A perspective on the scope of videoconferencing-based telemedicine in respiratory diseases outpatient clinic.

Introduction: Telemedicine is rapidly expanding across various fields worldwide. While it finds application in respiratory diseases due to the imperative need for protection against the risk of transmission and the close monitoring of patients with chronic diseases, there is a scarcity of publications detailing telemedicine experiences in respiratory diseases. This study aims to retrospectively evaluate the prospective management of patients with respiratory diseases through videoconference-based telemedicine, intending to establish a foundation for its judicious application in pulmonology cases. Materials and Methods: In this descriptive study, anonymized medical records of all 478 patients assessed via videoconference-based telemedicine over an eight-month period from June 2020 to February 2021 were reviewed. The analysis included demographic characteristics, disease history, attendance methods, the necessity for in-person physical examination after the initial videoconference (VC) session, the inclusion of investigations, pre-diagnosis, diagnosis processes, follow-up period, and outcomes. Follow-up data for all patients included in the study were reviewed at the end of June 2021. Result: Median age of the patients was 55 (44-67), with a male predominance of 55%. Approximately 30% resided in a city other than the one in which the physician offering telemedicine was situated. Seventy-nine (16.7%) individuals received telemedicine via VC sessions without the requirement for any in-person examinations. The most prevalent disease among those who applied for telemedicine was asthma. Median duration of the initial VC session was 13 (8-18) minutes. At least half of the individuals seeking videoconference-based telemedicine for chronic respiratory disorders, such as asthma, COPD, and interstitial lung disease, had previously been followed by either the telemedicine provider or another physician in the same hospital. However, the vast majority of telemedicine applications in disease categories such as COVID, post-COVID, pulmonary nodules, and lung cancer were submitted by first-time applicants. Conclusions: This pioneering study suggests that videoconference-based telemedicine may be an alternative/complementary tool for patients, particularly those with chronic respiratory diseases.

Association between pulmonologists' tobacco use and their effort in promoting smoking cessation in Turkey: a cross-sectional study.

BACKGROUND: A strategy to reduce the number of smoking-related deaths is to encourage the involvement of health-care professionals in tobacco-use prevention activities and cessation counseling. Previous studies have shown that physicians' smoking status affects their efforts to provide smoking cessation counseling. This study investigates the association between pulmonologists' tobacco use and their efforts in promoting smoking cessation during their routine clinical practices in Turkey. METHODS: This cross-sectional study was performed among active members of the Turkish Thoracic Society (TTS) between June 2010 and February 2011 using an Internet-based self-administered questionnaire. Participants gave their written informed consent. The survey included questions about responders' sociodemographics, smoking status, and their routine clinical practice for smoking cessation counseling using the basic 5A's (Ask, Advise, Assess, Assist, and Arrange) of smoking cessation counseling. According to the total score for the 5A's protocol, smoking cessation counseling was dichotomized into low- and high-effort groups in promoting smoking cessation. Pearson's chi-square test and t-test were used to compare groups and logistic regression models for the research question, which was approved by the TTS Scientific Ethical Committee. RESULTS: The response rate was 41 % (N = 699/1701); 9.9 % were current smokers, and 72.7 % indicated that they provided high effort in promoting smoking cessation. A univariate analysis showed that noncurrent smokers were more likely to make a high effort than current smokers (odds ratio [OR], 1.82; 95 % confidence interval [CI]: 1.09-3.05; P = 0.02). However, there was no association between tobacco use (current smoking) and making high effort in promoting smoking cessation after controlling for the two confounders, sex and practicing in smoking cessation outpatient clinic (OR, 1.47; 95 % CI: 0.86-2.50; P = 0.1). CONCLUSIONS: Despite low response rate in our study and suspicions of underreporting, the smoking rate among the pulmonologists in our study was high. Non-current smokers were more likely to provide high effort in promoting smoking cessation compared to current smokers in univariate analysis. However, after controlling for the two confounders, sex and practising in SCOC, there was no association between tobacco use and providing high effort in promoting smoking cessation. Thus, improving medical school education, specialty training and post-graduate training on smoking cessation counseling may positively affect physician' effort in promoting smoking cessation.

[The frequency of performing smoking cessation outpatient clinic in chest disease specialists who are members of Turkish Thoracic Society and factors affecting this performance]. / Türk Toraks Dernegi üyesi olan gögüs hastaliklari hekimleri arasinda sigara birakma poliklinigi yapilma sikligi ve iliskili faktörler.

INTRODUCTION: Although helping patients to stop smoking is a good clinical practice that has to be carried out by physicians everywhere and in every area, it is known that carrying out this help systematically in accordance to a programme in smoking cessation outpatient clinics significantly improves the chance of success. MATERIALS AND METHODS: The study is a cross-sectional survey performed among chest disease specialists who are members of Turkish Thoracic Society (TTS), between June 2010 and February 2011. As independent variables relevant to status of performing/not performing Smoking Cessation Outpatient Clinic (SCOC); sex, age (younger or older than 40), being graduated before or after 1996, being or not being in a consultant position, work place (Hospital of Ministry of Health/private hospital/university hospital), having or not having an education for smoking cessation help and being or not being member of a City Tobacco Control Committee (CTCC) were investigated. Data was collected via a web-questionnaire prepared by using WHO Global Health Professionals Questionnaire which was sent to members through TTS secreteriat. RESULTS: 41% (699/1701) of members of TTS responded. 39.5% of responders reported that they perform SCOC. When the factors possibly affecting the performance of SCOC are evaluated with logistic regression analysis; being graduated after 1996, having an education for smoking cessation help, being a member of CTCC and not being an active smoker are found to improve this performance. CONCLUSION: Our study showed that having an education for smoking cessation help (and tobacco control) makes chest disease specialists get more responsibility on this topic. Accordingly, continuous efforts for improving awareness of personal and social responsibilities of all physicians, especially chest disease specialists, have to be made to provide their taking active roles in tobacco control.

A Retrospective Assessment of the Continuous Health Care Provided to COVID-19 Patients Consulted Via Videoconference.

OBJECTIVE: Telemedicine has been defined as a valuable tool in delivering care for COVID-19 patients. However, clinicians and policymakers should be convinced that traditional and new technological methods of clinical management may be equally effective. The purpose of this study was to generate some initial recommendations based on the clinical utility of videoconference consultation in forward triage and follow-up for COVID-19 patients. MATERIAL AND METHODS: This retrospective cross-sectional study evaluated the medical records of 100 COVID-19 patients consulted using a videoconference program (Skype), from September 1, 2020, to February 3, 2021. The data were analyzed on demographic characteristics, disease history, the need for physical examination after videoconference consultation, pre-diagnostics and diagnostics, treatment decisions, number of videoconference consultation sessions in follow-up, duration of sessions, and final outcome. RESULTS: The male COVID-19 patients constituted 54% of the total sample. The median age was 51 (42-61) years. The median duration of the initial videoconference consultation session was 16 (12-21) minutes. Following the initial videoconference consultation session, 14 patients required follow-up with all face-to-face visits; the remaining patients were primarily followed with videoconference consultation sessions. For 25 patients, it was sufficient to provide only videoconference consultation sessions; they were not required to be in the hospital for physical examination or any subsequent investigation at all. A total of 14 patients were hospitalized. There was no statistically significant difference between the high-risk group and the other patients according to the components of the disease management process via videoconference consultation. CONCLUSION: Videoconference consultation enables a holistic assessment regardless of the patient's characteristics and allows for more time to be spent on each patient, particularly during the pandemic period without risk of contagion. It can be used as a forward triage and follow-up tool to identify patients in need of emergency hospitalization and continuous health care.

The effect of postgraduate training in smoking cessation care on the clinical practice of pulmonologists.

INTRODUCTION: Many studies have shown that training in smoking cessation care (SCC) is important for increasing the number and quality of delivered interventions by health professionals, and various training methods are available. The study aimed to identify the relationship between receiving training on SCC and the frequency of providing outpatient-based SCC among pulmonologists who were members of the Turkish Thoracic Society (TTS). METHODS: For this cross-sectional study, a self-administered online questionnaire-based survey was conducted on a group of active pulmonologists who were members of the TTS, between April and October 2019. The survey included questions about demographics, smoking status, participation in SCC training, and providing outpatient-based SCC. RESULTS: A total of 199 (53%) pulmonologists were actively taking part in outpatient-based SCC. Compared to those that were not providing outpatient-based SCC, median age, median time since graduation, and the number of non-academics, non-current smokers and recipients of smoking cessation care training were significantly higher in the group providing outpatient-based SCC (p<0.001, p<0.001, p=0.002, p=0.001, respectively). It was observed that having SCC training increased more than 6-fold the likelihood of providing outpatient-based SCC (AOR=6.45; 95% CI: 3.96-10.49; p<0.001). CONCLUSIONS: The most crucial obstacle in providing smoking cessation is healthcare workers not providing smoking cessation to smokers. It is worthwhile to devote more tasks and resources to training physicians on smoking cessation care since this may increase their effective involvement in tobacco cessation.

Correlation Between Daily PM10, Nitrogen Dioxide, and Ozone Measurements with the Stringency Index in 15 Different Districts of a Big Metropolis.

OBJECTIVE: Studies have investigated the effects of lockdowns on air quality around the world and found that fine particulate matter and nitrogen dioxide concentrations decreased due to reduced human activity, while ozone concentrations increased. In this study, we aimed to evaluate the correlation between daily stringency index values of our country and daily PM10, nitrogen dioxide, and ozone measurements in different districts of Istanbul between March 1, 2020, and February 28, 2022. MATERIAL AND METHODS: Ministry of Environment and Urbanization and National Air Quality Monitoring Network data on Istanbul air quality monitoring stations were used. The analysis included 15 stations that can monitor at least 75% of the days in a year. PM10, nitrogen dioxide, and ozone were the main pollutants analyzed. RESULTS: There was negative correlation between daily PM10 measurements and daily stringency index values in 3 stations; there was positive correlation in 6 stations. Between daily stringency index values and daily nitrogen dioxide measurements, there was a negative correlation in 3 stations and a positive correlation in 1 station. The daily measurements of 1 station showed a negative correlation with the daily values of stringency index for both PM10 and nitrogen dioxide. In 1 station, while PM10 measures were negatively correlated with stringency index, nitrogen dioxide measurements were positively correlated. CONCLUSION: This study showed that pandemic limitations could not improve Istanbul's air quality everywhere. For adequate evaluation of impact of the limitations on air quality, it may be more relevant to study the socioeconomic infrastructure of each living area, the sociospatial inequality, industrial employment, the number of households, the density of employee class, and so on with all influencing factors that could have contributed to these various changes.

The Knowledge and Attitude about New Generation Tobacco Products among Physicians.

OBJECTIVE: Health hazards of e-cigarettes including "e-cigarette or vaping product use-associated lung injury" are better understood today. Just as e-cigarettes, heated tobacco products release toxic emissions. We aimed to determine the knowledge and attitude about new generation tobacco products among physicians who were the members of an organization for health care professionals, the majority of whom are pulmonologists. MATERIAL AND METHODS: In this cross-sectional study, a self-administered online questionnaire-based survey was conducted among the physicians from April to October 2019. The survey included questions about demographics (gender, age, graduation date from medical institution, and academic title), their smoking status, their knowledge and attitudes toward new generation tobacco products, and additionally about whether new generation tobacco products can be used to aid in smoking cessation. RESULTS: Among the 506 members who responded to the survey, 56.7 % were female; the mean age was 42.4 ± 10.9 years (20-74). About 74.5% were pulmonologists, 5.5% were thoracic surgeons, and 20% were other physicians. Among the responders, the frequency of those who have not heard of new generation tobacco products before was determined as 9.5%, 24.5%, and 41.3%. At least 58.9% of participants lacked the knowledge necessary to discuss these products with their patients and the rate reached 76.7% for the heated tobacco product. To the question of whether new generation tobacco products can be used in smoking cessation, 68.4% responded "I never agree that they can be used." Non-current smokers (P = .003), elders (P = .001), those who had training on smoking cessation assistance (P = .001), and those who had experience in smoking cessation assistance (P = .009) were significantly more prevalent in the group who answered: "I never agree that they can be used." CONCLUSION: Physicians must become considerably more knowledgeable about the new generation tobacco products and hazards. Otherwise, these new tobacco products may pose new threats to national and global tobacco control efforts.

Turkish Thoracic Society's Statement Report on Electronic Cigarettes and Heated Tobacco Products.

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.

COVID-19 Pandemic and the Global Perspective of Turkish Thoracic Society.

It has been more than 3 months now since the first case of COVID-19 was reported in Turkey. Globally, the number of confirmed cases and deaths reached 9,653,048 and 491,128 respectively, as reported by 216 countries by June 27, 2020. Turkey had 1,396 new cases, 194,511 total cases, and 5,065 deaths by the same date. From the first case until today, the Turkish Thoracic Society (TTS) has been very proactive in educating doctors, increasing public awareness, undertaking academic studies, and assisting with public health policies. In the present report, social, academic, and management perspectives of the pandemic are presented under appropriate subtitles. During this critical public health crisis, TTS has once again demonstrated its readiness and constructive stance by supporting public health, healthcare workers, and the environment. This review summarizes the perspective of TTS on each aspect of the COVID-19 pandemic and casts light on its contributions.