OBJECTIVE:The objective of this study was to examine the separate and combined effects of tobacco and biomass smoke exposure on pulmonary histopathology in rats.INTRODUCTION:In addition to smoking, indoor pollution in developing countries contributes to the development of respiratory diseases.METHODS:Twenty-eight adult rats were divided into four groups as follows: control group (Group I, no exposure to tobacco or biomass smoke), exposed to tobacco smoke (Group II), exposed to biomass smoke (Group III), and combined exposure to tobacco and biomass smoke (Group IV). After six months the rats in all four groups were sacrificed. Lung tissue samples were examined under light microscopy. The severity of pathological changes was scored.RESULTS:Group II differed from Group I in all histopathological alterations except intraparenchymal vascular thrombosis. There was no statistically significant difference in histopathological changes between the subjects exposed exclusively to tobacco smoke (Group II) and those with combined exposure to tobacco and biomass smoke (Group IV). The histopathological changes observed in Group IV were found to be more severe than those in subjects exposed exclusively to biomass smoke (Group III).DISCUSSION:Chronic exposure to tobacco and biomass smoke caused an increase in severity and types of lung injury.CONCLUSION:Exposure to cigarette smoke caused serious damage to the respiratory system, particularly with concomitant exposure to biomass smoke.

BackgroundMalignant pleural mesothelioma (MPM) is an uncommon neoplasm. MPM occurs more frequently in patients born or living in certain villages of Turkey.ObjectivesWe aimed to review radiological findings of MPM.Patients and MethodsWe reviewed the CT findings in 219 biopsy-proven MPM patients admitted to our clinic between 1993 and 2008.ResultsThe most common CT findings included pleural thickening (n=197, 90%) classified as diffuse (n=138, 63%), nodular (n=49, 22%) and mass-type (n=16, 7%). Pleural effusion was found in 173 patients (79%), involvement of the interlobar fissures in 159 (73%), mediastinal pleural involvement in 170 (78%), volume contraction in 142 (65%), mediastinal shift in 102 (47%) and mediastinal lymphadenopathy in 54 (25%).ConclusionMPM may present with diverse radiological features. Pleural thickening and pleural effusion were the most frequent radiological findings. Thoracic CT scans might be assessed more cautiously in patients with environmental exposure to asbestos.

The aim of this study is to assess the Xpert MTB/RIF assay for diagnosis of the Mycobacterium tuberculosis complex in clinical samples and to compare the results by reference to the diagnostic method, Bactec MGIT 960. Materials and methods:A total of 7407 samples were included from patients not primarily suggesting pulmonary or extrapulmonary tuberculosis (TB), collected from patients required to be screened for TB and excluding TB diagnoses since it was a differential diagnosis. Also included were a total of 411 samples from patients primarily suggesting pulmonary or extrapulmonary TB.Results: In the first group, 152 of 7407 samples yielded positive results with the Bactec MGIT 960, 131 (1.77%) were found positive with Löwenstein-Jensen medium, and 295 (3.99%) were found positive with Ziehl-Neelsen staining. In the second group, 24 (5.8%), 17 (4.1%), and 28 (6.8%) of 411 samples were found positive. Xpert MTB/RIF [27 (6.6%) of 411 samples] detected 3 additional samples as positive, and these 3 cases were clinically compatible with TB. Conclusion:The Xpert MTB/RIF assay shows superior performance for the diagnosis of TB. Its usefulness in culture-negative patients and the best method for integrating this diagnostic method into current tuberculosis diagnostic algorithms both need further study.

The results of this study demonstrate that symptoms suggestive of asthma are quite common and constitute a major health problem in Sivas, Turkey. This study also showed that, despite a high rate of reported symptoms exists, the rate of diagnosis and treatment of asthma is low among the adult population in Sivas.

Pulmonary alveolar microlithiasis (PAM) is

ÖZET (sırasıyla r= 0.395, p= 0.008; r= 0.391, p= 0.009; r= 0.790, p< 0.001), FVC, FEV 1 , PaO 2 , değerleri arasında negatif korelasyon olduğu belirlendi (sırasıyla r= -0.681, p< 0.001; r= -0.766, p< 0.001; r= -0.661, p= 0.003 GİRİŞMaluliyet değerlendirme işlemleri dünyada olduğu gibi ül-kemizde de önceleri meslek kaynaklı hastalıklar nedeniyle gündeme gelmiş, zaman içinde tüm hastalıkları kapsayacak değişikliklere uğramıştır. Bu nedenle son yıllarda hekimler olarak; sosyal sigortalar, genel sağlık sigortası, özürlü haklarıyla ilgili yapılan yasal düzenlemeler ve değişiklikler nedeniyle bu yasal haklardan yararlanmak amacıyla maluliyet ve özür durumunun değerlendirilmesi talepleriyle daha fazla karşılaşmaktayız (1).Maluliyet değerlendirme sürecinin her ülkenin kendi medikolegal yapısına özgü olmakla birlikte bazı ortak yönle-ri bulunmaktadır. "American Medical Association (AMA)" ve "American Thoracic Society (ATS)" gibi pek çok kurum solunum fonksiyonlarındaki etkilenmenin şiddetini değerlendiren rehberler yayınlamıştır (Tablo 1,2) (2,3). Bu rehberlerin tümü solunumsal etkilenmenin belirlenmesinde çoğu olguda spirometri ve difüzyon kapasitesi ölçümlerinin yeterli olduğu, bazı özel durumlarda ise egzersiz testinin kullanılması gerektiğini belirtmiştir (4).Ülkemizde Türk Toraks Derneği, solunumsal maluliyet talebi sorunuyla karşılaşacak göğüs hastalıkları uzmanlarının, tıbbi veriler ışığında karar vermelerine yardımcı olmak amacıyla bir rehber hazırlamıştır (1). Bu rehbere göre solunumsal maluliyetin değerlendirilmesi protokolü Tablo 3'te verilmiştir.Ülkemizde ilk kez 1964 yılında yayımlanan yasa ile insanların, iş kazaları ve meslek hastalıkları, maluliyet, yaşlılık, muhtaçlık gibi durumlar nedeniyle maddi yardım, tazminat ve/veya erken emeklilik gibi haklardan yararlanabileceği belirtilmiştir (5). Bu kanun temelinde çıkarılan pek çok yönetmelikle düzenlenen haklardan yararlanmak amacıyla birçok hasta solunumsal maluliyet oranlarının belirlenmesi için göğüs hastalıkları hekimlerine başvurmaktadır. Ancak ülkemizde maluliyet konusuna yaklaşımın yasal ve tıbbi kuralları konusunda henüz belirli standartlara ulaşılamamıştır.Biz de bu çalışmada solunumsal maluliyetin değerlen-dirilmesi talebiyle bir üniversite hastanesi göğüs hastalıkları kliniğine başvuran hastaların demografik, klinik, laboratuvar özelliklerini ve maluliyet oranlarının belirlenmesi sürecini incelemeyi amaçladık. MATERYAL ve METODOcak 2010-Temmuz 2011 tarihleri arasında hastanemiz göğüs hastalıkları polikliniğine solunumsal maluliyetin değerlendirilmesi için başvuran ardışık 136 hastanın raporları geriye dönük olarak incelendi. Makale için yerel etik kuruldan izin alındı. Hastaların demografik özellikleri, meslek anamnezi, solunumsal semptomları, solunum sistemi radyolojik ve fizik muayene bulguları, çevresel ve mesleksel maruziyet özellikleri, ek hastalık-ları, spirometri, arteryel kan gazı (AKG) analizi sonuç-ları ve göğüs hastalıkları dışında maluliyet değerlendir-mesi yapan bölümler kaydedildi. Solunum Fonksiyon TestiKliniğimizde akım duyarlı (V ...

Background: The role of biomarkers for prognostication and diagnosis of pulmonary embolism (PE) is increasing. It has been reported that pregnancy-associated plasma protein-A (PAPP-A) can be used as a proatherosclerotic marker. The present study was aimed to evaluate whether PAPP-A levels are helpful in the differential diagnosis of patients presenting with suspected PE. Methods: 53 consecutive patients evaluated for suspected PE were prospectively enrolled in the study. Serum PAPP-A levels were measured in the blood samples which were taken at admission. Multi-slice computed tomographic angiography was used to verify the diagnosis of PE. Results: PE was detected in 24 out of the 53 patients, while it was excluded in 29 patients by thorax multi-detector computerized tomography scan. No significant difference was detected in mean serum PAPP-A level between groups (5.72 ± 0.31 mg/L vs. 5.67 ± 0.06 mg/L, respectively). Conclusions: Serum PAPP-A level has no role in the evaluation for PE.

Objective: To evaluate chest X-rays of patients with pulmonary tuberculosis and to determine whether the extent of radiographic lesions correlates with bacteriological parameters. Methods: In this retrospective, descriptive study, we evaluated chest X-rays, as well as AFB detection by smear microscopy and culture for Mycobacterium tuberculosis, initially and during the first two months of treatment, in 800 male patients hospitalized between 1995 and the present at a 250-bed hospital in northwestern Turkey. Results: The initial mean ESR was 58 ± 37 mm/h. Initial sputum smears and cultures were positive in 83.8% and 89.5% of the patients, respectively. After the first month of treatment, the proportion of patients with positive sputum culture was higher among those with cavitary tuberculosis than among those with non-cavitary tuberculosis (53.7% vs. 37.7%, p < 0.001). The number of affected zones was not correlated with age, symptom duration, contact with an active tuberculosis patient, or concomitant diabetes (p > 0.05 for all) but was positively correlated with the ESR (r = 0.23, p < 0.001). During the first and second months of treatment, conversion to smear-negative status was less common in patients with bilateral involvement than in those with unilateral involvement (p < 0.001 and p = 0.002 for months 1 and 2, respectively). Disease extent did not correlate with age, symptom duration, contact with an active tuberculosis patient, or concomitant diabetes but did correlate with delayed bacteriological recovery. Conclusions: Chest X-ray and bacteriology are valuable tools for the evaluation of pulmonary tuberculosis.Keywords: Radiography, thoracic; Bacteriology; Tuberculosis, pulmonary/drug therapy. ResumoObjetivo: Avaliar radiografias de tórax de pacientes com tuberculose pulmonar e determinar se a extensão das lesões radiográficas correlaciona-se com os parâmetros bacteriológicos. Métodos: Neste estudo descritivo e retrospectivo; foram avaliadas radiografias de tórax, baciloscopias para BAAR e culturas de escarro para Mycobacterium tuberculosis no momento basal e durante os dois primeiros meses de tratamento. A amostra foi composta por 800 pacientes masculinos internados entre 1995 até o presente em um hospital com 250 leitos no noroeste da Turquia. Resultados: A VHS média inicial foi de 58 ± 37 mm/h. Inicialmente, a baciloscopia e as culturas de escarro tiveram resultado positivo em 83,8% e em 89,5% dos pacientes, respectivamente. Após o primeiro mês do tratamento, a proporção de culturas positivas foi maior nos pacientes com doença cavitária do que naqueles sem doença cavitária (53,7% vs. 37,7%; p < 0,001). Não houve correlação do número de zonas afetadas com idade, duração de sintomas, contato com paciente com tuberculose ativa, diabetes concomitante (p > 0.05 para todos), mas houve correlação positiva com VHS (r = 0,23, p < 0,001). Durante o primeiro e o segundo mês de tratamento, a negativação da baciloscopia foi menos frequente nos pacientes com comprometimento bilateral do que naqueles com compr...