Serap Argun Baris

Endobronchial Tuberculosis Mimicking Asthma.

Endobronchial tuberculosis (EBTB) is defined as tuberculosis infection of the tracheobronchial tree with microbial and histopathological evidence. The clinical symptoms of the diseases are nonspecific. Chronic cough is the major symptom of the disease. The diagnosis is often delayed due to its nonspecific presentation and misdiagnosed as bronchial asthma. This case is presented to recall the notion that the endobronchial tuberculosis can mimic asthma and the importance of bronchoscopic evaluation in a patient with chronic cough and treatment resistant asthma.

Prevalence of smoking and chronic obstructive pulmonary disease amongst teachers working in Kocaeli, Turkey

AimTo evaluate smoking and COPD prevalence amongst teachers working in the schools of Kocaeli City, Turkey.MethodIn this cross-sectional study, a questionnaire focusing on respiratory symptoms and smoking habits was administered to all participants who accepted to join the study.All subjects also underwent a physical examination and a pulmonary function test performed with portable spirometer. According to GOLD criteria, subjects who had post-bronchodilator FEV1/FVC < 70% and negative reversibility test were classified as COPD.ResultsA total of 685 teachers were included [female n = 307 (45%), male n = 378 (55%)] with mean age 38.9 ± 8.9 years. Smoking habit was evaluated in 660 subjects: 291 (44.1%) were smokers, 252 (38.2%) were non-smokers and 117 (17.7%) were ex-smokers. Pulmonary function test was available in 651 subjects and 510 (78.3%) were defined as normal on spirometric analysis. Small airway obstruction was found in 115 of the cases (17.7%) in whom FEF25-75 level was found to be lower than 70% predicted. FEV1/FVC level was lower than 70% in 16 subjects (2.5%). Five subjects who had positive reversibility test were excluded from the study. The remaining 11 subjects who were considered as COPD consisted of 2 (18%) females and 9 (82%) males. Six of these subjects were aged over 40 years.ConclusionSpirometry has an important role in early diagnosis of COPD. Spirometric evaluation of cases with risk factors for COPD could be helpful in diagnosing patients before the progressive decline in lung function begins. Further studies are needed to evaluate whether the interventional strategies at this stage such as smoking cessation could prevent the progression of disease.RiassuntoScopoValutare la prevalenza di tabagismo e bronchite cronica ostruttiva (BPCO) tra gli insegnanti delle scuole di Kocaeli City in Turchia.MetodiStudio trasversale per il quale è stato distribuito un questionario incentrato sui sintomi respiratori e sull’abitudine tabagica a tutti i partecipanti che hanno accettato di prendere parte allo studio. Tutti i soggetti si sono sottoposti ad una visita e ad una spirometria effettuata con uno spirometro portatile. Sono stati classificati come BPCO, sulla base dei criteri GOLD i soggetti che avevano dopo broncodilatatore un rapporto FEV1/FVC < 70% e non presentavano reversibilità.RisultatiSono stati inclusi 685 insegnanti [femmine n = 307 (45%), maschi n = 378 (55%)] con un’età media di 38,9 ± 8,9 anni. In 600 soggetti è stata valutata l’abitudine al fumo: 291 (44,1%) erano fumatori, 252 (38,2%) non fumatori e 117 (17,7%) ex-fumatori. La spirometria era disponibile in 651 soggetti e 510 (78,3%) avevano una spirometria normale. Un’ostruzione delle piccole vie è stata riscontrata in 115 casi (17,7%), individuati per il valore di FEF25-75 < 70% del teorico. Il rapporto FEV1/FVC era < 70% in 16 soggetti (2,5%). Cinque soggetti che hanno mostrato una broncoreversibilità sono stati esclusi dallo studio. I rimanenti 11 soggetti che sono perciò stati considerati come BPCO risultavano composti da 2 (18%) femmine e 9 (82%) maschi. Sei di questi soggetti avevano un’età superiore a 40 anni.ConclusioniLa spirometria riveste un ruolo importante nella diagnosi precoce di BPCO. Una valutazione spirometrica dei casi con fattori di rischio per BPCO potrebbe essere di aiuto nel riuscire a fare diagnosi prima che inizi la progressione del declino della funzionalità respiratoria. Ulteriori studi sono necessari per valutare se le strategie di intervento in questo stadio, come la cessazione del fumo, possano prevenire la progressione della malattia.

Positron emission tomography/computed tomography in cases with tuberculosis mimicking lung cancer

Fluorodeoxyglucose positron emission tomography/ computed tomography (PET/CT) is a powerful tool in cancer imaging. The basic principle is the accumulation of the radiopharmaceutical in areas of increased glucose metabolism. However, glucose is also an important substrate for inflammatory cells. Recent studies suggested that PET/CT findings should be interpreted with caution in tuberculosis-endemic regions.1,2 Here we reported the images of two cases with pulmonary tuberculosis mimicking lung cancer. The first case was a 67-year-old female who was admitted with a history of cough and hemoptysis for the last 3 months. The computed tomography of thorax revealed a mass lesion in the left upper lobe of 4.1 cm × 4.5 cm in diameter. The maximum standardized uptake value (SUVmax) of the mass lesion was 13.6 on the PET/CT examination. Other case was a 68-year-old male patient who was admitted with a history of 2 months of cough. The thorax CT revealed a 4 cm × 2 cm mass lesion with spicular radiation in the left upper lobe

Interstitial Pneumonitis Associated with FOLFOX-6 Chemotherapy

Ilknur Basyigit1, Tugba Onyilmaz1, Hasim Boyaci1, Suleyman Temiz2, Nagihan Inan3, Serap Argun Baris1* and Fusun Yildiz1 1Kocaeli University Faculty of Medicine, Department of Pulmonary Diseases, Kocaeli, Turkey 2Kocaeli University Faculty of Medicine, Department of Medical Oncology, Kocaeli, Turkey 3Kocaeli University Faculty of Medicine, Department of Radiology, Kocaeli, Turkey *Corresponding author: Serap Argun Baris, Kocaeli University Faculty of Medicine, Department of Pulmonary Diseases, Umuttepe, Kocaeli, Turkey, Tel: +90 (262)3037211; E-mail: serapargun2002@yahoo.com

A Case of Tracheal Amyloidosis Admitted with Rectus Abdominis Muscle Hematoma

Tracheobronchial amyloidosis is often misdiagnosed as chronic airway diseases in relation to the symptoms of chronic cough and dyspnea. Here, we presented a case admitted to emergency department with severe cough and stomachache and diagnosed with rectus abdominis muscle hematoma due to chronic cough. The case had a history of asthma and no clinical improvement despite the use of inhaled drugs nearly five years. He was diagnosed with tracheobronhial amyloidosis after bronchoscopic and histopathologic evaluation. This case presented to remind the tracheal pathologies in differential diagnosis of chronic cough and emphasize the importance of bronchoscopic evaluation.

Coexistence of pulmonary tuberculosis and sarcoidosis

Tuberculosis (TB) and sarcoidosis are granulomatous diseases with different etiologies and management; however, they have similar clinical and histological characteristics. Coexistence of TB and sarcoidosis is extremely rare. Presently described is a case of coexistence of pulmonary tuberculosis and sarcoidosis confirmed microbiologically and histopathologically.

Assessment of Palliative Care in Lung Cancer in Turkey

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.

The Role of Cardioselective Beta Blockers in Cardiopulmonary Exercise Test and Echocardiography in COPD Patients

Affiliation: Canakkale Government Hospital, Department of Pulmonary Diseases, Canakkale, Turkey. Kocaeli University School of Medicine, Department of Pulmonary Diseases, Kocaeli, Turkey. Corlu Government Hospital, Department of Pulmonary Diseases, Tekirdag, Turkey. Derince Derince Training and Research Hospital, Department of Cardiology, Kocaeli, Turkey. Kocaeli University School of Medicine, Department of Cardiology, Kocaeli, Turkey.

Aspiration of Barium Sulfate during an Upper Gastrointestinal Examination

A fifty three years old man admitted to emergency department with complaints of sudden onset cough and dyspnea during the upper gastrointestinal examination. He had a history of tuberculosis twentyfive years ago. He was ex smoker and had a smoking history of 25 package/years. He was tachypneic but the other vital signs were normal at emergency room. At respiratory examination, the breathe sounds were roughened. The laboratory levels of hemogram and biochemical parameters were normal. Arterial blood gas analysis showed an acute respiratory acidosis (PaO2: 73.7 mmHg, PaCO2: 24.3, pH: 7.59, SaO2: 97.4%). Chest X-ray has shown in Figure 1. What is your pre-diagnosis?

Knowledge Level of Kocaelis Population Regarding Smoking and Smoking Cessation

Knowledge Level of Kocaeli’s Population Regarding Smoking and Smoking Cessation Background: A questionnaire was designed and administered to people living in Kocaeli province, Turkey, in order to determine their level of knowledge about smoking before the initiation of a social responsibility project aimed at increasing the smoking cessation rates in Kocaeli. Material-Method: The sample selection was made on the basis of the population sizes of 12 counties in Kocaeli province; participants over the age of 18 completed the questionnaire over the phone. Results: A total of 2721 participants were included in the study. It was found that the knowledge level about smoking-related diseases was quite high, and the conditions mentioned most frequently by the participants were lung diseases, cancer, and cardiac diseases. Only 2.8% of the subjects reported that they had no information about the harmful effects of smoking. Knowledge level was not different among age groups or educational levels of the participants. The percentage of subjects who believed that smoking cessation was a matter of personal will power was 49%, while only 8.4% reported that medical support was required. The most recalled anti-smoking activities were the recent law prohibiting smoking in enclosed areas and commercials about smoke-free air.