Background and Aims: In recent years, there has been a significant brain drain in the health sector due to healthcare workers migrating abroad to work. This study analyzes the push and pull factors that prompt nurses to leave the country.
 Methods: The sample of the cross-sectional and descriptive study consists of 270 nurses working in Istanbul. The researchers used a questionnaire to collect data on the nurses' demographic information, work history, and attitudes toward brain drain. The data collected was analyzed using statistical tests such as Chi-Square, Independent two sample T-test, Kruskal Wallis, and Pearson Correlation test. A statistical significance level of 0.05 was used to determine the significance of the results.
 Results: The mean age of the nurses was 33.6±8.95 years, and the mean working period was 10.8±9.27 years. Most were female, married, and had a bachelor's degree. Fifteen percent of the participants had attempted to go abroad, 53% were only at the thought stage, and 32% stated that they did not want to go abroad. The scores for both push and pull factors were significantly higher among those who wanted to go abroad than those who did not (p

BACKGROUND: Intensive care units (ICU) are multidisciplinary departments where patients with life-threatening diseases, major surgical interventions, respiratory failure, coma condition, hemodynamic insufficiency, and ≥1 organ failure are admitted for relevant diagnoses and treatment. AIM: The present study sought to investigate pathogens causing infections in patients admitted to our respiratory ICU and their antibiotic resistance patterns. MATERİALS and METHOD: The antibiogram results and clinical data of all patient samples submitted between January 1, 2008, and December 31, 2010, were retrospectively reviewed. RESULT: In total, 248 patients with 561 culture results were included in the study. Microbial growth was detected in the following samples: blood, 336 (59.9%); deep tracheal aspirate, 104 (18.6%); urine, 89 (15.9%); wound drain, 12 (2.1%); central venous catheter liquid, 7 (1.3%); phlegm, 10 (1.8%); Foley tip liquid, 1 (0.2%); and pleural effusion, and 1 (0.2%). Rapid growth was most frequently noted in the cultures of coagulase-negative staphylococci (25.3%), Acinetobacter spp. (23.1%), and Escherichia coli (12.6%). STATISTICAL ANALYSIS Descriptive statistics for continuous variables were expressed as means and standard deviations. The intermittent variables were converted into cross-tables and analyzed using Fisher’s exact and Pearson’s chi-square tests. The normal distribution of the study data was assessed using Kolmogorov–Smirnov test. The mean values of the variables were analyzed using Student’s t-test. Bidirectional hypotheses were used, and a p-value of <0.05 was considered statistically significant. The IBM Statistical Package for the Social Sciences Ver. 18.0 for Windows (SPSS Inc., Chicago, IL, USA) software was used for statistical analyses. IN CONCLUSION, the present study revealed microorganisms’ resistance profiles similar to those of other relevant studies. The study provides important insights into the selection of empiric antibiotic therapy for patients admitted in intensive care unit. Keywords: respiratory intensive care unit, intensive care infections, antibiotic resistance, antibiotic susceptibility

Spinal cord injury without vertebral abnormalities (SCIWORA) accompanying radiography and tomography is common in the pediatric population. However, very few cases have been reported so far in adults and it is a very rare condition. Magnetic resonance imaging (MRI) has become a preferred investigation for the diagnosis of SCIWORA with its increased availability and utilization in recent years. Here we report a case of adult SCIWORA involving cervical spinal cord, characterized by focal neurologic features.

Proton pump inhibitors (PPIs) are invaluable therapeutic options in a variety of dyspeptic diseases. In addition to their well-known risk profile, PPI consumption is related to food and environmental allergies, dysbiosis, osteoporosis, as well as immediate and delayed hypersensitivity reactions (HSRs). The latter, although a rare event, around 1-3%, due to the extraordinarily high rate of prescription and consumption of PPIs are related to a substantial risk. In this Position Paper, we provide clinicians with practical evidence-based recommendations for the diagnosis and management of HSRs to PPIs. Furthermore, the unmet needs proposed in the document aim to stimulate more in-depth investigations in the topic.

Non-Hodgkin Lymphoma (NHL) is the most common hematological malignancy, and Diffuse Large B-Cell Lymphoma (DLBCL) is the most common histological type. A 56-year-old male patient was admitted to our clinic with complaints of shortness of breath and fatigue for 1 month. It was learned in his professional history that he had been a dental technician for 30 years. He was diagnosed with pneumoconiosis in 2020 and his chest radiograph was q/t 3/3 according to the International Labor Organization (ILO) International Classification of pneumoconiosis radiographs. Laboratory examinations revealed an increase in erythrocyte sedimentation rate (ESR 50 mm/h) and serum lactate dehydrogenase (LDH 368 IU/L) levels. On thoracic computed tomography (CT), enlarged lymph nodes and lymphadenopathies (LAP) with local conglomeration and calcifications in the mediastinal, subcarinal and bilateral hilar areas were seen. Widely disseminated inhomogeneous mass-like consolidation areas, including internal calcifications, extending from the hilum to the parenchyma in both lungs, were observed more prominently in the right middle zone. Diffuse interstitial thickenings, infiltrations and centrilobular nodular density increases in both lungs, nodular consolidated areas with recessed contours and nodules and ground glass densities were observed, especially in the left upper zone. In the lateral part of the left 5th rib, a heterogeneous soft tissue mass of approximately 12x5 cm, causing cortical destruction, invading the surrounding soft tissues and muscle planes, and containing internal cystic-necrotic components was observed. On abdominal CT, enlarged lymph nodes and LAPs, some of which contain calcifications, were observed in the abdomen. The pathology result was reported as Diffuse B-Cell Lymphoma in the patient who underwent transthoracic biopsy due to radiographic appearances that are not typical for PMF. Here, we presented a case of pneumoconiosis with occupational carcinogen exposure and presenting with lymphoma.

Aim: Percutaneous endoscopic gastrostomy (PEG) is a feeding method used in patients who are expected to require enteral nutrition for more than 2-3 weeks. We aimed to evaluate PEG indications, complications, and post-procedural patient prognosis in patients followed up in our intensive care unit and fed via PEG.
 Materials and Methods: We retrospectively reviewed 51 patients receiving PEG between January 1, 2017, and December 31, 2022, in the Respiratory Intensive Care Unit.
 Results: Among the patients receiving PEG, 30 (58%) were male. The average age was 63.9, ranging from 23 to 90. The mean scores for the Glasgow Coma Scale (GCS), Acute Physiology and Chronic Health Evaluation II (APACHE II), and Sepsis Related Organ Failure Assessment (SOFA) were 8.47, 22, and 7.45, respectively. The mean duration until PEG placement was 24.8 days, and the average intensive care unit (ICU) hospitalization was 48.8 days.PEG was performed in 21 patients (41.2%) due to cerebrovascular disease, in 19 patients (37.3%) due to Alzheimer, dementia, or Parkinson's disease, and 18 patients (35.3%) due to prolonged mechanical ventilation. The complication rate associated with PEG was 13.7%. Among the patients who underwent PEG, 35 (68.6%) were discharged, while 16 (31.4%) died.
 Conclusion: Considering its easy use at bedside, low complication, and mortality rates, PEG insertion is appropriate for continuing enteral therapies, especially in intensive care patients with insufficient oral intake.

Aims: The impact of postoperative complications after surgery for lung cancer is substantial, with the increasing age of patients and the presence of comorbidities. Impairment in exercise capacity is a potential modifiable risk factor for postoperative complications. This study aimed to assess the contribution of preoperative pulmonary rehabilitation (PR) for increasing operability conditions in non-small cell lung cancer (NSCLC) for patients with limited pulmonary functions and postoperative results.
 Methods: The patients with NSCLC who had preoperative pulmonary rehabilitation and underwent surgical resection in our clinics between 2010-2019 were evaluated retrospectively. The patients enrolled in a comprehensive, multidisciplinary, supervised outpatient 10-day duration PR program preoperatively, consisting of bronchial hygiene, breathing control, energy conservation techniques, exercise training (endurance and strength), psychological support, and nutritional support. Exercise capacity and VO2 peak were evaluated by using an incremental shuttle walk test (ISWT).
 Results: Eighteen patients who underwent surgery due to NSCLC and had a pre-operative pulmonary rehabilitation program were evaluated. All the cases were male; the mean age was 66.2 (53-77) years. The squamous cell/adenocarcinoma ratio was 2.6 (13:5), and the mean tumor size was 4.6 (8-18) cm. The postoperative hospital stay was 12.7 (4-42) days, and they were followed up for an average of 30.2 (2-83) months. 
 Conclusion: Complete surgical resection is the most effective curative treatment for lung cancer. However, many patients with lung cancer also have severe COPD, increasing their risk of postoperative complications and their likelihood of being considered "inoperable." Preoperative pulmonary rehabilitation (PR) has been proposed as an intervention for risk modification and to decrease surgical morbidity and mortality. The results of our study also revealed the importance of preoperative pulmonary rehabilitation in centers where lung cancer surgery was performed.

Abstract
 Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a common multifactorial disease which has heterogeneous pathogenesis. The most important risk factor is smoking. In addition to many pathogenic mechanisms taking part in inflammatory process, Our study group does research on the relation of COPD with single nucleotide gene polymorphism at ET-1 gene. In the current studies there being a high ratio of Endotelin-1 (ET-1) in BAL liquid of COPD cases made researchers think ET-1 may have an important role in pathogenesis of COPD. 
 Methods: This prospective case-control study included 89 patients admitted with COPD and 87 control patients. In our study, we search for the density of single nucleotide gene polymorphism (+134 insA/delA) in ET-1 gene in the 87 smoking COPD and 89 healthy cases. Allele ratio and genotype distribution, distribution amongst three genotype in the COPD patient and healthy control group was analyzed. In this study, for endothelin gene -3A/-4A (-138 insertion/deletion) polymorphism analysis, PCR-RFLP method was used. 
 Results: In comparison with the healthy group, the COPD group has higher ratio of ET-1 gene (+134 insA/delA) polymorphism (p< 0,001). 
 Conclusion: Endotelin-1 gene polymorphism (+134 insA/delA) significantly increased in the patients than healthy ones (p

Tüberküloz basilinin inhalasyonu, immün yanıtın uyarılmasıyla etkenin temizlenmesi ya da primer enfeksiyon oluşumu ile sonuçlanır. Primer tüberküloz enfeksiyonu, olguların %95’inde sessiz seyreder ve latent döneme girer. Olguların %5'inde ise primer tüberküloz hastalığına neden olur. Bu evrede mikobakteriler hematojen, lenfojen yol ile çevre dokulara ve akciğer dışı organlara yerleşebilir. Akciğer dışındaki odaklarda reaktivasyon olursa ekstrapulmoner tüberküloz ortaya çıkmaktadır. Ürogenital tüberküloz (ÜG-TB); plevral tüberküloz ve periferal lenfadenopatiden sonra en sık karşılaşılan ekstrapulmoner tüberküloz şeklidir. Böbrekler genellikle basilin akciğerden hematojen yol ile yayılması sonucu enfekte olmaktadır. Akciğer röntgenogramında, ÜG-TB vakalarının yaklaşık yarısında spesifik bulgu izlenmemektedir. Tedavi edilmemiş olgular renal parankim hasarı ve obstrüktif nefropati ile birlikte son dönem böbrek yetmezliğine sebep olabilir. Bu olgumuzda ürogenital tüberküloz tanısı almış hastada bir ilaç yan etkisi olarak gelişen hipersensitivite reaksiyonu ve bunun yönetiminden bahsedilmiştir.

Pneumoconioses are parenchymal lung diseases caused by dust accumulation in the lungs and the resulting tissue reaction. A 75-year-old male patient presented with the complaints of fatigue and shortness of breath for 6 months. In his professional history, it was learned that when he was 18 years old, he worked in a lead mine blasting with dynamite for 4 months, and then worked in tunnel and road construction, blasting, sand screening and transportation for 3 months. According to the International Labor Organization (ILO) International Classification of pneumoconiosis radiographs, the chest radiograph was r/q 2/2 + A2. In his history, it was learned that he applied to our hospital with the complaint of bloody sputum in 1982, open lung biopsy was performed for tuberculosis and malignancy, and the biopsy was reported as fibrotic lung tissue. We presented a case of pneumoconiosis presenting with bilateral pleural effusion accompanied by pulmonary thromboembolism.