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Introduction GOLD 2017 report proposed that the combined COPD assessment should be done according only to symptom burden and exacerbation history in the previous year. Objective This study aims to investigate the change in the COPD groups after the GOLD 2017 revision and also to discuss the evaluation of group C and D as a single group after the GOLD 2019 report. Method The study was designed as a cross-sectional. 251 stable COPD patients admitted to our out-patient clinic; aged ≥40 years, at least one-year diagnosis of COPD and ≥10 pack-year smoking history were consecutively recruited for the study. Results In GOLD 2017, a significant difference was found between the distribution of all groups compared to GOLD 2011 (P = 0,001). 31 patients included in group C were reclassified into group A and 37 patients in group D were reclassified into group B. The FEV1 values of group A and B patients were significantly low and group C and D patients had had exacerbations in more frequently the previous year in GOLD 2017 compared to GOLD 2011. Conclusion After the GOLD 2017 revision, the rate of group C patients decreased even more compared to GOLD 2011 and the group C and D may be considered as a single group in terms of the treatment recommendations with the GOLD 2019 revision. We think that future prospective studies are needed to support this suggestion.

Purpose: This study was conducted to the Turkish validity and reliability study of the ‘Scale of Self-efficacy in Nursing Care of Children with Epilepsy’ (SSENCCE). Design and methods: The construct validity of the scale was evaluated with explanatory factor analysis (EFA) and confirmatory factor analysis. The reliability of the scales used in the research was examined with composite reliability and Cronbach's alpha coefficients. Results: A total of 144 nurses participated in the study. The variance explained in the 12-item scale was 53.6%, and the eigenvalue was found as 6.442. The commonality values of the scale items ranged from 0.304 to 0.712, and the factor loads ranged from 0.552 to 0.844. Cronbach's α of the SSENCCE was calculated as 0.907. Conclusion: The Turkish version of the ESSENCE is a valid, reliable, and appropriate tool for assessing the self-efficacy of nurses providing care for children with epilepsy. Practice implications: Considering that there is no scale that is used to evaluate the self-efficacy of nurses who provide care for children with epilepsy in Turkey, it is thought that this study will guide future research on the subject and the improvement of the clinical experience of nurses.

This study was conducted with randomized controlled and experimental design to examine the effect of breathing exercise on daytime sleepiness and fatigue on patients with obstructive sleep apnea syndrome. The first application was performed by teaching patients in the intervention group breathing exercises including diaphragmatic and pursed lip breathing via the face-to-face interview technique. Then, the researcher applied breathing exercises in the same patient group every morning/evening for 10–15 min and a total of 20–30 min for eight weeks via the online interview method. The data were collected via a questionnaire, Epworth sleepiness scale (ESS), and Piper Fatigue Scale (PFS). Chi-square, Student’s t, Mann Whitney U, paired sample t-test, analysis of variance (ANOVA) and generalized estimating equations were used to assess the data. It was determined that PFS total mean score of the intervention group which was 6.15 ± 1.65 before the application decreased to 5.34 ± 1.94 in the eighth week (p > 0.05) and PFS total mean score of the control group which was 5.59 ± 1.76 before the application increased to 5.77 ± 1.81 in the eighth week (p > 0.05). ESS total mean score of the intervention group which was 12.13 ± 4.34 at the baseline decreased to 9.13 ± 4.71 in the eighth week (p > 0.05) and ESS total mean score of the control group which was 10.37 ± 2.77 at the baseline increased to 10.5 ± 2.85 in the eighth week (p > 0.05). It was concluded that breathing exercise performed in the intervention group decreased the fatigue and daytime sleepiness mean scores of the patients at the end of the fourth and eighth week. In addition, the group-time interaction was significant, which was associated with the intervention group.

Objective COVID-19 has spread worldwide and leads to an increased risk of mortality. We aimed to analyze what actions have been effective in fighting COVID-19 in Turkey with a comparison to pandemic-affected countries. Methods This was a retrospective observational cross-sectional study. The Republic of Turkey Ministry of Health official web page includes data reported daily from 11 March to 26 April. Global COVID-19 data were recorded daily from https://www.worldometers.info/coronavirus/country/. Data were analyzed for 31 days according to Intensive Care Unit (ICU) admission, intubation and mortality rates. Segmented regression analysis was used. The results from COVID-19-affected countries were compared with the results from Turkey for the first 65 days. Results In total, 889.742 tests were performed (positive=110.130 [12.37%]). The mortality rate was 2.55% (n=2805) on 27 April 2020. The annual percent change (APC) values of the cases showed 5 segments ([23.1], [14.7] [11.4], [3.7], [0.7]; each p=0.001). ICU admission showed 4 segments (APC: [3.1, p=0.001], [-2.2, p=0.10], [-7.6, p=0.001], [-4.5, p=0.001]). The decline of APC for intubation rates showed 5 segments (APC: [1.1, p=0.10], [-1.1,p=0.001], [-2.0, p=0.001], [-0.4, p=0.40], [-2.7, p=0.001]). The mortality rates showed 4 segments (APC: [-6.3, p=0.001], [8.4, p=0.001], [0.2, p=0.30], [1.4, p=0.001]). Deaths were reported per 1 million individuals for the first 65 days: Spain 11.6%, Italy 11.4%, UK 11.3%, France 11.1%, USA 10.3%, Germany 8.4%, Iran 8.2%, Turkey 7.5%, South Korea 4.1% and China 2.4%. Conclusion Public health policies and protocols to combat COVID-19 helped control the spread and decrease positive cases and mortality rates in Turkey. Turkey managed COVID-19 better than Spain, Italy, UK, France, USA and Turkey managed COVID-19 similarly to Germany and Iran. China and South Korea were best at managing COVID-19.

Aim:This study aimed to analyze the judicial reports prepared in emergency services and to emphasize the importance of forensic medicine education for the physicians working at these services and the reflection of the situation to the judicial authorities.Materials and Methods:Reports prepared by Forensic Medicine Department of Gaziantep University Medical Faculty were accepted as the gold standard and the judicial reports of the same patients prepared in emergency services were compared retrospectively.Results:Most reports were found to be prepared as temporary reports. The concepts of general condition, consciousness, life-threatening clinical status and simple medical interventions were frequently mentioned, while other concepts were not mentioned. The success rate of identifying cases with and without life-threatening clinical status in emergency services was 83.49% and 85.52%, respectively. The success rate of identifying cases that could and could not be treated with simple medical intervention was 84.20% and 58.62%, respectively.Conclusion:It has been determined that the problems in both mentioning basic concepts and accurate report writing cannot be solved in the judicial reports organized in emergency departments. In order to protect themselves, physicians have a tendency to report the consequences more severe than they actually are. However, it should be kept in mind that this tendency may not protect the physician, but also may cause additional legal problems.

Objective: epidemiological studies have shown that mortality owing to the coronavirus disease 2019 (COVID-19) could be under-reported under different conditions. Excess mortality analysis is suggested as a useful tool in estimating the impact of the disease. Material and methods: mortality data between January 01 and May 18, 2020, were analyzed to evaluate the excess mortality owing to COVID-19 in Istanbul, the city most affected by the pandemic in Turkey. The average weekly percentage changes in the number of deaths in 4 previous years were compared with those in the year 2020 using excess mortality analysis. Results: the number of deaths in Istanbul was significantly higher in 2020 (p=0.001), with a 10% weekly increase between the 10th and 15th weeks, which started to decrease until the 20th week. The excess mortality found during the study period was 4,084 deaths, higher than the officially reported COVID-19 mortality. Conclusion: our findings demonstrated that mortality owing to COVID-19 could be higher than the official figures reported by health authorities., NA

OBJECTIVE: To compare nerve growth factor (NGF) levels in patients who received antimuscarinic, versus onabotulinum toxin-A (onaBoNT-A) injection, as well as to investigate whether there is a correlation between NGF levels, and 8-item overactive bladder questionnaire(OAB-V8), urogenital distress inventory (UDI)-6, and incontinence impact questionnaire (IIQ)-7 forms. MATERIAL AND METHODS: Fourty adult patients with OAB were enrolled in this prospective study. An antimuscarinic was prescribed to 20 naive patients, and onaBoNT-A injection was administered to 20 patients, who were refractory to antimuscarinics. Urine samples were obtained before, and after 3(rd) and 6(th) months of treatment, and NGF levels were measured. Symptom scores of OAB-V8, UDI-6,and IIQ-7 were recorded. RESULTS: There was no significant difference between groups in terms of the initial OAB-V8, IIQ-7, and UDI-6 scores, whereas NGF values showed no significant difference over time in onaBoNT-A group (p=0.069, p=0.069). NGF levels were significantly lower in 3(rd) and 6(th) months, in patients receiving antimuscarinic (p=0.003, p=0.007); a strong correlation was found in 3rd month between the NGF levels, OAB-V8 scores (r=0.704, p=0.001), and IIQ-7 scores (r=0.676, p=0.001), and a moderate correlation between NGF levels, and UDI-6 scores (r=0.583, p=0.007). In the 6(th) months, a very strong correlation was found between NGF levels, and OAB-V8 scores (r=0.811, p=0.004), and a strong correlation was found between NGF levels, and IIQ-7 scores (r=0.671, p=0.001). In onaBoNT-A group, there was no significant correlation between NGF levels, and other variables. CONCLUSION: NGF level might be a good marker to evaluate effectiveness of treatment in patients receiving antimuscarinics, owing to correlation of urinary NGF levels with symptom scores. Lack of correlation in patients receiving onaBoNT-A injection could be a result of differences in the mechanism of action.

Purpose There is still an evident need for useful biomarkers and effective therapeutic approaches regarding the challenging management of sepsis. The aim of the study is to evaluate the effect of each Cytosorb hemoadsorption therapy course on blood levels of inflammatory biomarkers of sepsis including endocan, copeptin, interleukin-6, procalcitonin, C-reactive protein. Methods There were a total of 178 samples belonging to 34 patients that were diagnosed with sepsis and undergone Cytosorb therapy during the study period. Patient demographics were recorded. Arterial blood samples were obtained both before and and after each Cytosorb course. Levels of copeptin, interleukin-6, procalcitonin, C-reactive protein, erythrocyte sedimentation rate, white blood cell count, and creatinine were assessed both before and after each Cytosorb treatment. Results Levels of endocan, copeptin, interleukin-6, procalcitonin, C-reactive protein, and erythrocyte sedimentation rate were all significantly decreased after the Cytosorb course when compared with levels before therapy (p = 0.039, 0.001, 0.010, 0.001, 0.002 and 0.001, respectively). There was no significant difference between white blood cell count and creatinine levels before and after Cytosorb courses (p = 0.204 and 0.277). Conclusion Cytosorb courses achieved significant decreases in endocan, copeptin, interleukin-6, procalcitonin and C-reactive protein levels. Decreasing plasma levels of inflammatory cytokines may help alleviate the cytokine storm and may have a role in improve outcomes. Further prospective randomized controlled studies with larger sample size are needed concerning the long-term effects of this decrease in cytokine levels on outcome and mortality.

Objectives: To examine the craniofacial morphologic features of children with celiac disease and to investigate the presence of specific features in this disease. Methods: Totally 100 celiac patients between the ages of 3 and 17 years who were diagnosed with celiac disease by biopsy and 100 healthy age- and sex-matched children were included in the study. Photographs of the children were taken using a SLR digital camera by one and the same person at a natural head position. The parameters specified on the photograph were measured with Image) 1.50b software. Twenty eight landmarks were identified on the photos. Using these landmarks, 41 distances and 5 angles were measured. Thirty eight anthropometric ratios were calculated. Results: Twenty seven distances, 1 angle and 9 ratios were determined shorter; 3 distances, 2 angles and 7 ratios were determined larger in patients with celiac disease compared with the healthy individuals. These differences were statistically significant. Conclusions: There were significant alterations in some craniofacial morphometric parameters in children with celiac disease when compared with healthy controls. However, since the data is limited, a clear conclusion could not be achieved about a morphological feature directly associated with celiac disease in children. Further prospective studies with longer follow-up periods are warranted to determine the effects of celiac disease on craniofacial morphological measurements. C1 [Isikay, Sedat] Hasan Kalyoncu Univ, Sch Hlth Sci, Dept Physiotherapy & Rehabil, Gaziantep, Turkey. [Bahsi, Ilhan; Orhan, Mustafa; Kizilkan, Nese] Gaziantep Univ, Fac Med, Dept Anat, Gaziantep, Turkey. [Kul, Seval] Gaziantep Univ, Fac Med, Dept Biostat, Gaziantep, Turkey. [Kocamaz, Halil] Pamukkale Univ, Fac Med, Dept Pediat Gastroenterol, Denizli, Turkey. [San, Murat] Cengiz Gokcek Obstet & Pediat Hosp, Dept Pediat, Gaziantep, Turkey.

Objective: to evaluate long-term effects of COVID-19, and to determine the risk factors in long-COVID in a cohort of the Turkish Thoracic Society (TTS)-TURCOVID multicenter registry.Methods: thirteen centers participated with 831 patients; 504 patients were enrolled after exclusions. The study was designed in three-steps: (1) Phone questionnaire; (2) retrospective evaluation of the medical records; (3) face-to-face visit. Results: in the first step, 93.5% of the patients were hospitalized; 61.7% had a history of pneumonia at the time of diagnosis. A total of 27.1% reported clinical symptoms at the end of the first year. Dyspnea (17.00%), fatigue (6.30%), and weakness (5.00%) were the most prevalent long-term symptoms. The incidence of long-term symptoms was increased by 2.91 fold (95% CI 1.04-8.13, P=0.041) in the presence of chronic obstructive pulmonary disease and by 1.84 fold (95% CI 1.10-3.10, P=0.021) in the presence of pneumonia at initial diagnosis, 3.92 fold (95% Cl 2.29-6.72, P=0.001) of dyspnea and 1.69 fold (95% Cl 1.02-2.80, P=0.040) fatigue persists in the early-post-treatment period and 2.88 fold (95% Cl 1.52- 5.46, P=0.001) in the presence of emergency service admission in the post COVID period. In step 2, retrospective analysis of 231 patients revealed that 1.4% of the chest X-rays had not significantly improved at the end of the first year, while computed tomography (CT) scan detected fibrosis in 3.4%. In step 3, 138 (27.4%) patients admitted to face-to-face visit at the end of first year; at least one symptom persisted in 49.27% patients. The most common symptoms were dyspnea (27.60%), psychiatric symptoms (18.10%), and fatigue (17.40%). Thorax CT revealed fibrosis in 2.4% patients. Conclusions: COVID-19 symptoms can last for extended lengths of time, and severity of the disease as well as the presence of comorbidities might contribute to increased risk. Long-term clinical issues should be regularly evaluated after COVID-19., NA

Background & objectives: There has been an ongoing debate about the impact of Ramadan fasting (RF) on the health of these individuals who fast during Ramadan. The aim of this meta-analysis was to evaluate the relationship between RF and glycaemic parameters in type 2 diabetes mellitus (T2DM) patients. Methods: Search terms were decided and databases such as MEDLINE EBSCO, Google Scholar and EMBASE were searched for eligible studies. Standardized mean differences and 95 per cent confidence intervals (CIs) of post-prandial plasma glucose (PPG), fasting plasma glucose (FPG), glycated haemoglobin (HbA1c) (%) and fructosamine levels were calculated for different treatment regimens. Results: Of the 40 studies, 19 were found eligible for inclusion in the meta-analysis. Based on pooled results, significant reductions in FPG were found in single oral antidiabetics (OAD) [standardized weighted mean difference (SMD)=0.47, 95% CI=(0.20-0.74)], multi-OAD [SMD=0.36, 95% CI=(0.11-0.61)] and multitreatment subgroups [SMD=0.65, 95% CI=(0.03-1.27)] and overall [SMD=0.48, 95% CI=(0.27-0.70)]. Furthermore, HbA1c (%) [SMD=0.26, 95% CI=(0.03-0.49)] and body mass index (BMI) [SMD=0.18, 95% CI=(0.04-0.31)] were significantly decreased in the multi-OAD group. Interpretation & conclusions: The meta-analysis showed that RF was not associated with any significant negative effects on PPG and fructosamine levels. However, BMI and FPG and HbA1c (%) were positively affected by RF.

Background Sarcopenia, obesity, and sarcopenic obesity are various features of the ageing process that can cause important health issues. The present study was undertaken to investigate the interrelationship between those body composition changes, including their clinical components and the quality-of-life variables. Methods A total of 423 individuals aged 65 years or older was included in this cross-sectional study. Sarcopenia was diagnosed according to The European Working Group on Sarcopenia in Older People criteria. Body composition parameters were measured with a bioelectrical impedance analyser, and Turkish population-based cut-off points were preferred for diagnosis of sarcopenia. Comprehensive geriatric assessment was performed on all patients. A logistic regression analysis was performed to identify important factors for sarcopenia and sarcopenic obesity. Results The prevalence of sarcopenic, obese and sarcopenic obese subjects was 14%, 35% and 11% respectively. The lowest mean gait speed and hand grip strength values were seen in the sarcopenic obese group (0.6 ± 0.3 m/s and 19.7 ± 9.8 kg respectively). Sarcopenic obese participants were associated with the highest rate for fall risk. The scores for domains of health-related quality of life were worse in both obesity and sarcopenic obesity when compared to others. Body mass index (BMI), number of drugs used, total body fat ratio and geriatric depression scale-short form scores were negatively correlated with all dimensions of SF-36 quality-of-life scale. Conclusions Sarcopenia, obesity and sarcopenic obesity are associated with many negative health outcomes, such as high fall risk and low health-related quality of life in geriatric population.

Objective. This study was designed to investigate the effects of Desert Dust Storms and Climatological Factors on Mortality and Morbidity of Cardiovascular Diseases admitted to emergency department in Gaziantep. Method. Hospital records, obtained between September 01, 2009 and January 31, 2014, from four state hospitals in Gaziantep, Turkey, were compared to meteorological and climatological data. Statistical analysis was performed by Statistical Package for the Social Science (SPSS) for windows version 24.0. Results. 168,467 patients were included in this study. 83% of the patients had chest pain and 17% of patients had cardiac failure (CF). An increase in inpatient hospitalization due to CF was observed and corresponded to the duration of dust storms measured by number of days. However, there was no significant increase in emergency department (ED) presentations. There was no significant association of cardiac related mortality and coinciding presence of a dust storm or higher recorded temperature. The association of increases in temperature levels and the presence of dust storms with “acute coronary syndrome- (ACS-) related emergency service presentations, inpatient hospitalization, and mortality” were statistically significant. The relationship between the increase in PM10 levels due to causes unrelated to dust storms and the outpatient application, admission, and mortality due to heart failure was not significant. The increase in particle matter 10 (PM) levels due to causes outside the dust storm caused a significant increase in outpatient application, hospitalization, and mortality originated from ACS. Conclusion. Increased number of dust storms resulted in a higher prevalence of mortality due to ACS while mortality due to heart failure remained unchanged. Admission, hospitalization, and mortality due to chest pain both dependent and independent of ACS were increased by the presence of dust storms, PM10 elevation, and maximum temperature.

Objective: In this study, we aimed to compare the analgesic efficacy of intravenous dexketoprofen trometamol, fentanyl, and paracetamol in patients presenting to the emergency department with renal colic. Materials and method: Data obtained from the emergency departments of Gaziantep University's Hospital for Research and Practice along with two other state hospitals in Gaziantep, Turkey between January 2016 and January 2017 was used for this study. A total of three hundred patients (n = 300), who presented to the ER with complaints most common to renal colic whose diagnoses were subsequently confirmed with Computerized Tomography were included in the study. Patients’ pain scores were recorded using the Visual Analogue Scale, at admission (immediately before drug administration), then at the 15th, and 30th minutes. SPSS 22.0 software package was used for analysis. p < 0.05 was considered significant. Results: At the 15th minute comparison, the efficacies of the three groups of drugs were not superior to one other, but at the 30th minute, dexketoprofen trometamol was statistically more effective than paracetamol and fentanyl. There was no statistically significant difference between fentanyl and paracetamol. The need for additional analgesia in the group receiving dexketoprofen trometamol was found to be lower. Dexketoprofen trometamol was statistically superior to the other two agents in achieving full analgesia at the end of the thirty-minute period. Fentanyl was found to be statistically significant in achieving moderate analgesia. Conclusion: As a Non-steroidal antiinflammatory drug dexketoprofen trometamol is superior to paracetamol and fentanyl in achieving analgesia and reducing the need for additional drugs for the treatment of renal colic.

Background: This study aims to investigate the prognostic factors that affect survival rates and durations in patients with T3 non-small cell lung cancer who underwent surgery. Methods: A total of 129 patients with T3 n on-small c ell l ung c ancer (125 males, 4 females; mean age 60±9.3 years; range 23 to 80 years) who were performed surgery in our clinic between January 1997 and December 2013 were evaluated retrospectively in terms of age, gender, type of resection, tumor histopathology, tumor, node and metastasis staging, lymph node invasion, chemotherapy and radiotherapy, and recurrence. Results: During the evaluation, while 61 patients (47.3%) were alive, 68 (52.7%) had lost their lives. One-, two- and five-year survival rates of the study population were 79.8%, 56.9% and 23.2%, respectively. Mean duration of survival was 41.5±4.0 months (range 33.7-49.4 months). Patient's age or tumor histopathology did not affect the duration of survival. Overall duration of survival was significantly longer in patients of stage IIB, patients who had low stages of lymph node invasion, who were performed lobectomy, who received chemotherapy or radiotherapy or who were without recurrence (p < 0.05 for each). Multivariate regression analysis revealed that lymph node invasion, presence of recurrence or pneumonectomy, or failure to have been administered chemotherapy increased mortality risk significantly (hazard ratios 0.217, 3.369, 2.791 and 2.254, respectively). Conclusion: Our findings revealed that lymph node invasion, presence of recurrence or pneumonectomy, or failure to have been administered chemotherapy are poor prognostic factors in T3 non-small cell lung cancer. Prognostic factors should be taken into consideration during treatment and follow-up periods of patients with T3 non-small cell lung cancer. © 2018 All right reserved by the Turkish Society of Cardiovascular Surgery. Amaç: Bu çalışmada cerrahi geçiren T3 küçük hücre dışı akciğer kanserli hastalarda sağkalım oran ve sürelerini etkileyen prognostik faktörler araştırıldı. Çalış­ma­ planı:­ Kliniğimizde Ocak 1997 - Aralık 2013 tarihleri arasında cerrahi uygulanan T3 küçük hücre dışı akciğer kanserli 129 hasta (125 erkek, 4 kadın; ort. yaş 60±9.3 yıl; dağılım 23-80 yıl) yaş, cinsiyet, rezeksiyon tipi, tümör histopatolojisi, tümör, nod ve metastaz evresi, lenf nodu tutulumu, kemoterapi ve radyoterapi ile nüks durumu açısından retrospektif olarak incelendi. Bulgu­­lar: Değerlendirme sırasında 61 hasta (%47.3) sağ iken 68’i (%52.7) hayatını kaybetmişti. Çalışma popülasyonunun bir, iki ve beş yıllık sağkalım oranları sırasıyla %79.8, %56.9 ve %23.2 idi. Ortalama sağkalım süresi 41.5±4.0 ay (dağılım 33.7-49.4 ay) idi. Hasta yaşı ve tümör histopatolojisi sağkalım süresini etkilemedi. Genel sağkalım süresi evre IIB hastalarında, düşük lenf nodu tutulum evresine sahip hastalarda, lobektomi uygulananlarda, kemoterapi veya radyoterapi alanlarda ve nüks olmayanlarda anlamlı olarak daha uzundu (her biri için p

The COVID-19-related death rate varies between countries and is affected by various risk factors. This multi-center registry study was designed to evaluate the mortality rate and the related risk factors in Turkey. We retrospectively evaluated 1500 adults with COVID-19 from 26 centers who were hospitalized between March 11 and July 31, 2020. In the study group, 1041 and 459 cases were diagnosed as definite and highly probable cases, respectively. There were 993 PCR-positive cases (66.2%). Among all cases, 1144 (76.3%) were diagnosed with non-severe pneumonia, whereas 212 (14.1%) had severe pneumonia. Death occurred in 67 patients, corresponding to a mortality rate of 4.5% (95% CI:3.5-5.6). The univariate analysis demonstrated that various factors, including male sex, age >= 65 years and the presence of dyspnea or confusion, malignity, chronic obstructive lung disease, interstitial lung disease, immunosuppressive conditions, severe pneumonia, multiorgan dysfunction, and sepsis, were positively associated with mortality. Favipiravir, hydroxychloroquine and azithromycin were not associated with survival. Following multivariate analysis, male sex, severe pneumonia, multiorgan dysfunction, malignancy, sepsis and interstitial lung diseases were found to be independent risk factors for mortality. Among the biomarkers, procalcitonin levels on the 3rd-5th days of admission showed the strongest associations with mortality (OR: 6.18; 1.6-23.93). This study demonstrated that the mortality rate in hospitalized patients in the early phase of the COVID-19 pandemic was a serious threat and that those patients with male sex, severe pneumonia, multiorgan dysfunction, malignancy, sepsis and interstitial lung diseases were at increased risk of mortality; therefore, such patients should be closely monitored., Turkish Thoracic Society, The study partially funded by The Turkish Thoracic Society.

Objective: We prospectively investigated the neoendothelialization of transcatheter secundum atrial septal defect (ASD) closure in children receiving one of three different occluders. Methods: Transcatheter ASD closure was performed for 44 children. The patients were divided into three groups: group I: Amplatzer, group II: Lifetech CeraFlex, and group III: Occlutech Figulla Flex II septal occluder. The data were prospectively analyzed. Markers of the three phases of wound healing were studied in all patients before and on the 1st and 10th days and 1st month post intervention. Results: The mean age of children was 7.08±3.51 years, and the mean weight was 26.07±15.07 kg. The mean ASD diameter was 12.65±3.50 mm. Groups I, II, and III comprised 34.1%, 31.8%, and 34.1% patients, respectively. No significant differences were observed between the groups regarding patient number, age, defect size, device diameter, or total septum/device ratio (p>0.05). Inflammatory and proliferative phase marker levels increased following the procedure (p0.05). Conclusion: All three devices were composed of nitinol with different surface coating techniques. Although the different manufacturing features were claimed to facilitate of neoendothelialization, no differences were observed among the three devices 1 month following the procedure.

Objective To identify the prevalence of the practice of defensive medicine among Italian hospital physicians, its costs and the reasons for practising defensive medicine and possible solutions to reduce the practice of defensive medicine. Methods Cross-sectional web survey. Main outcome measures Number of physicians reporting having engaged in any defensive medicine behaviour in the previous year. Results A total of 1313 physicians completed the survey. Ninety-five per cent believed that defensive medicine would increase in the near future. The practice of defensive medicine accounted for approximately 10% of total annual Italian national health expenditure. Conclusions Defensive medicine is a significant factor in health care costs without adding any benefit to patients. The economic burden of defensive medicine on health care systems should provide a substantial stimulus for a prompt review of this situation in a time of economic crisis. Malpractice reform, together with a systematic use of evidence-based clinical guidelines, is likely to be the most effective way to reduce defensive medicine.

Background/aim For the early stage of nonsmall-cell lung cancer, surgical resection provides the best survival, but the surgical risk generally increases with age because of the increased prevalence of comorbidities, especially cardiovascular disorders. The aim of this study was to compare survival and mortality rates of two groups with different ages, younger and older than 70 years, who went curative resection for nonsmall-cell lung cancer. Materials and methods We analyzed the patients who underwent curative lung cancer surgery in the Department of Thoracic Surgery of Gaziantep University Research Hospital between January 1997 and November 2014. Patients were divided into 2 groups according to their ages. Results A total of 497 patients were included in data analysis (381 were under 70 years old and 116 of them were ≥70 years old). The older group showed a 1.4-fold increased risk of mortality hazard ratio when the probability of survival was analyzed by histological type, lymph node involvement, disease stage, and age. Conclusion There was no distinct increase in 30-day mortality rates of patients with nonsmall-cell lung cancer who were ≥70 years old, but the hazard rate for long-term survival was higher in the older group. Curative pulmonary resections due to lung cancer should be carefully performed in septuagenarians.