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Query: UMLS:C0242379 (lung cancer)
71,905 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

It is generally considered that tuberculosis (TB) is a disease which upregulates Th1 cell function. There is a hypothesis that infection of Mycobacterium tuberculosis may prevent allergic disorders such as bronchial asthma. However, our clinical experience of patients with TB somewhat conflicts this hypothesis. Hence, we investigated Th1/Th2 balance in the peripheral blood of patients with active TB by measuring serum levels of IgE antibody and by intracellular cytokine assay. We found that serum levels of IgE in the patients with active TB were significantly higher than in those with lung cancer or with COPD. In the TB patients, titers of IgE tended to correlate with disease severity. Intracellular cytokine assay demonstrated that IFN-gamma-positive cells were significantly decreased in the patients with active TB compared to normal controls. The ratio of IFN-gamma-positive (Th1-like)/IL-4-positive (Th2-like) cells was remarkably reduced in the TB patients (p < 0.0001). This ratio showed a significant negative correlation with erythrocyte sedimentation rate and with C-reactive protein. Therapy against TB for 2-3 months did not result in significant changes of the Th1/Th2 ratio. These findings suggest that infection of M. tuberculosis does not systematically upregulate Th1 cells in some patients, and is unlikely to prevent allergic disorders like asthma.
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PMID:Can Mycobacterium tuberculosis infection prevent asthma and other allergic disorders? 1130 44

Acute exacerbation of chronic bronchitis (AECB) is a very common condition, which presents with deteriorating sputum production and dyspnoea in a patient with pre-existing COPD or chronic bronchitis. As these symptoms are relatively non-specific and also the presenting feature of a wide range of other conditions, the physician should carefully consider the differential diagnosis before deciding on whether or not a patient indeed has AECB. The differential diagnosis can be summarised as pneumonia, pneumothorax, cardiac failure/cor pulmonale, bronchiectasis, asthma, tuberculosis, sinusitis and other forms of upper respiratory tract sepsis, diffuse panbronchiolitis, lung cancer, gastro-oesophageal reflux, the presence of a foreign body in the airway, melioidosis, and lung abscess. This article aims to discuss these conditions, with brief presentation of clinical cases, in the evaluation of differential diagnosis of AECB.
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PMID:Solutions for difficult diagnostic cases of acute exacerbations of chronic bronchitis. 1158 3

There is a resurgence of interest in lung cancer screening, motivated by the fact that many lung cancer patients cannot be cured due to advanced disease at presentation. Lung cancer screening may detect more early stage disease. Very early stage squamous cell type lung cancer in the central tracheobronchial tree can be detected and local bronchoscopic treatments such as photodynamic therapy can be applied if the tumor is strictly intraluminal and nodal disease is absent. So, accurate staging regarding tumor size and nodal disease is much more important than treatment per se. Bronchoscopic treatments are less morbid treatment alternatives than surgery and surgical bronchoplasty, especially for patients suffering from COPD and who have poor cardiovascular status due to their smoking history.
Lung Cancer 2001 Dec
PMID:The role of photodynamic therapy in the management of stage I/II NSCLC. 1174 Sep 91

According to the WHO reports from 1997, Bosnia and Herzegovina takes a disgraceful first place in smoking prevalence in Europe. 53% of smokers over 15, then 22% of women, 67% of men are percentages that are not achieved by countries at a much lower development level than B&H. The mortality rate of men (aged 35-64) as a result of tobacco varies from 11% to 45% from country to country. In 11 European countries it is > or = 40% and they are all in the eastern part of the region: Belarus, the Czech Republic, Hungary, Kazakhstan, Lithuania, Poland, Russia, Slovenia, Ukraine, B&H. Tobacco addiction, like other drug addictions, is basically a neurobiological mediated brain disease. In the same way, the discontinuation of drug taking, in this case nicotine, is a very important addiction component and one of its clearest manifestations. So, the symptoms of iving up smoking are in fact the symptoms mediated by noradrenalien (excitement, tension, long-lasting desire, distraction, insomnia, increase in appetite, putting on weight, etc). According to the Diagnostic and Statistical Manual for Mental Disorders-4th Edition (DSM-IV), both toxicomanic nicotine addiction and the discontinuation of smoking are classified as diseases. The smokers who give up smoking before they are 50 decrease their mortality risk by 50% over the next 15 years compared to those who continue smoking. This risk decrease is related to the incidence decrease and mortality rate from specific, smoking-related diseases, including: coronary heart disease, strokes, peripheral vascular diseases, COPD and lung cancer. The assistance to addict to give up of smoking is duty of professionals.
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PMID:[Nicotine addiction]. 1176 34

To assess proliferating activity, DNA ploidy changes of lung cancer cells before and after chemotherapy, we performed a flow cytometry analysis (FC) using fresh bronchoscopy specimens from 38 patients with lung cancer. Among 33 males and 5 females, squamous cell carcinoma (NSLC) was recognized in 12 males, 15 males had small cell lung cancer (SCLC) and 6 males had lung cancer with no histological type (LC) defined. Three women had SCLC, 1 had NSCLC and one had LC. Control consisted of 11 COPD patients. The percentage of diploid cells was significantly lower and cells with hypoploid cells were significantly higher in study group before treatment. High percentage of G2M cells characterised NSCLC and LC groups, whether high number of S phase cells characterised NSCLC and SCLC group before treatment. The treatment lowered percentage of G2M cells in NSCLC and CA group, whether diploid, hypoploid and S phase cells did not differ than those from before treatment.
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PMID:Proliferating activity, DNA ploidy changes of lung cancer cells before and after chemotherapy. 1182 May 86

John Hutchinson, a surgeon, recognized that the volume of air that can be exhaled from fully inflated lungs is a powerful indicator of longevity. He invented the spirometer to measure what he called the vital capacity, ie, the capacity to live. Much later, the concept of the timed vital capacity, which became known as the FEV(1), was added. Together, these two numbers, vital capacity and FEV(1), are useful in identifying patients at risk of many diseases, including COPD, lung cancer, heart attack, stroke, and all-cause mortality. This article cites some of the rich history of the development of spirometry, and explores some of the barriers to the widespread application of simple spirometry in the offices of primary care physicians.
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PMID:John Hutchinson's mysterious machine revisited. 1201 Aug 55

The sputum smear-negative patients have been a diagnostic challenge for health professionals. Adenosine deaminase (ADA) activity has been shown to rise in various body fluids of patients with tuberculosis (Tb). A prospective clinical trial was conducted to determine the diagnostic value of ADA activity in bronchoalveolar lavage (BAL) in sputum smear-negative subjects highly suggestive for pulmonary Tb. Nineteen (M/F: 15/4, mean age 46.8 +/- 16.5 years) sputum smear-negative patients highly suggestive for pulmonary Tb constituted Group I. Acid fast bacilli (AFB) grew on sputum and/or BAL culture of all subjects in this group. Twenty-nine patients (M/F: 19/10, mean age 55.7 +/- 8.0 years) with non-tuberculous pulmonary diseases constituted Group II. Ten of them had interstitial lung disease, nine lung cancer, five pneumonia and five COPD. Twelve subjects (M/F: 7/5, mean age 48.4 +/- 12.8 years) constituted the controls (Group III) undergoing fiberoptic bronchoscopy (FOB) for various indications and the lungs were found to be normal eventually. Albumin and ADA activity levels were measured in plasma and BAL in all the subjects. LocalADA was calculated. PlasmaADA and BALADA of Group I was significantly higher (P < 0.001) than that of the other groups. LocalADA was also the highest in Group I when compared with the others (P < 0.001) but that of Group II was also higher (P < 0.01) when compared with controls. With a cut-off value derived from the control subjects, sensitivity of BALADA was 100% and specificity 85.3%. Sputum PCR results are available in a couple of days whereas that of BALADA are available in a couple of hours and BALADA costs cheaper than PCR in our country. Therefore, we conclude that BALADA may be a useful, cheaper and faster diagnostic test in sputum smear-negative patients highly suggestive for pulmonary Tb. LocalADA need not be calculated as it is also significantly higher in Group II subjects and thus not as reliable as BALADA.
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PMID:Adenosine deaminase activity in bronchoalveolar lavage in Turkish patients with smear negative pulmonary tuberculosis. 1219 40

Satisfactory palliation of the lesions involving the carinal region is difficult to achieve because the stenting is conducted in an unsuitable anatomy, in highly symptomatic patients. During the period 1987-2000 we performed 785 operative rigid bronchoscopies in 524 patients, 184 of whom received a respiratory stent. The stenting of the carinal region was carried out in 27 patients with the use of the Frietag Dynamic stent. In this group of patients indication for stenting was as follows:--advanced lung cancer (22);--esophageal cancer invading the lower trachea (1);--severe tracheobronchomalacia (2);--postintubation stenosis of the lower trachea (2). No perioperative mortality was observed. All patients experienced symptomatic improvement. Follow-up ranged from 1 to 60 months: all neoplastic patients died for advanced disease without significant respiratory problems with a median survival of 5.6 months; three patients treated for benign diseases are still alive at 2, 31 and 65 months from stent deployment. No major complications were observed: in two patients the stent was removed after few days due to mucous retention; furthermore we observed symptomatic respiratory infections caused by a residual space between the tracheal wall and the prosthesis in other two patients with severe COPD. Dynamic stent is to be considered the stent of choice for palliation of the carinal region because it is effective and well tolerated with a low complications rate. The main limitations of such prosthesis are the shortness of the right bronchial branch and the size, sometimes inadequate.
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PMID:[Use of the Dynamic Stent in the palliation of carinal and distal tracheal stenosis]. 1219 95

Lung cancer is associated with smoking and age, both of which are associated with comorbidity. We evaluated the impact of comorbidity on lung cancer survival. Data on 56 comorbidities were abstracted from the records of a cohort of 1,155 patients. Survival effects were evaluated with Cox regression (outcome crude death). The adjusted R(2) statistic was used to compare the survival variation explained by predictive variables. No comorbidity was observed in 11.7% of patients, while 54.3% had 3 or more (mean 2.97) comorbidities. In multivariate analysis, 19 comorbidities were associated with survival: HIV/AIDS, tuberculosis, previous metastatic cancer, thyroid/glandular diseases, electrolyte imbalance, anemia, other blood diseases, dementia, neurologic disease, congestive heart failure, COPD, asthma, pulmonary fibrosis, liver disease, gastrointestinal bleeding, renal disease, connective tissue disease, osteoporosis and peripheral vascular disease. Only the latter was protective. Some of the hazards of comorbidities were explained by more directly acting comorbidities and/or receipt of treatment. Stage explained 25.4% of the survival variation. In addition to stage, the 19 comorbidities explained 6.1%, treatments 9.2%, age 3.7% and histology 1.3%. Thirteen uncommon comorbidities (prevalence <6%) affected 21.2% of patients and explained 3.5% of the survival variation. Comorbidity count and the Charlson index were significant predictors but explained only 2.5% and 2.0% of the survival variation, respectively. Comorbidity has a major impact on survival in early- and late-stage disease, and even infrequent deleterious comorbidities are important collectively. Comorbidity count and the Charlson index failed to capture much information. Clinical practice and trials need to consider the effect of comorbidity in lung cancer patients.
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PMID:Impact of comorbidity on lung cancer survival. 1251 1

A 1:1 matched population-based case-control study was conducted in Xuanwei City, Yunnan Province, where the lung cancer mortality is among China's highest. In this study there were 86 newly diagnosed lung cancer cases and 86 matched control subjects with the same sex, fuel type used, and age(+/- 2 years). Buccal cells were collected from each subject to determine the genotypes of GSTM1 and GSTT1. It was found that the rate of GSTM1 null genotype was higher in the case group than in the control group, and its odds ratio was 2.39(95% CI: 1.25-4.56). The odds ratio became 2.62(95% CI: 1.33-5.15) when other possible confounding factors such as smoking, COPD, and the lifetime exposure to unvented fuel combustion (tons) were adjusted. No association was found between GSTT1 null genotype and lung cancer. The rate of GSTM1 null genotype in Xuanwei City was found to be similar to those of other Chinese populations.
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PMID:[Glutathione S-transferase GSTM1 and GSTT1 genotypes and susceptibility to lung cancer]. 1271 36


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