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Background: Subjects with chronic obstructive pulmonary disease (COPD) present increased mortality and poor health-related quality of life (HRQoL) as compared with the general population. The objective of this study was to evaluate whether an improvement in QoL after 1 year of proper management is a predictor of survival in a cohort of patients followed up for 10 years. Methods: In this prospective study, 306 COPD patients were assessed for eligibility between January 2003 and September 2003. Thirty-five patients were excluded due to failure to meet inclusion criteria or declining to participate and 20 patients were also excluded subsequently because they could not complete the questionnaire. Two hundred and fifty one patients were assessed at the beginning. St. George Respiratory Questionnaire (SGRQ) and pulmonary function test (PFT) were performed at the initial visit and the end of the first year. Mortality information was obtained from hospital records and direct family interviews. Results: A comparison between respiratory diseases mortality according to baseline paramaters reveals that age and presence of cardiac comorbidity indicates a higher risk of death and associated with worse QoL. After a cox regression analysis, the relative risk of death of any cause related to baseline QoL score was 1.042 (95% CI: 1.028–1.057), and 1.030 (95% CI: 1.011–1.050) for respiratory cause mortality. However, the relative risk of death when there was a deterioration in QoL after one year of follow up was 1.175 (95% CI: 1.130–1.221) for all-cause mortality and 1.214 (95% CI: 1.151–1.280) for respiratory cause mortality. Conclusions: A QoL worsening in the initial year of follow up more strongly predicts 10-year mortality of any cause and for respiratory diseases than the baseline assessment alone predicts, among patients with COPD.

Objective: We aimed to investigate the effect of inhaled corticosteroids (ICS) in the outcomes of community-acquired pneumonia (CAP), as well as to determine if ICS usage is exist among the risk factors for mortality in those patients. Materials and Methods: In this retrospective cross-sectional multicentre study, 1069 hospitalised CAP patients were investigated using CAP Database of Turkish Thoracic Society (TURKCAP Database). The patients were divided into two groups, depending on their ICS use. The data were analysed by appropriate statistical methods. Results: 172 (75.8%) of the 227 patients who were on ICS had COPD and 37 (16.3%) had asthma. There were fewer patients with fever among ICS-users compared to non-ICS users (P = 0.013), and less muscle pain (P = 0.015) and fewer GIS symptoms (P = 0.022). No statistically significant difference was found between ICS use/ type of ICS and the duration of hospitalisation (P = 0.286). The multivariate regression analysis showed that patients using ICS had lower body temperature and, less crackles/bronchial sound. In the multivariate logistic regression model lung cancer (OR: 6.75), glucose (OR: 1.01) and CURB-65 (OR: 1.72) were significantly associated with mortality in the CAP patients. ICS usage were not found to be associated with mortality. Conclusion: The use of ICS by the patients with CAP admitted to the hospital is not independently related with any radiological pattern, hospitalisation duration and mortality. ICS usage may diminish fever response and may suppress the findings of crackles and/or bronchial sounds. This needs further confirmation. © 2020 John Wiley & Sons Ltd

Introduction In this study it is aimed to evaluate the prevalence of smoking, factors affecting smoking status, and the attitudes of the elementary school students towards the smoking prohibition law which was approved in July 2009, in city. Materials and Methods The universe of this descriptive study was 6th-7th-8th class, 8236 urban and 4937 semi-urban, total 13.173 elementary schools students in city center. Study population was determined on the basis of a previous study in which the smoking trial prevalence was found 17.5%, 831 students in 6 urban 3 semi-urban, total 9 schools were chosen randomly. A questionnaire was prepared investigating smoking status, the effects of smoking and family history. Among the 9 chosen schools, the questionnaire was applied to 615 students. SPSS 14.0 statistical package was used. Result Forty-seven percentages of the students were female. Prevalence of smoking trial was found 23.5% (16% in urban, 35% in semi-urban schools) while the prevalence of smoking was 7.1% (1.7% in urban, 15.7% in semi-urban schools). Mean age of first smoking trial was 10.04 ± 2.3. The smoking prohibition law was supported by 86.6% of the students, the warnings on the cigarette package was thought to be effective by 43.3% students and 35.2% of the students were exposed to passive smoke. Male gender, social status, education level of the family, smoker family member or close friends were found to be important risk factors for smoking prevalence of the students. Conclusions The early onset of smoking should guide the smoking struggle be concentrated in elementary school especially in semi-urban areas where the smoking prevalence is high.

Introduction In our country, this is usually done by patient relatives. In this study, we aimed to investigate the thought of doctors who done the diagnosis, doctors who arrange the treatment, first degree relatives of patients with lung cancer, and population as a control. Materials and Methods 310 subjects (100 doctors, 110 first degree realtives of patients, and 100 subjects as a control) were included to the study. The mean age was 39.77 ± 11.44 years and there was 170 females. 46% of doctors were giving cancer treatment (chemotheraphy/radiotheraphy). Result 84.5% of subjects were answered the question (Do you want to know the diagnosis of lung cancer if you are lung cancer?) as "yes" and the answers were not different between groups (p> 0.05). 72 of doctors were giving information about diagnosis of patients. This ratio was 89.1% in doctors who arrange lung cancer treatment whereas it was 57.4% in doctors who do not arrange cancer treatment. The percent age of learning of diagnosis of lung cancer throughout the time in doctors, population, and patient's relatives were 19%, 34%, and 59% respectively (p< 0.05). Information about quality of life was more important in relatives of patients (87%) than population (65%) and doctors (63%) (p< 0.05). Quality of life was more important for doctors who arrange lung cancer treatment (76.7)% than doctors who did not (48.8%) (p< 0.05). Patients who were more children wanted to stay with their family at end stage of disease (p< 0.05). Conclusions According to this study we think that doctors should say the diagnosis of lung cancer in the form of they understand, inform the patients and relatives about treatment, and quality of life and this can increase patient trust to doctor and compliance of patients to the treatment.

Background and aims The treatment of asthmatic patients is particularly focused on the control of symptoms as well as functional and inflammatory parameters. In our study, we investigated the relationship between the asthma control test (ACT) which evaluates symptoms and airway inflammation and functional parameters. Materials and methods Stable asthmatic patients admitted to our pulmonary outpatient clinic were enrolled in the study consecutively and underwent the ACT, pulmonary function tests and methacholine bronchial provocation test (MBPT). Additionally, fractional exhaled nitric oxide level (FeNO) and induced sputum cell distribution were assessed. All these parameters were re-evaluated at the third month after adjusting medications of the patients according to baseline ACT scores. Results Of the 101 patients screened, we analyzed 83 who proceeded to the follow up visit. At the baseline visit, 8 were totally controlled, 36 partially controlled and 39 uncontrolled according to ACT. At the follow up visit, 10 were totally controlled, 39 partially controlled and 34 uncontrolled. Comparison of the two visits in terms of all parameters revealed significant reductions only in the percentages of patients with MBPT positivity (p = 0.029) and FeNO levels > 20 ppb (p = 0.025) at follow up. The percentages of patients with FeNO > 20 ppb, MBPT positivity, induced sputum eosinophilia or induced sputum neutrophilia did not show significant differences between totally controlled, partially controlled and uncontrolled groups at both baseline and follow up visits. Conclusion Although the ACT scores did not show significant correlations with the airway inflammation parameters tested in this study, a marked reduction in the percentage of patients with MBPT positivity and FeNO > 20 ppb at follow up may suggest the importance of the control concept in the management of asthma.

Background/aim: The reliability and validity of the Turkish version of the Leicester Cough Questionnaire (LCQ) have been evaluated before. This study aimed to validate the Turkish version of the LCQ in chronic obstructive pulmonary disease (COPD) patients with cough. Materials and methods: COPD (GOLD B, C, D) patients over age 40 (n = 75) and healthy volunteers as a control group (n = 75) were included. A sociodemographic data form, the LCQ, the Short Form-36 (SF-36) quality of life questionnaire, and the World Health Organization Quality of Life Brief Form for Turkish people were completed. The internal reliability of the LCQ was determined using the Cronbach alpha coefficient (>0.6) and its repeatability by the intraclass consistency coefficient (P < 0.05) was accepted as significant. Results: For internal consistency, Cronbach alpha coefficients of all subscales of the LCQ, physical, psychological, and social, were found as 0.72, 0.86, and 0.83, respectively, with 0.92 for the total index. There was significant internal consistency for all subscales and the total index (Cronbach alpha coefficients of >0.6). In test-retest reliability, the correlation coefficient ranged between 0.71 and 0.80 for each question and was calculated as r = 0.89 for total LCQ score (P < 0.001). Conclusion: The Turkish version of the LCQ has been found to have acceptable reliability and validity for use in Turkish COPD patients with chronic cough

Background/aim The optimal empiric antibiotic regimen for patients with community-acquired pneumonia (CAP) remains unclear. This study aimed to evaluate the clinical cure rate, mortality, and length of stay among patients hospitalized with community- acquired pneumonia in nonintensive care unit (ICU) wards and treated with a β-lactam, β-lactam and macrolide combination, or a fluoroquinolone. Materials and methods This prospective cohort study was performed using standardized web-based database sheets from January 2009 to September 2013 in nine tertiary care hospitals in Turkey. Results Six hundred and twenty-one consecutive patients were enrolled. A pathogen was identified in 78 (12.6%) patients. The most frequently isolated bacteria were S. pneumoniae (21.8%) and P. aeruginosa (19.2%). The clinical cure rate and length of stay were not different among patients treated with β-lactam, β-lactam and macrolide combination, and fluoroquinolone. Forty-seven patients (9.2%) died during the hospitalization period. There was no difference in survival among the three treatment groups. Conclusion In patients admitted to non-ICU hospital wards for CAP, there was no difference in clinical outcomes between β-lactam, β-lactam and macrolide combination, and fluoroquinolone regimens.

Aim: To investigate the clinical characteristics, risk factors, and survival time of patients with lung cancer (LC) and pulmonary embolism(PE). Methods: A retrospective cohort analysis was conducted on 1219 LC patients admitted between January 2000 to December 2016.114 patients were excluded because of the invalid data.1105 cases were divided into PE group and non-PE group. Socialdemographic data, clinical and laboratory findings, comorbidty, treatment modalities, and mortality were exctracted from patient9 files. Results: 104 patients (9,4%) had PE. PE was diagnosed incidentally in 31 patients(29,8%). Mean age in PE group was found lower(57,8±11,5 years vs 61,3±7,4 years)(p 0,05).In patients with stage 4 cancer PE rate was found highe (p Conclusion: PE is found higher in lung cancer patients and approximately one third of them was found incidentally. Especially we should pay attention to young and female patients, patients with stage 4 cancer, during chematherapy, and patients with coronary artery disease and diabetes mellitus which cause vascular inflammation.

WOS: 000413705700025, PubMed ID: 28708954, Background: Previous reports have shown that vaccination rates of adult at-risk populations are low in Turkey. There are differing reports with regards to the effectiveness of the influenza and the pneumococcal polysaccharide vaccine (PPSV23) on the clinical outcomes of community acquired pneumonia (CAP). The purpose of this study was to analyze the influenza (FV) and pneumococcal vaccination (PV) status, the factors that influence the receipt of influenza/pneumococcal vaccine and the effects of prior vaccination on the clinical outcomes in adults hospitalized with CAP. Patients and Methods: Patients hospitalized with CAP between March 2009 and October 2013 and registered at the web-based Turkish Thoracic Society Pneumonia Database (TURCAP) were included in this multicentric, observational study. Of a total of 787 cases, data were analyzed for 466 patients for whom self-reported information on PV and FV was available. Results: In this adult population with CAP, the vaccination rate with both the pneumococcal and influenza vaccines was found to be 6%. Prior FV was found to be the sole variable that was associated with the receipt of PV [OR 17.8, 95% CI (25-75:8.56-37.01), p < 0.001]. Conversely, being vaccinated with PPSV23 was the only predictor of receipt of FV [OR 18.1, 95% CI (25 - 75:8.75 - 37.83), p < 0.001]. Compared to the unvaccinated cases, the chest radiograms of the vaccinated patients revealed less consolidation. The latter also reported fatigue, muscle pain and gastrointestinal symptoms less frequently. Although there was a trend for lower 30-day mortality and for lower rates of intensive care unit (ICU) admission, these did not reach statistical significance. A pneumonia severity index (PSI) score >= 90, CURB-65 score >= 3 and multilobar involvement, but not the vaccination status, were identified as independent determinants of ICU admission. Conclusions: This study showed that, among patients hospitalized with CAP, the FV and/or PV rates are low. Prior vaccination does not appear to significantly affect the clinical outcomes.

Varenicline, a widely used smoking cessation drug, has partial agonistic activity at α4β2 nicotinic receptors, and full agonistic activity at α7 nicotinic receptors. Thus it may interact with cognitive processes and may alleviate some of the cognitive disturbances observed in psychotic illnesses such as schizophrenia. We aimed to test the effects of varenicline on sensorimotor gating functioning, which is crucial for normal cognitive processes, especially for the integration of sensory and cognitive information processing and the execution of appropriate motor responses. Prepulse inhibition (PPI) of the acoustic startle reflex was used to test the sensorimotor gating functioning. First, the effects of varenicline and nicotine on rats having high or low baseline PPI levels were evaluated; then, varenicline was applied prior to apomorphine (0.5 mg/kg), and MK-801 (0.15 mg/kg), which are used as comparative models of PPI disruption. Varenicline (0.5-3 mg/kg) did not change PPI when given alone in naïve animals. When rats were selected according to their baseline PPI values, varenicline (1 mg/kg) significantly decreased PPI in high-inhibitory (HI) but not in low-inhibitory (LI) rats. Nicotine (1 mg/kg; tartrate salt) produced a similar activity in LI and HI groups. In combination experiments, varenicline did not reverse either apomorphine or the MK-801-induced disruption of PPI. These results demonstrate that the effects of both varenicline and nicotine on sensorimotor gating are influenced by the baseline PPI levels. Moreover, varenicline has no effect on apomorphine or the MK-801-induced disruption of PPI.

OBJECTIVES : We aimed to evaluate toll- like receptor 2 (TLR- 2) expression on monocytes and peripheral blood CD4+/CD8+ T cell ratio, as well as the relationship of these cells with pulmonary functions in chronic obstructive pulmonary disease (COPD) patients.

Objective: To investigate the impact of high-frequency chest wall oscillation in chronic obstructive pulmonary disease patients with infective exacerbation. Design: Clinical randomized controlled trial. Setting: Patients received high-frequency chest wall oscillation therapy at the Department of Pulmonology. Subjects: Stage III-IV chronic obstructive pulmonary disease patients hospitalized with acute infective exacerbation who had received high-frequency chest wall oscillation therapy were studied. Interventions: Patients were randomized into two groups, which were classified as I and II. All patients have been treated with bronchodilators, antibiotics, if necessary oxygen and patient education, as part of acute chronic obstructive pulmonary disease exacerbation protocol. Group II patients received additional high-frequency chest wall oscillation therapy. Main measures: Body mass index (B), forced expiratory volume in the first second (O), modified Medical Research Council dyspnea scale (D) and 6-minute walking test (E) (BODE) index, forced expiratory volume in the first second, dyspnea, exercise capacity, oxygenation parameters and hospitalization of duration were recorded at baseline and at three-days and five-days follow-up. Results: From April 2009 to July 2011, a total of 99 patients were assessed for eligibility, 50 patients were enrolled and randomized into two groups. A total of 50 (100%) patients (25 in Group I and 25 in Group II) were followed up for five days. Application of high-frequency chest wall oscillation therapy resulted in no significant advantage in all outcomes ( p > 0.05). Mean (SD) baseline BODE index value in Group I was 7.72 (1.76), in Group II was 7.72(1.89) ( p = 0.55). On the fifth-day assessment, mean (SD) BODE index value in Group I was 7.24 (1.83), in group II was 6.44 (2.46) ( p = 0.18). Conclusions: The application of high-frequency chest wall oscillation therapy offers no additional advantages on infective exacerbations in chronic obstructive pulmonary disease.

WOS: 000389053000029, PubMed ID: 27966314, Background/aim: Treatment failure in hospitalized patients with community-acquired pneumonia is a major cause of mortality. The aim of this study was to evaluate the factors affecting treatment success in community-acquired pneumonia. Materials and methods: A total of 537 patients (mean age: 66.1 +/- 15.8 years, 365 males) registered to the Turkish Thoracic Society Pneumonia Database were analyzed. Of these, clinical improvement or cure, defined as treatment success, was achieved in 477, whereas 60 patients had treatment failure and/or died. Results: Lower numbers of neutrophils (5989.9 +/- 6237.3 vs. 8495.6 +/- 7279.5/mm(3)), higher blood urea levels (66.1 +/- 42.1 vs. 51.2 +/- 38.2 mg/dL), higher Pneumonia Severity Index (PSI) scores (123.3 +/- 42.6 vs. 96.3 +/- 32.9), higher CURB-65 scores (2.7 +/- 1.2 vs. 2.2 +/- 0.9), lower PaO2/FiO(2) ratios (216.3 +/- 86.8 vs. 269.9 +/- 65.6), and the presence of multilobar (33.3% vs. 16.4%) and bilateral (41.7% vs. 18.9%) radiologic infiltrates were related to treatment failure. The PSI score and PaO2/FiO(2) ratio were independent param-eters affecting treatment results in multivariate linear regression analysis (P < 0.001). Conclusion: The risk of treatment failure is high in patients with severe pneumonia and with respiratory failure. Effective treatment and close monitoring are required for these cases.

In this study, we aimed to investigate the respiratory symptoms of miners who were survivors from Soma mine disaster at 2014. 90 survivors from Soma mine disaster that caused 302 death were invited to include the study by telephone. 39 miners were accepted to include study. Chest radiography, pulmonary function test, and ATS-DLD 78 respiraory questionnaire including socialdemographic findings were applied to all 39 miners. Chest radiography of miners were evaluated in accordance with ILO standards by 3 certificated readers. All miners were male and mean age was 35,3±6,2 years. Mean FEV1 % and FVC % were 89,2% (54%-124%) and 88,4% (45%-124%) respectively. Cough, sputum, wheezing, and dyspnea were seen in 17 (43,6%), 16 (41%), 13 (33,3%), and 18 (46,6%) miners respectively. 5 miners had COPD and 4 miners had asthma diagnosis. 23 (59%) miners were exposed severe dust more than 1 years. 32 (82,1%) miners also had smoking history and 23 of them were current smoker. There was no relation with duration of work and presence of symptoms (p>0,05). Also there was relation with duration of work and pulmonary function tests (p>0,05). After chest radiography evaluation, 12 (30,8%) of miners were considered to have pneumoconiosis by all 3 experienced readers. There was no relation with presence of pneumoconiosis findings and duration of work and presence of symptoms (p>0,05). In conclusion, half of the patients had respiratory symptoms and one third of them has pneumoconiosis findings at chest radiography.

There are many studies about clinical and laboratory results of carbon monoxide poisoning.Time duration from poisoning to admisson to hospital is also important. In this study we analyzed systemic,respiratory,and cardiovascular effects of carbon monoxide poisoning at Soma mine disaster retrospectively. The data of 90 male patients who were survivor from Soma Mine Disaster that caused 302 death as a result of carbon monoxide poisoning were invastigated retrospectively. Percentage of admission to hospital after mine disaster in first four hours, between four and eight hours, and after eight hours were 15,6%, 40%, and 44,4% respectively. General symptoms were headache (93,3%), dizziness (73,3%), nausea (50%), syncope (24,4%), vomiting (5,6%), visual disturbances (5,6%), confusion (3,3%). Respiratory symptoms were dyspnea (40%), cough (63,3%), and sputum (18,9%). Cardiac symptoms were chest pain (22,2%) and tachycardia (40%). There were pathological findings in 45,6% of patients. Level of leukocyte, urea, liver enzymes (SGOT, SGPT), and CK-MB were found higher in patients admitted to hospital after 8 hours than patients who admitted to hospital at first four hour (p In conclusion, transfer time to hospital in carbon monoxide poisoning is important. To reduce the effect of carbon monoxide poisoning emergency support systems must be improved.

WOS: 000389842500001, PubMed ID: 28393724, Introduction: Pneumonia in cases with preceding hospitalization, hemodialysis, intravenous therapy, wound care, or chemotherapy within the prior 30 days and residence in nursing homes are defined as healthcare associated pneumonia (HCAP). The aim of this study was to compare the demographic and laboratory data, isolated causative agents and prognosis of patients with community-acquired pneumonia (CAP) and HCAP in a large population in Turkey. Materials and Methods: The data of 785 cases (average age 65.3 +/- 16.4, 530 male) registered to Turkish Thoracic Society Respiratory Infections Study Group CAP database (TURCAP) were examined. The demographic data, clinical history, pneumonia severity scores (PSI), laboratory and radiologic findings of the CAP and HCAP patients were compared. Results: Out of 785 cases, 207 (26.4%) were diagnosed with HCAP and 578 (73.6%) with CAP. Among HCAP cases, 140/207 (67.6%) had preceding hospitalization in the last 90 days, 28/207 (13.5%) were on a hemodialysis program during the previous 30 days and 22/207 (10.6%) were staying in nursing homes. Patients with HCAP more frequently had comorbidities (93.2% vs. 81.6%; p= 0.001) and higher PSI scores (103.9 +/- 37.2 vs. 94.6 +/- 35.4; p= 0.002) compared to patients with CAP. A causative microorganism was isolated in only 12.1% (70/578) of CAP and 14.5% (30/207) of HCAP patients. The length of stay in hospital was higher in HCAP than CAP (8.6 +/- 5.5 vs. 7.5 +/- 6.1 days, p= 0.03); however the rates of treatment failure, intensive care unit admission and mortality were similar. Conclusion: In comparison to CAP, HCAP patients tend to have more severe disease, despite have no difference in mortality. The current criteria for HCAP do not predict worse clinical outcomes. Further work is required to define local risk factors for multidrug-resistant pathogens.

Currently, new biomarkers like N-Terminal-Pro-B-Type natriuretic peptide (NT-proBNP) have been used in the differential diagnosis of pleural effusions. In our study, we aimed to investigate the diagnostic value of NT-proBNP, especially in cardiac originated pleural effusions. Forty-five patients with pleural effusions were included in the study. NT-proBNP levels and biochemical markers involved in the Light's criteria were analyzed in pleural fluid and serums of the patients. Pleural fluid culture, AFB smear, cytology were performed where they were indicated according to the clinical evaluation. In patients, to whom cardiac pathology was considered to be; cardiological evaluation and echocardiography were also done. Thirty-eight pleural effusions were exudative and, 7 were transudative according to the Light's criteria. Final diagnosis were malignant effusion in 13, infection (tuberculosis/pneumonia) in 10, congestive heart failure in 21, and other conditions related with pleural effusion in 1 of the patients. Median (25th to 75th percentiles) NT-proBNP levels of serum and pleural fluid due to congestive heart failure (CHF) were 4747 pg/mL (931-15754) and 4827 pg/mL (1290-12.430) while median NT-proBNP levels of serum and pleural fluid related with non-cardiac reasons were 183 pg/mL (138-444) and 245 pg/mL (187-556) respectively. NT-proBNP levels of serum and pleural fluid were significantly high in CHF (p< 0.001 for both). When four groups were compared serum and pleural fluid NT-proBNP levels were highest in the CHF group which was followed by malignancy, infection and others (p< 0.001 for both). Fourteen of 21 patients who were accepted to have congestive heart failure as the final diagnosis by a cardiological evaluation had an exudative pleural fluid according to the Light's criteria. Serum and pleural fluid NT-proBNP levels were higher in transudates and this reached statistically significance for pleural fluid (p= 0.009). We suggest that measurement of pleural fluid NT-proBNP is a smart approach and pleural fluid NT-proBNP can reflect cardiac origin of effusions better than serum NT-proBNP and Light's criteria.

OBJECTIVES: This study aimed to investigate the additional diagnostic value of endobronchial biopsy (EBB) in the diagnosis of pulmonary sarcoidosis. MATERIALS AND METHODS: This retrospective cross-sectional study included 59 patients with a preliminary diagnosis of sarcoidosis who were admitted to the Pulmonary Diseases Outpatient Clinic of a tertiary healthcare center between January 2005 and October 2012. The socio-demographic characteristics of the patients as well as clinical and radiological findings were recorded. All patients, irrespective of the presence of an endobronchial lesion (EBL), underwent fiberoptic bronchoscopy (FOB); two to four specimens were taken using EBB from the carina of the right middle lobe in the patients with EBL. RESULTS: Of the patients, 39 (66.1%) had normal bronchoscopic findings, while 5 had EBL. Diagnosis was based on EBB in 11 patients (18.6%). Six patients (15.3%) with normal bronchial mucosae were pathologically diagnosed by EBB. There was no statistically significant relationship between the diagnostic ratio of EBB and disease stage, extrapulmonary involvement, FOB findings, elevated lymphocyte rate in bronchoalveolar lavage (≥ 13%), a CD4/CD8 ratio of ≥ 3.5, and serum angiotensin-converting enzyme (ACE) level (p> 0.05). CONCLUSION: EBB not only offers the advantage of a high diagnostic ratio in patients with mucosal abnormalities but also contributes to pathological diagnosis in patients with normal mucosa. We recommend using EBB to support diagnosis with a low complication rate for patients undergoing FOB with a preliminary diagnosis of sarcoidosis in healthcare centers, where endobronchial ultrasound (EBUS) is unavailable.

The effect of add on omalizumab therapy for two years, on current asthma control, and future exacerbations were evaluated in severe allergic and non-allergic asthma patients treated with high doses inhaled steroids and long acting beta agonist combinations. 37 allergic asthma and 8 non-allergic asthma patients receiving omalizumab theraphy during last two years were included to the study. Initial, first, second years ACT, FEV1 and exacerbations treated with a minimum 3 day systemic steroids were calculated. The difference between two groups were analyzed with Portable SPSS. Mean age of omalizumab group of 26 women and 11 males was 41,9±11,7 years. Mean age of control group of 5 women and 3 male was 59,5±14,8 years (p All two groups had statistically meaningful increase in their ACT level for the first and second years (p 0,05). ACT increase in 16.week and first year in allegic asthma group was greater comparing with increase in non-allergic asthma group (p 0,05). Decrease in exacerbation rate in 1. and 2. year in allergic asthma group and non-allergic asthma group was found similiar (p> 0,05). Add on omalizumab in compatible severe non-allergic asthma patients seems benefical therapy for current control and future risk for exacerbations.

Aim: In the literature, there is no study that focuses on frequency of ICS use and the differences between ICS users and non-users in patients with pneumonia.Our aim is to search for differences regarding clinical characteristics,laboratory parameters,duration of hospitalization and response to treatment between ICS users and pneumonia patients. Methods: 1069 patients were included in the study.Patients(n:922) were divided into two groups as ICS users and non-users.Differential characteristics of pneumonia in ICS users were evaluated using regression analysis. Results: 227out of 922patients were using ICS.ICS use was associated with older age(p=0.0001),higher rates of smoking(p=0.02),higher values of PCO2(p=0.0001)and patchy infiltrations(p=0.011) on thorax computerized tomography(CT).On the other hand,it was associated with lower values of PO2(p=0.016),PO2/FiO2(p=0.017) and lower rates of mortality(p=0.006),less common fever(p=0.013),gastrointestinal symptoms(p=0.22),myalgia(p=0.015),pleural effusion (p=0.002) and consolidations on chest x-ray(p=0.01).Mean duration of hospitalization for ICS users was 14.35±5.57 days and 15,8±8,85 days for non-users(p=0.5).According to regression analyses,ICS was associated with lower prevalences of consolidations on chest x-ray(p=0.011) and pleural effusion (p=0.014) and higher prevalences of patchy infiltrations on thorax CT(p=0.003) and accompanying COPD(p=0,0001). Conclusion: ICS use is associated with better treatment response and lower mortality rates in hospitalized pneumonia patients in contrary to what is expected. New larger-scaled studies are warrented regarding our topic.

Introduction:We evaluated mortality rate and factors related to short(30 days) and long term mortality of community-acquired pneumonia(CAP). Methods: Patients registered to “Pneumonia Data Base,TURCAP” that prepared by Turkish Thoracic Society Respiratory Infections Scientific Assembly between January 2009-2013 were included. Characteristics and clinical-laboratory findings, pneumonia indices were obtained. All cause mortality was recorded. Results: Of the 785 patients,68% were male, and the mean age was 66±16 years. The median follow-up was 38 months, With respect to all-cause mortality,71(9%) patients had died within 30 days, 29,6% within 1 year,349(44%) by study end. Median survival time was 51 months. Short-term mortality was higher in;older age, initial symptoms of chest pain, impaired consciousness, malignancy, serebrovascular diseases, high blood urea nitrogen level, low hematocrit level;parapneumonic effusion and abscess (compared to pneumonia) and extended infiltration,PSI and CURB-65 scores. In multivariate analysis;PSI scores and comorbid diseases were independent factors. For long term mortality, other than short term factors(except extended infiltration);male gender,presence of fever, chronic heart and renal failure, >2 hospitalisation in last 2 months, steroid/immunosuppresive therapy in last 3 months were found to related. Independent factors were PSI score,malignancy,frequent hospitalisation in the last 2 months and low hematocrit levels. Conclusion: Malignancy and PSI scores were the strongest predictors of short and long term mortality,whereas lower hematocrit levels and previous frequent hospitalisation were also strong long term mortality predictors.

Positron emission tomography(PET) with FDG is routinely performed for investigating suspected lung cancers although there is potential for false-positive FDG uptake.The aim of this study was to investigate the effect of incidental FDG findings at extrapulmonary locations on duration of diagnosis and time to treatment in patients staged for lung cancer. The lung cancer patients diagnosed in our clinic were divided into two groups according to time period like before PET CT usage and after PET CT usage.Soscial demographic findings,pathological diagnosis,treatment modalities and treatment results were recorded retrospectively from patients files.Also number of radiological and surgical procedures and time to treatment from diagnosis were recorded. 1312 patients were included study.427 patients(32,5%) were in a period before PET CT usage and 885 patients(67,5%) were in a period after PET CT usage.Mean age was smaller PET CT group(p Although PET CT was important tool in diagnosis and staging of lung cancer it can cause increase in time to treatment and diagnostic procedures.

Aim: of the study was to validate the Turkish version of Leicester Cough Questionnaire and use for Turkish patients with cough. The questionnaire was translated into Turkish by using appropriate translation steps. The lettered patients over 18 years old who had no psychological diseases included into the study.The patients social-demographic data were recorded. After clinical examination,Turkish questionnaire had been applied to the patients.For reliability analysis, internal consistency and test-retest method were used. Cronbach alpha coefficent and item-total statistics were calculated for each question and subscales.The questionnaire had been applied to 100 patients twice with the interval of two weeks to quantify test-retest reliability.For validation the questionnaire is compared withSF-36 andWHOQOL-BREF-TR which were validated before in Turkish. 58 female,42 male total 100 chronic cough patients who had been followed at Celal Bayar University Chest Disease Department and 100 control group were included into the study between July 2013-July 2014.Mean age of patients was 44,7±16,4 years.For internal consistency,cronbach alpha coefficients of all subscales ranged between 0,73-0,89and calculated as 0,92 for total index. In test-retest reliabilty, the correlation coefficient ranged between 0,598-0,788 for each question and calculated as r=0,905 for total LCQ score. (p Our study indicates that the Turkish version of LCQ has been found to have acceptable reliability and validity for use in Turkish patients with cough.

ITNF-α plays a critical role in host defenses against bacterial and particularly myobacterial infections. Anti TNF-α theraphy has been used for the treatment of inflammatory diseases. Aim of this study was to assess the pulmonary infections in patients receiving anti TNF-α treatment. The data files of patients who admitted to approval for the TNF-α inhibitors treatment, were retrospectively evaluated between 2008-2014. 997 patients were followed in our department during this period. 421 (42,2%) patients were male and mean age was 43,1±15,8 years. Bacterial pneumonia was seen in 35 patients candiadal pneumonia was seen in 4 patients, parasitic infection was seen in 9 patients and additionally 2 patients had pneumocystis jirovecii infection. 17 patients developed tubercolosis. Culture positive pulmonary tuberculosis occured in 9 patients, 8 patients developed extrapulmonary tuberculosis (4 tuberculosis lymphadenitis, 2 tuberculous pleurisy, 1 urogenital tuberculosis, 1 skin tuberculosis). All of patients developed tuberculosis INH prophylaxis. 59 patients of 67 patients developed infections were also using other immunosuppresive treatment with TNF-α inhibitors. Tuberculosis and pulmonary infections other than tuberculosis risk increased in patients receiving TNF-α inhibitors theraphy. The clinicians must be careful in terms of pulmonary infections other than tuberculosis in these patients.

WOS: 000389053000023, PubMed ID: 27966308, Background/aim: There has been growing interest in the use of serum procalcitonin (PCT) and C-reactive protein (CRP) in patients with community-acquired pneumonia (CAP). The aim of this study was to investigate whether an assessment of fever, leukocyte count, and serum CRP and PCT levels on admission and during follow-up (day 3) provides any information about the clinical outcome in hospitalized patients with CAP. Materials and methods: Patients with a diagnosis of CAP who were admitted to and followed at four university hospitals were evaluated retrospectively using the Turkish Thoracic Society Pneumonia Database. Results: A total of 103 hospitalized CAP patients (57 males, mean age: 61.5 +/- 16.7 years) were enrolled in the study. Treatment failure (TF) was observed in 20 patients (19.4%). Pneumonia Severity Index scores, serum CRP levels, and PCT levels on admission were significantly higher in the TF group. There were significant decreases in CRP and PCT levels between admission day and day 3 in the treatment success group. Conclusion: In patients with CAP, the body temperature and leukocyte count on admission do not predict outcome. Monitoring levels of CRP and PCT may be useful as a predictor of treatment outcome.

Background: The aim of this study is to investigate the prevalence of metabolic syndrome (MetS), carotid intima media thickness (IMT), and serum C-reactive protein (CRP) levels in patients with chronic obstructive pulmonary disease (COPD), and the possible relationships among them. Methods: Fifty stable COPD patients and 40 healthy controls were included in the study. The participants were further divided into four groups according to their smoking status. Pulmonary function tests were performed in COPD patients. Anthropometric measurements and blood chemistry analysis, serum CRP levels and carotid intimamedia thickness (IMT) measurements were performed in all the study population. Results: Prevalence of metabolic syndrome was 43% in COPD patients and 30% in the control group (p = 0.173). FEV1% and FEV1/FVC were higher in COPD patients with MetS (p = 0.001 and p = 0.014, respectively) compared to those without MetS. Prevalence of MetS was significantly different among the COPD patients with different stages (p = 0.017) with the highest value in stage 2 (59%). Carotid IMT was significantly higher in COPD patients than in control group (1.07 ± 0.25 mm and 0.86 ± 0.18 mm, respectively; p < 0.001). Serum CRP levels were not different in COPD patients and controls, however they were higher in individuals with MetS compared to those without MetS regardless of COPD presence (p = 0.02). Conclusions: Early markers of atherogenesis, in terms of carotid IMT, were found to be higher in COPD patients than in healthy controls. MetS prevalence was observed to decrease as the severity of airflow obstruction increased. Therefore, screening COPD patients for these cardiovascular risk factors would be a novel approach even in absence of symptoms.

Objective: This study investigated the attitudes of Turkish adults towards the ban on smoking in public areas and compared annual smoking cessation rates before (pre-2009) and after (post-2009) the ban became law, using data from a survey of teachers. Methods: A self-reported questionnaire was used to collect data from teachers in Manisa, Turkey. Annual smoking rates were calculated. Joinpoint regression analysis was used to identify when a significant change occurred in the annual smoking cessation rate. Results: Questionnaire response rate was 79.6% (579/727); 47.8% (277) of respondents were male. Smoking prevalence among men and women was 32.7% and 24.7%, respectively, and 97.3% of nonsmokers and 75.5% of current everyday smokers supported the law changes. Results of the Joinpoint analysis showed no significant change in annual smoking cessation rate between 2001–2002 and 2006–2007; but there were significant reductions in smoking rates between 2007–2008 and 2010–2011. Conclusions: Teachers in Turkey have a positive attitude to the law on smoking. The smoking cessation rate in teachers was significantly increased by changes in legislation.

WOS: 000317543300016, PubMed ID: 25207072, Objective: Unlike seasonal influenza, seen in previous years, the strain identified in the 2009 influenza-A pandemic involved high mortality. In this study, prognostic factors and general characteristics of pneumonia cases developed in Turkey during the H1N1 pandemic between October 2009 and January 2010 were analyzed. Study Design: Multicenter retrospective study. Material and Methods: This multicentric retrospective study was conducted between August and October 2010 and patients' data were collected by means of standard forms. Results: The study included 264 pneumonia cases, collected from 14 different centers. Mean age was 47.5 +/- 18.6 years. Nineteen patients (7.2%) were pregnant or had a new birth and comorbid diseases were detected in 52.3% of all patients. On admission, 35 (13.8%) cases had altered mental status. Overall, 32.6% were treated in intensive care units (ICU) and invasive/non-invasive mechanical ventilation was performed in 29.7%. The mean duration of ICU stay was 2.9 +/- 6.2 and total hospital stay was 12.0 +/- 9.4 days. Mortality rate was 16.8% (43-cases). The length of ICU treatment, total hospital stay, and mortality were significantly higher in H1N1-confirmed patients. Mortality was significantly higher in patients with dyspnea, cyanosis, and those who had altered mental status on admission. Patients who died had significantly higher rate of peripheral blood neutrophils, lower platelet counts, higher BUN, and lower SaO(2) levels. Conclusion: This study showed that pneumonia developed during H1N1 pandemic in our country had resulted in a high mortality. Mortality was especially high among patients with cyanosis, altered mental state and those with lower SaO(2).

The levels of smoking of 1st and 2nd year students at Faculty of Medicine and Manisa School of Health at Celal Bayar University were investigated in 2006-2007. This study is carried out in order to see if there is a change in the same students' level of smoking while they are in 3rd and 4th year. In addition, the study aimed to examine the factors affecting the level of use and attitudes towards the law effectuated in July 19, 2009. This is a follow-up study with 80.42% return rate. A 26-item structured questionnaire was administered. The participants filled out the questionnaires under supervision of the researchers in their classrooms. The University Institutional Review Board approved the study. The total of participants (263) of the follow-up study included 189 female and 74 male. The rate of experimenting with smoking was 49% with the mean age of 15.7 (SD= 4.01 years). The mean age of experimenting with smoking was the earliest on male students studying at faculty of medicine. The level of smoking was found to be the most on females, studying at faculty of medicine and staying at the dormitory, with smoking parents (p< 0.05). The most important reason to begin smoking was curiosity (55.2%) while bad breath and yellowing of teeth were the reasons to quit (91.7%). 83.3% of the students thought that the law will be effective on quit smoking. The level of both experimenting and use of smoking has been increased over time. It is suggested that medical students' awareness about the danger of smoking should be raised at earlier grades. In addition, lectures should be offered to students at School of Health and they should be encouraged to unite in order to fight with smoking.

Aim: We aimed to assess mannose-binding lectin (MBL) gene polymorphisms and serum MBL concentrations in a sample of Turkish chronic obstructive pulmonary disease (COPD) patients as well as in cigarette smokers. Furthermore, we looked for the possible correlations of serum MBL concentrations with pulmonary function tests.

Objective: Airway inflammation and oxidative stress biomarkers increase in chronic obstructive pulmonary disease (COPD) and this is thought to be related to faster decrease in lung functions. Systemic markers of oxidative stress include nitric oxide (NO) and malonyl dialdehyde (MDA), while antioxidant markers are erythrocyte superoxide dismutase (SOD) and gluthathion-peroxidase (GSH-Px). We investigated the relationship between levels of systemic oxidative/antioxidant markers and functional parameters.

Background and aims: Recently a multidimensional grading system based on the body mass index (B), degree of airflow obstruction (O), dyspnea (D) and exercise capacity (E) - the BODE index - has begun to be used increasingly for the evaluation of chronic obstructive pulmonary disease (COPD) patients. The aim of our study was to investigate the relation- ship between the BODE index and disease duration, annual exacerbation and hospitalization rates, health related quality of life and systemic inflammatory markers like C-reactive protein (CRP), tumor necrosis factor (TNF)-α and interleukin (IL)-8. Materials and methods: In 88 stable COPD patients we evalu- ated the body-mass index, pulmonary function tests, Modified Medical Research Council dyspnea scale and six- minute walk test (6MWT). BODE scores were determined. Disease duration, number of exacerbations and hospitaliza- tion in the previous year were recorded. We also performed arterial blood gases analysis, administered the St. George’s Respiratory Questionnaire (SGRQ) and measured serum lev- els of CRP, TNF-α, IL-8. Results: According to BODE score 52% of patients were BODE 1, 21% BODE 2, 15% BODE 3 and 12% were BODE 4. There was a significant relationship between BODE index and COPD stage as classified according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) (p < 0.001). Correlations between BODE score and disease duration (p = 0.011), number of exacerbations (p < 0.001) and hospitaliza- tions (p < 0.001) in the last year were also observed. SGRQ symptom, activity, emotion scores and total scores were found to be significantly correlated to BODE (p < 0.001). Serum CRP levels and BODE were also correlated (p = 0.014); however, no correlation was found between serum levels of TNF-α and IL-8 and BODE. Conclusions: As the BODE index shows a strong correlation with various prognostic and follow up parameters of COPD and systemic inflammation, its use should be considered for the evaluation of COPD patients.