Turkish thoracic society early career members task force group’s virtual congress notes: european respiratory society international congress 2020

In this article, Early Career Task Force Group members of the Turkish Thoracic Society summarize the European Respiratory Society 2020 virtual congress. Current developments in the field of respiratory diseases were compiled with the addition of sessions specific to coronavirus disease 2019 this year. Almost all of the congress sessions were examined, and the important and striking results of the congress were highlighted. Congress sessions were attended by expert researchers, and the prominent messages of each session were highlighted in short summaries. They were then grouped under relevant titles and ranked in order of meaning and relation. It was finalized by a team of researchers

Factors Influencing Diagnostic Success of Computed Tomography-guided Transthoracic Needle Biopsy in Intrathoracic Lesions: An Experience of a Reference Chest Disease Hospital

Introduction:Transthoracic needle biopsy (TNB) is a common, safe and inexpensive procedure used in the diagnosis of intrathoracic lesions. Until today, there is still no study about the influence of standardized uptake value (SUVmax) in positron emission tomography/computed tomography (PET/CT) on the diagnostic success of TNB in intrathoracic lesions. We aimed to analyze the factors, one of which was the SUVmax value influencing the diagnosis success of CT-guided TNB in pulmonary, mediastinal and pleural lesions. Secondary aim was to investigate the predictive clinical factors of complications.Methods:A retrospective study of 403 patients who underwent CT-guided TNB at a reference chest diseases hospital between February 2019 and February 2021 was conducted. A pulmonologist had performed the procedure with a 20-gauge fine-needle (Spinal) or a 14-gauge automated needle (tru-cut). Data of pathology, microbiology and clinical follow-up of the patients were collected. A chi-square and Student’s t-test were used to evaluate the patient-related factors (gender and smoking), lesion-related factors (type, side, location, size, presence of necrosis observed by CT, SUVmax value in PET/CT), and procedure factor (type of needle) on the diagnostic success. Additionally, associations between clinical characteristics of patients and the complications were assessed.Results:A total of 403 patients underwent CT-guided TNB were enrolled and overall success was 70% (284/403). Smoking history (75% vs 43%, p=0.02) was predictor for diagnostic success. Lesion size and SUVmax value were significantly high in diagnosed patients (for both p<0.001). Diagnostic success was high in peripheral and central lesions, more notably in central lesions (p=0.004, p=0.016, respectively). The 9.2 SUVmax cut-off value had sensitivity of 79%, specificity of %53, success of 79% (p<0.01). Cardiovascular diseases, anti-coagulants, vitamin K antagonists, and salicylate induced complications (p=0.031, p=0.022, p=0.011, p=0.04, respectively). Low-molecular-weight-heparin was associated with hemorrhage (p=0.016).Conclusion:We observed that type, size and SUVmax value of lesion and smoking status were the predictive factors for a diagnostic biopsy

Effects of Gluteus Maximus Muscle Strength on Ataxia, Gait, and Equilibrium in Multiple Sclerosis

Introduction: Multiple sclerosis (MS) is an autoimmune disease that causes scar tissue in the nervous system and seriously affects the quality of life of people. Muscle weakness, spasticity and coordination problems are seen primarily in the lower extremities. Strengthening exercises improve muscle strength in people with multiple sclerosis, but there is no consensus on their effect on walking capacity. Methods: To determine the relationship between gluteus maximus muscle strength, ataxia, balance and walking capacity in Multiple Sclerosis. An experimental study design was applied. Gluteus maximus muscle strength was measured using a dynamometer. Walking capacity was determined by the 6-minute walk test (6MWT) and dynamic gait index (DGI). Balance was evaluated with the one-leg standing test (SLS). The severity of ataxia was measured with the International Ataxia Rating Scale (ICARS). Fatigue was evaluated with VAS and quality of life of all patients with SF36 short form. Results: EDSS mean of the study = 3.39 ± 1.4; 2 men and 16 women with mean age = 37.17 ± 9.16 years were included. 6MWT, DGI, ALS, ICARS, VAS were different before and after treatment (p\u3c0.05). There was no significant difference other than physical function and general health among the sub-parameters of SF36 (p\u3e0.05). Correlation of muscle strength with ataxia, gait and balance was not significant (p\u3e0.05) Conclusion: In individuals with MS, the fact that the treatment program consists of modalities that include balance and sensory exercises as well as muscle strengthening exercises increases the success of rehabilitation

Impact of Nosocomial COVID-19 Infection Among Hospitalized Patients with Respiratory Diseases

Objective: There are very few studies concerning the frequency and course of nosocomial Coronavirus disease-2019 (COVID-19) infection among patients hospitalized having diseases other than COVID-19. In our study, patients who were admitted to the pulmonology inpatient clinic from the emergency room due to non-COVID-19 diseases and later diagnosed with COVID-19 (index cases) and the nosocomial transmission caused by these patients and the clinical outcomes were analyzed. Method: This study was carried out on 44 inpatients without COVID-19 at a pulmonology inpatient clinic during the first wave of COVID-19 pandemic. Oro-nasopharyngeal swab samples were taken at the time of hospitalization to detect COVID-19 by reverse transcription-polymerase chain reaction (RT-PCR) test. The test results of four patients were found to be positive. Due to the risk of nosocomial transmission, the remaining patients were re-evaluated for COVID-19 disease by clinical, radiological, and RT-PCR tests (1 to 3 times, and/or if symptoms developed). All patients were followed up for 30 days after discharge. Results: Thirty-six males (81%) and 8 females (19%) with a mean age of 65.6±13.6 (31-93) years were included in the study. Twenty-five of these patients had cancer, six had chronic obstructive pulmonary disease exacerbation, four had an aggravation of idiopathic pulmonary fibrosis, three had infected bronchiectasis, two had pulmonary embolisms, and four had other disorders. The RT-PCR test results were found positive in 4 patients. In about two weeks, COVID-19 infection emerged in 16 of the remaining 40 patients, and 10 of them (63% of the infected) died. The RT-PCR test results of patients with COVID-19 infection were found to be positive on day 8.2 averagely (6-13). Conclusion: Nosocomial transmission of COVID-19 may create a risk of severe illness and death among vulnerable patients. It is crucial to take necessary measures in order to reduce the risk of COVID-19 transmission in hospitals

Evaluation of patients with fibrotic interstitial lung disease: Preliminary results from the Turk-UIP study

OBJECTIVE: Differential diagnosis of idiopathic pulmonary fibrosis (IPF) is important among fibrotic interstitial lung diseases (ILD). This study aimed to evaluate the rate of IPF in patients with fibrotic ILD and to determine the clinical-laboratory features of patients with and without IPF that would provide the differential diagnosis of IPF. MATERIAL AND METHODS: The study included the patients with the usual interstitial pneumonia (UIP) pattern or possible UIP pattern on thorax high-resolution computed tomography, and/or UIP pattern, probable UIP or possible UIP pattern at lung biopsy according to the 2011 ATS/ERSARS/ALAT guidelines. Demographics and clinical and radiological data of the patients were recorded. All data recorded by researchers was evaluated by radiology and the clinical decision board. RESULTS: A total of 336 patients (253 men, 83 women, age 65.8 +/- 9.0 years) were evaluated. Of the patients with sufficient data for diag-nosis (n=300), the diagnosis was IPF in 121 (40.3%), unclassified idiopathic interstitial pneumonia in 50 (16.7%), combined pulmonary fibrosis and emphysema (CPFE) in 40 (13.3%), and lung involvement of connective tissue disease (CTD) in 16 (5.3%). When 29 patients with definite IPF features were added to the patients with CPFE, the total number of IPF patients reached 150 (50%). Rate of male sex (p<0.001), smoking history (p<0.001), and the presence of clubbing (p=0.001) were significantly high in patients with IPE None of the women <50 years and none of the men <50 years of age without a smoking history were diagnosed with IPE Presence of at least 1 of the symptoms suggestive of CTD, erythrocyte sedimentation rate (ESR), and antinuclear antibody (FANA) positivity rates were significantly higher in the non-IPF group (p<0.001, p=0.029, p=0.009, respectively). CONCLUSION: The rate of IPF among patients with fibrotic ILD was 50%. In the differential diagnosis of IPF, sex, smoking habits, and the presence of clubbing are important. The presence of symptoms related to CTD, ESR elevation, and EANA positivity reduce the likelihood of IPF

Rare presentation of postcholecystectomy syndrome: Magnetic resonance cholangiopancreatography findings of remnant gallbladder

Post-cholecystectomy syndrome is defined as recurrent or persistent symptoms, consisting of upper abdominal pain or dyspepsia after cholecystectomy. Post-cholecystectomy syndrome occurs due to biliary and non-biliary disorders. Biliary stricture, remnant or recurrent bile calculi, strictures involving the sphincter of Oddi or biliary dyskinesia are common cause of this syndrome. Remnant gallbladder and retained calculi in the remnant gallbladder after incomplete cholecystectomy are rare cause of post-cholecystectomy syndrome. In this study, our purpose was to define findings of remnant gallbladder, which is a rare cause of post-cholecystectomy syndrome with magnetic resonance cholangiopancreatography in two patients

Country-based analysis of COVID-19 publications in the first few months of the pandemic

Dear Editor, Assisted by the advanced technology and trade, the novel coronavirus has swiftly diffused around the globe. In a matter of few months, by March 2020, the world was faced with a pandemic1 . The fatality rates have varied within a wide band according to countries. Hospital capacities have been tested severely as SARS-CoV-2 spread at unprecedented rates, causing COVID-19 patients to need heavy hospitalization and intensive care. In almost all countries, lockdowns have led to economic and psychological problems. The urgency and global scope of the pandemic created a lacuna to be filled by national and international information sharing. Almost all scientific journals have prioritized COVID-19 and published additional issues to share the knowledge and experience on COVID-19. The need for inter-disciplinary and multidisciplinary collaboration required a prompt adaptation of academics to the crisis management

A Rare cause of acute abdomen: Idiopathic necrosis of the fourth part of the duodenum

Duodenum nekrozu peritonit nedenlerinden biridir. İyi bilinen ve mutlak girişim gerektiren cerrahi acillerdendir. Çoğunlukla cerrahi sonrası duodenum güdüğünün kanlanmasının iyatrojenik nedenlere bağlı bozulması veya nekrotizan pankreatit sonucu gelişmektedir. Bu yazıda akut karın bulguları acil servise başvuran herhangi bir etiyolojik neden saptanmaksızın duodenumun 4. kısmında nekroz tespit edilen 69 yaşında kadın hasta sunulmuştur. Çekilen abdominal bilgisayarlı tomografisinde anormal değişiklikler saptanmış ve laparatomi yapılan hasta tüp duodenostomi uygulanarak başarılı bir şekilde tedavi edilmiştir. (Gazi Med J 2012; 23: 29-32)Duodenal necrosis is one of the causes of peritonitis. It remains a well-known surgical emergency requiring prompt surgical intervention. Duodenal necrosis mostly occurs following iatrogenic devascularisation of a duodenal stump or in the course of necrotising pancreatitis. We present a case of idiopathic necrosis of the fourth part of the duodenum without a certain aetiologic cause in a 69-year-old woman who was admitted to our hospital with acute abdomen findings. Abdominal computed tomography scan revealed abnormal results. Laparotomy was performed and the case was successfully treated with tube duodenostomy. (Gazi Med J 2012; 23: 29-32

Relationship between Sarcopenia and Respiratory Functions in Geriatric Male COPD Patients

Introduction: Sarcopenia can be defined as the loss of skeletal muscle mass and strength, especially with aging. In total, 21.6% of patients with chronic obstructive pulmonary disease (COPD) have sarcopenia. In our study, we investigated whether the evaluation of respiratory muscles can be correlated with peripheral muscle measurement and what kind of relationship is between sarcopenia and pulmonary function tests. Methods: A retrospective observational study conducted in a single center included 75 male COPD patients admitted to the pulmonary rehabilitation unit. The data were obtained from the hospital information management system and patient files. Results: The mean age of 75 male patients included in the study was 65±9 years, 76% had a history of smoking, and 46% had comorbidities. Sarcopenia was detected in 20 patients, 16 of whom were over 65 years of age. While the mean Handgrip was 50, Quadriceps 36, and Pinchmeter 17 in all age groups, it was 58, 38, and 17 in the over 65 age group, and 21, 21, and 12 in the 65 age group with cachexia, respectively. There was no statistical relationship between sarcopenia and forced expiratory volume 1 (FEV1), forced vital capacity, FEV1/FEV, Global Initiative for Chronic Obstructive Lung Disease stages, modified Medical Research Council, and COPD assessment test scores in patients over 65 years of age (p>0.05). Conclusion: Although it was observed that the frequency of malnutrition and sarcopenia was higher than normal in the COPD patient group over 65 years of age, a decrease in pulmonary function tests and a decrease in effort capacity due to sarcopenia were observed, a statistically significant result was reached due to the insufficient number of cases