INTRODUCTION: To compare the effectiveness of shock index (SI), modified shock index (MSI), Rapid Emergency Medicine Score (REMS), quick Sepsis Related Organ Failure Assessment (qSOFA), and Acute Physiology and Chronic Health Evaluation (APACHE II) scoring systems in the early prediction of 30-day mortality in critically ill COVID-19 patients admitted to the intensive care unit.
METHODS: This study was conducted as a single-center, retrospective, observational cohort study and included patients admitted to the intensive care unit due to COVID-19 infection during the 12-month period between March 2020 and February 2021. The receiver operating characteristic curves of the scoring systems were constructed to predict 30-day mortality, and their area under curve (AUC) values were calculated. A p-value of 0.05 or less was accepted as statistically significant.
RESULTS: The study was completed with a total of 634 intensive care patients. Mortality occurred in 75.7% (n=480) of the patients. The AUC values of the SI, MSI, REMS, qSOFA, and APACHE II scores in predicting 30-day mortality were found to be 0.59, 061, 0.72, 0.59, and 0.63, respectively. The most effective scoring was determined as REMS
DISCUSSION AND CONCLUSION: According to our results, REMS is a scoring system that can be used to predict 30-day mortality in COVID-19 patients admitted to the intensive care unit.

INTRODUCTION: This study aimed to analyze candidate listing and lung transplant outcomes in cystic fibrosis (CF) patients referred to a lung transplant center in Turkey.
METHODS: Between January 2015 and July 2022, 27 patients were evaluated retrospectively in our lung transplant center for end-stage lung disease due to CF. The characteristics of the patients at the time of admission, their status on the list, survival, and lung transplantation results were recorded.
RESULTS: Of the total patients, 14 (51.9%) of the patients were females and 13 (48.1%) were males. The average age was 17.81±7.24 years, and the mean body mass index (BMI) was 15.5±2.0 years. Six patients had cystic fibrosis-related diabetes (22.2%). Twenty-five patients (92.6%) were receiving supplemental oxygen. Low BMI was present in 23 (85.2%) patients, osteopenia in 8 patients (29.6%), and osteoporosis in 15 patients (55.6%). Four patients had liver fibrosis (14.8%). Twenty-five patients (92.6%) were added to the waiting list. Because of the early case and low BMI, one patient from each was omitted. The mean overall waiting time was 544.0±376.5 days. Nine patients (45%) on the waiting list died. Lung transplantation (4 bilateral pulmonary + 1 bilateral lobar) was performed on 5 patients (20%) on the waiting list. One of the lung recipients died in the early postoperative period.
DISCUSSION AND CONCLUSION: Contrary to developed countries, patients referred to our lung transplant center due to CF consisted of pediatric and young adult patients. Patient referral should be planned considering the long waiting period and the shortage of donors in Turkey, and the need for time to manage modifiable comorbidities. Patients with CF should be referred early to the transplantation center to obtain the best benefit from lung transplantation.

INTRODUCTION: Ankylosing spondylitis (AS) is a chronic inflammatory disease. Its main symptom is inflammatory low back pain. The presence of central sensitization (CS) in chronic pain conditions has been emphasized in several studies, but there are insufficient studies on AS patients. The aim of this study was to evaluate the relationship between disease activity in AS, the type of pain, and the presence of CS.
METHODS: Patients’ age, gender, body mass index, disease duration, drugs used in the treatment, pain type and severity, presence of CS disease activity, and quality of life were evaluated.
RESULTS: Evaluation was made on 80 patients, comprising 49 (61.2%) females and 31 (38.8%) males. A statistical significance was found between the presence of CS and high scores of painDETECT, Bath Ankylosing Spondylitis Disease Activity Index, Numerical Rating Scale for pain, Ankylosing Spondylitis Disease Activity Index-sedimentation, Ankylosing Spondylitis Quality of Life Index, low Short-Form-12 (SF-12) physical score (***p<0.001), low SF-12 mental score (**p<0.01), and increased age (*p<0.05).
DISCUSSION AND CONCLUSION: The results of this study demonstrated that as CS was present in the majority of AS patients, multidirectional evaluation of these patients is required, and in treatment approaches, evaluation is important in respect of treatments for CS in addition to the suppression of inflammation.

INTRODUCTION: The aim of this study was to investigate the patients treated for COVID -19 in pandemic hospitals in northwestern Syria.
METHODS: The study evaluated all patients hospitalized for COVID -19 by the pandemic emergency departments of hospitals in northwestern Syria between July 1, 2020 and December 01, 2020. Demographic, clinical, laboratory, and imaging characteristics, 4C mortality index scores treatments, and progressions of all patients hospitalized for COVID -19 were retrospectively reviewed.
RESULTS: A total of 991 patients admitted to hospitals in northwestern Syria by pandemic emergency services for treatment and follow-up were included. 114 patients from Afrin Hospital, 251 from Al-Bab Hospital, 527 from Azez Vatan Hospital, and 99 from Jarablus Hospital were included in the study. When comparing the mortality and hospitalization rates of the patients according to the 4C Mortality Score, it was found that the patients with high-risk score in Azez and Jarabulus hospitals and those with very high-risk score in El Bab hospital had significantly higher mortality and hospitalization rates in the ICU (p<0.05).
DISCUSSION AND CONCLUSION: The data that can be obtained from studies evaluating the approach to the COVID -19 epidemic in this and similar regions are important for the development of health services in disadvantaged regions. We believe that our study will make an important contribution to the literature, as it is the first and only data reflecting hospitalized patients with COVID -19 in this region.

INTRODUCTION: Maladaptive emotion regulation (ER) styles act as transdiagnostic mechanisms that underlie many psychiatric symptoms linked to cancer. ER and fear of compassion (FC) were studied in breast cancer, but their effects on psychiatric symptoms of colorectal cancer (CRC) patients are not studied. We aim to examine the role of ER and FC on depression and anxiety in Turkish CRC patients.
METHODS: This observational, cross-sectional study recruited 38 patients with CRC who were being followed up by the general surgery department of a university hospital. Emotion Regulation Questionnaire, Fear of Compassion Scale, the Exercise of Self-care Agency Scale, Hospital Anxiety and Depression Scale, Distress Thermometer, Numeric Pain Intensity Scale, and Ostomy Adjustment Inventory were applied. Multiple regression analyses were performed to identify factors affecting depression and anxiety levels.
RESULTS: Twenty-nine men and 9 women (median age=56.5, 28–69), most of whom were married and highly educated, were recruited. Expressive suppression (p=0.013) and pain (p=0.010) positively (Model, R2=0.42, p<0.001) and self-care agency (p=0.021) negatively influenced anxiety levels. Expressive suppression (p=0.017) and male gender (p=0.020) positively influenced depression levels (Model, R2=0.28, p=0.003). There was no association between cognitive reappraisal and levels of depression and anxiety. Among ostomates (n=17), 11 patients had low and 6 patients had medium adaptation to an active ostomy. No patient exhibited high adjustment to an ostomy.
DISCUSSION AND CONCLUSION: Findings indicate that in CRC patients, expressive suppression affects levels of anxiety and depression while cognitive reappraisal does not. FC was not found to be related to anxiety and depression. Physicians should carefully observe the patients’ and the caregivers’ ER strategies and the dynamic and interactive psychological states to understand which patients need psychological and psychiatric interventions. We suggest future studies explore the interventions that target expressive suppression patterns to prevent anxiety and depression in CRC patients.

INTRODUCTION: Congenital myasthenic syndrome (CMS) is a heterogeneous group of diseases that are not immune-mediated. It is caused by structural defects in different synaptic proteins of neuromuscular transmission as a result of different mutations. CMS is classified according to the location of the mutant protein as presynaptic, synaptic basal lamina-associated, or postsynaptic. In this study, we aimed to help further the knowledge of this issue by analyzing the clinical features and treatment responses of patients with an extremely rare condition of CMS.
METHODS: The clinical information of 13 patients who attended the CMS clinic at Mersin City Training and Research Hospital and Aydýn Maternity and Child Hospital were reviewed. After considering the clinical diagnosis in all our cases, we performed a genetic diagnosis with whole exon sequencing or a CMS panel.
RESULTS: Of the 13 patients included in this study, 11 (84.6%) were males and 2 (15.4%) were females. The mean age of our patients was 73.30±60.56 months, and the mean age at the time of diagnosis was 44±49.15 months. In our patients diagnosed with CMS, 9 (69.2%) COLQ mutations, 2 (15.4%) CHAT mutations, 1 (7.7%) RAPSN mutation, and 1 (7.7%) SCN4A mutation were observed. Ephedrine was started in 8 of the 9 patients with COLQ mutations, and a good response was obtained. A good response to treatment was not observed in those patients who were started on pyridostigmine.
DISCUSSION AND CONCLUSION: CMS can often be confused with other neuromuscular diseases. In patients presenting with ptosis, bulbar findings, apnea, and muscle weakness, CMS should be prediagnosed, and a genetic examination should be performed on these patients.

INTRODUCTION: In the emergency department, death from acute pancreatitis may be predicted using the ED-SAS (emergency department peripheral capillary oxygen saturation, age, and systemic inflammatory response syndrome) scoring system.
METHODS: One-center cohort observational research method was used in this study. It was decided to use a full case study technique. The hospital automation system was used to do retrospective screening on individuals who had presented to the emergency department with a diagnosis of acute pancreatitis. For the statistical evaluation of ED-SAS scoring system’s ability to predict 30-day mortality, the area under the curve (AUC) and receiver operating characteristic (ROC) curve were used.
RESULTS: A total of 112 patients were studied, with an average age of 62.5±18.4 years. The AUC (95% confidence interval: 0.696–0.856) for the ED-SAS scoring system for the prediction of death in patients with acute pancreatitis was 0.784 (Youden’s index: 0.381), and the p-value was 0.001. The ED-SAS’s sensitivity was 57.1%, specificity was 80.9%, positive predictive value was 16.7%, and negative predictive value was 96.6% when the cutoff number was greater than 1.
DISCUSSION AND CONCLUSION: The ED-SAS may be used to predict 30-day mortality in individuals with acute pancreatitis in the ED.

INTRODUCTION: Atherosclerotic cardiovascular disease (ASCVD) is a major cause of morbidity and mortality worldwide. The aim of the study was to reveal the success rates of glycemic control, serum low-density lipoprotein cholesterol (LDL-C), serum triglyceride (TG), and non-high density lipoprotein cholesterol (non-HDL-C) targets in type 2 diabetes mellitus (T2DM) patients according to recent guidelines.
METHODS: The study was a retrospective observational study of 389 previously diagnosed T2DM patients (217 women and 172 men) in an outpatient diabetes clinic. Demographic characteristics, comorbidities, medications, and laboratory measurements were recorded from the electronic system. ASCVD risks and target rates for LDL-C, TG, non-HDL-C, and HbA1c were evaluated according to 2019 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guidelines.
RESULTS: In total subjects, mean values of age, BMI, and HbA1c were 57.95±9.53 years, 31.45±5.36 kg/m2, and 7.83±1.35%, respectively. Of the total cases, 22.6% had moderate, 12.6% had high, and 64.8% had very high ASCVD risks. The percentages of patients with target LDC C, TG, and Non-HDL-c values were low in overall patient group (7.8%, 45.5%, and 8.9%, respectively). Coronary artery disease was found more frequently in men with T2DM than in women (p=0.001). Diabetic polyneuropathy was seen more prominent in patients with statin treatment (p<0.001). Although lower LDL-C was seen in patients under statin treatment (p<0.001), the percentage of patients with target LDL-C was similar in both groups (p=0.239). In this study 8.9% of total T2DM patients were on target for Non-HDL-C values. It is noteworthy that, patients using statins have lower Non-HDL-C and better target rates (p<0.001 and p=0.029). In patients with >7% HbA1c, LDL-C target success rates were lower (p=0.028), but Non-HDL-C target success rates were higher (p=0.039).
DISCUSSION AND CONCLUSION: In this pilot observation, the rate of achievement of the lipid targets recommended by 2019 ESC/EAS was low. More attention is needed to achieve success rates of lipid parameters and manage the risk of ASCVD in T2DM patients.

INTRODUCTION: This study aimed to retrospectively evaluate pleural complications in patients who were polymerase chain reaction (PCR)-positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and admitted to the hospital with COVID-19 pneumonia.
METHODS: A total of 164 patients who applied to our hospital between March 2020 and May 2021 with PCR-positive for SARS-CoV-2 were retrospectively evaluated and were followed up and treated in the service or intensive care unit. Pleural complications were detected during the treatment of COVID-19 pneumonia. In the current study, mortality was taken as the death of the patients in the first 30 days after hospitalization. Pleural complications occurring during treatment were classified into two groups: the pneumothorax (PNX) group and the pneumomediastinum (PMN) group.
RESULTS: Of the patients, 69 (52.3%) had isolated PNX and 14 (43.7%) had isolated PMN. PNX and subcutaneous emphysema were determined in 50 (37.9%) patients, PMN and subcutaneous emphysema were determined in 13 (40.6%), PMN, PNX, and subcutaneous emphysema were determined in 3 (9.4%), and PMN and PNX were determined in 2 (6.3%) patients. Hydro-PNX was determined in 12 (9.1%) patients, and PNX and empyema were determined in 1 (0.7%) patient. When the relationship between pleural complications occurring during treatment due to COVID-19 pneumonia and mortality was examined, mortality was observed in 14 (43.8%) of the PMN patients and 104 (78.8%) of the PNX patients (p<0.001). When the relationship between gender and mortality was examined, mortality was observed in 75 (65.8%) of the male patients and in 43 (86%) of the female patients (p=0.008).
DISCUSSION AND CONCLUSION: As a result, it was found that PNX after positive pressure ventilation increased mortality more than other pleural complications and worsened the prognosis. We think this issue will contribute to the literature in the COVID-19 pandemic and in pandemic diseases that may occur later and cause pleural involvement.

INTRODUCTION: The total number of citations of a research article can be used to determine its impact on the scientific arena. We aimed to identify the top 100 articles published on thyroid surgery and evaluate their characteristics.
METHODS: The authors searched the Thomson Reuters Web of Knowledge for citations of articles on thyroid surgery published from 2010 to 2021. The number of citations, authorship, year, journal, and country and institution of publication were recorded for each article.
RESULTS: Among the top 100 articles, there were 86 original articles, 12 review articles, and 6 proceeding papers. Top 100 articles received a total of 5285 citations (an average of 52.8 citations per journal) from 3469 different journals, and the most cited article received 218 citations. The leading institutions were Harvard University (12%), University of Insubria (9%), and Johns Hopkins University (7%). The top 100 articles were published in 25 different journals, with “Surgery” having the highest numbers (n=14), followed by “World Journal of Surgery” (n=10). The 100 most cited articles are most frequently based in the USA (41%), Italy (17%), and Germany (13%).
DISCUSSION AND CONCLUSION: The present study has produced a detailed list of the most cited articles on thyroid surgery. This list makes it possible to recognize classic articles on thyroid surgery, as well as research trends and academic achievements in this field.

INTRODUCTION: The recent increased use of electric scooters (E-scooter) in daily life has generated a great deal of discussion involving various areas, such as infrastructure problems, legal issues, and rider safety. This study aimed to manage the analysis of the clinical and demographic characteristics of patients who were admitted to emergency departments due to e-scooter accidents, especially during post-legal regulations in Turkey.
METHODS: The study is conducted as cross-sectional and descriptive research. The notice, data, and documents of the patients included in the study were scanned retrospectively, after which certain measurements were performed, such as the Injury Severity Score (ISS), Abbreviated Injury Scale (AIS), Trauma and Injury Severity Score (TRISS), and Pediatric Trauma Score (PTS) for children aged 15 years or under.
RESULTS: The age of the patients included in this study varies from 5 to 76 years, with a mean age of 27.20±11.90 years. When the injury regions of the patients were examined, the results were revealed as follows: 49.6% (n=58) to the upper extremities, 45.3% (n=53) to the lower extremities, 35.0% (n=41) to the head/face, 8.5% 9% (n=10) to the thorax, 0.9% (n=1) to the cervical vertebra, and 0.9% (n=1) to the thoracic vertebra. Considering the correlation between age, hospital admission time, and accident rates in the accidents with trauma scores, no statistically significant association was found between age and AIS (p>0.05) or ISS (p>0.05), and a statistically significant negative correlation of 45.2% was found between age and TRISS (p=0.001; p<0.01).
DISCUSSION AND CONCLUSION: Although it is revealed that E-scooter accidents lead to minor injuries to patients, the use is outside the target audience, causing injury due to mechanical deficiencies and noncompliance with legal rules.

INTRODUCTION: Metabolic syndrome is a worldwide health problem. The International Diabetes Federation (IDF) recommends a population- and country specific definition of cutoff points of waist circumference for the diagnosis of abdominal obesity. The purpose of this study was to determine the waist circumference cutoff values of the Turkish population.
METHODS: The study was conducted on a total of 1379 subjects (767 females and 612 males) who were admitted to the study hospital’s central laboratory for a routine check-up and blood tests and accepted to participate in this study. The participants were evaluated for the presence of the IDF criteria (other than waist circumference) for the diagnosis of metabolic syndrome.
RESULTS: To determine the cutoff values of waist circumference for predicting ≥2 risk factors defined by the IDF, a receiver operating characteristic (ROC) curve was plotted for each sex separately. The area under the ROC curve for men and women was 0.69 and 0.75, respectively. The cutoff values of waist circumference for predicting the presence of multiple risk factors (with at least 80% sensitivity) for men and women were 94 cm and 96 cm, respectively.
DISCUSSION AND CONCLUSION: For Turkey, it is more rational to use the waist circumference cutoff points identified in this study (i.e., 94 cm for men and 96 cm for women) than to use the IDF’s cutoff points recommended for the European subjects for the diagnosis of metabolic syndrome.

INTRODUCTION: Thoracic surgery is an operation with relatively high morbidity and mortality. It requires even greater care in patients undergoing hemodialysis (HD) because they are at greater risk than the general population. In light of the literature, we examined the results of major thoracic surgery performed at our clinic in patients with chronic renal failure (CRF) undergoing HD.
METHODS: Patients who underwent major thoracic surgery while receiving HD at our clinic between December 2015 and October 2021 were included in the study. The patients were analyzed in terms of pulmonary function values, smoking status, serum urea–creatinine values, comorbidities, ejection fraction, type of surgery, amount of drainage, discharge time, intensive care requirement, histopathological diagnosis, morbidity, and mortality.
RESULTS: Major thoracic surgery was performed in 15 patients receiving HD. Of the patients, 12 were males and 3 were females. The mean age was 61.2±15.8 years. The surgical approach was video-assisted thoracoscopic surgery in 6 patients, thoracotomy in 8, and sternotomy in 1. The most common surgical intervention was lobectomy. The mean length of stay in the intensive care unit was 0.9 days. Postoperative morbidity was observed in 4 patients (26.7%). Mortality due to pneumonia occurred in 1 patient (6.7%)
DISCUSSION AND CONCLUSION: The number of patients requiring HD is globally increasing every year. Therefore, HD patients with lung cancer or requiring major thoracic surgery for other reasons are constantly increasing. Therefore, after a detailed risk assessment, we consider that operations should be performed in experienced centers with multidisciplinary perioperative management.

INTRODUCTION: Abdominal tuberculosis (ATB) is a very rare type of extrapulmonary tuberculosis that occurs as a result of infection of the gastrointestinal tract, peritoneum, lymph nodes, and solid organs with Mycobacterium tuberculosis or Mycobacterium bovis. In this study, we aimed to evaluate the clinical, laboratory, radiological, and histopathological features, diagnostic methods, and prognosis of pediatric cases diagnosed with ATB.
METHODS: Thirteen patients diagnosed with ATB in our hospital between January 1, 2011, and January 1, 2021, were evaluated retrospectively.
RESULTS: Ten (76.9%) of the patients were females. The mean age was 13.5 years. TST was positive in 9 patients. Three patients had a history of TB contact. The median time between diagnosis and onset of symptoms was 45 (15–150) days. The most common presenting symptom was abdominal pain. Seven of the patients were diagnosed with proven tuberculosis. M. tuberculosis grew in cultures of 5 patients. Tuberculosis polymerase chain reaction positivity was detected in the tissue of two of them. C-reactive protein was high in 9 (69.2%), sedimentation was high in 11 (84.6%) patients, albumin value was low in 5 (38.4%), and anemia was present in 10 (76.9%) patients. A single abdominal area was involved in 7 patients, and multiple abdominal areas were involved in 6 patients. The most frequently involved intra-abdominal area was the peritoneum, and the second was the lymph node. Two patients had isolated abdomen. Pulmonary tuberculosis accompanied in 9 (69.2%) patients. Eleven (84.6%) patients underwent laparoscopy. Intra-abdominal abscess complications developed in 1 patient. The mean follow-up period was 23 (18–61) months. None of the patients died.
DISCUSSION AND CONCLUSION: ATB can be easily overlooked because it is very rare, and its clinical findings are nonspecific. It should be kept in mind in patients with chronic abdominal symptoms. Although tuberculosis is a preventable disease, the positive effects of early diagnosis and treatment on prognosis should not be forgotten.

INTRODUCTION: Although preoperative biliary stenting (PBS) restores enterohepatic circulation during the preoperative period, its postoperative outcomes remain unclear. This study aimed to evaluate the effects of PBS on bacterial colonization in bile fluid and postoperative morbidity and mortality rate for pancreatic surgery.
METHODS: A total of 70 patients who underwent pancreaticoduodenectomy due to periampullary tumor between January 2016 and May 2020 were analyzed retrospectively. Patients were divided into PBS and non-PBS groups. Intraoperative and postoperative outcomes were compared between the two groups.
RESULTS: The rate of positive growth in bile culture was significantly higher in the PBS group (89.2%) compared with the non-PBS group (9.5%) (p<0.001). The rates of postoperative infectious complications were found to be 85.7% and 28.5% in PBS and non-PBS groups, respectively (p<0.001). In the PBS group, the rate of postoperative complications increased with the time interval between stenting and surgery (p=0.007). There were no significant differences in both groups in terms of length of hospital stay and postoperative mortality (p=0.186 and p=0.294, respectively).
DISCUSSION AND CONCLUSION: Biliary stenting before pancreaticoduodenectomy increases the complications such as bacterial colonization in bile fluid, postoperative wound site infection, and intra-abdominal abscess. The prolonged time between PBS and surgery increases the rate of postoperative infectious complications.

INTRODUCTION: The 6-minute walk test (6MWT) values have an important role in pretransplant patient management, as they are an indicator of increased mortality in end-stage lung patients awaiting lung transplantation. However, there are not enough studies on the follow-up role of the 6MWT after lung transplantation. Although the 6MWT is widely used, it may not be an effective measure of functional endurance in some conditions and disease groups. Therefore, we investigated the relationship between the classical distance covered in 6 min and the distance walked in the first 1 or 3 min.
METHODS: The study was compared with the preoperative 6MWT results and posttransplant results of patients who underwent lung transplantation between 2016 and 2021. The correlations of distances traveled during posttransplantation at 1, 3, and 6 min were analyzed. The subjects who completed the 6MWT during the follow-up were included in the study.
RESULTS: There was a significant difference found between the pretransplantation 6-minute walk distance (6MWD) and posttransplantation 6MWD in the sixth month. A strong correlation between the distances of the 1-minute walk test (1MWT) and the 6MWT was found in the first month of posttransplantation. 1MWT and 3-minute walk test (3MWT) distances were significantly correlated with 6MWD in the sixth month posttransplantation.
DISCUSSION AND CONCLUSION: In the early posttransplantation period, 1MWT and 3MWT can be an alternative to the 6MWT to evaluate the functional status in this patient group.

INTRODUCTION: There are several clinical outcomes associated with coronavirus disease 2019 (COVID-19) infection, including pneumonia, acute respiratory distress syndrome, and death. The aim of this study is to evaluate whether serum cortisol levels affect COVID-19 prognosis.
METHODS: A retrospective study was conducted with COVID-19 pneumonia patients hospitalized in an internal medicine clinic at the Haseki Training and Research Hospital in Istanbul from March 13 to May 31, 2020. Demographics, laboratory test results, and clinical outcomes of the patients were recorded. The patients were divided into two groups based on whether they were hospitalized for 1–9 days or ≥10 days. Both groups were classified according to their average age and duration of hospitalization/discharge, and laboratory parameters were analyzed.
RESULTS: This study was conducted on 129 COVID-19 pneumonia patients, 13 of whom died during the study period. The mean age was 68.7±10.9 years for nonsurvivors and 55.7±15.9 years for survivors (p=0.001). Serum cortisol levels were significantly elevated in patients with a long hospital stay. While there was no significant difference in the hemogram or biochemical parameters of the two groups, correlation analysis showed a close relationship between serum cortisol levels and length of hospitalization.
DISCUSSION AND CONCLUSION: Cortisol is a reliable predictor of the length of hospital stay and prognosis of COVID-19 patients.

INTRODUCTION: Remote lung injury is one of the most challenging issues in patients undergoing ischemia reperfusion (IR) injury of the lower limbs. We examined the role of progesterone (PG) on the remote injury of the lungs seen after IR of the lower limbs.
METHODS: Eighteen male Sprague Dawley rats were divided into three groups. (1) Control: rats had only two physiological saline injections intraperitoneally (i.p.) 2 h apart under general anesthesia. (2) IR: underwent 2 h tourniquet induced ischemia for both lower limbs followed by 2 h of reperfusion. Animals were injected with physiological saline (i.p.) before both ischemia and reperfusion. (3) IR + PG: rats underwent the same IR protocol as the IR group and were injected with PG (16 mg/kg, i.p.) before both ischemia and reperfusion. After reperfusion, rats were sacrificed, and lung tissues were taken out for histopathologic and biochemical analyses.
RESULTS: In IR + PG group, tissue levels of malondialdehyde and nitric oxide decreased significantly compared with the IR group (p<0.01). Similarly, glutathione level and superoxide dismutase and glutathione S-transferase activities significantly increased in the IR + PG group than in the IR group (p<0.05, p<0.01, and p<0.05, respectively). In light microscopy, reduced inflammatory cell infiltration, amelioration in alveolar structure, and mild vascular congestion in the parenchyma were seen in the IR + PG group. A significant improvement in histopathologic score was seen in the IR + PG group compared with the IR group (p<0.001).
DISCUSSION AND CONCLUSION: PG might be effective in attenuating remote injury of the lung in lower body IR via its antioxidant function.

INTRODUCTION: The aim of this study was to investigate the differences between ampullary carcinomas and pancreatic head carcinomas and to contribute significantly to this issue, which has not been sufficiently addressed in the literature.
METHODS: The study was a retrospective descriptive study. The data of 125 patients with resected periampullary adenocarcinoma were retrospectively reviewed between July 2011 and July 2020. The patients were divided into two groups, ampullary and nonampullary carcinomas, and were compared in terms of clinical, demographic, and pathological aspects.
RESULTS: A total of 109 patients were included in the study with nonampullary carcinoma predominance (59.6% had nonampullary and 40.4% had ampullary). The most common admission complaint was jaundice. The median follow-up was 24 months (range: 1.4–80.4 months). Both median overall survival (OS) and median disease-free survival (DFS) were statistically significant longer in ampullary carcinomas compared with nonampullary carcinomas (OS: 74.5 months vs 16.9 months, 95% CI: 12.6–21.2, p<0.001; DFS: 21.6 months vs 8 months, 95% CI: 10.7–32.6, p<0.001).
DISCUSSION AND CONCLUSION: Ampulla carcinomas are rare tumors with a better prognosis and longer survival than pancreatic head carcinomas. If it is evaluated in a different category from pancreatic tumors, it may be possible to receive less aggressive treatment and avoid unnecessary toxicity for selected patients. Further studies are needed.

Severe acute respiratory syndrome coronavirus 2 is known to cause the new coronavirus disease 2019 (COVID-19), in which many organs and systems such as the lung, heart, and immune system can be severely affected. Currently, the treatment process is generally based on supportive and palliative care. Some potential drugs are being tested for treatment. At this point, perhaps a promising treatment method for many diseases in the future seems to be stem cell therapy in recent times. Stem cell therapy in COVID-19 may be a treatment method that can play an important role, especially in resistant and severe cases. In this review, we summarized the potential mechanisms of stem cell therapy and developments in this treatment modality.

We planned surgery a fifty six year-old female patient, who applied with the complaint of dyspnea, due to the suspected malignancy. We carried out intrapericardial bilobectomy superior and the final pathological examination showed primary pulmonary fibrosarcoma. Primary pulmonary fibrosarcoma is a very rare type of tumor and surgery is the main choice of treatment. We present this case to contribute to the literature.