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Despite significant decreases in morbidity and mortality of cardiovascular diseases (CVD) and cancers, morbidity and cost associated with chronic obstructive pulmonary disease (COPD) continue to be increasing. Failure to improve disease outcomes has been related to the paucity of interventions improving survival. Insidious onset and slow progression halter research successes in developing disease-modifying therapies. In part, the difficulty in finding new therapies is because of the extreme heterogeneity within recognized COPD phenotypes. Novel biomarkers are necessary to help understand the natural history and pathogenesis of the different COPD subtypes. A more accurate phenotyping and the ability to assess the therapeutic response to new interventions and pharmaceutical agents may improve the statistical power of longitudinal clinical studies. In this study, we will review known candidate biomarkers for COPD, proposed pathways of pathogenesis, and future directions in the field.

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Acquired immune deficiency syndrome (AIDS) is an immune system disease caused by the human immunodeficiency virus (HIV). The purpose of this review is to investigate the correlation between an immune system destroyed by HIV and the frequency of pneumonia. Observational studies show that respiratory diseases are among the most common infections observed in HIV-infected patients. In addition, pneumonia is the leading cause of morbidity and mortality in HIV-infected patients. According to articles in literature, in addition to antiretroviral therapy (ART) or highly active antiretroviral therapy (HAART), the use of prophylaxis provides favorable results for the treatment of pneumonia. Here we conduct a systematic literature review to determine the pathogenesis and causative agents of bacterial pneumonia, tuberculosis (TB), nontuberculous mycobacterial disease, fungal pneumonia, Pneumocystis pneumonia, viral pneumonia and parasitic infections and the prophylaxis in addition to ART and HAART for treatment. Pneumococcus-based polysaccharide vaccine is recommended to avoid some type of specific bacterial pneumonia.

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Objective: It is well known that various sleep disorders are common in cases of chronic obstructive pulmonary disease (COPD). However, restless legs syndrome (RLS) has not been extensively studied in these patients. The aim of the current study was to investigate the prevalence of RLS and its impact on sleep quality in patients with COPD.
Methods: The study included a total of 50 patients with COPD with a mean age of 67.2±7.7 years; 39 (78%) were male. The RLS diagnosis was made based on the questionnaire items standardized by the International RLS study group. Dyspnea severity (mMRC), quality of life (CAT), sleep quality [Pittsburgh sleep quality index (PSQI)], and daytime sleepiness [Epworth sleepiness scale (ESS)] were evaluated using certain specific questionnaires. The subjects were studied in two groups: RLS-positive and RLS-negative groups.
Results: In the study population, RLS was detected in 17 (34%) patients. It was found that the RLS-positive subjects had a longer disease duration (p=0.006), a higher hospital admission rate (p=0.008), and lower spirometric values (p=0.023 for FVC; p=0.001 for FEV1). The CAT score was significantly higher in the RLS-positive group (p=0.019). The RLS-positive group had higher PSQI and ESS scores (p<0.001 for both). There were negative correlations between PSQI, ESS scores, and spirometric measures (FVC and FEV1), whereas PSQI and ESS scores had positive correlations with disease duration, mMRC, and CAT scores.
Conclusion: In our study, it was observed that RLS is a common condition in patients with COPD. As the duration and severity of COPD increases, RLS becomes more prevalent and sleep quality deteriorates.

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Objective: Body mass index (BMI) is used as a basic parameter in assessing obesity. However, BMI is not sensitive in the assessment of body fat percentage (BFP) and body fat distribution (BFD). The aim of this study is to determine the effect of BFP and BFD on the pulmonary functions and compare this effect with BMI.
Methods: This study was conducted with a total of 170 volunteers. BMI, waist-to-hip ratio (WHR), and BFPs of healthy normal weight, overweight, and obese individuals were measured and their pulmonary function tests were statistically compared with each other.
Results: There was no significant relationship between BMI increase and pulmonary function test results of the individuals. There were significant correlations between BFP increase and forced expiratory volume (FEV1%) and forced expiratory flow between 25% and 75% of FVC (FEF25–75%). In the male patients, FEV1% value was negatively correlated with waist circumference. In female patients, WHR was positively correlated with FEV1/forced vital capacity (FVC), FEV1/FVC%, whereas it was negatively correlated with FEV1% values.
Conclusion: Because the widely used BMI is incapable of distinguishing BFP and BFD, it can be insufficient for evaluating the lung functions.Therefore, determining the body composition is important in the evaluation of obese individuals.

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Objective: This study aimed to investigate the smoking prevalence and associated factors among the students of Balýkesir University and determine the level of nicotine dependence in smokers.
Methods: Six faculties and two graduate schools located at the Balýkesir University campus were enrolled. The cluster method was used as the sampling method. To observe the rates of smoking initiation while studying at the university, first-year and final year students were compared.
Results: A total of 1096 students were enrolled, with a mean age of 20.4±2.2 years. The regular smoking prevalence rate was 25.5%, occasional smoking rate was 9.5%, alcohol consumption rate was 28.0%, and drug abuse rate was 5.0%. The mean age for attempting to smoke was 16.6±2.2 years. The leading causes of smoking were curiosity, spiritual space, affection, and to comply with friends. According to the Fagerström questionnaire, the level of nicotine dependence was low in 53.0% of the participants, moderate in 8.7%, and high in 28.4%. The average smoking prevalence rate was 23.6% in first-grade students, whereas it was 44.8% in last-grade students. The factors that influence smoking were as follows: being in the last grade, mother, siblings, and friends who smoke, higher allowance, use of alcohol and drugs. Smoking was found to be more prevalent among males.
Conclusion: Last-grade students had a higher smoking prevalence rate than the first-grade students. Family, social environment, and smoking behavior of friends have an influence on smoking. All risk factors, including past history and university period, should be considered together in tobacco control.

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Objective: To evaluate the clinical, laboratory, radiological, and demographic data of H3N2 pneumonia cases hospitalized to the Pulmonology Department during H3N2 pandemics and compare them with non-H3N2 community-acquired pneumonia (CAP) cases.
Methods: The study population consisted of all CAP cases hospitalized to our Pulmonology Department between December 2013 and February 2014 during the influenza outbreak. The patient files were evaluated for physical findings, laboratory data, radiological findings, and treatment and outcome of cases. H3N2 was diagnosed using polymerase chain reaction (PCR) analysis of throat swabs. The clinical, radiological, and laboratory findings of H3N2 pneumonia cases were compared with those of non-H3N2 pneumonia cases. Mann–Whitney U test, Chi-square test, Fisher’s exact test, and logistic regression analysis by the forward step wise method were used for statistical analyses. P value<0.05 was considered significant.
Results: During the H3N2 pandemic outbreak, 69 cases were diagnosed with CAP; 62 (89.8%) with non-H3N2 CAP, and 7 (10.2%) with H3N2 pneumonia. The demographic data, CURB-65, pneumonia severity index (PSI) scores, and clinical, radiological, and laboratory findings of the two groups were similar (p>0.05). The rates of treatment failure and/or transport to the intensive care unit with the need of invasive mechanical ventilation and mortality rates were also similar in both groups (p>0.05).
Conclusion: H3N2 pneumonia/viral pneumonia is a member of CAP. Although the number of H3N2 cases are extremely small to draw a conclusion, the results of this study highlight that the clinical, radiological, and laboratory findings of H3N2 pneumonia cases are not different from those of non-H3N2 CAP cases.

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Objective: In this study, we aimed to investigate smoking habits of women during pregnancy and determine the related factors.
Methods: In this cross-sectional study, a total of 1021 women were included in the first 24 h after they gave birth in the hospital between March and May 2014. The study was conducted at only one hospital. Participants were interviewed face-to-face by researchers using a questionnaire. Data were analyzed using IBM SPSS Statistics for Windows v.22.0. The relation between categorical variables was determined using chi-square test. Statistical significance was achieved when the p value was less than 0.05. Ethics committee approval from the hospital and written informed consent from the participants were obtained for the study.
Results: The frequency of smoking during pregnancy was 13.0%. The majority smoked until birth (10.1%). Household smoker was significantly associated with smoking during pregnancy (p<0.001), and advanced maternal age (>35 years) during pregnancy was associated with smoking until birth during pregnancy (p<0.05).
Conclusion: The prevalence of smoking was still high among pregnant women in spite of strict measures and all efforts against smoking in Turkey. Advanced maternal age and household smoker were associated with smoking during pregnancy. Special focus is needed on the issue of smoking during pregnancy not only by pregnant women but also by their household’s members.

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Objective: Malignant pleural effusion (MPE) is a frequent and disturbing complication of metastatic disease. Talc pleurodesis via percutaneosly placed 12–18F catheters is an effective procedure to treat recurrent MPE. We aimed to determine the efficiency of talc pleurodesis through very-small-bore catheters in the treatment of recurrent malignant pleural effusion.
Methods: We performed 13 talc pleurodesis procedures in 10 patients with recurrent MPE via pre-existing 7F (6 patients) and 8F (4 patients) pig-tail catheters. We analyzed technical and clinical success of the procedure.
Results: All procedures were performed successfully. Complete or partial clinical success was achieved in 8 out of 10 patients. No major complication was observed.
Conclusion: Talc pleurodesis through 7F or 8F catheters may be performed in selected patients with reduced patient discomfort, and similar success rates that was obtained using higher caliber catheters in the treatment of recurrent MPE.

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Interstitial lung disease (ILD) is a negative prognostic factor associated with increased morbidity and mortality in patients with dermatomyositis (DM). Spontaneous pneumomediastinum is a rare complication of DM and it can be fatal. We present a 48-year-old woman with DM and ILD complicated by pneumomediastinum without pneumothorax and subcutaneous emphysema.

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We present the case of a 67-year-old man who presented to our hospital with acute shortness of breath. He was initially treated for a presumed infective exacerbation of chronic obstructive pulmonary disease (COPD) but did not respond to standard therapy. Further investigations were performed and revealed a large pulmonary vein thrombus. Clinical, laboratory, and radiological investigation did not identify an underlying cause for his thrombus. Idiopathic pulmonary vein thrombosis is much rarer than the more well-known pulmonary embolism and is worthy of consideration as an uncommon cause of pulmonary decline. To our knowledge, this is the first case report in the English literature of idiopathic pulmonary vein thrombus occurring in the setting of known COPD.

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Primary lung lymphoma (PLL) is a rare entity. It is difficult to diagnose, with a nonspecific clinical and radiological presentation. It may masquerade as pneumonia and lung tumors, and this disease should be kept in mind especially in the differential diagnosis of nonresolving pneumonias. This report describes a PLL case.

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