Tuberkuloz ve toraks最新文献

{"title":"Characteristics of patients with symptomatic and incidental pulmonary thromboembolism.","authors":"Başak Gönen, Pervin Hanci, Osman Nuri Hatipoğlu","doi":"10.5578/tt.202403946","DOIUrl":"https://doi.org/10.5578/tt.202403946","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary thromboembolism (PTE) has a wide range of clinical presentations. With the advances in computed tomography (CT) technology and easier access to CT, the incidence of incidentally diagnosed cases of PTE has increased. The main aim of our study was to determine the frequency of patients incidentally diagnosed with PTE and whether these patients differ from patients with symptomatic PTE in terms of case characteristics.</p><p><strong>Materials and methods: </strong>We retrospectively analysed the charts of 148 patients with PTE diagnosed and treated in 2022. Demographic characteristics, thrombus localisation, risk factors, and treatment modalities were compared between symptomatic patients with clinically suspected PTE and patients with incidentally diagnosed PTE by imaging methods performed for other purposes without clinically suspected PTE.</p><p><strong>Result: </strong>Out of 148 patients with PTE, 42 (28.3%) were diagnosed incidentally. The rate of concomitant malignancy was significantly higher in patients with incidental PTE (54.8%) than in patients with symptomatic PTE (28.3%) (p < 0.01). There was no significant difference between symptomatic and incidental PTE patients in terms of the pulmonary artery segment in which the thrombus was located (p > 0.05).</p><p><strong>Conclusions: </strong>In our patient group, approximately one out of four patients diagnosed with PTE were incidentally diagnosed. Patients with malignancies may not have symptoms suspicious for PTE or their symptoms may go unrecognized.</p>","PeriodicalId":519894,"journal":{"name":"Tuberkuloz ve toraks","volume":"72 3","pages":"179-184"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of melanoma with atypical presentation.","authors":"Çağla Tezduyan, Merih Yalçiner, Elif Berna Köksoy","doi":"10.5578/tt.202403963","DOIUrl":"10.5578/tt.202403963","url":null,"abstract":"<p><p>Malignant melanoma, a cancer type with a high mortality rate and increasing incidence worldwide, primarily affects the skin but can also occur in various other organs and tissues, including the respiratory tract. Although primary lung malignant melanomas are rare, they are often diagnosed at advanced stages due to their asymptomatic nature, and their atypical presentations may lead to misdiagnosis as other malignancies. In this case report, a mass lesion almost completely filling the right lung initially led to the consideration of small cell lung carcinoma, but a definitive pathological diagnosis could not be obtained in subsequent studies. The diagnosis was confirmed by soft tissue biopsy taken from the anterior thoracic wall. Considering clinical, pathological, and radiological evaluations, possible diagnoses included sarcoma, small-cell lung cancer, and melanoma. The patient, diagnosed through multiple tissue sampling and detailed dermatological examination, presents an interesting atypical case. This case highlights that rare variants of melanoma can be mistaken for other cancer types, such as lung cancer, sarcoma, or lymphoma. Patients may not always present with a noticeable skin lesion; therefore, a meticulous skin examination is crucial in such cases. Malignant melanoma is a noteworthy disease, considering its increasing incidence and early diagnosis holds vital importance for appropriate treatment and management.</p>","PeriodicalId":519894,"journal":{"name":"Tuberkuloz ve toraks","volume":"72 3","pages":"229-232"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bispectral index monitoring: Optimizing anesthesia in rigid bronchoscopy.","authors":"Özal Adiyeke, Onur Sarban, Ergün Mendeş, Hilal Akça, Engin İhsan Turan, Barış Demirkol, Mehmet Akif Özgül, Funda Gümüş Özcan","doi":"10.5578/tt.202403938","DOIUrl":"https://doi.org/10.5578/tt.202403938","url":null,"abstract":"<p><strong>Introduction: </strong>This study investigates the application of bispectral index (BIS) monitoring in rigid bronchoscopy to enhance anesthetic delivery and patient outcomes, a topic that remains underexplored.</p><p><strong>Materials and methods: </strong>A retrospective analysis of 155 patients undergoing elective rigid bronchoscopy under general anesthesia was conducted. Patients were divided into BIS-monitored and conventional anesthesia groups. Inclusion criteria were adults aged over 18 years with American Society of Anesthesiologists (ASA) physical status I-IV.</p><p><strong>Result: </strong>No significant demographic differences were found between the groups. The BIS group showed significant reductions in propofol usage (231.40 ± 74.63 mg vs. 190.19 ± 91.83 mg, p= 0.003) and prednol dosage (94.27 ± 42.56 mg vs. 79.71 ± 18.97 mg, p= 0.020). Remifentanil administration approached statistical significance (56.99 ± 34.69 mcg vs. 45.36 ± 36.75 mcg, p= 0.055).</p><p><strong>Conclusions: </strong>No significant demographic differences were found between the groups. The BIS group showed significant reductions in propofol usage (231.40 ± 74.63 mg vs. 190.19 ± 91.83 mg, p= 0.003) and prednol dosage (94.27 ± 42.56 mg vs. 79.71 ± 18.97 mg, p= 0.020). Remifentanil administration approached statistical significance (56.99 ± 34.69 mcg vs. 45.36 ± 36.75 mcg, p= 0.055).</p>","PeriodicalId":519894,"journal":{"name":"Tuberkuloz ve toraks","volume":"72 3","pages":"191-196"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The need for a new classification system in chronic obstructive pulmonary disease.","authors":"Esra Ertan Yazar","doi":"10.5578/tt.202403961","DOIUrl":"https://doi.org/10.5578/tt.202403961","url":null,"abstract":"<p><p>The current classification fails to fully meet the needs of physicians and COPD patients in clinical practice. The future classification should aim to prevent the development of disease in high-risk groups, enable early diagnosis before irreversible damage occurs, identify subgroups, and provide pathophysiological insight to inspire drug development. It would be reasonable to thoroughly examine and assess the contributing factors such as an increase in the annual decline of (FEV1), bronchial hyperresponsiveness, variable obstruction, FEV1 % predicted, blood eosinophil count, preserved ratio impaired spirometry (PRISm), and the subgroups of group B as potential additions to the new classification.</p>","PeriodicalId":519894,"journal":{"name":"Tuberkuloz ve toraks","volume":"72 3","pages":"233-236"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of mycobacterial microscopy and culture results from clinical samples: A five-year analysis.","authors":"Ahmet Balikçi, Mehmet Erbakan, Aylin Babalik","doi":"10.5578/tt.202403955","DOIUrl":"https://doi.org/10.5578/tt.202403955","url":null,"abstract":"<p><strong>Introduction: </strong>Ehrlich-Ziehl-Neelsen (EZN) staining and culture methods are often used to diagnose tuberculosis. This study aimed to determine the acidfast bacteria (AFS) positivity rates in various clinical samples sent to our laboratory over five years and the growth and resistance rates in two different (solid and liquid) cultures and compare them with the data from Türkiye and the world.</p><p><strong>Materials and methods: </strong>A total of 62.456 clinic samples were accepted in the microbiology laboratory between 2019 and 2024. The mycobacterial culture was performed by searching for acid-resistant bacilli microscopically and parallel inoculation media [solid Löwenstein-Jensen (L-J) and MGIT 960 liquid]. Those growing in the MGIT 960 system were identified using BD MGIT TBC Identification test kits that detect the MPT64 antigen. AFS and MPT64 antigenpositive samples were identified as Mycobacterium tuberculosis complex (MTBC) while AFS-positive samples and MPT64 antigen-negative results were classified as non-tuberculous mycobacteria (NTM). Drug susceptibility testing was performed with the BACTEC MGIT 960 SIRE kit. Susceptibility to NTM samples was not performed.</p><p><strong>Result: </strong>Out of a total of 120.829 samples, 95.101 were lung samples and 25.728 were extrapulmonary samples. AFS positivity was detected in 2961 (2.4%) samples. MTBC grew in 6854 (5.6%) samples, and NTM grew in 1506 (1.24%) samples. Contamination was detected in 7171 (5.9%) media. Two thousand one hundred and sixty-nine susceptibility tests were performed. Considering antibiotic resistance rates, isoniazid resistance was detected in 154 (7%), rifampicin resistance in 140 (6.4%), ethambutol resistance in 18 (0.8%), and streptomycin resistance in 120 (0.5%) samples. All four-drug resistance was observed in 91 (4.1%) samples. AFP positivity and resistance rates for rifampicin have decreased significantly, while there have been no significant changes in NTM rates over the years.</p><p><strong>Conclusions: </strong>When our data was determined, the sensitivity of microscopy was low. It is understood that mycobacterial culture and microscopy must be evaluated together to exclude tuberculosis infection. The high mycobacterial culture positivity rate, which is 5.6%, is due to the high number of follow-up patients and new referrals. It is seen that the change in sensitivity rates is due to the period of the COVID-19 epidemic, and it is similar to World Health Organization (WHO) data.</p>","PeriodicalId":519894,"journal":{"name":"Tuberkuloz ve toraks","volume":"72 3","pages":"185-190"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of mean platelet volume (MPV), MPV/PLATELET (PLT) ratio, and lymphocyte/monocyte ratio (LMR) as poor prognostic factor in EGFR-mutant lung adenocarcinoma treated with EGFR tyrosine kinase inhibitor.","authors":"Hasret Gizem Kurt, Berna Akinci Özyürek, Yurdanur Erdoğan, Nalan Akyürek","doi":"10.5578/tt.202403838","DOIUrl":"https://doi.org/10.5578/tt.202403838","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Platelets (PLT) and host systemic inflammatory response (SIR) are known to be effective in the aggregation of cancer cells and the formation of metastasis. There are studies pointing out to the prognostic efficacy of lymphocyte-monocyte ratio (LMR) showing SIR activation and mean platelet volume (MPV) values indicating platelet activation in various cancer types. We predict that easy-to-access hemogram parameters such as MPV, MPV/PLT, and LMR can be guiding in the clinical follow-up period of patients with epidermal growth factor receptor (EGFR) positive mutation and who received EGFR, tyrosine kinase inhibitor (TKI) in the first-line treatment in predicting the progression of the disease, predicting the survival time of the patients, and evaluating the response to treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;The study is retrospective and included patients with stage III and stage IV pulmonary adenocarcinoma with positive EGFR mutations and for whom TKI was used in the first-line treatment between January 2011 and January 2021. MPV, MPV/PLT, and LMR values of the patients were calculated before treatment. Age, sex, comorbidity, smoking history, TNM stage, metastasis localizations, EGFR mutation types, TKI treatments used in first-line treatment, and MPV, MPV/PLT, and LMR values at the 1st month of treatment were recorded. With Kaplan-Meier, six-month, one-year, three-year, and five-year survival rates, average life expectancy, and 95% confidence intervals for these periods were calculated. Variables that may affect progression and overall survival (OS) were determined by performing univariate and multivariate Cox regression analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Result: &lt;/strong&gt;One hundred and two patients were included in the study. The mean age of the patients was 64.30 ± 12.6 years. Eighty-four patients were in stage IV at the time of diagnosis. The expected mean progression-free survival (PFS) period of the cases was found to be 13.3 months. The mean life expectancy of the cases was found to be 35.1 months. Web-based Cutoff Finder algorithm written in the R program (http://molpath.charite.de/cutoff) was used to determine the ideal cut points for MPV, MPV/PLT, and LMR. The cut-off values were found to be 7.55 fL for MPV, 0.251 for MPV/PLT, and 2.615 for LMR, respectively. In univariate Cox regression analysis, LMR level lower than 2.615 increased the rate of progression 1.747 times (95% confidence interval: 1.129-2.705) and the death rate 2.056 times (95% confidence interval: 1.217-3.475) (p= 0.012, p= 0.007). The mean PFS LMR cut-off value was 10.3 months, and 15.3 months, and mean OS durations were 25.1 months and 40.8 months for the groups with low and high cut-off values respectively (p= 0.011, p= 0.006 log-rank test). According to the results of multivariate Cox regression analysis, MPV/PLT &lt; 0.251, smoking, presence of pleural and adrenal metastases, and gefitinib treatment were independent factors in det","PeriodicalId":519894,"journal":{"name":"Tuberkuloz ve toraks","volume":"72 3","pages":"197-207"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared and unique transcriptomic signature genes and pathways among biopsy, peripheral blood mononuclear cells and bronchoalveolar lavage samples in IPF patients revealed using comparative meta-transcriptome analysis.","authors":"Seha Akduman, Nur Ekimci Gürcan, Nehir Kizililsoley, Altay Burak Dalan, Ömer Faruk Bayrak, Emrah Nikerel","doi":"10.5578/tt.202403859","DOIUrl":"10.5578/tt.202403859","url":null,"abstract":"<p><strong>Introduction: </strong>Idiopathic pulmonary fibrosis (IPF) affects the tissue surrounding the alveoli and occurs when the lung tissue becomes thick and stiff for unknown reasons. Clinical findings are fairly well settled, but the molecular mechanisms of IPF are still poorly known.</p><p><strong>Materials and methods: </strong>To further our understanding, we collected publicly available transcriptome dataset from IPF cohorts, grouped them according to sampling method [bronchoalveolar lavage (BAL), biopsy, blood], and performed comparative meta-transcriptome study to (I) unravel key pathways (II), set out differences in discovered genes, pathways, and functional annotation with respect to the sampling method, and (III) find biomarkers for early diagnosis.</p><p><strong>Result: </strong>The resulting lists are also compared with DisGeNet reported genes, earlier work, and Kyoto encyclopedia of genes and genomes (KEGG) pathways. Several pathways are shared among BAL and biopsy samples while blood samples point to alternative pathways, indicating the noise in information obtained from these samples.</p><p><strong>Conclusions: </strong>Common to all sampling methods, interleukin-10 pathway and extracellular signaling pathways are pointed as further targets.</p>","PeriodicalId":519894,"journal":{"name":"Tuberkuloz ve toraks","volume":"72 3","pages":"208-218"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is using inhaled corticosteroid effective against COVID-19 pneumonia severity and mortality?","authors":"Hatice Kiliç, Emine Argüder, Musa Civak, Emin Gemcioğlu, Ayşe Kaya Kalem, İmran Hasanoğlu, Bircan Kayaaslan, Sibel Günay, Esmehan Akpinar, Habibe Hezer, Ebru Şengül Şeref Parlak, Filiz Sadi Aykan, Yasin Kocaman, Esra Ünsay Metan, Mükremin Er, Aynil Dalkiran, Hülya Çelenk Ergüden, Zeynep Hancioğlu, Emre Altin, Eren Ceylan, Fatma Eser, Adalet Altunsoy Aypak, Esragül Akinci, Selma Karaahmetoğlu, Emra Asfuroğlu Kalkan, Osman Inan, Abdürrezzak Yilmaz, Bağdagül Yüksel Güler, Esra Çopuroğlu, Işıl Özkoçak Turan, Emre Demir, Serhat Hayme, Derya Gökmen, Aziz Ahmet Surel, Ebru Ünsal, Hatice Canan Hasanoğlu, İhsan Ateş, Rahmet Güner, Ayşegül Karalezli","doi":"10.5578/tt.202403934","DOIUrl":"10.5578/tt.202403934","url":null,"abstract":"<p><strong>Introduction: </strong>It is known that the use of inhaled corticosteroids increases the incidence of pneumonia in patients followed up with the diagnosis of chronic asthma and chronic obstructive pulmonary disease (COPD). This study aimed to investigate the contribution of inhaled steroid use to pneumonia severity and mortality in cases with COVID-19 pneumonia.</p><p><strong>Materials and methods: </strong>The study is a retrospective, observational study. Among the cases admitted to the pandemic clinic, patients diagnosed with COVID-19 pneumonia were included. The plan was to compare cases who received and did not receive inhaled corticosteroids in terms of pneumonia severity and mortality. In order to define risk factors for mortality, univariate and multivariable negative binomial regression analyses were performed.</p><p><strong>Result: </strong>In our study, it was observed that n= 540 (75%) cases did not receive inhaled corticosteroids (group 1), and 180 (25%) cases used inhaled corti costeroids (group 2). Group 1 and group 2 cases were compared in terms of pneumonia severity with no significant difference between the two groups (p= 0.11). Then, risk factors affecting mortality in all cases were examined with univariate analyses. Increasing age, applying mechanical ventilation, having severe pneumonia, having interstitial lung disease, and applying prone position were found to be statistically significant factors in mortality (p < 0.05).</p><p><strong>Conclusions: </strong>In conclusion, in our study, it was observed that the use of inhaled corticosteroids did not increase the severity of pneumonia and mortality. It was thought that the treatment they received could be continued when the patients treated with inhaled corticosteroids due to asthma and COPD had COVID-19 pneumonia.</p>","PeriodicalId":519894,"journal":{"name":"Tuberkuloz ve toraks","volume":"72 3","pages":"219-228"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of thoracic aortic aneurysm with long-term hoarseness as the sole symptom.","authors":"Mayu Kazui, Hiroaki Matsumoto, Yosuke Maezawa, Shinichiro Okauchi, Gen Ohara, Hiroaki Satoh","doi":"10.5578/tt.202403944","DOIUrl":"10.5578/tt.202403944","url":null,"abstract":"","PeriodicalId":519894,"journal":{"name":"Tuberkuloz ve toraks","volume":"72 3","pages":"237-238"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-existence of sarcoidosis and pulmonary embolism.","authors":"Övgü Velioğlu Yakut, Miraç Öz, Serhat Erol, Öznur Yildiz, Özlem Özdemir Kumbasar","doi":"10.5578/tt.202402917","DOIUrl":"10.5578/tt.202402917","url":null,"abstract":"","PeriodicalId":519894,"journal":{"name":"Tuberkuloz ve toraks","volume":"72 2","pages":"173-175"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}