No abstract

Objective: A previously unknown contagious disease, which later turned out to be a worldwide pandemic originated from Wuhan, capital of Hubei province in China by the end of 2019. While this upheaval affected numerous countries tragically, mortality rate and necessity for ICU were relatively low in Turkey. Methods: A total of 166 patients (65 at ICU, 101 at pandemic service) were analyzed to uncover effect of radiological and laboratory parameters on prognosis in COVID-19. One hundred and one patients (60.8%) were treated in pandemic service and 65 (39.15%) were treated in ICU. Results: Mean age of the patients in pandemic service was 61.1±16.2 (23−93) and of patients in ICU was 64.6±15.7 (15−90) (p>0.05). Initial mean CRP value for pandemic service group was 68.14±6.5 mg/dL (3.11−271), whereas it was 117.07±11.5 mg/dL (0−360) for ICU (p<0.05). Mean D-dimer value for the patients in ICU was 5572.2±1075.6 ng/mL and for the patients in pandemic service it was 1904.9±290.7 ng/mL (p<0.05). There was a correlation between CRP and D-dimer values (p<0.05). Of 66 patients in ICU group, 30(49.2%) had early stage CT findings, 22 (36.1%) had progressing stage CT findings and 9 (14.8%) had severe stage CT findings. However, of 101 patients in pandemic service group, 67 (66.9%) had early stage CT findings, 32 (31.7%) had progressing stage CT findings and 2 (2%) had severe stage CT findings. Conclusion: CT staging is a substantial prognostic factor and may help clinicians decide treatment modality. Furthermore, CRP and D-dimer values are also prognostic during follow-up. Thus, the necessity of taking these parameters into consideration while implementing treatment algorithms has emerged. As a conclusion, CT stage, CRP and D-Dimer values should be adopted as crucial prognostic factors in order to provide efficient healthcare.

No abstract

Objective: Pleural empyema is a collection of purulent liquid in the cavity between the visceral and parietal pleura developing during the postinflammatory period. It can have a high morbidity and mortality rate if not treated. The aim of this study was to spirometrically evaluate respiratory function in patients before and after decortication surgery, which is a treatment used in late phase, chronic pleural empyema. Methods: Patient files were evaluated retrospectively according to the criteria of the study. Forced expiratory volume-1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC% values measured in the week before surgery and 6 months after the procedure were then compared with preoperative values. Results: A significant improvement was seen in spirometric values. The mean preoperative values of FVC 2.33±0.71 L, FEV1 1.91±0.56 L, and FEV1/FVC% 82.77±8.50% increased postoperatively to 2.64±0.65 L (p=0.000), 2.28±0.57 L (p=0.000), and 86.52±7.47% (p=0.014), respectively. The increase in postoperative values for FVC, FEV1, and FEV1/FVC% were 13.3%, 19.3%, and 4.53%, respectively. These results were statistically quite significant for FVC, FEV1, and significant for FEV1/FVC. Conclusion: The results indicate that decortication is an effective operation to treat eligible stage III empyema patients.

Objective: Evaluating the benefits of metastasectomy and the possible prognostic factors associated with overall survival after surgical treatment. Methods:Between January 2000 and January 2012, 148 pulmonary metastasectomy operations were performed on 126 patients (78 males, 48 females), with a median age of 32. Data were examined retrospectively for age, gender, primary tumor histology, number of lesions, operative techniques, resection margins, mediastinal lymph node involvement, time to metastasis, and additional therapies. Effects of possible prognostic factors on 2-year and 5-year survival were then evaluated.Results: Most patients (84%) were asymptomatic; 126 patients underwent 148 metastasectomy operations. Definitive pathology revealed sarcoma in 63 (50%), epithelial tumor in 58 (46%), and melanoma in 5 (4%). Complete resection (R0) was achieved in all patients. Average postoperative hospital length of stay was 5.4 (range: 2-8) days. Morbidity was 6.3%, and 30-day mortality was 1.6%. Median overall survivals were found to be 42, 27, and 11 months (p=0.029), with median disease-free intervals of 32, 21, and 7 months for epithelial tumors, sarcomas, and melanomas, respectively (p<0.001). The median survival of patients with single, 2 to 3, and 4+ metastatic nodules was 30, 18, and 15 months, respectively (p=0.012). Median survival of patients with a disease-free interval of less than 12 months was 16 versus 30 months in those with an interval of more than 12 months (p=0.003). Additional mediastinal lymph node involvement was directly correlated with a worse outcome (p=0.044). Conclusion:Pulmonary metastasectomy is a safe and effective choice of treatment. Univariate analyses verified that histopathology of the tumor, disease-free interval, number of metastatic lesions, and lymph node involvement were significant prognostic factors in patients undergoing pulmonary metastasectomy.Keywords: Lung metastases, pulmonary metastasectomy, secondary neoplasm, surgery, survival analysis ÖzetAmaç: Bu makalede, pulmoner metastazektomilerin sağkalıma olan katkısı ve sağkalıma etki eden diğer prognostik faktörler araştırıldı.Yöntemler: Ocak 2000 -Ocak 2012 tarihleri arasında 126 hastaya 148 pulmoner metastazektomi uygulandı. Hastaların 78'i erkek, 48'u kadın olup ortalama yaş 32 idi. Hastalar yaş, cinsiyet, primer tümör histolojisi, lezyon sayısı, ameliyat teknikleri, komplet ve inkomplet rezeksiyon sayıları, mediasten lenf nodu tutulumu, hastalıksız yaşam süreleri ve ek tedavi yönünden incelendi. Prognostik faktörlerin iki ve beş yıllık sağkalım üzerine etkileri değerlendirildi. Bulgular:Hastaların çoğunluğu (%84) asemptomatik idi. 126 hastaya 148 cerrahi girişim uygulandı. Olguların 63'unde (%50) sarkom, 58'inde (%46) epitelyal tümör ve 5'inde (%4) melanom metastazı saptandı ve tümünde komplet (R0) rezeksiyon gerçekleştirildi. Ameliyat sonrası ortalama hastanede kalış süresi 5,4 (2-8) gün, morbidite oranı %6,3, mortalite oranı %1,6 idi. Epitelyal tümörler, sarkomlar ve melanomlar için ortanca sürvi 42, 27 ve 1...