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Background: There are difficulties in the treatment of smoking cessation in elderly patients. However, elderly smokers who gave up smoking had lower rates of death from heart attack, stroke, and cancer, as well as improved cognitive function. This study aimed to investigate the affecting factors and the success of smoking cessation rate in patients aged 60 and over in Turkey. Methods: Six smoking cessation outpatient clinics from four provinces were included in the study. The records of 1,065 patients who applied to a smoking cessation outpatient clinic between 2016 and 2019 and who were 60 yr of age or older were scanned. Overall, 917 cases that could be reached after treatment were included in the study. Smoking cessation rates at the first month, 3rd month, 6th month, 9th month and 12th month were given. Results: Of the 917 cases, 65.1% were male and 34.9% were female. Smoking cessation rates were 45.6% on the first month, 39% on the third month, 35.1% on the sixth month, 31.2% on the ninth month, and 30.3% at the twelfth month. Smoking cessation success was higher in men than in women. Conclusion: Since the success of smoking cessation in the elderly was similar to that of adults. Since smoking is an independent risk factor for death in the elderly, there should be greater willingness to provide elderly patients with smoking cessation treatment to reduce physical function loss and promote healthier aging.

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OBJECTIVE: The aim of this study was to investigate the interobserver agreement in determination of the dominant histological pattern and the final diagnosis in lung adenocarcinomas. MATERIAL AND METHOD: A total of 12 patients with a diagnosis of primary lung adenocarcinoma were included in the study. Twelve pathologists from eight study centers were asked first to determine the dominant histological pattern in these cases and then to decide whether the final diagnosis was in situ, minimally invasive or invasive adenocarcinoma. RESULTS: The kappa value for the agreement in determining the dominant pattern among the pathologists was 0.36 (p < 0.001), with the values for the lepidic, acinar, papillary, solid, micropapillary patterns and mucinous character of adenocarcinoma being 0.34, 0.28, 0.30, 0.80, 0.16 and 0.38 respectively (p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001). None of the cases was diagnosed as in situ adenocarcinoma. On the other hand, the kappa value for the agreement in differentiating minimally invasive from invasive adenocarcinoma among reviewers was 0.17 (p < 0.001). CONCLUSION: The agreement among pathologists in determining the subtype of lung adenocarcinomas that depends on the identification of the dominant pattern was at intermediate level. In addition, the agreement in deciding whether the case is minimally invasive or invasive, was at low level. The criteria defining the histological patterns should be clarified and described in more detail. Educational activities and larger multicenter studies might be helpful in improving the agreement and standardization.

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INTRODUCTION: The importance of the evaluation of health status in chronic obstructive pulmonary disease (COPD) is recently highlighted in many studies. In this study, we aimed to test the validity and reliability of the Turkish version of St. George Respiratory Questionnaire (SGRQ). MATERIALS AND METHODS: The study was conducted in seven centers in Turkey. Three hundred and twenty one COPD patients (40-75 years) were included to the study. Turkish versions of breathlessness, Cough, and Sputum Scale (BCSS), mMRC (Modified Medical Research Council) dyspnea scale, SGRQ, COPD assessment test (CAT) and Short Form Health Survey (SF-36) were carried out to the patients. The statistical analysis of SGRQ was performed by using the coefficient of internal consistency, discriminative analysis for different stages and the correlation with the other scales. RESULTS: The mean age was 62.4 ± 8.9 years and the mean FEV1 was 51.9 ± 19.2% pred. The coefficient of internal consistency (Cronbach alpha) was 0.8815. The correlation between the total score measured initially and that obtained two weeks later was found to be highly significant (r= 0.90, p< 0.0001). According the results of validation of both total score and the components of SGRQ, the correlation between the total score of SGRQ and CAT was 0.782 (p< 0.0001), SGRQ and SF-36 was between -0.481 ile -0.819 (p< 0.0001). The total and component scores were able to discriminate different disease stages and a significant correlation was found to be with pulmonary function tests. CONCLUSION: SGRQ Turkish version is a reliable and valid assessment tool for COPD patients in clinical practice.

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BACKGROUND: Cardiovascular disease (CVD) contributes significantly to mortality in chronic obstructive pulmonary disease (COPD). Red blood cell distribution width (RDW), an automated measure of red blood cell size heterogeneity that is largely overlooked, is a newly recognized mortality marker in patients with established CVD. It is unknown whether RDW is associated with mortality in COPD patients. AIMS: To study the prognostic value of RDW in patients with COPD and to compare the value of this measurement with cardiac, respiratory, and hemotological status. METHOD: We performed retrospective analyses of 270 patients stable with COPD who were admitted to our hospital between January 2007 and December 2009. Demographic, clinical, echocardiographic, and laboratory characteristics were registered and recorded COPD deaths were registered as outcomes. RESULTS: In the overall patients, the RDW level had a mean value of 15.1 ± 2.4. RDW was positively correlated with C-reactive protein (CRP) (p = 0.008, r = 0.21), right ventricular dysfunction (RVD) (p < 0.001, r = 0.25), and pulmonary arterial hypertension (PAH) (p = 0.03, r = 0.14). Variables (p < 0.1) included in the univariate survival analysis were forced expiratory volume in 1 second (FEV1% predicted), RDW levels, age, PaCO2, albumine and CRP levels, presence of CVD, presence of anemia, presence of RVD, and presence of PAH. Subsequent multivariate analysis suggested that RDW levels (1.12; 95% CI, 1.01 to 1.24; p = 0.01), and presence of RVD (2.6; 95% CI, 1.19 to 5.8; p = 0.01) were independently related to mortality. CONCLUSION: Elevated RDW levels were associated with increased mortality risk in stable COPD patients.

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BACKGROUND: Angiopoietin 2 (Ang-2) has an important role in tumor angiogenesis. In this study, Ang-2 levels of serum and bronchioloalveolar lavage fluids (BALF) in patients with lung cancer were measured and correlated with clinical and biochemical parameters. METHODS: Thirty-five cases newly diagnosed with lung cancer and 18 controls with non-cancerous lung diseases were included in the study. Tumor histology, staging, metastasis, tumor markers, biochemical and clinical parameters were all recorded. RESULTS: Serum Ang-2 levels were significantly higher in the lung cancer group compared to the control (lung cancer median: 2.42 ng/mL [2.19-2.98], control 0.67 [0.31-1.10]; P < 0.001), whereas Ang-2 levels in BALF were lower in the lung cancer group compared to the control (lung cancer median 0.41 ng/mL [0.22-0.79], control 0.67 [0.46-1.03]; P = 0.02). In the cancer group, higher serum Ang-2 levels (r = 0.52, P < 0.001) were associated with the stage of cancer. No significant correlation was observed between BALF Ang-2 levels and non-small cell lung cancer stages and small-cell lung cancer advanced stage (P = 0.793, r = 0.07). Serum Ang-2 levels were significantly higher in distant metastasis (M1) versus no distant metastasis (M0) (M1: 2.57 ng/mL [2.38-2.87], M0: 2.22 [1.49-2.40], P = 0.01). No significant correlation was observed between BALF Ang-2 levels and M1 (r = 0.11, P = 0.53). CONCLUSIONS: Serum Ang-2 levels were significantly higher in lung cancer patients and positive correlations were observed between serum Ang-2, tumor stage, and metastasis.

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INTRODUCTION: This study is aimed to evaluate the reliability and validity of the Turkish version of chronic obstructive pulmonary disease (COPD) Assessment Test (CAT) in seven centers. MATERIALS AND METHODS: 321 patients between 4-75 years of age, diagnosed and staged by Global Initiative for Obstructive Lung Disease (GOLD) 2011 criteria were included. The Breathlessness, Cough, Sputum scale (BCSS), mMRC (Modified Medical Research Council ) dyspnea index, St. George Respiratory Questionnaire (SGRQ), CAT and Short Form-36 (SF-36) were used concurrently. In the statistical analyses, internal consistency, item-total score correlation, explorative factor analysis, correlation with other scales were calculated. RESULTS: The mean age was 62.4 ± 8.9 years and 89.7% of the patients were male (n= 288). Mean FEV1% was 51.9 ± 19.2 and most of the patients were in Stage 3. CAT total score was 17.8 ± 9.5. In the internal consistency, Cronbach alpha coefficient was found as 0.9116 and item-total score correlation coefficients were between 0.62-0.79 and all were statistically significant (p< 0.0001). The correlation of the test-retest score calculated after two weeks with the initial score was 0.96 (p< 0.0001). In the structural validity, factor analysis with principle component analysis and varimax rotation was performed. One factor solution was achieved with eigenvalue of 4.956 and it represented 61.9% of the total variance. All the items were contained in the factor and the factor loads were between 0.71-0.85. The correlation coefficients of CAT with other indexes were moderate to good. The discrimination of CAT among disease stages has been shown to be significant (p< 0.0001) and a significant correlation was found with pulmonary function tests (p< 0.0001). CONCLUSION: It is demonstrated The Turkish version of COPD Assessment Tool is reliable and valid.

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OBJECTIVE: The aim of this study was to compare the results of virtual bronchoscopy (VB) images in defining tracheobronchial pathologies with those of fiber-optic bronchoscopy (FOB) in patients with clinical indication for bronchoscopy. METHODS: Twenty-two patients with bronchoscopy indication were evaluated with FOB and VB. The VB results were evaluated blindly, independent of the FOB results. RESULTS: In 19 of the 22 patients, tracheobronchial abnormalities were present on FOB, whereas 3 patients had normal findings on FOB. In 17 of 19 patients, VB demonstrated the FOB diagnosis of tracheobronchial abnormality. While FOB detected 11 endoluminal lesions, VB detected 6. While FOB detected 20 obstructive lesions, VB detected 26. In evaluating external compression, FOB detected 2 lesions and VB detected 15. CONCLUSIONS: VB is a non-invasive, uncomplicated, and reproducible examination method in patients with an indication for thorax examination. Virtual bronchoscopy could find a clinically broader field of application in the future.