Tracheobronchial amyloidosis is a rare presentation and accounts for about 1% of benign tumors in this area. The diagnosis of disease is delayed due to nonspecific pulmonary symptoms. Therapeutic approaches are required to control progressive pulmonary symptoms for most of the patients. Herein, we report a case of a 68-year-old man admitted with progressive dyspnea to our institution for further evaluation and management. He was initially diagnosed with and underwent management for bronchial asthma for two years but had persistent symptoms despite optimal medical therapy. Pulmonary computed tomography scan revealed severe endotracheal stenosis. Bronchoscopy was performed and showed endotracheal mass obstructing 70% of the distal trachea and mimicking a neoplastic lesion. The mass was successfully resected by mechanical resection, argon plasma coagulation (APC), and Nd-YAG laser during rigid bronchoscopy. Biopsy materials showed deposits of amorphous material by hematoxylin and eosin staining and these deposits were selectively stained with Congo Red. Although this is a rare clinical condition, this case indicated that carrying out a bronchoscopy in any patient complaining of atypical bronchial symptoms or with uncontrolled asthma is very important.

New treatment regimens for COVID-19, which threatened the world recently, continue to be investigated. Although some of the treatments are promising, it is thought to be early to clearly state that there is definitive treatment. Experiences and treatment protocols studies coming from the centers are still very important. The aim of this study is to evaluate factors affecting the treatment process in the first cases followed in our clinic. The consecutive hospitalized patients with COVID-19 pneumonia were analyzed in this retrospective and cross-sectional study. Datas were recorded from the electronic and written files of patients. Eighty three patients were evaluated. The median age was 50±15 years. Fourty eight (57.8%) patients had one or more comorbidities. The most common comorbidity was hypertension. The most common symptom was cough in 58 patients (70%). The overall mortality was 15% and 85% of the patients were discharged. The time between the onset of symptoms and hospitalization was statistically significantly longer in deceased patients (p=0,039). Age, D-Dimer, troponin, creatine kinase (CK), CK-MB, ferritin, procalcitonin, and neutrophil to lymphocyte ratio were statistically significantly higher in deceased patients than survivor patients. Performed subgroup analysis, in the patients receiving azithromycin plus hydroxychloroquine and other antibiotics plus hydroxychloroquine, the duration of hospitalization was shorter in azithromycin group (p=0,027). Early treatment and early admission to the hospital can be crucial for the better treatment process. Combination therapy with azithromycin may be preferred in the first treatment choice because it can shorten the length of hospital stay.

The main purpose of the study was to investigate changes in mean platelet volume (MPV) values in patients with obstructive sleep apnea syndrome (OSAS) who had undergone uvulopalatal flap (UPF) surgery.The study included a review of the medical records of 37 adult patients who had undergone UPF surgery after being diagnosed with OSAS. The baseline blood parameters of patients, including the MPV and platelet distribution width (PDW) values, were measured and repeated 3 months after treatment. Polysomnographic evaluations of the patients were also performed during admission and the 3rd month control. Comparisons of MPV values and their correlation with polysomnographic parameters were the main outcomes measured.The blood parameters of all patients were similar except for MPV values, which were significantly lower after treatment (P < 0.001). Patients' apnea hypopnea index (AHI) and apnea episodes were significantly reduced after the UPF surgery, whereas their oxygen saturation significantly increased (P < 0.001). The MPV values were not correlated with polysomnographic parameters (P > 0.05).The UPF surgery, which is a relatively simple surgical intervention to treat OSAS, alleviates nocturnal hypoxic episodes and lowers platelet volume. These may both be important predictors of adverse cardiovascular outcomes related to OSAS.

Introduction: The Severe Acute Respiratory Syndrome (SARS-CoV-2) virus, which emerged from China and spread all over the world, has affected the world in every aspect and will do so in the foreseeable future. This study was carried out to investigate the possible aggravating effect of smoking on the prognosis of patients with COVID-19 pneumonia presenting with pulmonary involvement. Materials and Methods: 114 adult patients who received inpatient treatment in our clinic with the diagnosis of COVID-19 pneumonia between 11 March 2020 and 30 April 2020 were retrospectively included in the study; in particular, they were evaluated in terms of smoking history, severity of disease, need for NIMV and ICU admission, and mortality during their hospitalization. Results: The mean age of the 114 patients hospitalized with COVID-19 pneumonia was 51.14 +/- 14.97 (range 16-81), and 77 (67.5%) were male. Of the patients, 19 (15.9%) were active smokers, 23 were ex-smokers (20.1%), 72 (63.1%) non-smokers. The effect of smoking on the severity of the disease, length of hospitalization, need for non-invasive mechanical ventilation (NIMV) and intensive care unit (ICU) admission and mortality were not statistically significant. Conclusion: The rate of active smoking in patients hospitalized with COVID-19 is lower than the population average. In this study, no correlation was observed between smoking status and the severity, prognosis and mortality of the disease. Further studies with larger number of patients and case series are needed to better elucidate the relationship between smoking and COVID-19 and the pathophysiologic mechanisms of the effects of smoking on the natural history of COVID-19 pneumonia.

Influenza A (H1N1) caused its first pandemic in 2009 in USA and Mexico. Since then, clinicians have exercised great care in order to make an early diagnosis of viral pneumonias. This is due in part to pandemic influenza A infection having greater impact on populations <65 years old than other viral strains, including seasonal influenza. Chest radiographies of those affected displayed a rapid progression of patchy infiltrates, and a large proportion of individuals required admission to intensive care units (ICU). Despite efforts, patients infected with the virus had a high mortality rate. The present multicenter study aimed to retrospectively evaluate the clinical, demographic and prognostic characteristics of patients diagnosed with epidemic viral pneumonia in Turkey. A total of 92 patients were included in the study. The Student's t-test and Chi-square tests were performed to analyze quantitative data, assuming a normal distribution, and to analyze qualitative data, respectively. Stepwise logistic regression was used to evaluate the effects of demographic variables and laboratory values on the virus mortality rate. The male/female ratio was 42/50 and the mean age was 48.74±16.65 years. A total of 69 (75%) patients were unvaccinated against influenza. The most common symptoms were cough (87%) and fever (63%). Chest computed tomography showed peripheral patchy areas of the lungs of ground glass density in 38 patients (41.3%). A total of 22 (59.4%) patients had H1N1, 5 (12.5%) patients had influenza B, and 38 (41.3%) patients met the criteria for admission to the ICU. Of these patients, 20 (52.63%) were monitored with a mechanical ventilator, with a noninvasive ventilator being adequate for 10 (26.32%) of patients. The length of stay in the ICU was 6.45±5.97 days and the duration of mechanical ventilation was 5.06±4.69 days. A total of 12 (13.04%) patients in the ICU succumbed. Logistic regression analysis revealed that among the parameters possibly associated with mortality, being an active smoker increased the risk of mortality 7.08-fold compared to other groups (P=0.005). In conclusion, viral pneumonia remains a significant health problem during the winter period. Considering the high number of ICU admissions and high rate of mortality for patients in the present study, earlier initiation of antiviral therapy is necessary. Active smoking increased mortality in viral pneumonia.