The predictors of COVID-19 mortality in a nationwide cohort of Turkish patients

he 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, corre sponding 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

A Case Report of Giant Lung and Liver Hydatic Cyst

28 yaşında kadın hasta yüksek ateş, karın ağrısı  şikayeti ile acil servise başvurdu. Hasta acil serviste yapılan tetkikler sonucu pnömoni tanısıyla servise yatırıldı. Hikayesinde daha öncesinde bilinen bir hastalık öyküsü olmayan hastanın, bir haftadır sağ omuz ve sağ kol ağrısı şikayeti olduğu öğrenildi. Ateş: 38,9º C, genel durum orta, solunum sesleri olağandı. Hastanın tetkilerinde C reaktif protein (CRP):9,1 mg/dl ve hemoglobin (HGB):9,82 g/dL olması dışında patoloji yoktu. Posteroanterior akciğer (PA akciğer) grafisinde sol akciğerde kalp sınırını silmeyen tüm zonlarda homojene yakın dansite saptandı. Öksürük, balgam  şikayeti olmayan hasta, PA akciğer grafisi ile birlikte değerlendirildiğinde, kitle olabileceği düşünülerek Toraks Bilgisayarlı Tomografi (BT) çekildi. Toraks BT 'de sol akciğerde 17x9x8 cm boyutlarında kalın cidarlı ve karaciğeri tamamen kaplayan 20 cm'lik kistik lezyon saptandı. Kist hidatik ön tanısıyla Göğüs Cerrahisi Kliniği ile konsultasyon yapıldı. Hastaya Göğüs Cerrahisi Kliniği tarafından operasyon uygulandı. Bu olgu, akciğer ve karaciğerde yer kaplayan büyük kistlerin olmasına rağmen, geç tanı alması nedeniyle sunulmuştur.Twenty?eight years old female who was presented with fewer and abdominal pain was admitted to our hospital's emergency department (ED). The patient was hospitalized   with diagnosis of pneumonia based on the tests performed at ED. She has been having shoulder and abdomen pain for one week without a known history of the disease earlier in the story. Her body temparature was 38.9º C and pulmonary examination was normal. There was no abnormal findings  in her laboaratuary tests except that; CRP was 9.1 mg/dl and HGB was 9.82 g/dL. Chest x?ray revealed  almost homogeneous density in all zones, especially in the left lung field, but cardiac contour was protected. She did not have cough or sputum, and based on  her chest x?ray findings, we decided to examine CT scan of the lungs, suspecting lung mass. CT report demonstrated   17x9x8 cm thick walled cystic lesion in the left lung and 20 cm cystic lesion covering the liver . The patient consulted with a thoracic surgeon with a preliminary diagnosis of hydatic cyst. The patient underwent surgery by by the Thoracic Surgery Clinic. This case was presented because of the late diagnosis, despite the precence of large cysts in the lung and liver

Smoking Cessation Success and Affecting Factors in Geriatric Patients

Background: There are difficulties in the treatment of smoking cessation in elderly patients. However, elderly smokers who gave up smoking had lower rates of death from heart attack, stroke, and cancer, as well as improved cognitive function. This study aimed to investigate the affecting factors and the success of smoking cessation rate in patients aged 60 and over in Turkey. Methods: Six smoking cessation outpatient clinics from four provinces were included in the study. The records of 1,065 patients who applied to a smoking cessation outpatient clinic between 2016 and 2019 and who were 60 yr of age or older were scanned. Overall, 917 cases that could be reached after treatment were included in the study. Smoking cessation rates at the first month, 3rd month, 6th month, 9th month and 12th month were given. Results: Of the 917 cases, 65.1% were male and 34.9% were female. Smoking cessation rates were 45.6% on the first month, 39% on the third month, 35.1% on the sixth month, 31.2% on the ninth month, and 30.3% at the twelfth month. Smoking cessation success was higher in men than in women. Conclusion: Since the success of smoking cessation in the elderly was similar to that of adults. Since smoking is an independent risk factor for death in the elderly, there should be greater willingness to provide elderly patients with smoking cessation treatment to reduce physical function loss and promote healthier aging

Küçük hücreli dışı akciğer karsinomu olan erkek olguda nadir bir tutulum: Meme metastazı

The breast is one of the uncommon site of metastasis in nonsmall cell lung cancer. Breast metastasis was detected by breast tissue biopsy and immunohistochemical analysis in a 59 year old male patient who was diagnosed previously as non-small cell lung cancer. We reported this case because it is extremely rare.Meme, küçük hücreli dışı akciğer karsinomunun nadir olarak metastaz yaptığı organlardan biridir. Küçük hücreli dışı akciğer karsinomu tanısı konulan, 59 yaşındaki erkek hastada meme dokusunun biyopsisi ve immunhistokimyasal analizi sonucu meme metastazı saptanmıştır. Olgu nadir görülmesi nedeniyle sunulmuştur