A 67-year-old woman was referred to our department for further evaluation of her abnormal, chest radiogram. Thorax computed tomography revealed a well-circumscribed, round mass in the middle lobe of the right lung. A thoracotomy was performed and pulmonary sclerosing hemangioma was diagnosed. We herein present a rare tumor of the lung.

BackgroundOne-third of the world’s population is infected with Mycobacterium tuberculosis. Investigation of Toll-like receptors (TLRs) has revealed new information regarding the immunopathogenesis of this disease. Toll-like receptors can recognize various ligands with a lipoprotein structure in the bacilli. Toll-like receptor 2 and TLR-4 have been identified in association with tuberculosis infection.ObjectivesThe aim of our study was to investigate the relationship between TLR polymorphism and infection progress.MethodsTwenty-nine patients with a radiologically, microbiologically, and clinically proven active tuberculosis diagnosis were included in this 25-month study. Toll-like receptor 2 and TLR-4 polymorphisms and allele distributions were compared between these 29 patients and 100 healthy control subjects. Peripheral blood samples were taken from all patients. Genotyping of TLR-2, TLR-4, and macrophage migration inhibitory factor was performed. The extraction step was completed with a Qiagen mini blood purification system kit (Qiagen, Ontario, Canada) using a peripheral blood sample. The genotyping was performed using polymerase chain reaction-restriction fragment length polymorphism.ResultsIn total, 19 of the 29 patients with tuberculosis infection had a TLR-2 polymorphism, and 20 of the 100 healthy subjects had a TLR-2 polymorphism (P < 0.001). The TLR-4 polymorphism and interferon-γ allele distributions were not statistically correlated.ConclusionsToll-like receptor 2 polymorphism is a risk factor for tuberculosis infection. The limiting factor in this study was the lack of investigation of the interferon-γ and tumor necrosis factor-α levels, which are important in the development of infection. Detection of lower levels of these cytokines in bronchoalveolar lavage specimens, especially among patients with TLR-2 defects, will provide new data that may support the results of this study.

ÖzetAmaç: Göğüs hastalıkları konsültasyonu (GHK), solunum sistemini ilgilendiren herhangi bir patolojinin tanı ve tedavisi, preoperatif hastaların solunum sistemi yönünden değerlendirilmesi veya postoperatif yaşanan pulmoner sorunlar nedeniyle hemen hemen tüm klinik branşlar tarafından istenmektedir. Bu çalışmamızın amacı bir devlet hastanesinde göğüs hastalıkları konsültas-yon yükünü ve özelliklerini değerlendirmektir. Gereç ve Yöntem: Bu çalışma-da ilçe devlet hastanesinde, acil vakalar dışında diğer kliniklerden istenen gö-ğüs hastalıkları konsültasyon kayıtları retrospektif olarak incelenmiş, hastaların genel özellikleri, tanı amaçlı istenen tetkikler ve konsültasyon sonuçla-rı literatür bulguları ile tartışılmıştır. Bulgular: Üç aylık sürede, yaş ortalaması 64±17 olan 110 hasta (51 kadın, 59 erkek) konsültasyonu yapıldı. En fazla genel yoğun bakım ünitesinden %16.3 (n:18) oranında konsültasyon istenmiş olup; bunu sırasıyla nöroloji (n=16, %14.5) ve genel cerrahi (n=16, %14.5) klinikleri takip etmekteydi. GHK istem nedenleri sırasıyla solunumsal (dispne, öksürük, hırıltılı solunum, balgam) yakınmalar (n=68, %61). Olguların 43'ünde (%39) kronik obstrüktif akciğer hastalığı (KOAH); 23'ünde (%20.9) normal solunum sistemi bulguları mevcuttu. Tartışma: Çalışmamız üç aylık yaz dönemi-ni kapsamaktadır ve acil servis konsültasyonları çalışmamıza dahil edilmemiştir. Bu şartlarda dahi göğüs hastalıkları hekimlerinin konsültasyon yoğun-luğuna dikkat çekmeyi ve ayrıca online veri kayıt sisteminin retrospektif analizleri kolaylaştırmadaki önemini vurgulamak istedik. Anahtar KelimelerKonsültasyon; Göğüs Hastalıkları; Devlet Hastanesi Abstract Aim: Consultation of a pulmonologist is requested from almost all clinical specialties about diagnosis or treatment of any pathology involving respiratory system, preoperative respiratory system evaluation or postoperative pulmonary problems. The aim of our study is to determine the burden and characteristics of pulmonology consultations in a state hospital. Material and Method: In this study, pulmonology consultation reports of clinics excluding emergency department was evaluated retrospectively, and characteristics of patients, diagnostic utilities and results of consultations were presented with associated literature knowledge. Results: 110 patients (51 female, 59 male) with medium age of 64±17 were consulted to pulmonology department in three months. Most of the consultation requests were from intensive care unit (%16.3, n=18), followed by neurology (n=16, %14.5) and general surgery (n=16, %14.5) departments. Major reason for pulmonology consultation requests were the presence of respiratory symptoms (dyspnea, cough, wheezing, sputum, n=68, %61). COPD was diagnosed in 43 (%39) patients, and normal respiratory system findings were observed in 23 (%20.9) patients. Discussion: With this study, we wanted to draw attention to extend of pulmonology consultation requests even with exclusion of emergency department consultations and the timing of the study period covering three months of...

In this case report we aimed to present a patient with granulocytic sarcomaa, neutropenic fever, ARDS and Pneumocystis jirovecii pneumoniae that was hospitalized in our intensive care unit. The patient recovered and then developed vancomycin resistant enterococci (VRE) bacteremia due to port catheter during follow up. The patient had risk factors for VRE bacteremia and he was administered linezolide without removing the catheter. He was discharged with recovery.

Objective: Chronic obstructive pulmonary disease (COPD) is a major public health problem with severe economic consequences. In this study, we tried to estimate the clinical factors affecting the economic cost of COPD exacerbations requiring hospitalization. Methods: A total of 241 patients who were hospitalized due to COPD exacerbations were included in the study. Data were examined retrospectively using hospital charts. Results: The average length of the hospital stay of the patients was 9.6±4.6 days. The average total direct cost for hospitalization was 1103.2±557.3 Turkish Lira (TL). The length of hospital stay or total costs were not different between male and female patients (respectively, p=0.78 and p=0.28) or between patients above 65 years old and others (respectively, p =0.77 and p=0.92). Presence of comorbidities increased total costs significantly (p=0.008). The total costs of medications and antibiotic costs, together with laboratory costs, were significantly higher in patients with comorbidities (p=0.02, p=0.003, and p<0.001). Length of hospital stay also tended to be higher in patients with comorbidities, but it was not statistically significant (p=0.09). Total costs and length of hospital stay tended to increase as the number of comorbidities increased (p=0.02 and p=0.008). Type of social insurance did not affect total costs or length of hospital stay (p= 0.16 and p=0.21). Conclusion: Length of hospital stay and direct costs of hospitalized COPD exacerbations significantly increased in the presence of comorbidities, while age, sex, and type of insurance did not have any significant effects.