It is difficult to distinguish coronavirus disease‐2019 (COVID‐19) from other viral respiratory tract infections owing to the similarities in clinical and radiological findings. This study aims to determine the clinical importance of platelet count and platelet indices in the differentiation of COVID‐19 from influenza and the value of these parameters in the differential diagnosis of COVID‐19. The medical records of the patients and the electronic patient monitoring system were retrospectively analyzed. Demographic characteristics, admission symptoms, laboratory findings, radiological involvement, comorbidities, and mortality of the patients were recorded. Forty‐three patients diagnosed with influenza and 54 diagnosed with COVID‐19 were included in the study. The average age of the COVID‐19 patients was lower than that of the influenza patients (influenza: 60.5 years, COVID‐19: 52.4 years; pp = 0.024),.024), and the male gender was predominant in the COVID‐19 group (influenza: 42%, COVID‐19: 56%). According to laboratory findings, the mean platelet volume (MPV) and MPV/platelet ratio were statistically significantly lower, whereas the eosinophil count and platelet distribution width levels were significantly higher (p < 0.05) in the COVID‐19 group. It was found that the most common symptom in both groups was dyspnea and that the symptom was more prevalent among influenza patients. In the diagnosis of COVID‐19, the platelet count and platelet indices are easily accessible, inexpensive, and important parameters in terms of differential diagnosis and can help in the differentiation of COVID‐19 from influenza during seasonal outbreaks of the latter.

Introduction: Researching carbapenem-resistant isolates enables the identification of carbapenemase-producing bacteria and prevents their spread. Methods: P. aeruginosa isolates were recovered from Medicine Faculty of Recep Tayyip Erdoğan University and identified by conventional methods and the automated Vitek 2 Compact system. Antimicrobial susceptibility experiments were performed in accordance with CLSI criteria and the automated Vitek 2 Compact system. The PCR method was investigated for the presence of β-lactamase resistance genes. PFGE typing was performed to show clonal relation among samples. Results: Seventy P. aeruginosa isolates were isolated from seventy patients. Of the patients, 67.1% had contact with the health service in the last 90 days and 75.7% of the patients had received antimicrobial therapy in the previous 90 days. Twenty-four isolates were carbapenem resistant, 2 isolates were multidrug-resistant except colistin, and none of the samples had colistin resistance. The gene encoding β-lactamase or metallo-β-lactamase was found in a total of 36 isolates. The bla VEB and bla PER genes were identified in 1 and 5 isolates alone or 17 and 13 isolates in combination with other resistance genes, respectively. The bla NDM was the most detected metallo-β-lactamase encoding gene (n=18), followed by bla KPC (n=12). bla IMP and bla VIM were detected in 5 and 1 isolates, respectively. Also, the association of bla VEB -bla PER and bla VEB -bla KPC -bla NDM was found to be very high. Much more resistance genes and cooccurrence were detected in hospital-acquired samples than community-acquired samples. No difference was found between the community and hospital-associated isolates according to PFGE results. Simultaneously from 6 patients, other microorganisms were also isolated and 5 of them died. Conclusion:The average length of stay (days) was found to be significantly higher in HAI group than CAI group. The death of 5 patients with fewer or no resistance genes showed that the co-existence of other microorganisms in addition to resistance genes was important on death.

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Microorganisms Isolated from Various Clinical Samples and their Antibiotic Susceptibilities in Intensive Care Unit Patients It is extremely important to identify the predominant infecting organisms and antibiotic resistance profiles in hospitals primarily departments at risk for infection such as intensive care units in terms of rational use of antibiotics and hospital infection control measures. In this study, it was aimed to determine the antibiotic resistance rates of microorganisms isolated from various clinical specimens of intensive care unit patients in our hospital between February 2010 and February 2011. Microorganisms were identified by conventional methods, antibiotic susceptibilities were determined by using Kirby-Bauer disk diffusion method and evaluated according to the Clinical and Laboratory Standards Institute (CLSI) recommendations. Growth was detected in 33 % out of 897 samples and 297 microorganisms consisting of 152 (51 %) Gram positive, 102 (34 %) Gram negative bacteria and 43 (14 %) Candida species were isolated. One hundred and thirty seven microorganisms were isolated from respiratory specimens, 87 from blood, 54 from urine and 19 from wound samples. The most frequently isolated Gram-negative bacteria was

A rare disease; congenital pulmonary airway malformation in an adult Congenital pulmonary airway malformation (CPAM), is a rare disease known as a developmental abnormality of the lower respiratory tract. It may occur in the neonatal period due to respiratory distress and patients usually die in the first few months of life. Rarely, it may remain asymptomatic until adulthood. In this study we describe an adult case and present a review of the literature. A 19-year-old male with no relevant medical history was admitted to our clinic with cough and wheeze. The patient had a history of frequent lower respiratory tract infection during childhood. Chest radiograph revealed a diffuse opacity and volume loss in the right hemithorax. High resolution tomography showed hypoplasia of the right hemithorax, multiple cysts in all of the lobes and segments on the right side, ground glass opacity and interlobular septal thickening of the whole right lung parenchyma. Right pneumonectomy was performed with the pre-diagnosis of congenital pulmonary airway malformation and the pathological examination was compatible with CPAM. CPAM is a rare disease in adulthood. We should consider CPAM in the differential diagnosis of patients with frequent recurrent pulmonary infection and cystic lung lesions. In order to prevent infections and to eliminate the risk of malignancy, surgical treatment should be applied for definite diagnosis and treatment.

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Çalışmamızda toplumdan kazanılmış pnömoni tanısıyla yoğun bakımda yatan hastalarda mortaliteyi etkileyen faktörlerin araştırılması amaçlanmıştır. Gereç ve Yöntem: Çalışmaya Ocak 2014-Ocak 2017 tarihleri arasında hastanemiz Göğüs Hastalıkları polikliniği ve acil servis ünitesine başvurmuş ve hastanemiz yoğun bakım ünitelerine toplumdan kazanılmış pnömoni tanısıyla kabul edilen toplam 50 vaka alındı. Olguların demografik özellikleri, ek hastalıkları, yatışının 1.,4. ve 7. gününde laboratuar bulguları, invaziv mekanik ventilasyon (IMV) uygulanma durumu, yatış süreleri kaydedildi ve mortalite ile ilişkisi incelendi. Bulgular: Çalışmaya 50 hasta alındı (20 K, %40; ortalama yaş 78±13). Sistolik kan basıncı ölenlerde sağ kalanlara göre istatistiksel olarak anlamlı olacak şekilde daha düşük saptandı (p=0,035). Ölenlerde yatışın 1. gününde bakılan total protein anlamlı derecede düşük (p=0,022), 4. günde bakılan üre anlamlı ölçüde yüksek (p<0,05), glukoz değeri anlamlı ölçüde yüksek (p=0,035), C-reaktif protein (CRP) değeri anlamlı ölçüde yüksek (p=0,011) tespit edildi. 7. gününde bakılan albumin değeri anlamlı ölçüde düşük tespit edildi (p=0,005). Ölenlerde 1. ve 4. gün karşılaştırıldığında platelet değerindeki düşme (p=0,001), protein değerindeki düşme (p=0,001), albümin değerindeki düşme (p=0,001), laktikdehirogenaz (LDH) değerindeki artış (p=0,022), PCO2 değerindeki artış (p=0,029) mortalite açısından istatistiksel olarak anlamlı saptanmıştır. Ölenlerin yaş ortalaması daha yüksek bulunmuş, bu durum istatistiksel olarak anlamlı saptanmıştır (p=0.023). Sonuç: İleri yaş, sistolik kan basıncında düşüklük, PLT, total protein ve albümin düzeylerinin düşük seyretmesi, LDH yüksekliği, tedaviye rağmen CRP ve beyaz küre sayısında (WBC) beklenen düşüşün olmaması, PCO2 değerinde artış yoğun bakım ünitesinde takip edilen toplum kökenli pnömoni hastalarında mortalite belirteci olarak kullanılabilir.

Although syncope is positively correlated with the severity of PTE, it does not predict the prognosis alone. Nonetheless, syncope in patients with PTE can be considered as an important alarming stimulus for clinical course.