Pulmonary Physician Consultancy in Emergency Services in Turkiye (PuPCEST) - a cross-sectional multicenter study.

Pulmonology is one of the branches that frequently receive consultation requests from the emergency department. Pulmonology consultation (PC) is requested from almost all clinical branches due to the diagnosis and treatment of any respiratory condition, preoperative evaluation, or postoperative pulmonary problems. The aim of our study was to describe the profile of the pulmonology consultations received from emergency departments in Turkiye. A total of 32 centers from Turkiye (the PuPCEST Study Group) were included to the study. The demographic, clinical, laboratory and radiological data of the consulted cases were examined. The final result of the consultation and the justification of the consultation by the consulting pulmonologist were recorded. We identified 1712 patients, 64% of which applied to the emergency department by themselves and 41.4% were women. Eighty-five percent of the patients had a previously diagnosed disease. Dyspnea was the reason for consultation in 34.7% of the cases. The leading radiological finding was consolidation (13%). Exacerbation of preexisting lung disease was present in 39% of patients. The most commonly established diagnoses by pulmonologists were chronic obstructive pulmonary disease (19%) and pneumonia (12%). While 35% of the patients were discharged, 35% were interned into the chest diseases ward. The majority of patients were hospitalized and treated conservatively. It may be suggested that most of the applications would be evaluated in the pulmonology outpatient clinic which may result in a decrease in emergency department visits/consultations. Thus, improvements in the reorganization of the pulmonology outpatient clinics and follow-up visits may positively contribute emergency admission rates.

Correlation Between Daily PM10, Nitrogen Dioxide, and Ozone Measurements with the Stringency Index in 15 Different Districts of a Big Metropolis.

OBJECTIVE: Studies have investigated the effects of lockdowns on air quality around the world and found that fine particulate matter and nitrogen dioxide concentrations decreased due to reduced human activity, while ozone concentrations increased. In this study, we aimed to evaluate the correlation between daily stringency index values of our country and daily PM10, nitrogen dioxide, and ozone measurements in different districts of Istanbul between March 1, 2020, and February 28, 2022. MATERIAL AND METHODS: Ministry of Environment and Urbanization and National Air Quality Monitoring Network data on Istanbul air quality monitoring stations were used. The analysis included 15 stations that can monitor at least 75% of the days in a year. PM10, nitrogen dioxide, and ozone were the main pollutants analyzed. RESULTS: There was negative correlation between daily PM10 measurements and daily stringency index values in 3 stations; there was positive correlation in 6 stations. Between daily stringency index values and daily nitrogen dioxide measurements, there was a negative correlation in 3 stations and a positive correlation in 1 station. The daily measurements of 1 station showed a negative correlation with the daily values of stringency index for both PM10 and nitrogen dioxide. In 1 station, while PM10 measures were negatively correlated with stringency index, nitrogen dioxide measurements were positively correlated. CONCLUSION: This study showed that pandemic limitations could not improve Istanbul's air quality everywhere. For adequate evaluation of impact of the limitations on air quality, it may be more relevant to study the socioeconomic infrastructure of each living area, the sociospatial inequality, industrial employment, the number of households, the density of employee class, and so on with all influencing factors that could have contributed to these various changes.

First Case Report Of Anca-Associated Vasculitis And Anthracosis Coexistence.

Anthracosis is a type of mild pneumoconiosis secondary to harmless carbon dust deposits. Although anthracosis was previously associated with inhaled coal particles, such as coal workers' pneumoconiosis, this hypothesis was later abandoned; pathology has been associated with inhaled dust particles. Our paper is the first case report of ANCA-associated vasculitis and anthracosis coexistence. In addition, it aims to highlight that histopathologically proven anthracotic granulomatous nodules can show high FDG uptake in PET/CT contrary to expectation. We present a case of a 73-year-old male with p-ANCA-associated vasculitis and anthracotic lung nodules accompanied by radiological and clinical findings. The patient got diagnosis with p-ANCA-associated vasculitis with serological and rheumatological tests. Atypically, the clinical findings of the patient were weak (No dyspnoea, cough or additional pulmonary complaints). Nodules were present on X-ray graphics and nodules' contours were irregular on CT. On PET/CT, SUV values of the nodules were high [12 kBq/mL]. Histopathological specimens showed multiple lung granulomas including anthracosis particles. Until performing the biopsy, we could not exclude the possibility of malignancy. Conclusion: When lung involvement of vasculitis is superimposed by anthracosis, it can create granulomas with high SUV values. The relationship between anthracosis and parenchymal lung diseases is a current topic and many recently published papers are present on this subject. To the best of our knowledge, our paper is the first paper showing the relationship between parenchymal involvement of vasculitis and anthracosis in the literature. Environmental pollution and dust particles are the known reasons for anthracosis particles in the nodules. It is open to future research on whether air pollution triggers new atypical cases or not.

A Case of Post-COVID-19 Fibrosis Mimicking Thoracic Manifestation of Ankylosing Spondylitis.

The most common thoracic manifestation form of ankylosing spondylitis is apical fibrocystic changes. It is also known as apical fibrobullous disease (AFBD). The patient was diagnosed with ankylosing spondylitis before 9 years. He suffered COVID-19 infection and passed an intensive care period. However, post-covid fibrosis (PCF) atypically affected dominantly apical zones. If we had no sequential CT evaluations, our case could be easily confused with AFBD. On CT taken before COVID-19, the lung apex was normal. Thus, it was confirmed that there was no rheumatologic thoracic manifestation in the patient before suffering from COVID-19 pneumonia. PCF created similar changes as AFBD. Our case is the first reported paper on this topic.

A case of B.1.1.7 SARS-CoV-2 UK strain with an atypical radiological presentation.

The new UK strain was first described in December 2020. It was seen for the first time in Turkey in February 2021. It is not yet known whether the new strain has different CT patterns compared to the classical type. We present a 68-years-old male patient with an atypical CT presentation in which GGOs are gathered around the areas of paraseptal emphysema accompanied by CT and clinical findings. This involvement is an unexpected pattern because of the atypical distribution of the GGO.