: BACKGROUND AND AIM: Mental disorders are common in chronic obstructive pulmonary disease (COPD) patients. In this study; anxiety/depression and affecting factors in COPD patients were examined. METHODS: COPD patients who applied to Akdeniz University Chest Diseases clinic between November 2019 and March 2020 were included in the study. The diagnosis and staging were assessed according to the Global Initiative for Chronic Obstructive Lung Disease 2020 (GOLD-2020). The data were collected via face-to-face interviews using the patient description form. In addition, COPD assessment test (CAT), modified-medical research council (m-MRC), and hospital anxiety and depression (HAD) scale were applied to the patients. Anxiety/depression status was assessed using HAD scale. We evaluated the relationship between HAD scores and questionnaire and clinical findings. The data were analyzed in SPSS 22.0 program. x 2 , ANOVA, Kruskal-Wallis, Student’s t-test, and Mann–Whitney-U test were used. Correlation and linear regression analysis were used. RESULTS: The majority of the 151 patients were male (84.8%), mean age was 66.1±9.5 years, and 27% were active smokers. Most of the patients had comorbidity (76.8%) and 4.6% of the patients reported that they had a psychiatric illness. The HAD-anxiety score was 4.70±4.03, and the HAD-depression score was 4.98±3.50. Depression and anxiety rates were 21.6% and 8.6%, respectively. The prevalence of anxiety and/or depression was found to be 23.7%. Multivariate analysis showed that the presence of comorbidity, severe COPD, and the number of complaints are the effective factors for both anxiety and depression. CAT and m-MRC scores were significantly correlated with HAD scores. CONCLUSIONS: Anxiety/depression was found five times more than that reported. Severe COPD, more complaints, and comorbidity were risk factors for anxiety/depression. were the these variables
{"title":"Anxiety depression scores and affecting factors in COPD patients","authors":"Nurgül Bozkurt","doi":"10.14744/ejp.2022.9021","DOIUrl":"https://doi.org/10.14744/ejp.2022.9021","url":null,"abstract":": BACKGROUND AND AIM: Mental disorders are common in chronic obstructive pulmonary disease (COPD) patients. In this study; anxiety/depression and affecting factors in COPD patients were examined. METHODS: COPD patients who applied to Akdeniz University Chest Diseases clinic between November 2019 and March 2020 were included in the study. The diagnosis and staging were assessed according to the Global Initiative for Chronic Obstructive Lung Disease 2020 (GOLD-2020). The data were collected via face-to-face interviews using the patient description form. In addition, COPD assessment test (CAT), modified-medical research council (m-MRC), and hospital anxiety and depression (HAD) scale were applied to the patients. Anxiety/depression status was assessed using HAD scale. We evaluated the relationship between HAD scores and questionnaire and clinical findings. The data were analyzed in SPSS 22.0 program. x 2 , ANOVA, Kruskal-Wallis, Student’s t-test, and Mann–Whitney-U test were used. Correlation and linear regression analysis were used. RESULTS: The majority of the 151 patients were male (84.8%), mean age was 66.1±9.5 years, and 27% were active smokers. Most of the patients had comorbidity (76.8%) and 4.6% of the patients reported that they had a psychiatric illness. The HAD-anxiety score was 4.70±4.03, and the HAD-depression score was 4.98±3.50. Depression and anxiety rates were 21.6% and 8.6%, respectively. The prevalence of anxiety and/or depression was found to be 23.7%. Multivariate analysis showed that the presence of comorbidity, severe COPD, and the number of complaints are the effective factors for both anxiety and depression. CAT and m-MRC scores were significantly correlated with HAD scores. CONCLUSIONS: Anxiety/depression was found five times more than that reported. Severe COPD, more complaints, and comorbidity were risk factors for anxiety/depression. were the these variables","PeriodicalId":42933,"journal":{"name":"Eurasian Journal of Pulmonology","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67324910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND AND AIM: Biologics can be used safely for patients with severe asthma during the coronavirus pandemic, but there is still a lack of information regarding their effects during SARS-CoV-2 infection. The aim of this study was to evaluate the impact of biologic therapies on the course of SARS-CoV-2 infection and to assess the outcome of COVID-19 for severe asthmatics in pandemic conditions. METHODS: A total of 100 severe asthma patients treated with biologics (7 treated with dupilumab, 22 with mepolizumab, and 71 with omalizumab) were included. Patients' demographic, clinical, and laboratory findings as well as the course of the COVID-19 disease were evaluated. RESULTS: Of the total 100 patients, 15% of patients were diagnosed with COVID-19. There were no significant differences between SARS-CoV-2 positive and negative patient groups in terms of demographic features, atopy, comorbidity, duration of asthma, and duration of biological use. The body mass index (BMI) was higher in the SARS-CoV-2 negative group than the positive group (p=0.005). Asthma exacerbation during COVID-19 was observed in 3 patients, and only 2 were hospitalized for 5 days. SARS-CoV-2 positive group exhibited lower eosinophil and lymphocyte levels when infected with COVID-19 than before COVID-19 (p=0.01 and p=0.0009 respectively). CONCLUSIONS: The rate of COVID-19 infection was higher in patients with severe asthma receiving biologics than in the general population. However, it can be speculated that treatment with biologics may have protection against severe COVID-19 and mortality. Further studies are required to investigate the role of biologic agents, which affect the level and function of eosinophils in viral infections, especially SARS-CoV-2.
{"title":"No increased risk of severe COVID-19 in asthma treated with biologics","authors":"Ş. Beyaz","doi":"10.14744/ejp.2022.9821","DOIUrl":"https://doi.org/10.14744/ejp.2022.9821","url":null,"abstract":"BACKGROUND AND AIM: Biologics can be used safely for patients with severe asthma during the coronavirus pandemic, but there is still a lack of information regarding their effects during SARS-CoV-2 infection. The aim of this study was to evaluate the impact of biologic therapies on the course of SARS-CoV-2 infection and to assess the outcome of COVID-19 for severe asthmatics in pandemic conditions. METHODS: A total of 100 severe asthma patients treated with biologics (7 treated with dupilumab, 22 with mepolizumab, and 71 with omalizumab) were included. Patients' demographic, clinical, and laboratory findings as well as the course of the COVID-19 disease were evaluated. RESULTS: Of the total 100 patients, 15% of patients were diagnosed with COVID-19. There were no significant differences between SARS-CoV-2 positive and negative patient groups in terms of demographic features, atopy, comorbidity, duration of asthma, and duration of biological use. The body mass index (BMI) was higher in the SARS-CoV-2 negative group than the positive group (p=0.005). Asthma exacerbation during COVID-19 was observed in 3 patients, and only 2 were hospitalized for 5 days. SARS-CoV-2 positive group exhibited lower eosinophil and lymphocyte levels when infected with COVID-19 than before COVID-19 (p=0.01 and p=0.0009 respectively). CONCLUSIONS: The rate of COVID-19 infection was higher in patients with severe asthma receiving biologics than in the general population. However, it can be speculated that treatment with biologics may have protection against severe COVID-19 and mortality. Further studies are required to investigate the role of biologic agents, which affect the level and function of eosinophils in viral infections, especially SARS-CoV-2.","PeriodicalId":42933,"journal":{"name":"Eurasian Journal of Pulmonology","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67326095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND AND AIM: Obstructive sleep apnea (OSA), having an increased inflammatory state due to an imbalance between sympathetic and parasympathetic activity, intermittent hypoxia, and increased cytokines, may aggravate the immune response for COVID-19 infection. Our aim was to evaluate the effect of OSA upon inflammatory response and length of stay in patients with favorable outcomes. METHODS: Patients admitted to an outpatient clinic after being hospitalized for treatment of COVID-19 were included consecutively in this cross-sectional multicenter observational study. STOP-Bang Questionnaire and a cut-off value of 3 points were used to identify patients with a high risk of OSA. RESULTS: Study population consisted of 201 patients with a median STOP-Bang score of 2.0 (1.0-4.0) points. According to the cut-off value of 3 points, 94 (46.8%) patients were classified as high-risk OSA patients. High-risk OSA patients were older, had many comorbidities such as hypertension, coronary artery disease, and diabetes mellitus, had higher serum D-dimer, ferritin, C-reactive protein, and procalcitonin measurements, and had a longer hospital stay. Possible risk factors associated with length of stay were age, lymphocyte count, and total STOP-Bang score. Multivariable analysis revealed that a 1 point increase in STOP-Bang score results in a 0.43 day longer hospital stay. CONCLUSIONS: Prevalence of OSA within COVID-19 patients with favorable outcomes is similar to the general population. However, the length of stay is related to the presence of high-risk OSA. Our study, therefore, suggests that OSA is related to delayed improvement of COVID-19 infection.
{"title":"High-risk obstructive sleep apnea is related to longer hospital stay in COVID-19 patients","authors":"Nilüfer Aylin Acet Öztürk","doi":"10.14744/ejp.2022.9921","DOIUrl":"https://doi.org/10.14744/ejp.2022.9921","url":null,"abstract":"BACKGROUND AND AIM: Obstructive sleep apnea (OSA), having an increased inflammatory state due to an imbalance between sympathetic and parasympathetic activity, intermittent hypoxia, and increased cytokines, may aggravate the immune response for COVID-19 infection. Our aim was to evaluate the effect of OSA upon inflammatory response and length of stay in patients with favorable outcomes. METHODS: Patients admitted to an outpatient clinic after being hospitalized for treatment of COVID-19 were included consecutively in this cross-sectional multicenter observational study. STOP-Bang Questionnaire and a cut-off value of 3 points were used to identify patients with a high risk of OSA. RESULTS: Study population consisted of 201 patients with a median STOP-Bang score of 2.0 (1.0-4.0) points. According to the cut-off value of 3 points, 94 (46.8%) patients were classified as high-risk OSA patients. High-risk OSA patients were older, had many comorbidities such as hypertension, coronary artery disease, and diabetes mellitus, had higher serum D-dimer, ferritin, C-reactive protein, and procalcitonin measurements, and had a longer hospital stay. Possible risk factors associated with length of stay were age, lymphocyte count, and total STOP-Bang score. Multivariable analysis revealed that a 1 point increase in STOP-Bang score results in a 0.43 day longer hospital stay. CONCLUSIONS: Prevalence of OSA within COVID-19 patients with favorable outcomes is similar to the general population. However, the length of stay is related to the presence of high-risk OSA. Our study, therefore, suggests that OSA is related to delayed improvement of COVID-19 infection.","PeriodicalId":42933,"journal":{"name":"Eurasian Journal of Pulmonology","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67326224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND AND AIM: The most important step in inpatient management to prevent mortality in COVID-19 patients is to diagnose clinical deterioration early and quickly. Early warning score (EWS) systems evaluate vital signs to detect early deterioration in a patient's clinical status. The aim of this study was to see how accurate the EWS is at predicting the need for a transfer to the intensive care unit (ICU) and the mortality in COVID-19 pneumonia patients who are hospitalized. METHODS: A total of 471 confirmed COVID-19 pneumonia patients treated in our COVID-19 wards were included in the present study. RESULTS: ICU admission occurred in 95 (20.1%) of the cases during hospitalization, with a death rate of 11.9%. Compared with patients who were not admitted to the ICU, those who were admitted had higher National Early Warning Score (NEWS), NEWS2, Modified Early Warning Score (MEWS), and Quick Sequential Organ Failure Assessment (qSOFA) score (p<0.001). NEWS was found to be superior to NEWS2, MEWS, and qSOFA in predicting patient clinical deterioration (p<0.001). NEWS outperformed NEWS2, MEWS, and the qSOFA score in predicting overall hospital mortality (p<0.05). ICU admission was substantially associated with high NEWS (>= 7) and NEWS2 (>= 7) (p=0.001, p=0.0028). CONCLUSIONS: NEWS and NEWS2 could be used routinely in pandemic wards to detect clinical worsening in COVID-19 pneumonia patients who are hospitalized.
{"title":"Predictive Value of Early Warning Scores for Clinical Deterioration and Mortality in Hospitalised COVID-19 Pneumonia Patients","authors":"U. Kasapoğlu","doi":"10.14744/ejp.2022.2004","DOIUrl":"https://doi.org/10.14744/ejp.2022.2004","url":null,"abstract":"BACKGROUND AND AIM: The most important step in inpatient management to prevent mortality in COVID-19 patients is to diagnose clinical deterioration early and quickly. Early warning score (EWS) systems evaluate vital signs to detect early deterioration in a patient's clinical status. The aim of this study was to see how accurate the EWS is at predicting the need for a transfer to the intensive care unit (ICU) and the mortality in COVID-19 pneumonia patients who are hospitalized. METHODS: A total of 471 confirmed COVID-19 pneumonia patients treated in our COVID-19 wards were included in the present study. RESULTS: ICU admission occurred in 95 (20.1%) of the cases during hospitalization, with a death rate of 11.9%. Compared with patients who were not admitted to the ICU, those who were admitted had higher National Early Warning Score (NEWS), NEWS2, Modified Early Warning Score (MEWS), and Quick Sequential Organ Failure Assessment (qSOFA) score (p<0.001). NEWS was found to be superior to NEWS2, MEWS, and qSOFA in predicting patient clinical deterioration (p<0.001). NEWS outperformed NEWS2, MEWS, and the qSOFA score in predicting overall hospital mortality (p<0.05). ICU admission was substantially associated with high NEWS (>= 7) and NEWS2 (>= 7) (p=0.001, p=0.0028). CONCLUSIONS: NEWS and NEWS2 could be used routinely in pandemic wards to detect clinical worsening in COVID-19 pneumonia patients who are hospitalized.","PeriodicalId":42933,"journal":{"name":"Eurasian Journal of Pulmonology","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67324099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND AND AIM: Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death worldwide, and the majority of patients have at least one comorbid condition of clinical significance. Therefore, we studied its prevalence and implication based on experience from the Republic of Moldova. METHODS: The study was a prospective cohort study that included 435 patients with COPD from 2015 to 2017. RESULTS: We found heart failure in 38.62% of the patients, hypertension in 50.11%, coronary artery disease in 23.45%, diabetes mellitus in 10.11%, renal failure in 1.15%, rheumatoid arthritis in 3.22%, depression in 4.83%, cognitive impairment in 4.37%, obesity in 29.89%, and cachexia in 3.22%. Only 24.65% of patients did not have comorbidities. One comorbidity was found in 23.73%, two in 24.19%, three or more in 27.42%. The Charlson comorbidity index (CCI) had a medium negative correlation with the 6-minute walking test (r=–0.37, p<0.001) and a weak correlation with the rate of exacerbations (r=0.17, p=0.016). CCI had a strong correlation with ADO (age, dyspnea and airflow obstruction) (r=0.75, p<0.001); moderate with BODE (body mass index, airflow obstruction, dyspnea, and exercise) (r=0.3, p<0.001); and weak with BODEx (body mass index, airflow obstruction, dyspnea, and exacerbations), CODEX (comorbidity, obstruction, dyspnea, and previous severe exacerbations), and DOSE (dyspnea, obstruction, smoking, and exacerbation). CCI had a medium correlation with St. George’s Respiratory Questionnaire (SGRQ) activity (r=0.36, p<0.001), impact (r=0.34, p<0.001), and total (r=0.37, p<0.001) scores, and the overall quality of life assessed by SGRQ and Clinical COPD Questionnaire. CONCLUSIONS: Patients with COPD require a multidisciplinary approach to assess and manage a variety of conditions, which influence the evolution and prognosis of COPD. Patients often have one or two comorbidities of clinical significance, and they are predominantly cardiovascular and metabolic. Patients with comorbidities tend to have a poorer health-related quality of life. Comorbidities can be assessed by multidimensional indexes such as ADO and BODE.
{"title":"COPD and comorbidities in the Republic of Moldova","authors":"A. Corlateanu","doi":"10.14744/ejop_78_21","DOIUrl":"https://doi.org/10.14744/ejop_78_21","url":null,"abstract":"BACKGROUND AND AIM: Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death worldwide, and the majority of patients have at least one comorbid condition of clinical significance. Therefore, we studied its prevalence and implication based on experience from the Republic of Moldova. METHODS: The study was a prospective cohort study that included 435 patients with COPD from 2015 to 2017. RESULTS: We found heart failure in 38.62% of the patients, hypertension in 50.11%, coronary artery disease in 23.45%, diabetes mellitus in 10.11%, renal failure in 1.15%, rheumatoid arthritis in 3.22%, depression in 4.83%, cognitive impairment in 4.37%, obesity in 29.89%, and cachexia in 3.22%. Only 24.65% of patients did not have comorbidities. One comorbidity was found in 23.73%, two in 24.19%, three or more in 27.42%. The Charlson comorbidity index (CCI) had a medium negative correlation with the 6-minute walking test (r=–0.37, p<0.001) and a weak correlation with the rate of exacerbations (r=0.17, p=0.016). CCI had a strong correlation with ADO (age, dyspnea and airflow obstruction) (r=0.75, p<0.001); moderate with BODE (body mass index, airflow obstruction, dyspnea, and exercise) (r=0.3, p<0.001); and weak with BODEx (body mass index, airflow obstruction, dyspnea, and exacerbations), CODEX (comorbidity, obstruction, dyspnea, and previous severe exacerbations), and DOSE (dyspnea, obstruction, smoking, and exacerbation). CCI had a medium correlation with St. George’s Respiratory Questionnaire (SGRQ) activity (r=0.36, p<0.001), impact (r=0.34, p<0.001), and total (r=0.37, p<0.001) scores, and the overall quality of life assessed by SGRQ and Clinical COPD Questionnaire. CONCLUSIONS: Patients with COPD require a multidisciplinary approach to assess and manage a variety of conditions, which influence the evolution and prognosis of COPD. Patients often have one or two comorbidities of clinical significance, and they are predominantly cardiovascular and metabolic. Patients with comorbidities tend to have a poorer health-related quality of life. Comorbidities can be assessed by multidimensional indexes such as ADO and BODE.","PeriodicalId":42933,"journal":{"name":"Eurasian Journal of Pulmonology","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67324196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although there has been a large number of studies focusing on the role of airways in coronavirus disease 2019 (COVID-19), the relationship still remains unclear. With the disruption of the defense mechanism of the airways, including the intact mucus barrier, ciliary activity, and normal cough reflex, sticky and difficult-to-remove sputum becomes the main problem and the cough becomes the main symptom. Although interferons are considered the main elements of the defense against the virus, the pathogenesis of COVID-19 is complex and cannot be elucidated with only elevated interferon levels;there is more. The progression of the disease is mainly determined by the type and the levels of interferons and the affected part of the respiratory system. The airways have an important role in the pathogenesis of COVID-19, as the microorganism uses the airways as a gateway to the body, being the first element of defense against the virus, the importance of its relationship with the immune system, and its importance in the treatment.
{"title":"Airway inflammation due to SARS-CoV-2","authors":"O. Karcıoğlu","doi":"10.14744/ejp.2022.8001","DOIUrl":"https://doi.org/10.14744/ejp.2022.8001","url":null,"abstract":"Although there has been a large number of studies focusing on the role of airways in coronavirus disease 2019 (COVID-19), the relationship still remains unclear. With the disruption of the defense mechanism of the airways, including the intact mucus barrier, ciliary activity, and normal cough reflex, sticky and difficult-to-remove sputum becomes the main problem and the cough becomes the main symptom. Although interferons are considered the main elements of the defense against the virus, the pathogenesis of COVID-19 is complex and cannot be elucidated with only elevated interferon levels;there is more. The progression of the disease is mainly determined by the type and the levels of interferons and the affected part of the respiratory system. The airways have an important role in the pathogenesis of COVID-19, as the microorganism uses the airways as a gateway to the body, being the first element of defense against the virus, the importance of its relationship with the immune system, and its importance in the treatment.","PeriodicalId":42933,"journal":{"name":"Eurasian Journal of Pulmonology","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67324479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Prognostic Value of Prognostic Nutritional Index in Patients with Non–Small-Cell Lung Cancer","authors":"Feyyaz Kabadayi","doi":"10.14744/ejp.2022.8003","DOIUrl":"https://doi.org/10.14744/ejp.2022.8003","url":null,"abstract":"","PeriodicalId":42933,"journal":{"name":"Eurasian Journal of Pulmonology","volume":"124 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67325084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
: BACKGROUND AND AIM: The use of computed tomographic pulmonary angiogram (CTPA) without determining pretest probability leads to overuse and morbidities as contrast-induced acute kidney injury (CI-AKI). We aimed to assess the predictive role of Wells’ rule and revised Geneva scores together with the D-dimer test in patients who underwent CTPA for the suspicion of pulmonary embolism (PE) and to investigate the frequency of CI-AKI. METHODS: This single-center study was conducted as a retrospective analysis of patients who underwent CTPA. Demographic and clinical variables, risk factors, pretest probability score (PPS), and biomarkers were recorded from written or electronic medical records. RESULTS: A total of 1259 CTPA scans performed for suspicion of acute PE were screened. After exclusion, we analyzed 895 CTPAs. PE rates in the emergency department and in-pa-tient wards were 9.1% and 13.9%, respectively. Immobility, high Wells’ rule, and Geneva scores were found to be predictors of PE. The [OR (95% CI)] were [12.92 (4.38–38.14)], p<0.001; [7.55 (1.96–28.61)], p<0.001; and [1.25 (1.07–1.39)], p=0.003, respectively. The diagnostic sensitivity of Wells’ rule and Geneva score for PE was 24.6% and 68.1%, respectively, while the diagnostic specificity for PE was 91.4% and 42.7% for Wells’ rule and revised Geneva score, respectively. CI-AKI was detected in 99 (20.7%) of 479 patients, and the history of myocardial infarction within 3 months was the only predictor of CI-AKI [OR (95% CI)] [6.30 (1.46–27.90)], p=0.014. CONCLUSIONS: D-dimer test and usage of PPS for patients considered PE may reduce overuse of CTPA and thereby CI-AKI prevalence.
{"title":"Predictive role of pretest probability scores and risk factors of contrast-induced acute kidney injury in patients who underwent CT pulmonary angiography for the suspicion of pulmonary embolism","authors":"O. Kilic","doi":"10.14744/ejp.2022.9521","DOIUrl":"https://doi.org/10.14744/ejp.2022.9521","url":null,"abstract":": BACKGROUND AND AIM: The use of computed tomographic pulmonary angiogram (CTPA) without determining pretest probability leads to overuse and morbidities as contrast-induced acute kidney injury (CI-AKI). We aimed to assess the predictive role of Wells’ rule and revised Geneva scores together with the D-dimer test in patients who underwent CTPA for the suspicion of pulmonary embolism (PE) and to investigate the frequency of CI-AKI. METHODS: This single-center study was conducted as a retrospective analysis of patients who underwent CTPA. Demographic and clinical variables, risk factors, pretest probability score (PPS), and biomarkers were recorded from written or electronic medical records. RESULTS: A total of 1259 CTPA scans performed for suspicion of acute PE were screened. After exclusion, we analyzed 895 CTPAs. PE rates in the emergency department and in-pa-tient wards were 9.1% and 13.9%, respectively. Immobility, high Wells’ rule, and Geneva scores were found to be predictors of PE. The [OR (95% CI)] were [12.92 (4.38–38.14)], p<0.001; [7.55 (1.96–28.61)], p<0.001; and [1.25 (1.07–1.39)], p=0.003, respectively. The diagnostic sensitivity of Wells’ rule and Geneva score for PE was 24.6% and 68.1%, respectively, while the diagnostic specificity for PE was 91.4% and 42.7% for Wells’ rule and revised Geneva score, respectively. CI-AKI was detected in 99 (20.7%) of 479 patients, and the history of myocardial infarction within 3 months was the only predictor of CI-AKI [OR (95% CI)] [6.30 (1.46–27.90)], p=0.014. CONCLUSIONS: D-dimer test and usage of PPS for patients considered PE may reduce overuse of CTPA and thereby CI-AKI prevalence.","PeriodicalId":42933,"journal":{"name":"Eurasian Journal of Pulmonology","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67325973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluation of whether smoking cessation among advanced lung cancer patients has a significant effect on anxiety and depressive symptoms","authors":"F. Güldaval","doi":"10.14744/ejp.2022.4002","DOIUrl":"https://doi.org/10.14744/ejp.2022.4002","url":null,"abstract":"","PeriodicalId":42933,"journal":{"name":"Eurasian Journal of Pulmonology","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67323947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
: Fungal empyema thoracis is a rare and emerging entity, and the increase in the rate of fungal infections is mainly due to the increasing use of broad-spectrum antibiotics, intravascular devices, and hyperalimentation, as well as to the increasing number of critically ill or immunocompromised patients. Candida species are the most common pathogens in fungal empyema thoracis, and it is extremely rare to isolate fungi as such in pleural fluid. We report here a 60-year-old male with a case of gastric carcinoma with perforation peritonitis who underwent laparotomy and partial gastrectomy and developed pleural effusion postsurgery. Cytological examination of the pleural fluid showed many yeast, budding, and pseudohyphae forms of fungal organisms morphologically consistent with Candida species in the background of inflammation.
{"title":"Fungal Empyema Thoracis due to Candida species: A diagnosis on fine needle aspiration cytology","authors":"K. Subramanian","doi":"10.14744/ejp.2021.8421","DOIUrl":"https://doi.org/10.14744/ejp.2021.8421","url":null,"abstract":": Fungal empyema thoracis is a rare and emerging entity, and the increase in the rate of fungal infections is mainly due to the increasing use of broad-spectrum antibiotics, intravascular devices, and hyperalimentation, as well as to the increasing number of critically ill or immunocompromised patients. Candida species are the most common pathogens in fungal empyema thoracis, and it is extremely rare to isolate fungi as such in pleural fluid. We report here a 60-year-old male with a case of gastric carcinoma with perforation peritonitis who underwent laparotomy and partial gastrectomy and developed pleural effusion postsurgery. Cytological examination of the pleural fluid showed many yeast, budding, and pseudohyphae forms of fungal organisms morphologically consistent with Candida species in the background of inflammation.","PeriodicalId":42933,"journal":{"name":"Eurasian Journal of Pulmonology","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67323982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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