An analysis of neuropathic pain, vasomotor manifestations, and sympathetic skin reactions in post-COVID-19 patients relative to healthy individuals.

This study aims to assess the incidence of neuropathic pain, vasomotor symptoms, and sympathetic skin responses (SSR) in patients who have recovered from COVID-19 infection and contrast these findings with healthy controls. The study encompassed 56 post-COVID-19 patients and 40 healthy controls (group 1: post-COVID-19 patients, and group 2: healthy controls). The presence of autonomic dysfunction symptoms (ADS) and orthostatic hypotension following COVID-19 infection was documented in group 1. Concurrently, fatigue and forgetfulness levels were appraised using the numerical rating scale, and the leeds assessment of neuropathic symptoms and signs pain scale was deployed to probe for the incidence of neuropathic pain among participants. SSR of all participants was conducted bilaterally from median and tibial nerves using an electroneuromyographic device. Among post-COVID-19 patients, neuropathic pain was observed in 17.9% of cases. There were no notable variations in the initiation and magnitude of bilateral median and tibial nerve SSR across the 2 groups. Significant discrepancies were observed in ADS scores between groups 1 and 2 (P = .001). Furthermore, a positive correlation was established between the latencies of the left median nerve SSR and ADS scores (R = 0.339, P = .014). The SSR patterns were congruous between healthy individuals and post-COVID-19 patients. However, a higher prevalence of autonomic dysfunction symptoms and correlations among SSR, autonomic dysfunction scores, fatigue, and forgetfulness levels were identified among post-COVID-19 patients.

COVID-19 and Crimean-Congo Hemorrhagic Fever: Is there any Similarity in Chest Radiology?

Objective: While the coronavirus disease 2019 (COVID-19) pandemic was continuing at full speed, patients with Crimean-Congo hemorrhagic fever (CCHF), which is endemic in our region, apply to the emergency department simultaneously. The presence of computed tomography (CT) lesions suggesting COVID-19 in some CCHF patients has brought to our mind the question of whether there is CCHF lung involvement even though respiratory symptoms are not at the forefront. Methods: In this study, the findings of chest CT, demographic data and clinical symptoms of cases who had thorax tomography scan with suspicion of COVID-19 in the emergency department in the spring and summer of 2020 and were diagnosed with CCHF as a result of the evaluation and followed up in our clinic were compared with the findings of COVID-19 cases that were hospitalized and treated in the same period. Results: Seventy-seven COVID-19 and 25 CCHF cases were included in the study. Myalgia, headache, diarrhea, nausea and vomiting were significantly higher in CCHF patients ( p<0.05). Cough was significantly more common in COVID-19 patients ( p=0.034). Ground-glass opacity (GGO) was the most common tomography finding in CCHF, and cases without lung involvement were significantly higher (p=0.001). GGO, consolidation, vascularization, atelectasis band, reverse halo, air-bubble, nodule were significantly high in COVID-19 patients. Conclusion: During the epidemic period, no pathological finding was found in thoracic CT in most of the CCHF cases, and the presence of involvement in the lung tomography in cases with similar clinical and laboratory findings should primarily suggest the diagnosis of COVID-19.

Results of bronchoscopic excision in typical carcinoid tumors of the lung in Turkey.

Aim Carcinoid tumors of the lung are the tumors originating from the neuroendocrine cells. Surgical excision remains the gold standard for the treatment. Treatment with interventional bronchoscopic excision has also been reported as an alternative option in typical carcinoid tumors of the lung. The aim of this study was to present results and outcomes in patients who were bronchoscopically treated and followed-up. Methods Data of 14 patients, who had undergone bronchoscopic excision due to typical carcinoid tumor of the lung between April 2008 and July 2015 were retrospectively evaluated. Bronchoscopic excision procedures were performed under general anesthesia, while control bronchoscopies were carried out with flexible bronchoscopy. Time between the first and last bronchoscopies was accepted as the follow-up duration. Results A total of 14 patients was evaluated with eight (57.1%) males. Mean age was 43.57±14.07 (23-68) years. The most common symptoms were shortness of breath and coughing. Mean of 5.69±3.35 (2-12) bronchoscopy procedures were performed in the patients during the diagnosis, treatment and follow-up. Mean follow-up duration was 32.0±19.22 months. At the long-term follow-up, two patients developed 50% stenosis and one patient developed granulation tissue in the endobronchial treatment site. None of the patients developed recurrence during the mean.

Simultaneous Chronic Invasive Fungal Infection and Tracheal Fungus Ball Mimicking Cancer in an Immunocompetent Patient.

Fungal infections of the lung are uncommon and mainly affect people with immune deficiency. There are crucial problems in the diagnosis and treatment of this condition. Invasive pulmonary aspergillosis and candidiasis are the most common opportunistic fungal infections. Aspergillus species (spp.) are saprophytes molds that exist in nature as spores and rarely cause disease in immunocompetent individuals. In patients with immune deficiency or chronic lung disease, such as cavitary lung disease or bronchiectasis, Aspergillus may cause a variety of aspergillosis infections. Here we present a case of a 57-year-old patient without immunodeficiency or chronic lung disease who was diagnosed with endotracheal fungus ball and chronic fungal infection, possibly due to Aspergillus. Bronchoscopic examination showed a paralyzed right vocal cord and vegetating mass that was yellow in color, at the posterior wall of tracheal lumen. After 3 months, both the parenchymal and tracheal lesions were completely resolved.

Successful Treatment of Bulla with Endobronchial Valves.

Emphysematous bullae are a complication of end-stage COPD. Patients with large bullae and poor respiratory function have limited treatment options. Surgical resection is a recognized treatment, but functional improvement after bullectomy is not satisfactory in patients with forced expiratory volume in 1 s (FEV1) < 35% predicted. When this 59-year-old male end-stage COPD patient was assessed, he was cachectic and lung function tests showed a FEV1 of 0.56 L (19% predicted) and a RV of 7 L (314% predicted), while 6MWT was 315 m and MRC dyspnea score was 4. Chest X-ray revealed a massive bulla of 10 cm in diameter in the right middle lobe. A fibrobronchoscopy was performed under local anesthesia and 2 Zephyr 4.0 valves were placed in the right middle lobe. Chest X-ray and CT scan performed 36 days later showed the complete resolution of the bulla. Seven months later, the patient demonstrated an improvement in FEV1 (+30%) and a decrease in RV from 314 to 262% predicted. This case report shows that the Zephyr valves may be successfully used to treat a large bulla in the right middle lobe in a patient with diffuse emphysema and severely impaired lung function.