The effect of in-patient chest physiotherapy in lung cancer patients.

GOALS OF WORK: The aim of our study was to investigate the effect of the in-patient chest physiotherapy (ICP) in patients with lung cancer. PATIENTS AND METHODS: Eighteen patients with stage IIIA, IIIB, or IV lung cancer (3 females and 15 males) were included. The demographic characteristics and the clinical history of the patients were recorded. Pain (visual analog scale), pulmonary function (pulmonary function test), functional capacity (6-min walking test, Karnofsky performance status (KPS) scale), and health-related quality of life (Nottingham Health Profile (NHP)) parameters were evaluated. The ICP program, including breathing control, breathing exercises, relaxation training, upper and lower extremity exercises, mobilization, and transcutaneous nerve stimulation, was designed to meet each patient's individual needs. MAIN RESULTS: After the exercise program, there was a significant decrease in the severity of the dyspnea, fatigue, and pain symptoms (p < 0.05), improvement in the physical mobility, pain, energy, emotional status and sleep subcategories of the NHP (p < or = 0.05), and increase in the 6-min walking distance (75 +/- 15.95 m, p = 0.003). However, pulmonary function test results and KPS scores did not show statistically significant changes (p > 0.05). CONCLUSIONS: ICP programs may be beneficial to lung cancer patients by reducing respiratory symptoms, pain, and improving health-related quality of life and exercise capacity. For this reason, the results of this study suggest that ICP programs, which are prepared by taking the individual requirements of lung cancer patients, should be placed in the treatment of the lung cancer.

[Severity scores and factors related with mortality in cases with community-acquired pneumonia patients in intensive care unit]. / Yogun bakimda izlenen toplum kökenli pnömoni olgularinin hastalik agirlik skorlamalari ve mortalite üzerine etkili faktörler.

Totally 48 cases with diagnosed as community-acquired pneumonia who were treated in intensive care units of two different university hospital included to the study. The mean age of cases was 67.8, 29 were males and 19 females. Glasgow Coma Score (GCS), Acute Physiology Assesment and Chronic Health Evaluation II (APACHE II), Pneumonia Severity Index (PSI) and Sequential Organ Failure Assessment Score (SOFA) of 46 cases were determined. The most common comorbid disease was cerebrovascular disease. We determined that microbiological tests were made in 30 cases and pathogen agent was established in 7 cases of them. The mean lenght of stay in hospital and intensive care unit were 16.1 days and 8.8 days respectively. The mean GCS was 11.4, the mean PSI was 130.7 and 38 cases were in high risk classes. The mean APACHE II and SOFA scores were 20.7 and 4.4 respectively. We determined that hypotension and intubation increased the mortality risk. The mean blood urea nitrogen, %PNL and respiratory rate were higher in cases who were died. The mortality rate in group 3b and group 4 were respectively 41.2% and 44.0%. Totally 20 (41.7%) cases died.

The effect of beclometasone dipropionate/formoterol extra-fine fixed combination on the peripheral airway inflammation in controlled asthma.

BACKGROUND: Suppression of small airway inflammation may contribute to achieving asthma control. We aimed to evaluate the additional effect of beclometasone dipropionate/formoterol (BDP/F) hydrofluoroalkane (HFA) pressurized metered dose inhaler (pMDI) (BDP/F-HFA 100/6 µg pMDI) on airway inflammation and functional parameters in asthma cases, who were optimally controlled by maintenance therapy. METHODS: Ninety-five controlled asthmatic patients were included. They were grouped as Group 1 [budesonide/formoterol 320/9 µg dry powder inhaler (DPI)] and Group 2 (fluticasone/salmeterol 500/50 µg DPI) according to the combination they used. Then Group 3 was established by random selection from these two groups, and BDP/F-HFA 100/6 µg pMDI treatment was prescribed. All patients were evaluated in the beginning of the study and were re-evaluated at the end of a 3-week treatment period by spirometry, exhaled nitric oxide (eNO) levels, and small airway functional indices, namely, Sacin and Scond values. RESULTS: There was no significant statistical difference in terms of age, height, weight, disease duration, symptoms, and spirometric parameters between the groups. There was a significant decrease in eNO levels in asthma cases who were on BDP/F-HFA therapy (p=0.001). A significant improvement in Sacin values at the end of the treatment period was observed in cases treated with BDP/F-HFA (p=0.001), indicating that inflammation was suppressed in peripheral airways. CONCLUSIONS: These results emphasize that asthma treatment has mainly focused on the strategy to keep the disease under control; maintaining optimal functional level might be underestimated. BDP/F-HFA may have an additional favorable effect on the peripheral airway inflammation in the controlled asthma.