Gamze Kirkil

Dynamic problems involving the mechanical model of respiratory devices prepared based on the working principle of the lung bring a different perspective to the current situation in clinical medicine in case the time scale changes. This paper delves into mathematical models performed by delta derivative and proportional derivative on arbitrary time scale for the instantaneous volume in the single compartment lung. First, these problems are solved with appropriate methods. Finally, results are supported on graphical representations of the equations to assess how well the operators mentioned perform in real-world problems and statistical analysis of selected arbitrary values is performed.

Aim: Aim: This study aimed to investigate the relationship between respiratory muscle strength and kinesiophobia in patients with Systemic Sclerosis (SSc) and to determine whether pulmonary function parameters influence movement-related fear in this population. Methods: : A cross-sectional study was conducted with 20 patients diagnosed with SSc. Respiratory muscle strength was evaluated by measuring maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) using a digital mouth pressure meter. Pulmonary function, including forced vital capacity (FVC) and diffusing capacity of the lungs for carbon monoxide (DLCO), was assessed via spirometry. Kinesiophobia levels were determined using the Tampa Scale of Kinesiophobia (TSK). Fatigue and dyspnea levels were also recorded as secondary clinical outcomes. Results: Results: High levels of kinesiophobia were prevalent among the participants. However, correlation analysis revealed no significant association between kinesiophobia scores and MIP, MEP, or FVC values (p > 0.05). Although pulmonary involvement was characterized by significant impairments in respiratory function and increased fatigue, these physiological deficits did not appear to be the primary drivers of kinesiophobia. Conclusion: Conclusion: Kinesiophobia in SSc patients appears to follow a course independent of objective pulmonary function and respiratory muscle strength. These findings suggest that movement-related fear is a distinct biopsychosocial construct in SSc that requires specific attention regardless of the severity of lung involvement.

Idiopathic pulmonary fibrosis (IPF) is a fatal lung disease. Lung cancer (LC) is among the most crucial comorbidity factors in patients with IPF. IPF patients that are diagnosed with LC have a reduced mean survival time. Therapeutic strategies for LC in patients with IPF need to be adapted according to the individual treatment risk. Life-threatening acute exacerbation (AE) of IPF may occur in association with cancer treatment, thereby severely restricting the therapeutic options for IPF-associated LC. Because LC and anticancer treatments can worsen the prognosis of IPF, the prevention of LC is as critical as managing patients with IPF.

Background/Objectives: The association between past coronavirus disease-19 (COVID-19) infection and pulmonary thromboembolism (PTE) is a potential research topic. We aimed to research the prevalence of previous COVID-19 infection in patients with PTE and to determine whether there is a difference in embolism severity in these cases. Methods: Study design: Multicenter, observational, cross-sectional. Patients diagnosed with PTE between 11 March 2022 and 11 March 2023 were prospectively included in this study, excluding cases with PTE along with active COVID-19, patients under the age of 18, and pregnant patients. Group 1 consisted of PTE cases with previous COVID-19, and Group 2 consisted of PTE cases without previous COVID-19. Key variables are D-Dimer level, right ventricle/left ventricle (RV/LV) ratio, simplified pulmonary embolism severity score, and treatment type. Results: A total of 1185 patients (Group 1; n = 360, Group 2; n = 825) were included in this study. The proportion of patients with RV/LV ratio > 1 on computed tomography pulmonary angiography (CTPA) was significantly high in Group 2 compared to Group 1 (27.9% vs. 19.7%, p = 0.003). In multivariate logistic regression analysis, the absence of any identifiable risk factor for PTE was found to be a 0.46-fold protective factor in the presence of previous COVID-19 (OR: 0.456 95% CI: 0.274–0.760, Wald = 9.070, df = 1, p = 0.003) and an RV/LV ratio > 1 on CTPA was found to be a 0.60-fold protective factor (OR: 0.603, 95% CI: 0.365–0.998, Wald = 3.874, df = 1, p = 0.049). Conclusions: The prevalence of previous COVID-19 infection in PTE cases was 30.4%, and 26.3% of idiopathic cases had previous COVID-19 infection. Although the parameters related to embolism severity were higher in the non-COVID-19 group, multivariate analyses revealed a 2.2-fold increased risk for idiopathic PTE and a 1.7-fold increased risk for RV/LV ratio > 1 on CTPA in patients without COVID-19 compared to those with prior COVID-19.

This study aimed to determine the effectiveness of education provided to university students on COVID-19 phobia. The study was structured as a pre-test, post-test single-group study, a quasi-experimental research design, conducted on 122 students at a university located in Eastern Anatolia. Pre-test forms (Information Form, COVID-19 Phobia Scale) were sent to the students via email, filled out, and returned to the researcher. Subsequently, online training was provided to the participating students, and post-test (COVID-19 Phobia Scale) data were collected. A statistically significant difference was found between the pre-test and post-test COVID-19 Phobia Scale values (p<.001). This difference was in favor of the pre-test, indicating a reduction in COVID-19 phobia levels after the intervention. The results of this study highlight the importance of pandemic phobia and education. It provides data support for pandemic and COVID-19 phobia for policymakers, healthcare administrators, and the literature.

Aims: Connective tissue diseases (CTD) are systemic diseases that most commonly cause lung involvement. To examine how the disease will progress and survival at the time of diagnosis in connective tissue disease related interstitial lung disease (CTD-related ILD). Methods: Patients with radiological diagnosis of CTD-related ILD were included in this retrospective study. Seventy-five patients aged over 18 years, who were diagnosed as having ILD radiologically and rheumatoid arthritis, Sjögren’s syndrome, polymyositis/dermatomyositis, systemic sclerosis, ankylosing spondylitis, systemic lupus erythematosus. Patients who underwent high-resolution computed tomography, pulmonary function test, carbon monoxide diffusion capacity test, and 6-minute walk test were included in the study. During the 1-year follow-up period, the data of the patients who died and survived were compared. Results: Of the 75 patients included in the study, 55 were women and 20 were men. There were comorbidities in 56 (74.66%) patients. There was no statistical difference between the patients’ CTD subtype and FEV1, FVC, FEV1/FVC, DLCO, 6MWT distance, and 6MWT baseline oxygen saturation. At the end of the 1-year follow-up period, four patients died. Age, sex, smoking, CTD subtype, presence of comorbidities, and chronic obstructive pulmonary disease were not associated with survival, but it was determined that non CTD duration, the presence of CHF, DM, and a fibrosis rate of >10% were statistically significantly associated with survival. Among the serologic markers, ESR (60.25±17.72 vs. 24.52±18.96) and CRP (81.12±80.53 vs. 6.36±7.53) were found to be statistically significantly higher in patients who died; the levels of other markers were similar to patients who survived. FEV1, FVC, and 6MWT distances were significantly lower in patients who died. The presence of emphysema, air cysts, nodule, atelectasis, septal thickening, parenchymal bands, air trapping, honeycomb, opacity, ground-glass, mosaic attenuation, and bronchiectasis was not found to be associated with survival in HRCT. However, calcific nodules, pleural effusion, bronchial wall thickening, and fibrotic change were found to be statistically significantly associated with survival. Conclusion: We suggest that patients with CTD-related ILD with comorbidity, low baseline respiratory function parameters, a fibrosis rate of >10% on HRCT, calcific nodule, pleural effusion, bronchial wall thickening, and fibrotic changes should be followed more closely in terms of disease progression and mortality.

Pulmonology is one of the branches that frequently receive consultation requests from the emergency department. Pulmonology consultation (PC) is requested from almost all clinical branches due to the diagnosis and treatment of any respiratory condition, preoperative evaluation, or postoperative pulmonary problems. The aim of our study was to describe the profile of the pulmonology consultations received from emergency departments in Turkiye. A total of 32 centers from Turkiye (the PuPCEST Study Group) were included to the study. The demographic, clinical, laboratory and radiological data of the consulted cases were examined. The final result of the consultation and the justification of the consultation by the consulting pulmonologist were recorded. We identified 1712 patients, 64% of which applied to the emergency department by themselves and 41.4% were women. Eighty-five percent of the patients had a previously diagnosed disease. Dyspnea was the reason for consultation in 34.7% of the cases. The leading radiological finding was consolidation (13%). Exacerbation of preexisting lung disease was present in 39% of patients. The most commonly established diagnoses by pulmonologists were chronic obstructive pulmonary disease (19%) and pneumonia (12%). While 35% of the patients were discharged, 35% were interned into the chest diseases ward. The majority of patients were hospitalized and treated conservatively. It may be suggested that most of the applications would be evaluated in the pulmonology outpatient clinic which may result in a decrease in emergency department visits/consultations. Thus, improvements in the reorganization of the pulmonology outpatient clinics and follow-up visits may positively contribute emergency admission rates.

Purpose The present research was undertaken to investigate the effect of yoga on pulmonary function and early clinical outcomes in patients scheduled for bariatric surgery. Materials and Methods This research with a randomized control group was performed on patients scheduled for bariatric surgery between October 2021 and June 2022 in the General Surgery Clinic of a University Hospital in Eastern Turkey. The sample consists of 100 randomized patients who received yoga breathing exercises and routine care. Pulmonary function test (PFT), posteroanterior chest X-rays (CXR), 6-min walk test, and oxygen saturation (SpO₂) were applied as a pretest. The researcher practiced yoga for 40 min every day of the week. Post-test measurements were performed at the end of the yoga practice. Control group patients underwent the tests at the same intervals without any modifications to the standard clinical protocol. Results The difference between the control and experimental groups was significant in terms of post-test PFT measurements (p < 0.001). In the CXR of the patients, a statistically significant improvement was determined in 61.5% of the patients with yoga breathing practice (p < 0.001). Also, there was a significant increase in the 6-min walk test and SpO₂ values in the experimental group (p < 0.05). Conclusion Yoga practice positively affected the pulmonary function values of the patients. Graphical Abstract

Aim: It is unknown whether there is an increase in the frequency of acquired respiratory tract infections (ARTIs) while the weight loss process continues after bariatric surgery (BS). Methods: An observational case-crossover study of 366 patients underwent BS between September 2018 and September 2019 was performed. Prospectively recorded data of ARTI events in the first pre- and post-operative ARTI seasons were compared. Results: Mean age was 36.4 ± 10.9 years and mean body mass index (BMI) was 44.1 ± 6.2 kg/m2. Mean change in BMI in an ARTI season was 13.2 ± 6.1 kg/m2. Among 366 patients, 180 (49.2%) were diagnosed with ARTI and the average numbers of ARTIs was 0.69 ± 0.85 in preoperative season. During the postoperative season, 134 (36.6%) patients were diagnosed with ARTI and the average numbers of ARTIs was 0.49 ± 0.76. Both period prevalence and average number of ARTIs in preoperative ARTI season was significantly higher than postoperative season (P = 0.001 for both). The change in BMI in an ARTI season was correlated with the postoperative period prevalence of ARTIs (r = 0.119, P = 0.022). Conclusion: These findings showed that the period prevalence and incidence of ARTIs reduced after BS. However, the frequency of ARTIs was higher in patients with greater weight loss.