Endobronchial coil lung volume reduction performed on patients with emphysema dominant COPD: Long term follow-up results.

Introduction: Chronic obstructive pulmonary disease (COPD) is a commonly seen, preventable, and treatable disease with permanent respiratory symptoms and air entrapment that is caused by particle exposure. In case of limited response to traditional treatment protocols, lung volume reduction may be performed in patients with emphysema dominant patterns. In this study, long term follow-up results of the patients who had been operated on by minimal invasive bronchoscopic lung volume reduction surgery by coil placement were reported. Materials and Methods: Records of the patients operated on by coil placement were retrospectively investigated, and pulmonary function test (PFT), echocardiography (ECHO), six-minute walking test (6MWT), tomography images, ventilation scintigraphy, and clinical summaries were evaluated. Out of 34 initial candidates, 18 patients were included in the study. Wilcoxon signed-rank test and Spearman's rho were utilized to compare interventions and follow-up testing. Result: The average age of 18 patients was 62 (50-74) years, and except for one patient, all were males (n= 17). Fifteen patients were operated bilaterally, and the rest were unilaterally operated, with an average of 10 coils placed per coil placement. An average of 90 days was between bronchoscopic coil placement, with a follow-up duration of 45 days in between. Mean total follow-up duration was 794 (± 424) days. Pneumonia and pneumonitis were seen in 33% of patients within the first month. Mortality from respiratory causes was found to be 11%, while mortality from all causes was found to be 22%. Statistical difference was observed regarding 6MWT after bronchoscopic volume reduction when compared the initial preoperative values. However, this difference was later lost statistically at the second follow-up performed after the completion of both sides. A benefit in improved resting saturation was observed after the second procedure, which was not evident after unilateral intervention. However, similiar to 6MWT, this benefit was lost at the second follow-up, with resting saturation instead being effected negatively. No difference was observed in PFT results; however, a correlation was seen between FEV1 and walking distance. No specific correlation had been seen in the ECHO evaluation. Conclusions: Benefits regarding 6MWT and resting saturation were observed in patients undergoing minimal invasive bronchoscopic lung volume reduction surgery with coils. This benefit was evident in the short term but was lost as the follow-up duration increased. A relatively high morbidity and mortality rate was also present, further stating the risky nature of pulmonary intervention, even minimally invasive procedures, on patients with COPD.

Hughes-Stovin Syndrome: A Rare Cause of Thrombosis and Pulmonary Artery Aneurysm.

Hughes-Stovin Syndrome (HSS) is a rare clinical condition characterized by thrombophlebitis as well as multiple pulmonary and bronchial aneurysms. It commonly presents with coughing, dyspnea, fever, chest pain, and hemoptysis, and its management usually consists of surgical and medical approaches. In this report, we discuss a case of a patient with HSS. A 30-year-old male patient was admitted to the pulmonary medicine ward for hemoptysis. After evaluation with chest CT, bilateral pulmonary embolism and pulmonary aneurysms were observed. Due to a history of aphthous lesions, Behçet's disease (BD) was considered the initial diagnosis; however, the patient did not fit the criteria and was later diagnosed with HSS. Intravenous methylprednisolone was initiated, along with a maintenance treatment with cyclophosphamide. Treatment response was observed in the fourth month; however, due to the persistence of hemoptysis, additional cycles of cyclophosphamide were later required, under which the patient's condition has been stable. HSS currently lacks clear diagnostic criteria, and further studies are needed to investigate genetic backgrounds, familial transmissions, and treatment alternatives.

Coronavirus Disease 2019 Pneumonia Scoring System Comparison and Risk Factors.

OBJECTIVE: Coronavirus disease 2019 is a disease caused by severe acute respiratory syndrome coronavirus 2, a novel type of coronavi- rus, which causes pneumonia in some hosts. No specific scoring method exists for mortality evaluation in novel coronavirus pneumonia. The aim of this study was to investigate factors affecting coronavirus disease 2019 mortality and comparison of pneumonia scoring sys- tems, pneumonia severity index, CURB-65, and MuLBSTA. MATERIAL AND METHODS: In this single-center clinical study, 151 patients who had been diagnosed with coronavirus disease 2019 infection and pneumonia between March 11 and May 31, 2020, were evaluated retrospectively. Correlation between patients' symptoms, comorbidities, drugs in use, radiological findings, and mortality was investigated. Parameters were also evaluated regarding their contribution to additional treatment requirements and days of fever response. RESULTS: A correlation between mortality and higher scores of pneumonia severity index, CURB-65, and MuLBSTA was found. When parameters were investigated separately, elevated glucose and urea levels, presence of diabetes, renal failure, hypertension, chronic obstructive pulmonary disease, cerebrovascular events and known malignancies, lymphocyte count, smoking history, radiological find- ings, and age correlated with mortality. In addition to these parameters, elevated calcium, potassium, brain natriuretic peptide, troponin, d-dimer, C-reactive protein, HC03, and lactate dehydrogenase levels were found significant regarding mortality. These parameters were not found statistically relevant regarding additional treatment requirement, fever response day, and total treatment duration. CONCLUSION: A modified version of present pneumonia scoring systems will be required to rigorously evaluate the severity of a patient's condition. A new scoring system that uses components of the present ones may prove useful and with further studies, a similar follow-up algorithm may be created.

Anti-fibrotic Treatment for Pulmonary Fibrosis Induced by COVID-19: A Case Presentation.

Coronavirus disease 19 infection clinical presentation varies from asymptomatic cases to acute respiratory distress syndromes. In some cases, pulmonary fibrosis is observed after or during the disease. Pirfenidone is an agent approved for the treatment of idiopathic pulmonary fibrosis. Here we report a patient treated with pirfenidone for pulmonary fibrosis related to coronavirus disease 19.

Evaluation of the Effect of COVID-19 Vaccination on Exacerbations of Chronic Obstructive Pulmonary Disease: A Single-Center Study.

BACKGROUND AND AIM:  Vaccinations have been one of the main approaches to reducing mortality and exacerbations caused by infectious agents in chronic obstructive pulmonary disease (COPD). Among viral pathogens, coronaviruses have been described to play a role. This study aims to investigate the role of coronavirus disease 2019 (COVID-19) vaccination on exacerbation reduction in patients with COPD. METHODS: Patients diagnosed with COPD prior to the study date were considered the study population. Exacerbations of COPD before and after the COVID-19 vaccination were recorded. Patients with influenza and/or pneumococcal vaccination were excluded from the study due to their known role in reducing exacerbations of COPD. RESULTS: The study included 152 patients with a mean age of 67.5 ± 9.7 years. Most patients were classified under Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages 2 and 3. In fully vaccinated patients, COPD exacerbation was observed to be higher than in those without full vaccination (70.5% vs. 55.3%, respectively). Total risk status and vaccination status, however, were seen to be in a positive correlation, with higher risk and complete vaccination status presenting with a higher count of COPD exacerbation. CONCLUSION: Although it is known that the administration of COVID-19 vaccines in patients in risk groups reduces the risk of disease, there is no study showing a positive effect on COPD exacerbations alone. In our study, it was observed that only the COVID-19 vaccine was ineffective in attacks without influenza and pneumococcal vaccines.