Learning platform for smoking cessation project: From begining to date

Although 35% of the adults in Turkey are current smokers, the number of trained physicians and smoking cessation (SC) clinics are not enough to meet the demand. Aim: This national project aimed to create the necessary infrastructure for providing SC therapy all-around the country and to train physicians in this topic. This project was run by Turkish Thoracic Society Tobacco Working Group and supported by a grant from Pfizer Foundation. Methods: For this purpose, an organization network including field training teams was planned. The training materials were prepared and standardized. A website of the project including a wide e-learning platform was created (www.sigarabirakmadaogrenmezemini.org). Results: Firstly, a central training program was planned. Forty volunteers from all regions of Turkey were participated to this program. Afterwards, field training programs were started to perform by these trainers. From the beginning field training sessions were performed in 11 cities with more than 300 participants. The project website was visited by 10.369 visitors and 518 participants completed e-training module since April 2011. Conclusion: The SÖZ project enabled a training ground that will last for years; a professional website and a trainer staff to generalize the program. Through this project, the integration of SC intervention in all health service steps will be provided, the number of SC clinics in Turkey will increase, and in future smoking rate will reduce in our country

Follow-up hemoglobin concentrations in ICU: Relationship between diagnostic blood loss and daily fluid balance

Bu çalışmanın amacı, belirgin kanaması olmayan solunumsal yoğun bakım hastalarının günlük hemoglobin değişikliklerini (ΔHb) saptamak; tanısal kan kaybı (TKK) ve günlük sıvı dengesi (SD)’nin bu değişiklikler üzerindeki olası etkilerini araştırmaktır. Solunumsal yoğun bakım ünitesinde, yatış süresi en az 72 saat olan, aktif kanama, akut/kronik böbrek yetmezliği, kanama diyatezi ve sepsis bulgusu olmayan 34 olgunun dosyası retrospektif olarak değerlendirildi. Demografik özellikler, etyolojik tanı, ek hastalık varlığı, uygulanan tedavi, ilk 24 saatte hesaplanan “Acute Physiology Assessment and Chronic Health Evaluation (APACHE) II” skorlaması, günlük hemoglobin sonuçları, günlük TKK ve SD kaydedildi. Günlük ΔHb ile TKK ve SD arasındaki korelasyon araştırıldı. İlk üç gün içinde ΔHb ≥ 0.5 g/dL/gün olan hastalar (grup A) ile ΔHb < 0.5 g/dL/gün olan hastalar (grup B) karşılaştırıldı. Olguların ortalama yaşı 55 ± 14, ortalama Hb değerleri girişte 13.2 ± 1.7 g/dL, çıkışta 12.6 ± 2.3 g/dL; giriş APACHE II skoru 19 ± 5 idi. Birinci gün TKK ortalama 25.2 ± 7.4 (10.5-49) mL idi. İzleyen günlerde, günlük TKK miktarının azaldığı ancak farkın istatistiksel olarak anlamlı olmadığı saptandı. Birinci gün SD ortalama 251 ± 1783 mL/gün idi. İlk üç günde ΔHb= -0.54 ± 1.5 g/dL iken, izleyen dört günde ΔHb= -0.23 ± 1.5 g/dL idi; aradaki fark istatistiksel olarak anlamlı değildi (p= 0.9). İlk üç gündeki ΔHb ile üç günlük SD ve TKK arasında korelasyon saptanmadı. Grup A ve grup B, yaş, cinsiyet, APACHE II skoru, SD ve TKK’ya göre karşılaştırıldığında anlamlı fark saptanmadı. Çalışmamızda günlük ΔHb ile TKK ve SD arasında anlamlı bir ilişki gösterilememiştir. Ancak bu ve benzeri çalışmalar, yoğun bakım hastalarında hemoglobin konsantrasyonunun, kanama olmaksızın düşebileceğini göstermesi açısından önemlidir.BULGULAR: Olguların ortalama yaşı 55±14, ortalama Hb değerleri girişte 13.2±1.7 g/dl, çıkışta 12,6±2,3; giriş APACHE II skoru 19±5 idi. Birinci gün TKK ortalama 25,2±7,4 (10,5-49) ml idi. İzleyen günlerde, günlük TKK miktarının azaldığı ancak farkın istatistiksel olarak anlamlı olmadığı saptandı. Birinci gün SD ortalama 251±1783 ml/gün idi. İlk 3 günde ∆Hb= -0,54±1,5 gr/dl iken, izleyen 4 günde ∆Hb= -0,23±1,5 gr/dl idi; aradaki fark istatistiksel olarak anlamlı değildi (p=0,9). İlk 3 gündeki ∆Hb ile 3 günlük SD ve TKK arasında korelasyon saptanmadı. Grup A ve Grup B, yaş, cinsiyet, APACHE II skoru, SD ve TKK’ya göre karşılaştırıldığında anlamlı fark saptanmadı. SONUÇ: Çalışmamızda günlük ∆Hb ile TKK ve SD arasında anlamlı bir ilişki gösterilememiştir. Ancak bu ve benzeri çalışmalar, yoğun bakım hastalarında HB konsantrasyonunun, kanama olmaksızın düşebileceğini göstermesi açısından önemlidir.To evaluate &amp;#916;Hb (daily changes of hemoglobin concentrations) in nonbleeding critically ill patients, and to investigate its&amp;#8217; relation with diagnostic blood loss (DBL) and fluid balance (FB). Hospital records of 34 nonseptic patients who stayed in respiratory intensive care unit (RICU) at least 72 hours with no evidence of acute bleeding, renal failure and bleeding diathesis, were evaluated retrospectively. Demographics, clinical features, acute physiology assessment and chronic health evaluation (APACHE) II scores, daily Hb levels, DBL and FB were recorded. Correlation statistics was performed between &amp;#916;Hb and DBL and FB. We compared the patients with &amp;#916;Hb &amp;#8805; 0.5 g/dL/day (group A) and the patients with &amp;#916;Hb &lt; 0.5 g/dL/day (group B) in the first three days. The mean age was 55 &plusmn; 14, Hb level was 13.2 &plusmn; 1.7 g/dL at admission and 12.6 &plusmn; 2.3 g/dL at discharge from RICU. DBL was 25.2 &plusmn; 7.4 mL/d, and FB was 251 &plusmn; 1783 mL/d for the first day in intensive care unit. DBL was lesser in subsequent days than in the first day but it wasn&amp;#8217;t significant. &amp;#916;Hb was -0.54 &plusmn; 1.5 g/dL for the first three days, while it was -0.23 &plusmn; 1.5 g/dL for subsequent four days (p= 0.9). &amp;#916;Hb in the first three days has no correlation with DBL and FB. Age, sex, APACHE II score, clinical features, DBL and FB were not differed between Group A and Group B. CONCLUSION: No relation was found between &amp;#916;Hb and DBL, and also FB; but studies like this are important to indicate that Hb concentrations may decrease in critically ill patients without any reason such as bleeding

Turkish Thoracic Society's statement report on electronic cigarettes and heated tobacco products

Tobacco addiction, which causes the death of more than 8.5 million people in the world every year, is a preventable global public health problem. There are 1.1 billion adult smokers worldwide and 60% of them desire or intend to quit but unfortunately, the tobacco industry continues to profit at the expense of people's lives by marketing electronic cigarettes and heated tobacco products as a smoking cessation method and they continue to poison young people with new threat tobacco products, promising a "smoke-free future" Turkish Thoracic Society is actively involved in the implementation of the National Tobacco Control Program to protect public health and has warned and raised awareness of new threats to the youth, such as electronic cigarettes and heated tobacco products. The purpose of this report is to provide information about electronic cigarettes and heated tobacco products and to present TTJ's position on the subject

Determination of anthropometric measurements in obstructive sleep apnea syndrome in Turkish population

Introduction: In this study, we aimed to determine the values of anthropometric measurements and rates used in the evaluation of obstructive sleep apnea syndrome (OSAS) in our country. Materials and Methods: Twenty accredited sleep centers in thirteen provinces participated in this multicenter prospective study. OSAS symptoms and polysomnographic examination and apnea-hypopnea index (AHI) >= 5 cases OSAS study group; patients with AHI <5 and STOP-Bang <2 were included as control group. Demographic characteristics (age, sex, body mass index-BMI) and anthropometric measurements (neck, waist and hip circumference, waist/hip ratio) of the subjects were recorded. Results: The study included 2684 patients (81.3% OSAS) with a mean age of 50.50 +/- 0.21 years from 20 centers. The cases were taken from six geographical regions of the country (Mediterranean, Eastern Anatolia, Aegean, Central Anatolia, Black Sea and Marmara Region). Demographic characteristics and anthropometric measurements; age, neck, waist, hip circumference and waist/hip ratios and BMI characteristics when compared with the control group; when compared according to regions, age, neck, waist, hip circumference and waist/hip ratios were found to be statistically different (p<0.001, p<0.001, p<0.05, respectively). When compared by sex, age, neck and hip circumference, waist/hip ratio, height, weight and BMI characteristics were statistically different (p<0.001, respectively). Neck circumference and waist/hip ratio were respectively 42.58 +/- 0.10 cm, 0.99 +/- 0.002, 39.24 +/- 0.16 cm, 0.93 +/- 0.004 were found in women. Conclusion: The neck circumference was lower than the standard value in men, but higher in women. The waist/hip ratio was above the ideal measurements in both men and women. In this context, the determination of the country values will allow the identification of patients with the possibility of OSAS and referral to sleep centers for polysomnography