Tuberkuloz ve toraks最新文献

{"title":"Evaluation and differential diagnosis of eosinophilia: A tertiary allergy center experience.","authors":"Özge Atik, Fatma Merve Tepetam, Şeyma Özden, Bahar Agayeva, Ali Can","doi":"10.5578/tt.2025041152","DOIUrl":"https://doi.org/10.5578/tt.2025041152","url":null,"abstract":"<p><strong>Introduction: </strong>Eosinophilia is a hematologic finding that may indicate a wide range of underlying conditions, from common allergic diseases to rare and potentially life-threatening disorders such as hypereosinophilic syndrome (HES), eosinophilic granulomatosis with polyangiitis (EGPA), and systemic mastocytosis. A structured diagnostic approach is crucial to identify the underlying etiology and guide appropriate treatment.</p><p><strong>Materials and methods: </strong>This retrospective cross-sectional study evaluated 232 adult patients with peripheral blood absolute eosinophil counts ≥1000 cells/µL, who were referred to a tertiary immunology and allergy clinic between January 2018 and December 2022. Demographic, clinical, and laboratory data were analysed. Diagnoses were grouped according to eosinophil count severity: Mild (1000-1499 cells/µL), moderate (1500-4999 cells/µL), and severe (≥5000 cells/µL). Diagnoses were based on established international guidelines, supported by laboratory, radiological, immunological, and genetic investigations.</p><p><strong>Result: </strong>The most commonly observed diagnoses included atopic diseases (53.4%), with allergic bronchopulmonary aspergillosis (ABPA, 11.6%), nonsteroidal anti-inflammatory drug-exacerbated respiratory disease (6%), and chronic eosinophilic pneumonia (3%) occurring less frequently. Rare conditions included EGPA (1.7%), HES (1.7%), parasitic infections (1.3%), systemic mastocytosis (0.4%), and Gleich syndrome (0.4%). Innate immune defect was detected in 0.4%. Molecular testing identified myeloid variant HES in four patients (FIP1L1-PDGFRA and PDGFRB mutations). The etiology remained undetermined in 19.8% of the patients. Atopic diseases were the most frequent diagnosis across all eosinophilia severity groups (38.3% vs. 14.2% vs. 0.8% p< 0.001 respectively).</p><p><strong>Conclusions: </strong>Atopic diseases are the most common cause of eosinophilia in adults, but clinicians must remain vigilant for less common but clinically significant diagnoses such as ABPA, HES, EGPA, and systemic mastocytosis. Managing eosinophilia effectively depends on a multidisciplinary strategy that incorporates algorithm-based decision-making to support accurate diagnosis.</p>","PeriodicalId":519894,"journal":{"name":"Tuberkuloz ve toraks","volume":"73 4","pages":"286-298"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145902157","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":"Fungal colonization and its clinical associations in pediatric cystic fibrosis: A 12-year single-center cohort study.","authors":"Ece Ocak, Gökçen Kartal Öztürk, Ece Halis, Bahar Girgin Dindar, Fevziye Çoksüer, Mehmet Mustafa Özaslan, Meral Barlik, Atacan Öğütçü, Figen Gülen","doi":"10.5578/tt.2025041144","DOIUrl":"https://doi.org/10.5578/tt.2025041144","url":null,"abstract":"<p><strong>Introduction: </strong>Fungal organisms are increasingly isolated from respiratory samples of patients with cystic fibrosis (CF), yet their clinical relevance remains incompletely understood. This study aimed to assess the frequency of colonization and clinical characteristics of CF patients with fungal colonization.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed CF patients followed at the Pediatric Pulmonology Division of Ege University between January 2011 and December 2022. Those with at least one respiratory culture analyzed for fungi were included. Fungal colonization was defined as the growth of the same species in at least 50% of cultures within one year. Demographic, clinical, spirometric, and microbiological data were evaluated.</p><p><strong>Result: </strong>Among the 98 patients, median age was 9.6 years (1.7-32.1), and 54.1% were male. Fungal growth was detected in 51 patients (52.0%), and 37 (37.7%) met the criteria for colonization. Candida albicans (32.7%) and Aspergillus fumigatus (13.3%) were the most commonly isolated species. Patients with fungal colonization were older (p< 0.001), more likely to have chronic Pseudomonas aeruginosa colonization (p< 0.001), had more inhaled antibiotic use (p< 0.001), CF-related liver disease (p= 0.018), and had lower FEV1% (p= 0.005) and body mass index z-scores (zBMI) (p< 0.001). Regression analyses identified lower zBMI (95% CI: 0.527-0.948; p= 0.021) and P. aeruginosa colonization (95% CI: 1.237-8.809; p= 0.017) as independent predictors of fungal colonization.</p><p><strong>Conclusions: </strong>Fungal colonization is common in children with CF and is associated with older age, impaired lung function, lower zBMI, and P. aeruginosa co-colonization. These findings support the need for routine fungal surveillance and further prospective studies to clarify clinical implications. Further research is needed to determine whether these relationships are causal.</p>","PeriodicalId":519894,"journal":{"name":"Tuberkuloz ve toraks","volume":"73 4","pages":"268-276"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145902161","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":"Polysomnography diagnostic methods in OSA: Question on precision and definitions?","authors":"Safy Kaddah, Antonio Esquinas","doi":"10.5578/tt.2025031143","DOIUrl":"https://doi.org/10.5578/tt.2025031143","url":null,"abstract":"","PeriodicalId":519894,"journal":{"name":"Tuberkuloz ve toraks","volume":"73 3","pages":"231-232"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152274","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":"Distribution of fluids between body compartments following fluid therapy in cardiac surgery.","authors":"Göksel Güven, Jonathan Montomoli, Stephanie Roelen, Emanuele Favaron, Arzu Topeli, Bas DE Mol, Can Ince, Wim Jan VAN Boven","doi":"10.5578/tt.2025031140","DOIUrl":"https://doi.org/10.5578/tt.2025031140","url":null,"abstract":"<p><strong>Introduction: </strong>Intravenous fluids are commonly used to resuscitate cardiac surgery patients in the operating room and ICU, assuming they expand the intravascular compartment. However, the quantitative information for their distribution and shift between the tissue compartments is still lacking. This study aimed to assess how administered fluids distribute across compartments and their effects on micro- and macrocirculation during the long term of cardiac surgery.</p><p><strong>Materials and methods: </strong>Thirty-three consecutive patients undergoing major cardiac surgery were prospectively enrolled. Information regarding the body fluid distribution [total body water (TBW), extracellular water (ECW), intracellular water (ICW)], sublingual microcirculation total vessel density (TVD), per-fused vessel density (PVD), and proportion of perfused vessel (PPV)], and hemodynamics were collected before surgery (T0), on the day of discharge from the intensive care unit (T1), and on the third day at the ward (T3). Correlations of the changes in microcirculatory and macrocircula-tory parameters were determined by linear regression.</p><p><strong>Result: </strong>Twenty-four patients were included in the analysis with available data. Body weight significantly increased from 86.0 ± 13.6 kg to 91.6 ± 13.3 kg at T1 and decreased to 87.8 ± 12.9 kg at T3 (p< 0.001). While TBW and ECW varied in parallel with body weight, ICW showed a continuous decrease throughout the study process. TVD, PVD, and PPV significantly decreased at T1, then increased at T3, but all remained lower than baseline (p< 0.001 for TVD and PVD, p= 0.034 for PPV). A cut-off point of a 5% increase in body weight predicted a 10% decrease in TVD with a sensitivity of 0.833 and specificity of 0.666. Besides, a cut-off point of a 4% increase in body weight predicted a 10% decrease in PVD with a sensitivity of 0.94 and specificity of 0.75.</p><p><strong>Conclusions: </strong>Administering fluid during operation and intensive care stay significantly reduces ICW and causes microcirculatory disturbances in cardiac surgery patients. Long-term microcirculation disturbances correlate with ECW and TBW in these patients.</p>","PeriodicalId":519894,"journal":{"name":"Tuberkuloz ve toraks","volume":"73 3","pages":"205-215"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152778","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":"Enhancing tuberculosis diagnosis: A deep learning-based framework for accurate detection and quantification of TB bacilli in microscopic images.","authors":"Dinesh Jackson Samuel Ravindran, Rajesh Kanna Baskaran","doi":"10.5578/tt.2025031113","DOIUrl":"https://doi.org/10.5578/tt.2025031113","url":null,"abstract":"<p><strong>Introduction: </strong>Tuberculosis (TB), a highly contagious disease, remains one of the leading causes of death globally. The proposed computer-assisted TB detection system enhances diagnostic accuracy and efficiency by integrating deep learning and segmentation techniques.</p><p><strong>Materials and methods: </strong>It consists of two key subsystems: Automated field-ofview (FOV) recognition and TB bacilli segmentation. Using a motorized microscopic stage, the system systematically captures Ziehl-Neelsen-stained sputum smear images at 100x magnification. A customized Inception V3 model with transfer learning identifies FOVs containing TB bacilli, reducing variability and manual effort. Segmentation techniques, including coarse-level thresholding and shape descriptors like area, perimeter, and eccentricity, refine bacilli detection and eliminate artifacts.</p><p><strong>Result: </strong>This study highlights the significant potential of deep learning and image processing techniques in advancing medical diagnostics, particularly TB detection. This framework has the potential to improve clinical outcomes and support global TB eradication efforts by providing a reliable tool for early TB diagnosis.</p><p><strong>Conclusions: </strong>The system achieved a mean receiver operating characteristic score of 0.9505, a precision of 0.924, a recall of 0.882, and an F1 score of 0.902, demonstrating its potential to improve TB screening, particularly in resource-limited settings. By minimizing reliance on skilled technicians and enhancing diagnostic reliability, this approach offers a scalable solution for effective TB detection and severity assessment.</p>","PeriodicalId":519894,"journal":{"name":"Tuberkuloz ve toraks","volume":"73 3","pages":"165-177"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152794","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":"Atelectasis in children: Results of flexible fiberoptic bronchoscopy.","authors":"Mehmet Mustafa Özaslan, Gökçen Kartal Öztürk, Meral Barlik, Fevziye Çoksuer, Bahar Girgin Dindar, Ece Ocak, Ece Halis, Atacan Öğütçü, Figen Gülen","doi":"10.5578/tt.2025031124","DOIUrl":"https://doi.org/10.5578/tt.2025031124","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary atelectasis is a significant respiratory problem in children. This study aimed to investigate the underlying causes of atelectasis and evaluate the outcomes of flexible fiberoptic bronchoscopy (FFB) in pediatric patients with this condition.</p><p><strong>Materials and methods: </strong>Clinical data and outcomes of 110 children who underwent FFB were retrospectively analyzed based on radiological imaging obtained at three and six months following the procedure, and the patients were categorized into three groups: Group 1 (complete resolution of atelectasis), Group 2 (partial resolution), and Group 3 (no resolution).</p><p><strong>Result: </strong>Between January 2016 and December 2023, a total of 110 pediatric patients with pulmonary atelectasis underwent FFB. The most common bronchoscopic findings were mucus plugs and secretions (50%), foreign body aspiration (7.3%), and congenital airway anomalies (3.6%). In 30% of the patients, bronchoscopy findings were normal. Complete resolution of atelectasis was observed in 55.4% of patients following FFB. The median duration of atelectasis in Group 3 was 90 days, significantly longer than that found in the other two groups (p= 0.002). Additionally, the median hospitalization period prior to bronchoscopy in Group 3 was 21 days, which was also longer than that found in the other groups (p= 0.004). The median atelectasis score in Group 1 was 2.34 (range: 0.9-3.1), significantly lower than in Groups 2 and 3 (p= 0.005).</p><p><strong>Conclusions: </strong>FFB is an effective tool for identifying the etiology of atelectasis in children. Prolonged duration of atelectasis and the presence of comorbidities were identified as risk factors for persistent, non-resolving atelectasis.</p>","PeriodicalId":519894,"journal":{"name":"Tuberkuloz ve toraks","volume":"73 3","pages":"187-194"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152780","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":"Disseminated tuberculosis despite preventive treatment in patients treated with tumor necrosis factor inhibitors: A report of two cases.","authors":"Roberto Rentería-Gámez, Wendy Rosario Cinencio-Chavez, Claudia Miriam Zaragoza-Calderón, Rafael Laniado-Laborin","doi":"10.5578/tt.2025031095","DOIUrl":"https://doi.org/10.5578/tt.2025031095","url":null,"abstract":"","PeriodicalId":519894,"journal":{"name":"Tuberkuloz ve toraks","volume":"73 3","pages":"227-230"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152821","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":"Investigating the effectiveness of non-polysomnography diagnostic methods used in sleep disorders in predicting the diagnosis of obstructive sleep apnea syndrome.","authors":"Kübra Güngör, Banu Gülbay, Turan Acican","doi":"10.5578/tt.20250311430","DOIUrl":"https://doi.org/10.5578/tt.20250311430","url":null,"abstract":"","PeriodicalId":519894,"journal":{"name":"Tuberkuloz ve toraks","volume":"73 3","pages":"233-234"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152763","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":"Radiological evolution from cyst to cancer in a patient with three primary lung cancers over 20 years.","authors":"Ulkar Ismayilova, Rashad Ismayilov, Gamze Durhan, Deniz Köksal","doi":"10.5578/tt.2025031075","DOIUrl":"https://doi.org/10.5578/tt.2025031075","url":null,"abstract":"","PeriodicalId":519894,"journal":{"name":"Tuberkuloz ve toraks","volume":"73 3","pages":"235-237"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152237","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":"Demographic and diagnostic trends in patients with histopathologically diagnosed pulmonary sarcoidosis: A 10-year singlecenter experience.","authors":"Baran Gündoğuş, Tekin Yildiz, Meltem Ağca, Selahattin Öztaş, Ülkü Aka Aktürk, Sümeyye Alparslan Bekir, Özlem Soğukpinar, Dilem Anil Tokyay, Ayşem Aşkım Öztin Güven, Birsen Ocakli","doi":"10.5578/tt.2025031116","DOIUrl":"https://doi.org/10.5578/tt.2025031116","url":null,"abstract":"<p><strong>Introduction: </strong>Sarcoidosis is a chronic and inflammatory multisystemic disease of unknown origin that causes various clinical manifestations. Epidemiologic data vary by numerous variables such as age, geographical location, sex, race, as well as genetic and environmental factors. Epidemiologic data help better characterize the heterogeneous disease of sarcoidosis, as in many other diseases, and facilitate a prognostic assessment. Thus, the present study sought to analyze epidemiologic data and changes in diagnostic strategies used in sarcoidosis over time.</p><p><strong>Materials and methods: </strong>The study reviewed patients who were diagnosed with sarcoidosis between January 01, 2011 and December 31, 2020, and had non-necrotizing granulomatous inflammation in at least one thoracic biopsy material.</p><p><strong>Result: </strong>Data from a total of 1.200 patients, of whom 768 (64%) were females and 432 were males (female/male: 1.77), were reviewed over a 10-year period. The results showed an increasing trend in the frequency of sarcoidosis in the 10-year period and an increasing incidence for males after 2015. The rate of asymptomatic patients was 15%, and asymptomatic sarcoidosis was significantly higher in males than in females. After 2012, video-assisted mediastinoscopy was replaced with endobronchial ultrasoundguided transbronchial needle aspiration as the preferred diagnostic technique.</p><p><strong>Conclusions: </strong>Epidemiologic data associated with sarcoidosis are likely to continue changing because of multiple factors such as health policies and technological changes and development. We believe that it is necessary to constantly monitor epidemiological changes in different geographical regions in the world.</p>","PeriodicalId":519894,"journal":{"name":"Tuberkuloz ve toraks","volume":"73 3","pages":"178-186"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152744","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}