Background: This study investigates whether or not sericin pleurodesis increases basic fibroblastic growth factor (bFGF) and high-sensitive C-reactive protein (hs-CRP) levels in rat plasma. Materials and Methods: A total of 42 adults, male, 12-week-old Wistar albino rats were obtained for the study. The rats were divided randomly into three groups, as sericin, talcum powder, and control group. After the administration of an anesthetic, the agents were administrated through a left thoracotomy. The rats were sacrificed 12 days later through cardiac puncture. The bFGF and hs-CRP levels were examined in plasma. Results: The mean rat plasma bFGF levels were 251.7 pg/mL in the sericin group (range: 101 to 821 pg/mL), 72.3 pg/mL in the talcum powder group (range: 24 to 131 pg/mL), and 133.1 pg/mL in the control group (range: 32 to 320 pg/mL). A significant difference was noted in the results of a Scheffe test between the sericin and talcum powder groups (p < 0.05, p = 0.046). Mean rat plasma hs-CRP levels were 1.038 ng/mL in the sericin group (range: 0.677 to 2.815 ng/mL), 1.343 ng/mL in the talcum powder group (range: 0.606 to 5.662 ng/mL), and 0.945 ng/mL in the control group (range: 0.586 to 1.261 ng/mL), indicating no significant difference among the groups. Conclusions: It was found that bFGF levels were significantly higher in the sericin pleurodesis group than in the talcum powder group, indicating the biochemical success of intrapleural sericin administration in inducing pleurodesis. On the other hand, hs-CRP, a marker of inflammation, was not found to be significant, indicating that hs-CRP returns to normal levels due to its short half-life.

Background and Objectives: Thoracic trauma usually results in high morbidity and mortality. It is the leading cause of death in patients within the first four decades of life. In this study, we aimed to identify risk factors for intensive care mortality and to evaluate factors affecting clinical outcomes and complications in patients with thoracic trauma who were treated in the intensive care unit (ICU). Materials and Methods: This was a retrospective, single-center study. Patients diagnosed with thoracic trauma and followed up in the ICU between 1 May 2023 and 1 January 2025 were included. Critically ill patients aged 18 years and older whose admission blood values were available and who had undergone radiological imaging were included in the study. Patients were grouped as Survivors or Non-survivors. The primary outcome was to determine risk factors for mortality. The secondary outcome was to evaluate factors affecting clinical outcomes and complications. The tertiary outcome was to determine the predictive value of the Injury Severity Score (ISS), Acute Physiology and Chronic Health Evaluation II (APACHE II), and Glasgow Coma Scale (GCS) for mortality. Results: A total of 104 patients (male/female ratio: 76/28) were included in the study. Twenty-four patients (23.1%) died, and eighty (76.9%) were discharged. Age in the Non-survivor group was found to be significantly higher (59.33 ± 22.21 vs. 40.50 ± 17.71; p < 0.001), and the proportion of women was also significantly higher in the Non-survivor group (p = 0.0082). Mortality was associated with advanced age, female sex, lower GCS score (p < 0.001), higher APACHE II scores (p < 0.001), and the presence of comorbid conditions (p = 0.003), including head trauma (p = 0.024) and cardiac arrest before ICU admission (p = 0.011). The Non-survivor group more frequently required mechanical ventilation (p < 0.001), vasopressor support (p < 0.001), and continuous renal replacement therapy (p < 0.001), and they developed ventilator-associated pneumonia (p < 0.001) and acute respiratory distress syndrome (p < 0.001) at higher rates. ICU length of stay was also significantly longer in the Non-survivor group (p = 0.045). The APACHE II score demonstrated the highest discriminatory performance, emerging as the strongest clinical predictor of mortality (AUC = 0.751, 95% CI: 0.630–0.872; p < 0.001). Age (OR: 1.06) and serum lactate levels (OR: 1.57) consistently emerged as strong independent predictors of mortality. The presence of head trauma significantly increased the risk of mortality, particularly in the APACHE II-adjusted model (OR: 9.08). The APACHE II–based model yielded high specificity (96.3%) and accuracy (88.5%), with good discrimination (AUC = 0.894) and the highest Nagelkerke R² (0.548). Conclusions: Factors that may shorten the length of ICU stay include infection control, early correction of acidosis, and maintenance of hemodynamic stability, which may reduce mortality. APACHE II was more closely related to overall clinical severity than the other scoring systems. Our data indicate that age-related frailty and acute physiological derangement, as best represented by the APACHE II score, are more significant determinants of survival than anatomic injury severity alone.

Aim: There is air in the pleural space without an external effect in the case of spontaneous pneumothorax, and it is important in terms of treatment, clinic, and underlying diseases in thoracic surgery. In this study, it was aimed to present the approach to the patients with spontaneous pneumothorax in the period of compulsory public service. Material and method: The patients who were treated with spontaneous pneumothorax between June 2017 and January 2018 in our clinic were included in this study. Gender, age, smoking status, type of treatment and length of hospital stay were recorded. Result: 18 patients (2 female, 16 male) were included in the study. Eleven of the patients (61.1%) were smoking. Surgical treatment was applied to 7 (38.8%) of the patients. As a surgical approach, videothoracoscopic wedge resection and partial pleural decortication in 5 patients, videothoracoscopic bulla ligation and partial pleural decortication in 1 patient and thoracotomy bulla ligation in 1 patient were applied. Ten patients were treated with tube thoracostomy and one patient was treated with nasal oxygen. Complications did not occur in the patients. Conlusion: Spontaneous pneumothorax is a disease requiring urgent diagnosis and treatment. The purpose of the treatment is to provide the lung totally expanded and to prevent recurrence of pneumothorax. Tube thoracostomy is usually the first approach, but we recommend that the videothoracoscopic surgery can be used in the conditions of the public hospital because of its advantages for the patients who have surgical indications.