Search

This study aimed to determine the value of either ultrasonography and computed tomography (CT) alone or both for diagnosing salivary gland stones. Based on their clinical findings and physical examination, 188 patients with salivary stones were included. Initially, an ultrasound was performed, and then a non-contrast-enhanced thin-sliced CT scan was done. The study included 161 patients with suspected submandibular gland (SMG) sialolithiasis and 27 with parotid gland (PG) sialolithiasis. Among the SMG cases, stones were confirmed in 130 patients through interventional sialoendoscopy. Sixteen of the stones were detected by CT scan only and were not seen in the previous ultrasound examination. After the second follow-up ultrasound, which was conducted after reviewing the CT scans, 9 of them were identified. Five patients with distal stones and ductal dilation on ultrasound were confirmed to have sialolithiasis. In 5 patients with stones detected on ultrasound but not on CT, dental filling artifacts were identified as the cause. For PG cases, stones were observed in 18 out of 19 patients with suspected sialolithiasis based on ultrasound and CT findings. Three patients with positive CT findings but negative ultrasound showed stones during sialendoscopy. During an ultrasound examination, palpating the floor of the mouth with the other hand's index finger can help identify stones obscured by the shadow of the mandible, thereby enhancing the test's accuracy. Patients with dental fillings, implants, and permanent dentures should not be referred for a CT scan to avoid unnecessary exposure to ionizing radiation. They also cause significant metallic artifacts in the field of interest. In these cases, ultrasound should be considered. To minimize the effects of ionizing radiation, it is recommended to create limited field requests for the target, focusing solely on the submandibular and PGs., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: We investigated the effectiveness of different types of nasal irrigation sprays in adult allergic rhinitis (AR) patients. Methods: A total of 1700 patients with AR (866 males and 834 females) were assigned to: Group 1: Hypertonic nasal spray group ( n = 600) (Sinomarin ® hypertonic nasal spray); Group 2: Algae-containing hypertonic nasal spray group ( n = 600) (Sinomarin Plus Algae ENT); and Group 3: Isotonic saline nasal spray group ( n = 500). All patients underwent an otolaryngological examination, continued their standard AR treatment, and received the assigned nasal spray additionally (1 spray to each nostril, 3 times a day, for 3 weeks). Allergic symptom scores, turbinate examination, total symptom scores, and quality of life (QoL) scores were evaluated during pre- and post-treatment periods. Results: In groups 1 and 2, symptom scores and turbinate color and edema, total symptom scores, and QoL scores increased after treatment ( P < .05). In the saline group, there were no significant differences in symptom scores and total symptom scores after treatment; however, improvement was detected in turbinate color and edema values after treatment. QoL scores increased after treatment. When comparing the 3 groups, the total symptom scores of groups 1 and 2 were significantly lower, and the QoL scores of groups 1 and 2 were considerably higher than those of the saline group. There were no significant differences between groups 1 and 2. Conclusion: Algae-containing and hypertonic nasal spray may be added to the standard AR treatment to increase QoL and decrease total symptom scores., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: In the postacute phase of coronavirus disease-2019 (COVID-19), survivors may have persistent symptoms, lung function abnormalities, and sequelae lesions on thoracic computed tomography (CT). This new entity has been defined as post-COVID interstitial lung disease (ILD) or residual disease., Aims: To evaluate the characteristics, risk factors and clinical significance of post-COVID ILD., Study Design: Multicenter cross-sectional analysis of data from a randomized clinical study., Methods: In this study, patients with persistent respiratory symptoms 3 months after recovery from COVID-19 were evaluated by two pulmonologists and a radiologist. post-COVID ILD was defined as the presence of respiratory symptoms, hypoxemia, restrictive defect on lung function tests, and interstitial changes on follow-up high-resolution computed tomography (HRCT)., Results: At the three-month follow-up, 375 patients with post-COVID-19 syndrome were evaluated, and 262 patients were found to have post-COVID ILD. The most prevalent complaints were dyspnea (n = 238, 90.8%), exercise intolerance (n = 166, 63.4%), fatigue (n = 142, 54.2%), and cough (n = 136, 52%). The mean Medical Research Council dyspnea score was 2.1 ± 0.9, oxygen saturation was 92.2 ± 5.9%, and 6-minute walking distance was 360 ± 140 meters. The mean diffusing capacity of the lung for carbon monoxide was 58 ± 21, and the forced vital capacity was 70% ± 19%. Ground glass opacities and fibrotic bands were the most common findings on thoracic HRCT. Fibrosis-like lesions such as interlobular septal thickening and traction bronchiectasis were observed in 38.3% and 27.9% of the patients, respectively. No honeycomb cysts were observed. Active smoking [odds ratio (OR), 1.96; 95% confidence interval (CI), 1.44-2.67), intensive care unit admission during the acute phase (OR, 1.46; 95% CI, 1.1-1.95), need for high-flow nasal oxygen (OR, 1.55; 95% CI, 1.42-1.9) or non-invasive ventilation (OR, 1.31; 95% CI, 0.8-2.07), and elevated serum lactate dehydrogenase levels (OR, 1.23; 95% CI 1.18-1.28) were associated with the development of post-COVID ILD. At the 6-month follow-up, the respiratory symptoms and pulmonary functions had improved spontaneously without any specific treatment in 35 patients (13.4%). The radiological interstitial lesions had spontaneously regressed in 54 patients (20.6%)., Conclusion: The co-existence of respiratory symptoms, radiological parenchymal lesions, and pulmonary functional abnormalities which suggest a restrictive ventilatory defect should be defined as post-COVID-19 ILD. However, the term “fibrosis” should be used carefully. Active smoking, severe COVID-19, and elevated lactate dehydrogenase level are the main risk factors of this condition. These post-COVID functional and radiological changes could disappear over time in 20% of the patients., Competing Interests: Conflict of Interest: The authors declare that they have no conflict of interest.

Objective: Pleural effusion is a common medical problem. It is important to decide whether the pleural fluid is a transudate or an exudate. This study aims to measure the attenuation values of pleural effusions on thorax computed tomography and to investigate the efficacy of this measurement in the diagnostic separation of transudates and exudates., Materials and Methods: 380 cases who underwent thoracentesis and thorax computed tomography with pleural effusion were classified as exudates or transudates based on Light's criteria. Attenuation measurements in Hounsfield units were performed through the examination of thorax computed tomography images., Results: 380 patients were enrolled (39 % women), the mean age was 69.9 ± 15.2 years. 125 (33 %) were transudates whereas 255 (67 %) were exudates. The attenuation values of exudates were significantly higher than transudates (15.1 ± 5.1 and 5.0 ± 3.4) (p < 0.001). When the attenuation cut-off was set at ≥ 10 HU, exudates were differentiated from transudates at high efficiency (sensitivity is 89.7 %, specificity is 94.4 %, PPV is 97 %, NPV is 81.9 %). When the cut-off value was accepted as < 6 HU, transudates were differentiated from exudates with 97.2 % specificity., Conclusion: The attenuation measurements of pleural fluids can be considered as an efficacious way of differentiating exudative and transudative pleural effusions., Competing Interests: Declaration of compting interest The authors declare no conflicts of interest., (Copyright © 2024 HCFMUSP. Published by Elsevier España, S.L.U. All rights reserved.)

Pulmonology is one of the branches that frequently receive consultation requests from the emergency department. Pulmonology consultation (PC) is requested from almost all clinical branches due to the diagnosis and treatment of any respiratory condition, preoperative evaluation, or postoperative pulmonary problems. The aim of our study was to describe the profile of the pulmonology consultations received from emergency departments in Turkiye. A total of 32 centers from Turkiye (the PuPCEST Study Group) were included to the study. The demographic, clinical, laboratory and radiological data of the consulted cases were examined. The final result of the consultation and the justification of the consultation by the consulting pulmonologist were recorded. We identified 1712 patients, 64% of which applied to the emergency department by themselves and 41.4% were women. Eighty-five percent of the patients had a previously diagnosed disease. Dyspnea was the reason for consultation in 34.7% of the cases. The leading radiological finding was consolidation (13%). Exacerbation of preexisting lung disease was present in 39% of patients. The most commonly established diagnoses by pulmonologists were chronic obstructive pulmonary disease (19%) and pneumonia (12%). While 35% of the patients were discharged, 35% were interned into the chest diseases ward. The majority of patients were hospitalized and treated conservatively. It may be suggested that most of the applications would be evaluated in the pulmonology outpatient clinic which may result in a decrease in emergency department visits/consultations. Thus, improvements in the reorganization of the pulmonology outpatient clinics and follow-up visits may positively contribute emergency admission rates., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Competing Interests: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.

Background: The coronavirus disease-2019 pandemic has contributed to work-related psychosocial risks in healthcare workers., Aims: To evaluate the perceived need for mental health services and related factors in Turkish healthcare workers practicing in pandemic hospitals., Study Design: Cross-sectional study., Methods: Data were collected from face-to-face interviews with healthcare workers at 19 pandemic hospitals in 13 provinces between September and November 2021. The study survey included the evaluation of the perceived need for and utilization of mental health services in the previous year, as well as sociodemographic, health-related, and work-related characteristics, the General Health Questionnaire-12, the World Health Organization Quality of Life-BREF (WHOQoL-BREF) questionnaire, and the Fear of coronavirus disease-2019 scale (FCV-19S)., Results: Of 1,556 participants, 522 (33.5%) reported a perceived need for mental health services, but only 133 (8.5%) reported receiving these services. Multiple logistic regression analysis of the perceived need for mental health services revealed significant relationships with lower age, female sex, being a current smoker, having a chronic disease, having a mental disorder, coronavirus disease-2019 contact within the last three months in settings other than the home or workplace, a positive coronavirus disease-2019 vaccination history, being a physician, being a non-physician healthcare professional, and coronavirus disease-2019 contact within the last three months at work. After adjustment for these characteristics, higher General Health Questionnaire-12 and FCV-19S scores and lower WHOQoL-BREF domain scores were related to the perceived need for mental health services in logistic regression analyses., Conclusion: The findings indicate a substantial need for mental health services amongst Turkish healthcare workers during the pandemic and outline participants’ characteristics regarding high-priority groups for the intervention. Future research may focus on developing actions and evaluating their efficiency.

Caregiving has become an increasingly important medical and social issue in recent decades. We performed a cross-sectional study on pulmonary patients and accompanying informal caregivers who were hospitalized in the chest disease ward of a tertiary center in Turkey between January 2020 and April 2021. Informal caregivers were asked to complete the Zarit Caregiver Burden Interview. A total of 141 inpatients (39% female, mean age: 76.8 ± 10.2 years) and their informal caregivers (77% female, mean age: 54 ± 11.9 years) were evaluated. The caregivers were classified as light to medium burden (group 1, burden score ≤40) and medium to heavy burden (group 2, burden score >40). The mean burden score was 35.7 ± 13.3 points. The number of female caregivers was higher in group 2 (p = 0.025). There was a positive correlation between the burden score and female gender (p = 0.002) and the number of chronic diseases of caregivers (p = 0.020). Statistical analysis revealed a negative correlation between the burden score and the level of education (r = > -0.174, p = 0.040). Caregiver burden is related to the characteristics of the caregiver rather than those of the patient being cared for. Female caregivers with lower education and more than one chronic disease perceive a higher caregiver burden.

Objectives: Sleep disorders associated with COVID-19 pandemic are termed as 'COVID-somnia.' In this study, we sought to assess the prevalence of COVID-somnia in healthcare workers, establish the factors that trigger this condition, and to investigate its relationship with anxiety and depression symptoms., Methods: This cross-sectional study was conducted between April 2021 and June 2021, and it included healthcare workers who served during the pandemic. Participants' demographic data, Beck Depression and Anxiety Inventories, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Insomnia Severity Index (ISI) were used, and the results were statistically analyzed. Multiple analyses of factors affecting ESS and ISI scores were evaluated using binary logistic regression model and PSQI score were analyzed using a multiple linear regression model., Results: A total of 1,111 healthcare workers who served during the pandemic voluntarily enrolled to the study. The mean age was 37.3 ± 8.48 years, and 63.5% were females. Our study showed that the healthcare workers, evaluated with the PSQI, experienced a deterioration of sleep quality. Primary factors affecting this are working on the front line, the presence of chronic diseases, depression, and anxiety. Regression analyses identified depression and anxiety as the common factors affecting ESS, ISI, and PSQI scores., Conclusion: Raising awareness regarding COVID-somnia among healthcare workers, who play a leading role in curbing the pandemic, would reduce sleep disturbances, depression, and anxiety. It would also contribute to the planning and implementation of preventive and therapeutic mental health programs with a multidisciplinary approach.

Background: The new type of corona virus has a wide range of symptoms. Some people who have COVID-19 can experience long-term effects from their infection, known as post-COVID conditions. The authors aimed to investigate prolonged musculoskeletal pain as a symptom of the post-COVID-19 condition., Methods: This is a descriptive study on the patients who were diagnosed with COVID-19 in a university hospital, between March 2020 and March 2021. Patient records and an extensive questionnaire were used to obtain relevant demographic and clinical characteristics, including hospitalization history, comorbidities, smoking history, duration of the pain, the area of pain, and the presence of accompanying neuropathic symptoms., Results: Of the diagnosed patients, 501 agreed to participate in the study. Among the participants, 318 had musculoskeletal pain during COVID-19 infection, and 69 of them reported prolonged pain symptoms as part of their a post-COVID condition which could not be attributed to any other cause. The mean duration of pain was 4.38 ± 1.73 months, and the mean pain level was 7.2 ± 4.3. Neuropathic pain symptoms such as burning sensation (n = 16, 23.2%), numbness (n = 15, 21.7%), tingling (n = 10, 14.5%), stinging (n = 4, 5.8%), freezing (n = 1, 1.4%) were accompanied in patients with prolonged musculoskeletal pain., Conclusions: Patients with COVID-19 may develop prolonged musculoskeletal pain. In some patients, neuropathic pain accompanies it. Awareness of prolonged post-COVID-19 pain is crucial for its early detection and management.

Background: Direct oral anticoagulants (DOACs) have been used in acute pulmonary thromboembolism as an alternative to warfarin due to drug interactions, narrow therapeutic range, and necessary close International Normalized Ratio (INR) monitoring. Phase 3 study results have reported that these drugs are at least as effective as warfarin and beneficial in terms of bleeding; however, studies that present up-to-date life data are necessary., Aims: To evaluate the frequency of using DOACs, which are prescribed with a limited number of indications in our country, and real-life data results., Study Design: Cross-sectional study., Methods: This cross-sectional survey collected the clinical data (history, current treatment, treatment duration, etc.) of patients with pulmonary thromboembolism and who applied to the physician for follow-up between October 15, 2019, and March 15, 2020. The researchers kept the patient records sequentially., Results: Data from 836 patients with acute pulmonary thromboembolism from 25 centers were collected, and DOAC was used in 320 (38.5%) of them. The most preferred DOAC was rivaroxaban (n = 294, 91.9%). DOAC was mostly preferred because it could not provide an effective INR level with warfarin (n=133, 41.6%). Bleeding was observed in 13 (4%) patients., Conclusion: The use of direct oral anticoagulants is becoming almost as widespread as conventional therapy. Real-life data results are important for their contribution to clinical practice.

In this article, Early Career Task Force Group members of the Turkish Thoracic Society summarize the European Respiratory Society 2020 virtual congress. Current developments in the field of respiratory diseases were compiled with the addition of sessions specific to coronavirus disease 2019 this year. Almost all of the congress sessions were examined, and the important and striking results of the congress were highlighted. Congress sessions were attended by expert researchers, and the prominent messages of each session were highlighted in short summaries. They were then grouped under relevant titles and ranked in order of meaning and relation. It was finalized by a team of researchers.

Artificial intelligence, with its increasing data volume, developing technologies, more information processing power and new algorithms, has a wide usage area in all sectors. In the field of health, these technologies is gaining an increasing place every day. Artificial intelligence methods can act as a simulation of the human mind and intelligence, resulting in the analysis and classification of complex data in a short time. Thus, by separating the small differences in the images examined, it can help diagnosis, detect preliminary signs of the disease and predict how the disease will develop. Computer based programs; diagnostic algorithms, surgical support and robotic systems developed on the basis of patient data are increasingly used in the drug development industry. In this study, artificial intelligence applications in the field of health and its use in pulmonology, the place of wearable technologies in our department and the advantages they provide us during the pandemic period were discussed in the light of the literature.

The COVID-19 pandemic has brought countries' health services into sharp focus. It was drawn to our group's attention that healthcare workers (HCWs) had a lower mortality rate against higher COVID-19 incidence compared to the general population in Turkey. Since risk of exposure to tuberculosis bacillus among healthcare workers are higher than the population, we aimed to investigate if there is a relationship between BCG and Mycobacterium tuberculosis exposure history with COVID-19 severity in infected HCWs. This study was conducted with 465 infected HCWs from thirty-three hospitals to assess the relationship between COVID-19 severity (according to their hospitalization status and the presence of radiological pneumonia) and BCG and Mycobacterium tuberculosis exposure history. HCWs who required hospital admission had significantly higher rates of chronic diseases, radiological pneumonia, and longer working hours in the clinics. Higher rates of history of contact and care to tuberculosis patients, history of tuberculosis, and BCG vaccine were observed in hospitalized HCWs. HCWs who had radiological pneumonia had a significantly increased ratio of history of care to tuberculosis patients and a higher family history of tuberculosis. The findings from our study suggest that the lower mortality rate despite the more severe disease course seen in infected HCWs might be due to frequent exposure to tuberculosis bacillus and the mortality-reducing effects of the BCG vaccine.

Purpose: The objective of this study is to investigate the effects of laparoscopic sleeve gastrectomy (LSG) on the polysomnographic parameters related to OSAS., Materials and Methods: We conducted this 3-year prospective cohort study in a tertiary care center between December 2016 and December 2019. In total, we enrolled 31 patients with severe obesity who underwent full-night polysomnography (PSG) before LSG. Later, the patients were re-evaluated by full-night PSG 12 months after the surgery., Results: The mean age of the patients was 44.1 ± 9.6 years. The mean body mass index (BMI) decreased significantly from a mean value of 49.8 ± 8.5 kg/m 2 at baseline to 33.2 ± 8.2 kg/m 2 and a percent BMI (%BMI) reduction of 33.8 ± 10.4% and a percent total weight loss (%TWL) of 35.4 ± 10.8% was achieved on the same day of the postsurgical PSG (p < 0.001). There was a remarkable improvement in the AHI (baseline: 36.1 ± 27.1, 12 months after the surgery: 10.3 ± 11.8; difference: 25.8 ± 22.8 events per hour) (p < 0.001). Importantly, there was a decrease in the percentage of non-rapid eye movement (NREM) 2 (p < 0.001), whereas NREM 3 and REM stages witnessed a significant increase (p = 0.001 and p < 0.001, respectively) after the surgery., Conclusion: The results of this study showed that weight loss after LSG yields improvement not only in AHI but also in many polysomnographic parameters such as sleep quality and desaturation indices.

Objectives: Healthcare workers (HCWs) possess a high risk for both latent tuberculosis infection (LTBI) and active disease. This study aimed to investigate tuberculosis (TB) disease history in hospital staff working in healthcare institutions in the Eastern Black Sea Region of Turkey., Material and Methods: This study included 460 HCWs employed in 5 hospitals in the Eastern Black Sea Region of Turkey. Between May 01 and July 31, 2016, the participants were asked to answer a questionnaire, including data about TB history. The data about family TB history, Bacilli Calmette-Guerin (BCG) vaccination, or tuberculin skin test (TST) application before starting work were also evaluated., Results: Of the 460 participants, 69.3% were women (n=319) and 30.7% (n=141) were men. The mean age was 32 (17-63) years. A total of 8 participants (1.7 %) had TB history. There was no statistically significant relationship between TB history and age, sex, body mass index (BMI), smoking habits, or presence of comorbidities (p>0.05 for all variables); family history of TB (p<0.001) and TST positivity (p<0.001) were significantly higher in participants with a TB history. Each participant was checked for the presence of both BCG scar and TST positivity. No difference was noted between positive TB history and negative HCWs (p>0.05). The duration of work (years) was higher in participants with a TB history. The p value was very close but did not reach the limits of significance (p=0.059)., Conclusion: In this study, the rate of TB among HCWs was 1.7% (8 of 460 HCWs). Family history of TB and TST positivity are strong predictors of TB in HCWs.

Pregnancy has always been a concern in epidemics all over the world. While coronavirus (COVID-19) disease ravages the world, it is a big curiosity how pregnant women will be affected by this disease. There are a few published case series and commentary of COVID-19 occurring during pregnancy. In this study, we discussed how to manage this disease in pregnant women. A 38-week pregnant, 37-year-old woman whose father passed away from COVID-19 admitted to the hospital with dyspnea, nonproductive cough, and fever. She had positive radiological features for COVID-19, and her rapid antibody test was positive. Lopinavir-ritonavir combination and azithromycin treatments were given, and the patient's symptoms regressed with treatment. The patient was taken to cesarean by providing isolation conditions, and she had a healthy baby with an uncomplicated delivery. There are no certain data about whether COVID-19 infection is worse in pregnant patients or not. On the basis of the limited data in the literature, we cannot see intrauterine transmission from infected mother to baby. However, we know that there would be serious pulmonary complications for the infected mother. Fortunately, the severe acute respiratory syndrome coronavirus 2 infection did not progress more severely in pregnant women than in the normal population compared with the previous severe acute respiratory syndrome outbreak.

Ochratoxin A (OTA) is a toxic metabolite produced by Aspergillus and Penicillium fungus. OTA found in the human and animal tissues can contaminate many foods that we daily consume in our lives. It accumulates especially in kidney. Although OTA is known to cause cell cycle arrest, the molecular mechanisms underlying this effect have not been fully understood, yet. We aimed to investigate the molecular details of OTA induced inhibitory response in G1 - G1/S phase of cell cycle and also the regulatory role of p53 in OTA mediated cell cycle arrest in human proximal tubule epithelial cells, HK-2. For this purpose, Cyclin E1 and Cyclin D1 mRNA expressions and Cyclin D1, Cdk4 and Cdk2 protein expressions were evaluated in HK-2 cells transfected with either 50 nM control siRNA or p53 siRNA for 72 h in the absence or presence of OTA using RT-PCR and Western blot analyses, respectively. Our findings showed that mRNA expressions of Cyclin D1 and Cyclin E1 and protein expressions of Cyclin D1, Cdk4 and Cdk2 were inhibited in HK-2 cells treated with two different doses of OTA, 10 μM and 25 μM, for 24 h. However, the downregulation of p53 led to enhance OTA-mediated increase in mRNA expressions of Cyclin D1 and Cyclin E1 and protein expressions of Cyclin D1, Cdk4 and Cdk2 compared to control siRNA transfected HK-2 cells. Our findings strongly suggest that the cell cycle arresting effect of OTA also performs via a p53 mediated mechanism besides other possible mechanisms., Competing Interests: Declaration of competing interest All authors declare that they have no conflict of interest. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Introduction: The results of standard chemotherapy in lung cancer are not very satisfactory, so it is important to identify genetic mutations that provide targeted therapies. Recent reports have suggested influences of racial difference on the frequency of mutation in lung cancer. We aimed to determine the frequency and regional distribution of genetic mutations of non-small cell lung cancer (NSCLC) in Turkey., Materials and Methods: Regional distribution of genetic mutations in lung cancer in Turkey (REDIGMA) study was carried out as a prospective, cross-sectional, observational study in a large number of centers in which lung cancer patients were followed and could perform genetic mutation analysis on patients' biopsy materials., Result: The 703 patients (77.7% male, mean age 63.3 ± 12.5 years) who were diagnosed as NSCLC from 25 different centers were included in the study. Tumor samples from patients were reported as 87.1% adenocarcinoma, 6.4% squamous cell carcinoma and 6.5% other. Mutation tests were found to be positive in 18.9% of these patients. The mutations were 69.9% EGFR, 26.3% ALK, 1.6% ROS and 2.2% PDL. Mutations were higher in women and non-smokers (p<0.000, p<0.001). Again, the frequency of mutations in adenocarcinoma was higher in metastatic disease. There was no difference between the patient's age, area of residence, comorbidity and clinical stage and mutation frequency., Conclusions: Our study revealed that the EGFR mutation rate in Turkey with NSCLC was similar to East European, African-American and Caucasian patients, and was lower than in East Asia.

Congenital pulmonary airway malformation (CPAM), is a rare disease known as a developmental abnormality of the lower respiratory tract. It may occur in the neonatal period due to respiratory distress and patients usually die in the first few months of life. Rarely, it may remain asymptomatic until adulthood. In this study we describe an adult case and present a review of the literature. A 19-year-old male with no relevant medical history was admitted to our clinic with cough and wheeze. The patient had a history of frequent lower respiratory tract infection during childhood. Chest radiograph revealed a diffuse opacity and volume loss in the right hemithorax. High resolution tomography showed hypoplasia of the right hemithorax, multiple cysts in all of the lobes and segments on the right side, ground glass opacity and interlobular septal thickening of the whole right lung parenchyma. Right pneumonectomy was performed with the pre-diagnosis of congenital pulmonary airway malformation and the pathological examination was compatible with CPAM. CPAM is a rare disease in adulthood. We should consider CPAM in the differential diagnosis of patients with frequent recurrent pulmonary infection and cystic lung lesions. In order to prevent infections and to eliminate the risk of malignancy, surgical treatment should be applied for definite diagnosis and treatment.

Introduction: Sleep quality is known to be associated with the distressing symptoms of cancer. The purpose of this study was to analyze the impact of cancer symptoms on insomnia and the prevalence of sleep-related problems reported by the patients with lung cancer in Turkey., Materials and Methods: Assesment of Palliative Care in Lung Cancer in Turkey (ASPECT) study, a prospective multicenter study conducted in Turkey with the participation of 26 centers and included all patients with lung cancer, was re-evaluated in terms of sleep problems, insomnia and possible association with the cancer symptoms. Demographic characteristics of patients and information about disease were recorded for each patient by physicians via face-to-face interviews, and using hospital records. Patients who have difficulty initiating or maintaining sleep (DIMS) is associated with daytime sleepiness/fatigue were diagnosed as having insomnia. Daytime sleepiness, fatigue and lung cancer symptoms were recorded and graded using the Edmonton Symptom Assessment Scale., Result: Among 1245 cases, 48.4% reported DIMS, 60.8% reported daytime sleepiness and 82.1% reported fatigue. The prevalence of insomnia was 44.7%. Female gender, patients with stage 3-4 disease, patients with metastases, with comorbidities, and with weight loss > 5 kg had higher rates of insomnia. Also, patients with insomnia had significantly higher rates of pain, nausea, dyspnea, and anxiety. Multivariate logistic regression analysis showed that patients with moderate to severe pain and dyspnea and severe anxiety had 2-3 times higher rates of insomnia., Conclusions: In conclusion, our results showed a clear association between sleep disturbances and cancer symptoms. Because of that, adequate symptom control is essential to maintain sleep quality in patients with lung cancer.

Introduction: Granulomatous lung disease (GLD) is caused by a wide range of conditions and it is challenge for pulmonologist. A detailed history of exposures is fundamental in GDL and has been found pivotal to reach a precise diagnosis., Materials and Methods: Between September 2014 and December 2016, the distribution of patients diagnosed with granulomatous lymphadenitis in the mediastinal/hilar lymph nodes by endobronchial ultrasound (EBUS) or mediastinoscopy was analyzed. To be listed as 'confident', a diagnosis of sarcoidosis required compatible histological, radiological and clinical findings in conjunction with negative cultures. Infectious entities listed as 'confident' had either microorganisms in tissue section, positive culture, positive serology or positive antigen detection in a consistent clinical pathological setting., Result: Granulomatous lymphadenitis was detected in 110 patients. The included 110 cases consisted of 70.9% women and median age of 53 (range 44-61) years. The final diagnosis of the patients was accepted to be sarcoidosis in 79 (71.8%), sarcoid like granulomas in 7 (6.4%), tuberculosis in 4 (3.6%), silicosis in 4 (3.6%), drug-associated granuloma in 2 (1.8%), hypersensitivity pneumonitis in 1 (0.9%), Chron disease in 1 (0.9%), unspecified in 12 (10.9%). Three patients were classified as tuberculosis based on culture., Conclusions: In this study, we found that the most common cause of granulomatous lymphadenitis was sarcoidosis. Contrary to expectations, the number of patients diagnosed with tuberculosis was very low.

Objectives: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are major components of COPD-related socioeconomic burden. Upper or lower respiratory tract infections, usually caused by respiratory viruses or bacteria, are common causes of AECOPD. Vaccination aganist influenza virus and Streptoccus pneumoniae , the most prevalent agents, is recommended by COPD guidelines. The aims of this study were to determine the factors affecting vaccination among patients with COPD and to assess the effect of vaccination status on AECOPD., Materials and Methods: Patients with COPD were recruited from the outpatient clinic of a tertiary hospital between December 2014 and January 2015. Demographic data, vaccination status, and COPD-related hospital admissions triggered by tracheobronchial infections were evaluated., Results: In total, 108 patients were enrolled; 102 (94%) subjects were male, and 6 (6%) subjects were female; the mean age was 65.6 years. The number of patients who had received pneumococcal and influenza vaccinations were 8 (0.07%) and 36 (33.3%), respectively. There was no significant correlation between the level of education and vaccination status. No significant difference was found between two groups in terms of exacerbation frequency, hospitalization rates, mMRC scores, and COPD stages., Conclusion: More efforts by both physicians and patients are needed to reach the ideal rates of vaccination for COPD., Competing Interests: Conflict of Interest: The authors have no conflicts of interest to declare.

Silibinin, the active component of Silybum marianum (L.), is a powerful antioxidant. Male rats with streptozotocin-induced diabetes were treated with silibinin. DNA damage was demonstrated by the comet assay in the control, diabetic, and treatment groups. DNA damage was increased in diabetic rats and decreased by silibinin treatment., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Pulmonary alveolar proteinosis (PAP) is a rare pulmonary disease characterised by alveolar accumulation of surfactant composed of proteins and lipids. Three main categories of PAP have been defined depending on the aetiology: primer/idiopathic, neonatal/congenital, secondary and exogenous/environmental exposure. Radiologically diffuse ground glass opacities, interlobular and intralobular septal thickening is seen. Although open lung biopsy is accepted as the gold standard in diagnosis, it can be diagnosed by showing bronchoalveolar lavage (BAL) fluid with a milky appearance and periodic acid-schiff (PAS) positive globules in biopsy with clinical and radiological findings. Theraphy for PAP are supportive care (oxygen), total lung lavage, inhale/subcutaneous granulocyte macrophage colony stimulating factor (GM-CSF), rituximab, plasmapheresis, lung transplantation. We report a case of PAP presented with cough and shortness of breath, diagnosed with BAL and transbronchial lung biopsy, treated by total lung lavage by reviewing literature.

The aim of the present study was to investigate DNA damage in peripheral blood lymphocytes of breast cancer (BC) patients before and after administration of chemotherapy. We analyzed the frequency of sister chromatid exchange (SCE), occurrence of micronuclei (MN), and lymphocyte proliferation rate index (PRI) as cytogenetic markers in 28 female BC patients before and after chemotherapy, and in 20 age-matched healthy female volunteers. Prior to treatment, BC patients showed significantly increased background levels of SCE and MN, and lowered PRIs compared to healthy women. In comparison with pre-treatment levels, SCE and MN frequencies were significantly elevated and PRI reduced in blood samples collected after chemotherapy. Our findings indicate that SCE, MN, and PRI may serve as sensitive biomarkers for routine detection of the genetic abnormalities that may occur following administration of antineoplastic drugs in the clinical setting, as well as for the monitoring of high-risk patients receiving chemotherapy for BC.

Combined pulmonary fibrosis and emphysema (CPFE) syndrome is a rare disease characterized with shortness of breath, upper lobe emphysema, lower lobe fibrosis and impairment of gas exchange. This syndrome is a disease usually seen in male smokers. Pulmonary hypertension is associated with mortality. Another important feature, spirometric volumes relatively protected and a reduction in carbon monoxide diffusion test. CPFE syndrome in the literature so far have been identified in only 70 patients. In this review CPFE syndrome is presented with literature.