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Background: Community-acquired pneumonia (CAP) is an acute bacterial or viral inflammation of the lung parenchyma. Worldwide it is one of the most common infectious diseases among children. Diagnosis of CAP is clinical, but chestX-ray (CXR) is used in special clinical situation or severe cases. The role of lung ultrasound (LUS) to diagnose and manage CAP is still debated. Aim: 1) To evaluate concordance between LUS and CXR in evaluating specific signs of CAP (Cohen’s Test). 2) To determine sensitivity and specificity of LUS in the diagnosis of CAP compared to CXR. 3) To evaluate the role of LUS during the follow-up of patients hospitalized for CAP. Methods: We enrolled 68 patients younger than 16 years: 41 cases with clinical and radiological diagnosis of CAP and 27 controls with no respiratory diseases who performed a LUS during hospitalization. Nine-teen cases were re-evaluated 30 days after discharge with both LUS and CXR. Results: LUS confirmed CAP diagnosis in 40/41 cases, showing the presence of single or multiple consolidations. Concordance (K) between LUS and CXR was 0.88 in the right hemithorax and 0.70 in the left hemithorax. Moreover, LUS showed 97% of sensitivity and 96% of specificity in the diagnosis of CAP compared to CXR. During the follow-up, LUS sensitivity and specificity were 100% and 94%, respectively. Conclusion: Our study showed the potential benefit of LUS in the diagnosis and follow-up of children with CAP, possibly avoiding the need to take CXR.

Introduction: Chylothorax is defined by the presence of chyle in the pleural space. Transudative chylothorax has been reported between %15 - %32 of all chylothorax cases. In this report, we present a case of transudative chylothorax possibly developed from pulmonary hypertension due to cardiac valvular insufficiency and right heart failure. Case Presentation: A seventy years old, female patient admitted to our hospital with symptoms of dyspnea, right-sided chest pain for last 6 months. On chest radiography, pleural effusion covering nearly half of the right hemithorax was observed. Closed chest tube drainage was performed for relieving excessive pleural effusion. Since the color of pleural effusion appeared to be milky, pleural effusion was evaluated biochemically for chylothorax. Triglyceride level was found three fold higher than normal, but pleural effusion was transudative. Discussion: Chylothorax does not always meet the exudative criteria. Transudative form has been reported between %15-32 in several studies due to various pathologies. Since now, only two cases of transudative chylothorax due to pulmonary hypertension secondary to right heart failure have been reported. The possible mechanism for transudative chylothorax is poorly understood. Although very rare, evaluation of transudative pleural effusion for chylothorax should be considered in any patient with pulmonary hypertension with pleural effusion in clinical practice.

Malignant pleural mesothelioma (MPM) is still a public health problem in Turkey mainly due to environmental fibrous mineral exposure (FME) (tremolite asbestos, erionite). Based on asbestos production and consumption data of USGS, Turkey had imported a total amount of 350,000 tons of asbestos between 1940-2013. Therefore we expect to diagnose occupational MPM cases especially after 2015 till 2040. We retrospectively reviewed reachable files of MPM patients who were admitted to our clinic between 1972-2010. Baseline patient characteristics were recorded. The study included 484 patients (M/F:310/174) with a mean age of 52.3 years (range:14-80). Right hemithorax was more commonly (56.7%) affected and epithelial histology was dominant (83.1%). The ratio of patients In conclusion, this study presented that currently MPM is mostly due to environmental FME. But in the future, we expect to diagnose higher occupational cases. Prevention of environmental FME could be obtained by educating villagers to avoid using asbestos contaminated soil for domestic usages and relocating the erionite villagers to an erionite free area. Yet some stone quarries which cause direct exposure to erionite are illegally operated in Cappadocian Region.Turkey started National Strategic Plan for Asbestos Management and Awareness, and ILO Safety and Health Construction Convention, 1988 (No:167) was powered by 5 February 2015, which is important for city reorganization process.

Rib fractures (RFs) are a common injury affecting greater than 145,000 people each year in the US, with at least one third of patients requiring hospital admission [1]. In spite of proper treatment, long-term disability and persistent chest wall pain frequently develop and may take several months to recovery; leads to high hospital, medicine, labor and social burden [1,2]. We thought that "How fractures are improving more rapidly". For this purpose, we made an experimental model to investigate the effect of zinc supplementation on the development of new bone in young rabbits. Twenty 6 weeks of age, male New Zealand white rabbits were evaluated in four groups, each including 5 subjects. To simulate the RFs [2]; subperichondrial costal cartilage resections beginning from the third costal cartilage were carried out in the right hemithorax according to groups. Rabbits in group 1 and 2 underwent partial resection of the two ribs; rabbits in group 3 and 4 underwent total resection of those. Zinc was administered by intraperitoneal injection of 6 mg / kg / day for 4 weeks after the surgery for group 2 and 4. The animals were followed-up at the twenty-fourth week of their life. In every subgroup, we analysed histologic changes in the bone. There were statistically significant differences for osteoblasts and osteoclasts among all subgroups. Histologic consolidation was significantly increased by zinc supplementation. In accordance with the literature, in our study while zinc stimulates osteoblastic bone formation, suppresses osteoclastic bone resorption. Our findings indicate that zinc supplementation accelerates the consolidation of ribs. Zinc can be used to increase the bone maturation such as the site of new bone formation in RF.