Fatma Demirci Üçsular

Aim Idiopathic pulmonary fibrosis (IPF) and chronic hypersensitivity pneumonitis (CHP) are interstitial lung diseases with overlapping clinical and radiological features, making differential diagnosis challenging. Inflammatory biomarkers such as neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been investigated in various diseases. This study aims to evaluate the role of NLR and PLR in distinguishing IPF from CHP. Materials and Methods This retrospective study included patients diagnosed with IPF and CHP based on multidisciplinary discussion between January 2013 and December 2018 at a tertiary chest diseases hospital. The neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios were calculated from blood samples obtained at the time of diagnosis. Demographic characteristics, laboratory parameters, and comorbidities were extracted from hospital records. Statistical analyses were performed to compare NLR and PLR values between the study groups and a healthy control group. Conclusion Our results indicate that NLR values were significantly higher in both IPF and CHP groups compared to the healthy control group. However, there was no statistically significant difference between IPF and CHP groups, suggesting that NLR and PLR are not reliable markers for differentiating these diseases. Further studies are needed to explore alternative biomarkers for the differential diagnosis of IPF and CHP. Keywords Idiopathic pulmonary fibrosis, chronic hypersensitivity pneumonitis, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, inflammatory biomarkers

In this study conducted in a single center in Türkiye, we aimed to investigate the effect of sex differences on survival and treatment adverse effects in 100 patients with advanced non-small cell lung carcinoma (NSCLC) treated with immune checkpoint inhibitors. This was a single-center, retrospective, observational study. All 100 patients with non-small cell lung carcinoma admitted to the Pulmonary and Medical Oncology Department of a Training and Research Hospital between January 2018 and March 2024 were evaluated. Demographic data, cancer characteristics, overall survival, and adverse effects of immune checkpoint inhibitors were investigated in the male and female patient groups. Patients were treated with nivolumab and atezolizumab as immune checkpoint inhibitors (ICI). This study included 100 patients, with 88 (88%) men and 12 (12%) women. The average age of the patients was 64.3±8.5 years, 63% had adenocarcinoma, and 80.6% of all patients were stage 4. Although overall survival was significantly lower in women compared to men in univariate analysis (P=0.047), this difference disappeared in multivariate analysis (P=0.168). Adverse effects were observed in 91% of the patients. Pleural effusion (P=0.040), hypothyroidism (P=0.003), and rash (P<0.001) were more common in women, whereas tiredness (P=0.804), pneumonitis (P=0.097), and hyperthyroidism (P=0.507) were not significantly different according to sex. The average follow-up period was 33.8±22.6 months, and 25% of patients died. The association of sex differences with adverse effects and survival in patients with NSCLC receiving ICI treatment is not fully understood. Further studies are needed to support this area of interest.

Giriş: Alt solunum yolu enfeksiyonları (ASYE) hastaneye ayaktan başvurularda ve yatan hastalarda önemli mortalite ve morbidite nedenidir. Hastane yatışı gerektiren ASYE vakalarında antibiyoterapinin zamanında başlanması önemlidir. Enfeksiyon tablosuna yol açan etkeni belirlemek için solunum yolu kültürleri alınmadan başlanan ampirik antibiyoterapi ve “en geniş” spekturumlu antibiyotikleri kullanma eğilimi enfeksiyon hastalıklarının yönetimini zorlaştırmakta, antibiyotik direnci gibi ciddi bir sorunu karşımıza çıkarmaktadır. Bu çalışmada hastaneye yatırılan ASYE olgularında izole edilen etkenler, antibiyotik direnç oranları, hastaların önceden hastaneye yatış ve antibiyotik kullanım durumları araştırılmıştır. Yöntem: Bu çalışmada 2013-2018 yılları arasında hastanemize ASYE tanısı ile yatırılan ve solunum yolu örneği kültürlerinde üreme saptanan olguların demografik özellikleri, hastane yatış sayıları, antibiyotik kullanım öyküleri ile kültürle elde edilmiş etkenleri ve antibiyotik dirençleri kesitsel tanımlayıcı metotla araştırılmıştır. Bulgular: 469 hastadan izole edilen 484 etkeni ve bu etkenlerin antibiyotik direnç profillerini inceledik. Hastaların etkenleri balgam ya da bronkoskobik aspirasyon örneklerinden elde edildi. Olguların çoğu erkek cinsiyette ve 63 yaşın üzerinde idi. En fazla izole edilen etken Pseudomonas aeruginosa (n= 220; %44) idi. Hastaların 451 (%96) tanesine yatışta ampirik antibiyotik başlanmış ve 247 tanesine (%65) başlanan antibiyotik ortalama 7,9 gün sonra değiştirilmişti. Hastalarımızın 228’i (%49) son bir yıl içinde en az iki kez hastaneye yatırılmış; 43 (%9.2) hasta son bir ay içinde antibiyotik almıştı. Son hafta içinde antibiyotik kullanmış ve halihazırda kullanmakta olan 19 hastanın 8’inde P. aeruginosa (%42) izole edildi. İzole edilen 17 S. pneumonia kökeninde bir (%6) penisilin, üç (%17) makrolid dirençli izolat saptandı. H. influenza 33 olguda izole edildi. Üç olguda (%8) ampisilin ve dört (%12) kinolon direnci rapor edildi. Tartışma ve Sonuç: Ampirik antibiyotik tedavisi başlanırken, artan kinolon direncinin ve olguların yarısından fazlasında P. aeruginosa etken olduğunun göz önüne alınması, özellikle daha önce hastaneye yatış sıklığı ve antibiyotik kullanma öyküsünün sorgulanması ve lokal antibiyotik direnç paternlerinin göz önüne alınmasının gerekli olduğu sonucuna vardık.

The comparison of exacerbation and pneumonia before and after conjugated pneumococcal vaccination in patients with chronic obstructive pulmonary disease, and the effect of inhaled corticosteroid use on results Introduction: Pneumococcal infections and exacerbations are important causes of mortality and morbidity in chronic obstructive pulmonary disease (COPD). The use of inhaled corticosteroids and pneumococcal vaccination are suggested for the control of the disease progression and exacerbations. The aim of this study is to assess the effect of pneumococcal conjugate vaccine on pneumonia and exacerbation in COPD patients using inhaled corticosteroids (ICSs). The secondary aim is to analyze the effect of ICS use and different ICS types, if administered, on exacerbation and pneumonia incidence in the study population. Materials and Methods: Medical records of 108 adult patients with COPD who were vaccinated with the pneumococcal conjugate vaccine (PCV13) were retrospectively evaluated. The number of acute exacerbations and pneumonia within one year before and after vaccination were evaluated in all included COPD patients. The comparison analysis was also performed based on the ICS types. Results: There were statistically significant differences between the mean numbers of pneumonia and exacerbations before and after vaccination (p< 0.05). There were no significant differences in the mean pneumonia attacks and acute exacerbations between patients using ICS and not using ICS (p> 0.05). Conclusion: This study revealed that PCV13 provides a significant decrease in both exacerbation and pneumonia episodes in COPD patients. On the other hand, the use of ICSs and the types of ICSs were not found to have adverse effects on pneumonia and acute exacerbations in vaccinated COPD patients.

Comorbidity,COVID-19,elderly patient,mortality

Objective: In our study, we aimed to examine the characteristics of COVID-19 disease, disease severity, comorbidities and mortality rates in elderly patients compared with non-elderly patients. Methods: Patients(n:469) who were followed up in outpatient, inpatient and intensive care units with the diagnosis of COVID-19 between 11 March 2020 - 01 June 2020 were retrospectively included in the study. Two groups of patients were formed, namely the elderly group (≥65 years, n:101) and non-elderly ( 56 can be used to predict cut-off mortality.

Introduction: the aim of this study is to investigate and report on the data regarding the clinical characteristics and outcomes of healthcare workers with COVID-19 at tertiary education hospitals from Turkey. Materials and Methods: This was a single center, retrospective, descriptive and observational study using cross-sectional data, which were collected from confirmed COVID-19 patients at a tertiary education hospital. Patients' demographic and clinical characteristics, mortality rates, and the factors associated with hospitalization were analyzed. Results: By May 15, 2020, 480 patients were diagnosed with COVID-19 in our hospital where 49 (10.2%) of whom were HCWs. The mean age was 40.0 +/- 8.45 (75.5% female). The most common symptoms were cough (32.7%), fever (30.6%), and myalgia (14.3%). Comorbidities were present in 32.7% of the patients. Most of the HCWs were nurses (53.1%) and physicians (18.4%), and the remaining 14 (28.6%) were cleaning and administrative staff. The severity of the disease was mild in 65.3% and severe in 34.7% HCWs. Leukocyte, neutrophil, lymphocyte and platelet values were statistically lower in hospitalized patients. There was a statistically significant relationship between the presence of infiltration on the chest X-ray, and the patient's symptoms with the severity of the disease (respectively p= 0.002 and 0.009). Conclusion: In conclusion, the frequency of COVID-19 in healthcare workers is high. The study presents the characteristics of HCWs infected with coronavirus from a single center in Turkey.