Results of bronchoscopic excision in typical carcinoid tumors of the lung in Turkey

Aim Carcinoid tumors of the lung are the tumors originating from the neuroendocrine cells. Surgical excision remains the gold standard for the treatment. Treatment with interventional bronchoscopic excision has also been reported as an alternative option in typical carcinoid tumors of the lung. The aim of this study was to present results and outcomes in patients who were bronchoscopically treated and followed-up. Methods Data of 14 patients, who had undergone bronchoscopic excision due to typical carcinoid tumor of the lung between April 2008 and July 2015 were retrospectively evaluated. Bronchoscopic excision procedures were performed under general anesthesia, while control bronchoscopies were carried out with flexible bronchoscopy. Time between the first and last bronchoscopies was accepted as the follow-up duration. Results A total of 14 patients was evaluated with eight (57.1%) males. Mean age was 43.57±14.07 (23-68) years. The most common symptoms were shortness of breath and coughing. Mean of 5.69±3.35 (2-12) bronchoscopy procedures were performed in the patients during the diagnosis, treatment and follow-up. Mean follow-up duration was 32.0±19.22 months. At the long-term follow-up, two patients developed 50% stenosis and one patient developed granulation tissue in the endobronchial treatment site. None of the patients developed recurrence during the mean 32-month follow-up. Conclusion Endobronchial treatment is a safe and successful treatment method in well selected typical carcinoid tumor cases that are centrally located, having no radiological suspicion of local or distant metastasis, distally visible but not located on the bronchi with a wide base on bronchoscopy

Simultaneous chronic invasive fungal infection and tracheal fungus ball mimicking cancer in an immunocompetent patient

WOS: 000378552900001PubMed ID: 27418930Fungal infections of the lung are uncommon and mainly affect people with immune deficiency. There are crucial problems in the diagnosis and treatment of this condition. Invasive pulmonary aspergillosis and candidiasis are the most common opportunistic fungal infections. Aspergillus species (spp.) are saprophytes molds that exist in nature as spores and rarely cause disease in immunocompetent individuals. In patients with immune deficiency or chronic lung disease, such as cavitary lung disease or bronchiectasis, Aspergillus may cause a variety of aspergillosis infections. Here we present a case of a 57-year-old patient without immunodeficiency or chronic lung disease who was diagnosed with endotracheal fungus ball and chronic fungal infection, possibly due to Aspergillus. Bronchoscopic examination showed a paralyzed right vocal cord and vegetating mass that was yellow in color, at the posterior wall of tracheal lumen. After 3 months, both the parenchymal and tracheal lesions were completely resolved

Successful Treatment of Bulla with Endobronchial Valves

Emphysematous bullae are a complication of end-stage COPD. Patients with large bullae and poor respiratory function have limited treatment options. Surgical resection is a recognized treatment, but functional improvement after bullectomy is not satisfactory in patients with forced expiratory volume in 1 s (FEV1) < 35% predicted. When this 59-year-old male end-stage COPD patient was assessed, he was cachectic and lung function tests showed a FEV1 of 0.56 L (19% predicted) and a RV of 7 L (314% predicted), while 6MWT was 315 m and MRC dyspnea score was 4. Chest X-ray revealed a massive bulla of 10 cm in diameter in the right middle lobe. A fibrobronchoscopy was performed under local anesthesia and 2 Zephyr 4.0 valves were placed in the right middle lobe. Chest X-ray and CT scan performed 36 days later showed the complete resolution of the bulla. Seven months later, the patient demonstrated an improvement in FEV1 (+30%) and a decrease in RV from 314 to 262% predicted. This case report shows that the Zephyr valves may be successfully used to treat a large bulla in the right middle lobe in a patient with diffuse emphysema and severely impaired lung function

The Impact of CoronaVac Vaccination on 28-day Mortality Rate of Critically Ill Patients with COVID-19 in Türkiye

Background:Vaccines against coronavirus disease-19 (COVID-19) have been effective in preventing symptomatic diseases, hospitalizations, and intensive care unit (ICU) admissions. However, data regarding the effectiveness of COVID-19 vaccines in reducing mortality among critically ill patients with COVID-19 remains unclear.Aims:To determine the vaccination status and investigate the impact of the COVID-19 vaccine on the 28-day mortality in critically ill patients with COVID-19.Study Design:Multicenter prospective observational clinical study.Methods:This study was conducted in 60 hospitals with ICUs managing critically ill patients with COVID-19. Patients aged ≥ 18 years with confirmed COVID-19 who were admitted to the ICU were included. The present study had two phases. The first phase was designed as a one-day point prevalence study, and demographic and clinical findings were evaluated. In the second phase, the 28-day mortality was evaluated.Results:As of August 11, 2021, 921 patients were enrolled in the study. The mean age of the patients was 65.42 ± 16.74 years, and 48.6% (n = 448) were female. Among the critically ill patients with COVID-19, 52.6% (n = 484) were unvaccinated, 7.7% (n = 71) were incompletely vaccinated, and 39.8% (n = 366) were fully vaccinated. A subgroup analysis of 817 patients who were unvaccinated (n = 484) or who had received two doses of the CoronaVac vaccine (n = 333) was performed. The 28-day mortality rate was 56.8% (n = 275) and 57.4% (n = 191) in the unvaccinated and two-dose CoronaVac groups, respectively. The 28-day mortality was associated with age, hypertension, the number of comorbidities, type of respiratory support, and APACHE II and sequential organ failure assessment scores (p < 0.05). The odds ratio for the 28-day mortality among those who had received two doses of CoronaVac was 0.591 (95% confidence interval: 0.413-0.848) (p = 0.004).Conclusion:Vaccination with at least two doses of CoronaVac within six months significantly decreased mortality in vaccinated patients than in unvaccinated patients