Siahmet Atlı

Asthma-COPD overlap (ACO) is a controversial concept without a universally accepted definition. In the study by Aslan and Enli, ACO was defined based on airflow limitation and reversibility; however, this approach may not fully reflect current guideline perspectives. Recent GINA and GOLD reports emphasize a phenotype-based approach rather than defining ACO as a distinct disease entity. Therefore, the observed limited diagnostic value of prostaglandin D2 (PGD2) may be influenced by methodological limitations, particularly patient selection and classification strategy.

Background: Tobacco cessation support remains underutilized in routine care for patients with airway diseases such as asthma and COPD. In this multicenter randomized trial (NCT05764343, registration date: 2023-03-01), we previously reported that immediately scheduled appointments to smoking cessation clinics improved access and quit rates at 1-week and 3-month follow-ups. The present study evaluated whether these effects were sustained at 12 months. Methods: This prospective, parallel-arm, multicenter randomized trial included 397 adult people who smoke diagnosed with asthma, COPD, or bronchiectasis. Participants were allocated to either usual support (brief advice only) or immediate support (brief advice plus an appointment scheduled at a smoking cessation clinic). Smoking status was assessed by telephone at 12 months. Self-reported quitters were invited for exhaled carbon monoxide (CO) testing. The primary outcome was continuous abstinence at 12 months, analyzed on an intention-to-treat basis. Results: Of 397 randomized patients, 330 (83.1%) completed the 12-month follow-up, with similar loss to follow-up between groups. In the intention-to-treat analysis, the 12-month smoking cessation rate was significantly higher in the immediate support group compared with the usual support group (20.7% vs. 11.6%, p = 0.019). Among non-quitters, quit attempts, smoking cessation clinic admission, and pharmacotherapy use were significantly more common in the immediate support group ( p < 0.05). Conclusion: Immediate scheduling of smoking cessation clinic appointments resulted in significantly higher 12-month quit rates compared to usual care. These findings support the integration of proactive referral strategies into routine management of patients with chronic airway diseases.

Introduction: A significant proportion of patients with chronic airway diseases continue to smoke even after the diagnosis. In addition, smoking cessation support continues to be a neglected issue in real-life settings by physicians for that patient group. Therefore, in our search for a...

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.

Introduction: Patients with airway diseases who bear the burden of smoking need access to smoking cessation support. We aimed to investigate the impact of immediately scheduled appointments on access to smoking cessation clinics compared with usual care in this patient group. Methods: This...