Background and Objectives: Acute exacerbation of idiopathic pulmonary fibrosis (IPF-AE) often results in severe respiratory distress requiring treatment in the intensive care unit and has a high mortality rate. Identifying prognostic markers and assessing disease severity are crucial for clinicians to gain detailed insights. The mean platelet volume-to-platelet count ratio (MPR) is an inflammatory marker commonly used in malignancies. This study aimed to evaluate MPR and other factors affecting mortality in patients with IPF-AE who were monitored in the intensive care unit (ICU). Materials and Methods: This retrospective study was conducted on patients monitored in the ICU for IPF-AE between 2017 and 2023. Demographic characteristics, vital signs, laboratory and imaging findings, and administered treatments were reviewed. MPR was calculated by dividing the mean platelet volume by the platelet count. The primary endpoint was defined as 1-month in-hospital mortality. Results: A total of 59 patients monitored in the ICU for IPF-AE were included in the study. The mean age of the patients was 62.75 years, and 81.4% of the participants were male. During the 30-day follow-up period, 62.7% of the patients died. The need for invasive mechanical ventilation (IMV) was significantly associated with increased mortality (p < 0.001). The optimal cutoff value for MPR was determined to be 0.033, with a sensitivity of 83.7% and specificity of 63.64%, indicating its predictive value for mortality (AUC: 0.764; 95% CI: 0.635–0.864; p < 0.001). Conclusions: In this study, the need for IMV emerged as a critical parameter in predicting mortality in patients with IPF-AE. Additionally, the use of the MPR as a prognostic biomarker may offer a novel approach in the management of IPF patients. These findings could contribute to the development of strategies aimed at early intervention in IPF patients. Further studies with larger sample sizes are needed to validate these results. This study has demonstrated that MPR is a significant prognostic biomarker for predicting mortality in patients with IPF-AE who are managed in the intensive care unit. The potential use of MPR as a biomarker in clinical decision-making may provide new approaches to the management of IPF patients. Additionally, the need for IMV in IPF-AE emerges as a critical parameter for predicting mortality. These findings may contribute to the development of early intervention strategies for IPF patients. Further studies with larger cohorts are needed to validate these results.

Introduction: Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is an infectious disease that has caused significant mortality and morbidity worldwide. COVID-19 is known to cause complications, such as myocardial damage, acute coronary syndrome, deep vein thrombosis, pulmonary embolism, arrhythmia, heart failure, acute ischemic stroke, liver damage, cytokine storms, ischemia-reperfusion damage and side effects of drug treatments. In our study, we aimed to evaluate the complications that developed during hospitalizations in patients with moderate-to-severe COVID-19 related pneumonia who were hospitalized in our COVID-19 service. Material and Method: This study included patients with moderate-to-severe COVID-19 pneumonia with a positive reverse transcriptase polymerase chain reaction (RT-PCR) test who were treated in our COVID-19 service between November 2020 and January 2021. Their demographic characteristics, treatment regimens, baseline laboratory values and complications during their hospitalization were retrospectively recorded. Results: The study group had a mean age of 62.92± 14.60 years and 40.6% (n= 55) were female. Approximately 35.3% (n= 48) of the patients developed complications due to COVID-19 during their follow-up period. Of the patients with complications, 63.8% (n: 30) were male, most common complications were elevated liver enzymes (47.9%) and pulmonary thromboembolism (20.8%). Of those patients with complications, the most common comorbidities were hypertension (40.4% [n= 19]), diabetes mellitus (25.5% [n=12]) and cardiovascular disease (23.4% [n=11]). There were no significant relationships between the presence of complications and age, sex or comorbid diseases (p>0.05 for each). Conclusion: There are more underlying conditions, such as hypertension, diabetes mellitus, cardiovascular disease, chronic lung disease in hospitalized patients with moderate-to-severe pneumonia compared to outpatients with COVID-19 pneumonia. Complications develop, especially in the management of COVID-19 pneumonia, which affect the treatment process and patient mobilization.

Aim The aim of our research was to investigate retrospectively the relationship between the symptoms and general characteristics, initial laboratory values and treatments in patients who had COVID- 19 and who applied to the chest diseases outpatient clinic for control after 1 month. Methods Three hundred fifteen patients who were diagnosed with COVID- 19 and applied to the chest diseases outpatient clinic between May 2020 and August 2020 for control in the 1st month were included in the study. Patient information was collected from the hospital information system and the e-pulse system. Results Females accounted for 50.2 % of the our patients and their mean age was 47.9 ± 14.8 (19-88) years. 14.3% (n: 45) of the individuals were 65 years of age and older. 20.6% (n: 65) of our patients were smoking. 70.2% (n: 221) of our patients were treated at home. 133 patients had at least one comorbid disease. The patients most frequently reported cough, dyspnea, weakness, myalgia and diarrhea. The most common symptoms were cough, dyspnea, weakness and myalgia in the first month. Initial D-dimer, initial CRP and the values of platelet, D dimer and CRP in the first month were detected to be higher in patients with persistens symptoms when the laboratory values of patients whose symptoms continue after 1 month were examined. It was determined that the symptoms had persisted in patients who had been hospitalized, had dual therapy, had comorbid diseases and had more common pathologies in their pulmonary imagings. Conclusion Symptoms may persist for a long time in hospitalized patients, in patients with COVID-19-related pneumonia and concomitant chronic diseases and in patients with high D-dimer and high CRP at the time of admission. Patients are informed that their symptoms may last for a long time, unnecessary hospital admissons can be avoided.

Meteorological factors affect the respiratory system, and the most important factor is the change in ambient temperature and humidity. We aimed to investigate the seasonal characteristics of patients diagnosed with cryptogenic organizing pneumonia. The study included 84 cryptogenic organizing pneumonia, 55 chronic obstructive pulmonary disease, and 42 asthma patients. To determine the characteristics of the disease according to the seasons, the number of attacks and admissions was grouped according to the seasonal characteristics and analyzed for three groups. Among cryptogenic organizing pneumonia and chronic obstructive pulmonary disease patients, males significantly predominated (p<0.001). The hospitalization rate was highest in chronic obstructive pulmonary disease patients but similar to cryptogenic organizing pneumonia and asthma patients (p<0.001). The highest admission rate in cryptogenic organizing pneumonia patients was observed in spring (39.3% in spring, 26.2% in fall, 22.6% in winter, and 11.9% in summer). In winter, cryptogenic organizing pneumonia patients were admitted less frequently than chronic obstructive pulmonary disease and asthma patients. The neutrophil-to-lymphocyte ratio was higher in cryptogenic organizing pneumonia patients than in asthma patients and similar to chronic obstructive pulmonary disease patients. As a result of our study, the high rate of diagnosis and admission in the spring in cryptogenic organizing pneumonia suggested that the effect of allergens on the formation of cryptogenic organizing pneumonia should be investigated. In contrast, it should be kept in mind that cryptogenic organizing pneumonia may develop as a prolonged finding of involvement that may occur in the lung parenchyma due to lung infections and/or cold weather triggering during the winter months. In this regard, further studies can be conducted in which allergens and/or the history of infection in patients and meteorological variables are also evaluated.

Background and aim Sarcoidosis is a multisystem inflammatory disease of unknown aetiology. This study aimed to evaluate the relationship between systemic inflammatory parameters, the systemic immune-inflammation index (SII) and the lymphocyte-to-monocyte ratio (LMR), and disease stage, clinical findings, and 18F-fluoro-2-deoxy-D-glucose (18F-FDG) tomography/computed tomography (PET/CT) uptake. Materials and methods Our study included 73 patients. The general characteristics, radiological features, spirometric tests, PET/CT findings, and laboratory parameters of the patients were recorded. Results Relapse and parenchymal fibrosis were not associated with metabolic parameters, such as LMR and SII. Serum angiotensin-converting enzyme (ACE) levels were lower in the relapsed group than in the non-relapse group. However, the patients’ PET/CT images indicated that 18F-FDG parenchym maximum standard uptake value (SUV max), lymph node SUV max, lymph node short axis dimension, SII, and LMR were similar between all patients, relapsed or not. Conclusion Although found to be significant in other inflammatory diseases, we found that SII and LMR alone did not indicate disease prognosis in sarcoidosis due to the small number of patients and the lack of homogeneity between the groups in our study. The usefulness of these markers for clinical use should be investigated by studies that include those with extrapulmonary sarcoidosis, and that calculate these markers at the time of disease diagnosis and during the post-treatment period.

Introductıon Sjögren syndrome is a chronic, systemic, inflammatory disease characterized with lymphocytic infiltration of the exocrine glands, frequently manifested by dryness in the region affected. Although the most common extraglandular involvement in SS is pulmonary involvement. Early diagnosis and treatment is considered to be important. It was aimed to evaluate the frequency of early lung involvement, high resolution computed tomography (HRCT) findings and data of pulmonary function test (PFT) in SS in this study. Materıal-Method Thirty five patients diagnosed with SS and referred by the Department of Rheumatology to determine potential lung involvement to the 8th chest diseases outpatient clinic of our hospital between September 2015 and december 2018 were included in this study. Respiratory signs, demographic features, length of disease and treatment regimens, PFT, data of 6-minute walk test (MWT) and findings of HRCT of the patients were retrospectively obtained from hospital information system and patient files. Results The mean age of the patients was 54.4 ± 9.2. The majority of the patients were women (94.3%). When the HRCT findings were evaluated, 28 (80%) patients had CT findings, while 7 (20%) patients had no CT findings. The most common HRCT findings found in patients were peribronchial thickening (48.6 %), ground glass appearance (28.6%) and prominence in interstitial scars. Conclusion We think that the evaluation of HRCT and PFTs in patients diagnosed with SS for assessing early pulmonary involvement will be guiding in terms of follow-up and treatment.