Turkish Thoracic Journal最新文献

Objective: In our study, the effects of the COVID-19 pandemic in Malatya province, other than confirmed case deaths, were investigated.

Material and methods: The records of those who died between 2016 and 2020 were reviewed on the official website of the Malatya Metropolitan Municipality, and the numbers of deaths in those 5 years were recorded on a weekly basis. The arithmetic mean of the deaths between 2016 and 2019 was calculated, and it was investigated whether the number of deaths in 2020 was more than expected.

Results: In 2020, 1743 (61%) excess deaths were detected. While the mean number of deaths reported 4 years before 2020 was 2860, it was determined that the number of deaths in 2020 was 4603, and there were 1743 (61%) excess deaths.

Conclusion: The deaths occurred in Malatya during the COVID-19 pandemic were more than expected. It has been supposed that some deaths were of polymerase chain reaction negative and hence unrecorded COVID-19 patients' deaths, and some deaths were caused by other indirect effects of the pandemic.

Objective: Humanitarian crisis in the Middle East geography has brought refugees into being. The aim of this study is to investigate the relationship between refugees' tuberculosis diagnosis process and air pollution parameters and environmental exposures.

Methods: A total of 229 patients with tuberculosis registered at Şanlıurfa Tuberculosis Dispensary during 2012-2018 were included. In this cross-sectional study, education levels, smoking status, warm-up style, and exposure to biomass, pesticides, dust storm, PM10, and sulfur dioxide were evaluated. Air parameters were received from https://www.havaizleme.gov.tr/. Bacteriological diagnosis was classified as smear-positive lung tuberculosis, smear-negative culture-positive lung tuberculosis, and other diagnostic methods. This study was approved by the Harran University Ethical Committee (10.12.2018; session: 12; decision no: 36).

Results: Of the 229 patients diagnosed with tuberculosis, 53.3% were males and 46.7% were females. The average age was 31.15 ± 15.16. About 24.5% of refugees lived in camps, while 75.5% lived outside of the camps. The rate of smear (+) lung tuberculosis was 38% and smear (-) culture (+) lung tuberculosis was 14.4%. Smoking (P = .007) in smear (+) cases and exposure to PM10 (P = .036) and sulfur dioxide (P = .015) in culture (+) cases were significant.

Conclusion: Smoking and air pollution are associated with delayed diagnosis of tuberculosis and severe forms of tuberculosis. We think that as a result of smoking cessation and reduction of air pollution, tuberculosis incidence in refugees can be reduced.

Objective: Drowning is a process of submersion and can lead to respiratory failure. Annually, there are an estimated 320 000 deaths worldwide due to drowning, in addition to nonfatal drowning events. There are limited data for respiratory failure due to drowning and its prognosis in Turkey. The aim of this study was to identify the therapeutic modalities used for acute respiratory failure (ARF) due to drowning, and its prognosis in hospitalized patients.

Material and methods: All adult drowning cases (according to the International Classification of Disease (ICD) diagnosis code) who were admitted to either the emergency department (ED) or the intensive care units (ICU), or the pulmonology inpatient clinics between 2008 and 2018 were included in the study. Data for demographic characteristics, radiologic evaluations, respiratory support and mechanical ventilation, hospital stay duration, and hospital mortality were retrospectively collected from hospital records.

Results: A total of 117 patients (47 females, 70 males, mean age: 57.3 years) were included in the study. The drowning accidents most commonly occurred in summer (86.3%). Of them, 31 victims (26.4%) were admitted to ICU due to severe respiratory failure. The mean pH was 7.32, and PaO2 was 69.13 mmHg in the arterial blood gas at admission. Invasive and noninvasive mechanical ventilation were performed in 24.7% and 25.6% of the patients respectively. The PaO2/FiO2 of 106 patients (who had accessible FiO2 values) were >300 in 12 (11%), 201-300 in 32 (30%), 101-200 in 49 (46%), and <100 in 13 (12%) patients. Bilateral opacities were observed in 85.4% of the patients. Cardiopulmonary resuscitation was performed in 8 (6.8%) patients. The hospital mortality rate was 6%.

Conclusion: The present study results show that with appropriate therapeutic and support strategies, respiratory failure due to drowning can be treated successfully.

High-flow nasal cannula oxygen therapy (HFNCOT) system consists of an air/oxygen supply system capable of delivering up to 100% humidified and heated oxygen at a flow rate of up to 80 L/min. The system includes a blender, active humidifier, single heated tube, and nasal cannula. HFNCOT has many physiological advantages compared with other standard oxygen therapies, such as anatomical dead space washout, more constant fraction of inspired oxygen, positive end-expiratory (PEEP) effect, supplement of adequate humidification and maintenance of muco-ciliary function. HFNCOT is mostly used for hypoxemic acute respiratory failure, although it also has other indications. HFNCOT is a common choice of physicians as its technology makes it more silent and comfortable. Though HFNCOT is used in many clinical settings, there is a lack of publications addressing devices and initial settings. We present a review on HFNCOT, with focus on device and application methodology.

COVID-19 pneumonia has several complications, such as acute respiratory distress syndrome, septic shock, myocarditis, pulmonary embolism, and thromboembolic stroke. We present a case of a 71-year-old woman who was diagnosed with COVID-19 pneumonia and was found to have a pneumothorax, spontaneous pneumomediastinum (SPM), and subcutaneous emphysema without a history of lung disease. The pathophysiology of SPM and subcutaneous emphysema is likely caused by rupture of the alveolar membrane due to direct damage by COVID-19 infection and frequent cough-induced barotrauma.

Objective: Ambient air pollution is an important cause of morbidity and mortality for both individual and public health. The major contaminant that creates air pollution in Turkey is particulate matter. This study aims to demonstrate Turkey's air quality in terms of particulatematter in the last 4 years.

Material and methods: In this descriptive study, the public data of the National Air Quality Monitoring Network between the years 2016 and 2019 were analyzed for particulate matter (PM10). Stations with less than 75% data throughout the year were excluded from the evaluation while calculating the annual average values. The averages of the years were compared statistically with each other.

Results: For 111 stations that made sufficient measurements for 4 years, the annual median value of particulate matter remained constant in 12 stations (10.8%), increased in 26 stations (23.4%), and decreased in 73 stations (65.7%). The level of air pollution at 18 stations has been sustained for 4 years. It has been observed that there is no significant improvement in the criterion that the daily average PM10 level should not be higher than 50 μg/m3 for more than 35 days, and pollution is detected above the limit value permitted by the World Health Organization in all provinces and stations except a few provinces every year. Finally, during the 4-year observation, the number of stations that did not make sufficient measurements throughout the year has been found to increase over the years.

Conclusion: Our data reveal that the air pollution attributable to particulate matter in Turkey between the years 2016 and 2019 did not regress prominently. On the contrary, air pollution has been found to gain permanency in certain provinces, and air quality monitoring has been inadequate due to insufficient measurement activities of some of the stations.

Objective: The purpose of this study was to compare the therapeutic effects of a pigtail catheter with a chest tube in the management of patients with spontaneous pneumothorax (SP).

Material and methods: A randomized controlled trial study was performed on patients with SP from August 2016 to December 2017 at Imam Reza Hospital, Tabriz, Iran. Forty-four patients were randomly assigned into 2 groups: group A with a 14-Fr pigtail catheter and group B using a 28-Fr chest tube. Two patients were excluded from the study.

Results: Forty-two patients participated in the study with 21 patients in each group. There were no significant differences between the groups in the patients' baseline data. The success rate was higher in patients with pigtail catheters (85.7%) than in patients with chest tubes (76.2%). However, the difference was not significant (P = .43). The procedure time was significantly shorter in the pigtail group compared to the chest tube group (P < .01). According to the visual analog scale (VAS), patients with pigtail catheters experienced milder pain during tube insertion than patients with chest tubes (P = .02). However, the pain score at the insertion site was not significantly different between the 2 groups for the first 2 days after the procedure. Patients with pigtail catheters experienced significantly less pain than patients with chest tubes during removal of the tube (P < .01). Also, there was no significant difference between the pain experienced by the 2 groups at the time of hospital discharge (P = .19). Analgesic drug usage was lower in patients with pigtail catheters compared to patients with chest tubes (P < .01). There was a trend toward lower median hospital stays demonstrated by patients with pigtail catheters compared to patients with chest tubes (P = .2).

Conclusion: Pigtail catheters might be as effective as chest tubes for treating patients with SP in terms of lung re-expansion.

Objective: Movies are among the most widely used media for advertising, promotional, and sponsorship activities of the tobacco industry, and the industry has been making huge investments in this sector for many years. In this study, the effects of movie scenes depicting the use of tobacco products, and the possible effects of the laws governing such scenes, were examined.

Material and methods: The sample of the study consisted of 50 films, the first 2 of which were the most watched each year, between the years 1992 and 2016, according to the data of the Center for Turkish Cinema Studies and the boxofficeturkiye.com websites. The scenes depicting the use of tobacco products were analyzed using the data collection form developed by the researchers. Each movie was evaluated separately by 2 researchers.

Results: A tobacco product was used in 82% of the 50 films watched. Men (87%), individuals between the ages of 25 and 64 (78.0%), and leading actors (40%) used more tobacco products, and the most frequently used product was the cigarette (93.1%). The number andduration of scenes containing tobacco was greater by 1.6 times before the first law was passed, and between the passage of the first law and the passage of the second law (P > .05, P > .05). The number and duration of the scenes decreased between the passage of the first and the second laws and after the second law was passed, by 3.6 and 5.3 times, respectively (P < .05, P < .05).

Conclusion: Consistent and comprehensive tobacco control policies have been effective in reducing the number of scenes that contain tobacco in the movies produced in Turkey. A comprehensive and multidisciplinary approach is required to overcome the tobacco industry's impact on cinema.