[Pharmacotherapeutic treatment strategies for smoking cessation]. / Pharmakologische Strategien zur Unterstützung einer Raucherentwöhnung.

Regular tobacco smoking occurs in about 35% of the male and 25% of the female German population. Individual attempts to independently quit smoking and to remain abstinent for 1 year have been shown to be successful in less than 5% of cases. This rate can be doubled by means of individual consulting and cognitive-behavioral interventions and additional pharmacological treatment might increase abstinence rates up to 25%. Apart from nicotine substitution (e.g. transdermal, oral and inhalative applications) and bupropion, recent studies have shown beneficial effects of varenicline for smoking cessation and abstinence. Varenicline, a selective partial nicotinergic agonist, has been specifically developed for the purpose of smoking cessation. Currently available data suggest that varenicline is more effective compared to nicotine substitution therapy and bupropion, increasing the abstinence likelihood by a factor of 2.3 compared to a placebo. Recent data regarding anti-nicotine vaccines suggest that this approach might yield a comparable treatment outcome and probably even better relapse-preventing effects than conventional psychopharmacological strategies. The first anti-nicotine vaccines are expected to be approved by national authorities within the forthcoming 1-2 years.

[Clinico-radiological characteristics of bronchial carcinoid].

OBJECTIVES: To review clinical and radiological characteristics of a patients with bronchial carcinoid. METHODS: In this retrospective study, we reviewed the clinical, pathological and imaging findings in 42 patients diagnosed with bronchial carcinoid during the seven years period. RESULTS: There were 23 women and 19 men, with a mean age of 47 years (range from 15 to 75). Thirty patients had typical and 12 atypical bronchial carcinoid. Dominant symtoms were cough (46.7%) and 38%. Tumor was localized in 28 patients in the left, and 14 in the right lung. On radiographs carcinoid manifested as tumor shadow in 40.5%, nodule and atelectasis in 21.4% cases each respectively, pleural effusion and pneumonia in 7.1% each respectively and hyperinflation in 2.4% of the cases. Computerized tomography revealed endoluminal tumor in 30.9% patients. CONCLUSION: Major imaging findings are central, tumor mass or nodule and obstruction signs like atelectasis. Diagnosis is confirmed by pathological examination of samples taken by bronchoscopy or surgery.

[Radiologic manifestation of primary pleural tumors].

OBJECTIVES: To show the radiological manifestations of primary pleural tumors. PATIENTS AND METHODS: we carried out a retrospective analysis of radiological findings in 62 patients with primary malignant tumor of pleura. RESULTS: Study included 39 male and 23 female patients. Malignant tumors were present in 92.7% of the patients and benign ones in 7.2%. The most common malignant tumor was mesothelioma (85.4%), and solitary fibrous tumor prevailed among benign tumors (9.7%). Diffuse malignant mesothelioma manifested on computed tomography (CT) as a pleural thickening and effusion in 67.4% of the patients, tumors and effusion in 11.7%, and only as an effusion in 9.8% cases. Thickening of the pleura appeared diffuse in 54% of patients and most often it had nodular pattern. Both localized malignant and all benign tumors presented as tumor-like changes with the signs of necrosis in 50%. CONCLUSION: The imaging methods have a key role in the diagnosis of pleural tumors. CT shows different morphologic features of pleural lesions that have been established as a useful tool for differentiating malignant from benign disease. However, magnetic resonance is preferred imaging method for assessing the extent and resectability of pleural tumors.

Cerebrospinal fluid protein reactions during non-neurological surgery.

OBJECTIVE: To study changes in cerebrospinal fluid (CSF) protein markers of blood-CSF barrier integrity and immunological reactions during surgical stress. SUBJECTS AND METHODS: Thirty-five patients without neurological or psychiatric disorders undergoing knee replacements had CSF and serum samples drawn from spinal and arterial catheters before, 3 h after and the morning after surgery. RESULTS: Serum albumin decreased during surgery and CSF albumin decreased during and after surgery, and, as a consequence, the CSF/serum albumin ratio decreased significantly during the study period, especially after the intervention. In contrast, CSF concentrations of beta-2-microglobuline (beta2M) increased significantly during surgery and remained high. The CSF general marker beta-trace protein (betaTP) remained unchanged. CONCLUSIONS: Central nervous system protein reactions to a non-neurological surgical intervention include sharply decreased permeability of albumin into the CSF and signs of intrathecal inflammatory activity.

[Chronic renal diseases in shoe industry workers]. / Hronicna oboljenja bubrega kod radnika u industriji obuce.

Surveillance of 1000 workers employed in shoeware industry (720 females and 280 male), revealed 56 workers with chronic renal disorders. The most frequent were: renal calculosis, inflammatory diseases and nephropathy with diabetes. There were no cases of malignant diseases or tuberculosis. With regard to labour conditions and the potential harmful effects of the production process no direct effects were observed in this field. However, their presence was evident in the already existing diseases.

The role of ECG monitoring during bronchoscopy in lung cancer patients.

Bronchoscopy, as an endoscopic technique, is associated with respiratory and circulatory disorders. Cardiac rhythm disorders are the most common cardiovascular complications of bronchoscopy. In order to study ECG changes during bronchological procedures, ECG monitoring was undertaken (30 min before, during and 30 min after bronchoscopy) in 100 patients, 76 with bronchial carcinoma and 24 suffering from some other pulmonary disease. Within the same intervals PaO2, PaCO2 and pH were recorded. All recorded arrhythmias were classified as minor and major. According to arrythmia noted during bronchoscopy, patients were divided into two groups: group 1 comprised 70 patients without arrythmia or with minor arrythmia (70%) and group 2, 30 patients with major arrythmia (30%). No significant difference was noted in associated cardiac disease, cardiological medication, blood pressure, pulse rat, PaO2, PaCO2 and pH (P < 0.05). The only statistically significant difference between the two groups of patients was related to localization of tumour in the lungs. We could not correlate the occurrence of major arrythmia during bronchoscopy in patients with lung carcinoma with any underlying cardiopulmonary condition. Significant differences were noted in effects of tumour localization, i.e. major arrhythmias are more common and more dangerous in cases of tumours of the left bronchial trunk (possible bronchoscopic stimulation of the left stellate ganglion), and we therefore believe that ECG monitoring is desirable in these cases for the early detection and appropriate management of haemodynamically dangerous arrhythmias.

[Dressler's syndrome during radiotherapy in bronchial carcinoma]. / Dresslerov sindrom u toku zracne terapije karcinoma bronha.

A case of Dressler's syndrome which has developed in a patient with bronchogenic carcinoma during radiotherapy is presented. Diagnosis is established according to symptomatology, clinical findings, chest X-ray, laboratory analysis and immunological findings. Existence of metastatic deposits in heart is excluded by the method of echocardiography. Short-term cardiologic therapy with antiflogistics is completely sufficient for maintaining the stability of "cardiologic status".