Turkish Thoracic Journal最新文献

Objective: This study aimed to evaluate attitude and practice toward use of regular tobacco cigarettes and electronic cigarettes among pregnant women.

Material and methods: A total of 1123 pregnant women participated on a voluntary basis in this questionnaire survey. Maternal characteristics, cigarette consumption parameters, and personal opinions regarding the adverse effects of smoking during pregnancy were evaluated.

Results: Active smokers composed 12.4% (9.4%: regular tobacco cigarettes, 3.0%: electronic cigarettes) of the study population. Smoking during the current pregnancy, particularly via regular tobacco cigarettes, was more likely for women with smoking during previous pregnancies (56.0% vs. 7.8%, P < .001), previous history of low birth weight infant delivery (16.1% vs. 8.6%, P = .013), premature delivery (16.7% vs. 7.0%, P < .001), and stillbirth (22.8% vs. 11.7%, P = .002). The presence versus absence of smoking during pregnancy was associated with a lower likelihood of being a housewife (70.5% vs. 80.5%, P = .010) and a higher likelihood of having an actively smoking mother (25.9% vs. 11.2%, P < .001) or partner (65.7% vs. 46.9%, P < .001). Regular tobacco cigarette users considered electronic cigarettes to have a higher risk of adverse impacts (11.1% vs. 2.9%, P = .012), while electronic cigarette users considered regular cigarettes to have a higher risk of nicotine exposure (55.9% vs. 13.0%, P < .001).

Conclusion: Our findings indicate being employed, having an actively smoking mother or partner, as well as smoking in previous pregnancies, to be the risk factors for increased likelihood of smoking during pregnancy.

Objective: It is still unknown how to call the pneumothorax that develops during the recovery period after coronavirus disease 2019. Patients who developed pneumothorax during the recovery period after coronavirus disease 2019 were compared with those who had a primary or secondary spontaneous pneumothorax without a coronavirus disease 2019 history.

Material and methods: Between 2020 and 2021, 160 patients with pneumothorax were retrospectively analyzed. Twenty-three patients had a history of coronavirus disease 2019 (coronavirus disease recovery) confirmed by real-time reverse transcriptase-polyme rase chain reaction, whereas the remaining 137 patients did not have a history of coronavirus disease 2019 (18 of the patients with secondary spontaneous pneumothorax group and 119 patients with primary spontaneous pneumothorax group).

Results: The median time between discharge and readmission to the hospital because of pneumothorax was 9 days in the coronavirus disease recovery group. There were statistically significant differences in regards to age (P < .001), gender (P = .02), the presence of bullae (P = .02), and dystrophic severity lung score (P = .04) between the coronavirus disease recovery and primary spontaneous pneumothorax groups, whereas no difference was found between the coronavirus disease recovery and the secondary spontaneous pneumothorax groups (P > .05). The prolonged air leak was observed in 17.6% (n = 25). Patients who had prolonged air leak were statistically higher in the coronavirus disease recovery group than the primary spontaneous pneumothorax group (56.5% vs. 10.1%), although it was almost similar between the coronavirus disease recovery and secondary spontaneous pneumothorax groups (P = .951). On logistic regression analysis, the coronavirus disease recovery group was the independent factor for prolonged air leak (odds ratio = 9.900, 95% CI = 1.557- 62.500, P = .01).

Conclusion: Pneumothorax may be developed during the recovery period after coronavirus disease 2019 in patients with previously healthy lungs, and it should be called as secondary spontaneous pneumothorax.

Objective: To evaluate the patients who were treated for intraocular tuberculosis retrospectively and present our findings and share our experience.

Material and methods: This study was a descriptive, cross-sectional, retrospective study. Patients who were followed up with the diagnosis of intraocular tuberculosis in the Ophthalmology and Pulmonary Medicine Departments of Dokuz Eylul University Faculty of Medicine in the last 15 years and received anti-tuberculosis therapy were included.

Results: A total of 16 eyes of 10 patients with a diagnosis of intraocular tuberculosis uveitis who were treated with anti-tuberculosis therapy were included in this study. The mean age was 48.1 [14.6] years (mean [standard deviation]). Four were [40%] male and 6 [60%] were female. Patients with tuberculosis uveitis had bilateral involvement (7 of 10 patients [70%]). Intraocular tuberculosis was presented in 7 eyes of 4 patients with serpiginous like choroiditis, 2 eyes of 2 patients with choroidal tuberculomas, 4 eyes of 2 patients with choroidal tubercles (miliary tuberculosis), and 3 eyes of 2 patients with intermediate uveitis. The mean duration from admission to treat- ment was 18.1 ± 17.4 days (range: 6-56 days). All patients in this study received a 4-drug regimen anti-tuberculosis therapy, Paradoxical reaction occurred in 30% of the patients. Eight patients had systemic steroid therapy and 4 had also topical steroid therapy. The mean length of follow-up was 14.7 months (standard deviation = 15.1, range: 6-48 months). Reactivation of intraocular tuberculosis was not observed in any patients.

Conclusion: High level of suspicion is a must for diagnosing intraocular tuberculosis. A complete ophthalmic examination can be performed in patients with suspected or proven tuberculosis. Early diagnosis and prompt treatment of intraocular tuberculosis can prevent serious complications and loss of vision.

Objective: Coronavirus disease 2019 is a disease caused by severe acute respiratory syndrome coronavirus 2, a novel type of coronavi- rus, which causes pneumonia in some hosts. No specific scoring method exists for mortality evaluation in novel coronavirus pneumonia. The aim of this study was to investigate factors affecting coronavirus disease 2019 mortality and comparison of pneumonia scoring sys- tems, pneumonia severity index, CURB-65, and MuLBSTA.

Material and methods: In this single-center clinical study, 151 patients who had been diagnosed with coronavirus disease 2019 infection and pneumonia between March 11 and May 31, 2020, were evaluated retrospectively. Correlation between patients' symptoms, comorbidities, drugs in use, radiological findings, and mortality was investigated. Parameters were also evaluated regarding their contribution to additional treatment requirements and days of fever response.

Results: A correlation between mortality and higher scores of pneumonia severity index, CURB-65, and MuLBSTA was found. When parameters were investigated separately, elevated glucose and urea levels, presence of diabetes, renal failure, hypertension, chronic obstructive pulmonary disease, cerebrovascular events and known malignancies, lymphocyte count, smoking history, radiological find- ings, and age correlated with mortality. In addition to these parameters, elevated calcium, potassium, brain natriuretic peptide, troponin, d-dimer, C-reactive protein, HC03, and lactate dehydrogenase levels were found significant regarding mortality. These parameters were not found statistically relevant regarding additional treatment requirement, fever response day, and total treatment duration.

Conclusion: A modified version of present pneumonia scoring systems will be required to rigorously evaluate the severity of a patient's condition. A new scoring system that uses components of the present ones may prove useful and with further studies, a similar follow-up algorithm may be created.

The coronavirus disease 2019 pandemic caused by severe acute respiratory syndrome-related coronavirus-2 continues its effects around the world with its new variants. Coronavirus disease 2019 infection may continue with a post-coronavirus disease period, which is characterized by high morbidity apart from the acute and subacute phases. Host immune response quality and inflammasome-induced uncontrollable inflammatory response take a role together in the pathogenesis of severe acute respiratory syndrome-related corona- virus-2 infection. Therefore, treatment of severe acute respiratory syndrome-related coronavirus-2 infection should basically include 3 measures: Viral replication, inflammation, and tissue damage control. Today, there is no effective therapy to control these points. At this point, preclinical studies have shown that mesenchymal stem cells can control inflammatory reactions and lung damage through both immune regulation and inflammasome control. Subsequently, controlled clinical studies on severe acute respiratory syndrome-related coronavirus-2 infection confirm their ability, indicating that mesenchymal stem cells may be a safe treatment option while reducing severe acute respiratory syndrome-related coronavirus-2-related morbidity and mortality. On the other hand, post-coronavirus syndrome is as important as acute coronavirus syndrome, it is a picture that can cause morbidity and mortality. Mesenchymal stem cell application can prevent the development of post-coronavirus syndrome through the mechanism of an inflammasome. However, there is no study that analyzes the effects of current treatments using mesenchymal stem cells in the post-coronavirus disease period, and that tests the use of mesenchymal stem cells when post-coronavirus syndrome develops. In this respect, studies that test the efficacy of mesenchymal stem cells in the post-coronavirus disease period are certainly needed.

Objective: Anecdotal reports among clinicians treating severe asthma patients with novel add-on treatments such as mepolizumab suggest that a fraction of these patients may experience a much more dramatic benefit from these agents than reported in large, randomized controlled studies. Although these patients have been referred to as super-responders in some studies, currently, there is no consensus regarding the nomenclature. Therefore, our aim was to assess the real-life data among patients receiving mepolizumab treatment due to severe eosinophilic asthma, in an effort to determine potential clinical and laboratory differences between super-responders and other group of patients.

Material and methods: Data from adult patients who received at least four doses of mepolizumab due to persistent severe asthma between Janury 1, 2020, and December 31, 2021, in a Tertiary Allergy Clinic were evaluated in a retrospective manner.

Results: A total of 57 patients with severe asthma receiving mepolizumab treatment were included [female: 38, male: 19]. At 4th- and 12th-month after initiation of mepolizumab treatment, significant differences in forced expiratory volume in 1 second, forced vital capacity, forced expiratory volume in 1 second/forced vital capacity, blood eosinophil count, and serum immunoglobulin E level were detected as compared to baseline (P < .001, P < 0.001, P =.027, P < .001, and P =.035). Also, at the 12th-month of treatment with mepolizumab, there were significant differences compared to baseline in asthma control test scores, number of asthma exacerbations, non-planned emergency room visits, hospitalizations, and daily need for oral corticosteroids (P <.001, for all parameters). Also, there was not a statistically significant difference between super-responders and responders groups in regard to age, gender, duration of disease, duration of mepolizumab treatment, allergen sensitivities, and comorbid conditions (chronic rhinosinusitis, nasal polyps, and aspirin sensitivity).

Conclusion: Our results suggest that mepolizumab may be an effective therapeutic option in patients with severe asthma. On the other hand, patients who were considered to be super-responders to mepolizumab treatment were not significantly different from the remaining group of patients (responders). Obviously, further studies are warranted to better define the super-responders among patients with severe asthma who receive mepolizumab treatment.

Objective: This study investigated the efficacy of high-flow nasal oxygen therapy in patients with severe acute exacerbation of chronic obstructive pulmonary disease admitted to the intensive care unit.

Material and methods: Totally, 23 patients were enrolled in the study. High-flow nasal oxygen therapy was administered with a predefined protocol. Vital signs, Visual Analog Scale for dyspnea, and arterial blood gas parameters were recorded at the beginning under low-flow oxygen support therapy and the 1st, 6th, 12th, and 24th hours of high-flow nasal oxygen therapy. High-flow nasal oxygen therapy duration, intensive care unit length of stay, and intensive care unit, in-hospital, and 60-day mortality were recorded as outcomes and compared according to the presence of pneumonia upon admission.

Results: In 12 patients (52.2%), pneumonia was present. High-flow nasal oxygen therapy was applied for a median of 57 hours [49.2-104.5]. Overall decreases were detected in heart rate (P = .001), respiratory rate (P < .001), and Visual Analog Scale for dyspnea (P = .001) during the first 24 hours of the therapy. Although there was an increase in PaCO2 (P = .001), pH increased (P < .001) over time too. No change in partial arterial oxygen pressure (P = .63) and partial arterial oxygen pressure/fraction of inspired oxygen ratio (P = .22) was noted. Nineteen patients (77%) were successfully weaned from high-flow nasal oxygen therapy. While the high-flow nasal oxygen therapy failure rate was 23%, the in-hospital and 60-day mortality rates were 8.6%. Outcomes were not different between patients with and without pneumonia.

Conclusion: High-flow nasal oxygen therapy was efficient in relieving respiratory distress and well-tolerated with no adverse out- come in severe acute exacerbation of chronic obstructive pulmonary disease patients admitted to the intensive care unit.

Objective: The coronavirus disease-2019 pandemic has affected the entire health system and patients other than coronavirus-infected patients. Hospital admissions of cancer patients decreased during the closure periods due to the pandemic. This study was conducted to determine whether there was an effect on the hospital admissions of newly diagnosed lung cancer patients in Turkey during the corona- virus disease-2019 pandemic.

Material and methods: In this retrospective study, newly diagnosed lung cancer patients were recorded from the Hospital Information Management System between January 1, 2017, and December 31, 2020, at our tertiary hospital. The number of newly diag- nosed lung cancer patients diagnosed in 2020 was compared with each year from 2017 to 2019.

Results: Between 2017 and 2020, 15 150 newly diagnosed lung cancer cases were analyzed. According to Global Cancer Observatory data, in 2018, 34 703 newly diagnosed lung cancer cases, and in 2020, 41 264 newly diagnosed lung cancer cases were observed in Turkey. Although a decrease was not observed in the number of patients according to Global Cancer Observatory data, both the total number of patients admitted to our hospital and the number of newly diagnosed lung cancer patients decreased in 2020. The number of newly diagnosed lung cancer patients by year was 4030 patients in 2017, 4004 patients in 2018, 4391 patients in 2019, and 2725 in 2020, respectively. In 2020, newly diagnosed lung cancer patients decreased by 38%, 32%, and 32% compared to 2019, 2018, and 2017, respectively. Also, a significant decrease was seen in the number of newly diagnosed lung cancer patients in the months with clo- sure due to the pandemic compared to the months without closure.

Conclusion: There was a significant decrease in hospital admissions of newly diagnosed lung cancer cases in the coronavirus dis- ease-2019 pandemic in our referral hospital. Precautions should be considered to diagnose and treat lung cancer patients in specialized centers during a pandemic due to epidemic diseases such as coronavirus disease-2019.

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.