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Sleep-related breathing disorders (SRBD) comprise obstructive sleep apnea (OSA), central sleep apnea (CSA), obesity-hypoventilation syndrome (OHS), as well as isolated sleep-related hypoxemia (ISRH), according to the recent International Classification of Sleep Disorders 3. During the last decades, there have been cumulative research reports indicating an association between the SRBD and increased cardiometabolic illness and death, as well as decreased quality of life. Notwithstanding, the results have been inconclusive, and the evidence level was not high regarding the effect of treatment for the SRBD on adverse outcomes. In the current work, we aim to give a comprehensive review of the clinical trials published from January 2022 to August 31, 2023. We highlight the heterogeneity of cardiometabolic disorders among adults with SRBD and particularly emphasize OSA management, drug therapy for OSA, positive airway pressure (PAP) therapy and cardiovascular outcomes, other effects of PAP in pregnancy and neurocognitive function, as well as the effects of surgical treatment and oral appliances. We also underline future directions in OSA management, telemonitoring, and druginduced sleep endoscopy in managing the SRBD, especially OSA. We ascertain that more studies are needed within the CSA, OHS, and ISRH research fields.

Background: The aim of the study was to share the effectiveness of pneumatic dilation in geriatric achalasia patients., Methods: Achalasia patients over the age of 65 and those under the age of 65 as the control group who received pneumatic dilation as the first-line treatment were evaluated in the study., Results: The average age of geriatric patients was 72.5 ± 55.92 years (65-90), with 50.3% of them being male. Follow-up was conducted for a mean of 64.52 ± 38.73 months. While pneumatic dilation was successful in 98.6% (141/143) of geriatric patients, it was also successful in 94% (141/150) of non-geriatric patients. Remission after single balloon dilatation was observed in 81.8% of geriatric patients, while it was observed in only 52.7% of non-geriatric patients (P = .000). When comparing remission after single dilatation and multiple dilatations, it was observed that geriatric patients who achieved remission after multiple balloon dilatation had higher lower esophageal sphincter pressure and Eckardt scores at the diagnosis and higher lower esophageal sphincter pressure and esophageal body resting pressures after the first balloon dilatation., Conclusions: The proportion of elders in the world population is increasing daily and this disease has been known to disproportionately afflict this group. Although surgical treatments, in particular per-oral endoscopic myotomy, have recently gained popularity as therapies for achalasia, pneumatic dilation remains the most commonly used in geriatric patients.

Objective: We examined the prevalence of esophageal cancer in 828 patients diagnosed with achalasia and the characteristics of patients who developed esophageal cancer., Material and Methods: The demographic characteristics and medical records of the patients who were followed up with a diagnosis of achalasia between 1995 and 2019 were investigated from the patient files., Results: The mean age of the patients was 51 ± 17.3, 390 of them were males (47.1%) and 438 were females (52.9%). The mean diagnosis age of the patients was 45.4 years. The median follow-up duration of the patients was 73 months (12-480). Esophageal cancer developed in 5 patients (0.6%) during follow-up. Three of these 5 patients had squamous cell carcinoma (60%) and 2 had adenocarcinoma (40%). Three of these patients were males (60%) and 2 were females (40%). The mean age of the patients was 68 (56-78), and cancer developed after a median of 156 months (24-216) after the achalasia diagnosis. Balloon dilation therapy was performed for the treatment of achalasia in all 5 patients who developed esophageal cancer., Conclusion: Achalasia patients have an increased risk of developing esophageal cancer compared to the general population, and patients should be followed closely for cancer development.

Background: The initial treatment for fecal incontinence (FI) includes supportive treatment and medical treatment. If the initial treatment fails, biofeedback therapy (BFT) is recommended. However, there are limited and conflicting results in the literature supporting the beneficial effect of BFT for FI. The aim of the study is to analyze the efficacy of BFT in 126 patients who have FI due to several causes., Methods: The data of 126 patients (88 females (69.8%) and 38 males (30.2%)) were collected retrospectively. Colonoscopy, anorectal manometry (ARM), and 3D-Endoanal ultrasonography (EAUS) were performed for all patients before applying BFT. In addition, all patients received toilet training instruction and training in Kegel and other pelvic floor strengthening exercises from an experienced nurse, before BFT., Results: The median age of participants was 54 years (range 18-75 years). While 80 patients (63.5%) had clinical and manometric benefit from BFT, 46 patients (36.5%) did not respond to BFT. According to the EAUS and ARM findings, BFT was beneficial in patients who had partial external sphincter failure, and was unsuccessful in patients who had both internal and external sphincter failure, both internal and external sphincter tears, and external sphincter tear rates of more than 25%. After BFT, significant increases in squeeze pressures were observed, with this increase being higher in the positive-response group., Conclusion: The results suggest that BFT is effective in the treatment of FI for specific patient populations.

Objectives: The aim of the present study was to investigate the presence of GJB2, GJB3, and GJB6 gene mutations in non-syndromic sensorineural hearing loss (NSHL) cases living in Sivas region, to provide appropriate genetic counseling for cases who were found to have mutation, and to contribute to decrease the frequency of mutant allele in the next generation and plan treatment and rehabilitation with early diagnosis., Materials and Methods: The study included 53 unrelated cases that were diagnosed with congenital NSHL between June 2009 and March 2010. Multiplex ligation-dependent probe amplification method was used for genotyping of GJB2, GJB3, and GJB6 gene mutations., Results: Heterozygous 35delG variant was determined in 1.9% (n=1) of cases, homozygous 35delG in 15.1% (n=8), heterozygous IVS1+1G>A mutation in 1.9% (n=1), compound heterozygous in 3.8% (n=2), and homozygous IVS1+1G>A variant in 3.8% (n=2). None of the cases had mutation in GJB3 and GJB6 genes. Mutated allele frequencies in the present study were found to be 17.9% for 35delG and 6.6% for IVS1+1G>A., Conclusion: The present study showed that 35delG mutation is the most common variant in the Sivas region, and that IVS1+1G>A mutation should be investigated in hearing loss. Another result of the present study was that genetic analyzes would allow early diagnosis of hearing impairments particularly when infants whose parents have consanguinity do not pass the newborn hearing screening.

Objectives: Effects of air pollution parameters of sulfur dioxide (SO2) and particulate matter (PM10) values on the respiratory system were investigated., Material and Methods: Data of SO 2 and PM10 were obtained daily for air pollution and classified into two groups: Group I (2006-2007), coal burning years and Group II (2008-2009), natural gas+ coal burning. Groups I and II were divided into two subgroups according to the months of combustion as combustible (November-April) and noncombustible (May-October). The number of patients with asthma and chronic obstructive pulmonary disorder (COPD) was recorded between 2006 and 2009., Results: There was no statistically significant difference between Groups I and II for PM10 and SO 2 (p>0.05). Within the years, the values of SO 2 and PM10 were statistically different between the groups defined by month (p<0.01). The number of patients in the combustible and noncombustible subgroups were found to be different for every 4 years, and the numbers of patients with COPD or asthma were not changed through the years. There was a strong correlation between PM10 and COPD (r=0.59, p<0.01) and a weak correlation between PM10 and asthma (r=0.25, p>0.05). A correlation was found between SO 2 and COPD (p<0.01) but not between SO 2 and asthma (p>0.05). The number of visits for COPD and asthma was statistically different between combustible and noncombustible subgroups (X2:58.61, p=0.000; X2:34.55, p=0.000, respectively). The r2 values for SO 2 and PM10 for COPD patients were 17% and 24%, respectively, in contrast to 8% and 5%, respectivley for asthma patients., Conclusion: Air pollution is known to increase respiratory disease occurrences. With decrease in the usage of solid fuel, air pollution could be reduced and may be effective in preventing respiratory diseases., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

Objectives: This study was performed on Suleyman Demirel University medical students to determine the quality of sleep and to investigate factors that affect of sleep quality., Material and Methods: Suleyman Demirel University Medical students at 1, 2, 3, 4, 5 and 6 classes included to this cross-sectional analytical study (n= 720). Refused to fill to the survey (188), and students were not come to faculty (195), applied survey to 337 students (46.8%). Epworth sleepiness scale (ESS), Pittsburgh (PSQI) and Berlin sleep questionnaires, and 13 pieces closed and open-ended socio-demographic questions were conduct a questionnare under observation. The collected data were analyzed by using descriptive statistics, chi-square, two independent groups t test, Pearson and Spearman's correlation, Mann-Whitney U, Kruskal-Wallis and ANOVA tests., Results: 337 students participated in the study, 42.1% were male, 57.9% were female, mean age was 21.3 ± 2.1 years. Depending on Body mass index (BMI) 31 were poor, 212 normal, 53 overweight, and 4 obese students. In 118 students (35.3%), and these students have a chronic disease associated with 15.6% used the drug because of illness and 38 percent of students (11.6%) were smokers. 18.1 ± 16.1 min for pupils in times of falling asleep, sleep duration per night. 6.6 ± 1.3h, the mean departure time was 7.7 ± 1.8. Scale with a total score of Pittsburgh class (p= 0.000), age (p= 0.003), BMI (p= 0.015) had a significant correlation between. Pittsburgh PUKI scores and without a significant difference in gender (p= 0.054), the use of stimulant substances (p= 0.032), weight (p= 0.021) and snoring (p= 0.002) with no significant difference were found. ESS total score and gender (p= 0.025), drug use (p= 0.035) and sports activities (p= 0.038). Ten students had snoring (3.0%), 5 students (1.5%) had witnessed apnea. Snoring 17.2% to in ESS > 10 points on it. Pittsburgh, the mean scores of those who witnessed apnea (14.0 ± 5.3), witnessed apnea, according to non-students (10.2 ± 6.4) were higher (p= 0.191).The effects PSQI and ESS results on the term were statistically significant by the multivariate regression analysis [F(10.602)= 4.56; p< 0.05; Wilkis Lamda 0.864, partial n 2 = 0.07]. To estimate of the value of PSQI by the stepwise regression analysis was performed; age and fall asleep properties has been included of the model (R2= 89%, p< 0.05). To estimate of the value of PSQI by the stepwise regression analysis was performed; fall asleep property has been included of the model in the the male gender (R2= 80%, p< 0.05). To estimate of the value of ESS by the stepwise regression analysis was performed; term property has been included of the model (R2= 65%, p< 0.05)., Conclusion: Medical school students participating in our study, although female-male ratio close to each other, we found that higher ESS and Pittsburgh scores in female more than male. In this case may be related to physiological, genetic, environmental, cultural and psychological differences., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

Background/aims: Previous studies have shown that the prevalence of abnormal acid reflux in fibrotic lung disease patients is high, and in particular, patients with secondary pulmonary fibrosis show higher esophageal acid exposure than normal controls. There are also some findings that, in patients with pathological reflux, pulmonary fibrosis may develop. The aim of this study is to investigate if pulmonary fibrosis is involved in the pathogenesis of chronic cough due to Gastroesophageal Reflux., Materials and Methods: A prospective study was performed in twenty-one patients with chronic cough due to gastroesophageal reflux who was diagnosed as reflux esophagitis by upper gastrointestinal endoscopy, histology, and in ten healthy controls without GER or any lung disease. All participitants underwent laryngoscopic examination and gastroesophageal scintigraphy with late lung imaging. Bronchoalveolar lavage fluid total and differential cell counts, T and B cell subsets, and the concentrations of IL- 1β and TNF-α were measured., Results: Reflux extending into the proximal esophagus was noted in 52.5%, and posterior laryngitis was present in 90.5% of the patients. No evidence of pulmonary aspiration was noted in the patients with reflux on scintigraphic examination. No significant difference was found between the GER and control groups in terms of cellular content, IL-1β and TNF-α levels or mean T cell subsets and B cell counts in bronchoalveolar lavage fluid. Forced expiratory volume in one second, forced vital capacity FEV1/FVC, total lung capacity, and carbon monoxide diffusion capacity values were within normal limits in the gastroesophageal reflux group., Conclusion: Our findings do not support the hypothesis that gastroesophageal reflux leads to chronic cough by triggering alveolar epithelial injury and subsequent pulmonary fibrosis.