Chest X-ray: Is it still important in determining mortality in patients hospitalized due to chronic obstructive pulmonary diseases exacerbation in intensive care unit?

OBJECTIVE: The present research aims to evaluate the effects of chest X-rays on mortality among patients who were hospitalized due to the exacerbation of chronic obstructive pulmonary disease (COPD) in intensive care unit (ICU) of a secondary care hospital. MATERIALS AND METHODS: Sixty-three patients (39 males, 60.9%), who were hospitalized in ICU due to COPD exacerbation between December 1, 2011, and December 31, 2012, were retrospectively reviewed in this study. Data, including demographics, smoking history, arterial blood gas measurements, posterior-anterior lung radiography (PALR) findings and mortality, were collected from the medical records. RESULTS: The mean age of the patients was 70.5 years (standard deviation [SD]: 13.3, range 44–88 years). Of all the cases, 42 (85.7%) had at least one comorbidity. The most common comorbidities were hypertension (34, 53.9%) and heart failure (19, 30.2%). Mean duration of hospital stay was 8 days (SD: 5.7, range: 2–26). Mechanical ventilation support was required in 17 (27%) cases. In total, seven female and four male patients died during hospitalization (17.7%). PALR indicated emphysema in 60.3%, infiltration in 54%, bronchiectasis in 31.7%, and unilateral or bilateral pleural effusion in 27% of the cases. Infiltration and pleural effusion in PALR were more common among the patients who died (died/alived 10/11 vs. 24/52, P = 0.008 and 6/11 vs. 11/52, P = 0.026, respectively). The multivariate model for mortality showed that only age (odds ratio 0.821, CI: 0.687–0.948, P = 0.044) was independently related to mortality. CONCLUSION: As a basic imaging method, PALR still remains as an important diagnostic tool for COPD patients hospitalized in ICU, and it may contribute to the prediction of mortality

The effect of body mass index on pulmonary rehabilitation outcomes in patients with chronic obstructive pulmonary disease

CONTEXT: Although pulmonary rehabilitation (PR) is increasingly used in patients with chronic obstructive pulmonary disease (COPD), the factors affecting the gains obtained from PR are still not clear. AIMS: We aimed to investigate the effect of body mass index (BMI) on PR outcomes in COPD. SETTINGS AND DESIGN: The study was a retrospective–descriptive study. SUBJECTS AND METHODS: Patients with BMI of 18.5–25 kg/m2 were referred to as Group 1 (n = 15) and patients with BMI ≥25 kg/m2 as Group 2 (n = 17). All patients received PR for 8 weeks. Six-min walking distance (6MWD), forced expiratory volume in 1-s, forced vital capacity (FVC), carbon monoxide diffusing capacity (DLCO), maximal inspiratory pressure (MIP), modified Medical Research Council dyspnea scale (mMRC), and COPD assessment test (CAT) scores were compared. STATISTICAL ANALYSIS USED: Paired t-test, Wilcoxon rank, and Mann–Whitney-U test were used for statistical analysis. RESULTS: Thirty-two patients were included in the study. Baseline parameters were similar except 6MWD. Following PR, 6MWD, mMRC, and CAT scores were significantly improved in both the groups (P < 0.05). A significant difference was found in favor of Group 1 for FVC (P = 0.039) and MIP (P = 0.018), while no difference was detected in DLCO. CONCLUSIONS: In this study, PR yielded similar gains between COPD patients with high BMI and those with normal BMI in terms of exercise capacity, dyspnea, and disease symptom severity. The only additional gains were achieved in the respiratory functions of patients with normal weight. All COPD patients should be referred to PR, regardless of the BMI, taking into account the resulting PR gains

RESEARCH BURDEN OF INTERSTITIAL LUNG DISEASES IN TURKEY - RBILD

Introduction: The aim of our study is to investigate the etiological distribution of ILD in Turkey by stratifying the epidemiological characteristics of ILD cases, and the direct cost of initial diagnosis of the diag-nosed patients. Material-Method: The study was conducted as a multicenter, prospective, cross-sectional, clinical observation study. Patients over the age of 18 and who accepted to participate to the study were included and evaluated as considered to be ILD. The findings of diagnosis, examination and treatment carried out by the cent-ers in accordance with routine diagnostic procedures were recorded observationally. Results: In total,1070 patients were included in this study. 567 (53%) of the patients were male and 503 (47%) were female. The most frequently diagnosed disease was IPF (30.5%). Dyspnea (75.9%) was the highest incidence among the presenting symptoms. Physical examination found bibasilar inspiratory crackles in 56.2 % and radiological findings included reticular opacities and interlobular septal thickenings in 55.9 % of the cases. It was observed that clinical and radiological findings were used most frequently (74.9%) as a diagnostic tool. While the most common treatment approaches were the use of systemic steroids and antifibrotic drugs with a rate of 30.7% and 85.6%, respectively. The total median cost from the patient's admission to diagnosis was 540 Turkish Lira. Conclusion: We believe that our findings compared with data from other countries will be useful in showing the current situation of ILD in our country to discuss this problem and making plans for a solution

Regional distribution of genetic mutation in lung cancer in Turkey (REDIGMA)

Introduction: The results of standard chemotherapy in lung cancer are not very satisfactory, so it is important to identify genetic mutations that provide targeted therapies. Recent reports have suggested influences of racial difference on the frequency of mutation in lung cancer. We aimed to determine the frequency and regional distribution of genetic mutations of non-small cell lung cancer (NSCLC) in Turkey

Evaluation of Patients with Fibrotic Interstitial Lung Disease: Preliminary results from the Turk-UIP Study

OBJECTIVE: Differential diagnosis of idiopathic pulmonary fibrosis (IPF) is important among fibrotic interstitial lung diseases (ILD). This study aimed to evaluate the rate of IPF in patients with fibrotic ILD and to determine the clinical-laboratory features of patients with and without IPF that would provide the differential diagnosis of IPF

Picturing asthma in Turkey: results from the Turkish adult asthma registry

Introduction: National data on asthma characteristics and the factors associated with uncontrolled asthma seem to be necessary for every country. For this purpose, we developed the Turkish Adult Asthma Registry for patients with asthma aiming to take a snapshot of our patients, thereby assigning the unmet needs and niche areas of intervention. Methods: Case entries were performed between March 2018 and March 2022. A web-based application was used to record data. Study outcomes were demographic features, disease characteristics, asthma control levels, and phenotypes. Results: The registry included 2053 patients from 36 study centers in Turkey. Female subjects dominated the group (n = 1535, 74.8%). The majority of the patients had allergic (n = 1158, 65.3%) and eosinophilic (n = 1174, 57.2%) asthma. Six hundred nineteen (32.2%) of the patients had obese asthma. Severe asthma existed in 670 (32.6%) patients. Majority of cases were on step 3–5 treatment (n: 1525; 88.1%). Uncontrolled asthma was associated with low educational level, severe asthma attacks in the last year, low FEV1, existence of chronic rhinosinusitis and living in particular regions. Conclusion: The picture of this registry showed a dominancy of middle-aged obese women with moderate-to-severe asthma. We also determined particular strategic targets such as low educational level, severe asthma attacks, low FEV1, and chronic rhinosinusitis to decrease uncontrolled asthma in our country. Moreover, some regional strategies may also be needed as uncontrolled asthma is higher in certain regions. We believe that these data will guide authorities to reestablish national asthma programs to improve asthma service delivery