Background: The C-reactive protein (CRP)/albumin ratio (CAR) is one of the new tools to assess the severity of inflammation. It is used to determine clinical severity and prognosis in many diseases. Aim: The present study aimed to investigate the relationship between C-reactive protein (CRP)/albumin ratio (CAR) and prognosis in pregnant patients with more severe COVID-19 infection. Retrospective study. Patients and Methods: The study was conducted in a retrospective manner by scanning the files of pregnant patients who had a positive polymerase chain reaction test result and were hospitalized in Adıyaman Training and Research Hospital. The patients were divided into two groups: patients who were admitted to the intensive care unit and patients who were not admitted. CRP/albumin ratio (CAR) levels were compared between these two groups. The cut-off value was determined in the prediction of intensive-care admission and poor prognosis. Results: 117 patient files were reviewed. 13 patients were followed up with intensive care, whereas 104 patients completed their treatment in the service. The CAR levels of the patients admitted to intensive care were significantly higher (P < 0.01). In the estimation of intensive-care admission, the CAR level was determined to be 0.970 in the area under the curve with 100% sensitivity and 86.5% specificity in the receiver operating characteristic (ROC) curve. The cut-off CAR level was calculated as 1.8. Conclusion: CAR is a valuable biomarker for predicting prognosis, as well as follow-ups of pregnant COVID-19 patients.

Drug-induced pulmonary disease is an important consideration in the differential diagnosis of patients with rheumatoid arthritis (RA) who present with respiratory symptoms. We report a patient with RA who developed acute respiratory failure two weeks after the administration of abatacept. The clinical findings were consistent with drug-induced acute respiratory failure, most likely acute eosinophilic pneumonia. Pulse steroid was administered at 1000 mg/kg/day in the emergency department. Chest X-ray and arterial blood gas values revealed significant improvement on the second day of hospitalization. However, in the second week, the patient's fever rose up to 40°C, procalcitonin level increased to 15 ng/mL (<0.5 ng/mL is normal), and the patient died because of sepsis in the fourth week. This is the second report of respiratory failure, after the abatacept administration in the literature. We have reported an acute respiratory failure that occurred after use of the biological agent abatacept. With the increasing use of novel immunomodulatory agents, it is important for clinicians and pathologists to add the possibility of a drug reaction to the traditional differentials of acute respiratory failures occurring in these settings.

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This study aimed to investigate the relationship between joint laxity and post-dural puncture headache (PDPH). MethodsA total of 123 patients with PDPH -73 females and 50 males -were included in the study. The patients were examined regarding joint laxity and classified into two groups according to the Beighton score. Those with a Beighton score between 0 and 3 were classified as Group I, and those with a score greater than 4 were classified as Group II. Data related to the demographic characteristics of the patients, time of onset of PDPH, severity, need for medical treatment, need for an epidural blood patch, and length of hospital stay were recorded, and a comparison was made between the two groups. ResultsThere was no significant difference between the groups in terms of age, gender distribution, and PDPH onset time (p>0.05). In Group II, which included patients positive for joint laxity, total headache duration, headache severity, need for medical treatment, need for epidural blood patch, and hospital stay were significantly higher than in Group I (p<0.05). ConclusionJoint laxity may increase the risk of PDPH after spinal anesthesia and may affect treatment processes. The Beighton score can determine the development and severity of PDPH in patients with joint laxity. Assessing joint laxity and Beighton score can improve clinical decision-making in managing PDPH and positively affect patient outcomes.

Amaç: Bu çalışmanın amacı akut tip A aort disseksiyonu olgularında, nötrofil-lenfosit oranı (NLR), trombosit-lenfosit oranı (PLR) ve ortalama trombosit hacminin (MPV) mortalite üzerindeki etkilerini araştırmaktır. Materyal ve metod: Ocak 2013 ile Kasım 2020 tarihleri arasında Adıyaman Eğitim ve Araştırma Hastanesi’nde akut tip A aort disseksiyonu tanısı ile opere edilen hastaların dosyaları retrospektif olarak tarandı. Hastalar taburcu olanlar (Grup I) ve eksitus ile sonuçlanan (Grup II) olmak üzere ikiye ayrıldı. Hastaların demografik verileri, preoperatif kan testleri, operasyon süreleri ve mortalite durumu kaydedildi. Preoperatif olarak alınmış olan kan örneklerinde NLR, PLR ve MPV değerleri hesaplanarak kaydedildi. Bulunan veriler gruplar arasında kıyaslanarak verilerin mortalite ile ilişkisi incelendi. Bulgular: Çalışmadaki hastaların 23’ü erkek 9’u kadındı. Hastaların 22’si şifa ile taburcu olurken 10 hasta mortalite ile sonuçlanmıştır. EF, CRP ve kardiyopulmoner by-pass sürelerinde eksitus grubunda anlamlı farklılık bulundu (p&lt;0.05). Eksitus ile sonuçlanan hastalarda MPV, NLR ve PLR düzeyleri daha yüksek tespit edildi. Fakat anlamlı farklılık tespit edilemedi (p&gt;0.05). Sonuç: MPV, NLR ve PLR’nin akut tip A aort dissekiyonunda mortaliteyi tahmin etmede etkisi gösterilemedi.