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Tobacco addiction, which causes the death of more than 8.5 million people in the world every year, is a preventable global public health problem. There are 1.1 billion adult smokers worldwide and 60% of them desire or intend to quit but unfortunately, the tobacco industry continues to profit at the expense of people's lives by marketing electronic cigarettes and heated tobacco products as a smoking cessation method and they continue to poison young people with new threat tobacco products, promising a "smoke-free future" Turkish Thoracic Society is actively involved in the implementation of the National Tobacco Control Program to protect public health and has warned and raised awareness of new threats to the youth, such as electronic cigarettes and heated tobacco products. The purpose of this report is to provide information about electronic cigarettes and heated tobacco products and to present TTJ's position on the subject.

This review aimed to highlight some important points derived from the presentations of the European Respiratory Society 2021 Virtual International Congress by a committee formed by the Early Career Task Group of the Turkish Thoracic Society. We summarized a wide range of topics including current developments of respiratory diseases and provided an overview of important and striking topics of the congress. Our primary motivation was to give some up-to-date information and new developments discussed during congress especially for the pulmonologists who did not have a chance to follow the congress. This review also committed an opportunity to get an overview of the newest data in the diverse fields of respiratory medicine such as post-coronavirus disease 2019, some new interventional and technologic developments related to respiratory health, and new treatment strategies.

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 score40). 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.

The objective of this study is to investigate the effects of laparoscopic sleeve gastrectomy (LSG) on the polysomnographic parameters related to OSAS. 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. 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/m2 at baseline to 33.2 ± 8.2 kg/m2 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

There are concerns regarding the risk and the course of COVID-19 in pregnancy and in the neonates. In this review, we aimed to present the current understanding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy and neonatal periods considering diagnosis, treatment, prognosis, and prevention. Few studies on pregnant women with COVID-19 have been conducted between December 2019 and April 2020. The majority of patients applied in the third trimester and presented with fever and cough. Ground-glass opacities and consolidation on computed tomography were reported to be common. COVID-19 was proposed to have a milder course than SARS and the Middle East respiratory syndrome coronavirus in pregnant women. Hydroxychloroquine and antiproteases (lopinavir/ritonavir) were reported to be safe; however, therapeutic efficacy and safety of remdesivir still lack evidence. As ribavirin and favipiravir have teratogenic effects, there are some debates on the use of ribavirin in severe cases. There is still no clear evidence of vertical transmission of SARS-CoV-2 during delivery. Occupational safety issues of pregnant healthcare workers on the frontline should be considered as their risk to develop severe pneumonia is higher because of altered maternal immune response. Knowledge about neonatal outcomes of COVID-19 was based on studies of the last trimester of pregnancy. There is much to be learnt about COVID-19 in pregnant women and in the neonates, especially concerning prognosis- and treatment-related issues.

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.

Dear Editor, Assisted by the advanced technology and trade, the novel coronavirus has swiftly diffused around the globe. In a matter of few months, by March 2020, the world was faced with a pandemic1 . The fatality rates have varied within a wide band according to countries. Hospital capacities have been tested severely as SARS-CoV-2 spread at unprecedented rates, causing COVID-19 patients to need heavy hospitalization and intensive care. In almost all countries, lockdowns have led to economic and psychological problems. The urgency and global scope of the pandemic created a lacuna to be filled by national and international information sharing. Almost all scientific journals have prioritized COVID-19 and published additional issues to share the knowledge and experience on COVID-19. The need for inter-disciplinary and multidisciplinary collaboration required a prompt adaptation of academics to the crisis management.

The novel coronavirus disease (COVID-19) is similar to connective tissue disease-associated interstitial lung diseases (CTD-ILD) in many aspects. However, patients with CTD-ILD have required particular attention during the pandemic since they are at high risk due to immunosuppressive treatments. Thus, prompt decisions for diagnosis and treatment initiation have become more important than earlier for these patients during the pandemic. Radiological perspectives have become inevitable for the differential diagnosis of this group during the pandemic, particularly to obtain rapid and accurate results that allow the physicians to start treatment immediately. However, in addition to radiological images, a definitive diagnosis also requires access to extensive information regarding patient history, including characteristics of comorbidities, and clinical and serological findings. Consequently, the differential diagnosis of COVID-19 and CTD-ILD can yield accurate treatment regimens that differ greatly between the 2 diseases, and also prevent the spread of the outbreak with COVID-19 patients treated under isolation. © 2021, AVES. All rights reserved.

Amaç: Pulmoner tromboemboli tanısı ile yatırılarak tedavisi yapılan hastalarda yatışında ve taburcu edildikten sonraki 6 ay boyunca devam eden tedavi sürecinde ortaya çıkabilecek komplikasyonlar ve sağ kalımı etkileyen faktörlerin araştırılması amaçlanmıştır.Materyal ve Metot: Çalışma Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi Eğitim ve Araştırma Hastanesi Göğüs Hastalıkları Kliniğinde pulmoner emboli tanısı ile yatırılarak takip ve tedavi edilen hastalarda yapıldı. 01/01/2014 - 01/12/2016 tarihleri arasında, spiral toraks anjio bilgisayarlı tomografisinde en az segmental pulmoner arterde dolum defekti saptanan erişkin hastalar çalışmaya alındı..Bulgular: Çalışmaya alınan toplam 50 hastanın yaş ortalaması 73,04±13,313 yıl ve 13’ü (%26) erkek, 37’si (%74) kadındı. Eksitus olanlarda nabız, Modifiye Geneva ve Wells skorları, pulmoner emboli şiddet indeksi ve basitleştirilmiş pulmoner emboli şiddet indeksi skorları sağ kalanlara göre yüksekti. Eksitus olanlarda hem RDW (Red Cell Distribution With) hem de 1. ve 5. Gün MCV (Mean Corpusculer Volum) ve hematokrit düzeyleri daha düşüktü. Eksitus olanlarda platelet sayısı daha yüksek iken 1. ve 5. gün kan total protein ve albümin düzeyleri düşük bulundu. ALP (Alkalen fosfataz)’ın 1. günde yüksekliği, 5. günde total bilirubin ve CRP (C-Reaktif Protein) yüksekliği mortalite ile ilişkili bulundu. Sonuç: Çalışmamızda Basitleştirilmiş pulmoner emboli şiddet indeksi skorunun yüksekliği, taşikardi, 1. gün ve 5. gün bakılan hemoglobin, total protein, albümin düzeylerinin düşük olması, RDW düzeyi yüksekliği, ALP yüksekliği, 5. Günde WBC, CRP ve total bilirubin düzeylerinin hala yüksek seyretmesi mortalite ile ilişkili bulunmuştur.

In this article, early career members of the Epidemiology and Environment Assembly of the European Respiratory Society (ERS) summarise a selection of five sessions from the ERS 2020 Virtual International Congress. The topics covered include risk factors for chronic respiratory diseases over the life course, from early life origins to occupational exposures in adulthood, and the interplay between these risk factors, including gene–environment interactions. Novel results were also presented on smoking prevention and potential risks of vaping. Finally, the challenges and opportunities for epidemiological and environmental research brought by the coronavirus disease 2019 (COVID-19) pandemic were a major topic of this year's congress., Highlights of #ERSCongress 2020 from the Epidemiology and Environment Assembly https://bit.ly/3ogC1Me

The Lung Science Conference (LSC) and the Sleep and Breathing Conference (SBC) are two conferences organised by the European Respiratory Society (ERS), the latter held in association with the European Sleep Research Society. This year, the LSC and SBC were both held in a virtual format with the participation of researchers and clinicians from around the world. The participation of Early Career Members (ECMs) was notable in both events: 216 of 363 (60%) delegates attending the LSC were under 40 years old, and 315 of 920 (34%) delegates were ≤40 years of age at the SBC. Both conferences included outstanding talks on the most recent advances in respiratory medicine and science, oral/poster communication sessions on novel research, exciting opportunities to network with peers, and much more!, This article provides a brief description of some of the most remarkable sessions of the @EuroRespSoc Lung Science Conference and the Sleep and Breathing Conference 2021 and presents the new incoming members of the ECMC (@EarlyCareerERS) https://bit.ly/2RSDP40

Objective: Cigarette smoking is one of the primary causes of cancer. Tobacco exposure affects many parameters such as prog-nosis, response to treatment, and quality of life after a cancer diagnosis. We aimed to assess the association between smoking status with de-mographical and clinical characteristics of patients with malignancy who were referred to the Nuclear Medicine Department. Material and Methods: A total of 440 (59.8% males; median age 62 years) patients diagnosed with malignancy who applied to the nuclear medicine department between December 2018 and May 2019 were assessed. The smoking behavior of patients was examined according to cancer diag-nosis, age, gender, and education level. The factors that may affect quitting smoking after the cancer diagnosis were evaluated. Results: Thirty-eight percent of patients were never smoked, 51.4% were former smokers, and 10.7% were current smokers. Smoking history in men and women was present at the rate of 87.8% and 23.7%, respectively. Breast and gynecological cancers were more common in never-smoker females (p

Introduction: Alpha-1 antitrpsin (AAT) deficiency is considered as a situation that should be evaluated for all of COPD patients at least once in their lives at guidelines. Although this information is known at theoretical level, this rule is not followed in our country and in many other countries. The aim of this study was to evaluate the AAT serum levels of COPD patients and the detected genetic mutations. Methods: Study was planned after the visit of the researcher to the AATD reference center in Barcelona. The sample consisted of COPD patients who applied to two different health institutions. Comparison of patients characteristics was made according to examination status and levels of serum AAT, also detected mutations were evaluated. Results: Totally 135 COPD patients were evaluated. Mean age of the study population was 63.4±11.2, with male dominance (96.6%). Among them 54.8% of them were examined for serum AAT levels. The comparison of AAT level tested and non-tested groups showed that AAT level tested group’s mean age was lower (p Conclusion: Detection of COPD patients for AAT deficiency is feasible and relevant for future directions.

As coronavirus disease 2019 (COVID-19) spreads across the world, the ongoing clinical trials are leading to a big race worldwide to develop a treatment that will help control the pandemic. Unfortunately, COVID-19 does not have any known effective treatment with reliable study results yet. In this pandemic, there is not a lot of time to develop a new specific agent because of the rapid spread of the disease. The process of developing a vaccine is long and requires hard work. Although the pathophysiology of the disease is not fully understood, some of the proposed treatment alternatives are based on old evidence and some have been used with the idea that they might work owing to their mechanism of action. The efficacy, reliability, and safety of the currently available treatment alternatives are therefore a matter of debate. Currently, the main therapies used in the treatment of COVID-19 are antiviral drugs and chloroquine/hydroxychloroquine. Other proposed options include tocilizumab, convalescent plasma, and steroids, but the mainstay of the treatment in intensive care units remains supportive therapies. WOS:000600070300012 2-s2.0-85103141655

Background/aim This study aimed to investigate the effect of clinical and pathological indicators at the time of the diagnosis on overall survival in patients recently diagnosed with non-small cell lung cancer. Materials and methods The study population consisted of patients who were diagnosed at the Faculty of Medicine at Isparta Suleyman Demirel University Hospital between January 1, 2010 and December 31, 2017 and presented to the medical oncology outpatient clinic. Results A total of 518 patients were evaluated, including 260 patients with squamous cell carcinoma, 207 patients with adenocarcinoma, 50 patients with non-small cell lung cancer-not otherwise specified, and 1 patient with large cell carcinoma. The average life expectancy was found to be 11.50 ± 1.40 months in patients with squamous cell carcinoma, 12.60 ± 1.59 months in patients with adenocarcinoma, and 8.70 ± 1.87 months in the other patients. The estimated 5-year relative survival rate for non-small cell lung cancer was 8% (7% for men and 18% for women). In the multivariate analysis, sex being male (HR, 2.41; P 2 (HR, 1.70; P < 0.001), the stage of cancer (HR, 1.37; P = 0.045), the presence of bone or liver metastasis (HR, 1.44, P = 0.009, HR, 1.57; P = 0.016, respectively), and the patient not having received radiotherapy (HR, 3.25; P < 0.001) or chemotherapy (HR, 1.85; P = 0.001) were defined as statistically significant predictive factors that reduced the overall survival. Conclusions In this study, sex, stage, performance status, the presence of liver or bone metastases, and treatment had an effect on overall survival.

Scientists from all over the world have been intensively working to discover different aspects of Coronavirus disease 2019 (COVID-19) since the first cluster of cases was reported in China. Herein, we aimed to investigate unclear issues related to transmission and pathogenesis of disease as well as accuracy of diagnostic tests and treatment modalities. A literature search on PubMed, Ovid, and EMBASE databases was conducted, and articles pertinent to identified search terms were extracted. A snow-ball search strategy was followed in order to retrieve additional relevant articles. It was reported that viral spread may occur during the asymptomatic phase of infection, and viral load was suggested to be a useful marker to assess disease severity. In contrast to immune response against viral infections, cytotoxic T lymphocytes decline in SARS-CoV-2 infection, which can be partially explained by direct invasion of T lymphocytes or apoptosis activated by SARS-CoV-2. Dysregulation of the urokinase pathway, cleavage of the SARS-CoV-2 Spike protein by FXa and FIIa, and consumption coagulopathy were the proposed mechanisms of the coagulation dysfunction in COVID-19. False-negative rates of reverse transcriptase polymerase chain reaction varied between 3% and 41% across studies. The probability of the positive test was proposed to decrease with the number of days past from symptom onset. Safety issues related to infection spread limit the use of high flow nasal oxygen (HFNO) and continuous positive airway pressure (CPAP) in hypoxic patients. Further studies are required to elucidate the challenging issues, thus enhancing the management of COVID-19 patients. WOS:000542299000018 2-s2.0-85087118043

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 (p0.05). 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.

Objective Tobacco use is one of the most important causes of preventable diseases worldwide. Doctors are responsible for their patients’ health status both by being a role model with their smoking related behaviours and by following the recommended strategies known as ‘5A’ and ‘5R’. While it is not clear what to add to the syllabi of medical faculties’ for tobacco related courses, we aimed to raise awareness about the importance of the topic by doing a research evaluating the clinicians’ implemention of the strategies in real life settings. Methods A cross-sectional study was conducted between February 11-15, 2019 at our university affiliated tertiary care hospital’s blood sample collection unit. Short questionnaires that contains 12 questions were asked to the patients who had just applied to the unit after their outpatient clinic examination, They are being interviewed by medical students after obtaining their oral informed consents. Results Data from 500 patients were evaluated. Their mean age was 46,44±14,78. 56.2% of them were males. 44.4% of them were graduates of primary education. Among the admitted clinics, 75.4% were from internal medicine related clinics, the rest was from surgical clinics. Current smoking rate was 34%; 46.6% of males, 17.8% of females. Among all patients, 41% of them were asked about their smoking status. Among current smokers, 31.8% had received only oral advices, only 6% had been referred to smoking cessation clinics. The populations who have higher rates for being questioned about their smoking status were males, patients with respiratory system related symptoms, and patients who went to clinics related to thoracic problems (pulmonology, cardiology, etc.) (p

In the last decade, outpatient smoking cessation clinics (SCCs) in Turkey have been extended countrywide. Initially, only counseling was covered under health insurance. In 2011 and 2015, free varenicline and bupropion preparations were distributed to SCCs, periodically. In the current study we aimed to compare outcomes between the free and paid medication periods.Patients applied to the local SCC in a secondary health care unit between June 2014 and June 2017. They were evaluated for SC interventions and had phone visits after their third month; these records were included in the study. Patients were grouped and evaluated according to medication's reimbursement status: free medication period (FP) and paid medication period (PMP).In total, 733 patients applied to the SCC, 77.7% of them had applied during the FP. Analyses were made involving 417 patients who had records of third-month phone visit. Mean age of the patients was 44.0±13.7 years with the majority of patients (65%) being male. Sociodemographic characteristics of patients in both groups were not statistically different, while the percentage of patients with comorbid diseases was lower in the FP group (p0.05). Treatment choices were different- the bupropion-prescribed group's rate was similar in both periods (53.5% in PMP vs 52.0% in FP), however varenicline was mostly prescribed in the FP (35.8% vs 14.1%) while nicotine replacement therapy was mostly prescribed in the PMP (32.4% vs 12.1%) (p0.05). Patients who used the advised treatment for at least 30 days (treatment adherent) and the rate of quitters at the third month were higher in FP (p0.05) from univariate analysis, however these differences were not statistically significant when a multivariate analysis was performed.Our study showed that the free medication period increased the quit attempts but the increased in treatment adherence and quit success of the participating smokers was not obvious.

Introduction In the last decade, outpatient smoking cessation clinics (SCCs) in Turkey have been extended countrywide. Initially, only counseling was covered under health insurance. In 2011 and 2015, free varenicline and bupropion preparations were distributed to SCCs, periodically. In the current study we aimed to compare outcomes between the free and paid medication periods. Methods Patients applied to the local SCC in a secondary health care unit between June 2014 and June 2017. They were evaluated for SC interventions and had phone visits after their third month; these records were included in the study. Patients were grouped and evaluated according to medication’s reimbursement status: free medication period (FP) and paid medication period (PMP). Results In total, 733 patients applied to the SCC, 77.7% of them had applied during the FP. Analyses were made involving 417 patients who had records of third-month phone visit. Mean age of the patients was 44.0±13.7 years with the majority of patients (65%) being male. Sociodemographic characteristics of patients in both groups were not statistically different, while the percentage of patients with comorbid diseases was lower in the FP group (p

Background and aim Despite the strict anti-tobacco policies, smoking is still a major preventable public health problem in Turkey. We aimed to evaluate the smoking status of university students and the influencing factors of their smoking according to both gender. Methods This cross-sectional study conducted between Mach 2017 and June 2017 at an university located in the Eastern Black Sea region of Turkey. Among all students who had been reached and agreed to participate the study were included. A self-administered questionnaire was used to collect information. Results Totally 2505 students’ data were evaluated with a mean age of 20.8±2.5 and female dominance (58.9%). Overall current smoking rate of the students was 27.9%; 15.3% among females and 46.0% among males, additionally, the rate of ever smokers was 60.7%; 51.9% among females, 73.4% among males (p

Aim: This study was conducted to evaluate the factors associated with treatment adherence and quit success in a group of patients that applied to our smoking cessation outpatient clinic (SCC) when varenicline and bupropion preparates were distributed free of charge by Turkish Ministry of Health. Methods: Among patients that applied to SCC between April 2015- December 2016 whom were evaluated suitable for smoking cessation interventions and started pharmachologic treatment and also reached by phone at their third month of first application were included to the study. The ones that had used prescribed treatment at least 30 days were grouped as treatment adherent while the others that used less than 30 days were grouped as treatment nonadherent. Results: Totally 346 patients’ data was evaluated. Mean age of them was 44.3±13.9 with male dominance (63%). Bupropion was started 52% of the patients, 59% of the patients was non-adherent to their treatment and at their third month 37.9% of them had quitted to smoke. Multivariate logistic regression analysis revealed that increase in control visit number, absence of advers reactions and varenicline use was associated with higher treatment adherence (p Conclusion: This study showed that most of the patients did not use the smoking cessation treatments adequately and main factor that affects quit success is treatment adherence. There is a need for a more close monitoring and follow for adequate use of treatment.