Thoracic research and practice最新文献

{"title":"Evaluation of the Prognostic Nutritional Index in Conjunction with Lung Cancer Stage and PET-CT SUVmax.","authors":"İlknur Kaya, Ümran Erbay, Şebnem Emine Parspur, Feride Marım, Mehmet Doğan, Şerife Kaya, Jülide Kan","doi":"10.4274/ThoracResPract.2026.2026-4-7","DOIUrl":"10.4274/ThoracResPract.2026.2026-4-7","url":null,"abstract":"<p><strong>Objective: </strong>Lung cancer is among the malignancies with the highest mortality rates globally, where nutritional and immune status significantly influence disease progression and prognosis. The study aimed to investigate the relationship of the prognostic nutritional index (PNI) with both the maximum standardized uptake value (SUVmax), measured by positron emission tomography-computed tomography, and the clinical stage of lung cancer.</p><p><strong>Material and methods: </strong>Patients who underwent fiberoptic bronchoscopy and were diagnosed with lung cancer at the Department of Pulmonology, Kütahya Health Sciences University, between January 1, 2022 and May 31, 2025, were retrospectively evaluated. A total of 241 patients diagnosed with lung cancer via bronchoscopy were evaluated; of these, 205 patients diagnosed with non-small-cell lung cancer (n = 205) were assessed according to stage.</p><p><strong>Results: </strong>A total of 241 lung cancer patients were included; the mean age was 68.35±8.52 years and 95.0% were male. The mean PNI was 41.41±9.50 and the mean primary tumor SUVmax was 10.53±5.22. PNI and primary tumor SUVmax showed a very weak negative association that did not reach statistical significance (Spearman ρ = -0.127; <i>P</i> = 0.055). Clinical stage was positively associated with SUVmax (ρ = 0.253; <i>P</i> < 0.001) and negatively associated with PNI (ρ = -0.186; <i>P</i> = 0.007).</p><p><strong>Conclusion: </strong>Higher clinical stage was associated with higher primary tumor SUVmax and lower PNI. The association between PNI and SUVmax was weak and not statistically significant; therefore, it should not be considered clinically discriminative on its own. PNI may serve as an adjunctive indicator of nutritional and immune status, but prospective studies with survival outcomes and multivariable adjustment are required before it can be used as a prognostic or staging tool.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"294-299"},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Clinical Outcomes of Nintedanib and Pirfenidone in Idiopathic Pulmonary Fibrosis: A Five-year Real-life Study.","authors":"Ayshan Mammadova","doi":"10.4274/ThoracResPract.2026.2026-6-18","DOIUrl":"10.4274/ThoracResPract.2026.2026-6-18","url":null,"abstract":"","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"337-338"},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory Emergencies in Disasters: A Narrative Review.","authors":"Ali Ekber Karabulut, Burcu Özen Karabulut","doi":"10.4274/ThoracResPract.2026.2026-6-13","DOIUrl":"10.4274/ThoracResPract.2026.2026-6-13","url":null,"abstract":"<p><p>Disasters cause a wide spectrum of respiratory injuries and affect hundreds of millions of people each year. Because the respiratory system is in continuous contact with the external environment, it is among the most vulnerable systems in disaster settings. Silica-and asbestos-containing dust released from earthquake debris, fine particulate matter from wildfire smoke, mold spores in flood-damaged interiors, ash and acidic gases from volcanic eruptions, toxic industrial chemicals released during chemical incidents, barotrauma from explosions, and biological or pandemic threats each trigger acute and chronic respiratory diseases through distinct mechanisms. This narrative review addresses respiratory emergencies associated with natural and human-made disasters, the underlying pathophysiological mechanisms, diagnostic and management approaches, vulnerable populations, and the influence of climate change on the rising burden of disaster-related respiratory disease. Evidence was synthesized from PubMed/MEDLINE, Web of Science, and Scopus, supplemented by official reports from the Emergency Events Database, the World Health Organization, and the United Nations Office for Disaster Risk Reduction. Available data indicate that acute respiratory infections are major causes of morbidity and mortality in disaster settings across all age groups. Furthermore, patients with chronic respiratory diseases face an increased risk of exacerbations, while the management of acute respiratory distress syndrome remains a significant challenge, particularly in resource-limited environments. Disaster preparedness planning must prioritize respiratory emergencies and strengthen response protocols for vulnerable groups.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":"27 5","pages":"324-334"},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective Evaluation of Safety of Using a Semi-automatic Robotic System for Transthoracic Biopsy of Lung Mass Under Positron Emission Tomography-computed Tomography Guidance.","authors":"Mudalsha Ravina, Ranganath Ganga, Rutuja Kote, Prateek Prasanth, Ajoy K Behera, Praveen Kumar Dubey, Ramkishore Velmurugan","doi":"10.4274/ThoracResPract.2026.2025-12-8","DOIUrl":"10.4274/ThoracResPract.2026.2025-12-8","url":null,"abstract":"<p><strong>Objective: </strong>Lung cancer poses unique challenges due to heterogeneity in tumor and metastatic cellular composition. The use of ¹⁸F-fluorodeoxy glucose positron emission tomography-computed tomography (¹⁸F-FDG PET-CT) integrates functional and anatomical imaging. This study assessed the safety and diagnostic yield of PET-CT-guided transthoracic needle biopsy for intrathoracic mass lesions using a semi-automatic robotic system.</p><p><strong>Material and methods: </strong>Forty consecutive patients underwent whole-body PET-CT imaging following which they underwent transthoracic biopsy, using a semi-automatic robotic biopsy system (Maxio^TM III; Perfint Healthcare Pvt Ltd., Chennai, Tamil Nadu, India), consisting of docking system, digital screen and a stereotactic arm. Clinicodemographic profile, PET-CT and biopsy findings, histopathology reports, and complications were retrieved from patient records.</p><p><strong>Results: </strong>The mean age of the patients was 57.08±12.39 years, and the mean maximum standardized uptake value was 16.71±8.61. PET-CT revealed a unilateral lung mass in 92.5% (n = 37) and bilateral lesions in 7.5% (n = 3) of patients. Heterogeneous ¹⁸F-FDG uptake was noted in 97.5% (n = 39). The average target lesion distance was 40±12.7 mm. At least four biopsy cores were obtained in all patients except one. Core length was 2 cm in 90% of cases. The most common complication was local pain, followed by pneumothorax in 12.5% (n = 5). Tissue was adequate for analysis in all cases. None of the patients had to undergo repeat PET-CT or biopsy. The diagnostic yield was 100%, with malignancy in 82.5% (n = 33), acute inflammation in 10% (n = 4), and tuberculosis in 7.5% (n = 3). 50% (n = 20) underwent next-generation sequencing for targeted mutation testing.</p><p><strong>Conclusion: </strong>Semiautomatic robotic assistance can be a safe option for diagnosing intrathoracic mass lesions, with an acceptable diagnostic yield.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"269-274"},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound- versus CT-guided Biopsy of Pleural-contact Pulmonary Lesions: A Comparative Analysis of Diagnostic Performance and Procedural Complications.","authors":"Mustafa Yeşilyurt, Esra Pınar, Ahmet Tuğrul Akkuş, Adem Karaman","doi":"10.4274/ThoracResPract.2026.2026-6-8","DOIUrl":"10.4274/ThoracResPract.2026.2026-6-8","url":null,"abstract":"<p><strong>Objective: </strong>To compare the diagnostic performance and complication profiles of ultrasound (US)-guided and computed tomography (CT)-guided biopsy in pleural-contact pulmonary lesions and to evaluate technical factors associated with pneumothorax development after CT-guided biopsy.</p><p><strong>Material and methods: </strong>This retrospective single-center study included 197 patients with pleural-contact pulmonary lesions who underwent image-guided transthoracic core needle biopsy between January 2023 and March 2026. Of these, 123 underwent CT-guided biopsies and 74 underwent US-guided biopsies. Diagnostic adequacy, diagnostic accuracy, and procedure-related complications were compared between the groups. Factors associated with pneumothorax after CT-guided biopsy were evaluated using univariate and multivariable logistic regression analyses.</p><p><strong>Results: </strong>Diagnostic adequacy was comparable between CT-guided and US-guided biopsies (93.5% vs. 89.2%, <i>P</i> = 0.281). Similarly, diagnostic accuracy did not differ significantly between the groups (93.0% vs. 97.0%, P = 0.331). Pneumothorax occurred in 34 patients (27.6%) following CT-guided biopsy, whereas none occurred after US-guided biopsy (<i>P</i> < 0.001). Chest tube placement was required in 7 patients (5.7%) in the CT-guided group and in none in the US-guided group (<i>P</i> = 0.047). In univariate analysis, the traversed aerated lung distance was associated with pneumothorax development (odds ratio, 1.056; 95% confidence interval, 1.005-1.110; <i>P</i> = 0.031); however, no independent predictor was identified in multivariable analysis.</p><p><strong>Conclusion: </strong>US-guided biopsy of pleural-contact pulmonary lesions demonstrated diagnostic adequacy and diagnostic accuracy comparable to CT-guided biopsy and was associated with lower pneumothorax and chest tube placement rates in this retrospective cohort. When an adequate acoustic window and pleural contact are present, US guidance may be a safe and effective alternative biopsy approach for appropriately selected pleural-contact pulmonary lesions.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"308-316"},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence in Respiratory Medicine: Epistemic Authority, Trust and Responsibility in Practice and in Training.","authors":"Fatma Eren Akgün, Sead Zeynel","doi":"10.4274/ThoracResPract.2026.2026-8-8","DOIUrl":"10.4274/ThoracResPract.2026.2026-8-8","url":null,"abstract":"","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"339-340"},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Qualitative Study on the Difficulties Faced by Healthcare Professionals Working in Smoking Cessation Clinics.","authors":"Esra Daharlı, Coşkun Daharlı","doi":"10.4274/ThoracResPract.2026.2026-6-7","DOIUrl":"10.4274/ThoracResPract.2026.2026-6-7","url":null,"abstract":"<p><strong>Objective: </strong>Smoking cessation clinics are an essential component of tobacco control policies, providing integrated pharmacological and behavioral interventions to support individuals in overcoming tobacco dependence. The quality and effectiveness of these services are closely associated with healthcare professionals' experiences and the organizational context in which care is delivered. This study aimed to explore healthcare professionals' experiences, perceived barriers, coping strategies, and recommendations regarding smoking cessation services in Türkiye.</p><p><strong>Material and methods: </strong>A qualitative phenomenological design was employed. Purposive sampling was used to recruit 13 healthcare professionals working in smoking cessation clinics, addiction units, and Healthy Life Centers. The study was conducted between November 2025 and April 2026. Data were collected through face-to-face semi-structured interviews and analyzed using thematic analysis.</p><p><strong>Results: </strong>Participants perceived smoking cessation clinics as valuable and effective services but identified several barriers that limited service delivery. Major challenges included low patient motivation, inadequate adherence to follow-up visits, normalization of smoking in social life, heavy workload, limited consultation time, insufficient multidisciplinary support, and medication access problems. Healthcare professionals reported using individualized counseling, motivational interviewing, evidence-based treatment algorithms, and digital follow-up systems to improve treatment adherence and cessation success. Professional motivation was primarily sustained by observing successful patient outcomes and contributing to improved quality of life, despite existing structural constraints.</p><p><strong>Conclusion: </strong>Smoking cessation services are influenced by the interaction of individual, organizational, and systemic factors. Strengthening multidisciplinary teamwork, improving institutional resources, expanding behavioral support, enhancing digital follow-up systems, and increasing public awareness may improve the effectiveness and sustainability of tobacco dependence treatment. Incorporating healthcare professionals' experiences into tobacco control policies may contribute to higher-quality services and better long-term cessation outcomes.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"300-307"},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of AI-based Chatbot Performance in Analyzing Clinical Scenarios versus Medical Residents: A Novel Approach in Chest Diseases Education.","authors":"Mehmet Hakan Bilgin, Hamit Hakan Alp","doi":"10.4274/ThoracResPract.2026.2026-1-2","DOIUrl":"10.4274/ThoracResPract.2026.2026-1-2","url":null,"abstract":"<p><strong>Objective: </strong>Rapid advancements in artificial intelligence (AI) technologies offer new opportunities in medical education. The aim of this study is to compare the performance of large language models, specifically ChatGPT-4 and Gemini, in analyzing clinical scenarios with that of chest diseases research assistants (residents), and to evaluate their potential roles in medical education.</p><p><strong>Material and methods: </strong>This cross-sectional, comparative study included 28 resident physicians working in the department of chest diseases at a tertiary-care university hospital. Four clinical scenarios involving diagnoses of massive pulmonary embolism, chronic obstructive pulmonary disease, asthma, and severe pneumonia/sepsis were presented to both participants and AI models (ChatGPT-4 and Gemini). Responses were scored by blinded experts based on current guidelines (Global Initiative for Chronic Obstructive Lung Disease, Global Initiative for Asthma, American Thoracic Society).</p><p><strong>Results: </strong>AI models achieved significantly higher scores than residents, particularly on structured questions requiring theoretical knowledge, classification skills, and the listing of contraindications (<i>P</i> < 0.05). However, it was observed that residents achieved success levels similar to those of AI models in situations requiring emergency intervention (e.g., shock management) through practical, results-oriented approaches. While AI models provided a broader spectrum in differential diagnosis, residents preferred \"telegraphic\" and practice-oriented responses.</p><p><strong>Conclusion: </strong>ChatGPT and Gemini have significant potential as clinical decision-support systems and educational assistants. However, rather than replacing human factors in clinical reasoning and emergency management, they should be positioned as complementary tools that accelerate physicians' access to theoretical knowledge.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"275-279"},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid Drug Desensitization to Platinum-based Chemotherapy Agents: A Single-center Experience.","authors":"Hazal Kayıkçı, Ebru Damadoğlu, Melek Cihanbeylerden, Çise Tüccar, Ayşegül Pehlivanlar Ustaoğlu, Kerim Çayıröz, Elif Hatipoğlu, Gül Karakaya, Ali Fuat Kalyoncu","doi":"10.4274/ThoracResPract.2026.2026-1-10","DOIUrl":"10.4274/ThoracResPract.2026.2026-1-10","url":null,"abstract":"<p><strong>Objective: </strong>To characterize the clinical features of patients with platinum-based hypersensitivity reactions (HSRs) and to evaluate rapid drug desensitization (RDD) outcomes across different platinum agents.</p><p><strong>Material and methods: </strong>This retrospective study included patients who underwent RDD for platinum agents between 2019 and 2023 at a tertiary adult allergy clinic. Index reaction characteristics, RDD procedures, and breakthrough reactions (BTRs) were systematically recorded and analyzed.</p><p><strong>Results: </strong>Of 2,131 patients receiving chemotherapy, 105 (5.0%) developed platinum-induced HSRs and were included in the analysis. The cohort comprised 75 (71.4%) females, with a mean age of 61.3±10.3 years. Carboplatin was the most frequently implicated agent (n = 56, 53.3%), followed by oxaliplatin (n = 35, 33.3%) and cisplatin (n = 14, 13.3%). Index reactions occurred at a median of 5 cycles (range: 1-20) and, according to Brown's classification, were mild in 26 patients (24.8%), moderate in 73 patients (69.5%), and severe in 6 patients (5.7%). A total of 430 RDD procedures were performed, with 62 (14.4%) BTRs occurring in 40 patients (38.1%). The proportion of RDD procedures completed without BTRs did not differ significantly among carboplatin (226/266, 85.0%), oxaliplatin (110/126, 87.3%), and cisplatin (32/38, 84.2%) (<i>P</i> = 0.800). Overall, 414 (94.1%) desensitization procedures were successfully completed. Sex distribution differed significantly by culprit platinum agent, with a male predominance observed among patients reacting to oxaliplatin compared with those reacting to cisplatin and carboplatin (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>This study demonstrates that desensitization to platinum-based chemotherapy achieved high success rates and produced comparable outcomes across different platinum agents. Notably, HSRs to oxaliplatin were observed significantly more frequently among male patients than HSRs to other platinum agents.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"317-323"},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tobacco Industry and Cannabis: A New Public Health Challenge for Türkiye.","authors":"Osman Elbek, Oğuz Kılınç","doi":"10.4274/ThoracResPract.2026.2026-6-2","DOIUrl":"10.4274/ThoracResPract.2026.2026-6-2","url":null,"abstract":"","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":" ","pages":"335-336"},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148166098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}