Objective: Previous studies have shown that the lactate/albumin ratio (LAR) can be a prognostic biomarker in intensive care unit (ICU) patients. However, the usefulness of LAR in predicting mortality and guiding intensive care unit admission in hospitalized patients due to community-acquired pneumonia (CAP) remains unclear. This study aims to evaluate the predictive value of the LAR compared to Pneumonia Severity Index (PSI), Confusion, urea, respiratory rate, blood pressure, 65 years or older (CURB-65), and quick-Sequential Organ Failure Assessment (q-SOFA) scores in determining the need for ICU admission and mortality among hospitalized patients with CAP. Methods: Adult patients diagnosed and hospitalized with community-acquired pneumonia between July 2021 and July 2023 were included. Patients’ demographics, comorbidities, disease severity scores, laboratory findings at the admission and outcomes were recorded. Patients were grouped and compared according to admission place (ward or ICU). Results: PSI, CURB-65, q-SOFA scores, and LAR were higher in ICU patients than in those admitted to the ward. Regarding the ICU admission, the AUC values for PSI, CURB-65, q-SOFA and LAR were 0.794 (95% CI: 0.737–0.843) (p < 0.001), 0.825 (95% CI: 0.771–0.870) (p < 0.001), 0.755 (0.690–0.813) (p < 0.001), and 0.749 (95% CI: 0.689–0.802) (p < 0.001), respectively. Regarding the mortality, the AUC values for PSI, CURB-65, q-SOFA, and LAR were 0.722 (95% CI: 0.661–0.778) (p < 0.001), 0.743 (95% CI: 0.683–0.797) (p < 0.001), 0.645 (0.575–0.711) (p: 0.02), 0.761 (95% CI: 0.702–0.814) (p < 0.001), respectively. There wasn’t any difference detected in pairwise comparisons of ROC curves. Conclusion: In this study, LAR was found to be a good predictor of ICU admissions and mortality in hospitalized patients with CAP and was non-inferior to PSI, CURB-65, or q-SOFA scores.

Chronic infection,lymphoma,viral shedding

Many studies have shown that the diagnostic value of lung ultrasound is much better than chest radiography in selected patients in emergency departments, intensive care units and inpatient clinics. However, there is insufficient data on the routine use of lung ultrasonography (LUS) in chest diseases outpatient clinics. The main aim of this study was to determine the diagnostic value of routine use of AUS in outpatients. One hundred and twenty-nine patients were included in the study. Lung ultrasound was performed by a pulmonologist on the same day as chest radiography (CXR), unaware of the patient's clinical and radiologic information. Chest radiographs of the patients were evaluated by two independent experts after patient recruitment was completed. The clinical final diagnosis (CFD), which was accepted as the reference standard, was obtained from hospital automation records. Patients were divided into two groups as those with pulmonary pathology (n= 74) and those without pulmonary pathology (n= 55) according to CFD. The sensitivity and specificity values of LUS and CXR were 48.05% and 50.64% and 78.85% and 84.62%, respectively. The rates of detection of pulmonary disease by LUS and CXR were similar (McNemar test, p< 0.05). There was moderate agreement between the two tests in assessing the presence of pulmonary pathology (kappa= 0.484, p< 0.05). Female sex and obesity negatively affected the diagnostic accuracy of LUS (p< 0.05), whereas age and symptom duration had no effect (p< 0.05). Mean LUS duration was 8.02 minutes. The study demonstrated that LUS can contribute as a preliminary diagnostic tool with or without CXR in outpatient settings. Especially in situations where chest radiography is unavailable or contraindicated, such as pregnancy, LUS can safely contribute to the diagnosis of lung disease.

Background/Aim: Acute lung injury (ALI) is a syndrome characterized by the disruption of alveolar endothelial and epithelial barriers, neutrophilic infiltration in pulmonary regions, and non-cardiogenic edema, associated with high mortality and morbidity. Despite intensive research efforts, there is currently no approved specific treatment for the condition. The aim of this study was to investigate the potential beneficial effect of ischemic post-conditioning in lipopolysaccharide (LPS)-induced lung injury and its possible association with inflammatory and apoptotic processes. Materials and Methods: Lung injury was induced in rats by a single intraperitoneal administration of 10 mg/kg LPS. Under anesthesia, latex tourniquets were wrapped around both hind limbs of the animals in a region close to the body to achieve complete ischemia. The ischemic conditioning procedure consisted of four cycles of 10 min of ischemia followed by 10 min of reperfusion. Inflammation, and apoptosis levels were measured using ELISA. Hematoxylin and eosin staining was used for histopathological evaluation, while TUNEL staining was employed for apoptotic cell counting. One-way analysis of variance (ANOVA) with post hoc Tukey test was used for comparisons between groups. Results: Intraperitoneal LPS administration induced neutrophil infiltration and apoptotic cell death in lung tissue. These effects were prevented by remote ischemic postconditioning (RIPostC) application. Additionally, the beneficial effects of ischemic conditioning can be transferred via serum. Conclusion: RIPostC can ameliorate LPS-induced ALI. The mechanism of the protective effects of RIPostC may lie in the suppression of apoptosis and neutrophil infiltration.

Background: In patients with community-acquired pneumonia (CAP), scoring systems are important for determining disease severity and selecting the appropriate unit and antibiotics for treatment. The aim of this study was to determine the 30- and 90-day mortality rates, identify influencing factors, and compare the effectiveness of the PSI, CURB-65, and I-ROAD systems in predicting mortality among patients hospitalized for CAP. Methods: We prospectively included adult patients with CAP requiring hospitalization at Hospital between January 2019 and January 2020. Patients were categorized based on the CURB-65, PSI, and I-ROAD systems, and their treatment success as well as 30- and 90-day survival rates were evaluated. Results: The study comprised 60 patients with CAP, of whom 40 were male (66.7%). When assessing factors influencing 30-day mortality, the impact of immunosuppression (p:0.004), presence of malignancy (p: 0.003), Apache II score (p:0.014), and steroid use (p:0.004) was found to be significant. Both PSI and CURB-65 had a impact on 30-day mortality (p = 0.005, p = 0.007). Although there was an observed difference in mortality between the I-ROAD groups, its effect on mortality was not statistically significant (p = 0.093). Analyzing 90-day mortality revealed that the PSI and CURB-65 classifications significantly affected mortality (p < 0.001; p = 0.037). Despite a mortality difference among the mild, moderate, and severe I-ROAD groups, the difference was not statistically significant (p = 0.256). Conclusions: Both PSI and CURB-65 were significant predictors for both 30-day and 90-day mortality, with PSI exhibiting the highest specificity. I-ROAD did not show statistical significance, although a notable difference was found between the groups.