OBJECTIVES: The diagnosis of sarcoidosis is frequently challenging, requiring a search for less invasive, more reliable diagnostic methods. The bronchoalveolar lavage fluid (BALF) analysis has been used in the differential diagnosis of sarcoidosis for many years with a
wide sensitivity and specificity rates. The objective of the study is to investigate whether diagnostic performance of the BALF analysis is
altered by clinicoradiological findings of patients with sarcoidosis.
MATERIALS AND METHODS: The present study is a retrospective, single-center, observational study, designed in a sarcoidosis outpatient
clinic in a training hospital. Patients who had undergone the bronchoalveolar lavage BAL procedure at diagnosis were included in the
study. Demographics, clinical and detailed chest X-ray, and high-resolution computed tomography (HRCT) findings at diagnosis were
recorded. According to the diagnostic performance, the BALF results were grouped as “diagnostic” and “non-diagnostic,” and recorded
parameters were compared between the groups.
RESULTS: Considering the BALF analysis of all the 257 patients, the mean lymphocyte ratio was 41±17.5 (5–80), and the mean CD4/CD8
was 5.5±4.7 (0.1–24.7). The BALF analysis was diagnostic in 56% (n=145) of patients. Diagnostic performance of the procedure did not
correlate with any of the demographic data, smoking status, spirometric findings, chest X-ray staging, HRCT findings, and tomography
scoring. Extrapulmonary involvement was significantly more frequent in the diagnostic group (66% vs. 34%, p=0.006).
CONCLUSION: BALF results signal sarcoidosis in more than half of the patients. The diagnostic role of BALF is greater in patients with
extrapulmonary involvement.
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OBJECTIVES: Dyspnea is a prominent symptom of chronic obstructive pulmonary disease (COPD). Patients with Global Initiative for
Obstructive Lung Disease (GOLD) Stage C-D often complain of dyspnea, but the relationship between their level of dyspnea and their
nutritional status has not yet been established. The aim of this study was to evaluate the dyspnea levels and nutritional status ofstable
COPD patients in the out patient clinic.
MATERIALS AND METHODS: Medical records including the Modified Medical Research Council (mMRC) Dyspnea Scale and the nutritional status of 41 patients were investigated in the study. The meanage of patients was 71.7±9.2 years. The Nutritional Risk Screening
2002 (NRS-2002) tool, body mass index (BMI), and mid-upper arm circumference were used to evaluate their nutritional status. We used
correlation analysis to display the relationship between NRS-2002 score and MRC, COPD stage, and biochemical and anthropometric
parameters indicating the nutritional status of patients.
RESULTS: Out of the 41 COPD patients 87.8% (36) enrolled in the study were men and 12.2% (5) were women.The GOLD stages of
the patients were 29.3% of patients with stage C and 70.7% with stage D.The risk of malnutrition (NRS ≥3) was detected in 48.8% of the
patients, whereas 51.2% of patients (NRS<3) were risk-free. The mid-upper arm circumference of at risk patients was lower (25.6±3.2 vs
29.9±2.7 cm, p=0.032). The NRS-2002 score had a positive correlation with mMRC records (r=0.351, p=0.024). There was a statistically
significant negative correlation between the NRS-2002 score and the mid-upper arm circumference (r=0.604, p<0.0001). Also, there was
a negative correlation between BMI and mid-upper arm circumference (r=0.699, p<0.0001).
CONCLUSION: The risk of malnutrition was common in stable COPD patients at the outpatient clinic, which seemed to adversely affect
their dyspnea level. Therefore, while planning the treatment of COPD patients, evaluating their nutritional status and taking precautions
accordingly contribute to the shortness of breath which is one of the most significant symptoms of the disease.
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Improved knowledge about the pathogenesis of asthma has facilitated the development of novel drugs and provided hope for patients
with severe asthma. After the short- and long-term success of omalizumab in severe allergic phenotype, researchers have targeted patients with severe eosinophilic asthma who comprise up to 45% of adult severe asthma. Interleukin (IL)-5 and IL-5 receptor subunit α play
crucial roles in the development, maturation, and operation of eosinophils. Currently, patients treated with anti-IL-5 biologicals depleting
eosinophils experience the positive efficacy of these drugs, especially with regard to the reduction of exacerbation rate. The aim of this
review was to shed light on severe eosinophilic asthma treatment with these new currently available agents selectively targeting IL-5 or
its receptor, discussing their usage including pre-treatment concerns, such as selecting the target population and choosing the right agent
among them, and subsequent assessment of relevant effect and safety issues.
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OBJECTIVES: Vitamin D may play an important role in immunity and its defiiency has been related to increased respiratory infections.
The aim of this study was to detect the prevalence of vitamin D defiiency and to investigate the relationship between radiological and
clinical effects on adult bronchiectasis (BR) patients.
MATERIALS AND METHODS: A total of 130 patients with BR and 73 healthy individuals (control group) were enrolled in this study.
Radiological severity was assessed using Modifid Reiff Score.
RESULTS: The mean age of patients was 41.9±9.1 years (range, 18–85). The mean 25-hydroxyvitamin D (25(OH)D) level was 14.7±9.6
ng/mL in BR patients and 19.8±6.9 ng/mL in the control group (p=0.001). Moreover, 95 (73.1%) adult BR patients were categorized as
vitamin D defiient. Patients in the vitamin D defiiency group had signifiantly higher Modifid Medical Research Council scores than
those in the group without vitamin D defiiency (p=0.036) The mean modifid Reiff score was higher in the vitamin D defiient group
than the without vitamin D defiiency group (6.9±3.8 vs 4.9± 2.7, p=0.001). Additionally, the vitamin D defiient group had lower forced
vital capacity% predicted value (p=0.02). This model showed that Reiff score (OR, 1.285[1.039–1.590]; p=0.021) was independently
related to vitamin D defiiency.
CONCLUSION: We found that vitamin D defiiency is commonly seen in adult BR patients in a stable period. Moreover, it might be
related to severe radiological fidings on chest computed tomography and worse lung functions.
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OBJECTIVES: A national newborn screening program for cystic firosis (CF) was started using immunoreactive trypsinogen (IRT) test on
January 1, 2015, in Turkey. We aimed to analyze the characteristics of newborn screen-positive (NBSP) infants in Mersin province.
MATERIALS AND METHODS: The data on NBSP infants were retrospectively analyzed between 2015 and 2017 from records of Mersin
Women & Children's Hospital and Mersin City Training and Research Hospital.
RESULTS: A total of 82,273 newborns were screened for CF by IRT test between January 2015 and December 2017 in Mersin. Among
those, 512 infants were defied as NBSP after two repeated IRT tests (IRT/IRT) (138 infants in 2015, 217 in 2016, and 157 in 2017). Sweat
test was normal in the majority of infants (115 infants [83.3%] in 2015, 189 [87.1%] in 2016, and 129 [82.2%] in 2017). Overall, between 2015 and 2017, after two repeated sweat tests, 4 infants had sweat test results in the intermediate range and 9 infants had positive
sweat tests. The incidence of CF for a 3-year period was approximately 1/9300 in our region. The positive predictive value of IRT test for
defiing CF was 1.8%, with a sensitivity of 90.0% and specifiity of 99.4%.
CONCLUSION: IRT/IRT test as a newborn screening strategy provides the opportunity for earlier diagnosis and treatment of CF patients.
More data are needed to understand the frequency of CF on a national level.
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OBJECTIVES: Lung cancer is one of the most common causes of mortality all around the world. The increased production of reactive oxygen species occurs with cell damage, and cysteine is an important factor in preventing oxidative damage by its functional thiol group. The objective of this study was to evaluate the relationship between thiol/disulfide homeostasis (TDH) and the risk factors, disease severity, and physical condition of patients with lung cancer.
MATERIALS AND METHODS: This is a prospective, controlled, nonblinded study, which included healthy volunteers and patients diagnosed with lung cancer who had not yet started any treatment.
RESULTS: There were 45 male (90%) and five female (5%) patients (mean age 64±9 years), and 41 male (82%) and nine female (18%) healthy volunteers (mean age 65±17 years) were included in this research. Overall, the thiol levels were lower in patients than the control group (p<0.001). The native thiol level means were 275±72 μmol/l in the patient group and 414±80 μmol/l in the control group, and the total thiol level means were 309±74 and 451±79 μmol/l, respectively. However, the disulfide parameter was not statistically significantly different between the two groups. There were no correlations between the tumor size and overall survival and the total thiol, native thiol, and disulfide levels.
CONCLUSION: This study showed that there is a significant relationship between lung cancer and TDH, but there were no correlations with the disease stage and the clinical performance status.
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OBJECTIVES: The number of smoking cessation outpatient clinics (SCCs) is increasing day by day in Turkey. The objective of this study is
to evaluate the situation of smoking cessation clinics in our country.
MATERIALS AND METHODS: The SCC list was obtained from the website of the Ministry of Health of the Republic of Turkey. A total
of 305 centers from 80 cities were called by telephone, and a questionnaire including questions about polyclinics was directed to SCC
employees whose verbal consent was obtained.
RESULTS: Of the 305 SCCs, 183 could be reached, 33 of which did not provide outpatient services. A questionnaire was directed to
146 SCCs. A total of 347 doctors work in these centers. Of these 146 SCCs, 69 (47.3%) accepted patients with appointments and 77
(52.7%) accepted patients directly. The specializations of physicians in the SCCs were as follows: 84 (57.5%) were chest disease specialists, 30 (20.5%) were general practitioners, 10 (6.8%) were psychiatrists, 12 (8.2%) were other branch physicians, 6 (4.1%) were family
physicians, and 3 (2.1%) were public health physicians. A total of 125 (85.6%) physicians working in SCCs received smoking cessation
training. Only 35 (24%) SCCs have one or more provincial tobacco control members. Eighty (54.8%) SCCs had a separate SCC room, 74
(50.7%) had a waiting room for the patients, and 63 (43.2%) had a carbon monoxide (CO) measurement device in the SCC.
CONCLUSION: All physicians in Turkey are able to provide smoking cessation services, but the chest physicians are mostly responsible
for this task. In addition to increasing the number of SCCs, it is very important to increase the quality and comply with the standards.
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OBJECTIVES: Community-acquired pneumonia (CAP) is a potentially lethal lower respiratory tract infection for children. For this reason,
early recognition and appropriate treatment is essential. In addition, we need to determine which patient will be hospitalized or not
hospitalized. Here, we aimed to evaluate the plasma endocan level to determine whether it is effective in making the decision on hospitalization and the assessment of the response to treatment in patients with CAP.
MATERIALS AND METHODS: This prospective case-control study was conducted between November 2015 and May 2016 at Erciyes
University School of Medicine. Fifty-three patients diagnosed as CAP with clinical and radiological findings were enrolled in the study.
The patients were divided into various subgroups, such as inpatient, outpatient, complicated, non-complicated, dead patients, etc., and
the levels of endocan were compared between the control group and those various groups.
RESULTS: A total of 53 children with a diagnosis of CAP and 55 healthy children were enrolled in the study. Patients were divided into
two groups: hospitalized patients and outpatients. There was no statistically significant difference between these groups’serum endocan
levels on the 1st day and serum endocan levels on the 4th day (p=0.783, p=0.419).
CONCLUSION: Serum endocan level had no significant value in predicting patients’ hospitalization. On the other hand, high serum
endocrine levels may be important in predicting the severity and prognosis of the disease.
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