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Objective: Cytokine storm and macrophage activation were shown to be important factors in the pathogenesis of SARS-CoV-2 infection. We aimed to investigate the factors associated with mortality in patients with COVID-19 infection. Material and Method: We grouped the adult patients followed-up with COVID-19 infection: Group A, outpatient (mild symptoms of COVID-19 infection, but no CT findings); Group B, mild/moderate illness (fever and respiratory tract symptoms of COVID-19 infection together with pneumonia on CT); Group C, severe (respiratory rate >30/minute, or oxygen saturation at room air of <93%, or PaO2/FiO2 of <300, or increase in CT findings more than 50% in 1-2 days) or critical illness (shock, or respiratory insufficiency requiring mechanical ventilation, or organ failure necessitating intensive care). Results: Of total (n =166), 38.6%(n =64) were female. Mean age was 57.69(±9.8). Group A comprises of 22.9% (n =38), Group B 59.0% (n =98), and Group C 18.1% (n =30) of the patients. 8.4% of the patients (n =14) were died. ROC analysis revealed that age (>61-year), CRP (>62 mg/dL), ferritin (>385 ng/mL), D-dimer (>0.8 ng/mL), lymphocyte (=850/mm3), procalcitonin (>0.08 µg/L), fibrinogen (>538 mg/dL), LDH (>469 U/L), AST (>39 U/L), SaO2 (=87%), and duration of hospitalization (>7 days) predicted the mortality. Kaplan-Meier analysis also showed that age (>61 year), smoking (present), SaO2, procalcitonin (>0.08 µg/L), LDH (>469 U/L) were associated with mortality. Cox regression analysis revealed that age (>61), CRP (>62), and LDH (>469) were positive predictors for mortality. Conclusion: We made an extensive analysis in a small patient population with a diagnosis of COVID-19 infection, and found a high rate of mortality. Older age, inflammatory biomarkers, mainly CRP and LDH, were associated with the mortality. [ABSTRACT FROM AUTHOR]

Introduction: Ischemia-modified albumin (IMA) level increases in inflammatory conditions. We aimed to investigate the association between IMA levels and the severity of coronavirus disease 2019 (COVID-19) infection in adult patients. Methodology: We grouped adult patients with COVID-19 infection: Group A - mild symptoms, but normal computed tomography (CT), Group B - mild/moderate illness, and Group C - severe or critical illness. We measured IMA levels at the time of diagnosis of COVID-19 infection. Results: Mean age of the total number of patients (n = 90) was 54.43 (± 8.11) year, and 46.7% (n = 42) were female. IMA levels were highest in Group C and lowest in A (p < 0.001). The most important factor predicting COVID-19 disease severity was IMA. Type 2 diabetes was more frequent in Group C (n = 31) than in Group B (n = 30) (p = 0.042). Asthma was less frequent, and coronary artery disease was more frequent in Group C than in Group A (n = 29) and B (p = 0.009). Duration of hospitalization was highest in Group C (p < 0.001). Conclusions: We analyzed a sample of patients with COVID-19 infection and found that IMA predicted severe COVID-19 disease. Disease severity grouping was based on patients' clinical and radiological features. IMA level measured when SARS-CoV-2 infection is diagnosed may be a useful marker in predicting likely disease severity or intensive care need. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to evaluate pregnant women admitted to the outpatient clinic in terms of sleep apnea risk and sleep quality. Materials and Methods: 31 women were included in this retrospective descriptive study which was conducted at the obstetrics and gynecology outpatient clinic of the hospital, between January 2016 and January 2017. Demographic characteristics, results of sleep questionnaires, pulmonary function test values, and birth information of the patients were obtained retrospectively for the 8th week and last trimester. Results: The mean sleep time was 7.9±1.3 hours at week 8 and 7.3±2.0 hours at last trimester; with no significant difference between the two periods (p=0.077). According to the sleep questionnaires there was no statistically significant difference between 8th week and the last trimester (p>0.05), except for Stanford Sleepiness Scale score (p=0.047). There was no significant difference according to pulmonary function test values between the 8th week and the last trimester (p>0.05), there was a statistical difference between two periods only in terms of FEV1% (p=0.047). No significant difference was found between the mean birth weight of babies of 13 pregnant women with poor sleep quality and mean birth weight of babies of 18 pregnant women with good sleep quality (p=0.565). Conclusion: As a result, in our study, nearly half of the pregnant women had worsened sleep quality in the last trimester according to the Pittsburg Sleep Quality Index, but birth weight was not affected in pregnant women with poor sleep quality. Sleep quality, the presence of OSAS in pregnancy and its relationship with pregnancy and postpartum complications are not clear, OSAS pregnancy studies should be performed especially in complicated pregnancies. [ABSTRACT FROM AUTHOR]

Ventilator-associated pneumonia (VAP) is defined as nosocomial pneumonia, which develops after 48 hours of mechanical ventilatory support in a patient who does not have pneumonia prior to intubation. VAP leads to prolonged mechanical ventilation, prolonged hospitalization, overuse of antibiotics, and increased medical costs. According to the National Nosocomial Infection Surveillance System (NNIS), one-third of all nosocomial infections in ICUs are pneumonia; of these, 83% is associated with mechanical ventilation. Care procedures should be performed in patients that have a high rısk for VAP to reduce risk factors, and early diagnosis should be provided. When VAP is diagnosed clinically, lower respiratory tract samples should be taken immediately, and empirical treatment should be started without waiting for culture results. Culture results and clinical response should be evaluated, and treatment should be reorganized in the first 48-72 hours. [ABSTRACT FROM AUTHOR]

This study was undertaken in the Gaziantep University Medical Intensive Care Unit (ICU) and aimed at determining the characteristics of patients, rates of invasive procedures, ICU length of stay, ICU mortality and its predictors. Between February 2007 and October 2008, 1033 patients were admitted to the ICU. Mean age was 55.3±19.2, mean APACHE II score was 19.5±9.6. The most common indications for ICU admission were hemodynamic instability (44%), mental status change (31%) and respiratory failure (30%). Sepsis (8%), pneumonia (6.7%), COPD exacerbation (5.8%), cerebrovascular accident (5.2%), gastrointestinal bleeding (4.5%), acute renal failure (3.5%) and meningitis (3.2%) were the most common ICU admitting diagnoses. Emergency rooms or regular wards were the most common sources of admission (>90%), only 8% of the patients being transferred from another center. Arterial catheterization was the most commonly performed invasive procedure (75%), followed by invasive mechanical ventilation (52%) and central venous catheterization (52%). Noninvasive mechanical ventilation was used in 12% of the patients. Median ICU length of stay was 4.3 (IQR 2.0-9.0) days. ICU mortality was 43%. Standardized ICU mortality (observed mortality / expected mortality based on APACHE II score) was 1.24 (CI, 1.11-1.38). APACHE II score >20, age >40, need for central venous catheterization and invasive mechanical ventilation for >24 hours increased ICU mortality, whereas a history of COPD decreased ICU mortality. [ABSTRACT FROM AUTHOR]

The article presents a study which aims to investigate gender differences with respect to psychiatric comorbidity (PC) in ostructive sleep apnea syndrome (OSAS). It evaluates data of patients with OSAS in University of Gaziantep from January 2006-January 2010. It shows that PC was found in 53.1% of OSAS patients with 42.6% in males and 76.26 in females.

Introduction: To evaluate the clinical profiles of obstructive sleep apnea syndrome. Material and Method: Sixty two consecutive patients who were diagnosed as having obstructive sleep apnea syndrome were included in the study. Results: The male/female ratio of patients with an apnea-hypopnea index of over 5 was 2.64. A family history of the syndrome was present in 43.5% of the patients. Of the 62 patients, 35% were diagnosed as having an overlap syndrome due to the coexistence of chronic obstructive pulmonary disease. The mean Epworth Sleepiness Scale score in mild, moderate and severe obstructive sleep apnea syndrome patients were 8.81±6.46, 10.38±5.14, 15.34±5.44, respectively (p=0.001). Hypertension, diabetes mellitus, coronary artery disease, subclinical hypothyroidism and cerebrovascular accidents were detected in 35.5%, 11.3%, 16.1%, 5.9%, and 1.6% of the cases, respectively. No correlation was identified between groups with respect to smoking habits, fasting blood glucose, triglyceride, LDL, HDL and total cholesterol levels. We detected a significant difference in neck and waist circumferences and hematocrit values in those having severe obstructive sleep apnea syndrome (p<0.05). Although the Epworth Sleepiness Scale score, smoking habit, gender distribution, neck circumference, fasting blood glucose, triglyceride, LDL, HDL and total cholesterol levels did not differ significantly between those having obstructive sleep apnea syndrome and overlap syndrome, body mass index, waist circumference and hematocrit values were significantly higher in overlap syndrome patients (p<0.01). Conclusion: Study showed that many OSAS patients have comorbid diseases, and taking a family history of patients suspected as having OSAS is essential. Also, severe obstructive sleep apnea syndrome patients have a higher Epworth Sleepiness Scale score, and neck and waist circumference. [ABSTRACT FROM AUTHOR]