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OBJECTIVE: Coronavirus disease 2019 (COVID-19) caused morbidity and mortality worldwide. Besides the acute effects, subacute and long-term effects are defined as long-COVID causing morbidity. The intensive care unit (ICU) data of long-COVID-19 cases were evaluated with the participation of 11 centers. MATERIAL AND METHODS: Study was designed by Turkish Thoracic Society Respiratory Failure and Intensive Care Working Group to evaluate long COVID-19 patients. All patients followed up in the ICU with long-COVID diagnosis were included in point prevelance study. RESULTS: A total of 41 long COVID-19 patients from 11 centers were included in the study. Half of the patients were male, mean age was 66 ± 14, body mass index was 27 ± 5. Hypertension, diabetes mellitus, lung cancer, malignancy, and heart failure rates were 27%, 51%, 34%, 34%, and 27%, respectively. Eighty percent had received COVID vaccine. Patients had moderate hypoxemic respiratory failure. APACHE II, SOFA score was 18 (14-26), 6 (3-8), respectively. Forty-six percent received invasive mechanical ventilator support, 42% were sepsis, 17% were septic shock. Bilateral (67%), interstitial involvement (37%) were most common in chest x-ray. Fibrosis (27%) was detected in thorax tomography. Seventy-one percent of patients received antibiotherapy (42% carbapenem, 22% linezolid). Sixty-one percent of the patients received corticosteroid treatment. CONCLUSION: More than half of the patients had pneumonia and the majority of them used broad-spectrum antibiotics. Presence of comorbidities and malignancies, intensive care severity scores, intubation, and sepsis rates were high. Receiving corticosteroid treatment and extensive bilateral radiologic involvement due to COVID-19 might be the reasons for the high re-admission rate for the ICUs.

OBJECTIVE: A 1-day point prevalence study was planned to obtain country data by determining the clinical characteristics, follow-up and treatment methods of coronavirus disease 2019 (COVID-19) cases that required intensive care unit (ICU) treatment in the second year of the pandemic. MATERIAL AND METHODS: All patients who were hospitalized in the ICUs due to COVID-19 between March 11, 2022, 08.00 am, and March 12, 2022, 08.00 am, were included in the study. Demographic characteristics, intensive care and laboratory data, radiological characteristics, and follow-up results of the patients were recorded. RESULTS: A total of 811 patients from 59 centers were included in the study, 59% of the cases were male, and the mean age was 74 ± 14 years. At least one comorbid disease was present in 94% of the cases, and hypertension was the most common. When ICU weight scores were examined, Acute Physiology and Chronic Health Evaluation-II: 19 (15-27) and Sequential Organ Failure Assessment: 7 (4-10) were seen. Sepsis was present in 37% (n = 298) of cases. PaO2/FiO2 ratios of the patients were 190 the highest and 150 the lowest and 51% of the cases were followed via invasive mechanical ventilation. On the study day, 73% bilateral involvement was seen on chest x-ray, and ground-glass opacities (52%) were the most common on chest tomography. There was growth in culture in 40% (n = 318) of the cases, and the most common growth was in the tracheal aspirate (42%). CONCLUSION: The clinical course of COVID-19 is variable, and ICU follow-up was required due to advanced age, comorbidity, presence of respiratory symptoms, and widespread radiological involvement. The need for respiratory support and the presence of secondary infection are important issues to be considered in the follow-up. Despite the end of the second year of the pandemic and vaccination, the high severity of the disease as well as the need for follow-up in ICUs has shown that COVID-19 is an important health problem.

INTRODUCTION[|]Ventilator-associated pneumonia (VAP) due to Acinetobacter baumannii (A. baumannii) has a high mortality rate in the intensive care unit (ICU). The guidelines recommend empirical antimicrobial therapy in cases of VAP; however, similar treatment is not recommended in cases of ventilator-associated tracheobronchitis (VAT) with a culture result of A. baumannii. The aim of this study was to evaluate the difference in the ICU and long-term mortality of patients with A. baumannii VAP and VAT who were treated with antibiotherapy.[¤]METHODS[|]This was a retrospective cohort study. Patients who were intubated in the respiratory ICU due to acute respiratory failure (ARF) and developed A. baumannii-associated VAP or VAT between January 2015 and January 2016 were included in this study. Demographic features, comorbidities, cause of ARF, arterial blood gas values, oxygenation level, chest X-ray findings, ICU severity scores (Sequential Organ Failure Assessment [SOFA] score, Charlson Comorbidity Index score, Acute Physiology and Chronic Health Evaluation II score), culture antibiotic susceptibility results, antibiotic regimen, length of ICU stay, and mortality details were recorded. Long-term mortality (1-, 2-, 3-, 12-month) details were obtained from national death records. The Kaplan-Meier method was used for long-term survival analysis.[¤]RESULTS[|]Among 503 consecutive patients intubated between January 2015 and January 2016, 78 (15.5%) who had A. baumannii-associated VAT and VAP were included. Of the 78 patients, 21 (35%) were cases of VAP and 50 (65%) were cases of VAT. Diagnoses of the 78 patients were 62% chronic obstructive pulmonary disease, 15% pneumonia, 10% acute cardiogenic pulmonary edema, 9% lung cancer, and 4% kyphoscoliosis. Among the VAP patients, 21 (75%) were male and 7 (25%) were female, while among the VAT patients, 38 (76%) were male and 12 (24%) were female. There was no statically significant difference between the VAP and VAT patients according to age, gender, comorbidities, the presence of acute respiratory distress syndrome or septic shock, Charlson and SOFA scores, or length of hospital and ICU stay. The median (quartile ratio) duration of mechanical ventilator use was 15 days (7–22 days) for VAP patients and 12 days (6–14 days) for VAT patients (p=0.649). The ICU mortality rate was 68% among VAP patients and 40% among VAT patients (p

Amaç: Literatürde “büyük taklitçi” olarak anılan inflamatuar bir hastalık olan sarkoidoz olgularında semptomlar ve tutulan organlar açısından cinsiyete göre farklılıklar bildirilmiştir. Bu çalışmada sarkoidoz olgularındaki semptom ve bulguların cinsiyete ve hastalığın evrelerine göre farklılıkları araştırıldı.Gereç ve Yöntemler: Bu retrospektif gözlemsel kohort çalışmamızda sarkoidoz tanılı olgular başvuru semptomlarına göre; asemptomatik, pulmoner semptomlar, ekstrapulmoner semptomlar, pulmoner ve ekstrapulmoner semptom birlikteliği olarak gruplandırıldı. Her iki cinsiyet bulguların sıklığı açısından karşılaştırıldı.Bulgular: Çalışmaya alınan 338 hastanın %71’i kadın olup yaş ortalaması 42,5±11,6 idi. Olguların %86’sı başvuru anında semptomatik olup, semptomların %31’i yalnız pulmoner, %23’ü yalnız ekstrapulmoner, %32’sinde ise hem pulmoner hem de ekstrapulmoner semptomlar birlikte idi. Kadın ve erkeklerde öksürük (sırasıyla %45; %42; p=0,620), balgam çıkarma (sırasıyla %9; %11; p=0,535), hemoptizi (sırasıyla %2; %1; p=0,678), ateş (sırasıyla %4; %4; p=0,999) bulguları açısından cinsiyete göre anlamlı farklılık bulunamadı. Dispne kadınlarda erkek olgulara göre anlamlı olarak daha sık izlendi (sırasıyla %33; %22; p=0,048). Kadın hastalarda erkeklere kıyasla göğüs ağrısı anlamlı olarak daha az görüldü (sırasıyla %7; %20; p=0,001). Aşırı terleme erkeklerde kadınlara göre anlamlı olarak daha fazla görülürken (p=0,004), eritema nodosum kadınlarda erkeklere göre fazla bulundu (p=0,003). Terleme dışındaki konstitüsyonel yakınmalarda cinsiyet farkı izlenmedi.Sonuç: Sarkoidozlu kadınlar daha yaşlıdır ve nefes darlığı ile eritema nodosum, kadınlarda erkeklere göre anlamlı oranda sık bulunmuştur. Erkeklerde ise terleme ve göğüs ağrısı belirgin yüksek tespit edilmiştir.

INTRODUCTION[|]In cases of pulmonary sarcoidosis, extrapulmonary involvement is not uncommon. The skin, eyes, and lymph nodes are the most common sites of extrapulmonary involvement, and multiple organs may be involved at the same time. In this study, patients with extrapulmonary sarcoidosis were investigated in terms of the localization of involvement.[¤]METHODS[|]Patients diagnosed with sarcoidosis between 1994 and 2015 were evaluated retrospectively. Demographic characteristics, symptoms, organ involvement, diagnostic methods, and the length of time between the diagnosis of sarcoidosis and additional organ involvement were recorded. The patients were consulted to the departments of dermatology, ophthalmology, and cardiology, and a chest X-ray, high-resolution computed tomography, and abdominal ultrasound examinations were performed.[¤]RESULTS[|]Extrapulmonary involvement was detected in 144 of a total of 337 sarcoidosis patients. In 92% of those patients with extrapulmonary involvement, there was accompanying pulmonary involvement. Women made up 75% of the group, and the mean age was 43 years. The most commonly detected extrapulmonary involvement was of the skin (n=41), followed by erythema nodosum (n=37), and involvement of the liver (n=24), lymph nodes (n=20), spleen (n=18), and salivary/parotid gland (n=15). The most frequent diagnostic method used was mediastinoscopy (n=41), followed by a skin biopsy (n=23), and a transbronchial lung biopsy (n=19). Of the 26 (18%) patients who had multiple-organ involvement, 2 were diagnosed as stage 0, 14 were stage 1, 9 were stage 2, and 1 was stage 3. The mean length of time before a diagnosis of extrapulmonary involvement was 24 days.[¤]DISCUSSION AND CONCLUSION[|]If there is extrapulmonary involvement in a case of sarcoidosis, it should be kept in mind that more than 1 organ system may be involved and the relevant additional tests may be required.[¤]

BackgroundThis study aimed to evaluate attitudes toward and exposure to gender discrimination in work life by chest diseases specialists and thoracic surgeons.MethodsA total of 275 members of Turkish Thoracic Society (TTS) were included on a voluntary basis in this online cross-sectional questionnaire-survey using an internal member-only social media platform of TTS. The questionnaire form elicited items on sociodemographic characteristics, occupational characteristics and gender discrimination in work life (general opinions, attitudes and exposure).ResultsFemale doctors (vs. males) were less likely to be a thoracic surgeon (13.8% vs. 34.5%, p

Tracheostomy is life-saving procedure in critical care patients which require long-term mechanical ventilation (MV) and an alternative to endotracheal intubation.(1,2) The factors affecting the survival of tracheostomized patients are not clearly known. The aim of this study was to investigate the factors affecting intensive care unit (ICU) and long-term mortality in the tracheostomized patients due to respiratory failure. A retrospective observational cohort study was planned between January 2016-2019 in tertiary ICU. Each patient underwent percutaneous and surgical tracheostomy was included. Demographic characteristics, diagnoses, causes of tracheostomy, comorbidities, Charlson and APACHE 2 scores, culture antibiogram results, ICU day and mortality (1-3 and 12 months) were recorded. In the analysis of the data, appropriate statistical tests and analyzes were used. 115 of 3620 patients admitted to tertiary ICU and underwent percutaneous and surgical tracheostomy due to respiratory failure between January 2016-2019 were included. 75 (65%) of the patients were male and median age was 68±14 years. Hospital mortality was higher in the group with Acinetobacter baumannii growth (p=0.04). According to Kaplan-Meier survival analysis, long-term follow-up of Acinetobacter baumanii growth did not affect survival (p=0.938). Patients with cerebro-vascular accident (CVA) had lower survival in long-term follow-up (p [Med-Science 2020; 9(1.000): 1-5]

INTRODUCTION[|]There are similarities in the symptoms and attacks of bronchiectasis and chronic obstructive pulmonary disease (COPD). Chronic systemic inflammation in COPD and destructive pulmonary inflammation in bronchiectasis lead to increases in inflammatory markers. The presence of peripheral blood eosinophil (PBE)(>2%) and the neutrophil-to-lymphocyte ratio (NLR) affect the type of attack and the treatment approach. The aim of this study was to investigate differences in inflammatory markers and the presence of PBE in COPD and bronchiectasis.[¤]METHODS[|]A retrospective, cross-sectional study of patients diagnosed in 2014 with bronchiectasis (J47.0-ICD) or COPD (J44.0-J44.9-ICD) at the inpatient or outpatient clinics of a chest disease hospital was performed. Patients with cancer, hematological disease, renal disease, or COPD with bronchiectasis were excluded. Demographic details and the C-reactive protein (CRP) levels were recorded, and the NLR was calculated. The study groups were then sub-classified according to PBE.[¤]RESULTS[|]In all, 2664 patients (outpatient bronchiectasis: n=1024, outpatient COPD: 775; inpatient bronchiectasis: n=180, inpatient COPD n=685) were included. The NLR was significantly lower in the bronchiectasis group. The median CRP level was lower in those with bronchiectasis than in the COPD inpatien group. The PBE values in the bronchiectasis and COPD inpatient groups was 24% and 40%, respectively and 18% and 40% in outpatient groups, respectively. The NLR in patients with PBE was lower than that observed in noneosinophilic patients.[¤]DISCUSSION AND CONCLUSION[|]Inflammatory markers were lower in patients with bronchiectasis than in those with COPD. Continuous anti-inflammatory treatment may be recommended for patients with COPD. NLR and PBE may be able to indicate the nature of advisable treatment in further studies.[¤]

Aim: Early identification and treatment of infections in patients using domiciliary non-invasive mechanical ventilation (NIMV) due to chronic respiratory failure (CRF) can reduce hospital admissions. We assessed C-reactive protein (CRP), procalcitonin, and neutrophil lymphocyte ratio (NLR) as indicators of infection/inflammation.Methods: The study was designed as a retrospective, observational, cross-sectional study, and was performed in 2016 in an intensive care unit outpatient clinic in patients using NIMV. Patients who came to the outpatient clinic with dyspnea, increased sputum, increased prothrombin, and who had hemogram, procalcitonin, and serum CRP, NLR, and PLT/MPV levels assessed, were enrolled into the study. Demographic characteristics, co-morbid diseases, respiratory symptoms, hemogram, biochemistry, CRP, and procalcitonin values in stable and acute attack patients were recorded from patient files. The descriptive statistics and CRP, NLR, and procalcitonin values were assessed.Results: During the study period, 49 patients (24 female) with chronic obstructive pulmonary disease (COPD, n = 24), obesity hypoventilation syndrome (OHS, n = 15), or interstitial lung disease, n = 10), and having had three inflammatory markers assessed, were included in the study. Their mean age was 67 (SD ± 12). Stable patients vs. those who had an acute attack was 41 vs. eight, and within 7 days of outpatient admission four patients were hospitalized. CRP, NLR, and PLT/MPV values were similar in patients' who had sputum purulence, and an increase in dyspnea and sputum, but procalcitonin was significantly higher in patients who had an acute attack. Procalcitonin was not correlated with CRP, NLR, and PLT/MPV.Conclusions: Patients with CRF had similar levels of CRP and NLR during a stable and acute attack state. Procalcitonin may be a better marker for therapeutic decisions in advanced chronic inflammatory diseases.