Clinical features of lung cancer in patients with connective tissue diseases: a 10-year hospital based study.

BACKGROUND: Connective tissue diseases (CTD) might be associated with various malignancies, and one of the most frequent is lung cancer (LC). Despite our understanding of pathogenesis, this association remains still unclear. The aim of the present study is to describe the clinical characteristics of patients with CTD who developed LC. METHODS: Of 375 successive patients with CTD followed up to University Hospital between 1995 and 2004, 24 patients were diagnosed with LC: 11 (46%) had systemic sclerosis (SSc), 6 (25%) rheumatoid arthritis (RA), 6 (25%) systemic lupus erythematosus (SLE), and 1 (4%) dermatomyositis. We analyzed LC stage, radiological presentation, histological type, patients' smoking status, method of diagnosis, treatment applied, and disease outcome. RESULTS: Average duration of CTD was 13.95 (range 0-30) years. Non-small cell lung cancer (NSCLC) was significantly more frequent than small-cell lung cancer (SCLC). Among patients with NSCLC, 21 patients (85%) presented with stage III or IV. With regard to treatment, 13% patients underwent surgery, 25% chemotherapy, 4% patients combined chemo- and radiotherapy and 58% patients had only supportive therapy. The median survival was 5 months (range 1-96 months). CONCLUSION: The majority of CTD patients who developed LC were diagnosed at advanced stage and had poor survival. Efforts for early detection of LC in CTD patients' group are warranted.

Doppler parameters of the maternal hepatic artery blood flow in normal pregnancy: maternal hepatic artery blood flow in normal pregnancy.

OBJECTIVE: Objective of our study was to evaluate changes in Doppler resistance indices in the common hepatic artery during normal pregnancy. STUDY DESIGN: Cross-sectional study included 210 healthy pregnant women gestational age 6-40 weeks, 40 healthy non-pregnant women and 30 women after delivery. We divided all pregnant women by pregnancy trimester. We registered pulsatility index (PI) and resistive index (RI) in the common hepatic artery and compared the evaluated values among non-pregnant women and women in first, second and third trimester and post partum and tested correlation of both parameters with gestational age. Statistical analysis was done by Chi square test, one-way ANOVA followed by post-hoc test and two-tailed Pearson and Spearman correlation. The difference was considered to be significant if p<0.05. RESULTS: We found lower values of PI and RI in the third trimester compared to control group and first and second trimester (p<0.01). There is negative correlation between the values of PI and RI with the gestation (p<0.01). CONCLUSION: Hepatic artery resistance indices decrease during the third trimester of pregnancy. This decrease may be the result of systemic arterial vasodilatation in normal pregnancy. The arterial resistance indices may be more useful for the evaluation of liver blood flow over the total blood flow as they are more reliable, being angle independent, easier to obtain, reflect vascular changes and might help in quick orientation about liver blood flow in pregnancies complicated by preeclampsia and HELLP syndrome. Our study is a pilot one, and further studies are needed to establish nomograms for the PI and RI during the gestation.