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Objectives: Spontaneous pneumothorax refers to the leakage of air into the space between the parietal and the visceral layers of the pleura. It occurs with or without a known lung disease. We aimed to investigate the effects of atmospheric pressure, humidity, and temperature changes on the incidence of spontaneous pneumothorax (SP)., Material and Methods: This study included 551 patients with spontaneous pneumothorax retrospectively screened between January 2009 and December 2013. The medical data of the patients were accessed via their medical records on the hospital automation system. The atmospheric pressure, temperature, humidity rate, amount of precipitation, and wind velocity on the day of spontaneous pneumothorax were obtained from the data provided by the general directorate of meteorology. The three consecutive days on which at least 2 cases of SP presented were collectively considered as a cluster. The study data were analyzed with the SPSS version 15 software package, using the Chi-square and the Student's t tests. A p value less than 0.05 was considered statistically significant., Results: Of the 552 patients included in the study, 89.3% had primary spontaneous pneumothorax and 10.7% had secondary spontaneous pneumothorax. Ninety-two percent of the patients were male and 8% were female. The mean age was 24 years. Clustering was observed in 71.7% of the study population. No significant differences were observed between yearly and monthly SP incidences. There were, however, differences between the days with SP and the days without SP with respect to atmospheric pressure, ambient temperature, wind velocity, and humidity rate. The differences between the atmospheric pressures were not statistically significant, although the differences between the ambient temperature and the humidity rate were statistically significant (p≤ 0.05)., Conclusion: We determined that the changes in the ambient temperature and the humidity rate affected the rate of spontaneous pneumothorax by altering the meteorological conditions., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

Background: The aim of the present study was to emphasize diaphragmatic injuries that can be overlooked in chest traumas., Methods: Between January 2000 and June 2013, fifty-three patients with traumatic diaphragmatic laceration were evaluted among 1349 patients who had chest injuries. Patients were examined regarding age, gender, associated injuries, surgical interventions, postoperative morbidity, mortality and length of hospital stays., Results: Of them, fifty-three cases had diaphragmatic lacerations. There were forty-eight male and five female patients, with a mean age of 31.06 (4-60) years and 35.80 (18-50) years. Thoracotomy in 66%, laparotomy in 20.75% and laparotomy+thoracotomy in 13.20% of the cases were performed. Video-assisted thoracoscopy was carried out in 15.09% of the patients. Diaphragm was repaired on the left in thirty-one cases and in the right in twenty-two cases. Pulmonary complications like morbidity was mostly seen in 37.73% of blunt trauma. Mortality was seen in three cases of penetrating trauma. Mean hospital duration was 8.75 days (range, 4-15 days). Patients were followed for a mean duration of 28.13 months (range, 3-60 months). There was no significant statistical difference between types of injury, ages and gender of cases (p=0.05); whereas, morbidity rate was important in patients with blunt trauma., Discussion: Diaphragmatic lacerations should be kept in mind when penetrating and blunt injuries to the thorax are evaluated.

Objectives: Malignant pleural effusion (MPE) means poor prognosis in the majority of cases. Intrapleural Hyperthermic perfusion chemotherapy (HIPEC) looks promising approach for these patients. We aimed to investigate whether cytoreductive surgery followed by HIPEC provides any survival benefit in cases with metastatic MPEs., Methods: Between January 2009 and December 2011, 19 patients with metastatic MPEs were treated with HIPEC following surgical interventions such as pleurectomy/decortication and/or lung resection (group 1). Comparison was done with historical control groups consisted of patients who received either talc pleurodesis or pleurectomy/decortication followed by systemic treatment for the management of metastatic MPEs between June 2007 and June 2008 (group 2 and 3). Statistical analyses including overall survival, disease free interval were done for the group comparisons., Results: Median survival in group 1, 2 and 3 were 15.4, 6, 8 months, respectively. One year survival was 54.7% in group 1 where it was 0.6% and 0.8% in group 2 and 3, respectively. There was no operative mortality. Morbidity was occurred in 1 patient in group 1 (5.3%)., Conclusions: HIPEC combined with cytoreductive surgery seems to be a promising treatment option for subjects with metastatic MPEs. Further studies are needed for the optimization of HIPEC method, drug of choice, and the best combination therapy for the multimodal treatment., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Background: We aimed to emphasize the importance of delay in diagnosis of traumatic diaphragmatic ruptures and to investigate the results of treatment methods., Methods: The records of 13 patients (11 males, 2 females; mean age 34.6; range 7 to 52 years) with traumatic diaphragmatic ruptures were evaluated with respect to demographic data, type and time of trauma, symptoms, diagnostic methods, localization, surgical therapy, morbidity and mortality., Results: Blunt trauma was present in 8 cases (61.6%) and penetrating trauma in 5. Migration of abdominal organs into hemithorax was detected in 11 cases radiologically. The duration between diagnosis and the event was 2-20 years in 6 patients (46.1%). Three of them were penetrating and 3 were blunt trauma. In 3 cases, diagnosis had been overlooked despite exploratory thoracotomy and laparotomy in another center. Right hemi-diaphragm was injured in 1 patient and the left in 12 cases. Primary repair through posterolateral thoracotomy was performed in all cases. Morbidity occurred in 1 patient. No mortality was observed., Conclusion: Diaphragmatic ruptures should be remembered in trauma cases because of the probability of their being missed, and ruptures should be explored during thoracotomy or laparotomy performed for other organ injuries. Delayed diagnosis will increase morbidity and mortality.