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Sensorineural hearing loss, a rare complication in Legionella pneumonia, is said to be attributable to the production of endoctoxin-like substances by Legionella species and their immune-mediated effect. A 43-year-old male patient presented with complaints of fever, chills, wheezing and hearing loss for the past five days. Bilateral widespread ground glass densities and consolidation, including air bronchogram, were detected in a thorax computed tomography. Bilateral moderate sensorineural hearing loss was detected upon a pure audio audiometry. Legionella pneumonia was diagnosed based on the presence of the Legionella antigen in the urine. Clinical and radiological improvement was achieved with fluoroquinolone and corticosteroid treatment. This case is presented to literature as a rare but significant complication of Legionella pneumonia. [ABSTRACT FROM AUTHOR]

AIMS: In pneumonia patients, we need practical biomarkers that can contribute to the diagnosis, prognosis and the prediction of mortality, and that can direct therapy and treatment setting. In this study, the diagnostic importance and value to predict prognosis and mortality are investigated for plasma proadrenomedullin (proADM) levels in pneumonia patients. MATERIALS AND METHODS: Sixty-three consecutive patients who had been diagnosed with pneumonia, as well as 54 volunteers as the control group, making 117 in total, enrolled in this study. The participants' ProADM, leukocyte count, erythrocyte sedimentation rate, C-reactive protein, and procalcitonin levels were measured, and their pneumonia severity index (PSI) and CURB-65 scores were calculated. RESULTS: Plasma proADM levels were higher in the controls. When we compare patients' proADM levels in the initiation, and after the treatment, patients' proADM levels were lower on the 7th day after the treatment. No significant supremacy was identified over the other markers. The ProADM levels were significantly correlated with PSI stages, but in deciding of the site of care, the distribution of proADM levels for the PSI and CURB-65 risk groups (as low and high risk) were statistically irrelevant. The mean proADM levels among the patients who developed complications were slightly higher than the others, but not to a statistically significant degree. A relationship was identified between the clinical severity scores and complications, and short-term mortality was 7.93%. The plasma proADM levels among the nonsurvivors were 0.7 nmol/L and 0.90 nmol/L in the survivors. Given these data, proADM failed to predict mortality while PSI and CURB-65 were superior predictors. CONCLUSION: Using proADM levels alone to predict pneumonia prognosis and mortality and deciding upon a therapy setting makes no sense, although in consideration of previous studies, proADM would be useful as a supplementary contributor to clinical severity scores. [ABSTRACT FROM AUTHOR]

Desquamative interstitial pneumonia is a type of smoking-associated major idiopathic interstitial pneumonia, which is characterized by accumulation of alveolar macrophages in alveolar lumens and septa and develops secondary to mainly active or passive exposure to cigarette smoke. Desquamative interstitial pneumonia mostly occurs in male smokers in association with non-specific symptoms responsive to steroid therapy and has a better prognosis than usual interstitial pneumonia. To date, no large-scale clinical studies have been performed on desquamative interstitial pneumonia patients. Factors responsible for the scarcity of data on the clinical course of this condition include the retrospective nature of the available information as well as its rare occurrence. Despite this, a general consensus exists as to the nature of its symptoms, association with smoking, age and gender distribution, findings of respiratory function tests, steroid responsivity and mortality. The objective of the present review article was to report on desquamative interstitial pneumonia and to describe its etiology, risk factors and clinical features, as well as the laboratory, bronchoalveolar lavage, radiological and histopathological findings, and the treatment and prognosis of affected patients. [ABSTRACT FROM AUTHOR]

Photodynamic therapy (PDT) is a method of treatment in which photosensitizer drug is administered to the patient and activated by diode laser used for illumination. It is used for treatment of advanced lung cancer without endobronchial critical stenosis and for early stage lung cancer. PDT application, efficacy, complications, and indications are briefly explained. [ABSTRACT FROM AUTHOR]

Objective: We aimed to demonstrate the approaches of physicians with a questionnaire toward the patients with pulmonary thromboembolism (PTE) in our country. Methods: An invitation letter including a questionnaire with 28 questions to assess the approaches they prefer in the patients with PTE and the capabilities of the departments they work at and a link for the questionnaire was directed to the mail groups of chest diseases specialists. Responses of the physicians who participated in the questionnaire were reviewed. Results: The examinations used to diagnose PTE such as D-dimer, troponin, echocardiographic Doppler ultrasonography and multidetector computed tomography (CT) have been performed in 94% of the institutions, ventilation/perfusion scintigraphy, MRI and pulmonary angiography examinations were performed in 50% of the instututions. While D-dimer test was performed in 73.2% of the institutions by quantitative ELISA; in 15.7% of them it was semiquantitative and in 11.6% of the instutitions it was performed by latex agglutination. 81% of physicians were seen to be using clinical probability scoring systems and most commonly used scoring method was seen to be Wells scoring with a rate of 90%. According to the simplified PESI score, 61.5% of the physicians reported to prefer outpatient treatment. In non-massive and submassive pulmonary thromboemboli patients, 86.2% of the physicians reported to prefer thr low molecular weight heparin (LMWH) treatment; vitamin K antagonist in maintenance treatment was also the most commonly resorted drug with a percentage of 84.9. Conclusion: The absence of the examinations used in the diagnosis and treatment of PTE in most institutions and difficulty to reach the available examinations at all hours of the day were significant facts. Especially; lack of access to high-sensitivity D-dimer test, bedside echocardiography used to assess right ventricular dysfunction, troponin and NT-proBNP makes us think about low adaptation to guidelines. [ABSTRACT FROM AUTHOR]

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Pulmonary alveolar microlithiasis (PAM) is a rare diffuse lung disease characterized by intra-alveolar accumulation of spherical calcium phosphate concretions (microliths). The disease predominates in a few countries, particularly Turkey, Italy, and Japan. Since most of the patients have no symptoms at the time of diagnosis, the disease is usually diagnosed incidentally during pulmonary radiography for other reasons, as in the current case. The SLC34A2 gene mutations can cause PAM. Characteristic radiographic findings of PAM consist of bilateral, fine, sand-like micronodules typically in the middle and lower zones. Although many authors argue that the typical radiological pattern precludes the requirement for a lung biopsy in most cases, it remains the most definitive procedure for confirmation of PAM. There is no known effective treatment for the disease. We present a case of pathologically diagnosed PAM with a review of the literature. [ABSTRACT FROM AUTHOR]

Congenital Lobar Emphysema (CLE) is a rare congenital pulmonary malformation and it is characterized by hyperinflation of one or more lobes of the lungs. The disease is usually encountered in infants aged less than 6 months and it is very rare in adulthood. Herein, we presented a patient with CLE, who received asthma treatment for dyspnoea complaint in adult age but was switched to anxiolytic medications as no benefit was achieved from asthma treatment. The diagnosis of the patient was made clinically, radiologically and scintigraphycally. Although it is a rarely encountered condition, CLE should be considered among the prediagnosis, in patients with localized unilateral hyperinflation on chest x-ray, presenting with dyspnoea in adult age. [ABSTRACT FROM AUTHOR]

Introduction: The smoking rate of the general population in Turkey is considerably high. Healthcare personnel are expected to be the primary elements in the campaign against smoking. More data are needed on smoking rates and smoking behaviour among military healthcare personnel. Material and Method: We aimed to establish smoking prevalence in a military training hospital in Istanbul and the impact of working in the healthcare sector on smokers. For this purpose, a 16-item questionnaire was applied to healthcare personnel. Results: Among the participants, 283 were males and 254 were females. Of the male participants, 47.7% were still smoking, while 17.7% had stopped. In females, these rates were 39.8% and 13.0%, respectively. Overall, 43.9% of the healthcare professionals were currently smokers and 15.5% were ex-smokers. In this study, the smoking rate of males was found to be higher than that of females (p=0.011). There was a significant difference between the smoking rate and education levels (p=0.011). The smoking rate was found to decrease with increased levels of education (r=-0.145, p=0.001). Conclusion: Data acquired in this study reveal that almost half (43.9%) of military healthcare professionals are smokers. Smoking prevalence of military healthcare professionals is similar to the general population in Turkey. Current anti-smoking campaigns are not effective in promoting smoking cessation. [ABSTRACT FROM AUTHOR]

Objective: The efficacy of immunotherapy in the field of oncology is increasingly understood. The PD-1 molecule in T cells acts as a stopping and limiting immune activation by triggering programmed cell death. The tumor may express PD-L1 that binds to the PD-1 molecule to stop the immunological response.This is a case report of the patient who has received immunotherapy as metastatic lung ca treatment and has been admitted to intensive care unit due to side effects. Case: A 48-year-old male patient was diagnosed as adenocarcinoma about 2 months ago. When she was diagnosed, she had bone metastases. PD1 was examined and cemiplimab was started as anti-PD1 treatment. The Intensive Care Unit (ICU) received a single dose of 350 mg cemiplimab 15 days before admission. She admitted to the emergency room with the exacerbation of shortness of breath that started at home for the last 2 days. When the patient arrived, the respiratory rate ranged from 30-40. The patient was urgently initiated non-invasive mechanical ventilation (NIV). 2 hours NIV was planned to be 15 minutes nasal. antibiotherapy was started. The patient was evaluated for cardiologic and cardiac insufficiency because of a history of previous coronary artery disease. Ejection fraction was evaluated as 45-50% and cardiac pathologies were excluded. He was started on prednisolone because he had pneumonitis as a side effect of using cemiplimab in his history. As the patient had left-sided effusion, he was consulted for thoracic surgery, but the patient refused pleurocene, but drainage was achieved by inserting pleurocene after respiratory distress persisted despite any treatment. 6. Non - invasive ventilation was continued on day 1 and he was discharged from intensive care unit. She was discharged home on the 7th day of her treatment in the clinic. Conclusion: Immunotherapeutic drugs are increasingly used as a treatment in the recent period. Intensive care units will increase the frequency of encountering side effects of these drugs and should prepare training plans to struggle them. [ABSTRACT FROM AUTHOR]