Spontaneous rib fracture due to severe cough may occur in patients with osteoporosis, chronic obstructive pulmonary disease, or bronchial asthma, receiving long-term steroid therapy. If these patients have severe chest pain, chest radiography should be performed to check for bone lesions.

Background/aim: This study aimed to identify children who have chest wall deformity, the prevalence of deformity, and the factors affecting the psychological and physical disorders caused by the deformity. Materials and methods: The study was conducted among 14,108 girls and boys aged 11-14 years, who were 5th-8th grade secondary school students in Ankara Province between October 2014 and March 2015. Results: Of the 14,108 students in our study, the mean age of the children was 12.53 ± 1.11 years (median 12.54, 11-14 years) and chest wall deformity was detected in 199 (1.41%) students. Male/female and pectus carinatum/pectus excavatum ratios were 2.16 and 1.59, respectively. According to multivariate logistic regression analysis, physical disturbance was found to be statistically significantly higher among children in age group 11 [adjusted OR (95% CI) =16.01 (1.89-135.61), P < 0.011] and in children who were aware of the deformity [adjusted OR (95% CI) = 0.31 (0.13-0.71), P < 0.006], and psychological disturbance was found to be statistically significantly higher in girls [adjusted OR (95% CI) = 15.44 (1.68-141.59), P < 0.015] and in those with a presence of family history [adjusted OR (95% CI) = 18.66 (1.92-181.60), P < 0.012]. Conclusion: In this study conducted in a large population, chest wall deformities were found to be more prevalent in boys (0.96%) and pectus carinatum was found as the most common deformity type in our country, contrary to the literature.

The Abramson technique is an effective, minimally invasive procedure for PC with shorter operating and hospitalization times and low morbidity rates.

Background A pneumothorax is common in patients admitted to the intensive care unit (ICU) with coronavirus disease (COVID-19) when non-invasive or invasive mechanical ventilation is performed to maintain adequate oxygenation. The aim of the present study was to investigate the effects of elevated inflammatory markers and an elevated systemic immune inflammatory index (SII) on mortality in this patient population. Materials and methods Between March 2020 and May 2021, 124 patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reacion positviity who were admitted to the ICU in our hospital and diagnosed with and treated for a pneumothorax were evaluated retrospectively. Interleukin-6 (IL-6), C-reactive protein, neutrophil, lymphocyte, platelet and white blood cell levels were measured. These parameters were used to calculate the neutrophil–lymphocyte ratio (NLR) and SII, and the association of these parameters with pneumothorax-related mortality was examined. Results This study included 39 female (31.5%) and 85 male (68.5%) patients. The mean age was 65.3 ± 12.6 years. Non-invasive mechanical ventilation was performed in 13 (10.5%) patients, and 111 (89.5%) patients received invasive mechanical ventilation. Tube thoracostomy was performed in 113 patients (91.1%), and 11 patients (8.9%) were treated with oxygen therapy. The factors affecting mortality in the pneumothorax patients were the Charlson Comorbidity Index (four or higher), IL-6 level and NLR. The IL-6 level was 53.4 in those who died versus 24.6 in those who survived ( p = 0.017). The NLR in the patients who died was 16.9 as compared to 12.5 in those who survived ( p = 0.011). Conclusion Elevated markers of infection were associated with an increased risk of mortality in pneumothorax patients with COVID-19 who received invasive or non-invasive mechanical ventilation in the ICU. In this patient population, high levels of positive end-expiratory pressure should be avoided, and inflammatory marker levels and the SII should be closely monitored.

Background The aim of this study was to evaluate the results of R0 resection of thymoma to identify prognostic factors for long-term outcomes. Methods Data of 62 patients (28 male, 34 female) with a mean age of 47.26 ± 14.42 years, who underwent R0 resection for thymoma and were followed-up between February 2004 and March 2016, were analyzed retrospectively. Results Eight patients had a video-assisted thoracoscopic thymectomy and 54 had a transsternal extended thymectomy. During a mean follow-up of 128.67 ± 7.95 months, regional recurrence of thymoma was observed in 9 (14.5%) patients. Overall 5- and 10-year survival rates were 85.36% and 78.20%, respectively. The 5- and 10-year survival rates in patients aged < 50 years were significantly better than in those aged ≥ 50 years (92% and 72% vs. 88% and 39%, p < 0.0001). The 10-year overall survival of patients in Masaoka stage I and II was better than those in stage III (88.9%, 78.4%, 69.8%, respectively, log-rank p < 0.001). The 10-year survival of patients with World Health Organization histological type A, AB, and B1 thymomas was better than those with type B2 and B3 (log-rank test p < 0.001). In multivariate analysis, age < 50 years ( p = 0.001), Masaoka stage ( p = 0.006), histological type ( p = 0.001), and recurrence ( p = 0.04) were independent prognostic factors for survival. Conclusion Our study indicates that age < 50 years, Masaoka stage, histological type, and recurrence are the determinants of survival in surgically resected cases of thymoma.