OBJECTIVE:Health hazards of e-cigarettes including “e-cigarette or vaping product use-associated lung injury” are better understood today. Just as e-cigarettes, heated tobacco products release toxic emissions. We aimed to determine the knowledge and attitude about new generation tobacco products among physicians who were the members of an organization for health care professionals, the majority of whom are pulmonologists.MATERIAL AND METHODS:In this cross-sectional study, a self-administered online questionnaire-based survey was conducted among the physicians from April to October 2019. The survey included questions about demographics (gender, age, graduation date from medical institution, and academic title), their smoking status, their knowledge and attitudes toward new generation tobacco products, and additionally about whether new generation tobacco products can be used to aid in smoking cessation.Results:Among the 506 members who responded to the survey, 56.7 % were female; the mean age was 42.4 ± 10.9 years (20-74). About 74.5% were pulmonologists, 5.5% were thoracic surgeons, and 20% were other physicians. Among the responders, the frequency of those who have not heard of new generation tobacco products before was determined as 9.5%, 24.5%, and 41.3%. At least 58.9% of participants lacked the knowledge necessary to discuss these products with their patients and the rate reached 76.7% for the heated tobacco product. To the question of whether new generation tobacco products can be used in smoking cessation, 68.4% responded “I never agree that they can be used.” Non-current smokers (P = .003), elders (P = .001), those who had training on smoking cessation assistance (P = .001), and those who had experience in smoking cessation assistance (P = .009) were significantly more prevalent in the group who answered: “I never agree that they can be used.”Conclusion:Physicians must become considerably more knowledgeable about the new generation tobacco products and hazards. Otherwise, these new tobacco products may pose new threats to national and global tobacco control efforts.

Since the lung is the most affected organ by COVID-19 disease, we aimed to evaluate the pulmonary function test, presence of hypoxemia, and Post-COVID-19 Functional Status Scale in 3- to 6-month post-COVID period. Post-COVID-19 Functional Status Scale, pulse oxygen saturation, and pulmonary function test were evaluated in 67 outpatients/inpatients after 3-6 months following COVID-19 (positive reverse transcription-polymerase chain reaction on nasopharyngeal swab) disease. Pre-COVID pulmonary function test parameters were available in 33 patients, and these were compared with post-COVID pulmonary function test parameters. We found 20.9% (14 patients) restrictive and 11.9% (8 patients) obstructive patterns in pulmonary function test. Of those with forced vital capacity < 80%, 53.3% were patients without known lung diseases. When pulmonary function test values before and after COVID-19 were compared, only a loss of 130 mL in forced expiratory volume in 1 second was determined (P = .005). About 65.4% of the patients with dyspnea were in the group without a lung disease (P = .002) and 66.7% of patients with forced expiratory volume in 1 second and forced vital capacity of .05). Smoking, hospitalization, oxygen support, and the severity of computed tomography involvement did not impact pulmonary function test. In post-COVID patients, the major disorder in the respiratory function test was determined as a restriction. However, advanced tests such as lung volumes and carbon monoxide diffusing capacity (DLCO) measurement and high-resolution lung tomography are needed to differentiate in terms of physical functional limitation or parenchymal fibrosis.

OBJECTIVE:Coronavirus disease 2019 is a disease caused by severe acute respiratory syndrome coronavirus 2, a novel type of coronavirus, which causes pneumonia in some hosts. No specific scoring method exists for mortality evaluation in novel coronavirus pneumonia. The aim of this study was to investigate factors affecting coronavirus disease 2019 mortality and comparison of pneumonia scoring systems, pneumonia severity index, CURB-65, and MuLBSTA.MATERIAL AND Methods:In this single-center clinical study, 151 patients who had been diagnosed with coronavirus disease 2019 infection and pneumonia between March 11 and May 31, 2020, were evaluated retrospectively. Correlation between patients’ symptoms, comorbidities, drugs in use, radiological findings, and mortality was investigated. Parameters were also evaluated regarding their contribution to additional treatment requirements and days of fever response.Results:A correlation between mortality and higher scores of pneumonia severity index, CURB-65, and MuLBSTA was found. When parameters were investigated separately, elevated glucose and urea levels, presence of diabetes, renal failure, hypertension, chronic obstructive pulmonary disease, cerebrovascular events and known malignancies, lymphocyte count, smoking history, radiological findings, and age correlated with mortality.In addition to these parameters, elevated calcium, potassium, brain natriuretic peptide, troponin, d-dimer, C-reactive protein, HC03, and lactate dehydrogenase levels were found significant regarding mortality. These parameters were not found statistically relevant regarding additional treatment requirement, fever response day, and total treatment duration.Conclusion: A modified version of present pneumonia scoring systems will be required to rigorously evaluate the severity of a patient’s condition. A new scoring system that uses components of the present ones may prove useful and with further studies, a similar follow-up algorithm may be created.

OBJECTIVE:To evaluate the patients who were treated for intraocular tuberculosis retrospectively and present our findings and share our experience.MATERIAL AND Methods:This study was a descriptive, cross-sectional, retrospective study. Patients who were followed up with the diagnosis of intraocular tuberculosis in the Ophthalmology and Pulmonary Medicine Departments of Dokuz Eylul University Faculty of Medicine in the last 15 years and received anti-tuberculosis therapy were included.Results:A total of 16 eyes of 10 patients with a diagnosis of intraocular tuberculosis uveitis who were treated with anti-tuberculosis therapy were included in this study. The mean age was 48.1 [14.6] years (mean [standard deviation]). Four were [40%] male and 6 [60%] were female. Patients with tuberculosis uveitis had bilateral involvement (7 of 10 patients [70%]). Intraocular tuberculosis was presented in 7 eyes of 4 patients with serpiginous like choroiditis, 2 eyes of 2 patients with choroidal tuberculomas, 4 eyes of 2 patients with choroidal tubercles (miliary tuberculosis), and 3 eyes of 2 patients with intermediate uveitis. The mean duration from admission to treatment was 18.1 ± 17.4 days (range: 6-56 days). All patients in this study received a 4-drug regimen anti-tuberculosis therapy, Paradoxical reaction occurred in 30% of the patients. Eight patients had systemic steroid therapy and 4 had also topical steroid therapy. The mean length of follow-up was 14.7 months (standard deviation = 15.1, range: 6-48 months). Reactivation of intraocular tuberculosis was not observed in any patients.Conclusion:High level of suspicion is a must for diagnosing intraocular tuberculosis. A complete ophthalmic examination can be performed in patients with suspected or proven tuberculosis. Early diagnosis and prompt treatment of intraocular tuberculosis can prevent serious complications and loss of vision.

OBJECTIVE:This study investigated the efficacy of high-flow nasal oxygen therapy in patients with severe acute exacerbation of chronic obstructive pulmonary disease admitted to the intensive care unit.MATERIAL AND METHODS:Totally, 23 patients were enrolled in the study. High-flow nasal oxygen therapy was administered with a predefined protocol. Vital signs, Visual Analog Scale for dyspnea, and arterial blood gas parameters were recorded at the beginning under low-flow oxygen support therapy and the 1st, 6th, 12th, and 24th hours of high-flow nasal oxygen therapy. High-flow nasal oxygen therapy duration, intensive care unit length of stay, and intensive care unit, in-hospital, and 60-day mortality were recorded as outcomes and compared according to the presence of pneumonia upon admission.Results:In 12 patients (52.2%), pneumonia was present. High-flow nasal oxygen therapy was applied for a median of 57 hours [49.2-104.5]. Overall decreases were detected in heart rate (P = .001), respiratory rate (P < .001), and Visual Analog Scale for dyspnea (P = .001) during the first 24 hours of the therapy. Although there was an increase in PaCO2 (P = .001), pH increased (P < .001) over time too. No change in partial arterial oxygen pressure (P = .63) and partial arterial oxygen pressure/fraction of inspired oxygen ratio (P = .22) was noted. Nineteen patients (77%) were successfully weaned from high-flow nasal oxygen therapy. While the high-flow nasal oxygen therapy failure rate was 23%, the in-hospital and 60-day mortality rates were 8.6%. Outcomes were not different between patients with and without pneumonia.Conclusion:High-flow nasal oxygen therapy was efficient in relieving respiratory distress and well-tolerated with no adverse outcome in severe acute exacerbation of chronic obstructive pulmonary disease patients admitted to the intensive care unit.

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.

In this article, Early Career Task Force Group members of the Turkish Thoracic Society summarize the European Respiratory Society 2020 virtual congress. Current developments in the field of respiratory diseases were compiled with the addition of sessions specific to coronavirus disease 2019 this year. Almost all of the congress sessions were examined, and the important and striking results of the congress were highlighted. Congress sessions were attended by expert researchers, and the prominent messages of each session were highlighted in short summaries. They were then grouped under relevant titles and ranked in order of meaning and relation. It was finalized by a team of researchers.

OBJECTIVEThe aim of this study was to explore the impact of smoking history on the severity of coronavirus disease 2019 radiologic findings. Therefore, we compared the computed tomography severity scores of smoking coronavirus disease 2019 patients with those of non-smoking coronavirus disease 2019 patients.MATERIAL AND METHODSA total of 121 patients were included in our study group. We retrospectively reviewed 121 patients who underwent reverse transcription-polymerase chain reaction sampling and computed tomography examination in our hospital between April 1, 2020, and July 30, 2020. All computed tomography images were independently reviewed by 2 radiologists.ResultsThere were 15 (12.4%) active smokers, 38 (31.4%) former smokers, and 68 (56.2%) never-smokers in this study. Among the 85 patients with evidence of pneumonia in thorax computed tomography, mean computed tomography severity scores were 8.02 and standard deviation 5.812. Computed tomography severity scores for patients with pathological computed tomography scans (n = 85) were performed for evaluating smoking status (never-smokers and smokers). We found a statistically significant relationship between computed tomography severity scores of never-smokers (n = 39) and smokers (n = 46) (Z = 2.243, P = .025). The computed tomography severity scores threshold for differentiating smokers in our study group was 8, with a sensitivity of 52.2% and a specificity of 79.5%. Among the 121 patients, 34 (28.1%) were in the asymptomatic group, 36 (29.75%) were in the mild group, 28 (23.14%) were in the common group, and 23 (19.0%) were in the severe group with severe pneumonia and respiratory distress. Five (1.47%), 16 (44.44%), 14 (50%), and 18 (78.26%) of the patients in these groups were smoking, respectively.ConclusionAmong coronavirus disease 2019 patients, smoking is associated with the progression of the disease and increased adverse effects. In our study, smoking status was significantly correlated with thorax computed tomography findings on admission. Computed tomography severity scores assessment helps to evaluate the disease extent in coronavirus disease 2019 patients.