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In December 2019, a novel coronavirus (COVID-19) pneumonia emerged in Wuhan, China and has rapidly spread to multiple countries worldwide. Pulmonary parenchymal opacities are often observed during chest radiography. Pneumothorax was reported in 1% of patients in studies. In this paper, we aimed to present a patient with a history of long-term hospitalization in intensive care unit due to COVID-19 pneumonia who was operated for right recurrent pneumothorax secondary to COVID-19 after discharge.

The Effect of Thiol-Disulfide Homeostasis on Prognosis in Patients with Early Stage of NSCLC Objective: Lung cancer has a poor prognosis. Thiol groups which have high antioxidant capacity, turn to disulpide (DS) groups with biochemical reactions that neutralize different oxidant compounds. Thiol/Disulpide homeostasis (TDH) has significant effects on cell mechanisms, transcription and apoptosis. We present the role of prognosis of dynamic TDH in patients operated for NSCLC. Methods: The patients who operated for early stage with NSCLC prospectively analysedTDH tests were measured by the automated spectrophotometric method. Results: 77 patients patients, 61 volunteer controls participated in this study. Native thiol (NT) and total thiol (TT) levels were significantly lower in the patient group. SS/NT ratio which is the indicator of oxidative stress of TDH also reached statistical significance in the patients (p

Objectives The diagnosis of sarcoidosis is frequently challenging, requiring a search for less invasive, more reliable diagnostic methods. The bronchoalveolar lavage fluid (BALF) analysis has been used in the differential diagnosis of sarcoidosis for many years with a wide sensitivity and specificity rates. The objective of the study is to investigate whether diagnostic performance of the BALF analysis is altered by clinicoradiological findings of patients with sarcoidosis. Materials and methods The present study is a retrospective, single-center, observational study, designed in a sarcoidosis outpatient clinic in a training hospital. Patients who had undergone the bronchoalveolar lavage BAL procedure at diagnosis were included in the study. Demographics, clinical and detailed chest X-ray, and high-resolution computed tomography (HRCT) findings at diagnosis were recorded. According to the diagnostic performance, the BALF results were grouped as "diagnostic" and "non-diagnostic," and recorded parameters were compared between the groups. Results Considering the BALF analysis of all the 257 patients, the mean lymphocyte ratio was 41±17.5 (5-80), and the mean CD4/CD8 was 5.5±4.7 (0.1-24.7). The BALF analysis was diagnostic in 56% (n=145) of patients. Diagnostic performance of the procedure did not correlate with any of the demographic data, smoking status, spirometric findings, chest X-ray staging, HRCT findings, and tomography scoring. Extrapulmonary involvement was significantly more frequent in the diagnostic group (66% vs. 34%, p=0.006). Conclusion BALF results signal sarcoidosis in more than half of the patients. The diagnostic role of BALF is greater in patients with extrapulmonary involvement.

BACKGROUND Elevated red blood cell distribution width (RDW) levels were associated with mortality in patients with stable chronic obstructive lung pulmonary diseases (COPD). There are limited data about RDW levels in acute exacerbation of COPD (AECOPD). AIM/OBJECTIVE The association of the RDW levels with the severity of AECOPD was evaluated according to admission location, (outpatient-clinic, ward and intensive care unit (ICU)). METHODS Cross sectional retrospective study was designed in tertiary care hospital for chest diseases in 2015. Previously COPD diagnosed patients admitted to hospital outpatient-clinic, ward and ICU due to AECOPD were included in the study. Patients demographics, RDW, biomarkers (CRP, RDW, Neutrophil to lymphocyte ratio (NLR), platelet to mean platelet volume (PLT-MPV)) C-CRP, biochemistry values were recorded from hospital electronic system. RDW values were subdivided below 0.11% (low), above and equal 0.15% (high) and between 0.11%-0.15% (normal). Neutrophil to lymphocyte ratio (NLR) and platelet to mean platelet volume (PLT-MPV) were also calculated. Biomarker values were compared according to where AECOPD was treated. RESULTS 2771 COPD patients (33% female) and 1429 outpatients-clinic, 1156 ward and 186 ICU were enrolled in the study. The median RDW values in outpatients-clinic, ward and ICU were 0.16 (0.09-0.26), 0.07 (0.01-0.14) and 0.01 (0.00-0.07) respectively (P

Dysnatremia is reported to have a prognostic effect in various diseases. A limited number of studies have been published on dysnatremiarelated parameters and clinical outcome in patients with pneumonia. The aim of the study is to analyze the factors related to baseline dysnatremia and to evaluate the clinical outcome of dysnatremia on hospital stay, 30-day and 1-year mortality in hospitalized patients with community-acquired pneumonia (CAP).The study is a two-centre, retrospective, crosssectional study. According to the baseline corrected sodium values, hospitalized patients with CAP were grouped as hyponatremia (135 mmol/L), normonatremia (135-145 mmol/L) and hypernatremia (145 mmol/L).Of all the 471 patients included, 119 (25.3%) had hyponatremia and 25 (5.3%) had hypernatremia. Higher leucocytes and lower albumin values correlated with hyponatremia while female gender, higher leucocytes and urea levels correlated with hypernatremia. Baseline hyponatremia prolonged hospital stay (9.2 ± 5.6, vs. 7.5 ± 4.6, respectively, p= 0.001) and increased 1-year mortality. On the other hand, hypernatremia predicted 30-day (40%, vs. 10%, p0.001) and independently predicted 1-year mortality (p0.001).In hospitalized patients with CAP, baseline hyponatremia prolongs hospital stay while hypernatremia signals a worse outcome both in the short term and long term.

Background A considerable percentage of empirical antibiotic treatment fails in hospitalized patients with community-acquired pneumonia (CAP). β-lactams and macrolid (BLM) combination or respiratory fluoroquinolones (FQ) are the most frequently used in these patients. The aim of the present study is to compare the treatment failure (TF) rates in BLM and FQ treatment and to analyze the predictive factors of TF. Method Hospitalized patients who were initially treated with either BLM or FQ were included retrospectively and treatment results of the two regimens were compared. Results Of the 144 patients included in the study, the mean age was 67±16 and 102 (71%) were male. Each group constituted of 72 patients. Antibiotic selection did not alter TF rates, length of stay (LOS) and 30-day mortality. Baseline higher levels of leucocytes, neutrophils to lymphocytes ratio (NLR), C-reactive protein (CRP), BUN/albumin, lactate dehydrogenase/aspartat aminotransferase (LDH/AST) levels and pneumonia severity index (PSI) scores were detected as predictors of TF. Conclusion Empirical treatments with either BLM or FQ do not correlate with TF, LOS and 30-day mortality. NLR, BUN/albumin and LDH/AST may suggest TF. These inexpensive and easily-reachable parameters have the potential as predictors of the treatment outcome in CAP. Notices of retraction Akyil, F. T., Bekir, S. A., Gungor, A., Akyuz, K., Kose, N., Turker, H., Akyil, M., & Sevim, T. (2019). TREATMENT FAILURE AND EMPIRIC ANTIBIOTIC CHOICE FOR HOSPITALIZED PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA: Β-LACTAM/Β-LACTAMASE INHIBITOR COMBINED WITH MACROLID OR FLUOROQUINOLONE ALONE?. International Journal of Research -GRANTHAALAYAH, 7(7), 360-369. https://doi.org/10.29121/granthaalayah.v7.i7.2019.778 Article retracted by : EditorReason(s) for retraction : Author's conflicts of interest

Background: Elevated red blood cell distribution width (RDW) levels were associated with mortality in patients with stable chronic obstructive lung diseases (COPD). There are limited data about RDW levels in COPD exacerbation. Aim/Objective: The association of the RDW levels with the severity of the acute exacerbation of COPD (AECOPD) were evaluated according to admission location, (outpatient-clinic, ward and intensive care unit (ICU). Methods: Cross sectional retrospective study designed in tertiary chest dieases hospital. COPD patients admitted to hospital outpatiens-clinic, ward and ICU due to AECOPD were included. Patients demographics, RDW, C-reactive protein (CRP), biochemistry values were recorded. RDW values were subdivided below 0.11% (low), above and equal 0.15% (high) and between 0.11-0.15% (normal). Neutrophile to lymphocyte ratio (NLR) and platelet to mean platelet volume (PLT-MPV) were also calculated. Recorded values were compared according to where AECOPD was treated. Results: 2771 COPD patients (33% female) and 1429 outpatients-clinic, 1156 ward and 186 ICU were enrolled in the study. The median RWD values in outpatients-clinic, ward and ICU were 0.16 (0.09-0.26), 0.07 (0.01-0.14) and 0.01 (0.00-0.07) respectively (p

Degerli Meslektaslarimiz, Plevra hastaliklari, gunumuzde insidansi giderek artan ve hem gogus hastaliklari hem de gogus cerrahisi kliniklerinin pratiginde yaygin bir is yuku olusturan sorun halinde karsimiza cikmaktadir. Cok genis sebeplere dayali bir dagilim gosteren plevra patolojilerinin tani ve tedavi yontemi multidisipliner yaklasim gerekmektedir. Bu konuyla ilgili cikarilan eserler oldukca degerli teorik bilgiler icermekle birlikte pratik ve vaka noktasinda bilgi birikimini gerektigi olcude yansitmadigi gozlenmektedir. Bu dusunceden yola cikarak, plevral hastaliklari ve cerrahi tedavi yaklasimini olgu sunumlari esliginde ozetleyen alaninda bu yonuyle ilk eser olan bu kitabi degerli okuyucularimiza sunmaktan gurur duyuyoruz. Bu eserde gunumuzdeki plevra patolojilerine yaklasim, guncel tani rehberleri ve cerrahi tedavideki yenilikler, gogus hastaliklari ve gogus cerrahisi alanlarinda kursu sahibi olan degerli hocalarimiz tarafindan olgular esliginde islenmistir. Klinik tecrubelerin kanita dayali yontemlerle aktarildigi, vakalarin guncel pratigimizde rehberlik edecegi bir kaynak olarak titizlikle hazirlanmistir. Eserin tum bolumlerinin hazirlik asamasinda emegi gecen kiymetli hocalarimiza ayri ayri sukranlarimizi sunariz. Kiymetli meslektaslarimiza faydali olmasi temennisiyle…. Kizlarimiz Zulal, Elif, Defne, Gokcen ve tum saglik calisanlarinin cocuklarina armagan olmasi dilegiyle

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., Aim: Sarcoidosis is known as the ‘great imitator’ for its versatile manifestations which differ among genders. The objective of this study is to investigate the signs and symptoms and differences in respect to gender and phases of disease.Material and Methods: This cohort study includes patients with sarcoidosis classified as asymptomatic, with pulmonary symptoms only, extrapulmonary symptoms only and those with both together. The frequency, prevalence, and severity of the signs and symptoms were compared between gender identities.Results: This study enrolled 338 patients, of which 71% were female, and mean age was 42.5±11.6. Most patients (86%) were symptomatic on presentation, and pulmonary symptoms were noted in 31%, extrapulmonary symptoms in 23% and both in 32%. There were no significant differences between genders regarding cough (45% in women, 42% in men, p=0.620), sputum (9%, 11%, respectively, p=0.535), hemoptysis (2%, 1%, respectively, p=0.678), fever (4%, 4%, respectively, p=0.999). Dyspnea was reported significantly more common in women (33% and 22%, respectively, p=0.048) whilst chest pain was more common in men (7%, and %20 respectively, p=0.001). Excessive perspiration was significantly more common in men, and erythema nodosum in women (p=0.004 and p=0.003, respectively). Frequencies of constitutional symptoms other than perspiration did not differ between sexes.Conclusion: Women with sarcoidosis were older than men and dyspnea and erythema nodosum were seen more commonly in women. Frequencies of other symptoms were similar between sexes.

OBJECTIVE: Sarcoidosis is a multisystem chronic disease characterized by granulomatous inflammation. It is reported that the frequency of other inflammatory and malignant diseases increases. The primary objective of the study is to determine the types of comorbid diseases and their frequency, and whether the risk of malignancies and autoimmune diseases such as rheumatoid arthritis and thyroid increases. The secondary objective is to identify the factors related to the comorbidities frequently detected. METHODS: The files of 694 patients who had the diagnosis of sarcoidosis between1998-2016 were evaluated. The frequency of comorbid diseases recorded was compared to the data of our country. RESULTS: Among the patients, 487 (70%) were female, and the mean age at diagnosis was 42.9 ± 11.8 (18-87). In 490 patients (70%) at least one comorbidity was detected. The most frequently detected comorbidities were systemic hypertension (22%), hepatosteatosis (16.9%), diabetes mellitus (16.4%), thyroid diseases (13.1%), and asthma (12%). Malignancy was found in a ratio of 4.0%, rheumatoid arthritis in 2.2%. The comparison to the frequencies across the country showed that the prevalence of diabetes mellitus, thyroid diseases, asthma, malignancy, and rheumatoid arthritis was higher. Diabetes, thyroid diseases, asthma were more frequent in women. The mean age of patients in which diabetes, thyroid diseases, asthma, rheumatoid arthritis or malignancy was detected as a comorbidity was higher than those without comorbidities. CONCLUSION: Comorbidities frequently occur among sarcoidosis patients, and the frequency of diabetes mellitus, thyroid diseases, asthma, malignancy, and rheumatoid arthritis is higher than the data of the country.

Objective: Sarcoidosis is a multisystemic disease, exact cause of disease is unknown but it is assumed that genetic predisposition and ethnic factors play a role in etiology. Studies related with familial sarcoidosis is limited and only case reports about familial sarcoidosis is available from our country. We aimed to evaluate the prevelance of familial sarcoidosis and clinical findings of cases with familial sarcoidosis. Methods: We retrospectively documented file records of 678 patients diagnosed with sarcoidosis and followed up in outpatient clinic of sarcoidosis from January 1996 to February 2016. 28 familial sarcoidosis cases in 14 families were enrolled into the study. Their demographic findings, family relationship, symptoms, laboratory and pulmonary function test results, radiological apperances, diagnostic methods, treatments were recorded. Results: Twenty-eight sarcoidosis patients out of 678 reported as familial cases, giving a prevelance of familial sarcoidosis as 4%. There were 8 sarcoidosis sib, 4 sarcoidosis mother-child, 1 sarcoidosis father-child and 1 sarcoidosis cousin relationship. Female/male ratio was 1.8, mean age of the study population was 43, most freguent symptoms were cough and dyspnea, stage 2 was mostly seen according to chest X-ray, most common CT appearance was mediastinal lymphadenopathy and mediastinoscopy was the most freguent diagnostic method. Conclusion: This study is important to lead interrogation of family in patients with suspected sarcoidosis and future studies investigating familial aggregation in sarcoidosis.

OBJECTIVE: The present study examines the clinical and radiological findings and pathological diagnoses of patients undergoing surgical biopsy with an multidisciplinary team (MDT) decision and investigates whether final diagnoses change on the reevaluated of pathological diagnoses at MDT meetings. MATERIALS AND METHODS: A total of 416 patients were discussed at MDT meetings held at the University of Health Sciences Istanbul Sureyyapasa Chest Diseases and Thoracic, Surgery Training and Research Hospital January between January 2016 and May 2019, with surgical biopsy decisions made for 50 (12%) patients. RESULTS: Among the 50 patients, 26 (52%) were female, with a mean age of 53 ± 12 years. The most common locations of the surgical biopsy were the right lung (n = 27, 54%), lower lobe (n = 38, 76%) and single lobe (n = 35, 70%). A definitive pathological diagnosis was established in 41 (82%) patients following the biopsy. The most common diagnoses were usual interstitial pneumonia (UIP; n = 19, 38%), sarcoidosis (n = 11, 22%), unclassifiable fibrosis (n = 9, 18%), (non-specific interstitial pneumonia; n = 5, 10%), (hypersensitivity pneumonitis; n = 2, 4%) and others (n = 4, 8%), respectively. Diagnoses of 13 (26%) such patients were revised. The revision was most common in the unclassifiable fibrosis and UIP subgroups. The radiological appearance was classified based on the high-resolution computed tomography parameters for idiopathic pulmonary fibrosis (IPF). The final diagnosis was IPF in eight of 14 patients with “probable” diagnoses, all four patients with “indeterminate” diagnoses and three of the 28 patients with “alternative” diagnoses. CONCLUSION: Diagnosing interstitial lung diseases is difficult, and while surgical biopsy provides the most definitive diagnosis, it is not enough by itself. IPF may vary in radiology. Patients diagnosed with UIP and unclassifiable fibrosis after biopsy should be reevaluated, and the final diagnosis should be established through a multidisciplinary approach.

Background: Elevated RDW levels were associated with mortality in patients with stable COPD. There are limited data about RDW levels in COPD exacerbation. Aim: We evaluated if there is any difference about the RDW levels in patients with COPD exacerbation in out patients clinic, ward and ICU. Methods: The study was designed as cross sectional observational retrospective, in a teaching chest disease hospital in 2014.Previously COPD diagnosed patients who admitted to hospital outpatients clinic, ward and ICU due to COPD exacerbation were included the study.Cancer, pneumonia, anemia, asthma, liver-renal diseases and rheumatologic-neurologic diseases patients were excluded.Demographics, hemogram values included RDW, CRP were recorded from hospital based electronic system. RDW were subdivided below 0.11% (low), above and equal 0.15% (high) and between 0.11-0.15% (normal).Recorded values were compared according to place where COPD exacerbation was treated. Results: 2771 COPD patients (33% female) and 1429 outpatients clinic, 1156 ward and 186 ICU were enrolled in the study. The median RWD values in outpatientsn clinic, ward and ICU were; 0.16, 0.07 and 0.01 respectively (p Conclusion: Patients with COPD exacerbation, lower RDW values should be considered carefully. Lower RDW can be used for decision of COPD exacerbation severity and follow up treatment response.