Transudates in malignancy: still a role for pleural fluid.

INTRODUCTION: The aims of this study were to determine the distribution of transudates and exudates among pathologically proven malignant pleural effusions, and to demonstrate the necessity for cytologic studies in patients with a transudative effusion. MATERIALS AND METHODS: This study is a retrospective review of all subjects diagnosed with malignant or paramalignant pleural effusion over a 10-year period at a tertiary hospital. The study included 67 subjects with malignant mesothelioma, 45 subjects with metastatic disease, and 36 subjects with paramalignant effusions. RESULTS: There were 55 female and 93 male subjects; the mean age of the sample was 62 years. Malignant pleural effusions were transudative in 1.5% of malignant mesotheliomas, 6.8% of metastatic diseases, and 11.1% of paramalignant effusions. CONCLUSIONS: Cytological examination of pleural fluid in patients with unexplained transudative effusion is essential to rule out malignant processes.

The changing epidemiological trends for carcinoma of the lung in Turkey.

OBJECTIVE: To compare epidemiological parameters for lung cancer in the last 2 decades (1986-1995 versus 1996-2005). METHODS: Data on demographic characteristics, and histological subtype of lung cancer patients were retrospectively collected by a chart review in Cumhuriyet University Hospital, Sivas, Turkey for the period of 1993-2005. All other full-text papers that report epidemiological data for lung cancer in Turkey were also searched for meta-analysis. RESULTS: A total of 25,604 patients were analyzed in the last 2 decades. The mean age at the time of diagnosis was 59.4 years, and 92.5% of the patients were males. In the last decade, the rate of squamous cell carcinoma decreased from 61-50%, however, the rate of small cell carcinoma increased from 19-24%, and the rate of adenocarcinoma from 20-26%. CONCLUSION: There was a shift in the male/female ratio in Turkey. The rate of squamous cell carcinoma decreased, however, small cell carcinoma and adenocarcinoma increased progressively.

[Resistance rates to antituberculous drugs in Sivas province]. / Sivas ilinde antitüberküloz ilaçlara direnç oranlari.

Infections caused by drug-resistant Mycobacterium tuberculosis strains represent a serious public health problem in recent years. The aim of this retrospective study was to investigate the resistance rates of M. tuberculosis complex strains isolated from clinical specimens in the laboratories of Cumhuriyet University and Numune State Hospitals in Sivas province (located in the middle Anatolia), between May 2004-May 2006 period, to the major antituberculous drugs. A total of 158 M. tuberculosis complex strains which were isolated from sputum, bronchial lavage fluid, stomach fluid, urine, pus, peritoneal fluid and cerebrospinal fluid samples, each of which from different patients were included to the study. The identification of the isolates and antituberculosis drug susceptibility testing were performed by MGIT (Mycobacteria Growth Indicator Tube) 960 system in both of the laboratories. Of 158 isolates 42 (26.6%) were found resistant to at least one of the drugs, while 116 (73.4%) were susceptible to all of the tested antimycobacterials. The overall resistance rates were found as 17.7% (28/153) for isoniazid, 11.4% (18/153) for streptomycin, 4.4% (7/153) for rifampicin, and 5.1% (8/153) for ethambutol. The rate of multidrug resistant isolates characterized with resistance to isoniazid+rifampicin were 3.8% (6/158). As a result, the most common resistance patterns observed in our region were found as single isoniazid resistance (13/158; 8.2%), single streptomycin resistance (8/158; 5.1%) and combined isoniazid+streptomycin resistance (8/158; 5.1%), respectively, with lower resistance rate to rifampicin (4.4%) in comparison to the previous results reported from Turkey.

Early autoimmune complications after thymomectomy in a patient with interstitial lung disease. Case report.

Thymoma has been associated with a variety of autoimmune disorders. We report a case of myasthenia gravis and pancytopenia in a 53-year-old man with lymphoepithelial thymoma and interstitial lung disease. Preoperative examination revealed neither hematologic abnormality nor myasthenia gravis. The patient had enteritis prior to thymomectomy, sternal infection in the first month of operation, and urinary infection at the third month. About three months after thymomectomy, he required mechanical ventilation support due to myasthenia gravis-related respiratory failure. One month later, a rapidly progressing pancytopenia developed. The patient died within two weeks of overwhelming septicemia unresponsive to treatment with antibiotics and steroids. The possible onset of myasthenia gravis or pancytopenia after thymomectomy should be kept in mind during follow-up. Recurrent infections in the early stages of thymomectomy may suggest a lethal onset of pancytopenia.