Introduction: The aims of this study were to determine the distribution of transudates and exudates among pathologically proven malignant pleural effusions, and to demonstrate the necessity for cytologic studies in patients with a transudative effusion. Materials and Methods: This study is a retrospective review of all subjects diagnosed with malignant or paramalignant pleural effusion over a 10-year period at a tertiary hospital. The study included 67 subjects with malignant mesothelioma, 45 subjects with metastatic disease, and 36 subjects with paramalignant effusions. Results: There were 55 female and 93 male subjects; the mean age of the sample was 62 years. Malignant pleural effusions were transudative in 1.5% of malignant mesotheliomas, 6.8% of metastatic diseases, and 11.1% of paramalignant effusions. Conclusions: Cytological examination of pleural fluid in patients with unexplained transudative effusion is essential to rule out malignant processes. Key words: Biochemical criteria, Pleural malignancy, Pleural neoplasms

Background: Eosinophilic bronchitis without asthma causes chronic coughs without the physiologic features of asthma. The aim of this study was to review the clinical features, pathogenesis, diagnosis, treatment and prognosis of this condition. Methods: The current literature was reviewed using Pubmed for all studies published in the English language using the search term ‘eosinophilic bronchitis’. Results: Eosinophilic bronchitis presents as normal spirometry, without evidence of airway hyperresponsiveness, and normal peak expiratory flow variability. When compared with asthma, mast cell recruitment to the superficial airways and mast cell activation appear to be a feature of eosinophilic bronchitis. In contrast, mast cell infiltration in the smooth muscle is significantly higher in asthma patients than in either eosinophilic bronchitis patients or healthy control subjects. In this condition, the absence of high IL-13 expression can contribute to the normal airway reactivity. The cough usually responds well to inhaled corticosteroids but dose and duration of treatment remain unclear. The condition can be transient, episodic or persistent unless treated, and occasionally, patients may require long-term treatment with oral corticosteroids. Conclusions: The condition is an important cause of chronic coughs which are corticosteroid responsive. The study of eosinophilic bronchitis suggests that eosinophil-dependent mechanisms are generally not important in the pathogenesis of asthma.

Aims and Background: Many factors have prognostic significance in small cell lung cancer (SCLC). The aim of this study was to define the prognostic factors influencing the response to therapy and the survival in SCLC. Methods: A consecutive series of 90 patients with SCLC was analyzed retrospectively using 32 pretreatment and 3 treatment-related prognostic factors with respect to their influence on survival. Prognostic factors were evaluated by univariate analysis and by the Cox multivariate regression model. Patients who survived more than 2 months were included in the univariate analysis. Results: The median survival of the whole population was 7 months, with a 1-year survival rate of 20%. In univariate analysis, prognosis was significantly influenced by gender, comorbidity, thoracic irradiation, receipt of more than 3 cycles of chemotherapy, response to chemotherapy, and performance status. The Cox model identified comorbidity (P = 0.03), receipt of more than 3 cycles of chemotherapy (P = 0.003) and response to chemotherapy (P = 0.002) as the only significant factors. Conclusions: The prognosis of SCLC is poor, and comorbidity information should be included in prognostic studies.

The aim of this study was to investigate the effects of various clinical, laboratory characteristics, and therapeutic modalities on the survival of patients with malignant pleural mesothelioma. One hundred consecutive patients with a pathologically proven diagnosis of malignant pleural mesothelioma treated between 1993 and 2005 were included in the study. Using a Cox proportional hazard model, comorbidity, weight loss, breathlessness, and performance status were identified as independent prognostic factors. Comorbidity had interestingly favorable effect on the survival. Treated patients with chemotherapy had significantly longer survival than those treated with best supportive care. However, it was necessary to complete at least 6 cycles for a survival benefit. In conclusions, comorbidity information should be recorded in the recent prognostic studies. The drugs used for the comorbidity may improve survival.