Background: Many studies have found that viral infections affect different tissues, including the inner ear. Coronavirus disease 2019 (COVID-19), a viral infection, is a significant health problem worldwide. Prestin is a motor protein with important functions both in the outer hair cells of the inner ear and in cardiac tissue. In addition, prestin is promising as an early biomarker in the detection of ototoxicity. To determine the severity of infection in COVID-19 patients and to determine whether other tissues are affected by the infection, lactate dehydrogenase (LDH), C-reactive protein (CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase MB (CK-MB), biochemical markers such as ferritin and D-dimer are used. This study aimed to compare prestin levels in patients with COVID-19 and healthy volunteers.Methods: In blood samples taken from 45 patients diagnosed with COVID-19 and 40 healthy volunteers, prestin levels were determined with the kit that used an enzyme-linked immunosorbent assay method and was commercially available. At the same time, LDH, CRP, ALT, AST, CK-MB, ferritin, and D-dimer levels were also detected in both patients and healthy control groups and correlations with prestin levels were examined.Results: The main result of our study is that serum prestin levels in COVID-19 patients are significantly higher than in healthy controls (p < 0.001). In addition, a statistically significant strong positive correlation was found between prestin-LDL (r = 0.537, p = 0.001), prestin-CRP (r = 0.654, p = 0.001), and prestin-D-dimer (r = 0.659, p = 0.001).Conclusion: The levels of prestin, a motor protein in inner ear outer hair cells and cardiac myocytes, were found to be higher in COVID-19 patients than in healthy volunteers. It also showed a positive correlation with CRP and D-dimer. This may be associated with systemic dysfunction.

In this study, our aim was to examine the effect of obesity and depression on asthma control in a way that questions the usability of ABSI, which is new in abdominal obesity measurement.

ÖZ GİRİŞ ve AMAÇ: Cerrahi girişimler ve uygulanan anestezi sonrasında meydana gelen patofizyolojik değişiklikler akciğer komplikasyonlarının gelişimini kolaylaştırmaktadır

OBJECTIVE:To evaluate the rate of pneumococcal pneumonia (PP) among patients with community-acquired pneumonia (CAP) in Turkey and to investigate and compare features of PP and non-PP CAP patients.MATERIAL AND METHODS:This multicenter, non-interventional, prospective, observational study included adult CAP patients (age ≥ 18 years). Diagnosis of PP was based on the presence of at least 1 positive laboratory test result for Streptococcus pneumoniae (blood culture or sputum culture or urinary antigen test [UAT]) in patients with radiographic findings of pneumonia.RESULTS:Four hundred sixty-five patients were diagnosed with CAP, of whom 59 (12.7%) had PP. The most common comorbidity was chronic obstructive pulmonary disease (30.1%). The mean age, smoking history, presence of chronic neurological disease, and CURB-65 score were significantly higher in PP patients, when compared to non-PP patients. In PP patients, 84.8% were diagnosed based ony on the UAT. The overall rate of PP patients among CAP was calculated as 22.8% considering the UAT sensitivity ratio of 63% (95% confidence interval: 45-81). The rate of intensive care treatment was higher in PP patients (P = .007). While no PP patients were vaccinated for pneumococcus, 3.8% of the non-PP patients were vaccinated (P = .235). Antibiotic use in the preceding 48 hours was higher in the non-PP group than in the PP group (31.8% vs. 11.1%, P = .002). The CURB-65 score and the rate of patients requiring inpatient treatment according to this score were higher in the PP group.CONCLUSION:The facts that PP patients were older and required intensive care treatment more frequently as compared to non-PP patients underline the burden of PP.

Introduction: The SARS-CoV-2 virus affects many organs, especially the lungs, with widespread inflammation. We aimed to compare the endogenous oxidative damage markers of coenzyme Q10, nicotinamide dinucleotide oxidase 4, malondialdehyde, and ischemia-modified albumin levels in patients with pneumonia caused by SARS-CoV-2 and in an healthy control group. We also aimed to compare these parameters between patients with severe and non-severe pulmonary involvement. Methods: The study included 58 adult patients with SARS-CoV-2 pneumonia and 30 healthy volunteers. CoQ10 and MDA levels were determined by high-pressure liquid chromatography. NOX4 and IMA levels were determined by ELISA assay and colorimetric method. Results: Higher levels of CoQ10, MDA, NOX4, and IMA and lower levels of COQ10H were observed inpatients with SARS-CoV-2 pneumonia than in the control group. MDA, IMA, NOX4, and CoQ10 levels were significantly higher in patients with severe pulmonary involvement than in patients with non-severe pulmonary involvement, but no significant difference was observed in CoQ10H levels. CoQ10 levels were significantly and positively correlated with both ferritin and CRP levels. Conclusion: SARS-CoV-2 pneumonia is significantly associated with increased endogenous oxidative damage. Oxidative damage seems to be associated with pulmonary involvement severity.

INTRODUCTION: In our study, we aimed to examine the effect of Lung ultrasonography on prognostic factors (parapneumonic effusion, empyema development, etc.) in patients with a diagnosis of pneumonia who were followed up in the Chest Diseases Clinic and Anesthesia Intensive Care Unit. METHODS: Fifty patients with a pre-diagnosis of pneumonia and / or pleural effusion were included in our study between 01.01.2017 - 01.06.2018 in the Chest Diseases Department of Van Yüzüncü Yıl University Medical Faculty and in the Anesthesia Intensive Care Unit. The patients were followed up with lung ultrasonography and the factors affecting the prognosis of these cases were examined. RESULTS: Of the patients included in the study, 16 were female (32%), 34 were male (78%); Their mean age was 60.4 +- 19.4 (15-87). Pleural effusion was detected in 56% of the cases. 28.57% of 28 cases were evaluated as transudate and 71.42% as exudate. Tube thoracoscopy was performed in 4 cases and decortication in 1 case, no patient required fibrinolytic. The mean hospitalization period of the patients was 7.78 +- 5.44 days (min. 2-Max 22). DISCUSSION AND CONCLUSION: As a result of the data obtained in our study, we are of the opinion that lung ultrasonography supports the need for more frequent use in current practice due to its advantages such as high success in interventional procedures, low complication rate, and most importantly, the opportunity to operate at the bedside, especially in intensive care.

INTRODUCTION:As asthma has a wide range of inflammatory pathways, the researchers were focused on the markers that may be associated with exacerbation and stability in asthma.OBJECTIVE:Our aim is to investigate the serum levels of some inflammatory markers and cytokines in stable and exacerbated asthmatic patients.METHODS:The study included in 59 non-smoker asthma patient (Exacerbated=25, Stable=34) and 30 healthy volunteers. The serum level of periostin, YKL-40, IL-4, IL-5, IL-37, and TNF-α were detected by enzyme-linked immunosorbent assay.RESULTS:Except for IL-37, the periostin, YKL-40, IL-4, IL-5, and TNF-α level in asthmatic patients were significantly higher than those of healthy control. In the exacerbated group, the periostin, YKL-40, IL-5, and TNF-α level were significantly higher than stable asthma and healthy control groups. The serum levels of IL-4 in exacerbated and stable asthma groups were significantly higher than healthy control group. There was a significant difference between IL4 levels, in stable asthma and healthy control groups. In exacerbated asthma group, IL-37 level was significantly lower than stable and healthy control groups. The highest area under the ROC curve (AUC) was found for IL-4. While there was a significant negative correlation between these parameters and FEV1, there was a positive correlation between IL-37 and FEV1, but not significant.CONCLUSIONS:This study showed that increased serum periostin, YKL-40, IL-5, IL-4, and TNF-α and decreased serum IL-37 were associated with exacerbation showing uncontrolled asthma.

Purpose Obstructive sleep apnoea (OSA) involves recurrent obstructive apnoeas and hypopnoeas which cause cyclic hypoxia, reoxygenation and formation of reactive oxygen species (ROS). We aimed to investigate a member of the nicotinamide adenine dinucleotide phosphate oxidase (NOX) family of enzymes, specifically (NOX4), not previously studied in humans, as well as 8-OHdG/106dG, MDA and IMA, which are known to be associated with oxidative stress. We also evaluated these parameters in predicting the presence and severity of OSA. Methods All 120 subjects (90 with OSA, 30 healthy controls) underwent polysomnography and had blood serum samples taken at the same time of day. Subjects were grouped by presence and severity of OSA, and serum markers were compared among groups. Results Age and body mass index were not significantly different among groups. In the OSA group, the levels of NOX4, IMA, MDA and 8-OHdG/106dG were significantly higher than in the healthy control group. NOX4 and other parameters were positively correlated with the severity of OSA. For all parameters, the highest levels were detected in patients with severe OSA. Conclusions The repeated hypoxia of OSA is associated with increases in the serum levels of inflammatory mediators such as MDA, IMA and 8-OHdG/106dG and the ROS NOX4. In this study, NOX4 and other markers were associated with the presence and severity of OSA.

CASE DESCRIPTION:A 52-year-old female patient was admitted to our clinic with complaints of cough, sputum, fever and fatigue. The patient has been receiving immunosuppressive therapy for thrombocytopenic purpura for 5 years.CLINICAL FINDING:Inspiratory crackles were heard on both hemithorax. Oxygen saturation measured with the pulse oximeter was 97%. Chest X-ray showed diffuse reticular opacities that were more prominent in the upper zones of both lungs. WBC counts were 17,600 mm3 and Platelet counts were 29,000 mm3. Thorax CT showed that there were many thin-walled cavities and millimetric nodules accompanied by ground-glass infiltrates in the upper and middle lobes. Gram staining of bronchial fluid, taken by bronchoscopy, revealed Gram-negative bacilli and intense polymorphonuclear leukocytes. The bacteria were defined as Delftia acidovorans by BD Phoenix automated system.TREATMENT AND OUTCOMES:The patient was hospitalized with suspicion of opportunistic pulmonary infections and cavitary lung disease. After the empirical treatment of intravenous piperacillin-tazobactam and oral clarithromycin, her clinical and radiological findings significantly regressed, and she was discharged with outpatient follow-up.CLINICAL RELEVANCE:This is the first example of cavitary pneumonia due to Delftia acidovorans in an immunocompromised patient. We would like to emphasize that Delftia pneumonia should be considered in the differential diagnosis of pulmonary cavitary involvement in such patients.

The Ewing's sarcoma family of tumors (ESFT) incorporates both the wellrecognized primary bone and the extraskeletal soft tissue sarcomas. Primitive neuroectodermal tumors (PNET) and ESFT have a similar neural phenotype and can be considered in the same entity. Here, we will present 28 years old patient with Ewing Sarcoma. Patient was admited chest pain. Chest radiograph showed a suspicious lesion in the left paracardiac area. Computed tomography (CT) scan and positron emission tomography (PET)/CT result were compatible with malignant tumor. The patient was underwent surgical resection as the bronchoscopic result couldn't a malignant finding and pathological finding was detected as Ewing's sarcoma. Ewing's sarcoma should be considered in patients who are very fast growing in the lungs, are properly confined and suspected of malignancy in FDG-PET/CT.

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OBJECTIVES:It is well-known that pseudoexfoliative material deteriorates iris dilatation function. This material was also found in lung tissue. The aim of the study was to evaluate pulmonary function in patients with pseudoexfoliation.METHODS:This prospective study included 60 pseudoexfoliation syndrome patients without any pulmonary diseases and 52 age- and gender-matched controls without any pulmonary diseases. Patients were asked about their cigarette use and the presence of any systemic diseases such as diabetes mellitus, arterial hypertension and asthma. All cases underwent full ophthalmologic and general medical examinations including pulmonary auscultation and pulmonary posterior-anterior X-ray. Pulmonary function tests were used for evaluation of pulmonary function. FVC, FEV1 , FEV1 %, FEV1 /FVC and saturation values were recorded.RESULTS:Mean age was 67.1 ± 8.8 (44-82) years in the pseudoexfoliation group and 63.8 ± 9.4 (43-82) years in the control group (P > .05). Mean FEV1 was 1.60 ± 0.62 in the pseudoexfoliation group and 1.84 ± 0.61 in the control group (P = .036). Mean FEV1 % was 70.65 ± 23.89 in the pseudoexfoliation group and 83.46 ± 17.83 in the control group (P = .002). Mean FEV1 /FVC ratios were 0.72 ± 0.15 in the pseudoexfoliation group and 0.77 ± 0.11 in the control group (P = .043). No statistically significant differences were found between the groups for FVC, saturation or cigarette use.CONCLUSION:These results suggest that there is decline in some pulmonary functions in pseudoexfoliation syndrome.

INTRODUCTION: To investigate the effect of tracheostomy on weaning and prognosis in patients undergoing long-term invasive mechanical ventilation (IMV) due to acute respiratory insufficiency. METHODS: The study was prospectively conducted on 24 tracheostomized T(+) and 26 non-tracheostomized T(-) patients who undergo long-term IMV due to acute respiratory insufficiency, between 2007-2009. RESULTS: The mean age of patients was 50+-18 in T(+) group and was 61+-18 years in T(-) group (p=0.04). The mean values of the APACHE II score on the first day were 22.25+-6 in the T(+) group and 27+-7 in the T(-) group, respectively (p=0.01). In T(+) group, the duration of intensive care and mechanical ventilation was longer than T(-) group, and the mean age and APACHE II score was lower (p<0.05). The mortality rate was 50% (n: 12) in T(+) group and 73% in T(-) group (p>0.05). In T(+) group, one patient developed transient tracheal stenosis and another one developed pneumothorax. The presence of acute renal failure (ARF) was associated with mortality, regardless of tracheostomy (P <0.05). In all patients, ≥23.5, the APACHE II score was related to mortality with 71% sensitivity and 68% specificity. DISCUSSION AND CONCLUSION: In conclusion, our study suggests that there is no a significant effect of tracheostomy on weaning and prognosis in patients undergoing of the long-term IMV. In patients with tracheostomy, intensive care and duration of mechanical ventilation are higher than those of patients without tracheostomy. Additionaly, ≥23.5 APACHE II scores and presence of ARF is associated with mortality regardless of tracheostomy.

Chylothorax refers to the presence of lymphatic fluid in the pleural space secondary to leakage from the thoracic duct or one of its branches. Whatever the etiology is, the main cause is the deterioration of the integrity of the thoracic duct or the obstruction of the duct. In cases of chylothorax, the mostly observed complaint is the dyspnea that occurs with the accumulation of lymphatic fluid in the intrapleural space. If patients left untreated, firstly nutritional insufficiency, fluid and electrolyte imbalance and in progressed phases immune deficiency will be developed due to loss of lymphatic fluid. In the diagnosis of chylothorax, the analysis of pleural fluid that optioned by thoracentesis is important. Milk like appearance, more than 110mg/dL of triglyceride levels in chemical analysis and a ratio of cholesterol/triglyceride smaller than 1 are important criteria for diagnosis. Chylothorax that could be caused by various etiologies may cause mortality which makes its' treatment an obligation as soon as diagnosis established. In treatment, draining of chylotic fluid should be performed primarily to relieve breathing. After then, medium chain triglyceride, total parenteral nutrition and somatostatin or octreotid are used for conservative approach. In cases where those conservative approaches failed, procedures like, surgical ligation of duct, pleuroperitoneal shunting and pleurodesis are being considered for treatment. It needs to be seriously addressed and it should be noted that in delayed treatment chylothorax has a high mortality rate.

Pulmonary Langerhans Cell Histiocytosis (PLCH) is an idiopathic interstitial lung disease with Langerhans cell infiltration in the lung.PLCH X has non-spesific symptoms, and most patients have smoking history.A combination of stellate nodules, reticular and nodular opacities, upper zone cysts or honeycombing, preservation of lung volume and costophrenic angle sparing are highly specific for PLCH.To contribute to the literature, two cases are presented.First case is 30 years old man with 10 pack/years smoking history was admitted with cough and persevering interstitial opacities.Second case is 34 years old man with 15 pack/years smoking history was admitted with persistant cough.On thorax CT the first case had reticulonodular opacities at the perifery of the upper and middle zones, second case had multiple parenchymal cystic nodular lesions.Open lung biopsy performed, immunohistochemical examination CD1a, CD68, S100 detecting antigenpositive and histologically and radiologically confirmed diagnosed of PLCH.

Introduction: Chronic obstructive pulmonary disease (COPD) is a progressive condition characterized by poorly reversible airflow limitations associated with an abnormal inflammatory response of the lung. Methods: We investigated whether prolidase levels in serum, total antioxidant status, total oxidative status (TOS), and the oxidative stress index (OSI) were associated with the etiopathogenesis of COPD, and whether there is a relationship between prolidase activity and oxidative parameters and carotid artery intima-media thickness (CIMT) in patients with COPD. This study included 91 patients with COPD and 15 control cases. Routine haematological and biochemical parameters were determined in all patients. All subjects were fully informed about the study and provided consent. Results: The mean age of the patients with COPD was 61.3 ± 10.5 years and that of the control group was 56.2 ± 12.1 years. The control group had a significantly higher plasma prolidase level than that in the COPD group. TOS and OSI levels in the control group were significantly lower than those in the COPD group. However, no significant differences were found in TALs or CIMT levels between the COPD and control groups. A negative correlation was detected between prolidase activity and age; however, no significant difference in age was observed between the two groups. Conclusion: These results indicate that prolidase activity decreases in patients with COPD.