Yenidoğan dönemi, solunum sisteminin yapısal ve fonksiyonel açıdan en hızlı değişim gösterdiği ve çevresel etkilere en duyarlı olduğu yaşam evresidir. Bu dönemde özellikle prematürelik, düşük doğum ağırlığı, perinatal komplikasyonlar ve enfeksiyonlar gibi faktörler, pulmoner morbidite ve mortalite riskini belirgin şekilde artırmaktadır. Respiratuar Distres Sendromu, bronkopulmoner displazi, transient takipne, mekonyum aspirasyon sendromu ve yenidoğan pnömonisi, neonatal yoğun bakım ünitelerinde en sık karşılaşılan solunumsal sorunlar arasında yer almaktadır. Güncel neonatoloji pratiğinde, bu problemlerin yönetimi yalnızca ventilasyon ve farmakolojik tedavilerle sınırlı kalmamakta; pulmoner rehabilitasyon yaklaşımları giderek daha önemli bir rol üstlenmektedir. Bu kitap bölümü, yenidoğanın pulmoner sistem gelişimini embriyolojik dönemden başlayarak doğum sonrası adaptasyon süreçleriyle birlikte ele almakta; yenidoğana özgü anatomik ve fizyolojik özellikleri, sık görülen pulmoner patolojileri ve neonatal yoğun bakım uygulamalarını kapsamlı biçimde irdelemektedir. Bölümde ayrıca non-invaziv ve invaziv solunum destek yöntemleri, sürfaktan tedavisi, ventilatör ilişkili akciğer hasarının önlenmesi, akciğer hacmini artıran stratejiler ve sekresyon yönetimine yönelik fizyoterapötik yaklaşımlar güncel literatür ışığında sunulmaktadır. Yenidoğanlara uyarlanmış nazik göğüs fizyoterapisi teknikleri, pozisyonlama, solunum paterni optimizasyonu ve minimal handling ilkeleri, pulmoner rehabilitasyonun temel bileşenleri olarak vurgulanmaktadır. Ayrıca aile merkezli bakım yaklaşımı, taburculuk sonrası ev programları ve ebeveyn eğitiminin uzun dönem solunum sağlığı üzerindeki etkileri ayrıntılı olarak ele alınmaktadır. Sonuç olarak bu bölüm, neonatal pulmoner rehabilitasyonun kanıta dayalı uygulamalarını bütüncül bir bakış açısıyla ele alan, klinisyenler, fizyoterapistler ve sağlık profesyonelleri için güncel ve kapsamlı bir başvuru kaynağı niteliği taşımaktadır.

Objective: The aim of this study was to objectively evaluate the presence of allergic reac-tions and pulmonary function in individuals working in small container-like spaces in Malatya following the February 6, 2023, Kahramanmaraş-centered earthquakes, and to examine their associations with physical activity, sleep quality, grip strength, and quality of life. Methods: This cross-sectional and descriptive study included 90 volunteers (aged 25–55 years) who had been working in container-like small spaces for at least two years. Sociodemographic characteristics, smoking status, and history of allergic reactions were collected using structured questionnaires. Pulmonary function was assessed using portable spirometry (FEV₁, FVC, FEV₁/FVC). Physical activity level was evaluated with the International Physical Activity Questionnaire–Short Form (IPAQ-SF), sleep quality with the Pittsburgh Sleep Quality Index (PSQI), and quality of life with the Short Form-36 (SF-36). Grip strength was measured using a digital dynamometer, and the highest value was used for analysis. Results: Of the participants, 92.2% were male, and the mean age was 39.0±9.5 years. The prevalence of self-reported allergic reactions was 5.6%. While FEV₁% (68.9±12.4) and FVC% (64.1±11.3) values were relatively low, the FEV₁/FVC ratio was pre-served (0.86±0.06). As the mMRC dyspnea grade increased, significant decreases were observed in FEV₁% and FVC% values (p< 0.001). Pulmonary function pa-rameters showed significant associations with fatigue and the physical func-tioning and physical role subscales of the SF-36. Conclusion: Individuals working in small container-like spaces demonstrated a tendency toward reduced ventilatory capacity without overt airway obstruction, along with dyspnea-related pulmonary function impairment. These findings highlight the importance of early screening strategies (spirometry and dyspnea scales) and environmental interventions aimed at improving ventilation, ergonomics, and physical activity in such work environments.

Background: Smoking adversely affects pulmonary function and systemic health; however, its impact on diaphragm muscle morphology and its relationship with functional capacity and psychosocial outcomes in individuals without clinically diagnosed respiratory disease remain unclear. This study aimed to evaluate diaphragm muscle thickness in smokers and to investigate its associations with pulmonary function, functional capacity, sleep quality, and depression. Methods: This cross-sectional observational study included 20 smokers and 20 age-matched never-smokers. Pulmonary function was assessed using spirometry. Functional capacity was evaluated with the 6-Minute Walk Test (6 MWT) and the 30 s sit-to-stand test (30 s STST). Sleep quality and depression were assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Beck Depression Inventory (BDI). Inspiratory and expiratory diaphragm muscle thicknesses were measured by ultrasonography. Between-group comparisons and correlation analyses were performed. Results: Smokers exhibited significant impairments in all assessed parameters except expiratory diaphragm thickness compared with controls (p < 0.05). Large to very large effect sizes were observed for FEV₁, FEF_25–75%, functional capacity, and inspiratory diaphragm thickness. Inspiratory diaphragm thickness showed moderate to strong positive correlations with pulmonary function parameters and a very strong positive correlation with functional capacity, while strong negative correlations were observed with sleep quality and depression (p < 0.05). Smoking duration was strongly associated with poorer functional and psychosocial outcomes. Conclusions: Smoking is associated with early and multidimensional impairments in diaphragm muscle morphology, pulmonary function, functional capacity, and psychosocial status, even in individuals without overt respiratory disease. Reduced inspiratory diaphragm thickness may represent an early and clinically meaningful marker of smoking-related respiratory muscle dysfunction.

The aim of this study was to objectively evaluate the presence of allergic reactions and pulmonary function in individuals working in small container-like

Amaç: Bu çalışmanın amacı, 2023 Kahramanmaraş depremleri sonrasında Malatya’daki konteynerlerde yaşayan bireylerde solunum fonksiyonlarını, dispne algısını ve sağlıkla ilişkili yaşam kalitesini değerlendirmek ve bu parametrelerin uyku kalitesi, kas gücü ve sosyodemografik faktörlere göre farklılaşıp farklılaşmadığını incelemektir.Yöntemler: Kesitsel tasarıma sahip bu saha çalışması, Malatya’daki Afet ve Acil Durum Yönetimi Başkanlığı (AFAD) Teknokent ve Rönesans konteynerlerinde yaşayan 25–55 yaş arası 360 bireyle yürütülmüştür. Solunum fonksiyonları portatif spirometre, dispne Modified Medical Research Council (mMRC), uyku kalitesi Pıttsburg Uyku Kalitesi İndeksi (PUKİ), yaşam kalitesi Sağlık Durumu Anketi Short Form (SF-36) ile değerlendirilmiştir. Kas gücü, el kavrama dinamometresi ile ölçülmüştür. Korelasyon ve çoklu doğrusal regresyon analizleri kullanılmıştır.Bulgular: FEV₁/FVC oranları genel olarak normal sınırlarda bulunurken, Zorlu Vital Kapasite (FVC) ve Fonksiyonel Ekspiratuar 1. Saniye Volümü (FEV₁) değerlerinde çeyrekler arası aralıkta geniş bir dağılım saptanmıştır. Cinsiyet ve çalışma durumuna göre solunum fonksiyonlarında büyük etki büyüklükleri saptanmıştır. El kavrama kuvveti ve SF-36 fiziksel alt boyutları ile FVC ve FEV₁ arasında orta–yüksek düzeyde pozitif korelasyonlar bulunmuştur. Çoklu regresyonda yaş, cinsiyet, vücut kitle indeksi, kas gücü ve çalışma durumu FVC’nin bağımsız belirleyicileri olarak belirlenmiştir.Sonuç: Konteynerde yaşayan bireylerde solunum sağlığı etkilenimi obstrüksiyondan ziyade fonksiyonel kapasite azalması şeklindedir ve afet sonrası izlemde fonksiyonel değerlendirmelerin önemini göstermektedir.

BACKGROUND Prolonged residence in post-disaster container settlements may adversely affect respiratory health through environmental, functional, and psychosocial pathways. However, population-based evidence incorporating objective pulmonary and functional indicators remains limited. OBJECTIVE This study aimed to quantify pulmonary function, dyspnea, fatigue-related functional capacity, and health-related quality of life among adults living in container settlements after the 2023 Kahramanmaraş earthquakes and to identify key sociodemographic and functional determinants. METHODS This cross-sectional field study included 360 adults (mean age 41.2±9.3 years; 53.6% female) residing in three container settlements in Malatya, Türkiye. Pulmonary function (FVC, FEV₁, FEV₁/FVC) was assessed using spirometry according to ATS/ERS standards. Dyspnea (mMRC), sleep quality (PSQI), muscle strength (handgrip dynamometry), and quality of life (SF-36) were evaluated. Group comparisons, correlation analyses, and multiple linear regression models were applied. Results Median FVC and FEV₁ were 2.85 L (IQR 2.30–3.40) and 2.32 L (IQR 1.85–2.85), respectively, while the mean FEV₁/FVC ratio remained within normal limits (80.1%±6.2). Significant differences in FVC and FEV₁ were observed by sex (p<.001; r=0.82) and employment status (p<.001; r=0.56). Handgrip strength showed strong positive correlations with FVC (r=0.74) and FEV₁ (r=0.77, both p<.001), whereas sleep quality demonstrated small but significant associations (p=.021; ε²=0.031). In multivariable analysis, age, sex, body mass index, employment status, and handgrip strength independently predicted FVC (adjusted R²=0.61; p<.001). RESULTS Respiratory impairment among adults living in post-disaster container settlements primarily reflects reduced lung volume and functional capacity rather than obstructive airway disease. Functional and social determinants, particularly muscle strength and employment status, play a central role, underscoring the need for integrated post-disaster respiratory surveillance and rehabilitation strategies. CONCLUSIONS Respiratory impairment among adults living in post-disaster container settlements primarily reflects reduced lung volume and functional capacity rather than obstructive airway disease. Functional and social determinants, particularly muscle strength and employment status, play a central role, underscoring the need for integrated post-disaster respiratory surveillance and rehabilitation strategies.