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1.
Anticancer Drugs ; 33(1): e555-e557, 2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34387587

RESUMO

Pazopanib is an oral multi-kinase inhibitor approved for the treatment of advanced renal cell carcinoma (RCC). It is an anti-angiogenic agent, which blocks the activation signaling pathways of tyrosine kinases and prevents the activities of primarily vascular endothelial growth factor receptors (VEGFR)-2 and VEGFR-3, which are important in lymphangiogenesis. Herein, we report a patient with advanced RCC who developed asymptomatic left-sided chylothorax under pazopanib therapy. Chylothorax developed in the 16th month and gradually increased until it was diagnosed by thoracentesis in the 22nd month. The development of chylothorax was attributed to pazopanib therapy after ruling out all possible traumatic and nontraumatic etiologies. The 'Adverse Drug Reaction Probability Scale' revealed a total score of 6, which fell into 'probable' category. Chylothorax regressed significantly 5 weeks after the discontinuation of pazopanib therapy.


Assuntos
Antineoplásicos/efeitos adversos , Carcinoma de Células Renais/tratamento farmacológico , Quilotórax/induzido quimicamente , Indazóis/efeitos adversos , Neoplasias Renais/tratamento farmacológico , Pirimidinas/efeitos adversos , Sulfonamidas/efeitos adversos , Adulto , Antineoplásicos/uso terapêutico , Humanos , Indazóis/uso terapêutico , Masculino , Pirimidinas/uso terapêutico , Sulfonamidas/uso terapêutico
2.
Lung ; 200(6): 807-815, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36173482

RESUMO

PURPOSE: The aim of this study is to determine the diagnostic performances of pleural procedures in undiagnosed exudative pleural effusions and to evaluate factors suggestive of benign or malignant pleural effusions in tertiary care centers. METHODS: This was a multicenter prospective observational study conducted between January 1 and December 31, 2018. A total of 777 patients with undiagnosed exudative pleural effusion after the initial work-up were evaluated. The results of diagnostic procedures and the patients' diagnoses were prospectively recorded. Sensitivity, specificity, and accuracy estimates with 95% confidence intervals were used to examine the performance of pleural procedures to detect malignancy. RESULTS: The mean age ± SD of the 777 patients was 62.0 ± 16.0 years, and 68.3% of them were male. The most common cause was malignancy (38.3%). Lung cancer was the leading cause of malignant pleural effusions (20.2%). The diagnostic sensitivity and accuracy of cytology were 59.5% and 84.3%, respectively. The diagnostic sensitivity of image-guided pleural biopsy was 86.4%. The addition of image-guided pleural biopsy to cytology increased diagnostic sensitivity to more than 90%. Thoracoscopic biopsy provided the highest diagnostic sensitivity (94.3%). The highest diagnostic sensitivity of cytology was determined in metastatic pleural effusion from breast cancer (86.7%). CONCLUSION: The diagnostic performance increases considerably when cytology is combined with image-guided pleural biopsy in malignant pleural effusions. However, to avoid unnecessary interventions and complications, the development of criteria to distinguish patients with benign pleural effusions is as important as the identification of patients with malignant pleural effusions.


Assuntos
Derrame Pleural Maligno , Derrame Pleural , Humanos , Masculino , Feminino , Derrame Pleural Maligno/diagnóstico , Derrame Pleural Maligno/etiologia , Derrame Pleural Maligno/patologia , Estudos Prospectivos , Derrame Pleural/diagnóstico , Derrame Pleural/etiologia , Derrame Pleural/patologia , Exsudatos e Transudatos , Pleura/patologia
3.
J Ultrasound Med ; 41(4): 951-959, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34268780

RESUMO

OBJECTIVES: Sarcoidosis can cause sarcopenia like other chronic diseases. Ultrasonography is a simple method, which has been used frequently in recent years. We aimed to evaluate the sarcoidosis patients with ultrasonography for sarcopenia and to compare the results of ultrasonography with the accepted standard method, bioelectrical impedance analysis (BIA). METHODS: BIA and handgrip test were applied to all patients diagnosed with sarcoidosis. The patients were classified according to the presence of probable sarcopenia with their handgrip results and the presence of sarcopenia with the appendicular skeletal muscle mass index calculated with using BIA. Ultrasonography was applied to each patient and the thickness of seven different muscle groups of the patients were evaluated. The ability of muscle thickness values measured by ultrasonography to predict sarcopenia was compared with the reference standard test BIA. RESULTS: Forty patients (women/men = 31/9) were included in our study. The mean age was 53.2 ± 12.5 years. A statistically significant positive correlation was observed between handgrip strength and gastrocnemius medialis (GM), rectus femoris (RF) cross-sectional area, rectus abdominis (RA), external oblique (EO), transversus abdominus (TA), and diaphragm thicknesses. Therefore, there was a significant correlation between fat free mass index with RA, EO, and TA muscles. According to the ROC analysis, statistically significant muscle groups predicting sarcopenia were found as GM, RF cross-sectional area, EO, and IO. Again, according to the ROC analysis, it was seen that the thicknesses of GM, RA, EO, IO, and TA muscles corrected for BMI predicted probable sarcopenia with quite high sensitivity and specificity. CONCLUSIONS: Muscle thicknesses measured by ultrasonography are helpful for the diagnosis of sarcopenia that may develop in chronic diseases such as sarcoidosis. Further studies with higher number of patients are needed to validate the results of the present pilot study.


Assuntos
Sarcoidose , Sarcopenia , Adulto , Idoso , Feminino , Força da Mão , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/fisiologia , Projetos Piloto , Sarcoidose/complicações , Sarcoidose/diagnóstico por imagem , Sarcopenia/complicações , Sarcopenia/diagnóstico por imagem , Ultrassonografia/métodos
4.
J Thromb Thrombolysis ; 52(2): 640-645, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33386561

RESUMO

Antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by arterial and/ or venous thrombosis accompanied by persistently elevated levels of antiphospholipid antibodies (aPLs). The aim of this study is to evaluate the pulmonary manifestations of APS and compare the levels of aPLs in patients with and without pulmonary involvement. We retrospectively reviewed the files of patients with the diagnosis of APS between October 2010 and May 2017. Demographic data, clinical, radiological and laboratory findings were recorded. The study included 67 patients (56 female/11 male) with a mean age of 39 ± 13 years. Pulmonary manifestations such as parenchymal and/or vascular involvement were seen in 12 (17.9%) patients. The patients with and without pulmonary manifestations were not significantly different in terms of age (p = 0.46), comorbidities (p = 0.48) and APS duration (p = 0.66). Acute pulmonary thromboembolism (PE) was determined in 11 (16.4%), alveolar hemorrhage in 2 (3%) patients. Four patients with acute PE (36%) developed chronic thromboembolic pulmonary hypertension (CTEPH). One patient developed both CTEPH and diffuse alveolar hemorrhage after acute PE during follow up. Antiphosholipid antibody IgM was highly positive in patients with PE compared to patients without PE (p = 0.005). Other antibodies and lupus anticoagulant were not significantly different in patients with and without PE. None of the patients were deceased due to pulmonary manifestations of APS. PE was the most common pulmonary manifestation of APS. The development of CTEPH was high among APS patients. Patients with APS should be closely followed for the onset of PE and CTEPH.


Assuntos
Síndrome Antifosfolipídica , Hipertensão Pulmonar , Adulto , Anticorpos Antifosfolipídeos , Síndrome Antifosfolipídica/complicações , Feminino , Hemorragia/etiologia , Humanos , Inibidor de Coagulação do Lúpus , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
5.
Tuberk Toraks ; 69(1): 59-64, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33853306

RESUMO

INTRODUCTION: Postoperative complications following thoracic procedures are a major cause of morbidity and mortality. Alveolar air leaks and/or bronchopleural fistulas are associated with increased risk of infection, prolonged chest tube, and hospital stay duration and therefore generate economical concern for health care providers. A variety of surgical sealants or adhesives have been introduced to overcome this complication. Since intraoperative BioGlue® application can also cause an inflammatory reaction and mimic tumor recurrence on FDG PET-CT, in the present study we aimed to investigate its potential role in false-positive PET-CT results in patients operated for NSCLC. MATERIALS AND METHODS: Data of six patients who underwent resection for primary NSCLC at our institution (Department of Thoracic Surgery, Hacettepe University Medical Faculty) between January 2015 and December 2018 and had false positivity, due to BioGlue® application, at the bronchial stump in follow-up FDG PET-CT were retrospectively analyzed from a prospectively collected database. RESULT: One of the 6 patients was female and 5 were male. The mean age was 68 years (range, 56-79 years). The average time interval between operation and postoperative FDG-PET imaging was 4.3 months (range, 4-6 months). Follow-up FDG-PET imaging SUVmax values ranged between 3.0 and 9.0 (median: 5.33). All patients have been evaluated by FDG-PET scan following the detection of soft tissue densities at the surgical site suspicious for recurrence at their follow-up chest CT scans. Four patients underwent a bronchoscopic examination, bronchial stumps were examined and multiple biopsies were taken from suspicious nodules or tissues and sent for pathologic examination. Histopathological results revealed inflammation which is compatible with foreign body granuloma, without any suspicion for malignancy, in all cases. Two patients were solely followed-up and subsequent FDG-PET imaging after 3 months revealed complete resolution of FDG uptake. CONCLUSIONS: To avoid unnecessary biopsies or surgical procedures, the possibility of false-positive results due to surgical adhesive product use should be taken into account while interpreting follow-up FDG-PET imaging results and the operative reports should be written in detail, describing which surgical materials used and their exact application sites.


Assuntos
Reações Falso-Positivas , Fluordesoxiglucose F18/efeitos adversos , Neoplasias Pulmonares/diagnóstico , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/efeitos adversos , Compostos Radiofarmacêuticos/efeitos adversos , Idoso , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Feminino , Seguimentos , Humanos , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Tomografia por Emissão de Pósitrons , Estudos Retrospectivos
6.
Tuberk Toraks ; 69(3): 307-313, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34581151

RESUMO

INTRODUCTION: Bronchoscopic biopsies and bronchial washings (BW) are commonly used together for the diagnosis of centrally located tumors. This study aimed to investigate the clinical relevance of routinely collecting BWs in patients who simultaneously had biopsies for visible endobronchial lesions in the current molecular analysis-driven personalized medicine era. MATERIALS AND METHODS: We retrospectively reviewed the patients who underwent fiberoptic bronchoscopy (FOB) between October 2011 and December 2016. Patients who had both BW and biopsy specimens (EBB: endobronchial forceps biopsy and/or EBNA: endobronchial needle aspiration biopsy) for visible endobronchial lesions were included in this study. Demographic and clinical data, macroscopic findings during FOB, pathology results, and final diagnoses were collected from the hospital database. RESULT: The study included 269 patients (220 males/49 females) with a mean age of 61.6 ± 10.6 years. While the overall diagnostic yield of FOB was 71.4%, the diagnostic yields of bronchoscopic procedures were 68.2% for EBB, 83.3% for EBNA, and 19.7% for BW. Only three patients (1.1%) with undiagnostic biopsies had positive BW cytology revealing merely malignant epithelial cells. CONCLUSIONS: BW provided a negligible diagnostic contribution in 1.1% (n= 3) of the patients. These three patients had undergone further diagnostic procedures for making a proper therapeutic management plan. In the era of personalized therapy, it is logical to obtain more biopsy in the time spent for BWs.


Assuntos
Neoplasias Pulmonares , Medicina de Precisão , Idoso , Biópsia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Retrospectivos
7.
Cytopathology ; 30(6): 592-600, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31165505

RESUMO

OBJECTIVE: The aim of this study was to investigate the utility of BRCA1-associated protein-1 (BAP1), glucose transporter (GLUT)-1 and desmin expression by immunohistochemistry in the discrimination between reactive and malignant mesothelial proliferations. METHODS: A total of 88 biopsies and 30 effusions from mesothelioma cases were studied. Control groups were composed of 35 tissues and 30 cell blocks. The 88 mesothelioma cases were from 43 males and 45 females (mean age 56 years). Tumours were mostly localised to pleura (66/88, 75%) and of epithelioid histology (75/88, 85%). Cytology samples were from 17 males and 13 females (mean age 58 years), and 16 pleural and 14 peritoneal effusions. Twenty cytology cases had corresponding tissue biopsies. RESULTS: BAP1 loss was detected in 61/88 (69%) tissues and in 20/30 (67%) cytology samples from mesothelioma with a specificity of 100% for both sampling methods. BAP1 loss was observed more frequently in pleural and biphasic tumours. GLUT-1 immunoreactivity was identified in 54/81 (67%) and 23/25 (92%) malignant tissues and effusions, and in 6/33 (18%) and 6/30 (20%) benign tissues and effusions, respectively. Desmin loss was observed in 74/80 (92%) malignant biopsy samples, 16/21 (76%) malignant effusions and 10/34 (29%) of benign tissues, but in none of the reactive effusions. Concordance rate of results between biopsy and cytology was as follows: BAP1 20/20 (100%); GLUT-1 13/18 (72%); and desmin 10/14 (71%). CONCLUSIONS: BAP1, GLUT-1 and desmin are useful markers in the discrimination between reactive and malignant mesothelial proliferations. BAP1 loss seems to be diagnostic for mesotheliomas both in biopsy and cytology samples.


Assuntos
Desmina/genética , Transportador de Glucose Tipo 1/genética , Neoplasias Pulmonares/diagnóstico , Mesotelioma/diagnóstico , Neoplasias Mesoteliais/diagnóstico , Proteínas Supressoras de Tumor/genética , Ubiquitina Tiolesterase/genética , Biomarcadores Tumorais/genética , Proliferação de Células/genética , Citodiagnóstico , Diagnóstico Diferencial , Feminino , Regulação Neoplásica da Expressão Gênica/genética , Humanos , Imuno-Histoquímica/métodos , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patologia , Masculino , Mesotelioma/genética , Mesotelioma/patologia , Mesotelioma Maligno , Pessoa de Meia-Idade , Neoplasias Mesoteliais/genética , Neoplasias Mesoteliais/patologia , Derrame Pleural Maligno
8.
Am J Emerg Med ; 35(10): 1582.e5-1582.e7, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28807443

RESUMO

Treatment with low-potency anti-psychotic agents is an important risk factor in the development of pulmonary embolism (PE). We report a case of 74years old female patient receiving olanzapine for psychotic depression admitted to the emergency service with the complaints of chest pain and shortness of breath. She had tachypnea, hypotension and tachycardia. Arterial blood gas analysis showed hypoxemia-hypocapnia and D-dimer level was high. Computed tomographic pulmonary angiography (CTPA) demonstrated pulmonary embolism in both main pulmonary arteries, through lobar and segmental branches. Tissue plasminogen activator (t-PA) was administered in intensive care unit. As the only possible risk factor for PE was olanzapine, olanzapine treatment was terminated with pyschiatry consultation. During the 12-month follow-up of the patient; malignancy was not observed. Diagnosis and prevention of PE are the important goals to reduce morbidity and mortality in subjects receiving olanzapine.


Assuntos
Benzodiazepinas/efeitos adversos , Embolia Pulmonar/induzido quimicamente , Varfarina/uso terapêutico , Doença Aguda , Idoso , Anticoagulantes/uso terapêutico , Benzodiazepinas/uso terapêutico , Angiografia por Tomografia Computadorizada , Depressão/tratamento farmacológico , Feminino , Humanos , Olanzapina , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/tratamento farmacológico , Inibidores Seletivos de Recaptação de Serotonina/efeitos adversos , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Índice de Gravidade de Doença
9.
Tuberk Toraks ; 64(2): 137-43, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27481080

RESUMO

INTRODUCTION: Conventional transbronchial needle aspiration biopsy (C-TBNA) is a technique in evaluating mediastinal/hilar lymph nodes (LN). We aimed to investigate diagnostic yield (DY) and safety of C-TBNAs performed in a single university clinic. PATIENTS AND METHODS: We retrospectively reviewed 363 consecutive C-TBNA procedures in 219 patients. The DY and its relationship with location, shortest diameter, SUVmax of LN, and number of sampled stations were evaluated. RESULT: Procedures were diagnostic in 257 (71%) LNs. The most common diagnoses were malignancy (n= 109.30%) and granulomatous inflammation (n= 68, 18.7%).The ratio of patients with at least one diagnostic cytology result was 77% (n= 168). DY was significantly increased with the increased number of sampled LNs (p= 0.033) and larger LN diameter (p< 0.001). Sensitivity, specificity, positive, and negative predictive values were 83.3%, 43.2%, 79.6%, and 49.3% respectively for cut-off LN diameter of 11.5 mm. There was nearly a significant relationship between DY and SUVmax (p= 0.05, cut-off= 4.8). The highest DY was in subcarinal LN (77.4%). No major complications were recorded. CONCLUSIONS: The DY of C-TBNA was 71%. The ratio of the patients with at least one diagnostic cytology result was 77%. The most common diagnoses were malignancy and granulomatous inflammation. The DY of C-TBNA was increased with the increased number of sampled LNs, larger LN diameter, and increased SUVmax. C-TBNA is a safe procedure.


Assuntos
Biópsia por Agulha Fina/métodos , Broncoscopia/métodos , Neoplasias Pulmonares/patologia , Linfonodos/patologia , Adulto , Feminino , Humanos , Pulmão/patologia , Masculino , Doenças do Mediastino/patologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Sensibilidade e Especificidade
10.
Tuberk Toraks ; 62(1): 79-84, 2014.
Artigo em Turco | MEDLINE | ID: mdl-24814080

RESUMO

The anatomic extent of disease, that is described by the TNM-classification remains the most important prognostic factor for lung cancer. Based on the changes in tumor characteristics, advances in diagnostic methods and treatment strategies, TNM-classifications are updated from time to time. The 7th TNM-classification was created on the basis of an international, large, and retrospective database. However due to retrospective data, there are still unanswered questions. Therefore "Prospective Lung Cancer Staging Project" is designed. In this project, in addition to the detailed evaluation of T, N, M descriptors; other factors, which were not considered to be relevant to lung cancer staging before, were also analyzed such as demographic data, histologic characteristics, certain biochemical and molecular prognostic and predictive factors. This project will be the basis of 8th TNM-classification for lung cancer. In this manuscript, we discuss the probable changes from the 7th TNM classification to the 8th.


Assuntos
Neoplasias Pulmonares/patologia , Demografia , Humanos , Neoplasias Pulmonares/classificação , Estadiamento de Neoplasias , Probabilidade , Prognóstico , Estudos Prospectivos , Estudos Retrospectivos , Terminologia como Assunto
11.
Tuberk Toraks ; 72(2): 167-172, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38869209

RESUMO

Tuberculosis (TB) is an airborne infectious disease caused by Mycobacterium tuberculosis (MTB). Although it typically affects the lungs (pulmonary TB), one-fifth of TB cases present as extrapulmonary TB. The diagnosis of extrapulmonary TB is often overlooked due to its atypical clinical and radiological manifestations. Differentiating TB from neoplastic conditions poses significant challenges. A 33-year-old female patient was admitted to the emergency clinic with shortness of breath, cough, and abdominal pain. Postero-anterior chest X-ray revealed massive pleural effusion leading to mediastinal shift. With a preliminary diagnosis of malignant pleural effusion, a pleural catheter was inserted, and the patient was referred for a positron emission tomography (PET/CT) to assess the primary site and the optimal location for a biopsy. The PET/CT revealed asymmetric soft tissue thickening on the left side of the nasopharynx, and increased fluorodeoxyglucose (FDG) uptake in the left cervical lymph nodes raised suspicion regarding primary nasopharyngeal cancer. Additionally, there was an increased FDG uptake observed in the mass lesion located in the right upper lobe, mediastinal lymph nodes, pleural surfaces in the left hemithorax, perihepatic areas, and peritoneum, indicating diffuse metastatic disease. Tuberculosis diagnosis was confirmed through biopsies demonstrating granulomatous inflammation in the lung and nasopharynx, along with culturing MTB from pleural effusion. Positron emission tomography played a crucial role in identifying sites of TB involvement. Despite its rarity, healthcare professionals should consider nasopharyngeal TB as a potential diagnosis when evaluating nasopharyngeal masses.


Assuntos
Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Humanos , Feminino , Adulto , Diagnóstico Diferencial , Tuberculose/diagnóstico , Tuberculose/patologia , Fluordesoxiglucose F18 , Metástase Neoplásica
12.
Sarcoidosis Vasc Diffuse Lung Dis ; 41(2): e2024030, 2024 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-38940718

RESUMO

BACKGROUND AND AIM: Thoracic involvement of Immunoglobulin G4-related disease (IgG4-RD) is relatively rare and may be disregarded at the time of initial diagnosis due to its asymptomatic nature. This study aimed to ascertain the prevalence and patterns of thoracic involvement in a retrospective cohort of Turkish patients with IgG4-RD. METHODS: A total of 90 patients (47 males and 43 females, with a mean age of 57.7±15.5 years) diagnosed with IgG4-RD were reviewed retrospectively. All computed tomography (CT) scans were re-evaluated by two thoracic radiologists and IgG4-related thoracic disease was assessed on four compartments: The mediastinum, pulmonary parenchyma, airways, and pleura. IgG4-related thoracic disease was categorized as: definite, highly probable, probable or possible. RESULTS: There were 64 patients who had undergone at least one thorax CT examination, and 18 (28%) were diagnosed with IgG4-related thoracic disease. The rate of IgG4-related thoracic disease increased by 20% and reached a ratio of 48.4% (n=31) after a thorough reevaluation of registry data specifically to thoracic findings. The mediastinum was the most frequently involved compartment, affecting 16 (51.6%) patients, followed by pulmonary parenchyma in 14 (45.2%) patients, and airways and pleura in 10 (32.3%) patients each. Other organ involvements were more prevalent and IgG4 levels were higher in patients with thoracic involvement. Eosinophils were significantly elevated in patients with thoracic involvement (p=0.023). CONCLUSIONS: IgG4-related thoracic disease is heterogeneous and likely to be more prevalent than currently recognized. The mediastinum is the most frequently involved compartment. It is important to assess IgG4-related thoracic disease at the time of initial diagnosis. Elevated levels of serum IgG4 and eosinophils, as well as a greater number of organ involvements may serve as indicators of thoracic involvement.

13.
Arch Environ Occup Health ; 78(6): 369-378, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37800384

RESUMO

Asbestos is a mineral with unique physical and chemical properties that make it highly resistant to heat, fire, and corrosion. Nevertheless, exposure to asbestos fibers has been linked to serious health problems, including lung cancer, mesothelioma, and asbestosis. Despite the ban on asbestos usage, asbestos-related diseases are still a major cause of morbidity and mortality worldwide. Analyzing the mineralogical features and fiber analysis of asbestos in biological materials is critical for scenarios where an asbestos exposure history cannot be obtained, a clinical diagnosis cannot be made, or legal aspects necessitate further investigation. This review outlines the mineralogical features and fiber analysis techniques of asbestos in biological materials.


Assuntos
Amianto , Asbestose , Neoplasias Pulmonares , Mesotelioma Maligno , Mesotelioma , Humanos , Mesotelioma/induzido quimicamente , Asbestose/etiologia , Neoplasias Pulmonares/induzido quimicamente , Mesotelioma Maligno/complicações
14.
Tuberk Toraks ; 60(1): 62-5, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22554370

RESUMO

A 50-year-old man presented with a 1-month history of dyspnea, weight loss, and pleuritic chest pain. He had environmental asbest exposure from birth to 12 years-old. Past medical history revealed maximal thymectomy operation and adjuvant radiotherapy with the diagnosis of minimally invasive lymphocytic thymoma 11 years ago. Thorax computerized tomography demonstrated a circumferential pleural thickening encasing the entire left lung and pleural effusion. VATS-pleural biopsy revealed the diagnosis invasive tymoma, Type B1, stage IVA. In conclusion, the diagnosis of invasive thymoma must be kept in mind in the differential diagnosis of diffuse pleural lesions. The recurrence of thymomas may be as long as 10 years after complete resection.


Assuntos
Recidiva Local de Neoplasia , Timoma/diagnóstico , Neoplasias do Timo/diagnóstico , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Derrame Pleural Maligno/diagnóstico , Derrame Pleural Maligno/epidemiologia , Timoma/epidemiologia , Neoplasias do Timo/epidemiologia
15.
Eur J Case Rep Intern Med ; 9(8): 003515, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36093305

RESUMO

Behçet's disease (BD) is multisystemic vasculitis with heterogeneous clinical manifestations. We describe the case of a 26-year-old man who presented with Budd-Chiari syndrome (BCS) related to BD. The patient received infliximab (IFX) due to the severity of vascular involvement. Subsequently, after IFX therapy, hospital-acquired pneumonia, trapped lung, and fungal infection of the lung and central nervous system developed as complications. The patient benefited from a second course of IFX and clinical remission was achieved following early identification and treatment of complications. Data on the presentation and prognosis of BCS related to BD are extremely limited. Our case report supports the growing evidence that anti-TNF antibody is a promising treatment for BD-related BCS. LEARNING POINTS: Behçet's disease-related Budd-Chiari syndrome is a rare form of vascular involvement that severely affects mortality.Behçet's disease-related Budd-Chiari syndrome is frequently confused with idiopathic thrombosis and may be underdiagnosed.Infliximab could be a therapeutic option for refractory Behçet's disease with major vascular involvement, but the increased risk of opportunistic infections should be kept in mind.

17.
Anatol J Cardiol ; 25(8): 544-554, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34369882

RESUMO

OBJECTIVE: In this study, we aimed to evaluate the accuracy of the original and simplified pulmonary embolism (PE) severity index (PESI) to predict all-cause mortality after 30 days of acute PE diagnosis up to five years within consecutive sub-periods. METHODS: Adult patients diagnosed with acute PE between January 1, 2003, and June 30, 2013, were retrospectively included. Data on baseline characteristics and mortality during a five-year follow-up were collected. RESULTS: The study included 414 patients (Male/Female=192/222). The median age at diagnosis was 61.5 (minimum-maximum, 18-93) years. Mortality rates were 13.3% at 30 days, 21.8% at 90 days, 32.6% at one year, and 51.0% at five years. Both stratification into risk classes according to the original PESI and low vs. high-risk classification of original and simplified PESI were significantly correlated with the 30-day, 31-90-day, 91-day-one-year, and one-five-year mortality. Significant PESI predictors for mortality were history of cancer [hazard ratio (HR): 3.31, 95% confidence interval (CI): 1.64-6.68; p=0.001] and heart failure (HR: 2.35, 95% CI: 1.04-5.32, p=0.041) at 31-90-day, history of cancer (HR: 5.45, 95% CI: 2.86-10.40, p<0.001) at 91-day-one-year, advancing age (HR: 1.04, 95% CI: 1.02-1.06, p<0.001) and history of cancer (HR: 5.53, 95% CI: 3.41-8.98, p<0.001) at one-five-year after acute PE diagnosis. CONCLUSION: All-cause long-term mortality in high-risk patients with acute PE according to original or simplified PESI significantly increased up to five years of follow-up. This survival disadvantage was mainly related to cancer and comorbidities rather than acute clinical manifestations. Future prospective studies are needed to demonstrate the effect of various comorbidities on long-term mortality in these patients.


Assuntos
Embolia Pulmonar , Doença Aguda , Adulto , Feminino , Humanos , Masculino , Prognóstico , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença
18.
Platelets ; 21(1): 49-52, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-19954409

RESUMO

Thrombopoiesis is regulated by a variety of cytokines. Intracellular adhesion molecules are inducible cell-surface glycoproteins that belong to the immunoglobulin superfamily. Cytokines, endothelium and adhesive molecules represent the point of crosstalk in normal and pathological hematopoiesis. With the hypothesis that circulating intracellular adhesion molecule-1 (ICAM-1) and lymhocyte adhesion molecule-1 (L-selectin) concentrations could be changed based on pathological thrombopoiesis resulting in quantitative platelet disorders, we evaluated ICAM-1 and L-selectin levels in patients with thrombocytosis, thrombocytopenia and healthy controls. The L-selectin levels were found to be significantly higher in the thrombocytopenia group compared to the control group. ICAM-1 levels were found to be significantly higher in both thrombocytopenia and thrombocytosis groups compared to control group. Our study corroborates our original hypothesis implying the roles of adhesion molecules in the challenging status of pathological thrombopoiesis.


Assuntos
Molécula 1 de Adesão Intercelular/metabolismo , Selectina L/metabolismo , Trombocitopenia/metabolismo , Trombocitose/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Citocinas/metabolismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transdução de Sinais/fisiologia , Adulto Jovem
19.
Arch Environ Occup Health ; 75(1): 56-59, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30614391

RESUMO

Interstitial pulmonary fibrosis is rare clinical entity related to welding usually associated with long term and heavy exposure to welding fumes. A 56-year-old asymptomatic male patient was referred to our clinic due to abnormal chest X-ray findings that was requested for regular controls. He has been working as a welder both indoor and outdoor settings for the last 25 years. The radiological findings were compatible with usual interstitial pneumonia on computed tomography of thorax. Pulmonary function tests, exercise capacity and laboratory results were within normal limits. Collagen tissue markers were negative. In order to confirm the relation of welding with pulmonary fibrosis, bronchoalveolar lavage was performed and stained with Prussian blue. The demonstration of hemosiderin-laden macrophages (25%) confirmed this association and allowed differential diagnosis. Besides it helped the patient decide to leave his job.


Assuntos
Lavagem Broncoalveolar , Doenças Profissionais/diagnóstico , Siderose/diagnóstico , Soldagem , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/diagnóstico por imagem , Fibrose Pulmonar/etiologia , Siderose/diagnóstico por imagem , Turquia
20.
South Med J ; 102(7): 741-3, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19488012

RESUMO

A 53-year-old diabetic woman with the diagnosis of myelodysplastic syndrome was admitted to our hospital with symptoms of anorexia, malaise, fatigue, night sweats, and weight loss. The radiological evaluation revealed waxing and waning pulmonary nodules. A diagnosis of pulmonary tuberculosis was reached by pathologic examination of a wedge biopsy. We did not find a similar case in the literature. Clinicians should keep tuberculosis in mind as a possible etiology of waxing and waning pulmonary nodules.


Assuntos
Síndromes Mielodisplásicas/complicações , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/diagnóstico , Complicações do Diabetes , Feminino , Humanos , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Tuberculose Pulmonar/patologia
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