Introduction: Community-acquired pneumonia (CAP) remains a major cause of morbidity and mortality in elderly patients. Early identification of high-risk individuals is crucial for improving outcomes. Biomarkers derived from routine laboratory tests, such as the lactate / albumin (L/A) ratio, may provide valuable prognostic information. Methodology: This retrospective, two-center observational study included patients aged ≥ 65 years who were hospitalized with CAP between January 2021 and December 2024. Demographic characteristics, comorbidities, clinical severity scores, and laboratory parameters obtained at hospital admission were analyzed. Laboratory-derived ratios, including L/A, C-reactive protein/albumin (CRP/A), procalcitonin/albumin (PCT/A), and lactate dehydrogenase/albumin (LDH/A), were calculated. Receiver operating characteristic (ROC) analysis and logistic regression were performed to assess predictors of in-hospital mortality. Results: A total of 150 patients were included, of whom 24% died during hospitalization. Non-survivors had significantly higher comorbidity burden, quick sepsis-related organ failure assessment (qSOFA) scores, lactate levels, and biomarker-based ratios. The L/A ratio was significantly associated with mortality (p < 0.001) and demonstrated moderate diagnostic performance (area under ROC, AUC = 0.263), with relatively favorable sensitivity and negative predictive value. Among the evaluated clinical scores, qSOFA showed the most balanced discriminatory performance. Multivariate analysis identified baseline oxygen saturation, Glasgow coma scale, albumin, and lactate levels as independent predictors of mortality. Conclusions: The L/A ratio is a readily available biomarker associated with mortality in elderly patients with CAP. Although not a standalone predictor, it may serve as a complementary prognostic tool alongside established clinical severity scores, particularly during early patient assessment.

Objective: This study aimed to evaluate the appropriateness of antibiotic therapy and discharge prescriptions in patients with lower respiratory tract infections (LRTIs) using the Medication Appropriateness Index (MAI) criteria. Methods: A retrospective cross-sectional study was conducted between January 2022 and January 2024 at a tertiary training and research hospital. A total of 111 patients diagnosed with community-acquired pneumonia, acute/chronic bronchitis, or infectious exacerbations of COPD and asthma were included. Prescriptions were evaluated independently by two physicians based on the ten MAI domains. Results: All prescriptions were fully appropriate regarding indication, effectiveness, dosage, and directions (100%). No clinically significant drug–drug or drug–disease interactions were detected. Unnecessary antibiotic duplication occurred in 4.5% of cases, and cost appropriateness was achieved in 68%. Monotherapy was predominant during hospitalization, while a trend toward narrower-spectrum and more cost-effective regimens was observed at discharge. Conclusion: According to MAI assessment, overall clinical appropriateness of antibiotic prescribing was high. Reducing unnecessary duplication and promoting cost-effective alternatives may further strengthen rational antibiotic use and antimicrobial stewardship practices.

Recent studies have reported a relationship between obstructive sleep apnea syndrome (OSAS) and benign prostatic hyperplasia (BPH). In this study, we investigated the association between continuous positive airway pressure (CPAP) therapy and changes in lower urinary tract symptoms, uroflowmetric parameters, nocturia-related quality of life, and prostate-specific antigen (PSA) levels in male patients with OSAS and BPH. The primary endpoint was the change in International Prostate Symptom Score (IPSS), while secondary endpoints included changes in International Consultation on Incontinence Questionnaire Nocturia Quality of Life Questionnaire (ICIQ-NQoL), Qmax, Qavg, post-void residual urine volume, and PSA levels. This retrospective single-center observational study screened 352 male patients diagnosed with OSAS. Of these, 38 patients diagnosed with BPH who regularly used CPAP therapy for at least 6 months and met the inclusion criteria were included in the study. ICIQ-NQoL, the IPSS, uroflowmetric measurements and PSA levels were evaluated in all patients before and after CPAP treatment. The mean age of the 38 patients was 61.03 ± 8.63 years and the age ranged between 47 and 78 years. The Apnea-Hypopnea Index was significantly correlated with PSA, IPSS, and ICIQ-NQoL scores ( r = 0.400, P = .013; r = 0.397, P = .014; and r = 0.333, P = .041, respectively). Significant improvements were observed in IPSS, ICIQ-NQoL, Qmax, Qavg, and post-void residual urine volume following CPAP therapy (all P < .001), whereas no significant change was observed in PSA levels ( P = .29). CPAP therapy may be associated with improvements in lower urinary tract symptoms, uroflowmetric parameters, and nocturia-related quality of life in patients with OSAS and BPH; however, no significant change was observed in PSA levels.

Aim: Haemoptysis is a clinical condition characterised by blood in the airways and is difficult to manage even for experienced clinicians. Bronchoscopy is a crucial tool in the treatment and evaluation of haemoptysis. However, we see that it is not used sufficiently in diagnosis and treatment. Within the scope of our research, we aimed to investigate the place and importance of bronchoscopy in haemoptysis through our bronchoscopy applications in patients we follow with the diagnosis of haemoptysis. Material and Method: The files and data of patients who were admitted to the Pulmonary Diseases Department and Intensive Care Unit with the diagnosis of haemoptysis or who were followed up as outpatients and underwent bronchoscopy were retrospectively reviewed. Results: Bronchoscopy findings were normal in 18% of patients, endobronchial lesions (EBL) in 18%, external compression in 1%, mucosal-submucosal infiltration, increased raying in 4%, narrowing of orifices in 2%, mucosal petechiae-vascularity increased in 2%, fragile mucosal hyperaemia-oedema in 12%, active haemorrhage in 5%, haemoptysis residues-coagulum in 37%, and purulent secretion in 1%. While no findings were observed in 19% of the patients during bronchoscopy and no procedure was performed, 55% received topical applications, 7% received only thermal applications, and 19% received both thermal and endobronchial treatments (EBT). Conclusion: We believe that our study will support the existing literature by revealing that bronchoscopy plays an important role in the diagnosis and treatment processes of patients with haemoptysis and that this method has the potential to increase its clinical contributions in the future.

Objective: To evaluate the association between nocturnal hypoxemia burden—expressed as the percentage of total sleep time spent below 90% oxygen saturation (%T90/TST)—and atherogenic indices, including the atherogenic index of plasma (AIP), Castelli risk index I (CRI-I), and Castelli risk index II (CRI-II), in obstructive sleep apnea syndrome (OSAS); and to assess pre–post changes after adherent continuous positive airway pressure (CPAP) therapy. Methods: Single-centre retrospective–prospective cohort of adults with moderate–severe OSAS. Hypoxemia burden was quantified as the percentage of total sleep time with peripheral oxygen saturation (SpO₂) < 90% (%T90/TST) and grouped as Low (≤5%), Mild (>5–≤10%), Moderate (>10–≤25%), and Severe (>25%). The lipid panel—total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG)—and atherogenic indices (AIP, CRI-I, CRI-II) were compared across %T90 groups and within patients before and after ≥3 months of adherent CPAP (device-verified ≥4 h/night on ≥70% of nights). Results: One hundred and four patients were included. Higher %T90 was associated with a progressively more atherogenic profile: LDL-C ( p = 0.027), TC ( p < 0.001), TG ( p < 0.001) and CRI-I ( p < 0.001), CRI-II ( p = 0.006), AIP ( p < 0.001) were significantly higher in the >25% group versus ≤5%. The lowest nocturnal SpO₂ (peripheral oxygen saturation) did not correlate significantly with lipids/indices. After adherent CPAP, LDL-C (118.0 → 102.5 mg/dL), TC (199.0 → 182.0 mg/dL), TG (152.5 → 129.0 mg/dL) and CRI-I (4.37 → 3.94), CRI-II (2.58 → 2.24), AIP (0.55 → 0.46) decreased significantly (all p < 0.001), while HDL-C did not change ( p = 0.570). Primary endpoints (CRI-I/II, AIP) remained significant after Bonferroni correction. Conclusion: In OSAS, greater hypoxemia burden (%T90/TST) is linked to a more atherogenic lipid profile, and adherent CPAP is associated with a meaningful reduction in atherogenic load (AIP, CRI-I/II). These findings indicate that nocturnal hypoxaemia, captured using index-based measurements (AIP, Castelli I/II) as well as traditional lipids, is associated with a general reduction in atherogenic risk.