Cardiac involvement is increasingly recognized in patients with community-acquired pneumonia (CAP). This study aimed to investigate the association between baseline troponin I levels and clinical outcomes, including overall survival, among hospitalized patients with CAP who underwent clinician-directed cardiac evaluation. In this retrospective cohort study, 491 patients were stratified according to baseline cardiac troponin I level (<19.8 ng/L vs ≥19.8 ng/L). Demographic characteristics, comorbidities, laboratory and echocardiographic findings, and clinical outcomes were compared between groups. Survival was analyzed using Kaplan–Meier methods and Cox proportional hazards regression. The median age was 67 years, and 66% were male. Elevated troponin I was detected in 140 patients (28.5%) who were older and had higher rates of coronary artery disease, congestive heart failure, and chronic renal failure, as well as higher Charlson Comorbidity Index (CCI) and Pneumonia Severity Index scores (all P < .05). These patients also had lower left ventricular ejection fraction, higher rates of intensive care unit admission, and in-hospital mortality. During a median follow-up of 439 days, 167 patients (34%) died. Kaplan–Meier analysis showed significantly reduced overall survival in patients with elevated troponin I levels (log-rank P < .001). In multivariate Cox regression analysis, male gender, elevated troponin I (hazard ratio [HR] = 2.016), higher CCI (HR = 1.275), increased blood urea nitrogen to albumin ratio (HR = 2.876), lower hemoglobin levels (HR = 0.841), and reduced ejection fraction (HR = 0.964) were independently associated with mortality. Elevated baseline troponin I was associated with increased mortality and reduced overall survival in this selected high-risk patient population. However, its discriminative performance for mortality was modest (area under the curve [AUC] = 0.64) and lower than that of CCI (AUC = 0.73). The addition of troponin I to a model including age and CCI resulted in only minimal improvement in discrimination (AUC 0.721 vs 0.724), indicating limited incremental prognostic value beyond established risk indices.

Introduction: Cytisine is a plant-derived alkaloid that has gained attention as a cost-effective pharmacotherapy for smoking cessation. This study aimed to compare the real-world effectiveness and safety of cytisine versus nicotine replacement therapy (NRT) among individuals enrolled in a smoking cessation program. Methods: This non-randomized observational study included 476 patients who received pharmacological treatment for smoking cessation between January 2024 and January 2025 at a tertiary smoking cessation clinic. Patients were grouped according to treatment modality: cytisine or NRT. The primary outcome was continuous abstinence at 6 months, based on self-reported smoking status without biochemical verification. Secondary outcomes included tolerability and factors associated with cessation success. Results: Of the 229 patients treated with cytisine, 124 (54.1%) achieved 6-month abstinence, compared to 77 of 247 patients (31.2%) in the NRT group (p<.001). Female sex and the presence of diabetes mellitus were independently associated with higher cessation success. Both treatments were generally well tolerated; no serious adverse events were reported. Cytisine users most commonly reported mild gastrointestinal symptoms and sleep disturbances. Conclusions: Cytisine was significantly more effective than NRT in achieving 6-month continuous abstinence in a real-world setting, with a comparable safety profile. Certain subgroups, such as women and patients with diabetes, may benefit more from pharmacologic cessation support. Implications: This study provides supportive evidence for the routine clinical use of cytisine as a first-line smoking cessation treatment, especially in low- and middle-income countries. Its affordability, tolerability, and short treatment duration offer distinct advantages for public health implementation.

BACKGROUND: Accurate assessment of lung volumes is essential for diagnosing ventilatory defects and managing pulmonary diseases such as interstitial lung diseases (ILDs) and chronic obstructive pulmonary disease (COPD). Although body plethysmography is the standard method, it can be limited by patient tolerance and complexity. Helium dilution method (HDM) is a portable and cost-effective alternative, while chest computed tomography (CT) offers noninvasive volume assessment through imaging. This study aimed to evaluate the agreement and potential interchangeability between TLC values measured by CT (TLC _CT ) segmentation and the TLC _HDM in patients with ILD and COPD. MATERIALS AND METHODS: In this retrospective study, patients who underwent HDM and chest CT were evaluated. Based on pulmonary function tests (PFTs), patients were grouped as having restrictive or obstructive ventilatory defects. TLC _CT and HDM were compared using Bland–Altman analysis to assess agreement and bias. RESULTS: The study included 213 patients. In the overall cohort, TLC _CT was slightly lower than TLC _HDM (mean difference = −0.32 L, 95% confidence interval [CI] −0.50 to −0.14 L, P = 0.0007). In subgroup analyses, the mean bias was −0.67 L (95% CI −0.84 to −0.51 L, P < 0.001) for ILD and +0.78 L (95% CI 0.35–1.21 L, P = 0.0007) for COPD, indicating underestimation and overestimation by CT, respectively. The overall 95% limits of agreement ranged from −3.0 to +2.25 L. CONCLUSION: Both HDM and CT provide valuable lung volume data. CT may serve as a reliable alternative in patients unable to undergo PFTs. Prospective studies are warranted to confirm clinical utility.

The aim of the study was investigate the effect of corticosteroid use on the need for invasive procedure like tube thoracostomy with underwater seal drainage (TT-UWSD) and Video Assisted Thoracoscopic Surgery (VATS) in adult patients diagnosed with parapneumonic effussion in the exudative phase. A retrospective cohort study was performed in a chest diseases hospital. A total of 65 patients were included in the study. While 30 patients received only medical treatment, 35 patients underwent invasive procedures. Data on characteristics, vital signs, and laboratory parameters were recorded from electronic medical records. Univariate and multivariate logistic regression analyses were performed to identify corticosteroid and other predictors of the need for invasive procedures. The outcomes of the multivariate regression analysis revealed that an longer duration of symptoms (OR = 1.10, 95% CI: 1.01–1.21, P < .033) and the presence of dyspnea (OR = 5.44, 95% CI: 1.26–23.50, P < .023) independently associated with an increased need for invasive procedures, while corticosteroid treatment (OR = 0.15, 95% CI: 0.02–0.81, P < .028) was observed to be associated with a reduced necessity for invasive procedures. Treatment with metilprednisolone, together with the absence of dyspnea and shorter symptom duration may independently decrease the need for invasive procedure in patients with parapneumonic pleural effusion in the exudative phase.