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BACKGROUND AND AIM: This study aimed to obtain real-life data of patients diagnosed with chronic obstructive pulmonary disease (COPD) at least one year ago, including smoking history, inhaler device training, and the number of exacerbations. METHODS: This study was planned as a nationwide, prospective, observational, multicenter, and noninterventional study, and web-based electronic case forms were used to register the patients. RESULTS: A total of 460 patients from 11 centers were included, of whom 88.3% were males. Of the total patients, 137 (29.8%) were current smokers, and 292 (63.5%) were ex-smokers. One hundred twenty-four (29.6%) patients did not receive inhaler device training. Repeated inhaler device training in the follow-up visits was not performed in 255 (60.8%) patients. Of the total participants, 187 (41.0%) reported no exacerbations in the previous year. The mean number of exacerbations per person over the previous year was 1.19. The annual rates of influenza and pneumococcal vaccines were 34.8% and 4.2%, respectively. CONCLUSIONS: Patients should be trained more efficiently in the risks of COPD, use of inhaler devices, exacerbations, and improving quality of life. [ABSTRACT FROM AUTHOR]

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Desquamative interstitial pneumonia is a type of smoking-associated major idiopathic interstitial pneumonia, which is characterized by accumulation of alveolar macrophages in alveolar lumens and septa and develops secondary to mainly active or passive exposure to cigarette smoke. Desquamative interstitial pneumonia mostly occurs in male smokers in association with non-specific symptoms responsive to steroid therapy and has a better prognosis than usual interstitial pneumonia. To date, no large-scale clinical studies have been performed on desquamative interstitial pneumonia patients. Factors responsible for the scarcity of data on the clinical course of this condition include the retrospective nature of the available information as well as its rare occurrence. Despite this, a general consensus exists as to the nature of its symptoms, association with smoking, age and gender distribution, findings of respiratory function tests, steroid responsivity and mortality. The objective of the present review article was to report on desquamative interstitial pneumonia and to describe its etiology, risk factors and clinical features, as well as the laboratory, bronchoalveolar lavage, radiological and histopathological findings, and the treatment and prognosis of affected patients. [ABSTRACT FROM AUTHOR]

Vomiting associated with anaphylaxis may lead to the aspiration of gastric contents with subsequent development of chemical pneumonitis. In cases with large volumes of aspiration, respiratory failure may develop. There are some differences of chemical pneumonitis from aspiration pneumonia like rapid development of respiratory failure and clinical and radiological recovery within a short time. We present this case because it is a rare and important case of gastric content aspiration during an anaphylactic reaction with subsequent development of chemical pneumonitis. Anaphylactic reaction was developed in a 26-year old female after intravenous injection of sultamicilline and metamizole. The patient vomited during the reaction leading to the aspiration of the gastric contents. She had dyspnea and low oxygen saturation at presentation to our emergency unit. She was cyanotic, sweaty, dyspneic and tachypneic. She was transferred to the intensive care unit on the basis of possible need for ventilation support. Her chest radiography showed bilateral basal infiltrations, more pronounced on the right side. With oxygen therapy, respiratory exercise, agents to ease expectoration, and postural drainage oxygen saturation was obtained to be 90%. No further invasive procedures (bronchoscopy, etc.) were deemed necessary due to rapid clinical improvement. A good radiological response was obtained on the first day. A possibility of vomiting during anaphylaxis should be borne in mind and measures should be taken to prevent gastric aspiration whenever possible. The aspiration of gastric contents may lead to severe clinical course including respiratory failure, therefore close monitoring of the patient is necessary. Also, it should be remembered that clinical presentation, treatment and complications are different in chemical pneumonitis from aspiration pneumonia. [ABSTRACT FROM AUTHOR]

Background/aim: Alpha-1 antitrypsin deficiency may be a potential predisposing factor for interstitial lung fibrosis. We investigated alpha-1 antitrypsin levels and its polymorphisms in patients with interstitial lung disease. Materials and methods: A total of 103 interstitial lung disease patients were compared. Results: The mean alpha-1 antitrypsin level in idiopathic interstitial pneumonia patients was 1.67 ± 0.33 g/L, and it was 1.54 ± 0.37 g/L in patients with nonidiopathic interstitial pneumonia (P = 0.13). Low alpha-1 antitrypsin levels were more frequently observed in nonidiopathic interstitial pneumonia patients compared with idiopathic interstitial pneumonia, but the difference was not statistically significant (8.9% vs. 0%, respectively, P = 0.4). In 100 patients, the normal PiMM genotype was detected, while abnormal ones (PiMZ, n = 2, 1.9%; PiMS, n = 1, 0.97%) were determined in three cases. When the frequency of alpha-1 antitrypsin polymorphism in interstitial lung disease patients was compared with the data of the healthy population, no significant difference was detected for the PiMZ and PiMS variants (P = 0.15 and P = 0.44, respectively). Conclusion: Lower levels of serum alpha-1 antitrypsin were more frequent in nonidiopathic interstitial pneumonia patients than idiopathic interstitial pneumonia without an increase in genetic polymorphism. The difference was not statistically significant. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to assess the role of several diagnostic tests and tools, immune markers, and the association between serum pro-brain natriuretic peptide levels and other parameters in patients with collagen tissue disorders with pulmonary involvement. Patients and methods: In this prospective study, 62 patients (17 males, 45 females; mean age 58.1±13.6 years; range 24 to 87 years) with pulmonary involvement of connective tissue disorders were evaluated using several functional parameters (six-minute walking test, serum pro-brain natriuretic peptide, echocardiographic measurement of the pulmonary pressure, respiratory functional parameters, and blood pressure measurement), bronchoalveolar lavage differential cytology and/or flow cytometric analysis. Results: Duration of disease was 7.6 years. Diagnoses included rheumatoid arthritis (38.7%), scleroderma (38.7%), primary Sjögren's syndrome (16.1%), mixed collagen tissue disorder (4.8%), and systemic lupus erythematosus (1.6%). Pulmonary hypertension was present in 38.7% of the patients with the highest incidence of rheumatoid arthritis showing reduced respiratory functions, partial oxygen pressure, and six-minute walk distance, as well as increased serum pro-brain natriuretic peptide and neutrophilic alveolitis. Conclusion: High serum pro-brain natriuretic peptide levels and neutrophilic alveolitis may provide diagnostic clues for a possible diagnosis of pulmonary hypertension and impaired respiratory functions. [ABSTRACT FROM AUTHOR]

Sarcoidosis and Sjögren's syndrome are chronic multi-systemic diseases. The association of these two diseases was reported only in 1% of patients with Sjögren's syndrome. We present this rare case in order to draw the attention to the prognostic importance of this difference. A 62-year-old female patient presented to our hospital with the complaints of dyspnea and a dry cough. Dry eye and dry mouth were present. Laboratory analyses revealed serum anti SS-A (Ro) (+++) antibody positivity. Chest computerized tomography revealed lymphadenopathy and reticular-micronodular appearance evident. Transbronchial needle aspiration guided with endobronchial ultrasound was conducted through 10R and 7 lymph nodes. Pathology was compatible with sarcoidosis. Pulmonary function test revealed 40% carbon monoxide diffusion capacity. It is of prognostic importance to distinguish sarcoidosis imitating Sjögren's syndrome from the association of sarcoidosis-Sjögren's syndrome, since sarcoidosis mostly limits itself and recover by itself without any functional restrictions, but the pulmonary involvement of Sjögren's syndrome causes permanent defects. [ABSTRACT FROM AUTHOR]

Background: This study aims to investigate the effects of the use of the Rapid Shallow Breathing Index on extubation success and time to extubation in patients undergoing elective isolated coronary artery bypass grafting., Methods: This prospective, randomized-controlled study included a total of 72 patients (55 males, 19 females; mean age 60.3±9.3 years; range 45 to 76 years) who underwent isolated coronary artery bypass grafting between February 2016 and November 2016. The patients were divided into two groups as the RSBI group (n=36) and the control group (n=36). The control group was extubated by conventional criteria that were routinely applied in our clinic, while the RSBI group was extubated, when the index scores became below 77 breaths per min/L, following ensuring hemodynamic stability and weaning procedure from mechanical ventilation., Results: The mean time to wean from mechanical ventilation was 5.8±1.0 hours in the RSBI group and 8.1±2.0 hours in the control group (p=0.03). Extubation protocol performed through the use of the index was found to provide 26% earlier extubation compared to the conventional extubation criteria. There was no significant difference in the postoperative follow-up parameters or clinical conditions., Conclusion: Our study results show that a practical tool such as the Rapid Shallow Breathing Index can be reliably used for making a decision in favor of extubation in patients undergoing coronary artery bypass grafting. A shortened time to extubation by the use of this index may provide substantial benefits in terms of prevention of infections, mechanical ventilation-induced lung injuries, and potential pulmonary complications., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article., (Copyright © 2018, Turkish Society of Cardiovascular Surgery.)

Objectives: This study aims to assess the role of several diagnostic tests and tools, immune markers, and the association between serum pro-brain natriuretic peptide levels and other parameters in patients with collagen tissue disorders with pulmonary involvement., Patients and Methods: In this prospective study, 62 patients (17 males, 45 females; mean age 58.1±13.6 years; range 24 to 87 years) with pulmonary involvement of connective tissue disorders were evaluated using several functional parameters (six-minute walking test, serum pro-brain natriuretic peptide, echocardiographic measurement of the pulmonary pressure, respiratory functional parameters, and blood pressure measurement), bronchoalveolar lavage differential cytology and/or flow cytometric analysis., Results: Duration of disease was 7.6 years. Diagnoses included rheumatoid arthritis (38.7%), scleroderma (38.7%), primary Sjögren's syndrome (16.1%), mixed collagen tissue disorder (4.8%), and systemic lupus erythematosus (1.6%). Pulmonary hypertension was present in 38.7% of the patients with the highest incidence of rheumatoid arthritis showing reduced respiratory functions, partial oxygen pressure, and six-minute walk distance, as well as increased serum pro-brain natriuretic peptide and neutrophilic alveolitis., Conclusion: High serum pro-brain natriuretic peptide levels and neutrophilic alveolitis may provide diagnostic clues for a possible diagnosis of pulmonary hypertension and impaired respiratory functions., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.