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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]

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]

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There is currently no national data on the effects of polyvinyl chloride (PVC) exposure on pulmonary function. In this study we recruited workers and administrative staff from two PVC plants between July 2008 and July 2009. A questionnaire, pulmonary function tests, carbon monoxide diffusion capacity, and peak flows were recorded. Particulate matter analyses were performed by the Adana Central Laboratory of the Directorate of Occupational Health and Safety. Data were analyzed with SPSS 13.0 software. Nine of the 147 subjects were female. The incidence of a cough was more common in the administrative group. Of the study population, 59.1% were smokers. Tobacco addiction significantly increased cough and dyspnea [OR= 1.10 (1.00-1.20, 95% CI) p= 0.007 and OR= 1.08 (1.02-1.14, 95% CI), p= 0.008, respectively]. Dust exposure was correlated with the incidence of a cough [OR= 0.20 (0.04-0.80, 95% CI) p= 0.008]. The period of work correlated with sputum production [OR= 1.00 (1.00-1.02, 95% CI) p= 0.044]. The FVC% was significantly higher in the administrative group, and FEV1/FVC and DLCO were higher in the exposed group. Tobacco addiction increased the risk of airflow limitation, as evaluated by FEV1/FVC < 70% and FEF25-75 < 50% [OR= 1.15 (1.06-1.25, 95% CI) p= 0.001 and OR= 1.09 (1.02-1.17, 95% CI) p= 0.010, respectively]. Tobacco addiction and increasing duration of work had a negative influence on DLCO in the exposed group (r= -0.270, p= 0.025 and r= -0.210, p= 0.037). In the exposed group PEF variability was significantly greater on workdays, compared with rest days. This study shows that tobacco consumption has a greater affect on the airways than PVC dust exposure. A median of 36 months exposure to PVC dust had no significant impact on pulmonary function parameters, except for DLCO and PEF variability.