Maşide Arı, Melike Bağnu Yüceege, Emrah Arı, Fevzi Nuri Aydın
Aims: To facilitate the early diagnosis of the related patient group by investigating the level of Malondialdehyde (MDA) in high-risk pulmonary thromboembolism (PTE). In addition, it was aimed to see the effect of treatment after acute PTE on oxidative stress and to evaluate whether it is associated with the development of chronic thrombus. Methods: This study was conducted prospectively in 44 patients diagnosed with PTE in single-center. At the time of diagnosis, after 6 months of follow-up and treatment, the MDA levels of the patients were evaluated together with the controlled tests. Results: MDA level was found to be a determinant in the estimation of high-risk PTE. In addition, MDA level was found to be higher at the time of diagnosis and after treatment in patients with chronic thromboembolism. Conclusion: MDA level is a guiding parameter in high-risk PTE. In addition, the continuation of oxidative stress in the case of chronic thrombus may be important in the remodeling of the precapillary pulmonary artery.
{"title":"The role of malondialdehyde in the evaluation of the treatment response in acute pulmonary thromboembolism","authors":"Maşide Arı, Melike Bağnu Yüceege, Emrah Arı, Fevzi Nuri Aydın","doi":"10.51271/jopic-0020","DOIUrl":"https://doi.org/10.51271/jopic-0020","url":null,"abstract":"Aims: To facilitate the early diagnosis of the related patient group by investigating the level of Malondialdehyde (MDA) in high-risk pulmonary thromboembolism (PTE). In addition, it was aimed to see the effect of treatment after acute PTE on oxidative stress and to evaluate whether it is associated with the development of chronic thrombus. Methods: This study was conducted prospectively in 44 patients diagnosed with PTE in single-center. At the time of diagnosis, after 6 months of follow-up and treatment, the MDA levels of the patients were evaluated together with the controlled tests. Results: MDA level was found to be a determinant in the estimation of high-risk PTE. In addition, MDA level was found to be higher at the time of diagnosis and after treatment in patients with chronic thromboembolism. Conclusion: MDA level is a guiding parameter in high-risk PTE. In addition, the continuation of oxidative stress in the case of chronic thrombus may be important in the remodeling of the precapillary pulmonary artery.","PeriodicalId":497714,"journal":{"name":"Journal of Pulmonology and Intensive Care","volume":"EMC-25 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135323048","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}
Aims: Early diagnosis and treatment affect mortality in hospital-acquired pneumonia (HAP). Therefore, clinicians need some objective parameters for guiding treatment. The aim of this study was to determine the course of ‘‘clinical pulmonary infection score’’ (CPIS), C-reactive protein (CRP) and procalcitonin (PCT) in patients under treatment as well as the relationship of these parameters with each other and mortality. Methods: This single-center, prospective, cross-sectional study focused on cases of HAP in hospitalized patients. In patients with HAP; CPIS, CRP and PCT assays were assessed on the first day. Appropriate treatment was initiated according to Turkish Thoracic Society HAP Task Force recommendations. On the 3rd day, CPIS evaluation and on the 4th day CRP and PCT analysis were repeated. All the patients’ one month mortality rates were recorded. Results: Among the 25 patients, there were 14 females. The mean age was 66±15 years. The mean duration for HAP development was 9.4±8.2 days. With a cutt-off value of 65 for age CPIS, CRP, PCT, length of hospital stay and mortality rate was not found different (p>0.05), however as the age increased HAP development duration significantly decreased (r=-0.416, p=0.03). We demonstrated a significant change between the first and the follow-up values of fever (p=0.046), leukocyte (p<0.001), PaO2/FiO2 (p=0.016), secretion presence (p<0.001), culture positivity (p<0.001) as well as total CPIS (p=0.030). However, there wasn’t a significant difference in CRP and PCT levels. We couldn’t show any relation between CPIS domains, total CPIS, CRP, PCT, HAP development duration and mortality rates. Conclusion: Monitoring HAP treatment according to CPIS was found better than CRP and PCT. However, these parameters had no effect on mortality. For more accurate comments, studies with more patients are needed.
{"title":"The role of clinical pulmonary infection score and some infection biomarkers in diagnosis and follow up in hospital acquired pneumonia","authors":"Seher Satar, Ayşın Şakar Coşkun, Tuğba Göktalay, Aylin Özgen Alpaydın, Fatma Taneli, Hörü Gazi, Sinem Akçalı, Pınar Çelik, Arzu Yorgancıoğlu","doi":"10.51271/jopic-0019","DOIUrl":"https://doi.org/10.51271/jopic-0019","url":null,"abstract":"Aims: Early diagnosis and treatment affect mortality in hospital-acquired pneumonia (HAP). Therefore, clinicians need some objective parameters for guiding treatment. The aim of this study was to determine the course of ‘‘clinical pulmonary infection score’’ (CPIS), C-reactive protein (CRP) and procalcitonin (PCT) in patients under treatment as well as the relationship of these parameters with each other and mortality. Methods: This single-center, prospective, cross-sectional study focused on cases of HAP in hospitalized patients. In patients with HAP; CPIS, CRP and PCT assays were assessed on the first day. Appropriate treatment was initiated according to Turkish Thoracic Society HAP Task Force recommendations. On the 3rd day, CPIS evaluation and on the 4th day CRP and PCT analysis were repeated. All the patients’ one month mortality rates were recorded. Results: Among the 25 patients, there were 14 females. The mean age was 66±15 years. The mean duration for HAP development was 9.4±8.2 days. With a cutt-off value of 65 for age CPIS, CRP, PCT, length of hospital stay and mortality rate was not found different (p>0.05), however as the age increased HAP development duration significantly decreased (r=-0.416, p=0.03). We demonstrated a significant change between the first and the follow-up values of fever (p=0.046), leukocyte (p<0.001), PaO2/FiO2 (p=0.016), secretion presence (p<0.001), culture positivity (p<0.001) as well as total CPIS (p=0.030). However, there wasn’t a significant difference in CRP and PCT levels. We couldn’t show any relation between CPIS domains, total CPIS, CRP, PCT, HAP development duration and mortality rates. Conclusion: Monitoring HAP treatment according to CPIS was found better than CRP and PCT. However, these parameters had no effect on mortality. For more accurate comments, studies with more patients are needed.","PeriodicalId":497714,"journal":{"name":"Journal of Pulmonology and Intensive Care","volume":"59 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135323046","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}
Hüseyin Türkdağlı, Deniz Çelik, Hüseyin Lakadamyalı, Özkan Yetkin
Hypersensitivity pneumonia of the lung, also called "extrinsic allergic alveolitis" or "hypersensitivity pneumonitis", is a condition in which the lung tissue becomes inflamed for reasons other than microbial causes. There may be many different reasons. Among the most common reasons were bird feeding, agricultural works and air conditioners. There are acute, subacute or chronic (slowly progressing) forms. Acute and subacute forms may recur, while the chronic form progresses and causes permanent and irreversible damage such as fibrosis and emphysema. Bird proteins, mammalian proteins, fungi, bacterial proteins and small molecular weight chemicals are generally blamed for the formation of the disease. Sometimes the causative agent may not be identified. In this case, we aimed to present a patient who applied to our clinic due to complaints of sudden respiratory distress, rapid fatigue and cough as a result of dust chlorine exposure, and was diagnosed with alveolitis, hospitalized and followed up.
{"title":"Alveolitis as a result of dust chlorine exposure","authors":"Hüseyin Türkdağlı, Deniz Çelik, Hüseyin Lakadamyalı, Özkan Yetkin","doi":"10.51271/jopic-0023","DOIUrl":"https://doi.org/10.51271/jopic-0023","url":null,"abstract":"Hypersensitivity pneumonia of the lung, also called \"extrinsic allergic alveolitis\" or \"hypersensitivity pneumonitis\", is a condition in which the lung tissue becomes inflamed for reasons other than microbial causes. There may be many different reasons. Among the most common reasons were bird feeding, agricultural works and air conditioners. There are acute, subacute or chronic (slowly progressing) forms. Acute and subacute forms may recur, while the chronic form progresses and causes permanent and irreversible damage such as fibrosis and emphysema. Bird proteins, mammalian proteins, fungi, bacterial proteins and small molecular weight chemicals are generally blamed for the formation of the disease. Sometimes the causative agent may not be identified. In this case, we aimed to present a patient who applied to our clinic due to complaints of sudden respiratory distress, rapid fatigue and cough as a result of dust chlorine exposure, and was diagnosed with alveolitis, hospitalized and followed up.","PeriodicalId":497714,"journal":{"name":"Journal of Pulmonology and Intensive Care","volume":"40 12","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135323055","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}
Aims: Previous studies have demonstrated that certain laboratory indicators play a crucial role in the identification of infections and prognosis assessment in individuals afflicted with febrile neutropenia. The concentration of procalcitonin exhibits an elevation in the presence of bacterial and fungal infections, while remaining unaltered in the context of viral illnesses. The objective of this study was to assess the efficacy of procalcitonin as a diagnostic tool for detecting infection and predicting prognosis in patients with febrile neutropenia. Methods: The present investigation involved a retrospective analysis conducted at a single center, focusing on a cohort of 61 patients who received treatment for febrile neutropenia. The study encompassed the analysis of patients' age, gender, current circumstances, and laboratory test results. Procalcitonin levels were evaluated in first day of hospitalization. Results: The age range of the patients in the study varied from 18 to 84 years, with a median age of 58. Out of the whole sample, 29 individuals (47.5%) were female, while 32 individuals (52.5%) were male. Out of the total sample size, 27 patients (44.2%) were diagnosed with lung cancer, 13 patients (21.3%) were diagnosed with breast cancer, and 4 patients (14%) were diagnosed with testicular cancer. Out of the total patient population, 24 individuals exhibited microbiologically confirmed infections, while 9 patients presented with clinically characterized infections. Out of the total number of cases, 10 cases, accounting for 16.3% of the sample, led to fatality. The median procalcitonin values were 1.5 ng/ml in patients diagnosed with microbiologically confirmed infection and 0.6 ng/ml in those diagnosed with clinically suspected infection. Furthermore, it is worth noting that the median procalcitonin value among individuals with fever of unknown origin was found to be 0.6 ng/ml, with statistical significance indicated by a p-value of less than 0.001. The median procalcitonin level was found to be 17.70 ng/ml in instances resulting in mortality, whereas it was 0.56 ng/ml in cases without mortality (p<0.001). Conclusion: We determined that procalcitonin must be routinely used in order to show enfection and mortality in patients with febrile neutropenia. Because procalcitonin is a sufficient and appropriate examination to show infection and mortality so it can be beneficial to decide treatment method, and hospitalization. Procalcitonin may also be more useful in predicting the prognosis of patients with febrile neutropenia.
{"title":"The relationship between level of procalcitonin and mortality in patients who have been followed for solid organ malignancy with febrile neutropenia","authors":"Bayram Yeşil, Mustafa Yıldız","doi":"10.51271/jopic-0022","DOIUrl":"https://doi.org/10.51271/jopic-0022","url":null,"abstract":"Aims: Previous studies have demonstrated that certain laboratory indicators play a crucial role in the identification of infections and prognosis assessment in individuals afflicted with febrile neutropenia. The concentration of procalcitonin exhibits an elevation in the presence of bacterial and fungal infections, while remaining unaltered in the context of viral illnesses. The objective of this study was to assess the efficacy of procalcitonin as a diagnostic tool for detecting infection and predicting prognosis in patients with febrile neutropenia. Methods: The present investigation involved a retrospective analysis conducted at a single center, focusing on a cohort of 61 patients who received treatment for febrile neutropenia. The study encompassed the analysis of patients' age, gender, current circumstances, and laboratory test results. Procalcitonin levels were evaluated in first day of hospitalization. Results: The age range of the patients in the study varied from 18 to 84 years, with a median age of 58. Out of the whole sample, 29 individuals (47.5%) were female, while 32 individuals (52.5%) were male. Out of the total sample size, 27 patients (44.2%) were diagnosed with lung cancer, 13 patients (21.3%) were diagnosed with breast cancer, and 4 patients (14%) were diagnosed with testicular cancer. Out of the total patient population, 24 individuals exhibited microbiologically confirmed infections, while 9 patients presented with clinically characterized infections. Out of the total number of cases, 10 cases, accounting for 16.3% of the sample, led to fatality. The median procalcitonin values were 1.5 ng/ml in patients diagnosed with microbiologically confirmed infection and 0.6 ng/ml in those diagnosed with clinically suspected infection. Furthermore, it is worth noting that the median procalcitonin value among individuals with fever of unknown origin was found to be 0.6 ng/ml, with statistical significance indicated by a p-value of less than 0.001. The median procalcitonin level was found to be 17.70 ng/ml in instances resulting in mortality, whereas it was 0.56 ng/ml in cases without mortality (p<0.001). Conclusion: We determined that procalcitonin must be routinely used in order to show enfection and mortality in patients with febrile neutropenia. Because procalcitonin is a sufficient and appropriate examination to show infection and mortality so it can be beneficial to decide treatment method, and hospitalization. Procalcitonin may also be more useful in predicting the prognosis of patients with febrile neutropenia.","PeriodicalId":497714,"journal":{"name":"Journal of Pulmonology and Intensive Care","volume":"376 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135323057","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}
Aims: Coronavirus Disease 2019 (COVID-19) is a virus zoonotic in nature, which presents itself with a broad spectrum of respiratory involvement. Without any specific treatment, various treatment modalities and markers for severity have been suggested. This study aimed to investigate the role of melatonin in the severity of COVID-19 infection, with the hypothesis that melatonin levels correlated with mortality, ward and intensive care unit (ICU) admission. Methods: The study was performed as a single-center prospective cohort. Patients who had been evaluated at the emergency ward for COVID-19 suspicion were defined as the study population. Those who had at least one COVID-19 RT-PCR positivity and did not have a history of cranial operation, being a shift worker, or under melatonin treatment were chosen. Ninety-six patients were deemed suitable for the study who had all the criteria fulfilled. Descriptive analysis for demographic data, Spearman correlation, and Mann-Whitney test for nonparametric evaluation was used. Results: Eighty patients were considered suitable after excluding 16 patients, primarily due to improper melatonin sampling times. A positive correlation was seen between melatonin levels and intensive care admission, which was not observed in ward admission or overall mortality. This implicates the possibility of melatonin being used as a marker for the severity analysis of COVID-19. Conclusion: With limited sensitivity, melatonin may be used for the evaluation of ICU admission. Its role in ward admission and overall mortality remains limited.
{"title":"Role of serum melatonin level in COVID-19 mortality and hospital admission","authors":"Yasemin Yılmaz Aydın, Aynur Yurtseven, Kerem Ensarioglu, Kemal Aydın, Cemil Kavalcı, Bahar Kurt, Fatma Uçar","doi":"10.51271/jopic-0021","DOIUrl":"https://doi.org/10.51271/jopic-0021","url":null,"abstract":"Aims: Coronavirus Disease 2019 (COVID-19) is a virus zoonotic in nature, which presents itself with a broad spectrum of respiratory involvement. Without any specific treatment, various treatment modalities and markers for severity have been suggested. This study aimed to investigate the role of melatonin in the severity of COVID-19 infection, with the hypothesis that melatonin levels correlated with mortality, ward and intensive care unit (ICU) admission. Methods: The study was performed as a single-center prospective cohort. Patients who had been evaluated at the emergency ward for COVID-19 suspicion were defined as the study population. Those who had at least one COVID-19 RT-PCR positivity and did not have a history of cranial operation, being a shift worker, or under melatonin treatment were chosen. Ninety-six patients were deemed suitable for the study who had all the criteria fulfilled. Descriptive analysis for demographic data, Spearman correlation, and Mann-Whitney test for nonparametric evaluation was used. Results: Eighty patients were considered suitable after excluding 16 patients, primarily due to improper melatonin sampling times. A positive correlation was seen between melatonin levels and intensive care admission, which was not observed in ward admission or overall mortality. This implicates the possibility of melatonin being used as a marker for the severity analysis of COVID-19. Conclusion: With limited sensitivity, melatonin may be used for the evaluation of ICU admission. Its role in ward admission and overall mortality remains limited.","PeriodicalId":497714,"journal":{"name":"Journal of Pulmonology and Intensive Care","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135323051","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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