OBJECTIVES: We evaluated the muscle responses of rat trachea to LA drugs, such as lidocaine and prilocaine, in terms of airway spasms.
MATERIALS AND METHODS: A total of 16 male rats were used. After ketamine anesthesia, the tracheal ring of each rat was removed and placed in the organ bath in the Krebs solution. The rat tracheal veins were randomly divided into two groups based on the LA applied at the basal tonus level: group 1 (n=8), lidocaine; group 2 (n=8), prilocaine. Second, the baths were washed. Supramaximal contraction was obtained by applying acetylcholine to the tracheal rings (n=16) at a basal tonus level. The rat tracheas with supramaximal contraction were randomly divided into two groups: group 3 (n=8), lidocaine; group 4 (n=8), prilocaine. The contraction responses of each group were recorded and statistically compared.
RESULTS: Lidocaine constituted a significant relaxation response in the tracheal tissue in both basal tonus and supramaximal tonus levels. Moreover, it was observed that the relaxation of lidocaine was higher in the supramaximal contraction than in the basal tonus tension level. However, for prilocaine, no significant change was observed in both tonus levels.
CONCLUSION: This study suggests that lidocaine as a LA drug should be preferred as the first choice in patients with respiratory risk, and that its use over prilocaine should be preferred, if supported by advanced clinical studies.
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OBJECTIVES: The aim of our study was to examine pulmonary functions of patients from all stages of chronic obstructive pulmonary
disease (COPD) according to their smoking status.
MATERIALS AND METHODS: A retrospective case-control study was carried out. Total of 148 patients were enrolled and divided into
two groups in regards to their smoking status (quitters, n=68; non-quitters, n=80). Pulmonary function parameters, COPD assessment test
score, Fagerström Nicotine Addiction Questionnaire score, smoking history and status were obtained from the electronic hospital data
system. Patients' admission and 12-month data were recorded.
RESULTS: In non-quitters, the mean FEV1 values decreased from 2.32±1.14 to 2.24±1.12 (p<0.001). Particularly, in Stage-0, in the early
high-risk group of COPD, the reduction in FEV1 was 90 mL, while the reduction was 70, 60, 40, and 40 mL in Stage-I, -II, -III, and -IV,
respectively. In quitters, the mean FEV1 levels increased from 2.10±1.19 to 2.19±1.20 (p<0.001). For COPD patients overall, an average
increase in FEV
1 of 80–110 mL was observed. At the end of the 12 months follow-up, 17 (27.5%) of the non-quitters showed deterioration, and fie (7.3%) of the quitters showed improvement in COPD stage.
CONCLUSION: FEV
1 decline was accelerated in COPD patients who continued to smoke, whereas this decline was not prevented by inhaler treatments. The Global Initiative for Chronic Obstructive Lung Disease Stage-0 group, which is not included in the current guidelines,
needs to be redefied. This group appears to be the most important group for implementing the smoking cessation and prevention strategy.
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Bilun GEMİCİOĞLU ,
Dilşad MUNGAN ,
Sevim BAVBEK ,
Füsun YILDIZ ,
Mehmet POLATLI ,
Sibel NAYCI ,
Ferda Öner ERKEKOL ,
Hatice TÜRKER ,
Hakan GÜNEN ,
Güngör ÇAMSARI ,
Öznur ABADOĞLU ,
Arif ÇIMRIN ,
A. Berna DURSUN ,
Özlem GÖKSEL ,
Seçil Kepil ÖZDEMİR ,
Şermin BÖREKÇİ ,
Ömür AYDIN ,
Birsen OCAKLI ,
Aygün GÜR ,
Arzu BAYGÜL ,
Zeynep MISIRLIGİL
OBJECTIVES: A multicenter trial was designed to validate the “Assessment Tools for Asthma (ATA)” questionnaire, a newly developed
questionnaire, which evaluates both asthma control and risk factors associated with asthma control with a single instrument.
MATERIALS AND METHODS: This cross-sectional study involved 810 cases from 14 clinics in 9 Turkish cities. The ATA questionnaire and Asthma Control Test (ACT) were administered. The Visual Analog Scale (VAS) was used to evaluate the control status of 100
randomized cases. ATA is an eight-item physician-administered questionnaire. It comprises the following two sections-ATA1, assesses
symptomatic control criteria, and the remaining section, queries the flre-up of asthma, control of comorbidities, treatment adherence,
and inhaler technique.
RESULTS: The mean scores for ATA1, ATA total, VAS, and ACT were 24.7±14.8, 53.8±19, 7.1±3, and 18.8±5.5, respectively. According to
the ATA questionnaire, among all patients, 34.3% had controlled, 18.8% had partly controlled, and 46.9% had uncontrolled asthma. Furthermore, 16.6% patients had flre-ups between visits, 96.4% patients had uncontrolled comorbidity, 17% patients had irregular asthma
treatment, and only 8.4% patients used the incorrect inhaler technique. The ATA questionnaire showed internal consistency (Cronbach’s
alpha coeffiient=0.683). ACT, ATA1, and two specialists’ evaluations using VAS correlated strongly with the ATA total scores (Spearman
correlation coeffiient (r) values: 0.776, 0.783, and 0.909, respectively; p-values: p<0.001, p<0.001, and p<0.001, respectively). According to Receiver Operating Characteristic analysis, the cut-off value of ATA was 50 (sensitivity=84.4%, specifiity=82.40%).
CONCLUSION: The validated ATA questionnaire may be a practical tool for physicians in asthma management.
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Ayşe Arzu YORGANCIOĞLU ,
Bilun GEMİCİOĞLU ,
Cemal CİNGİ ,
Ömer KALAYCI ,
Ali Fuat KALYONCU ,
Claus BACHERT ,
Peter HELLİNGS ,
Oliver PFAAR ,
Holger J. SCHÜNEMANN ,
Dana WALLACE ,
Anna BEDBROOK ,
Wienczyslawa CZARLEWSKI ,
Jean BOUSQUET
Gerçek yaşamda, çevresel maruziyetlerin de etkilediği rinit ve astım mültimorbidite durumlarında, dijitalleşmiş ve kişiye odaklanan tedaviler için
bütünleştirilmiş tedavi yollarının değerlendirilmesi önerilmektedir. Gerçek yaşamdaki bu durum mültisipliner bir yaklaşımla basamaklandırılıp,
rehberilerinde ülkelerdeki gereksinimlere göre değiştilmesini gerektirebilir. Allerjik rinitte hem farmakoterapi hem immünoterapi açısından acil
yeni yaklaşımlara ihtiyaç olduğu görülmüştür. 3. Aralık 2018’de Paris’te bir toplantı yapılmış ve iki ayrı belge hazırlanmıştır. Bu yayında bunlara
ait bir özet sunulup, ülkeye ve sağlık sistemine uygun kullanımın çerçevesi oluşturulmak istenmiştir.
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OBJECTIVES: Management of chronic obstructive pulmonary disease (COPD) includes interventions such as improving skills in coping with the disease. We aimed to examine the effect of self-management training on the quality of life and functional parameters in patients with moderate to severe COPD.
MATERIALS AND METHODS: Sixty-one consecutive patients with COPD were recruited in the study prospectively. The patients were randomized into two groups: self-management training (n=31) and standard care (n=30). Each patient was evaluated by spirometry, COPD assessment test (CAT), St George’s respiratory questionnaire (SGRQ), hospital anxiety and depression scale (HADS), modified British Medical Research Council (mMRC) dyspnea scale, and short form-36 (SF-36). A team of physiotherapists, psychologists, pulmonary disease specialists, and dietitians provided self-management training and biweekly counseling via phone. At the end of three months, both the groups were re-evaluated using the same assessment parameters.
RESULTS: We found no significant difference between the baseline demographic characteristics of the self-management training and standard care groups. We observed a reduction in CAT (p<0.001), SGRQ impact (p=0.013), activity subscales (p<0.001) and the total scores (p=0.020), and HADS anxiety (p=0.012) and depression (p=0.014) scores in the self-management training group after the education session. A significant increase in SF-36 physical function score was also observed (p=0.008). No significant improvement in the functional parameters was observed in either group; however, the change in FEV1 was more pronounced in the self-management training group than in the control group (p=0.017). The hospital readmissions and 1-year survival rates were similar for both the groups after receiving education (p>0.05).
CONCLUSION: Our results suggest that the self-management training of the patients with COPD improves the quality of life and reduces the symptoms of depression and anxiety. Therefore, at the least, self-management training should be done as the first step of pulmonary rehabilitation in patients with COPD who cannot access pulmonary rehabilitation facilities.
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The recommendation of conducting pulmonary function tests (PFTs) from different societies during and after the coronavirus disease
(COVID-19) pandemic was rated by the experts of the Turkish Thoracic Society (TTS) and presented as the TTS experts consensus report.
Information about the topic has been provided.
Globally, as of mid-May 2020, there have been over 4.4 million confirmed cases of COVID-19. There are two main routes of transmission
of COVID-19: respiratory droplets and contact transmission. PFTs are non-invasive tests that are commonly performed in routine assessment and follow-up of patients in the pulmonology units. However, PFTs may generate aerosols and require sharing common surfaces.
With regard to the high prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the community, PFTs should not
be performed routinely in confirmed or suspected patients with COVID-19 during the pandemic. Because of the risk of human-to-human
transmission of COVID-19, PFTs should be restricted to a small patient population with selected indications. Triage for COVID-19 should
be performed prior to testing. Only essential PFTs such as spirometry, diffusion capacity of the lungs for carbon monoxide (DLCO), arterial blood gas analysis, or pulse oximetry should be performed in the selected cases. Tests should be scheduled to allow sufficient time
for donning and doffing of the technical personnel with the full personal protective equipment (PPE) (gown, a filtering respirator mask,
goggles or full-face shield, and disposable gloves), ventilation of the room, and application of post-test cleaning and disinfection procedures of the equipment and the testing room.
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OBJECTIVES: No studies have been specifically conducted on asthma patients undergoing cardiac surgery for assessing mortality and
morbidity. Distinct effects of cardiac surgery lead to negative effects on respiratory functions, putting patients with existing lung diseases
under an increased risk. We aimed to investigate whether asthma patients are under higher risk for mortality and possible complications
after coronary artery bypass graft (CABG) surgery than patients without asthma.
MATERIALS AND METHODS: The study included patients who underwent elective CABG surgery at our hospital between November
2014 and November 2015. Patients with a history of asthma were verified with physical examination and spirometric measurements by
a single. The asthma group was compared with the controls in terms of mortality and morbidities.
RESULTS: Asthma patients were extubated later than control patients (p=0.028); however, prolonged intubation (longer than 24 h) frequency was not different (p>0.05). Asthma patients required longer stay in the intensive care unit (ICU) (p=0.003) than controls. The
incidence of perioperative asthma exacerbations was significantly lower in patients in whom asthma was previously well-controlled. The
incidence of postoperative sibilant rhonchi was lower in patients in whom asthma was under control than in those in whom asthma was
partially controlled (p=0.020).
CONCLUSION: Asthma is associated with longer ICU stay and asthma-related pulmonary complications after CABG surgery. Preoperative evaluation of asthma patients scheduled for CABG surgery requires consideration of the control status of asthma. Studies with more
controls are needed to provide further evidence on the topic.
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