tomography (CT) showed a mass lesion and intraparenchymal nodules on the left upper lobe. Percutaneous transthoracic biopsy was performed, and the diagnosis was reported to be an epidermoid carcinoma. After the shared decision, A shared decision with the family and oncology specialists, the patient decided to try Cuban blue scorpion venom oral drops. Initially, it was well tolerated. However on the sixth day of treatment, sudden death occurred. Scorpion venom has been considered as a natural source for cancer therapy. Rhopalurus junceus is an endemic scorpion species from Cuba. Although it belongs to the most dangerous species related to human scorpionism, and no fatal stings have been reported. Currently published articles investigate the composition and in vitro anticancer activity of the venom; there are no controlled clinical trials evaluating toxicity or effectiveness. Uncontrolled use of alternative treatment options may lead to unexpected interactions with concomitant medications.

Objective: To evaluate the clinical features and outcomes of patients who were admitted with a diagnosis of coronavirus disease 2019 (COVID-19) but who were not confirmed with polymerase chain reaction (PCR) positivity.

Material and methods: This is a retrospective analysis of all patients admitted to two tertiary care centers between March 15 and May 15, 2020, with a diagnosis of COVID-19. From a common database prepared for COVID-19, we retrieved the relevant data and compared the clinical findings and outcomes of PCR-positive patients with those of PCR-negative cases who had been diagnosed on the basis of typical clinical and radiographic findings.

Results: A total of 349 patients were included in the analysis, of which 126 (36.1%) were PCR-negative. PCR-negative patients were younger (54.6 ± 20.8 vs. 60.8 ± 18.9 years, P = .009) but were similar to PCR-positive patients in terms of demographics, comorbidities, and presenting symptoms. They had higher lymphocyte counts (1519 ± 868 vs. 1331 ± 737/mm3, P = .02) and less frequently presented with bilateral radiographic findings (68.3% vs. 79.4%, P = .046) than PCR-positive patients. Besides, they had less severe disease and better clinical outcomes regarding admission to the intensive care unit (9.6% vs. 20.6%, P = .023), oxygen therapy (21.4% vs. 43.5%, P < .001), ventilatory support (3.2% vs. 11.2%, P = .03) and length of hospital stay (5.0 ± 5.0 vs. 9.7 ± 5.9 days, P < .001).

Conclusion: This study confirms that about one-third of the COVID-19 patients are PCR-negative and diagnosed based on clinical and radiographic findings. These patients have a more favorable clinical course, shorter hospital stays, and are less frequently admitted to the intensive care unit.

Melanoma is an uncommon tumor and represents about 1.5% of all neoplasms. In the mediastinum, it presents as a primary neoplasm or metastasis. Diagnosis is essential for the adoption of the best therapy. Endosonography-guided fine needle aspiration (EUS-FNA) obtains cell samples and, when associated with other auxiliary exams such as immunohistochemistry, is useful to identify and differentiate primary and/or metastatic mediastinal lesions from a wide variety of other neoplasms. The endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) sensitivity is low and similar to endobronchial ultrasound-guided transbronchial needle biopsy (EBUS-TBNB) performed with the ProCore 25G or 22G needle. Thus, the diagnosis of this type of tumor becomes a great challenge. The authors report the first case in the literature of metastatic mediastinal melanoma derived from malignant cutaneous melanoma, which was submitted to Endosonography-guided fine needle biopsy (EUS-FNB) with the new ProCore 20G, to obtain tissue, being confirmed by histological examination of the specimens obtained with a single puncture.