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COPD is an abbreviated disease name formed from the initials of "Chronic Obstructive Pulmonary Disease." The term "chronic" is used to indicate a long-standing condition, while the term "obstructive" is used to indicate blockage of the airways (bronchi), which is characteristic of this disease. In COPD, this long-term blockage of the airways is irreversible and progressive. The most important cause of the disease is cigarette addiction. If smoking is stopped, the progression of the disease slows down, but if it is not stopped, the disease progresses very rapidly.

COPD should be suspected in a smoker who has had a long-standing cough, sputum production and shortness of breath. For a definite diagnosis of COPD, a pulmonary function test (PFT) must be performed. This test is quite simple. The person takes a deep breath and blows the air quickly into the plastic tube of the breathing test device. In addition to diagnosing COPD, the PFT also determines the severity of the disease.

The cornerstone of COPD treatment is quitting smoking. The medications used in COPD treatment do not prevent the progression of the disease; they are used only to reduce shortness of breath. Most of the medications used in COPD treatment are taken by inhalation (inhaler therapies). Because the doses of inhaled medications are very low and only a very small portion of the dose enters the bloodstream, side effects are almost nonexistent. However, because the medications reach the airways directly, their effects are very strong. Inhaled medications are used through devices that differ from one another in how they work and in their form, and they must be used with the correct technique to be effective. For this reason, how to use the devices must be learned very well. Inhaled medications are not habit-forming and do not cause any harm to the lungs.

Asthma is a chronic (long-term) inflammatory (inflammation that is not caused by microbes) disease of the airways (bronchi). Many cells that are produced by the bone marrow and pass into the bronchial system through the blood play a role in the development of inflammation. After the airways encounter any agent or allergen to which a person is sensitive, the bronchi temporarily narrow, resulting in shortness of breath, wheezing and cough. The disease has a genetic component. About 40-50% of people with asthma in childhood and about 30-35% in adulthood are allergic. Allergy may lose its importance with advancing age. Whether allergic or not, about half of patients with asthma have problems of the nose (polyps, persistent colds, nasal congestion), throat (pharyngitis) and sinuses (sinusitis). In other words, there is a general sensitivity in the nose, sinuses, throat and lungs of these people.

Allergy tests are performed in two groups: skin tests and blood tests. The purpose of the tests is to show whether the patient has antibodies (that is, a type of immune response) against certain allergens. Worldwide, this assessment is generally made with 10-15 standard antigens. Apart from research purposes, testing with more antigens is unnecessary at first. There is no point in testing every adult patient with food antigens. Further allergy testing should be done only at an Allergy Center. In general, skin tests should be done first, and blood tests should be used if necessary or when skin testing cannot be performed. Skin tests have a higher diagnostic value. Some antiallergic medications used in treatment can affect the results of skin tests and must therefore be stopped before the test.

Allergy tests are performed in two groups: skin tests and blood tests. The purpose of the tests is to show whether the patient has antibodies (that is, a type of immune response) against certain allergens. Worldwide, this assessment is generally made with 10-15 standard antigens. Apart from research purposes, testing with more antigens is unnecessary at first. There is no point in testing every adult patient with food antigens. Further allergy testing should be done only at an Allergy Center. In general, skin tests should be done first, and blood tests should be used if necessary or when skin testing cannot be performed. Skin tests have a higher diagnostic value. Some antiallergic medications used in treatment can affect the results of skin tests and must therefore be stopped before the test.

Bees are a group of membrane-winged insects with about 100,000 subspecies. The honey made by honeybees is a good source of food. However, when these insects sting people, they can cause allergic reactions that are sometimes even fatal. The rate of severe allergic reactions varies from one population to another. It has been reported that 1-4 out of every 100 people in Turkey are allergic to bees. Immunotherapy (commonly known as allergy shots) is beneficial for some people with allergies.

Lung cancer occurs as a result of the uncontrolled growth of abnormal cells in the lungs. Cancer cells can spread within the lung, to neighboring tissues or to other distant parts of the body. In 80-90% of lung cancers, the cause is smoking. The more cigarettes smoked and the longer the duration of smoking, the higher the risk of developing lung cancer. When smoking is stopped, the risk of lung cancer gradually decreases and falls to half that of people who continue to smoke after five years. The risk of lung cancer is also increased in people who do not smoke themselves but are exposed to cigarette smoke for a long time. Asbestos exposure, air pollution, exposure to radon gas and genetic predisposition can be counted among the other causes.

The symptoms of lung cancer usually do not appear in the early stage. For this reason, the vast majority of patients are diagnosed at an advanced stage. Symptoms of lung cancer may be due to the lung cancer itself, its spread to neighboring or distant organs, or hormone-like substances secreted by the cancer cells. Common symptoms are: a persistent cough that does not go away, blood-streaked sputum, shortness of breath, fatigue, swelling of the neck and face, loss of appetite and weight loss, hoarseness, and pain in the chest, back or shoulder.

First, the patient's medical history is taken, the symptoms are evaluated and a detailed physical examination is performed. If lung cancer is suspected on a chest X-ray, a computed tomography scan of the lung is taken. For a definite diagnosis, a biopsy must be performed and the tissue obtained must be examined pathologically. Where the biopsy will be taken from is decided according to the location of the patient's cancer, the areas it has spread to and the patient's general condition. In centrally located tumors, biopsies are taken by performing "fiberoptic bronchoscopy," while in tumors close to the patient's back or chest, biopsies can be taken by inserting a needle through the back or chest wall.

In a patient diagnosed with lung cancer, the first thing to do in order to determine the treatment method is staging of the disease. For staging, the whole body, including the brain, must be evaluated with imaging methods (positron emission tomography, magnetic resonance imaging, scintigraphy, ultrasonography). In some cases, additional biopsy examinations may also be needed. In patients with early-stage disease (Stage 1 and 2), the most effective treatment is surgical removal of the tumor, while in patients with locally advanced (Stage 3) and advanced (Stage 4) disease, chemotherapy and/or radiotherapy are among the treatment options.

Bronchoscopy is a procedure in which a thin camera with a flexible tip (fiberoptic bronchoscope) is inserted through the nose or mouth to examine the large airways (bronchi) of the lungs. During the procedure, the throat, larynx, windpipe and bronchial tree are examined. With a bronchoscope that has a channel through which biopsy forceps can pass, it is possible to take biopsies from areas thought to be abnormal. Fiberoptic bronchoscopy can be performed with local anesthesia or light sedation.
Rigid bronchoscopy is an inflexible open tube that is inserted through the mouth only, under general anesthesia. It is generally used during procedures performed to remove foreign bodies or for treatment purposes.

Bronchoscopy is generally a safe diagnostic procedure. Rarely, complications such as temporary fever, bleeding and shortness of breath may occur. These conditions can be treated easily. The risk of a collapsed lung with bronchoscopic biopsy is less than 1%. Even in this case, the lung recovers quickly with the treatment given.

Tuberculosis is a contagious disease caused by a microbe called Mycobacterium tuberculosis. One third of the world's population has been exposed to the tuberculosis bacterium. According to World Health Organization data, about 8.4 million people contract the disease every year and 2 million people die from it. Tuberculosis is a serious public health problem.

Tuberculosis is transmitted through the respiratory route. When sick people cough, sneeze or talk, respiratory secretions are spread into the air as droplets. Healthy individuals become infected by breathing in these droplets, which contain the tuberculosis bacterium. Not everyone who becomes infected necessarily develops the disease. The bacilli taken in may remain latent in the body without making the person sick, and cause disease when body resistance falls. The period of highest risk for developing the disease is the first two years. The people at the highest risk for transmission are family members and close coworkers who spend a long time in the same environment as the patient.

The organ most commonly affected is the lung. However, after the bacilli are taken in through the respiratory route, they can spread through the blood and lymphatics to all other organs and tissues of the body (for example: lymph nodes, the lining of the lung, brain, kidney, bone, stomach and intestinal system, etc.) and cause disease. The diagnosis of tuberculosis is made by demonstrating the tuberculosis bacillus in sputum. The patient's complaints and chest X-ray findings raise suspicion. In a suspected patient, a definite diagnosis of tuberculosis is made by demonstrating the bacillus on microscopic examination of the sputum and growing it in culture. In tuberculosis of organs outside the lung, the diagnosis can also be made by tissue biopsy.

In order to kill the tuberculosis bacterium effectively and to prevent the development of drug resistance, 4 types of drugs are used together in treatment. The basic drugs that can be used in treatment are isoniazid, rifampicin, ethambutol, pyrazinamide and streptomycin. The treatment duration is six months. After the first two months of treatment are completed, the number of drugs is reduced. In some special cases, the duration of treatment may be extended. It is very important to take the treatment regularly every day. Regular treatment both ensures the patient's recovery and protects public health by quickly stopping contagiousness.

Sleep apnea is a serious disease characterized by repeated pauses in breathing during sleep, which causes drops in oxygen and interrupted sleep, creates a risk of sudden death and affects many body systems. Obstructive sleep apnea syndrome (OSAS) occurs in some people as a result of blockages and narrowing of the upper airway during sleep, for reasons we do not fully understand. The three typical findings of OSAS are snoring, excessive daytime sleepiness, and pauses in breathing noticed by relatives (witnessed apnea), with long-standing, continuous snoring and excessive daytime sleepiness. In addition, waking up tired and unrested, morning headaches, and waking at night with a sense of choking or with palpitations are frequently seen. Fatigue, frequent night-time urination, depression and irritability are other findings.

Sleep apnea is diagnosed by an overnight stay in a sleep laboratory for a test called polysomnography. With polysomnography, the patient's breathing movements through the nose and mouth during sleep, oxygen levels, heart rate and rhythm, movements of the chest and abdomen during sleep, and the characteristics of brain waves during sleep are evaluated. Recognizing the disease and grading its severity polysomnographically guides the planning of treatment options. A detailed examination of the upper airway is also important in the diagnosis of OSAS.

Treatment is determined by the severity of the sleep apnea. Whatever the severity, the first step is to take general measures: losing weight, changing sleeping position, and avoiding alcohol and sedative medications. At present, medications have no place in the treatment of OSAS.

The most effective and definitive treatment of this disease is devices that deliver continuous positive airway pressure, which we call PAP devices. These devices open up narrowed airways by creating positive pressure. PAP therapy is delivered through a low-resistance hose and a mask at the end of the hose. It reduces symptoms from the moment it is started. The mask used is of great importance for effective PAP therapy. For this reason, many types of PAP masks have been developed to suit the patient's comfort, such as nasal (worn over the nose), oral (applied through the mouth), oronasal (covering the nose and mouth) and nasal pillow masks. Nasal masks should be the first choice.