Idiopathic pulmonary fibrosis (IPF) is a chronic progressive lung disease, and lung cancer is a significant comorbidity with high prevalence and adverse impact on survival. Early detection of IPF and targeted interventions require understanding the associated risk factors and clinical presentation of lung cancer in IPF. This single-center, retrospective cohort study aimed to identify risk factors for lung cancer in IPF patients, investigate its clinical features, and determine its impact on survival. Of the 1481 patients with interstitial lung disease, 436 met the criteria for IPF per American Thoracic Society/European Respiratory Society guidelines. Patients followed up for <6 months (n = 31), patients with both IPF and lung cancer (n = 19), and patients whose data were incomplete (n = 18) were excluded from the study. In the end, the study group consisted of 59 patients who developed lung cancer during follow-up, and the control group consisted of 59 randomly selected IPF patients without cancer. Patients' clinical, radiological, and laboratory data were collected from their medical records. The mean age of the sample, 83.9% of which was male, was 66.9 ± 8.3 years. Emphysema, low body mass index, absence of antifibrotic therapy, presence of weight loss symptoms, and ≥36 pack-years of smoking were significant risk factors for lung cancer (P <.05), as also confirmed by multivariate analysis. Squamous cell carcinoma was the most common histological type (45.8%), with lower lobe predominance (59.3%) and peripheral location (78.0%). Most tumors (78.0%) were within or adjacent to fibrotic tissue. The median time from IPF diagnosis to lung cancer development was 2.80 years. The 0 to 3, 3 to 5, and >5-year mortality rates for patients with and without lung cancer were 15.2% to 3.3%, 35.5%- 8.4%, and 42.3% to 15.2%, respectively (P = .026). Our study identified significant risk factors for lung cancer in IPF patients and demonstrated its negative impact on survival. The presence of emphysema, low body mass index, absence of antifibrotic therapy, and ≥36 pack-years of smoking were significantly associated with lung cancer development. Awareness of these factors is crucial for early diagnosis and appropriate treatment strategy determination, potentially improving outcomes in this high-risk population.

BACKGROUND AND AIM: Chronic obstructive pulmonary disease (COPD) is a systemic condition. Oxidative stress and air trapping may lead to alterations in diaphragm mobility and thickness. Therefore, assessing diaphragm function in these patients is of great importance. The aim of this study is to evaluate diaphragm thickness and mobility using ultrasonography in COPD patients and to determine their relationship with clinical classification and exacerbation frequency. METHODS: This single-center, prospective study assessed diaphragm excursion, diaphragm thickness, inspiratory and expiratory durations, contraction speed, and thickening fraction using ultrasound. Spirometry and diffusing capacity for carbon monoxide were performed, and lung volumes and capacities were calculated. Patients were followed for three months to record the number and severity of exacerbations and hospitalizations. Diaphragm parameters were compared with clinical and functional tests to examine their association with COPD classification and exacerbations. RESULTS: A total of 81 patients, 70 of whom were male, were included in the study. Diaphragm excursion during deep inspiration showed a significant negative correlation with FEV1 classification (r=-0.38, p<0.001). Significant correlations were also observed between diaphragm excursion during deep inspiration and residual volume (RV) (%; L) (r=-0.39, p<0.001; r=-0.37, p<0.001) and the residual volume/total lung capacity ratio (RV/TLC) (r=-0.52, p<0.01). Diaphragm excursion during deep inspiration significantly decreased with increasing Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage (p=0.007). No significant differences were found between diaphragm thickness and either GOLD or FEV1 classification. During the three-month follow-up, patients with lower diaphragm excursion during deep inspiration experienced significantly more exacerbations (p=0.012). CONCLUSIONS: Our study demonstrated that diaphragmatic excursion during deep inspiration is associated with GOLD classification, FEV1 severity, and the frequency of acute exacerbations. Our findings suggest that diaphragmatic dysfunction in this context is more closely related to impaired mobility than to reduced muscle thickness. Although diaphragmatic excursion was significantly associated with exacerbation risk in univariate analysis, it did not remain an independent predictor after multivariable adjustment. Further longitudinal studies are warranted to better define the prognostic significance of diaphragmatic excursion in COPD.

BACKGROUND: Managing small Lung-RADS 4 pulmonary nodules is clinically challenging. While CT-guided TTFNAB is standard, its efficacy and safety for lesions ≤2 cm require further evaluation to optimize outcomes and reduce unnecessary surgeries. OBJECTIVES: This study aimed to evaluate the diagnostic accuracy, safety, and factors influencing the outcomes of CT-guided TTFNAB in Lung-RADS category 4 pulmonary nodules measuring ≤2 cm. DESIGN: Retrospective study SETTING: Single-center, a tertiary referral center MATERIALS AND METHODS: A retrospective analysis was performed on 95 patients who underwent CT-guided TTFNAB between January 2021 and April 2024. Data included demographics, lesion characteristics (size, location, density, and pleural proximity), histopathological findings, and procedural outcomes. MAIN OUTCOME MEASURES: The primary endpoints were diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and factors influencing TTFNAB results, alongside procedural complications—specifically pneumothorax and chest tube requirement. SAMPLE SIZE: 95 patients RESULTS: Of the 95 nodules, 26 (27%) were benign and 69 (73%) were malignant according to TTFNAB. Final pathology confirmed 18 (19%) benign and 77 (81%) malignant lesions. All biopsies yielded sufficient material. Sensitivity, specificity, and overall diagnostic accuracy were 83%, 94%, and 89%, respectively. The PPV was 98%, while the NPV was 65%. Pleural thickening was significantly more frequent in both the TTFNAB benign group (38% vs. 13%, P=.006) and final benign diagnosis group (44% vs. 14%, P=.008). Pneumothorax occurred in 30% of cases, with 24% of these requiring chest tube drainage. No significant associations were found between diagnostic accuracy or complications and variables such as age, emphysema, Lung-RADS category, or nodule size. CONCLUSION: CT-guided TTFNAB is an effective diagnostic method for confirming malignancy in pulmonary nodules ≤2 cm classified as Lung-RADS 4, providing an overall accuracy of 89% and a PPV of 98%. However, a benign TTFNAB result cannot be considered diagnostically safe: the NPV of 65% and false-negative rate of 35% indicate that a negative biopsy does not reliably exclude malignancy. Clinicians must not rely on a negative result alone; close radiological follow-up or surgical biopsy is essential for these high-risk lesions. LIMITATIONS: The retrospective single-center design, small sample size, and limited generalizability. IRB APPROVAL NUMBER: 2024/010.99/6/23 (Date: 26.07.2024)

Objective: Plasma osmolality provides insight into fluid and electrolyte balance and can serve as a prognostic marker in critically ill patients. There is limited research on the relationship between plasma osmolality and mortality in pulmonary embolism (PE). The potential role of plasma osmolality in predicting mortality in PE patients is examined in this study. Methods: A retrospective analysis was conducted on patients admitted to the chest diseases ward with acute PE. Data on demographics, comorbidities, clinical and laboratory results, in-hospital mortality, and 30-day mortality were collected. Plasma osmolality was calculated using sodium, plasma glucose, and blood urea nitrogen (BUN) levels at admission. Patients were categorized into hyposmolality, normosmolality, and hyperosmolality groups. Results: The study included 226 patients (100 males, 44.2%), aged 23-90 years. In-hospital mortality occurred in 13 patients (5.8%). The mortality rate was significantly higher in patients with a simplified Pulmonary Embolism Severity Index score ≥1 (P = .031). In addition, lower albumin levels (P = .008) and higher BUN (P = .007) and urea levels (P = .005) were significantly associated with in-hospital mortality. No significant differences in D-dimer, creatinine, glucose, sodium, and osmolality levels were observed between patients who were discharged and those who experienced in-hospital mortality. Mortality rates within 30 days did not significantly differ across osmolality groups (P > .05). Conclusion: This study did not find a significant correlation between plasma osmolality and short-term mortality in patients with acute PE.Cite this article as: Eraslan BZ, Kodalak-Cengiz S, İçmeli ÖS, Kiral N, Şener-Cömert S. The effect of plasma osmolality on prognosis in non-massive pulmonary embolism. Cerrahpaşa Med J. 2025; 49, 0050, doi: 10.5152/cjm.2025.24050.

BACKGROUND:Spirometry is one of the basic methods used in the diagnosis, treatment, and follow-up of respiratory disease. Spirometric test results that do not comply with international standards may be misinterpreted and lead to misdiagnosis and treatment. We aimed to assess the tests of patients that meet the "American Thoracic Society/European Respiratory Society (ATS/ERS) 2019" recommendations, to identify the most common errors, and to explore patient characteristics possibly associated with failure to reach these standards. METHODS:A total of 1000 spirometries performed between January and December 2023 were randomly selected retrospectively. Spirometric maneuvers were evaluated for meeting the acceptability criteria of the ATS/ERS 2019 guidelines. RESULTS:The acceptability spirometry rate was 62.5%. The most frequently unmet criterion was failure to meet any of the three ends of forced expiration at 20.7%. There was no significant difference between male and female in terms of the acceptability of maneuvers. The 45-59 and 60-74 age groups were statistically more significant than the younger and older. Smoking, diagnosis of chronic obstructive pulmonary disease, and number of spirometry practices were significantly associated with conformity to test acceptability criteria. The forced expiratory volume in 1 second (FEV1) divided by the forced vital capacity, FEV1, and forced expiratory times had a statistically significant independent effect on the acceptability of spirometric maneuvers. CONCLUSION:Nearly one-third of the tests performed by an experienced technician in a tertiary care hospital did not meet the acceptability criteria. Our study shows the importance of the learnability of maneuvers through repeated spirometry experiences.

BACKGROUND AND AIM: Pneumonia is one of the leading causes of morbidity and mortality worldwide. This study aimed to evaluate the impact of the Glasgow prognostic score (GPS) on the prognosis of patients hospitalized with community-acquired pneumonia (CAP). METHODS: A retrospective review was conducted on patients hospitalized in our department with CAP. The GPS was calculated based on C-reactive protein (CRP) and albumin levels. RESULTS: The study included 121 patients, of whom 80 (66.1%) were male. The median age was 70 years. Early mortality occurred in 11 patients (9.1%). Patients with a GPS of 2 had significantly longer hospital stays than those with a GPS <= 1 (p=0.002). Similarly, early mortality rates were statistically significantly higher in patients with a GPS of 2 (17.3%) compared to those with a GPS <= 1 (2.9%) (p=0.009). A receiver operating characteristic (ROC) curve analysis was performed to determine the cutoff point for predicting mortality using the GPS. GPS values of 1.5 or higher were found to predict mortality with a sensitivity of 81.82% and a specificity of 60.91%. Age, average length of hospital stay, and the incidence of malignancy were significantly higher in patients who died within 30 days compared to survivors (p=0.011, p=0.001, and p=0.041, respectively). Upon evaluating the effects of age, length of hospital stay, GPS, and malignancy-which were found to be significant in univariate analyses-using logistic regression analysis, GPS was not identified as having a significant impact on mortality. CONCLUSIONS: The GPS is associated with early mortality in patients with CAP. However, its independent impact on mortality is not statistically significant when considering other factors such as age, length of hospital stay, and malignancy. This suggests that while GPS can be a useful indicator for initial assessments, its prognostic value may be limited when other clinical variables are considered.

Abstract Background As in numerous cancers, the connection between the Ki-67 proliferation index and response to treatment in cellular breakdown in the lungs is underlined. The purpose of this study was to investigate the connection between the Ki-67 proliferation index and radiotherapy’s therapeutic and survival effects in small cell lung cancer. Methods The limited-stage small cell lung cancer patients in our hospital were retrospectively reviewed. Patients receiving standard chemoradiotherapy were included in the study. Age, sex, cancer stage, comorbidities, response to treatment, and survival time were recorded. Bronchoscopic or transthoracic lung biopsy specimens which were taken at the time of diagnosis were stained with the Ki-67 immunohistochemical stain. Survival of patients and treatment response were compared statistically with the Ki-67 values. Results The Ki-67 proliferation index (62.29 ± 7.52) was lower in patients with partial response than in patients with complete response (77.08 ± 2.84) (p < 0.001). When the correlation between survival time and Ki-67 was examined, there was a positive correlation between the Ki-67 and survival time (p: 0.019; r: 0.426). The patients were divided into two groups: Ki-67 < 68.70 and Ki-67 ≥ 68.70. In patients with Ki-67 ≥ 68.70, the survival rate was better than that of patients with Ki-67 < 68.70 (p: 0.012). In Cox regression analysis, Ki-67 PI < 68.7 was found that increased mortality by 2742 times independently. Conclusions Patients with a high Ki-67 had a better survival effect than those with low Ki-67, and patients with complete responses had a higher Ki-67 value.

OBJECTIVES:To investigate the relationship of the erythrocyte distribution width (RDW)/albumin ratio on hospital length of stay (LOS) and prognosis in patients hospitalized with chronic obstructive pulmonary disease (COPD) exacerbation. METHODS:Patients hospitalized in our clinic for COPD exacerbation were retrospectively analyzed. Demographic characteristics, comorbidities, pulmonary function tests, arterial blood gas, history of hospitalization due to exacerbation in the last year, LOS, C-reactive protein, RDW, albumin, platelet counts, and 30-day mortality status were recorded. Significant cut-off RDW/albumin ratio values that could predict hospitalization for 10 days or more were analyzed. RESULTS:A total of 58 patients were included in our study. With a significant cut-off value of ≥5.22 for the RDW/albumin ratio to predict a duration of hospitalization of more than 10 days, a sensitivity of 68.42% and specificity of 74.36% were obtained. No significant association was found between the RDW/albumin ratio and 30-day mortality (p=0.14). The RDW/albumin ratio (p=0.005) and mortality (p<0.001) were found to be higher in patients with an LOS of 10 days or more. The RDW/albumin ratio and mortality, which were statistically significant in patients hospitalized for 10 days or more, were analyzed using logistic regression, and no significant results were found. CONCLUSION:In further analysis results of patients hospitalized due to COPD exacerbation, there was no significant relationship between length of hospital stay, mortality, and the RDW/albumin ratio.

BACKGROUND The effect of COVID-19 infection on pulmonary function is unknown. OBJECTIVE This study aimed to evaluate pulmonary function tests (PFTs) of patients hospitalized with the diagnosis of COVID-19 pneumonia at 3 and 6 months post-discharge. METHODS Patients aged 18 years and over who had positive COVID-19 PCR test results and were hospitalized in the pandemic service between 1 May 2020 and 31 October 2020, were included in the study. All patients were evaluated with PFTs FVC, FEV1, FEV1/FVC, and FEF25-75 at 3 and 6 months after discharge. RESULTS The mean age of 34 patients included in the study was 47.7 ± 12.7 years. The FVC, FEV1, FEV1/FVC, and FEF25-75 measurements at 3 and 6 months post-discharge showed no significant difference (P = 0.765, P = 0.907, P = 0.707, and P = 0.674, respectively). There was no significant difference in any PFT measurements at the third month follow-up, regardless of the pharmacological treatment protocols applied during hospitalization (P > 0.05). However, FEV1/FVC and FEF25-75 levels were 83.1 [3.4]% and 91.0 [10.0]%, respectively, in those who received systemic steroid treatment, and 78.3 ± 8.5% and 72.5 ± 25.7% in those who did not (P = 0.019 and P = 0.048, respectively). In addition, FVC and FEV1 levels increased significantly from the third to the sixth month follow-up in patients who received systemic steroid therapy (P = 0.035 and P = 0.018, respectively). CONCLUSION Although there is no significant difference in PFT measurements from 3 to 6 months in COVID-19 patients, systemic steroid therapy may have a beneficial effect on respiratory function in COVID-19 patients.

BACKGROUND AND AIM: Idiopathic pulmonary fibrosis (IPF) is a chronic and progressive lung disease of unknown etiology. Acute exacerbation of IPF (AE-IPF) can cause sudden deterioration in the prognosis of the disease and is responsible for a significant proportion of deaths due to IPF. The aim of our study is to examine the medical histories, symptoms, clinical findings, laboratory tests, and radiological images of cases hospitalized in our clinic due to AE-IPF, and to determine mortality rates during and after the AE. METHODS: We retrospectively examined the records of patients hospitalized with a diagnosis of AE-IPF. We recorded their demographic data, comorbidities, physical examination and laboratory findings, radiological findings, spirometry results, treatment status, intensive care needs, and mortality-related data. Statistical analyses were performed using Chi-square and Mann-Whitney U tests. RESULTS: Out of 28 cases, 19 (67.9%) were male with a mean age of 67.1 +/- 11.4 years. The most common comorbidities were hypertension (39.3%), chronic obstructive pulmonary disease (35.7%), diabetes (32.1%), chronic renal failure (14.3%), and atrial fibrillation (14.3%). In respiratory function tests, mean forced vital capacity and carbon monoxide diffusion capacity was 65 +/- 17.1% and 47 47 +/- 14.2%, respectively. All patients had newly developed ground-glass opacity and/or consolidation areas in their chest computed tomography images. It was observed that the mean duration of steroid use initiated due to an AE was 7.1 days. Of the cases, 23 (82.1%) were discharged home, while the remaining 5 (17.9%) were transferred to the intensive care unit, where, unfortunately, all of them lost their lives. Among the discharged patients, 6 succumbed within three months. Consequently, the mortality rate within the hospital stay and the subsequent three months for patients hospitalized with AE-IPF was determined to be 39.3%. Notably, the mortality rate was significantly higher in patients with chronic renal failure compared to those without (p=0.016). CONCLUSIONS: It was observed that the in-hospital and early post-discharge mortality rate for patients hospitalized with AE-IPF was approximately 40%. This finding underscores the serious negative impact of AEs on the prognosis of the disease.

Abstract Background  Mediastinal lymphadenopathies with high 18-fluorodeoxyglucose uptake in patients previously operated on for lung cancer are alarming for recurrence and necessitate invasive diagnostic procedures. Peroperative placement of oxidized cellulose to control minor bleeding may lead to a metastasis-like image through a foreign body reaction within the dissected mediastinal lymph node field at postoperative examinations. In this study, we investigated clinicopathological features and the frequency of foreign body reaction mimicking mediastinal lymph node metastasis. Methods  Patients who underwent surgery for lung cancer between January 2016 and August 2021 and who were subsequently evaluated for mediastinal recurrence with endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) were included. Patients were grouped according to the results of EBUS-TBNA as metastasis, foreign body, and reactive. Clinicopathological features of these patients were compared and characteristics of patients in the foreign body group were scrutinized. Results  EBUS-TBNA was performed on a total of 34 patients during their postoperative follow-up due to suspicion of mediastinal recurrence. EBUS-TBNA pathological workup revealed metastasis in 18 (52.9%), foreign body reaction in 10 (29.4%) and reactive lymph nodes in 6 (17.6%) patients. Mean maximum standardized uptake value (SUVMax) for metastasis group and foreign body group were 9.39 ± 4.69 and 5.48 ± 2.54, respectively ( p  = 0.022). Time interval between the operation and EBUS-TBNA for the metastasis group was 23.72 ± 10.48 months, while it was 14.90 ± 12.51 months in the foreign body group ( p  = 0.015). Conclusion  Foreign body reaction mimicking mediastinal lymph node metastasis is not uncommon. Iatrogenic cause of mediastinal lymphadenopathy is related to earlier presentation and lower SUVMax compared with metastatic lymphadenopathy.

Aim Maximum mid-expiratory flow (MMEF) is one of the pulmonary function tests that report small airway disease. Our study aimed to investigate the role of MMEF values in asthma control, the prevalence of small airway disease, and their effect on asthma control in patients with asthma with normal forced expiratory volume in one second (FEV1) values.Material and Method Patients who presented to the Chest Diseases outpatient clinic of our hospital between 2018 and 2019 and were diagnosed as having asthma were included in the study. The characteristics of the patients, pulmonary function tests, their asthma treatment, and asthma control test (ACT) scores were recorded. Patients with FEV1 <80 in the pulmonary function test, those with additional lung disease, those who had an attack in the last 4 weeks, and patients who smoked were excluded from the study. MMEF <65 was defined as small airway disease.Results The MMEF% and MMEF (L/s) values of the group with uncontrolled asthma were found to be statistically significantly lower than those of the controlled asthma group (p = 0.016 and p = 0.003, respectively). MMEF% and MMEF (L/s) values in those with wheezing were found to be significantly lower compared with those without wheezing (p = 0.025 and p = 0.049, respectively). The MMEF% and MMEF (L/s) values of the patients with nocturnal symptoms were found to be statistically significantly lower than in patients without nocturnal symptoms (p = 0.023 and p = 0.041, respectively). ACT values of patients with MMEF <65 were found to be statistically lower than those of patients with MMEF >65 (0.047).Conclusion Considering small airway disease in patients with asthma may be beneficial in clinical practice.

-OBJECTIVE: The aim of this study was to identify changes in smoking behaviors along with the reasons thereof, 1 year after the pandemic started. Alterations in the smoking behavior of patients were investigated in the study.PATIENTS AND METHODS: Patients admit-ted to our Smoking Cessation Outpatient Clinic between March 1st, 2019, and March 1st, 2020, and registered in the Tobacco Addiction Treatment Monitoring System (TUBATIS) were evaluated. Patients were called in March 2021 by the same physician who conducted the smoking cessation outpatient clinic.RESULTS: When the first year of the pandemic was over, the smoking behavior of 64 (63.4%) patients did not change. Of the 37 patients who changed their smoking behavior, eight (21.6%) increased the amount of tobacco they consumed, twelve (32.5%) decreased the amount of tobacco they consumed, eight (21.6%) quit smoking, and nine (24.3%) relapsed smoking. When the reasons for the changes in smoking behavior were examined 1 year after the pandemic started, it was determined that the primary reason for patients who increased the amount of tobacco they consumed and started smoking again was stress, and the primary cause in those who reduced the number of cigarettes and quit smoking was health concerns due to the pandemic.CONCLUSIONS: This result can be a guide for estimating smoking trends in future crises or pandemics and for making necessary plans during the pandemic period to increase the rate of smoking cessation.

Amaç: Bu retrospektif çalışmada, hiperbarik oksijen tedavisinin ardışık uygulamalarda hastaların solunum fonksiyonları ve diyafragma hareketleri üzerindeki etkilerini değerlendirmeyi amaçladık. Hastalar ve Yöntem: Çalışma grubu, Haziran 2019-Aralık 20219 tarihleri arasında hiperbarik oksijen tedavisi uygulanan çeşitli hastalık tanısı alan 22 hastadan oluşuyordu. Dinamik ve statik akciğer hacimleri, difüzyon kapasitesi, maksimum inspiratuar ve ekspiratuar basınçlar gibi solunum fonksiyonları tedavi seanslarının başlamasından ve bitiminden önce değerlendirildi. Ayrıca torasik ultrasonografi ile diyafram kalınlığı, gelgit volümü ve derin inspirasyon sırasındaki diyafram hareketleri ölçüldü. Bulgular: Çalışmaya yaş ortalaması 53.3±10.0 yıl olan yirmi iki hasta (16 erkek;6 kadın) dahil edildi. Hastaların hiperbarik oksijen tedavilerinin sonunda yapılan ölçümlerde total akciğer kapasitesi, vital kapasite ve rezidüel volüm de artış görüldü (p<0.05). Diğer statik akciğer hacimleri, maksimum inspiratuar ve ekspiratuar basınçlar, akciğer karbon monoksit difüzyon kapasitesinde değişiklik gözlenmedi. Tidal volümü hareketi ve vital kapasite sırasında diyafram kalınlığı ve diyafram hareketi artmıştır (p<0.05). Sonuç: Çalışmamızda hiperbarik oksijen tedavisinin diyafram ve solunum fonksiyonları üzerindeki etkisini, spirometri, diyafram görüntüleme teknikleri ve difüzyon kapasitesi yöntemleri ile değerlendirdik. Sonuç olarak, hiperbarik oksijen tedavisi pulmoner ve diyafram kası fonksiyonlarında anlamlı bir değişikliğe yol açmıştır.

Objective: This study aimed to determine the frequency of smoking cessation and affecting factors in patients who applied to the smoking cessation clinic. Method: This study included smokers aged 18 years and over who applied to the Chest Diseases Clinic Smoking Cessation Outpatient Clinic between 1 April 2019 and 31 July 2019. All participants were evaluated with a sociodemographic questionnaire, Fagerström Test for Nicotine Dependence (FNBT) and Beck Depression Scale during the initial outpatient clinic admission. Subsequently, smoking cessation treatment was started and all participants were called at 6 and 12 months and their smoking cessation status was questioned. Smokers who did never smoked for the last 1 year were accepted as ex-smokers. Results: A total of 270 participants were included in the study, and 48 (19.5%) of the participants were found to quit smoking at the end of one year. There was no significant difference between ex-smokers and current smokers in terms of age, gender, marital status, educational level, employment status, income level, duration of smoking, FNDT and Beck’s depression scores (p>0.05). However, smoking status in the phone call at 6-month (OR=316.976 and 95% CI=80.035-1255.374, p

Aim: The aim of our study is to evaluate thyroid functions in OSA patients and to examine the relationship between disease severity and thyroid functions. Material and method: The complete records of patients diagnosed with OSA with polysomnography (PSG) in our hospital between 2014-2017 were examined retrospectively. Patients who received lithium, dopamine agonist and amiodarone treatment that affect thyroid functions were not included in the study. TSH, free T4 (fT4), free T3 (fT3) values, which were routinely performed before PSG, and sleep parameters evaluated with PSG were recorded. It was evaluated as clinical hypothyroidism (TSH high, fT4 low), subclinical hypothyroidism (TSH high fT4 normal) Results: A total of 208 OSA patients, 83 women (39.9%) and 125 men (60.1%), were included in the study. The mean age of the patients was evaluated as 48 ± 11 years. Subclinical hypothyroidism was found in 22 (10.5%) of the patients, and subclinical hypothyroidism in 1 (0.48%). No significant difference was found in the OSA group and control group in terms of thyroid functions. no significant difference was found between TSH, free T4, free T3 and disease severity When thyroid functions were compared according to OSA severity(p> 0.05). There was no significant correlation between TSH and total AHI. (p=0.798) There was a significant correlation between TSH and REM AHI values (p = 0.046; r =0.197) In terms of gender, TSH level in OSA patients was found to be statistically significantly higher in females than males (p=0.049) Conclusion: The prevalence of hypothyroidism in patients having OSAS does not seem to be different from the one in the general populationlong-term follow-up studies can show the significance of routine evaluation of OSA patients for thyroid disease