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Giriş: Alt solunum yolu enfeksiyonları (ASYE) hastaneye ayaktan başvurularda ve yatan hastalarda önemli mortalite ve morbidite nedenidir. Hastane yatışı gerektiren ASYE vakalarında antibiyoterapinin zamanında başlanması önemlidir. Enfeksiyon tablosuna yol açan etkeni belirlemek için solunum yolu kültürleri alınmadan başlanan ampirik antibiyoterapi ve “en geniş” spekturumlu antibiyotikleri kullanma eğilimi enfeksiyon hastalıklarının yönetimini zorlaştırmakta, antibiyotik direnci gibi ciddi bir sorunu karşımıza çıkarmaktadır. Bu çalışmada hastaneye yatırılan ASYE olgularında izole edilen etkenler, antibiyotik direnç oranları, hastaların önceden hastaneye yatış ve antibiyotik kullanım durumları araştırılmıştır. Yöntem: Bu çalışmada 2013-2018 yılları arasında hastanemize ASYE tanısı ile yatırılan ve solunum yolu örneği kültürlerinde üreme saptanan olguların demografik özellikleri, hastane yatış sayıları, antibiyotik kullanım öyküleri ile kültürle elde edilmiş etkenleri ve antibiyotik dirençleri kesitsel tanımlayıcı metotla araştırılmıştır. Bulgular: 469 hastadan izole edilen 484 etkeni ve bu etkenlerin antibiyotik direnç profillerini inceledik. Hastaların etkenleri balgam ya da bronkoskobik aspirasyon örneklerinden elde edildi. Olguların çoğu erkek cinsiyette ve 63 yaşın üzerinde idi. En fazla izole edilen etken Pseudomonas aeruginosa (n= 220; %44) idi. Hastaların 451 (%96) tanesine yatışta ampirik antibiyotik başlanmış ve 247 tanesine (%65) başlanan antibiyotik ortalama 7,9 gün sonra değiştirilmişti. Hastalarımızın 228’i (%49) son bir yıl içinde en az iki kez hastaneye yatırılmış; 43 (%9.2) hasta son bir ay içinde antibiyotik almıştı. Son hafta içinde antibiyotik kullanmış ve halihazırda kullanmakta olan 19 hastanın 8’inde P. aeruginosa (%42) izole edildi. İzole edilen 17 S. pneumonia kökeninde bir (%6) penisilin, üç (%17) makrolid dirençli izolat saptandı. H. influenza 33 olguda izole edildi. Üç olguda (%8) ampisilin ve dört (%12) kinolon direnci rapor edildi. Tartışma ve Sonuç: Ampirik antibiyotik tedavisi başlanırken, artan kinolon direncinin ve olguların yarısından fazlasında P. aeruginosa etken olduğunun göz önüne alınması, özellikle daha önce hastaneye yatış sıklığı ve antibiyotik kullanma öyküsünün sorgulanması ve lokal antibiyotik direnç paternlerinin göz önüne alınmasının gerekli olduğu sonucuna vardık.

PURPOSE: This study aims to investigate whether there is a significant difference between typical and atypical parenchymal patterns in the development of fibrosis, which is the most crucial factor affecting morbidity in pulmonary sarcoidosis. METHODS: In our hospital, 145 cases with Siltzbach Types 2 and 3 sarcoidoses diagnosed by clinical, radiological, and histopathologic were retrospectively investigated. Perilymphatic nodules, accompanying mosaic attenuation, and interlobular septal thickening and central peribronchovascular bunch-like thickening on high-resolution computed tomography were assessed as typical. Solid nodules, galaxy finding, consolidation, ground-glass opacity, isolated mosaic attenuation, and interlobular septal thickening, and pleural fluid were accepted as atypical findings. Findings indicating fibrosis were fine and rough reticular opacity, traction bronchiectasis, volume loss, and cystic changes. For the analysis of variables, SPSS 25.0 program was used. RESULTS: Ten (16%) of the 61 cases with typical findings and 16 (19%) of the 84 with atypical findings developed fibrosis (P = 0.827). The mean age of cases with fibrosis was higher. With the cut-off of 50 years, sensitivity was 61.5%, and specificity was 68.9%. The highest fibrosis rate was in cases with ground glass pattern (n = 7/17), whereas higher reversibility rates were in those with miliary pattern (n = 9/12) and galaxy sign (n = 5/6). CONCLUSION: The incidence of fibrosis is higher in the atypical group with no significant difference. The incidence of fibrosis differs in each atypical pattern, being highest in ground-glass opacity and lowest in the miliary pattern.

Introduction: The Coronavirus Disease-2019(COVID-19) pandemic continues to upset the whole world with mortality. While CURB-65 (Confusion-Urea-Respiratory Rate-Blood Pressure- age ≥65 years) and GPS (The Glasgow Prognostic Score) are defined prognostic scores for pneumonia and malignancies, the CALL (Comorbidities, Age, Lymphocyte count, LDH) score is defined for COVID-19. Objective: We aimed to compare these scores in predicting mortality in hospitalized patients with COVID-19. Methods: The data of 408 hospitalized patients with COVID-19 were retrospectively recorded. Demographic, clinical, laboratory data, also CURB-65, GPS and CALL scores were compared between survivors(n:358) and non-survivors(n:50). Receiver operating characteristic(ROC) analysis was used to predict the mortality abilities of scores. Results: Mean age, male gender, smoker, dyspnea from symptoms, presence of any comorbidity, COPD and carcinoma were found to be significantly higher at non-survivor group(all p Conclusions: CURB-65 score is a simple and feasible score for predicting mortality in COVID-19 and may be routinely used in all patients hospitalized with COVID-19.

Purpose: Lung cancer is one of the most common cancers worldwide and smoking plays an important role in the development of lung cancer. The study aims to determine the impact of a lung cancer diagnosis on the period of smoking habits. Also, we aimed to find out the factors affecting smoking cessation in patients after being diagnosed with lung cancer.Materials and Methods: Our study is a descriptive study with 410 patients diagnosed with lung cancer and who had a history of smoking in a training and research hospital in Izmir between April and December 2018. The socio-demographic characteristics of the patients, smoking history, smoking status after the diagnosis, the duration of smoking cessation after the diagnosis, the relationship between smoking and lung cancer disease were investigated.Results: The mean age of the participants was 60.41±14.85 and 62.7% of the patients were male. Quitting smoking rate was significantly increased and the number of cigarettes smoked daily was decreased after the diagnosis of lung cancer. The rate of quitting smoking after the diagnosis was higher in male patients compared to female patients and the smoking cessation rate was found to be higher in employees. The smoking cessation rate of those who do not use alcohol is significantly higher. The smoking cessation rate was higher in the first year after the diagnosis of lung cancer.Conclusions: This study showed that the majority of the patients had quit smoking after the diagnosis of lung cancer., Amaç: Akciğer kanseri dünyada en sık görülen kanserlerden biri olup, kanser gelişiminde en önemli rolü sigara oynamaktadır. Çalışmamızda akciğer kanseri tanısı almış ve aktif sigara içen hastalarda kanser tanısı aldıktan sonra sigara içme durumlarının nasıl etkilendiği ve bırakma üzerine etkili faktörlerin belirlenmesi amaçlanmıştır.Gereç ve Yöntem: Çalışmamız Nisan-Aralık 2018 tarihlerinde İzmir’de bir eğitim ve araştırma hastanesinde akciğer kanseri tanısı almış ve sigara öyküsü olan 410 kişi ile yapılmış tanımlayıcı ve kesitsel bir araştırmadır. Hastaların sosyo-demografik özellikleri, sigara öyküsü, tanı sonrası sigarayı bırakıp bırakmadığı, sigarayı tanı aldıktan ne kadar surer sonar bıraktığı, sigara kullanımı ile akciğer kanseri hastalığı arasında ilişki incelenmiştir. Bulgular: Yaşlarının ortalaması 60.41±14.85 olan hastaların %62.7’si erkektir. Hastaların akciğer kanseri tanı sonrasında sigarayı bırakmaları anlamlı olarak artmış ve günlük içtikleri sigara sayısı anlamlı olarak azalmştır. Sigara bırakmada erkeklerin kadınlara göre ve çalışanların sigara bırakma oranları oranı yüksek bulundu. Alkol kullanmayanların sigara bırakma oranı anlamlı şekilde fazladır. Sigara bırakma zamanı ilk bir yıl içinde fazladır.Sonuç: Bu çalışma ile aktif sigara içicilerinin büyük bir kısmının akciğer kanser tanısı aldıktan sonra sigarayı bıraktıkları tespit edilmiştir.

Aim: We aimed to evaluate platelet-to-lymphocyte ratio (PLR) in patients with sarcoidosis. Methods: A total of 310 sarcoidosis patients and 220 healthy controls retrospectively were recorded in this study. Results: PLR was significantly higher in patients with sarcoidosis than in the control group, and was also significantly higher in patients with pulmonary involvement in stage 2–3–4 than in stage 1. PLR were significantly positive correlated with erythrocyte sedimentation rate. The cut-off values for PLR for predicting a sarcoidosis diagnosis were determined as 158. Conclusion: Increase in PLR value can be used for guiding both the diagnosis of sarcoidosis and the involvement of parenchyma.

Pulmonary metastases are usually seen as parenchymal nodules, lymphatic-interstitial spread and pleural effusion, however cavitary and cystic metastatic lesions are rare. While breast cancer, gastrointestinal tumors, kidney tumors, malignant melanoma, sarcomas, lymphoma and leukemia mostly metastasize to the lung, endometrial adenocarcinoma rarely metastasizes. A 73-year-old woman with multiple cystic-cavitary lung lesions was referred to our clinic because of chronic cough. She had endometrial adenocarcinoma metastasis to the lung. We wanted to present our case because of the rare occurrence of cystic-cavitary lung metastases and the rare presentation of metastasis of endometrial carcinomas to the lung.

Leptomeningeal metastasis is a very rare complication of infiltration of leptomeninges and subarachnoid space with malignant cells. It is an indicator of poor prognosis. Its incidence is 3.8% in non-small cell lung carcinoma (NSCLC). This rate is higher in patients with epidermal growth factor receptor (EGFR) mutation. Brain magnetic resonance imaging (MRI) is the first choice in the diagnosis. The diagnosis of leptomeningeal metastasis is difficult and often bypassed because it is rare and does not cause gross mass lesions such as brain metastasis. Systemic chemotherapy, intrathecal therapy, cranial radiotherapy and targeted treatment agents are an option in the treatment. It has been shown that targeted therapies can be promising because of the ability to switch to cerebrospinal fluid in appropriate patients. We present the case with EGFR positive lung adenocarcinoma whit leptomeningeal metastasis (LM) due to its rarity, difficulty in diagnosis and its association with EGFR mutation.

Objective: There is currently no specific treatment for COVID-19. Favipiravir treatment has been shown to be effective in in-vitro and pre-clinical trials in the treatment of COVID-19. In this study, we aimed to present the characteristics and treatment results of our patients who were hospitalized with the diagnosis of COVID-19 pneumonia and received favipiravir treatment in the chest diseases clinics of our hospital. Method: The database created by the COVID-19 Study Group of our hospital consisting of the data of patients diagnosed with COVID-19 who applied to our hospital between March 11, 2020 and May 15, 2020 was examined. 471 patients enrolled in the database and 412 hospitalized patients were evaluated and included in 38 patients in whom favipiravir was used for treatment in the chest diseases clinic. Treatments, drug doses, initiation time of favipiravir, clinical and radiological responses to treatment were analyzed retrospectively. Fever control, improvement of respiratory failure, improvement in laboratory values, and absence of radiological deterioration were accepted as response criteria to treatment. Results: It was observed that 30 of 38 patients who were given favipiravir treatment in the chest diseases clinic were successfully discharged. Eight patients whose general condition deteriorated despite favipiravir treatment in the clinic and who had an indication for intensive care were transferred to intensive care. Three of these eight patients died and 5 of them were successfully discharged. Conclusion: Mortality rate was found to be 7.9% in COVID-19 cases who received favipiravir treatment in our chest diseases clinic. After the favipiravir treatment started to be used more effectively in our country, it was observed that transfers to intensive care units decreased and mortality decreased. Therefore, although favipiravir is thought to be effective in the treatment of COVID-19 infection, further prospective controlled studies are needed.

Objective: The concept of quality of life (QoL) in lung cancer includes many physical, psychological and social components. We aimed to assess the effect of chemotherapy (CT) on QoL of lung cancer patients using QoL scales. Methods: Fifty inoperable lung cancer patients who were newly diagnosed and taken into a CT plan were included. Patients were followed in terms of responsiveness and toxicity. Turkish versions of the EORTC QLQ-C30 and LC13 scales were used before every cycles. Results: The average age was 60.1 years. There was no difference between QoL and age/income levels. The assessment of physical, social and occupational functions and overall health status of the male patients was better than female. Overall health status without comorbidity was better in the first cycle CT. Chemotherapy led to deterioration in social functions and economic status together with increase in neuropathy, constipation and hair loss. Patients with complete or partial response to treatment were observed to have better physical, occupational, emotional, cognitive and social functions, economic status and overall health; less fatigue, pain, shortness of breath, neuropathy and better appetite. Toxicities were found to affect the QLQ C30 and LC13 scales adversely. Conclusion: Presence of comorbidity, low education levels, socioeconomic status and CT induced hematologic/gastrointestinal toxicities are the major parameters affect QOL in lung cancer. Chemotherapy leads to deterioration in social functions, increase in adverse events as well as worsening in economic status. Radiologic complete or partial response and small cell carcinoma are states in which parameters of QoL are affected positively by chemotherapy.

Objective The aim of this study is to find out the potential risk factors including charlson comorbidity index (CCI) score associated with death in COVID‐19 patients hospitalised because of pneumonia and try to find a novel COVID‐19 mortality score for daily use. Methods All patients diagnosed as confirmed or probable COVID‐19 pneumonia whom hospitalised in our Chest Diseases Education and Research Hospital between March 11, 2020 and May 15, 2020 were enrolled. The optimal cut‐off values, sensitivity and specificity values and odds ratios to be used in mortality prediction of the novel scoring system created from these parameters were calculated by ROC analysis according to the area under the curve and Youden index. Results Over 383 patients (n: 33 deceased, n: 350 survivors) univariate and multivariate regression analysis showed that CCI and lymphocyte ratio were prognostic factors for COVID‐19‐related mortality. Using this analysis, a novel scoring model CoLACD (CoVID‐19 Lymphocyte ratio, Age, CCI score, Dyspnoea) was established. The cut‐off value of this scoring system, which determines the mortality risk in patients, was 2.5 points with 82% sensitivity and 73% specificity (AUC = 0.802, 95% CI 0.777‐0.886, P

Objective: The aim of this study is to find out the potential risk factors including Charlson Comorbidity index (CCI) score associated with death in COVID-19 cases hospitalized due to pneumonia and try to find a novel COVID-19 mortality score for daily use. Methods: All patients diagnosed as confirmed or probable COVID-19 pneumonia whom hospitalized in our Chest Diseases Education and Research Hospital between March 11, 2020 and May 15,2020 were enrolled. The optimal cut-off values, sensitivity and specificity values and odds ratios to be used in mortality prediction of the novel scoring system created from these parameters were calculated by ROC analysis according to the area under the curve and Youden index. Results: Over 383 patients (n:33 deceased, n:350 survivors) univariate and multivariate regression analysis showed that CCI and lymphocyte ratio were prognostic factors for COVID-19 related mortality. Using this analysis, a novel scoring model CoLACD (CoVID-19 Lymphocyte ratio, Age, CCI score, Dyspnea) was established. The cut-off value of this scoring system, which determines the mortality risk in patients, was 2.5 points with 82% sensitivity and 73% specificity (AUC = 0.802, 95% CI 0.777-0.886, p

Aim: To evaluate Platelet-to-Lymphocyte Ratio (PLR) and Neutrophil-to-Lymphocyte Ratio (NLR) in patients with HP. Method: A sample of 140 total patients, 50 having chronic HP and 20 having acute HP, and a control group of 70 more patients were included in this retrospective study conducted with hospital Ethical Committee approval. Results: PLR and NLR values were significantly higher in all HP patients than in the control group ( p

Objectives Air pollution is caused by exhaust emissions from motor vehicles, fuel consumption for heating of residences, and especially emissions from industrial facilities around the world. The exposure to outdoor air pollution has been associated with acute and chronic health problems, from irritation to death. In this study, we aimed to determine whether air pollution increases the frequency of hospital admission and whether there is a difference between disease subgroups, age, and gender, in the 2-year period in Izmir province where - air pollution is increasing. Materials and methods Collection of health data for the project compiled by the Ministry of Health, in cooperation with the Izmir Provincial Health Directory Information Processing Department, and information obtained on the age groups, gender, admission time, and diagnosis of illness [International Classification of Diseases (ICD)10 code] on the residents of Izmir in 2016/2017. Results The daily numbers of patients with respiratory complaints and air pollution were found to be related. Both air pollution and the admission rate increase in the January-March period. In male patients, the risk of hospitalization increases for 1.14%. Males had a higher increase in the rate of diagnosis of chronic rhinitis (increase of 6.22%) than females who had an increase of 0.97%. It was observed that there was a 2.62% increase in the incidence of bronchiectasis, 2.53% in that of asthma, and 2.49% in that of dyspnea. Conclusion There was a significant increase in respiratory diseases during the days when the air pollution was high, and this was observed as the upper respiratory tract infection and acute bronchitis in the young group and chronic respiratory diseases in the elderly group upon hospital admissions. The reduction of air pollutants and inhalation of clean air are the most important aspects in providing a healthier and longer life.

INTRODUCTION: It was aimed to reveal the general characteristics of oncology patients referred to emergency service of chest diseases training hospital. METHODS: A retrospective analysis was performed on the socio-demographic data, the referral symptoms and emergency diagnoses of the subjects diagnosed with malignity who referred to emergency service along one month. RESULTS: Of 118 subjects included in the study, 13 (84.7 %) were women and 105 (84.7 %) were men and the average age was 61.2 years. Frequent age interval was between 50-59. The symptoms most often seen in our cases were dypnea (50 %), pain (27.9 %), fever (14.4 %) and hemoptysis (10.1 %), whereas nausea (9.3%), cough-expectoration (7.6%) and weakness (5.9%) were observed less frequently. 87.5% of non-small cell lung carcinoma and 23.5% of small cell lung carcinoma had advanced stage lung cancer. The most frequent encountered emergency diagnoses were respiratory insufficiency in 49 (41.5%) cases, bone metastasis in 14 (11.8%) and brain metastasis in 13 (11%). DISCUSSION AND CONCLUSION: It was observed that the most frequent complaints for emergency deferral were dyspnea and pain and the most frequent emergency diagnoses were respiratory insufficiency and metastatic disease. General requirement was for palliative treatments and the mortality was lower.

INTRODUCTION: Pulmonary thromboembolism (PTE) is a disease that mortal and hardly diagnosed. Since findings of PTE are nonspesific diagnosed can be so hard sometimes. Major risk factors are malignancy, immobility, previous surgery, thrombophilia, advanced age, and genetic factors. Studies on the relationship between gender and prognosis in PTE have very different results. In this study, we aimed to evaluate gender differences in terms of prognosis, intensive care admission, laboratory, and radiological tests. METHODS: We retrospectively analyzed the data of 348 patients diagnosed with Acute PTE between January 2012 and December 2015. All of these patients were patients who applied to the emergency department of our center, which is a third step chest diseases hospital. We used the PTE guideline jointly designed by the European Society of Cardiology (ESC) and the European Respiratory Society (ERS) for prognosis classifications. RESULTS: The mean age of the patients was 62.7, while the male patients were younger. Women's sPESI scores and mean ages were observed higher than men. Although women had more bad prognostic factors, no significant difference was found between both genders in terms of early mortality. DISCUSSION AND CONCLUSION: Although there is a difference between mean age and simplified Pulmonary Embolism Severity Index (sPESI) scores; no difference in early mortality between men and women. Gender studies in PTE are an area that is open to new studies, since the studies conducted on this subject give quite different results and these results may affect the follow-up protocols.

INTRODUCTION Reduced exercise capacity is a main feature of Interstitial Lung Diseases (ILDs) and it is related to closely prognosis of these patients. Pulmonary Rehabilitation (PR) results to improve in peak exercise capacity, dyspnea and quality of life in ILDs. OBJECTIVES We aimed to evaluate the benefits of PR in patients with ILDs and to determine whether there are similar gains in patients with severe ILD. METHODS We recruited ILD stable patients. All patients were evaluated with pulmonary function test, exercise capacity [6-minute walking test (6MWD)], quality of life [Short Form-36 (SF-36), St. George's Respiratory Questionnare (SGRQ), Hospital anxiety and Depression (HAD)] before and after PR (8 week). RESULTS Fifty-seven patients who completed PR program, 30 women and 27 men, included in this study. It was determined a significant difference in terms of quality of life and exercise capacity (P

Objectives Neuroendocrine tumors of the lungs are a clearly different group of tumors with definite ultrastructural, immunohistochemical, and molecular features. We reported and analyzed the incidence, clinicopathological features, surgery rates, responses to first-line therapy, and survival outcomes of this rare condition according to our lung cancer patient database. Materials and methods We retrospectively collected the data of 62 patients who were histopathologically diagnosed with large cell neuroendocrine carcinoma of lung (LCNEC) between January 2010 and January 2016. Results The patients were predominantly (95%) men (male:female=59:3) with their average age being 60.3±8.6 years. Diagnosis was made by the fine-needle aspiration biopsy (NAB) in 7 patients, bronchoscopic transbronchial biopsy in 13, and surgery in 42. Nearly 43.5% of the patients presented with the tumor in the right upper lobe. Additionally, tumors of 46.8% patients could be observed in peripheral locations. Sixteen patients presented with stage 1, 17 with stage 2, 15 with stage 3, and 14 with stage 4. Median progression-free survival (PFS) was 29 months (SE: 12.2) (95% CI, 5.2-52.8 months). Progression-free survival (PFS) was significantly better in patients with low N, M0, early stage, p63 positive, and TTF-1 positive across the entire cohort. Overall survival (OS) was significantly better in patients with comparatively lower N, M0, low stage, and peripheral location. Conclusion This study demonstrated a single-center experience with clinicopathologic factors and survival outcomes of LCNEC patients.

Hughes-Stovin syndrome (HSS) is a rare disease characterized by deep vein thrombosis and pulmonary and/or bronchial artery aneurysms. A 28-year-old female patient was followed-up for 5 months with pulmonary embolism. When she presented with hemoptysis at her 5th month, pulmonary artery aneurysm was detected on thoracic CT angiography. The abdominal magnetic resonance (MR) angiography revealed thrombus in the inferior vena cava. Because she didin't carry the criteria for Behcet's disease, she was diagnosed as Hughes-Stovin Syndrome (HSS) and steroid treatment was started. The patient who had a response to the treatment, stay in remission for a long time. The prognosis was poor in patients with HSS, and aneurysmal rupture was the main cause of death. In order to emphasize the fact that, when the pulmonary arterial aneurysm is seen, in view of the possibility of Behcet or its variant HSS,rapid onset of treatment can be life-saving. A rare female case is presented in the light of the literature.

Aim: We aimed to evaluated results of eosinophilic and non-eosinophilic-COPD patients. Methods: The study was recorded 202 stable-COPD patients from January 2015 to December 2015. Patients were divided into two group according to percentage of peripheral blood eosinophil as non-eosinophilic ≤2 % (n=80) and eosinophilic >2 % (n=122). Results: There was no found significant difference in terms of age, gander, comorbidity and exacerbations between groups. FEV1 values were significantly higher and CAT scores were significantly lower in eosinophilic group. Number and percentage of neutrophils were found higher and number and percentage of lymphocytes were found lower in non-eosinophilic patients. Platelet distribution width (PDW) and platelet-to-lymphocyte ratio (PLR) were significantly higher in non-eosinophilic patients compare to eosinophilic patients (Figure 1) Conclusion: Although we did not find any difference in terms of the number of exacerbations between eosinophilic and non-eosinophilic stable COPD patients. Our results showed that non-eosinophilic stable COPD patients are more symptomatic and have more airflow limitation.

Background: Exercise training have been shown to be the effective approach for functional outcomes in interstitial lung diseases (ILD). In many studies, the duration of exercise programs (EPs) varies between 8-12 weeks. However, the optimal duration of EPs is still unknown. Objective: In our prospective non-controlled study, we aimed to compare the results of the 8th week with the results of the 12th week of the PR programs applied to the patients with ILD. Methods: A total of 14 patients [Age; 63(53,70) years, body mass index: 28(25,32) kg/m2, disease duration; 1.5 (1,4) years] with ILD [11 idiopathic pulmonary fibrosis, 2 sarcoidosis (stage 3 and 4) and 1 nonspecific interstitial pneumonia] were included in the study. 6-minute walk test, pulmonary function test, arterial blood gas analysis, mMRC dyspnea scale, quality of life questionnaires and hospital anxiety depression scale were performed at before and 8 and 12 weeks after the program. Results: 6-minute walk distance, dyspnea, anxiety, depression and quality of life improved both at 8th and 12th week after EP when compared the with the initial assessment(P

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive interstitial lung disease (ILD) with unknown etiology that occurs primarily in older adults with a median survival time of 2.5±3.5 years. Since there is no curative treatment for IPF, patients with IPF may have symptoms of depression and anxiety more than those of other interstitial lung diseases. There is a few studies about comparison of anxiety depression with other interstitial lung disease and IPF. In this study, we investigated whether anxiety depression in IPF was more frequent than other ILDs and its effect on quality of life.The study was designed as a prospective study. Age, sex, smoking status, respiratory symptoms, comorbidities, pulmonary function tests, diffusion capacity of the lungs for carbon monoxide (TLCO), SF-36, and depression/anxiety levels, radiological findings, erythrocyte sedimentation rate (ESR), CRP level, blood gas analysis, complete blood count parameters were recorded.The mean age of 50 IPF and 42 non-IPF interstitial lung disease patients were 67.4±7.1 and 64.9±7.2, respectively. Compared with the non-IPF group, SF-36 total, SF-36 physical function and SF-36 physical role severity were significantly lower in the IPF group, while the GAP score was significantly higher. There was no significant difference between the two groups in HAM-Anxiety and HAM-depression for total scores. But mild anxiety was present in most of non-IPF group. No severe anxiety was observed in this group. Forty-nine of 50 patients with IPF patients had moderate-severe anxiety and the difference was statistically significant compared to non-IPF patients.This is one of the first studies of anxiety and depression symptoms are also important in non IPF ILD like IPF. Patients with non-IPF ILD have similar anxiety depression with IPF patients in this study. This study led to the conclusion that anxiety depression should also be evaluated in non-IPF ILD patients.

INTRODUCTION: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is frequently used as an important initial investigation for diagnosing and staging for both suspected malignant and benign mediastinal lesions for the last 10 years. AIM: We aimed to analyze the correlation between probability of malignity by EBUS-TBNA and maximum standard uptake value (SUVmax) obtained by 18F-labeled fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET CT). METHODS: This is a retrospective study using hospitals' database records. Demographic features of the patients, characteristics of the biopsied lymph nodes (LNs), PET-CT results, and SUVmax are obtained from hospital database system. RESULTS: A total of 322 patients underwent EBUS-TBNA for a final diagnosis. The mean age was 59.4 years. The most common final diagnosis was nonsmall cell lung cancer. When we compared the average SUVmax, as the SUVmax increased, the probability of malignity increased significantly (P < 0.001). We studied a Youden index for SUVmax and the cutoff point for SUVmax was 9 for 54.39% sensitivity and 79.1% specificity. CONCLUSION: Our study in a real-life setting showed that EBUS-TBNA is effective in diagnosing patients who had mediastinal LNs suspected of malignancy. We also showed that as the SUVmax increased, the probability of malignancy increased. We believe that more data are needed from a larger number of patients from different centers.

Aim: Lung cancer remains the leading cause of cancer-related deaths worldwide. Number of studies have focused on exploring the efficacy of consolidation chemotherapy (CCT) following concurrent CRT to improve survival. But these studies have discordant results. For patients with LA-NSCLC the efficacy and safety of consolidation chemotherapy (CCT) following concurrent chemoradiotherapy (CRT) is not well defined. Therefore, the aim of this study was to evaluate the efficacy and toxicity of CCT. Methods: We retrospectively analysed the clinical records of LA-NSCLC patients treated with concurrent CRT as an initial treatment at our Chest Diseases Hospital between January 2010 and January 2014. All patients were cyto-histologically proven NSCLC and clinically diagnosed as stage III according to the American Joint Committee on Cancer (AJCC) 2009 staging system. All patients treated with curative thoracic radiotherapy with concurrent platinum doublet chemotherapy. We investigated the overall survival (OS) and progression-free survival (PFS) on exploring the efficacy of consolidation chemotherapy (CCT) following concurrent CRT to improve survival. Results: 63 LA-NSCLC patients were participated in the study (6 female, 57 male). The median OS is 18 (95% CI) and the median PFS is 9 (95% CI) months. The detailed datas will be presented during the congress.

ACOS Asthma- COPD overlap syndrome causes major problems in differential diagnosis of especially in smoking and older patients. ACOS carrying some characteristics of both asthma and COPD, is clinically markedly worst then both. Patients with ACOS, has a rapid worsening of pulmonary function tests, high ratios of exacerbations, multi symptoms, worst quality of life and a higher cost of administration. Estimated ratio of ACOS among asthmatic and COPD is as high as 15-55 %. In the history of 57 years old dyspneic patient there are childhood onset asthma, allergic rhinitis lasting about 20 years, diabetes mellitus and hypertension; in parental history, he has an asthmatic mother with 35 packages/years of smoking ( ex about 10 years). The patient radiologically compatible findings with emphysema have had diagnosis of COPD by a pulmonary disease specialist 9 years ago. In the last years there is an obvious increase in his dyspnea and worsening of life quality. Pulmonary function laboratory tests are, FEV1:1,58 (53%), FVC:2,52 (68%),FEV1/FVC:63 and 520 ml(20%) reversibility values, blood count total IGE:328 IU/ml, house hold dust allergy in his pricks test and has symptoms and findings compatible with ACOS and the treatment is ICS+LABA+LAMA+SAMA+ montelukast sodyum+ sustained release teofilin + omalizumab + antihistaminic + nasal corticosteroids spreys.

Pulmonary hydatid cyst (PHC) is a parasitic infestation caused by larvae of Echinococcus granulosus. The lung is the most commonly involved organ after the liver. There is lack of enough data on the efficacy of bronchoscopy in patients with PHC, and the diagnostic usefulness of bronchoscopy is still controversial. We aimed to present the diagnostic efficacy of bronchoscopy and disease characteristics of patients with PHC.PHC was diagnosed in 72 patients--51% of patients in Group I (uncomplicated PHC) and 49% of patients in Group II (complicated PHC)--in Dr Suat Seren Education and Research Hospital for Chest Diseases and Thoracic Surgery. The data of patients including age, gender, symptoms, and radiological, bronchoscopic, microbiological, and pathological findings were retrospectively evaluated.The bronhoscopic findings were defined as hyperemia (44%), normal (38%), edema (32%), purulent secretion (24%), external bronchial compression (24%), and endobronchial cyst membrane (21%), respectively. Cyst membranes were seen during bronchoscopy in 7 (20.5%) of the patients and 6 (86%) of them were in Group II. Hydatoptosis (expectoration of cyst contents), cough, hemoptysis, leukocytosis, Echinecoccus IgG positivity, chest pain, and fever were significantly higher in Group II. According to radiological images, the multiple cystic nodular lesions and well-shaped cystic nodular lesions were significantly higher in Group I. However, water-lily sign, images of abscess, and pneumonic infiltration were significantly higher in Group II.The diagnosis of PHC is usually made with the combination of clinical, radiological, serological, and surgical procedures. We suggest that the fiberoptic bronchoscopy can be used as a diagnostic method, especially in complicated PHC.

Background and objective: Extrapulmonary sarcoidosis is common, and is almost always associated with concomitant thoracic involvement. Extrapulmonary manifestations vary on the basis of gender, age at presentation and ethnicity. The aim of this study was to investigate extrapulmonary involvement in patients with sarcoidosis in Turkey. Methods: This study was conducted by Turkish Thoracic Society Clinical Problems Study Group. New cases of sarcoidosis between 1 June 2004 and 31 May 2006 were recorded on electronic case record forms sent to all potential investigators and information about extrapulmonary involvement was collected. Results: One hundred and nineteen of 293 patients (83 female, 36 male, mean age = 45 ± 12 years) had extrapulmonary involvement in this study (40.6%). The median time to diagnosis was 6 months and this was longer than patients with just thoracic sarcoidosis (P = 0.001). Extrapulmonary symptoms were present in 181 (61.8%) patients, and skin lesions, arthralgia and back pain were the commonest (33.4%, 20.8% and 16.4%, respectively). Incidence of organ involvement was independent of age with the exception of ocular involvement, which was higher in those under the age of 40 years (P = 0.007). Conclusions: Skin and peripheral lymph node involvement were the most common sites of extrapulmonary involvement and ocular involvement was more common in those under the age of 40 years in patients with sarcoidosis in a Turkish population.

Background: Prolonged Tp-e interval and Tp-e/QT ratio was found associated with sudden cardiac death in different clinical conditions. Granulomatous inflammation of ventricular myocardium can lead to inhomogeneity of ventricular repolarization and ventricular arrhythmia. Novel ventricular repolarization parameters, Tp-e interval, Tp-e/QT and Tp-e/QTc ratios have not been evaluated in patients with sarcoidosis without cardiac symptoms previously. Methods: Sixty-one consecutive patients diagnosed with pulmonary sarcoidosis were retrospectively reviewed. The 12-lead ECG examinations were performed. QTdispersion, Tp-e intervals and Tp-e/QT ratio were measured. Results: Comparison of ECG parameters between two groups showed a significantly higher average heart rate in the patients with sarcoidosis than controls. QTdispersion was higher in patients group. Tp-e interval was significantly prolonged in the study group compared to the control group. Tp-e/QT and Tp-e/QTc ratios were significantly higher in patients with sarcoidosis compared to control subjects . CONCLUSIONS: Tp-e interval, Tp-e/QT and Tp-e/QTc ratios are increased in patients with sarcoidosis without any cardiac symptoms. These parameters might be used as a marker for predicting the ventricular arrhythmias and sudden cardiac death in patients with sarcoidosis.

Summary: The emergence of drug resistance is a major problem for tuberculosis (TB) control. The aim of this study was to determine the rates of resistance against TB drugs in patients with pulmonary tuberculosis (PTB). Data from 387 patients with active PTB between the years of 1999 and 2004 from the Research and Education Hospital for Chest Diseases and Chest Surgery were evaluated retrospectively. The patients were categorized as new, re-treatment, extrapulmonary and chronic cases. The study group consisted of 268 (69%) new, 57 (14.7%) re-treatment, 49 (12.6%) extrapulmonary and 13 (3.3%) chronic TB cases. The rates of resistance to isoniazid (INH), rifampicin (R), ethambutol (E) and streptomycin (S) were calculated separately for each group. The resistance to any of the drugs was 7.8% in the new cases, 58.5% in the re-treatment cases and 100% in the chronic cases. The multidrug-resistance (MDR)-TB rates were found to be 2.16%, 11.3% and 92.3% among the new, re-treatment and chronic cases, respectively. These data are important as they reflect the drug resistance rates during the pre-notification time period in western Turkey. Keywords: Drug resistance, Tuberculosis control programs, Tuberculosis

WOS: 000288959600009, PubMed ID: 20946338, Background and objective: Extrapulmonary sarcoidosis is common, and is almost always associated with concomitant thoracic involvement. Extrapulmonary manifestations vary on the basis of gender, age at presentation and ethnicity. The aim of this study was to investigate extrapulmonary involvement in patients with sarcoidosis in Turkey. Methods: This study was conducted by Turkish Thoracic Society Clinical Problems Study Group. New cases of sarcoidosis between 1 June 2004 and 31 May 2006 were recorded on electronic case record forms sent to all potential investigators and information about extrapulmonary involvement was collected. Results: One hundred and nineteen of 293 patients (83 female, 36 male, mean age = 45 +/- 12 years) had extrapulmonary involvement in this study (40.6%). The median time to diagnosis was 6 months and this was longer than patients with just thoracic sarcoidosis (P = 0.001). Extrapulmonary symptoms were present in 181 (61.8%) patients, and skin lesions, arthralgia and back pain were the commonest (33.4%, 20.8% and 16.4%, respectively). Incidence of organ involvement was independent of age with the exception of ocular involvement, which was higher in those under the age of 40 years (P = 0.007). Conclusions: Skin and peripheral lymph node involvement were the most common sites of extrapulmonary involvement and ocular involvement was more common in those under the age of 40 years in patients with sarcoidosis in a Turkish population.

Sarkoidoz, idiyopatik granülomatöz bir hastalıktır. Genellikle akciğer tutulumu vardır. Tanısı, granülomatöz inflamasyonun bilinen diğer nedenlerinin dışlanması gerekliliği yüzünden zor olabilir. Çok merkezli çalışmamızda sarkoidozun klinik görünümleri ve tanısal yaklaşımlarının değerlendirilmesi amaçlandı. Çalışma protokolü internet üzerinden araştırmacılara gönderildi ve yeni tanı almış sarkoidoz olgularına ait bilgilerini göndermeleri istendi (klinik, radyolojik ve tanısal). İki yıl içinde 293 hasta verisi toplandı. Solunumsal yakınmalar, hastaların %73.3’ünde bulundu ve öksürük en sık yakınmaydı (%53.2), dispne (%40.3) ikinci sıklıktaydı. Konstitüsyonel yakınmalar hastaların yarısında görüldü. En sık olanı yorgunluktu (%38.6). En yaygın bulgu eritema nodozum (%17.1) idi. En sık akciğer radyogramı bulgusu bilateral hiler lenfadenomegali (%78.8) idi. Radyolojik evrelemede hastaların çoğunluğunun Evre I ve Evre II olduğu bulundu (sırasıyla %51.9 ve %31.7). Histolojik doğrulama 265 (%90.4) hastada gerçekleşmişti. Bronkoskopilerin üçte biri normal iken, mukozal hiperemi (%19.8) ve bronş duvarının dışarıdan basısı (%16.8) yaygın anormal bulgular idi. Sık kullanılan örnekleme yöntemleri arasında yer alan mediastinoskopide tanı başarısı %100 idi. En sık kullanılan tanı yöntemi olan transbronşiyal biyopsinin başarı oranı %48.8 idi. Sarkoidoza çok yönlü yaklaşım, sık ve seyrek rastlanan bulguları göz önünde bulundurularak ayırıcı tanı listelerinde yer alması, olası tutulmuş alanlara yönelik tanısal incelemelerin organizasyonu ve birarada çalışan ekip üyelerinin konunun uzmanı olması sayesinde iyileştirilir. Sarcoidosis is an idiopathic granulomatous disease. It usually affects the lung. The diagnosis may be problematic since the known causes of granulomatous inflammation must be excluded. This multicenter study aimed to evaluate the clinical presentations and diagnostic approaches of sarcoidosis. The study protocol was sent via internet, and the participants were asked to send the information (clinical, radiological and diagnostic) on newly diagnosed sarcoidosis cases. 293 patients were enrolled within two years. Pulmonary symptoms were found in 73.3% of the patients, and cough was the most common one (53.2%), followed by dyspnea (40.3%). Constitutional symptoms were occured in half of the patients. The most common one was fatigue (38.6%). The most common physical sign was eritema nodosum (17.1%). The most common chest radiograhical sign was bilateral hilar lymphadenomegaly (78.8%). Staging according to chest X-ray has revealed that most of the patients were in Stage I and Stage II (51.9% and 31.7%, respectively). Sarcoidosis was confirmed histopathologically in 265 (90.4%) patients. Although one-third of the bronchoscopy was revealed normal, mucosal hyperemi (19.8%) and external compression of the bronchial wall (16.8%) were common abnormal findings. The 100% success rate was obtained in mediastinoscopy among the frequently used sampling methods. Transbronchial biopsy was the most frequently used method with 48.8% success rate. Considering sarcoidosis with its most common and also rare findings in the differential diagnosis, organizing the related procedures according to the possibly effected areas, and the expertise of the team would favour multimodality diagnosis.