Risk Factors for Chronic Obstructive Pulmonary Disease in Women

In the rural part of our country the use of traditional biomass was common and as a result of this, women who light the fire and bake bread and cook meals as well as children around them are exposed to the smoke that come out . The aim of this study was to to determine possible risk factors and associated conditions of COPD in women. The study was prospective and case-controlled. Fifty-two female patients with COPD followed up in Akdeniz University Hospital Department of Respiratory Medicine were included in this study. All cases were enrolled between December 2000 and October 2003. Fifty-four female non COPD subjects were chosen as the control group. These control subjects who did not have lung diseases were randomly selected in different outpatient clinics in the same hospital. Age, place of residence, comorbid conditions, cigarette smoking (active and passive), occupational exposure, air pollution, socio-economic status, education level, passive smoking in childhood, the fuel used for heating, cooking and baking bread and its duration were questioned. Results from this study suggest that exposure to cooking smoke, low education level, living in rural area, baking bread at home were associated risk factors with COPD among women

A Case of Swyer-James (Macleod’s) Syndrome with Bilateral Involvement

Swyer-James (Macleod’s) syndrome (SJMS) is a rare disorder thought to be a complication of childhood infections. Unilateral hyperlucency, reduced lung volume, diminished vascular markings and bronchiectasis may be detected on radiological analysis. Bilateral involvement is rare. We present a 20-yearl-old man who was diagnosed as having bilateral SJMS by radiological analysis and ventilation-perfusion scintigraphy

Antibiotic treatment outcomes in community-acquired pneumonia

Background/aim: The optimal empiric antibiotic regimen for patients with community-acquired pneumonia (CAP) remains unclear. This study aimed to evaluate the clinical cure rate, mortality, and length of stay among patients hospitalized with communityacquired pneumonia in nonintensive care unit (ICU) wards and treated with a β-lactam, β-lactam and macrolide combination, or a fluoroquinolone. Materials and methods: This prospective cohort study was performed using standardized web-based database sheets from January 2009 to September 2013 in nine tertiary care hospitals in Turkey. Results: Six hundred and twenty-one consecutive patients were enrolled. A pathogen was identified in 78 (12.6%) patients. The most frequently isolated bacteria were S. pneumoniae (21.8%) and P. aeruginosa (19.2%). The clinical cure rate and length of stay were not different among patients treated with β-lactam, β-lactam and macrolide combination, and fluoroquinolone. Forty-seven patients (9.2%) died during the hospitalization period. There was no difference in survival among the three treatment groups. Conclusion: In patients admitted to non-ICU hospital wards for CAP, there was no difference in clinical outcomes between β-lactam, β-lactam and macrolide combination, and fluoroquinolone regimens

The Effectiveness, Safety, and Tolerability of Pirfenidone in Idiopathic Pulmonary Fibrosis: A Retrospective Study

IntroductionIn this study we aimed to investigate the effectiveness and safety profile of pirfenidone for the treatment of idiopathic pulmonary fibrosis (IPF) in a real-life setting.MethodsClinical records of patients diagnosed with mild-to-moderate IPF and receiving pirfenidone treatment across three centers in Turkey between January and September 2017 were retrospectively collected. Pulmonary function measurements, including percentage of forced vital capacity (FVC%) and percentage of diffusion capacity (DLCO%) were analyzed in patients who received pirfenidone treatment for at least 6months. Decline in lung function, defined as an absolute decline of at least 10% in FVC from baseline, or death at 6months was also analyzed. Safety data were included for all follow-up visits.ResultsIn the pooled cohort (n=60), patients were mostly men (73.4%) and current or former smokers (61.7%). Average baseline FVC% and DLCO% were 68.4% and 48.7%, respectively. Forty-seven patients (78.3%) had a high-resolution computed tomography scan with a definite interstitial pneumonia (UIP) pattern, and 18 patients (30%) had a surgically proven UIP pattern. Forty-six (76.7%) patients with IPF remained stable and 14 (23.3%) patients had progressed according to decline in FVC of at least 10% during the therapy course. After 6months of therapy, cough decreased in 58.3% of patients. At least one side effect due to therapy was encountered in 33 (55.0%) IPF patients. Dyspepsia (36.4%), nausea (27.3%), and rash/photosensitivity (24.2%) were the most frequent side effects in our cohort. Sixteen patients (26.7%) needed dose adjustment, one patient (1.7%) discontinued therapy, and one patient (1.7%) died in the study period.ConclusionsThis study shows that pirfenidone seems to be an effective treatment for IPF and also had tolerable and relatively acceptable side effects.FundingRoche

Pulmonary Symptoms and Functions in Cotton Factory Workers

To determine the effects of chronic cotton dust exposure on respiratorytract.We planned a cross sectional study in cotton textile workers. Meanworking period of all subjects had been calculated as 18.0 ± 3.7 years. Atotal of 250 (95.4%) out of 262 were administered a respiratoryquestionnaire and all subjects were examined, and subjected to spirometricevaluation. 146 (%58.4) workers were exposed to cotton dust.Onehundredfour (41.6%) subjects working in places without dust wereregarded as control group.No statistically significant difference in respiratory symptoms, signs andspirometric parameters was found between study groups. In spirometricevaluations, in those having complained of symptoms compatible withallergic rhinitis and byssinosis PEFR, in those with bronchialhyperreactivity FEV1, PEFR and MMEF and in those with physicalexamination findings FVC, FEV1, FEV1/FVC, PEFR, MMEF values weresignificantly lower.No statistically significant impairment of pulmonary system wasdetected in workers due to chronic cotton dust exposure for 18 years

[The pilgrimage and the burden of pneumococcal disease in adults].

Pneumococcal disease is responsible for significant morbidity and mortality. All over the world, 1.6 million people die of pneumococcal disease every year; this estimate includes the deaths of 1 million children aged less than 5 years and the deaths of 600.000- 800.000 adults. The burden of pneumococcal disease is high in adults. Increasing age and the presence of comorbidity has a significant affected of the risk of developing the disease. During mass gatherings, such as pilgrimage individuals, is exposed to severe community-acquired pneumococcal infections. Individuals who has Streptococcus pneumoniae in nasopharynx, have the potential to infection and leave exposed to the risk of pneumococcal disease the other Individuals with sneezing, coughing or out of breath, given breath through droplets of these microorganisms. In the present review, the relationship of pneumococcal disease in adults and pilgrimage, vaccination strategies will be considered and then during a visit to Pilgrimate and Umrah pilgrims against the current vaccine recommendations will be summarised

Evaluation of efficacy and safety of pirfenidone 200 mg tablets in patients with idiopathic pulmonary fibrosis in a real-life setting

Background/aim: Phase III trials have demonstrated a significant efficacy and an acceptable safety for pirfenidone in patients having mild to moderate idiopathic pulmonary fibrosis (IPF). Real-life data on the use of pirfenidone 200 mg tablets are limited. This study aimed to investigate the efficacy and safety of pirfenidone 200 mg tablets for the treatment of IPF in a real-life setting. Materials and methods: A retrospective, multicenter study conducted in four university hospitals in Turkey between January 2017 and January 2019. Clinical records of patients diagnosed with mild to moderate IPF and receiving pirfenidone (200 mg tablets, total 2400 mg/day) were reviewed retrospectively and consecutively. Pulmonary function measurements including forced vital capacity (FVC%) and diffusing capacity of the lungs for carbon monoxide (DLCO%) were analyzed at baseline and after 6-month of pirfenidone treatment. Descriptive statistics were expressed as mean, standard error or median (minimum-maximum), number and percentage, where appropriate. Results: The study included 82 patients, of whom 87.8% were males (mean age, 66 years). After 6-month of treatment, 7 patients discontinued the treatment. Of the remaining 75 patients, 71 (94.6%) remained stable, 4 (5.4%) had progressive disease as evident by a decline in the FVC% of at least 10% while on treatment, and 45 (61.3%) had improved cough. At least one adverse event (AE) associated with the treatment was observed in 28 (37.3%) patients. Conclusion: Pirfenidone 200 mg was effective and well tolerated and associated with relatively mild and manageable AEs in IPF patients

Effects of the COVID-19 pandemic on the follow-up and treatment of patients with idiopathic pulmonary fibrosis: a cross-sectional, multicentre phone call survey

Objective To learn about the attitudes and behaviours of patients with idiopathic pulmonary fibrosis (IPF) in relation to the difficulties experienced during the COVID-19 pandemic. Design A cross-sectional, multicentre phone call survey. Setting Four university hospitals in Turkey. Participants The study included patients with IPF receiving antifibrotics for at least 3 months and with doctor appointment and/or scheduled routine blood analysis between March and May 2020 (the first 3 months after the official announcement of the COVID-19 pandemic in Turkey). Interventions Phone calls (a 5 min interview) were performed in June 2020. A questionnaire and the Hospital Anxiety-Depression Scale were applied. Main outcome measures Patients' preferences for disease monitoring, patients' attitudes and behaviours towards IPF, drug continuation, COVID-19 diagnosis and anxiety/depression status. Results The study included 115 patients with IPF (82 male; mean age, 68.43 +/- 7.44 years). Of the patients, 73.9% had doctor appointment and 52.2% had scheduled routine blood testing; 54.5% of patients with doctor appointment self-cancelled their appointments and 53.3% of patients with scheduled routine blood testing did not undergo testing. Of the patients, 32.2% were on nintedanib and 67.8% were on pirfenidone; self-initiated drug discontinuation rate was 22.6%. The percentage of patients communicating with their physicians was 35.7%. The route of communication was by phone (34.8%). The frequency of depression and anxiety was 27.0% and 38.3%, respectively. The rates of drug discontinuation (35.1% vs 16.7%, p50%) of patients self-cancelled their appointments and nearly a quarter of patients discontinued their medications. Providing a documentation of the problems experienced by patients with IPF about management of the necessary requirements during the COVID-19 pandemic, this study may be a model for patients with chronic diseases