Research Burden of Interstitial Lung Diseases in Turkey - RBILD.

Introduction: The aim of our study is to investigate the etiological distribution of ILD in Turkey by stratifying the epidemiological characteristics of ILD cases, and the direct cost of initial diagnosis of the diagnosed patients. Material-Method: The study was conducted as a multicenter, prospective, cross-sectional, clinical observation study. Patients over the age of 18 and who accepted to participate to the study were included and evaluated as considered to be ILD. The findings of diagnosis, examination and treatment carried out by the centers in accordance with routine diagnostic procedures were recorded observationally. Results: In total,1070 patients were included in this study. 567 (53%) of the patients were male and 503 (47%) were female. The most frequently diagnosed disease was IPF (30.5%). Dyspnea (75.9%) was the highest incidence among the presenting symptoms. Physical examination found bibasilar inspiratory crackles in 56.2 % and radiological findings included reticular opacities and interlobular septal thickenings in 55.9 % of the cases. It was observed that clinical and radiological findings were used most frequently (74.9%) as a diagnostic tool. While the most common treatment approaches were the use of systemic steroids and antifibrotic drugs with a rate of 30.7% and 85.6%, respectively. The total median cost from the patient's admission to diagnosis was 540 Turkish Lira. Conclusion: We believe that our findings compared with data from other countries will be useful in showing the current situation of ILD in our country to discuss this problem and making plans for a solution.

Evaluation of balance in patients with chronic obstructive pulmonary disease with practical tests.

INTRODUCTION: Patients with chronic obstructive pulmonary disease (COPD) have impaired balance and hence fall more frequently. Easy application of balance evaluation tests can prevent the loss of time in the outpatient clinic for patients with COPD. In this study, we aimed to compare the efficacy of Berg Balance Scale (BBS), a time-consuming but a widely used test, with other easy-to-perform tests such as the Single Leg Stance (SLS), Five Repetition Sit to Stand (5STS), Four Step Square (FSST), and Timed Up and Go (TUG) tests. METHODS: A total of 71 patients with COPD and 70 control subjects with matching demographic characteristics were included in the study. All patients undertook pulmonary function tests and their scores of 6-min walk-test (6MWT), modified Medical Research Council (mMRC) dyspnoea scale, COPD assessment questionnaire (CAT) and body mass index (B) were recorded. In addition, the severity of airway obstruction (O), the dyspnoea severity (D) and exercise capacity (E) (BODE) index scores were measured. All patients with COPD were classified into four groups, A to D, based on the GOLD 2017 criteria. All subjects undertook the BBS, SLS, 5STS, FSST and TUG tests. RESULTS: Balance tests revealed increased balance impairment in patients with COPD in comparison with the control subjects (P < .05). The BBS, SLS, FSST and TUG examinations suggested that balance impairment was frequent in Groups C and D patients with COPD (P < .05). FSST and TUG had the highest correlation with BBS (r = -.812 and -.842 and P < .001 and <.001, respectively). The results of FSST and TUG were the closest to those of BBS test. CONCLUSIONS: FSST and TUG tests can be applied for the assessment of bodily balance status among patients with COPD in outpatient clinics.

The effect of ankaferd blood stopper used for massive haemoptysis in a patient with mounier-kuhn syndrome: A case report.

Mounier-Kuhn Syndrome (MKS) is a rare disorder derived from the muscular and elastic tissue defects of the trachea and the main bronchial walls, characterized by tracheobronchomegaly. Patients may present with complaints of cough, phlegm, dyspnoea and haemoptysis. Haemoptysis may be minor and mixed with phlegm or it may be massive. Establishment of airway patency is a priority in the management of massive haemoptysis. Cold saline solution, diluted adrenaline or tranexamic acid may be administered via the endobronchial route to stop haemorrhage while establishing the airway patency. Ankaferd Blood Stopper (ABS) has a haemostatic property and can be locally administered to the airway. In this report, we aim to highlight the effects of ABS administered via an endobronchial route for emergency palliation of a patient with MKS presenting with massive haemoptysis.

The evaluation of cardiac functions according to chronic obstructive pulmonary disease groups.

Objectives: We aimed to compare right and left ventricular functions by echocardiography (ECHO) according to chronic obstructive pulmonary disease (COPD) groups, and to determine their associations with functional parameters.Methods: Data of patients with COPD who underwent ECHO between 2015 and 2018 were analyzed retrospectively. The results of pulmonary function tests, 6-minute-walking test (6MWT), Modified Medical Research Council (mMRC), COPD assessment test (CAT), and BODE scores were recorded together with ECHO results showing right and left ventricular functions.Results: 126 COPD patients were evaluated. Of these, 37.3% was in group A, 28.6% in group B, 12.7% in group C, and 21.4% in group D. Most common comorbidities were cardiovascular diseases (CVD) and pulmonary hypertension (PH); these were most frequently seen in groups D and B. Regarding ECHO parameters, differences were present among groups in systolic pulmonary arterial pressure (sPAP) and left ventricle end-systolic diameter (LVEF) (p < 0.001 and 0.004, respectively). sPAP was highest in groups D and B whereas LVEF was lowest in group D.Conclusion: Our results suggest that patients' symptoms in symptomatic COPD groups B and D might be related to increased PAP and concomitant cardiovascular comorbidities. Therefore, a detailed cardiovascular investigation should be performed from early stages in COPD.

Retrospective review of epidemic viral pneumonia cases in Turkey: A multicenter study.

Influenza A (H1N1) caused its first pandemic in 2009 in USA and Mexico. Since then, clinicians have exercised great care in order to make an early diagnosis of viral pneumonias. This is due in part to pandemic influenza A infection having greater impact on populations <65 years old than other viral strains, including seasonal influenza. Chest radiographies of those affected displayed a rapid progression of patchy infiltrates, and a large proportion of individuals required admission to intensive care units (ICU). Despite efforts, patients infected with the virus had a high mortality rate. The present multicenter study aimed to retrospectively evaluate the clinical, demographic and prognostic characteristics of patients diagnosed with epidemic viral pneumonia in Turkey. A total of 92 patients were included in the study. The Student's t-test and Chi-square tests were performed to analyze quantitative data, assuming a normal distribution, and to analyze qualitative data, respectively. Stepwise logistic regression was used to evaluate the effects of demographic variables and laboratory values on the virus mortality rate. The male/female ratio was 42/50 and the mean age was 48.74±16.65 years. A total of 69 (75%) patients were unvaccinated against influenza. The most common symptoms were cough (87%) and fever (63%). Chest computed tomography showed peripheral patchy areas of the lungs of ground glass density in 38 patients (41.3%). A total of 22 (59.4%) patients had H1N1, 5 (12.5%) patients had influenza B, and 38 (41.3%) patients met the criteria for admission to the ICU. Of these patients, 20 (52.63%) were monitored with a mechanical ventilator, with a noninvasive ventilator being adequate for 10 (26.32%) of patients. The length of stay in the ICU was 6.45±5.97 days and the duration of mechanical ventilation was 5.06±4.69 days. A total of 12 (13.04%) patients in the ICU succumbed. Logistic regression analysis revealed that among the parameters possibly associated with mortality, being an active smoker increased the risk of mortality 7.08-fold compared to other groups (P=0.005). In conclusion, viral pneumonia remains a significant health problem during the winter period. Considering the high number of ICU admissions and high rate of mortality for patients in the present study, earlier initiation of antiviral therapy is necessary. Active smoking increased mortality in viral pneumonia.

Comparison of the Fractional Exhaled Nitric Oxide Levels in Adolescents at Three Schools Located Three Different Distances from a Large Steel Mill.

Objectives. Exposure to ambient metals and air pollutants in urban environments has been associated with impaired lung health and inflammation in the lungs. Fractional exhaled nitric oxide (FeNO) is a reliable marker of airway inflammation. In this study, we aimed to compare the FeNO levels of three schools that have different distances from iron and steel industry zone for assessing the effects of heavy metals and air pollution on their respiratory health. Methods. Pulmonary function test and FeNO measurements were evaluated in 387 adolescents in three schools which have different distance from plant. Results. FeNO levels were significantly higher in School I (n = 142; 18.89 ± 12.3 ppb) and School II (n = 131; 17.68 ± 7.7 ppb) than School III (n = 114; 4.28 ± 3.9 ppb). Increased FeNO concentration was related to the distance of iron and steel industry zone in young adults. Conclusion. The FeNO concentrations in school children were inversely proportional to the distance from the steel mill. There are needed some studies that can evaluate the safe distance and legislation must consider these findings.

Candida glabrata Pneumonia in a Patient with Chronic Obstructive Pulmonary Disease.

Pneumonia remains an important cause of morbidity and mortality among infectious diseases. Streptococcus pneumoniae and viruses are the most common cause of pneumonia. Candidiasis in such patients has been associated with haemodialysis, fungal colonization, exposure to broad-spectrum antibiotics, intensive care unit (ICU) hospitalization, and immunocompromised patients. The most common cause of infection is C. albicans. The case presented here is of a 66-year-old male patient diagnosed with C. glabrata. The patient suffered from chronic obstructive pulmonary disease.

Moxifloxacin related thrombocytopeniae: A case report.

Drug-induced thrombocytopenia can be caused by various medications, most frequently, antibiotics. There have been reports of thrombocytopenia cases due to the usage of quinolone antibiotics, although moxifloxacin-related thrombocytopenia has been reported very rarely. The case is here presented of a 60-year old male with chronic obstructive pulmonary disease who presented with complaints of progressively worsening dyspnea. After hospitalization, progressive thrombocytopenia was detected which had started on the 3rd day of moxifloxacin treatment. Other causes of thrombocytopenia were excluded and the thrombocyte count returned to normal after discontinuation of moxifloxacin.