Sonographic assessment of diaphragm structure and function would be a useful clinical tool in patients with chronic obstructive pulmonary disease (COPD). Our aim was to determine the muscle thickness of the diaphragm and the usefulness of clinical practice in patients with COPD. The diaphragmatic thickness of 34 COPD patients and 34 healthy subjects was measured during tidal volume (Tmin) and deep inspiration (Tmax) on both sides using a B-mode ultrasound. The body mass index and the modified Medical Research Council (mMRC) index values were reported. There was no correlation among TminR (P = 0.134), TminL (P = 0.647), TmaxR (P = 0.721), and TmaxL (P = 0.905) between the patients with COPD and the control group. There was also no significant difference between diaphragmatic thickness and COPD severity, respiratory function (P = 0.410), and frequency of exacerbations (P = 0.881) and mMRC (P = 0.667). Diaphragmatic dysfunction in COPD is related to mobility restriction rather than muscle thickness.

Objective: Pneumonia is a leading cause of mortality worldwide, especially in the elderly. The use of clinical risk scores to determine prognosis is complex and therefore leads to errors in clinical practice. Pneumonia can cause increases in the levels of cardiac biomarkers such as N-terminal pro-brain natriuretic peptide (NT-proBNP). The prognostic role of the NT-proBNP level in community acquired pneumonia (CAP) remains unclear. The aim of this study was to evaluate the prognostic role of the NT-proBNP level in patients with CAP, as well as its correlation with clinical risk scores. Methods: Consecutive inpatients with CAP were enrolled in the study. At hospital admission, venous blood samples were collected for the evaluation of NT-proBNP levels. The Pneumonia Severity Index (PSI) and the Confusion, Urea, Respiratory rate, Blood pressure, and age ≥ 65 years (CURB-65) score were calculated. The primary outcome of interest was all-cause mortality within the first 30 days after hospital admission, and a secondary outcome was ICU admission. Results: The NT-proBNP level was one of the best predictors of 30-day mortality, with an area under the curve (AUC) of 0.735 (95% CI: 0.642-0.828; p < 0.001), as was the PSI, which had an AUC of 0.739 (95% CI: 0.634-0.843; p < 0.001), whereas the CURB-65 had an AUC of only 0.659 (95% CI: 0.556-0.763; p = 0.006). The NT-proBNP cut-off level found to be the best predictor of ICU admission and 30-day mortality was 1,434.5 pg/mL. Conclusions: The NT-proBNP level appears to be a good predictor of ICU admission and 30-day mortality among inpatients with CAP, with a predictive value for mortality comparable to that of the PSI and better than that of the CURB-65 score.

Objectives: Nicotine is an addictive alkaloid agent. Electronic cigarette (e-cigarette) is a product that contains nicotine and various ingredients while producing steam. Its usage is spreading among people in Turkey like in other countries. The aim of this study is to find out the frequency of e-cigarette usage among medical students, their views on e-cigarette and their awareness. Methods: To find out the smoking habits of medical students, the frequency of their e-cigarette usage, as well as their level of knowledge on the issue, a survey composed of 36 questions is applied among the students of Ufuk University Faculty of Medicine. Results: The percentage of cigarette usage among the students is 22.8% while 11.5% of these students tried e-cigarette. The percentage of male students who tried e-cigarette is significantly higher than the female students (63.9% vs. 36.1%) (p=0.004). 43.7% (n=31) of 71 active smokers are using e-cigarettes as well. In the survey, 75% of the e-cigarette users claim that their cigarette deprivation stayed unchanged and 52.8% of the smokers state that they did not experience any side effects depending on e-cigarette usage. Both the students who never smoke and the ones who are active smokers state that they received information about e-cigarette generally from their friends (35.8% and 47.9%, respectively). Both groups think that e-cigarette is less harmful than cigarette. The active smokers have more information about the contents of e-cigarette when compared to the group of non-smokers (25.9 % vs. 46.5%) (p=0.004). Neither of these groups know that e-cigarette is banned by the Ministry of Health (p=0.377). Conclusion: The percentage of e-cigarette usage among the medical school students cannot be underestimated. This study reveals that students do not have sufficient information about the potential harms of e-cigarette. In addition to the informative and anti-smoking studies on cigarette usage, studies on the harms of e-cigarettes must also be carried out. Keywords: Awareness, electronic cigarette, medical students