Prognostic factors for survival in patients with thymic epithelial tumors.

BACKGROUND: Aim of the study was to identify and evaluate the prognostic efficacy of standard clinicopathological factors of thymic epithelial tumors (TETs) for treatment-related outcomes. MATERIALS AND METHODS: All patients treated between 1993-2008 at Ege University Faculty of Medicine Departments of Radiation Oncology and Thoracic Surgery were reviewed retrospectively. RESULTS: Forty-seven patients with a median age of 51 (range: 24-72) were identified. Complete resection was performed in 23 (51.1%), incomplete resection with microscopic residues in 17 (37.8%), subtotal resection with gross residues in 2 (4.4%) and biopsy in 5 (11.1%) patients. Radiotherapy was administered to 39 (83%) patients. Median follow-up duration was 51 months (range: 3-168 months). Five-year local recurrence-free survival (LRFS), disease-free survival (DFS), and overall survival (OS) rates were 93%, 90% and 85% for thymoma and 80%, 66% and 72% for thymic carcinoma patients, respectively. In multivariate analysis, the extent of resection was the only significant prognostic factor for OS (P = 0.001). CONCLUSIONS: The most important prognostic factor for overall survival was the extent of resection. Further studies with larger numbers of patients are required to confirm the prognostic factors and to obtain a better understanding of the biological behavior of TETs.

The effect of blood vessel invasion on prognosis of operated stage I non-small cell lung cancer patients.

OBJECTIVE: A retrospective study was conducted to identify the effect of blood vessel invasion on prognosis in surgically treated stage I non-small cell lung cancer patients. METHODS: A total of 71 consecutive patients who had undergone complete resection for stage I primary non-small cell lung cancer (NSCLC) between 1998 and 2007 were evaluated. All pathological specimens were examined for evidence of blood vessel invasion. The follow-up period was 5-118 months. Survival data were analyzed for all patients using the Kaplan-Meier test. RESULTS: There were 63 men and 8 women (mean age 59.2, age range 35-86). The most common tumor types were adenocarcinoma (35 patients, 49 %) and squamous cell carcinoma (26 patients, 37 %). Twenty-five patients (35 %) had stage IA disease, and 46 had (65 %) stage IB disease. In 13 cases (18 %) blood vessel invasion was demonstrated, whereas in the remaining 58 cases there was no evidence of vascular invasion. Minimum and maximum follow-up periods were 5 and 118 months respectively, with a mean of 41.76 +/- 27 months (median 33.5 months). Overall disease-free survival was 79.6 +/- 6.4 months: 38.3 +/- 12.0 months for the group with blood vessel invasion and 87.5 +/- 6.7 months for the remaining group. The difference between the two groups was statistically significant ( P < 0.003). Overall survival rate was 86.7 +/- 6.7 months: 44.5 +/- 11.3 months for blood vessel invasion group and 98.2 +/- 6.2 months for the remaining group. The difference between the two groups was statistically significant ( P < 0.001). CONCLUSION: Vascular invasion can be an important factor for predicting unfavorable prognosis in stage I NSCLC patients.

[Study of urease test or breath test (BT) and correlation with gastric biopsy to detect helicobacter pylori (Hp) in dyspeptic patients at "Hospital Nacional Cayetano Heredia hospital" (HNCH)--Lima]. / Estudio de la prueba de la ureasa o test de aliento (TA) y correlación con biopsia gástrica para la detecci ón de helicobacter pylori (Hp) en pacientes dispépticos del Hospital Nacional Cayetano Heredia Lima.

OBJECTIVE: To establish the utility of the IPEN ureasa test or breath test with C14, in the detection of Helicobacter pylori infection in dyspeptic patients at the HNCH. MATERIAL AND METHODS: 31 dyspeptic patients that attended the outpatient GI clinic during September 2004 were included. All of them had an upper endoscopy, gastric biopsies, and a Breath Test with C14, done at the IPEN (Peruvian Institute of Nuclear Energy). The diagnosis of HP infection was based on the histopathology report. RESULTS: Of the 31 Breath Test, one was a false negative and in 30 there was a good correlation with the biopsies results, 23 demonstrated the HP infection and in 7 this was not present. CONCLUSION: The IPEN Breath Test showed in this study a sensibility of 96.6% and a specificity of 100%, demonstrating that is a very useful diagnostic tool for HP infection.

Estudio de la prueba de la ureasa o test de aliento (TA) y correlación con biopsia gástrica para la detección de Helicobacter Pylori (Hp) en pacientes dispépticos del Hospital Nacional Cayetano Heredia-Lima / Study of the test of ureasa or test of breath (TA) and correlation with gastric biopsy for the detection of Helicobaster Pylori (HP) in dyspeptic patients of the Hospital National Cayetano Heredia-Lima

Objetivo: Determinar la utilidad del test de la ureasa o test del aliento con carbono 14 en la detección de la infección por Helicobacter pilory (Hp) en pacientes dispépticos del Hospital Nacional Cayetano Heredia. Material y Método: Se incluyó a 31 pacientes dispépticos que acudieron a la consulta externa del Servicio de Gastroenterología del HNCH en el mes de setiembre de 2004 y que aceptaron voluntariamente participar en este estudio y a los cuales se les indicó endoscopía alta y biopsia gástrica. A todos ellos se les realizó igualmente el TA, que se realizó con cápsulas de urea marcada con carbono 14 (C14) comercializadas por el Instituto Peruano de Energía Nuclear (IPEN) y con reactivos producidos por el mismo instituto. El diagnóstico de Hp se basó en el análisis histológico con coloración de hematoxilina-eosina. Resultados: De los 31 Test del aliento, hubo un falso negativo y 30 estudios correlacionaron de las biopsias, de los cuales 23 estudios fueron positivos y 7 negativos. Conclusiones: El test del aliento realizado en el IPEN con C14 demuestra en este estudio una sensibilidad de 96.6 por ciento y una especificidad del 100 por ciento, que lo hace una herramienta diagnóstica para la infección por Hp muy confiable.

Objective: To establish the utility of the IPEN ureasa test or breath test with C14, in the detection of Helicobacter pylori infection in dyspeptic patients at the HNCH. MATERIAL AND METHODS: 31 dyspeptic patients that attended the outpatient GI clinic during September2004 were included. All of them had an upper endoscopy , gastricbiopsies, and a Breath Test with C14, done at the IPEN (Peruvian Institute of Nuclear Energy) . The diagnosis of HP infection was based on the histopathology report. RESULTS: Of the 31 Breath Test , one was a false negative and in 30 there was a good correlation with the biopsies results , 23 demonstrated the HP infection and in 7 this was not present. CONCLUSION: The IPEN Breath Test showed in this study a sensibility of 96.6 per centand a specificity of 100 per cent , demonstrating that is a very useful diagnostic tool for HP infection.

Effect of different levels of cigarette smoking on lipid peroxidation, glutathione enzymes and paraoxonase 1 activity in healthy people.

The purpose of this study was to examine the effect of different levels of cigarette smoking on lipid peroxidation, glutathione enzymes and paraoxonase 1 (PON1) activity in a healthy population. The study included 130 subjects who were classified as mild (20 cigarettes daily, Group III, n=33) and never smokers (controls, Group IV, n=32). Malondialdehyde (MDA) levels, PON1 and erythrocyte glutathione enzyme activities were measured. MDA levels were significantly higher in smokers than never smokers (P<0.05 for Group I, P<0.001 for Group II and III). PON1 activity was significantly lower in heavy smokers (P<0.001). Glutathione peroxidase (GSH-Px) activity was significantly lower in the smokers (P<0.0001). Glutathione reductase (GR) activity was significantly higher in smokers (P<0.0001). MDA levels negatively correlated with PON1 and GSH-PX activities (P<0.01), whereas they positively correlated with GR activities (P<0.001). At every level, cigarette smoking is associated with increased lipid peroxidation and causes an impairment in antioxidant systems.

Pulmonary tuberculosis in patients with diabetes mellitus.

BACKGROUND: Diabetes mellitus has been reported to modify the presenting features of pulmonary tuberculosis, but there are varying data, particularly regarding the association with lower lung field involvement. OBJECTIVES: To determine whether diabetes mellitus alters the clinical and radiographic manifestations of tuberculosis in nonimmunocompromised hosts and to define the determinants of lower lung field involvement. METHODS: A retrospective review of the records of all patients with tuberculosis and diabetes mellitus seen during a 14-year period and of an age- and sex-matched nondiabetic control group with tuberculosis was carried out. The duration of symptoms, tuberculin reaction, bacteriologic and radiographic findings of the two groups were compared. RESULTS: The presence of diabetes mellitus was found not to have an effect on patients' symptomatology, bacteriology results, tuberculin reaction and localization of pulmonary infiltrates. On the other hand, fewer diabetic patients were smear-positive and fewer had reticulonodular opacities compared with the control patients. A higher number of insulin-dependent diabetic patients presented with cavitary disease as compared with nondiabetic controls. Lower lung field tuberculosis was significantly associated with female gender and, in patients older than 40 years, was more frequently observed in diabetics. CONCLUSION: These data show that diabetes does not affect the presenting features of pulmonary tuberculosis to a large extent and is only associated with lower lung field disease in older patients.

Rinoescleroma reporte de cinco casos clínicos / Rinoescleroma reports of five clinical cases

Se evaluaron cinco pacientes con un rango de edad de 25-60 años, tres de sexo femenino y 2 de sexo masculino, todos de condición socioeconómica baja, 3 de ellos naturales de provincias. El tiempo de enfermedad varió de 6 meses a 10 años, caracterizado por compromiso de vías aéreas superiores (obstrucción nasal, estridor laríngeo, tos y expectoración esporádica), historia previa de tratamiento antibióticos y otros medicamentos sintomáticos. El diagnóstico se baso en a:) examen otorrinolaringológico, evidenciando en todos los pacientes infiltrado granulomatoso con exudado, alteraciones de la estructura con obstrucción de luz en nasofaringe u orofaringe, b) Biopsia de lesión, todos los pacientes presentaron procesos granulomatoso crónico con células sugerentes de rinoescleroma. c) Cultivo de secreción, siendo positivo en 3/5 de los pacientes, se aisló Klebsiella sp, Klebsiella rhinoescleromatis y Klebsiella ozaenae, según la histria clínica dos pacientes recibieron tratamiento antibiótico previo, pudiendo haber negativizado el cultivo. Tres pacientes recibieron ciprofloxacino 500 mg dos veces por día por un tiempo de 4 a 12 semanas, un cuarto paciente recibió ciprofloxacina por siete meses y un paciente recibió tetraciclina 500 mg cuatro veces al día por 6 semanas. El seguimiento de 3 semanas a un año muestra evolución favorable, desaparición y mejoría de la sintomatología y negativización de los cultivos.

The oral glucose tolerance test in patients with respiratory infections.

The aim of this study, carried out in a specialized centre for chest diseases in Turkey, was to determine the prevalence of glucose intolerance in tuberculosis (TB) and pneumonia so as to assess the specificity of the association of TB with diabetes mellitus. The study group comprised 58 active pulmonary TB patients without any history of diabetes mellitus and the matched control group consisted of 23 community-acquired pneumonia patients. An oral glucose tolerance test (OGTT) was performed at the time of diagnosis and 3 months after the treatment was started in both groups. Glucose intolerance was found in six (10.4%) patients and diabetes mellitus in five (8.6%) patients in the TB group. In the control group, four (17.4%) patients were found to be diabetic and none of them were glucose intolerant. There was no significant difference between the two groups (p > 0.05). There was a higher prevalence of abnormal OGTT results among elderly patients in both groups. OGTT results returned to normal in both the TB and pneumonia groups after treatment. The results suggest that glucose intolerance occurs in the setting of infection and is reversible following adequate antimicrobial treatment.