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Murat Özdede,1 Alper Tuna Güven,2 Damla Karadeniz Güven,3 Oğuz Abdullah Uyaroğlu,1 Mine Durusu Tanriover1 1Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of General Internal Medicine, Ankara, Turkey; 2Başkent University Adana Hospitals, Department of Internal Medicine, Division of General Internal Medicine, Adana, Turkey; 3Adana City Hospital, Department of Pulmonology, Adana, TurkeyCorrespondence: Alper Tuna Güven, Başkent University Adana Hospitals, Department of Internal Medicine, Division of General Internal Medicine, Yüreğir, Adana, Turkey, Tel +90 541 802 2135, Email alper.tuna.guven@gmail.comBackground: COVID-19 creates a hypercoagulable state with a wide spectrum of clinical manifestations. Of those, venous thromboembolism (VTE) is prevalent, and numerous studies have highlighted the importance of VTE prophylaxis. Pre-pandemic VTE prophylaxis practices have already been poor, despite guidelines. We hypothesized that the gap between guidelines and practices might have been closed due to increased awareness.Materials and Methods: Non-COVID-19 patients hospitalized in the internal medicine ward of a university hospital between January 1st, 2021, and June 30th, 2021, were assessed. VTE risk and thromboprophylaxis requirements were assessed using the Padua Prediction Score (PPS). The results were compared with the findings of the study conducted in the same setting before the pandemic.Results: A total of 267 patients were included, and 81 patients (30.3%) received prophylaxis. A total of 128 patients’ (47.9%) PPS was ≥ 4, and 69 patients (53.9%) received prophylaxis; 12 low-risk patients (8.6%) received prophylaxis although it was not indicated. Compared to the pre-pandemic figures, both appropriate prophylaxis use and overuse rates have risen. While the increment rate of appropriate prophylaxis was statistically significant, the increment rate of overuse did not reach statistical significance. Patients hospitalized for infectious diseases and respiratory failure were more likely to receive appropriate prophylaxis.Conclusion: We have demonstrated a significant increase in appropriate pharmacologic prophylaxis rates among high-risk patients. Besides all the collateral damage the pandemic has created, it might also have brought collateral benefits with regards to VTE prophylaxis.Keywords: COVID-19, venous thromboembolism, risk assessment, quality of health care, quality improvement

Background/aim Cystic fibrosis is an autosomal recessive disease with a defect in mucociliary activity that is characterized by recurrent pulmonary infections. Bacterial agents frequently implicated in airway colonization are Haemophilus influenzae, Staphylococcus spp., and Pseudomonas spp. Fungal isolation from sputum is common in adults. However, growth of fungal agent only in sputum culture in patients with cystic fibrosis is insufficient for the diagnosis of fungal diseases. There is limited data about the clinical significance of fungal isolation in sputum cultures. The aim of the study was to investigate the clinical outcomes andsignificance of fungal isolation from sputum samples in adult CF. Materials and methods This retrospective study included patients who have been admitted between October 2017 and January 2019 in an adult cystic fibrosis unit. Patients were grouped according to fungal pathogenicity as; fungal disease group, colonization group, and nonisolated group. The data of the last one year, including demographics, clinical data, laboratory, treatment modalities, results of cultured bacteria and fungus from sputum samples, respiratory function parameters, frequency of exacerbation, and hospitalizationwere compared between groups. Results A total of 330 sputum samples from 88 adult patients with CF were collected. Patients were divided into 3 groups, the fungal disease group (n = 10, 11.4%), colonization group (n = 49, 55.7%), and nonisolated group (n = 29, 32.9%). Presence of pulmonary exacerbation, number of admissions to emergency department, and the number of positive cultures for bacteria from sputum were higher in the fungal disease group (p = 0.03, p = 0.01 and p < 0.001). The fungal disease group had higher rate of antibiotics by parenteral routethan other groups (p = 0.001) whereas lung functions were similar. Use of nutritional supplementation and parenteral antibiotherapy were the factors associated with elevated risk of fungal isolation. Conclusion Frequent use of parenteral antibiotics and use of nutritional supplementation were found to be independent risk factors for fungal isolation from sputum in adult CF.

As coronavirus disease 2019 (COVID-19) spreads across the world, the ongoing clinical trials are leading to a big race worldwide to develop a treatment that will help control the pandemic. Unfortunately, COVID-19 does not have any known effective treatment with reliable study results yet. In this pandemic, there is not a lot of time to develop a new specific agent because of the rapid spread of the disease. The process of developing a vaccine is long and requires hard work. Although the pathophysiology of the disease is not fully understood, some of the proposed treatment alternatives are based on old evidence and some have been used with the idea that they might work owing to their mechanism of action. The efficacy, reliability, and safety of the currently available treatment alternatives are therefore a matter of debate. Currently, the main therapies used in the treatment of COVID-19 are antiviral drugs and chloroquine/hydroxychloroquine. Other proposed options include tocilizumab, convalescent plasma, and steroids, but the mainstay of the treatment in intensive care units remains supportive therapies. WOS:000600070300012 2-s2.0-85103141655

Aims: Fatigue, diminished vitality, and increased bodily pain are common symptoms of chronic rhinosinusitis. On the other hand, there is an increased prevalence of rhinosinusitis symptoms among patients with unexplained chronic fatigue and/or bodily pain. Fibromyalgia syndrome is characterized by widespread pain and fatigue. In this study we aimed to determine the prevalence of fibromyalgia among patients with chronic sinusitis. Materials and Methods: This study included 58 consecutive patients who were diagnosed as chronic rhinosinusitis (24 women and 34 men, mean age: 42.61 ± 10.97). Computed tomography (CT) imaging of the paranasal sinuses and nasal endoscopic examinations were performed for each patient. The CT scans were staged by using the Lund-Mackay staging system, and endoscopy scores were obtained according to Lund and Kennedy. Results: Fibromyalgia was diagnosed in 23 patients (39.7%). Eighteen patients among 24 females (75%) and 5 patients among 34 males (14.7%) had fibromyalgia. Total endoscopy score was significantly higher in patients with fibromyalgia than patients without fibromyalgia, while CT scores were comparable between those subgroups. Conclusion: Fibromyalgia syndrome is commonly present in patients with chronic sinusitis. Higher nasal endoscopy scores might predict the presence of this disease.