Spontaneous pneumothorax is defined as the rupture of bleb or emphysematous bullae that develop just beneath the pulmonary pleura. Weather changes may influence the incidence of spontaneous pneumothorax. The aim of this study was to examine the influence of rainfall, temperature and atmospheric pressure changes on the onset of spontaneous pneumothorax. The study involved 669 spontaneous pneumothorax admissions to three reference hospitals in Ankara, Turkey between 1996 and 2006 (612 males and 57 females with the mean age of 34.0 +/- 15.5 years). The meteorological data were obtained from Turkish State Meteorological Services for temperature, atmospheric pressure, and rainfall. The correlation between these values and spontaneous pneumothorax clusters, which was defined as the admission of at least two patients with pneumothorax within three days of each other, was evaluated. Among 669 episodes of spontaneous pneumothorax, 472 (70.5%) occurred in 188 clusters. When compared to days without spontaneous pneumothorax, the amount of average rainfall on the day of admission with spontaneous pneumothorax, one day before and two days before the admission was significantly high. Similarly, the atmospheric pressure on one day and two days before the admission of spontaneous pneumothorax patients was significantly low. In addition, maximum temperature level was significantly lower on admission day of spontaneous pneumothorax patients compared to those on the days without spontaneous pneumothorax. This largest series of the literature shows that spontaneous pneumothorax occurs in clusters and suggests that rainfall, temperature and falls in atmospheric pressure might play a role in the pathophysiology of spontaneous pneumothorax.

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Intrathoracic ectopic goiters are rare. To our knowledge, only two reports of thyroid tissue on the aorta have been reported in the English literature. A 42-year-old woman was found to have a right paracardiac mass. Sternotomy revealed a firm and encapsulated tumor attached to the anterolateral surface of the ascending aorta and a defect in the right superior part of the pericardium. The mass was completely excised and histopathologic examination confirmed a multinodular goiter. We discuss the features of this rare tumor.

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Management of prolonged air leak with autologous blood patch pleurodesis is a safe, easy and effective method. To our knowledge, this is the first report in the literature on the use of this method after hydatid cyst surgery.