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OS was found longer in female patients with sMPMN (P < 0.05), and in all group with mMPMN (P < 0.005).

ÖzObjective: In Obesity Hypoventilation syndrome (OHS), pulmonary hypertension (PH) is an important morbidity and mortality reason compared to pure Obstructive Sleep Apnea syndrome (OSAS). However, few studies are available in the literature about this subject. For this reason, we evaluated OHS and pure OSAS cases in our study from the point of right heart-related echocardiographic parameters and PH. Materials and Methods: Obese [body mass index (BMI) >30 kg/m 2 ] cases diagnosed by polysomnography were included in the study. The subjects were divided to two groups as OHS and pure OSAS. OHS criteria were defined as obesity (BMI >30 kg/m 2 ) and for another reason unexplained (neuromuscular, chest wall, restrictive or obstructive pulmonary diseases) daytime hypercapnia (PaCO 2 >45 mmHg). Patients with severe hypothyroidism, renal and heart insufficiency, cardiac drug anamnesis were not included in the study. Transthoracic echocardiography was performed to all cases and those with left-heart pathology were excluded from the study. Systolic pulmonary artery pressure (PABs) >35 mmHg was accepted as PH. Results: Of the 115 cases studied (mean age: 49.3±10.6/year, female/ male: 53/62, BMI: 40.5±6.1 kg/m 2 ), 70 were pure OSAS and 45 were OHS. In the OHS group, PABs, right ventricular diameter and pulmonary velocities were significantly higher than the pure OSAS group (p=0.002, p=0.015, p=0.012, respectively). The frequency of PH in OHS was significantly higher than group with pure OSAS (48.8% vs. 17.1%, p<0.001). In the overall group, there was a positive correlation between PABs value and apnea-hypopnea index, OSAS phase, oxygen desaturation index, SpO 2 <90% elapsed time, and OHS presence (r=0. ) ve başka bir nedenle açıklanamayan (nöromüsküler hastalık, göğüs duvarı patolojileri, restriktif ve obstrüktif akciğer hastalıkları gibi) gündüz hiperkapnisi (PaCO 2 >45 mmHg) olarak tanımlanmıştır. Ciddi hipotiroidi, böbrek ve kalp yetmezliği, kardiyak ilaç anamnezi olanlar çalışmaya dahil edilmedi. Olgulara transtorasik ekokardiyografi yapıldı ve sol kalp patolojisi olanlar çalışma dışı bırakıldı. Sistolik pulmoner arter basıncı (PABs) >35 mmHg olması, PH olarak kabul edildi. Bulgular: Çalışmaya alınan 115 olgunun (ortalama yaş: 49,3±10,6/ yıl, kadın/erkek: 53/62, VKİ: 40,5±6,1 kg/m 2 ) 70'i saf OUAS, 45'i OHS idi. OHS grubunda PABs, sağ ventrikül çapı ve pulmoner velosite saf OUAS grubuna göre anlamlı olarak daha yüksekti (p=0,002, p=0,015, p=0,012). OHS grubunda, PH sıklığı saf OUAS grubuna göre anlamlı olarak daha fazlaydı (%48,8 ve %17,1, p<0,001). Genel grupta, PABs değeri ile apne-hipopne indeksi, OUAS ağırlığı, oksijen desaturasyon indeksi, SpO 2 <%90 geçen süre ve OHS varlığı arasında pozitif korelasyon vardı (sırasıyla; r=0,307, p=0,001; r=0,259, p=0,005; r=0,405, p<0,001; r=0,162, p<0,001; r=0,305 p=0,001). PABs ile ortalama ve minimum SpO 2 arasında negatif korelasyon vardı (sırasıyla r=-0,404, p<0,001; r=-0,344, p<0,001). Sonuç: OHS olgularında; PABs, sağ ventrikül çapı ve pulmoner velosite ve PH sı...

Aim of the studyEarly transient brachial plexopathy following radiotherapy (RT) in patients with head and neck cancer may be underreported and associated with a dose-response. Our purpose was to determine the incidence of early transient radiation-ınduced brachial plexopathy (RIBP) in patients receiving primary RT (± chemotherapy) for locally advanced head and neck cancer (HNC).Material and methodsTwenty-seven locally advanced HNC patients who have no finding of brachial plexopathy at the diagnosis were evaluated 3 times by a specifically developed 13-item questionnaire for determining early transient RIBP. The 54 brachial plexus in 27 patients were delineated and dose volume histograms were calculated.ResultsMedian follow-up period was 28 (range: 15–40) months. The mean BP volume was 7.9 ±3.6 cm3, and the mean and maximum doses to the BP were 45.3 (range: 32.3–59.3) Gy, and 59.4 (range: 41.4–70.3) Gy, respectively. Maximum dose to the BP was ≥ 70 Gy only in 2 nasopharyngeal cancer patients. Two (7%) early transient RIBP were reported at 7th and 8th month after RT under maximum 67.17 and 55.37 Gy, and mean 52.95 and 38.60 Gy RT doses.ConclusionsTwo (7%) early RIBP were seen in the patient group, although brachial plexus maximum doses were ≥ 66 Gy in 75% of patients.

IntroductionAlthough the recommended optimal treatment of glioblastoma multiforme (GBM) is adjuvant chemoradiotherapy, trials in GBM have excluded patients older than 70 years. In this study, we aimed to assess overall survival (OS) and prognostic factors in elderly patients (≥ 70 years) with newly diagnosed GBM treated with radiotherapy (RT) ± concurrent/adjuvant temozolomide (TMZ).Material and methodsInclusion criteria were patients ≥ 70 years, pre-RT Karnofsky performance status (KPS) ≥ 60, and time between diagnosis and start of RT ≤ 2 months. A total of 40 patients aged ≥ 70 years, 12 female and 28 male, treated between January 2004 and December 2012, were evaluated. Median age was 73.5 years (range, 70–83 years). The median RT dose was 60 Gy (range, 30–62 Gy). Twenty-one (52.5%) received concurrent TMZ, and of those 12 (30%) went on to receive adjuvant TMZ.ResultsThe median OS was 7 months (95% CI: 5.45–8.54). One- and two-year OS for the whole cohort was 38% and 16%, respectively. Sex, type of surgery, tumor size, and RT dose did not significantly affect the OS. Presence of concurrent TMZ (p < 0.005) and presence of adjuvant TMZ (p < 0.001) were associated with longer OS in our cohort.ConclusionsRT ± TMZ seems to be a well-tolerated treatment in patients ≥ 70 years with GBM. Even though no superiority was found between conventional or hypofractionated RT regimens (p = 0.405), the addition of concurrent and adjuvant TMZ to RT increased the OS in our study.