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    Middle lobe syndrome: a retrospective analysis
    (Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2013) Meteroglu, Fatih; Sahin, Atalay; Eren, Tahir Sevval
    Background: This study aims to evaluate the efficacy middle lobe syndrome (MLS) surgery in patients with recurrent pulmonary infections. Methods: We retrospectively reviewed 37 cases (19 females, 18 males; mean age 12.3 years; range 6 to 55 years) who underwent surgery due to MLS in Dicle University, Faculty of Medicine, Department of Thoracic Surgery between January 1994 and January 2011. The underlying etiology, symptoms of the disease, bronchoscopic and radiological findings, and the outcome of surgery were evaluated. Results: Coughing was the most common symptom. The mean duration of symptoms was 5.49 years (range, 6 months to 15 years). Indication for surgery was bronchiectasis in 33 cases, collapsed lungs in two case, and total atelectasis in two cases. No postoperative mortality was seen. The mean length of hospital stay was 7.14 days (range, 5 to 13 days). The mean follow-up was four years (range, 1 to 15 years). Infection, cough and mucus were absent after surgery. Conclusion: In MLS, lobectomy is indicated for unresolving pulmonary infections and bronchial stenosis. Patients become asymptomatic following surgery.
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    Risk factors affecting post-traumatic acute respiratory distress syndrome development in thoracic trauma patients
    (Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2019) Avci, Alper; Sarac, Ezgi Ozyilmaz; Eren, Tahir Sevval; Onat, Serdar; Ulku, Refik; Ozcelik, Cemal
    Background: This study aims to investigate the risk factors affecting post-traumatic acute respiratory distress syndrome development in thoracic trauma patients. Methods: This two-centered, retrospective study included 3,080 thoracic trauma patients (2,562 males, 518 females; mean age 33.9 +/- 19.4 years; range, 2 months to 91 years) treated between January 2005 and January 2019. Demographic characteristics, mechanisms of injury, traumatic injuries, injury severity score and new injury severity score results, treatments, comorbidities, complications, morbidity and mortality rates, and durations of hospital stay were collected. Data were used to predict the risk factors for development of post-traumatic acute respiratory distress syndrome by univariate and multivariate statistical analysis. Results: Acute respiratory distress syndrome was detected in 81 patients. In multivariate logistic regression analysis; age, pulmonary contusion, intracranial hemorrhage, rib fracture (unilateral and four-five pieces), femur and tibia fracture, diabetes mellitus, chronic obstructive pulmonary disease, blood transfusion (>= 3 units), high white blood cell count at admission, sepsis, and hepatic injury were detected as independent risk factors (p<0.05). Optimal cutoff points (sensitivity/specificity ratios) for acute respiratory distress syndrome development risk were >= 16 (79%/68%) for injury severity score, >= 27 (90%/68.7%) for new injury severity score, and >= 16,000 (75.3%/71.6%) for admission white blood cell count. New injury severity score was superior than injury severity score to predict the development of acute respiratory distress syndrome. Conclusion: Acute respiratory distress syndrome causes significant mortality and morbidity in trauma patients. In addition to the well-known risk factors, diabetes mellitus and chronic obstructive pulmonary disease were independent risk factors. We defined a cutoff value for new injury severity score to predict post-traumatic acute respiratory distress syndrome.