Guidelines exist for the diagnosis, treatment, and follow-up of sarcoidosis; however, considerable variation in clinical practice remains. This study aimed

Background/aim: In our country, there is no data on whether the clinicians give an asthma action plan to implement to patients followed up with a diagnosis of asthma, and whether patients can manage their treatment according to this plan. The present study aimed to determine the use of asthma action plans in our country and the awareness levels of patients about the plan.Materials and methods: Multicenter, cross-sectional descriptive study was conducted in outpatient immunology and allergy and pulmonology clinics of secondary and tertiary health-care centers. Adults asthmatics filled out a case registration form regarding age, gender, educational status, duration of asthma, and smoking history. Subjects answered The Global Initiative for Asthma (GINA) assessment of control questions and whether they had previously been mentioned an asthma action plan and benefited from it. Results: Data of 265 asthmatic adults (mean age: 48.4 (standard deviation: 13.4) years, 194 (73.2%) females) were analyzed. The asthma control state of 212 (80.0%) patients was controlled, and 53 (20.0%) patients was uncontrolled. An asthma action plan was mentioned to 91 (34.3%) of 265 patients. Among these 91 patients who were mentioned about the asthma action plan, 85 (93.4%) were given written asthma action plan, 85 (93.4%) stated that they benefited from the plan. The rate of being given an asthma action plan in illiterate patients was significantly lower than in patients with any education (p<0.001).Conclusion: Rate of mentioning an asthma action plan to asthmatics is low. Almost all patients to whom an asthma action plan is recommended benefit significantly from the plan. It is important to give patients with asthma an asthma action plan. It would be even more useful to give this plan in written form.

Determining the optimal duration of anticoagulation after pulmonary embolism remains a clinical challenge. Although guidelines recommend individualized decisions based on recurrence and bleeding risk, no universally accepted algorithm exists. This study aimed to evaluate pulmonologists' practice patterns regarding extended anticoagulation in Türkiye. A 14 item questionnaire based on current international guidelines on pulmonary embolism management was distributed to pulmonology specialists. The survey collected information on physicians' demographics, preferred duration of extended anticoagulation therapy, anticoagulant choice, use of imaging or laboratory tests when determining treatment duration, and reliance on clinical guidelines. Associations between professional characteristics and clinical decision-making patterns were analyzed using chi-square tests and Fisher's exact tests. A total of 159 pulmonologists participated in the study. Most physicians (76.1%) preferred extending anticoagulation therapy for an additional three months, and 88.1% reported using bleeding risk assessment tools when determining treatment duration. The most common reasons for extended therapy were high thrombus burden (51.6%), transient or reversible venous thromboembolism risk factors (50.3%), prior thrombolytic therapy (47.2%), and persistent deep vein thrombosis (45.3%). Direct oral anticoagulants were the most frequently preferred agents, with rivaroxaban selected by 74.8% of respondents. More than half of respondents routinely requested imaging or laboratory tests at the third month, most commonly lower extremity venous doppler ultrasonography (61.6%), echocardiography (56.0%), and computed tomography pulmonary angiography (52.2%). Additionally, 67.9% of participants reported that current clinical guidelines were partially sufficient for guiding treatment decisions. Considerable variability exists in self-reported practice patterns regarding extended anticoagulation after pulmonary embolism among the participating pulmonologists. These findings suggest a perceived need for clearer clinical guidance and more practical integrated risk assessment tools to support treatment decisions.

Background/Objectives: Sarcoidosis is a multisystem inflammatory disease characterized by heterogeneous clinical manifestations and variable disease severity. Hematological inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), red cell distribution width (RDW), and systemic immune-inflammation index (SII), have recently attracted attention as accessible indicators of systemic inflammation in sarcoidosis. This study aimed to evaluate radiological stage, symptom burden, pulmonary function parameters, and hematological markers in patients with sarcoidosis. Methods: This retrospective multicenter cohort study included histopathologically confirmed sarcoidosis patients from 10 centers. Demographic characteristics, clinical manifestations, pulmonary function test parameters, serum angiotensin-converting enzyme (ACE) levels, and hematological inflammatory markers (MPV, RDW, NLR, PLR, SII) were evaluated. Patients were categorized according to radiological stage (stage 0–I vs. stage II–IV), symptomatic status, and symptom burden (<3 vs. ≥3 symptoms). Results: Among 458 patients included in the study, stage I (47.8%) and stage II (46.9%) disease were the predominant radiological presentations. Patients with stage II–IV disease were older and demonstrated significantly lower forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, and diffusing capacity for carbon monoxide (DLCO) values together with higher serum ACE levels compared with stage 0–I disease. Dyspnea, weight loss, and extrapulmonary involvement were more frequent in stage 2–4 disease. No significant associations were observed between radiological stage and NLR, PLR, or SII values. MPV and RDW values differed significantly between symptomatic and asymptomatic patients. Patients with ≥3 symptoms demonstrated significantly lower pulmonary function parameters together with statistically significant higher NLR, PLR, and SII values. In multivariate analyses, only the SII demonstrated an independent association with a high symptom burden. Conclusions: Serum ACE levels were associated with advanced radiological stage, whereas hemogram-derived inflammatory indices, particularly the NLR, PLR, and SII, were associated with symptom burden rather than radiological stage in sarcoidosis and may reflect symptomatic inflammatory activity.

Aims: Bronchoalveolar lavage (BAL) is widely used to identify causative pathogens and guide antimicrobial therapy in hematopoietic stem cell transplant (HSCT) recipients; however, the factors associated with microbiological positivity remain poorly defined. This study aimed to evaluate the microbiological diagnostic yield of BAL, its impact on antimicrobial management, and the clinical factors associated with microbiological positivity.Methods: This retrospective observational study included 49 HSCT recipients who underwent 61 bronchoscopic BAL procedures. Demographic, clinical, radiological, laboratory, microbiological, and procedural data were collected from electronic medical records. Clinical characteristics were compared according to BAL microbiological positivity. Univariate and multivariable logistic regression analyses were performed to identify factors associated with microbiological positivity.Results: BAL microbiological positivity was detected in 28 of 61 procedures (45.9%). Ground-glass opacities and consolidation were the predominant chest CT findings. Aspergillus fumigatus complex was the most frequently isolated organism in culture, while galactomannan assay positivity and cytomegalovirus PCR detection were the most common positive microbiological test results. Antimicrobial therapy was modified following bronchoscopy in 29 procedures (47.5%) and occurred significantly more frequently in BAL-positive than BAL-negative cases (64.3% vs. 33.3%, p=0.016). Neither bronchoscopy indication, predominant chest CT pattern, neutropenia, ongoing antimicrobial therapy, nor BAL sample acceptance time was associated with microbiological positivity. Bronchoscopy-related complications occurred in only two procedures (3.3%), both consisting of minor bleeding.Conclusion: BAL provides an acceptable microbiological diagnostic yield with a low complication rate in HSCT recipients and has a substantial impact on antimicrobial management.

BACKGROUND AND AIM: Progressive pulmonary fibrosis (PPF), depending on the underlying disease, lacks a complete consensus on diagnosis, follow-up, and treatment approaches, both in our country and worldwide. This study aims to evaluate the approaches of pulmonologists and rheumatologists to PPF patients using a questionnaire. METHODS: A web-based questionnaire consisting of 23 questions was prepared to assess the facilities of physicians’ departments and their approaches to the diagnosis, follow-up, and treatment of patients with PPF. The questionnaire was sent to doctors’ personal email addresses and the participants’ responses were analyzed. RESULTS: A total of 91 pulmonologists and 39 rheumatologists completed the online survey. Among the participants, 44% had less than 10 years, 35% had 10-25 years, and 21% had more than 25 years of professional experience. Multidisciplinary councils were conducted in 63% of hospitals, 71% had thoracic radiologists, and 40% collaborated with pathologists specializing in interstitial lung diseases (ILD). The most common underlying primary diseases were rheumatoid arthritis-associated ILD (46.2%) and systemic sclerosis-associated ILD (45.4%). During follow-ups, the most commonly used methods included respiratory function tests (90%), carbon monoxide diffusion tests (84%), high-resolution computed tomography (79%), and pulmonary symptoms evaluations (79%). First-line medications for the underlying disease were steroids (85%), while second-line medications were mycophenolate mofetil (58.5%). Antifibrotic drug treatment was prescribed by 85% of participants, and 78.5% of them reported that they would use a combination of antifibrotic and immunosuppressive agents. While 28% of participants reported no hesitation in the diagnosis and treatment of PPF, the absence of a multidisciplinary team (35%) and challenges in interpreting radiological findings (31.5%) were the most commonly cited obstacles. CONCLUSIONS: This study highlights the importance of multidisciplinary councils for physicians managing patients with PPF. Although the management of PPF patients varied, the physicians’ approaches to diagnosis, follow-up, and treatment of PPF patients aligned closely with recommendations in PPF guidelines.