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Eurasian Journal of Pulmonology
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This is an Open Access Journal

Open Access journal
ISSN (Online) 2148-5402
Published by Medknow Publishers

[427 journals]

Chest drain size: Does it matter?
- Authors: David J McCracken, Ioannis Psallidas, Najib M Rahman
  Pages: 1 - 6
  Abstract: David J McCracken, Ioannis Psallidas, Najib M Rahman
  Eurasian Journal of Pulmonology 2018 20(1):1-6
  Pleural disease is common with an increasing incidence and so represents a significant proportion of the workload for respiratory physicians. Chest drain insertion continues to be considered a mainstay of pleural disease management however the optimum drain size required for various pleural conditions remains unclear. Traditionally large-bore chest drains were inserted through a surgical technique of blunt dissection however smaller bore Seldinger (guidewire) drains have dramatically increased in popularity in recent times most likely due to ease of insertion and perceived increased patient tolerability. Despite British Thoracic Society Guidelines advocating a preference for small-bore chest drains, their use remains controversial. We aim to review the literature in each category of pleural disease including pneumothorax, malignant pleural effusion and pleural infection, regarding chest drain size, comparing the role, effectiveness and complications of each.
  Citation: Eurasian Journal of Pulmonology 2018 20(1):1-6
  PubDate: Fri,4 May 2018
  DOI: 10.4103/ejop.ejop_2_18
  Issue No: Vol. 20, No. 1 (2018)
Prediction of postoperative pulmonary complications in lung cancer
surgery: Is proportion of emphysema important?
- Authors: Tevfik Ilker Akcam, Seyda Ors Kaya, Onur Akcay, Ozgur Samancilar, Serpil Sevinc, Seher Susam, Kenan Can Ceylan
  Pages: 7 - 11
  Abstract: Tevfik Ilker Akcam, Seyda Ors Kaya, Onur Akcay, Ozgur Samancilar, Serpil Sevinc, Seher Susam, Kenan Can Ceylan
  Eurasian Journal of Pulmonology 2018 20(1):7-11
  OBJECTIVE: Preoperative evaluation in thoracic surgery is highly important to determine surgical suitability, estimate postoperative pulmonary complications, and for patient follow-up. However, there is neither a definite explanation about the possible complications nor a gold standard method.MATERIALS AND METHODS: In this study, 297 patients undergoing anatomic lung resection for primary lung carcinoma were retrospectively evaluated. To form a homogeneous group, all factors that increase the rate of pulmonary complication were excluded except emphysema. Patients who did not meet these criteria were removed from the study. The study continued with 104 other patients. This patient subgroup was divided into groups according to Goddard Classification– Score (GdCS). The correlation between GdCS and other variables was statistically investigated.RESULTS: According to the GdCS of 104 patients, the patient distribution was as follows: 10 patients (9.6%) were G0, 28 patients (26.9%) were G1, 42 patients (40.4%) were G2, 22 patients (21.2%) were G3, and 2 patients (1.9%) were G4. Thirty-five (33.6%) of 104 patients had a pulmonary complication during the postoperative follow-up. The average drainage time was longer for higher GdCS scores, and the rate of exposition to a pulmonary complication was higher in the patients with increased GdCS.CONCLUSION: In view of these findings, Goddard's scoring for chronic obstructive pulmonary disease-emphysema patients was considered likely to be an indicative parameter in the preoperative evaluation and postoperative follow-up of thoracic surgery patients.
  Citation: Eurasian Journal of Pulmonology 2018 20(1):7-11
  PubDate: Fri,4 May 2018
  DOI: 10.4103/ejop.ejop_8_18
  Issue No: Vol. 20, No. 1 (2018)
Does anthracosis reported in endobronchial ultrasound-guided
transbronchial needle aspiration exclude metastasis?
- Authors: Serhat Erol, Ceyda Anar, Onur Fevzi Erer, Zekiye Aydogdu, Serir Aktogu
  Pages: 12 - 16
  Abstract: Serhat Erol, Ceyda Anar, Onur Fevzi Erer, Zekiye Aydogdu, Serir Aktogu
  Eurasian Journal of Pulmonology 2018 20(1):12-16
  OBJECTIVES: In some studies, it has been hypothesized that anthracotic pigmentation in mediastinal lymph nodes is a sign of benign conditions and excludes metastasis from thoracic and extrathoracic malignancies. The aim of this study was to evaluate the clinical significance of mediastinal lymph node anthracosis in cancer patients who underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).MATERIALS AND METHODS: In this study, medical data of patients with lung cancer or extrathoracic cancer who underwent EBUS-TBNA for investigation of mediastinal lymph node metastasis were evaluated retrospectively. EBUS-TBNA cytology reported as anthracotic pigmentation was included in this study. Patients were excluded from the study if cytology of aspirated lymph nodes reported as “benign,” “malignancy,” or “granulomatous inflammation.”RESULTS: There were 50 eligible patients. Thirty-one (62%) patients underwent EBUS-TBNA for lung cancer staging and 19 (38%) for evaluation of extrathoracic metastasis. A total of 120 lymph nodes were sampled. The most sampled station was subcarinal. EBUS-TBNA was false negative in eight of 31 (25.8%) lung cancer patients and one of 19 (5.2%) extrathoracic malignancy patients.CONCLUSIONS: Anthracotic pigmentation of lymph nodes in EBUS-TBNA cannot exclude metastasis in lung cancer patients and mediastinoscopy should be performed before surgery in this group. In patients with extrathoracic malignancy, anthracotic pigmentation is associated with benign conditions. However, further investigation with larger cohort is needed.
  Citation: Eurasian Journal of Pulmonology 2018 20(1):12-16
  PubDate: Fri,4 May 2018
  DOI: 10.4103/ejop.ejop_5_18
  Issue No: Vol. 20, No. 1 (2018)
Can the da Vinci robotic system be alternative to open surgery for
schwannoma in posterior mediastinum?
- Authors: Erkan Kaba, Tugba Cosgun, Kemal Ayalp, Alper Toker
  Pages: 17 - 21
  Abstract: Erkan Kaba, Tugba Cosgun, Kemal Ayalp, Alper Toker
  Eurasian Journal of Pulmonology 2018 20(1):17-21
  OBJECTIVE: In the present study, the outcomes and technical details of patients who underwent surgical resection for benign schwannoma with the da Vinci robotic system are presented.MATERIALS AND METHODS: In the scope of our robotic surgery program, 26 (8.7%) patients out of 296 patients were operated using the da Vinci robotic system. Five patients (19.2%) who underwent surgery of benign schwannoma were included in the study. Prospectively, collected data of these patients were retrospectively evaluated. Age, gender, robot docking and console times, length of hospital stay, anatomic localizations of the lesions, pathology results, blood infusion needs, and mortality and morbidity rates of the patients were recorded.RESULTS: All patients were male, and the mean age was 43.2 ± 12.1 years. The mean length of hospital stay was 3 ± 0.9 days. The mean console time was 27.6 ± 18.8 min, and the mean docking time was 12 ± 4 min. None of the patients received blood transfusion. Utility incision was made in only one patient. Postoperative ptosis was detected in two patients with tumors where located in the apical region, and no mortality occurred.CONCLUSION: Due to the advantages of robotic surgery to the surgeon, patients with schwannoma in extreme locations that would pose challenges in dissection could be operated with da Vinci system.
  Citation: Eurasian Journal of Pulmonology 2018 20(1):17-21
  PubDate: Fri,4 May 2018
  DOI: 10.4103/ejop.ejop_7_18
  Issue No: Vol. 20, No. 1 (2018)
Can neutrophil/lymphocyte ratio and platelet/lymphocyte ratio be used in
differential diagnosis of Stage I sarcoidosis from tuberculosis
lymphadenopathy?
- Authors: Cengiz Ozdemir, Sinem Nedime Sökücü, Seda Tural Önür
  Pages: 22 - 26
  Abstract: Cengiz Ozdemir, Sinem Nedime Sökücü, Seda Tural Önür
  Eurasian Journal of Pulmonology 2018 20(1):22-26
  OBJECTIVE: It is challenging to differentiate mediastinal lymph node enlargement caused by tuberculosis (TB) and sarcoidosis as both diseases may cause granulomatous inflammation. The objective of this study is to evaluate the use of neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) as possible markers in the differential diagnosis of Stage I sarcoidosis and TB lymphadenopathy in patients who present with mediastinal lymph nodes and no parenchymal involvement. MATERIALS AND METHODS: A total of 19 TB, 55 sarcoidosis, and 32 control patients, whose clinical records were available, were included in this retrospective study. All patients had a granulomatous reaction revealed on their lymph node biopsy specimen. The complete blood count at the time of diagnosis was included in the study. RESULTS: NLR and PLR were both significantly increased in Stage 1 sarcoidosis patients compared to controls while only PLR was significantly increased in the TB group (for sarcoidosis, NLR P < 0.001 and PLR P < 0.001; for TB, NLR P = 0.12; PLR P = 0.017). There were neither significant differences in serum NLR nor PLR between sarcoidosis and TB groups. CONCLUSION: Although NLR and PLR are useful tools to differentiate Stage 1 sarcoidosis from controls and PLR may be used to differentiate TB lymphadenopathy from controls, these parameters may not be used to differentiate between Stage 1 sarcoidosis and TB lymphadenopathy.
  Citation: Eurasian Journal of Pulmonology 2018 20(1):22-26
  PubDate: Fri,4 May 2018
  DOI: 10.4103/ejop.ejop_1_18
  Issue No: Vol. 20, No. 1 (2018)
The effect of cognitive functions on the ability to learn how to use a
Diskus device in patients with chronic obstructive pulmonary disease
- Authors: Baykal Tulek, Nart Bedin Atalay, Ercan Kurtipek, Gülfem Yildirim, Fikret Kanat, Mecit Süerdem
  Pages: 27 - 32
  Abstract: Baykal Tulek, Nart Bedin Atalay, Ercan Kurtipek, Gülfem Yildirim, Fikret Kanat, Mecit Süerdem
  Eurasian Journal of Pulmonology 2018 20(1):27-32
  OBJECTIVE: Dry powder inhalers are a group of inhaled medications commonly used for the treatment of chronic obstructive pulmonary disease (COPD). Although they can be more easily administered than metered dose inhalers, there is a high rate of errors in device use. The present study aims to evaluate the relationship between the ability to learn how to use a Diskus device and cognitive functions in patients with COPD.MATERIALS AND METHODS: The study included 30 inhaler-näive patients who were newly diagnosed with COPD. During their first visit, patients were administered a broad array of standardized neuropsychological tests and given a training on inhaler use. During the second visit, patients were divided into two groups according to their performance in the use of Diskus device: effective and ineffective.RESULTS: Twenty-nine patients who completed the study showed a negative correlation between the cognitive test scores and Diskus training parameters. The number of errors and duration of training increased as the cognitive scores decreased. In Visit 2, a comparison between patients with ineffective and effective use of the Diskus device showed that cognitive function scores were higher in those with effective use.CONCLUSIONS: Evaluation of cognitive functions in COPD patients is important in establishing an effective inhalation treatment.
  Citation: Eurasian Journal of Pulmonology 2018 20(1):27-32
  PubDate: Fri,4 May 2018
  DOI: 10.4103/ejop.ejop_6_18
  Issue No: Vol. 20, No. 1 (2018)
Relationship between hematological examination, glucose, HbA1clevel, and
disease stages in patients with obstructive sleep apnea syndrome
- Authors: Erhan Ugurlu, Ilknur Can, Mehmet Sercan Ertürk, Ismail Hakki Akbudak, Nese Dursunoglu, Sibel Ozkurt
  Pages: 33 - 36
  Abstract: Erhan Ugurlu, Ilknur Can, Mehmet Sercan Ertürk, Ismail Hakki Akbudak, Nese Dursunoglu, Sibel Ozkurt
  Eurasian Journal of Pulmonology 2018 20(1):33-36
  OBJECTIVE: Obstructive sleep apnea syndrome (OSAS) is an episodic disease that is characterized by intermittent partial interruption of breathing during sleep, which results in low oxygen levels in organs and tissues. The characteristic symptoms of OSAS include snoring, apnea or hypopnea, and excessive daytime sleepiness. Our aim is to determine the early diagnosis of diabetes and to initiate treatments for OSAS patients according to the results of polysomnography (PSG) in the sleep polyclinic based on fasting blood glucose and HbA1c levels in patients with known OSAS without diabetes.MATERIALS AND METHODS: Patients who applied to the sleep polyclinic of the Pamukkale University and were diagnosed with OSAS using PSG were included in the study.RESULTS: A total of 44 patients with OSAS and a control group consisting of 47 people meeting these criteria were included. Compared with the control group, the patient groups showed significantly higher Hb values (P < 0.05) and lower mean corpuscular volume (P < 0.05). Significant negative correlations were found between glucose levels and mean O2saturation values in patients with severe OSAS (apnea–hypopnea index > 30) (r = −0.583, P = 0.02).CONCLUSION: In conclusion, even though significant differences were not found in the glucose and HbA1c levels of patients with OSAS, glucose metabolism was deteriorated when saturation was decreased in severe OSAS. Therefore, glucose levels should be observed frequently, particularly in severe cases of OSAS or in patients with hypoxia, regardless of the stage. More attention should also be paid to the development of diabetes.
  Citation: Eurasian Journal of Pulmonology 2018 20(1):33-36
  PubDate: Fri,4 May 2018
  DOI: 10.4103/ejop.ejop_11_18
  Issue No: Vol. 20, No. 1 (2018)
Features of endobronchial metastases from extrathoracic malignancy and
positron emission tomography-computerized tomography findings
- Authors: Coskun Dogan, Seda Beyhan Sağmen, Elif Torun Parmaksız, Ali Fidan, Nesrin Kıral, Banu Salepçi, Sevda Şener Cömert
  Pages: 37 - 42
  Abstract: Coskun Dogan, Seda Beyhan Sağmen, Elif Torun Parmaksız, Ali Fidan, Nesrin Kıral, Banu Salepçi, Sevda Şener Cömert
  Eurasian Journal of Pulmonology 2018 20(1):37-42
  OBJECTIVE: We aimed to investigate radiological and bronchoscopic aspects of endobronchial metastases (EBMs) from extrapulmonary cancers and the correlation of EBM with findings of integrated positron emission tomography-computed tomography (PET-CT) findings.MATERIALS AND METHODS: Patients who underwent bronchoscopic evaluation between January 2013 and December were analyzed retrospectively. Patients with endobronchial lesions in the airways and histopathologically diagnosed with extrapulmonary cancer metastasis were included in the study.RESULTS: A total of 16 patients with EBM who underwent bronchoscopic biopsies were evaluated. The patients consisted of 10 (62.5%) females and 6 (37.5%) males and the mean age was 61.8 ± 9.1. The common primary cancer related to EBM was breast 9 (%56.4). The mean interval from diagnosis of primary cancer to EBM was 55.1 ± 48.5 (1–180) months. A total of 13 (81.2%) cases were assessed with the PET-CT report. The mean SUVmaxvalue of the lung lesions was calculated as 9.8 ± 4.3. According to PET-CT, 92.4% of the cases had extrapulmonary metastasis. The mean survival duration from diagnosis of EBM was 8.5 ± 6.7 (1–21) months in 9 deceased patients.CONCLUSION: The most frequent extrapulmonary primary tumors with endobronchial metastasis were breast and the mean survival time was usually short. It was reported that most cases were multimetastatic. It was concluded that PET-CT can play a role in identifying the EBM and other organ metastasis and was important tool in planning the treatment.
  Citation: Eurasian Journal of Pulmonology 2018 20(1):37-42
  PubDate: Fri,4 May 2018
  DOI: 10.4103/ejop.ejop_10_18
  Issue No: Vol. 20, No. 1 (2018)
Meandering pulmonary vein: Very rare incidental finding
- Authors: Murat Serhat Aygun, Mustafa Çalık, Saniye Goknil Çalık
  Pages: 43 - 45
  Abstract: Murat Serhat Aygun, Mustafa Çalık, Saniye Goknil Çalık
  Eurasian Journal of Pulmonology 2018 20(1):43-45
  Meandering pulmonary vein (MPV) is a rarely seen pulmonary vascular anomaly and confused with the scimitar syndrome which is more commonly seen. In this paper, we presented a case of left MPV which mimes arteriovenous malformation. A 30-year-old man was referred to our clinic for pulmonary nodule detected in routine evaluation before employment examination. Diagnosis of MPV was made by Pulmonary CT angiography. It showed abnormal drainage of upper lob pulmonary vein to the inferior pulmonary vein and form abnormal common pulmonary vein which shouldn't be exist. Because of any symptoms no further examination was recommended. According to our best knowledge to date only 17 cases reported in the literature. MPV diagnosis has been significantly changed by the means of advances in CT technology. Non-invasive diagnosis is possible with modern multisectional CT that clearly shows the anatomy of veins and enables the detailed MPV examination. Hereby, unnecessary radiological examination or surgery can be prevented.f veins and enables the detailed MPV examination.
  Citation: Eurasian Journal of Pulmonology 2018 20(1):43-45
  PubDate: Fri,4 May 2018
  DOI: 10.4103/ejop.ejop_4_18
  Issue No: Vol. 20, No. 1 (2018)
Waterpipe (narghile, hookah) tobacco smoking-induced acute eosinophilic
pneumonia
- Authors: Ali Nihat Annakkaya, Ege Güleç Balbay, Özlem Öztürk, Binnur Önal, Fuat Aytekin, Öner Balbay
  Pages: 46 - 49
  Abstract: Ali Nihat Annakkaya, Ege Güleç Balbay, Özlem Öztürk, Binnur Önal, Fuat Aytekin, Öner Balbay
  Eurasian Journal of Pulmonology 2018 20(1):46-49
  Acute eosinophilic pneumonia (AEP) is characterized by a febrile illness, diffuse pulmonary infiltrates, hypoxemic respiratory failure, and pulmonary eosinophilia. A temporal relationship has been described in a number of patients between the development of AEP and the recent onset of cigarette smoking. A 22-year-old male patient with no known chronic disease was admitted to the emergency service for 3 days with the complaints of cough, fever, dyspnea, and pleuritic chest pain. He was formerly a nonsmoker but was a waterpipe (narghile, hookah) tobacco smoker as a new habit once a night for the last 2 months. The erythrocyte sedimentation rate and C-reactive protein are elevated. Arterial blood gases revealed moderate hypoxemia. Computed tomography scans included bilateral, random, and patchy ground-glass opacities and also small bilateral pleural effusions. Echocardiograhic examination was normal. We had accepted the patient as an acute eosinophilic pneumonia due to rapid response to corticosteroid treatment, no microorganism in bronchoalveolar lavage (BAL) culture, and predominant eosinophilia was observed (70%–80%) in BAL.
  Citation: Eurasian Journal of Pulmonology 2018 20(1):46-49
  PubDate: Fri,4 May 2018
  DOI: 10.4103/ejop.ejop_3_18
  Issue No: Vol. 20, No. 1 (2018)
Fatal aspiration of iodine oral contrast
- Authors: Zeljko Vucicevic, Vesna Vucelic
  Pages: 50 - 52
  Abstract: Zeljko Vucicevic, Vesna Vucelic
  Eurasian Journal of Pulmonology 2018 20(1):50-52
  We report on a case of massive iodine oral contrast aspiration with consequential cardiorespiratory arrest. The patient was successfully resuscitated and treated with mechanical ventilatory support and an urgent bronchoscopy toilet with only modest success. Instead of esophagography, the X-ray image showed an almost classical “bronchography.” A few hours later, the chest X-ray was indicative of acute noncardiogenic pulmonary edema. Respiratory status additionally deteriorated due to bilateral pleural effusions, severe exacerbation of chronic obstructive pulmonary disease, and heart failure, and the patient died of multiorgan failure 8 days after admission to the Intensive Care Unit. The incidence of fatal complications of oral iodine contrast aspiration is very rare but can be even lower if fully cooperative, and well-instructed patients are selected. Special attention should be paid to those with any kind of swallowing difficulties.
  Citation: Eurasian Journal of Pulmonology 2018 20(1):50-52
  PubDate: Fri,4 May 2018
  DOI: 10.4103/ejop.ejop_9_18
  Issue No: Vol. 20, No. 1 (2018)