Magnesium deficiency is defined as a pathophysiologic factor in numerous illnesses. This study aims to define the effects of magnesium levels on patients in the intensive care unit (ICU) regarding length of stay in the ICU, length of mechanical ventilation (MV), and 28-day mortality. The following data were collected during initial assessment of patients admitted to the ICU with acute respiratory failure (ARF). Demographic data, magnesium and potassium levels, Charlson's Comorbidity Index (CCI), Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores, length of MV, length of hospital stay in the ICU, 28-day mortality, and ICU discharge status. In the initial serum analysis prior to treatment of patients in the ICU, the mortality rate of the patient group with hypermagnesemia was found to be statistically significant when compared with other magnesium levels ( P = .018). Apart from renal failure, ICU mortality is higher in the hypermagnesemia group than other groups. Hypermagnesemia is an electrolyte abnormality that is generally seen in older individuals and those with serious comorbidity and it can be used in mortality prediction.

At the time of diagnosis of malignant pleural mesothelioma (MPM), distant metastases are rare, but can occur through the hematogenous route or an adjacent route. Central nervous system (CNS) metastasis is rarely seen and the incidence is not known. Metastases occur more often in patients with relatively prolonged survival following aggressive treatment. Metastasis most often occurs in the cerebral cortex, cerebellum, intracranial meninges, or the spinal cord. CNS metastases can be seen in all histological types of MPM. Presently described are the cases of 2 patients diagnosed with malignant mesothelioma and in whom a rarely seen cranial metastasis was determined.

Aim: This study was designed to compare the method of internal jugular vein (IJV) catheterization with prior ultrasonographic (USG) skin marking with the conventional method regarding the performance of a less experienced practitioner in learning ultrasonographic manipulation and safely performing the cannulation. Methods: The records of patients admitted to the Intensive Care Unit of Ataturk Chest Diseases and Chest Surgery Research and Training Hospital between April and September 2018 were retrospectively examined. 14 female and 26 male patients (n=40) whose IJV cannulations had been performed with the two above-mentioned methods were included in the study. The practitioner was theoretically trained by an experienced radiologist before the cannulation. Results: The success rate was 65% in the conventional group and 95% in the USG skin-marked group; the difference was statistically significant (P=0.019). The mean time from the first entry of the needle to the skin to the placement of the catheter in successful cannulations in conventional and USG-marked methods were 110.6 (25.6) and 121.6 (28.3) seconds, respectively. There was no statistically significant difference (P=0.22). Conclusion: This study shows that educating the inexperienced practitioner about the use of USG in IJV cannulation and successful application of skin marking method is important.

The aim of this study is to evaluate the association of survival with nutritional status, comorbidity and life quality of patients with locally advanced and advanced non-small cell lung cancer (NSCLC) coexisting with chronic obstructive pulmonary disease (COPD). Patients and methods:This study was performed with 64 patients (6 female, 58 male) diagnosed with locally advanced and advanced NSCLC from March to August 2015. Demographic features of the patients were evaluated with Mini Nutritional Test (MNT), Charlson Comorbidity Index (CCI), Fat Free Mass Index (FFMI), Nutritional risk screening (NRS 2002), European Organization for Research and Treatment of Cancer (EORTC), Quality of Life (QOL) Group (EORTC-QLQ-C30). The association of those scales' results with survival was analyzed.Results: Of the patients, 34.4% (n=22) had the diagnosis of COPD. A significant relationship between the presence of COPD and survival was not detected. According to NRS 2002, 33% of the patients were under the risk of nutritional deficiency. According to MNT, 18.8% of the patients showed the presence of malnutrition. According to CCI, the patients were in low, moderate and high-risk groups respectively 57.8%, 37.5% and 4.7%. FFMI averages of the survivors and ex ones were 19.74 kg/m2 and 18.10 kg/m2, respectively. After 6 monthfollow up, 25% of the patients died. In the univariate analyses, MNT (p=0.000), NRS 2002 (p=0.000) and FFMI (p=0.012) were associated with survival. According to the EORTC-QLQ-C30 scale, performance status, functional scale, physical, occupational, social function values and symptom scores were associated with survival. Conclusion:In the study, when nutritional status was evaluated with FFMI and life quality scales, the result was detected to be associated with survival. On the other hand, whether or not the patient was diagnosed with COPD, histological type of cancer, stage of the disease, metastasis sites and CCI were not detected to be associated with survival.

Objectives: To determine whether Bayesian Analysis (BA) predicts malignancy with similar specificity and sensitivity values ​​ in both subgroups of solitary pulmonary nodules (SPNs) and to compare PET-CT findings in solid and subsolid subgroups of PET-CT scanned SPNs. Study Design: An observational study. Setting: Department of Chest Diseases, Ankara Chest Diseases and Chest Surgery Training and Research Hospital. Period: February 2013 to February 2016. Materials and Methods: 156 patients with SPNs and whose histopathological diagnosis confirmed by fiberoptic bronchoscopy biopsy, transthoracic tru-cut biopsy or surgical methods were evaluated retrospectively. BA and PET-CT findings of nodules were evaluated. Results: 73.3% of male patients and 80% of females with subsolid SPN were diagnosed malignant. BA was statistically significantly found to be consistent with definitive diagnosis in Kappa compliance analysis in solid and nonsolid nodules (p <0.005 kappa = 0.604; p = 0.023 kappa = 0.358). The sensitivity of BA in solid and subsolid nodules was 63.6% and 80%, respectively, while their specificity was 93.4% and 73%, respectively. Positive predictive values (PPVs) ​​were found to be 84% in solid nodules and 36% in subsolid nodules. Negative predictive values (NPVs) ​​were calculated as 83% in solid nodules and 95% in subsolid nodules. In the patients with SPN included in our study, Kappa compliance analysis was performed separately in the solid and subsolid subgroups of patients who underwent PET-CT. When the cutoff value of Kappa compliance analysis in solid nodules was taken 2.5, definitive diagnosis and suvmax uptake were found to be statistically consistent (p <0.005 kappa = 0.638). When the cutoff value of Kappa compliance analysis in subsolid nodules was taken to be 2.5 as malignancy value, definitive diagnosis and suvmax uptake were found to be statistically consistent as in subgroup (p=0,011 kappa=0,399). When we took PET-CT suvmax cutoff value as 2.5, sensitivity uptake and specificity of PET were found in solid nodules, to be 68.4% and 93.1%, respectively. PPV was 86.7% and NPV was 82%. The sensitivity and specificity values ​​of subsolid subgroup were 70% and 75% respectively, whereas the PPVs and NPVs ​​were 50% and 87.5%, respectively. Conclusion: In subsolid SPNs, as in BA, PET-CT seems to be more reliable when used exclusively in malignancy exclusion. Although a significant suvmax cut-off value was determined for malignancy, the PPV of PET-CT is lower than that of solid SPNs.