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Objective: To investigate the symptoms of lung cancer in Turkey and to evaluate approaches to alleviate these symptoms. Subjects and Methods: This study included 1,245 lung cancer patients from 26 centers in Turkey. Demographic characteristics as well as information regarding the disease and treatments were obtained from medical records and patient interviews. Symptoms were evaluated using the Edmonton Symptom Assessment Scale (ESAS) and were graded on a scale between 0 and 10 points. Data were compared using the χ², Student t, and Mann-Whitney U tests. Potential predictors of symptoms were analyzed using logistic regression analysis. Results: The most common symptom was tiredness (n = 1,002; 82.1%), followed by dyspnea (n = 845; 69.3%), appetite loss (n = 801; 65.7%), pain (n = 798; 65.4%), drowsiness (n = 742; 60.8%), anxiety (n = 704; 57.7%), depression (n = 623; 51.1%), and nausea (n = 557; 45.5%). Of the 1,245 patients, 590 (48.4%) had difficulty in initiating or maintaining sleep. The symptoms were more severe in stages III and IV. Logistic regression analysis indicated a clear association between demographic characteristics and symptom distress, as well as between symptom distress (except nausea) and well-being. Overall, 804 (65.4%) patients used analgesics, 630 (51.5%) received treatment for dyspnea, 242 (19.8%) used enteral/parenteral nutrition, 132 (10.8%) used appetite stimulants, and 129 (10.6%) used anxiolytics/antidepressants. Of the 799 patients who received analgesics, 173 (21.7%) reported that their symptoms were under control, and also those on other various treatment modalities (dyspnea: 78/627 [12.4%], appetite stimulant: 25/132 [18.9%], and anxiolytics/antidepressants: 25/129 [19.4%]) reported that their symptoms were controlled. Conclusion: In this study, the symptoms progressed and became more severe in the advanced stages of lung cancer, and palliative treatment was insufficient in most of the patients in Turkey.

ÖZET St. George solunum anketinin Türkçe geçerlilik ve güvenilirliği

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It is demonstrated The Turkish version of COPD Assessment Tool is reliable and valid.

Evaluation of the anti-inflammatory effect of infliximab in a mouse model of acute asthmaDEVECI F, MUZ MH, ILHAN N, KİRKİL G, TURGUT T, AKPOLAT N. Respirology 2008 13: 488-497 Background and objective: To evaluate the potential role of anti-tumour necrosis factor (TNF)-a mAb (infliximab) on the inflammatory response in a mouse model of acute asthma. Methods: BALB/c mice received intraperitoneal (i.p.) ovalbumin (OVA) on days 0 and 14, 100 mg of OVA intranasally on day 14 and 50 mg of OVA intranasally on days 25, 26 and 27. The low-dose (2.5 mg/kg) and high-dose (6.25 mg/kg) infliximab groups received i.p. infliximab before each i.p. sensitization and on challenge days 1, 6, 13, 20 and 27. The control group received i.p. injections of normal saline with alum on days 0 and 14 and normal saline without alum on days 14, 25, 26 and 27.Results: There were statistically significant decreases in the numbers of BAL fluid (BALF) neutrophils, eosinophils, as well as lung eosinophils in both the low-and high-dose infliximab groups when compared with the control OVA sensitized/challenged group. The lower dose of infliximab did not alter lung neutrophil counts, but a marked decrease was seen with the high dose of infliximab. After treatment with low and high doses of infliximab, BALF levels of regulated on activation normal T cell expressed and secreted (RANTES), granulocyte macrophage-colony stimulating factor (GM-CSF), TNF-a, IL-6, macrophage inflammatory protein (MIP)-2, and levels of RANTES, IL-4, GM-CSF, TNF-a, IL-6 and MIP-2 in lung tissue were significantly decreased when compared with the control OVA sensitized/challenged group. There was a significant decrease in BALF IL-4 only in the high-dose infliximab group. Conclusions: These results show that an anti-TNF-a mAb has a considerable anti-inflammatory effect on allergen-induced lung inflammation in an animal model of acute asthma.

An imbalance between oxidative stress and antioxidant capacity is thought to play an important role in the pathogenesis of chronic obstructive pulmonary disease (COPD). However, studies in regard to stable COPD patients and effect of zinc supplementation are lacking. We investigated the effects of zinc picolinate supplementation on the oxidant stress, and pulmonary function tests (PFTs) of patients with stable COPD. Thirty patients with COPD, and 15 healthy non-smokers who were matched for age and sex were included in the study. Their baseline spirometry, plasma malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), and zinc levels were measured. All parameters were repeated after 8 weeks of supplementation with 22 mg of zinc picolinate daily. The mean MDA levels in the COPD group at baseline were higher than controls (0.51+/-0.15 vs 0.39+/-0.15 nmol/mL, p=0.037), while SOD (0.16+/-0.022 vs 0.20+/-0.04 U/mL, p=0.000), CAT (14.79+/-3.03 vs 17.37+/-2.60k/mL, p=0.008) and zinc levels (77.33+/-4.29 vs 91.45+/-3.95 mg/dL, p=0.000) were lower in the patients compared to controls. Eight weeks of zinc supplementation produced significant increase in mean SOD (p=0.029) and zinc levels (p<0.001). However, no significant change in mean MDA, CAT levels and forced expiratory volume in one second (FEV1) (% predicted), and FEV1/FVC (%) parameters was observed after zinc supplementation. The Pearson's coefficients of correlation between MDA, SOD, CAT, Zn levels and spirometric measurements were not significant on either day 1 nor 8 weeks of zinc supplementation. In conclusion, the results indicate that zinc supplementation may have favorable effects on oxidant-antioxidant balance in patients with COPD. The lack of an effect on PFT may be due to the short duration of the supplementation. Longer duration of zinc supplementation may be necessary to see clinical benefit.