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Introduction: This study investigated the clinical and radiological characteristics and demographics of patients who developed pulmonary embolism (PE) after Coronavirus disease-2019 (COVID-19) vaccination. Methods: The cases of PE were analyzed retrospectively. Data on clinical, demographic, and radiologic characteristics, laboratory findings, Pulmonary Embolism Severity Index (PESI) scores, early mortality scores, PE severity classes, and risk categories for early mortality (low-risk, intermediate-high-risk, intermediate-low-risk and high-risk) were collected from patient files as defined in the European Society of Cardiology guidelines. Patients were divided into two groups: those who had received a COVID-19 vaccine (group 1) and those who had not (group 2). Patients who developed PE within 1 month after vaccination were analyzed separately. Results: A total of 97 patients were included in the study, of whom 61 (62.9%) patients were female. Seventy-five (77.3%) study patients with PE had a history of COVID-19 vaccination (group 1), and 22 (22.7%) had never been vaccinated (group 2). Five (6.6%) patients had received a vaccine within 1 month before PE developed. No significant differences were found between groups 1 and 2 regarding demographics, clinical and radiologic characteristics, laboratory findings, PESI scores, early mortality scores, and PE severity classes (p>0.05), except for mean pulmonary artery pressures. The mean age of patients who developed PE within 1 month after vaccination was 74.6 years, and 80% of these patients were female. The average time to PE after vaccination was 22.2 days, and the mean PESI score was 86.6. Two patients (40%) were in the low-risk category for early mortality and one patient (20%) was in the intermediate/high-risk category. Conclusion: Overall, the characteristics of patients who developed PE after COVID-19 vaccination were comparable to those of patients who had not received a vaccine injection. No statistically significant increases in the incidence of PE were observed within the first month after being vaccinated.

INTRODUCTION[|]In the management of asthma disease, the aim is to keep the disease under control with treatment. Asthma control test (ACT) is the most widely used and important test that is easily figured out by the patients. This test is filled by the patient during the clinical practice. The present study aims to evaluate how the filling of ACT by the physician will affect the outcome and the concordance of results with clinical and functional parameters.[¤]METHODS[|]Patients who applied to the Outpatient Clinic of Chest Diseases in our Hospital between dates of June–August 2016 and who had at least one year of asthma diagnosis were included in this study. The patients filled their own answers to the ACT before the outpatient clinic examination. The same test was given to the patients by the doctor during physical examination.[¤]RESULTS[|]A total of 105 asthma patients were included in this study whose mean age was 38.8+-13.6 (14–76) years, 58 (55%) of them were female and 47 (44.8%) of them were male. Mean ACT score of the cases was 14.5+-5.8, while it was 13.9+-4.4 in the tests filled by the doctor. 33.3% of the cases were college graduates, 23.8% of them were high school graduates, 38.1% of them were primary school graduates, and 4.8% of them were middle school graduates. A statistically significant difference was detected (p=0.02) between the results of asthma control tests filled by the doctor and that of those filled by the patients. It was detected that the status of education of the patient was the factor with the highest impact on the situation. It was found that ACT results filled by doctors were in higher concordance with clinical and functional parameters.[¤]DISCUSSION AND CONCLUSION[|]Our study demonstrated that ACT being filled by the doctor in societies with lower levels of educational status would yield results that were in higher concordance with asthma control.[¤]

INTRODUCTION[|]Pleural effusion is an important problem in cancer patients as it will affect the stage, prognosis and treatment. Therefore, it is necessary to distinguish between paramalignant and malignant effusions. In this study, we aimed to investigate the role of PET-CT in the evaluation of pleural effusion.[¤]METHODS[|]Patients diagnosed with malignancy and associated pleural effusion and evaluated by PET-CT were prospectively included in this study. SUDmax values of pleural fluid were recorded in consideration of the demographic information and PET-CT findings. In all patients, biochemical parameters, including glucose, LDH, albumin and total protein and pH values of the pleural fluid obtained by thoracentesis, were measured. All pleural fluid samples were sent for cytological evaluation. After cytological evaluation, patients were defined as having malignant or paramalignant pleural effusion and accordingly divided into two groups. The t-test was used to compare SUDmax values between the groups. A chi-square test was used to compare categorical data.[¤]RESULTS[|]A total of 69 patients (30 women [43%] and 39 men [57%]) with a mean age of 63.55 (37–88) years were included in this study. The cytological analysis revealed malignant pleural effusion in 53 patients. In the follow-up of 16 patients, pleural fluid was accepted as of paramalignant nature due to the absence of both atypical cells in the fluid cytology and also clinical findings favoring malignancy. The mean SUDmax value was found to be 1.43 in paramalignant fluids and 1.5 in malignant fluids but without any statistically significant difference. Malignant cytological findings were detected despite the absence of FDG involvement in 23 (33%) cases, including patients with lung cancer (n=13), mesothelioma (n=3), breast cancer (n=2), colon cancer (n=2), ovarian cancer (n=1), gastric cancer (n=1), or endometrial cancer (n=1). PET had a sensitivity of 56.6% and a specificity of 50% in the detection of malignant pleural effusions with a 78.9% positive, and 25.8%negative predictive value.[¤]DISCUSSION AND CONCLUSION[|]Distinguishing between malignant and paramalignant effusions according to FDG uptake in pleural fluids may cause misleading results. Therefore, we suggest that advanced diagnostic procedures should be used in cases where the presence of malignant fluid will change the clinical approach.[¤]

Amaç: Akciğerin sarkomatoid karsinomlarının SK klinik ve radyometabolik PET-BT özelliklerinin incelenmesi ve bu özelliklerin sağ kalım üzerine etkisini araştırmak. Gereç ve Yöntem: Ocak 2014-Aralık 2016 arasında akciğer kanseri tanısı alan olguların kayıtları retrospektif olarak incelendi. Küçük hücreli dışı akciğer kanseri KHDAK ve SK tanısı alan olguların dosyaları ayrıldı. Bu olguların klinik ve radyometabolik özellikleri birbirleri ile karşılaştırıldı. Gruplara ait veriler Ki Kare, Mann Whitney U ile karşılaştırıldı. Sağ kalım analizleri Kaplan-Meier, Logrank yöntemi ile hesaplandı. Tüm testlerde p

INTRODUCTION[|]The association of lymphopenia detected in patients with sarcoidosis with disease activity was investigated in the present study.[¤]METHODS[|]Patients who were diagnosed as having sarcoidosis and healthy volunteers/individuals with no diagnosis of active disease between July 2016 and June 2017 were included in this study. Patients who were detected to have an absolute lymphocyte count (ALC) of 80% was 2+-0.7 (p=0.016). A positive correlation was detected between ALC and DLCO% (p=0.044, r=0.230). Although lymphopenia was detected in 42% of patients whose DLCO value was 80% (p=0.01). No significant association was detected among the sarcoidosis stage, symptom, and radiologic findings of the patients with the absolute lymphocyte count (p>0.05). [¤]DISCUSSION AND CONCLUSION[|]Lymphopenia is frequently detected in patients with sarcoidosis. Lower DLCO values may be detected in patients with lymphopenic sarcoidosis.[¤]

INTRODUCTION[|]Seasonal and weather changes may affect the development of pulmonary embolism. The effects of seasonal and meteorological factors on mortality are controversial. We aimed to investigate the effects of seasons and meteorological data on patients with a low and high pulmonary embolism severity index and those with 30-day mortality. [¤]METHODS[|]Pulmonary embolism cases were included in our study. Daily pressure, humidity, temperature, and wind values were taken from the general online information by the Directorate of Meteorology. All cases were divided into the low-risk and high-risk group, using a simplified pulmonary embolism severity index. [¤]RESULTS[|]Eighty-six patients diagnosed with pulmonary thromboembolism were included in the study. Comparison between the two groups revealed that the disease was detected during winter in the high-risk group (31.3%) and during summer in the low-risk group (59.1%) (p=0.011). No statistically significant results were found on the day of diagnosis and pressure, humidity, temperature, and wind averages on the 7th day based on the severity index (p>0.05). There were no statistically significant results detected when comparing the average air pressure, humidity, air temperature, season, and wind for mortality in 30 days (p>0.05). [¤]DISCUSSION AND CONCLUSION[|]In the light of these data, it was determined that seasonal and meteorological factors had no effect on mortality in pulmonary embolism.[¤]

Aspergillus fumigatus and Aspergillus niger are Aspergillus species that generally invade cavitary structures of the lungs and form fungus balls of Aspergillus hyphae, fibrin, mucus, blood, and inflammatory and epithelial cells; they are very rarely seen in extra-respiratory organs and systems. Tracheal diverticulum is a rare and mostly asymptomatic entity usually found in the paratracheal region, but its etiology and pathophysiology is not fully known. An interesting and very rare case of aspergilloma located in a tracheal diverticulum is presented in this article.

Combined pulmonary fibrosis and emphysema syndrome (CPFE) is a rare disease characterized by emphysema in the upper lobes of the lung and fibrosis in the lower lobes. CPFE is an important risk factor for lung cancer (LC). Although CPFE might increase the risk of LC, the prevalence of CPFE in patients with LC and the incidence of LC in patients with CPFE are unknown. LC in patients with CPFE (LC-CPFE) is associated with poor survival outcomes. The aim of this study was to present a case with CPFE to draw attention to the possibility that it may be accompanied by LC.

Lymphoma with cardiac involvement is rare; however, there can be very serious consequences. It is usually revealed in autopsy studies. Cardiac invasion by lymphoma may occur through retrograde lymphatic flow, hematogenous spread, or direct invasion from neighboring structures. Direct invasion is the most common, and has the most destructive results. The clinical signs and symptoms are nonspecific. Presently described is the case of a patient who was initially examined in a cardiology polyclinic due to exertional dyspnea and cardiomegaly seen in a chest X-ray. Echocardiographic examination revealed a suspected mass and the patient was referred to our clinic. A mass lesion filling the mediastinum and invading the right ventricle was detected in a computed tomography image of the chest. On the same day, a tru-cut biopsy with thoracic ultrasound guidance was performed by the pulmonologist. Three days after the biopsy, the patient was referred to the hematology clinic for treatment of pathological lymphoma. This case was presented to draw attention to the importance of prompt diagnosis and treatment of thoracic and mediastinal mass lesions with a multidisciplinary approach and to emphasize that a biopsy can be performed quickly and safely in patients with a mediastinal mass with the guidance of ultrasound, even when there is cardiac involvement.

INTRODUCTION[|]The aim of this study was to investigate the sociodemographic, clinical, radiological, histopathological, and survival characteristics of lung cancer patients ≤55 years of age.[¤]METHODS[|]The files of patients diagnosed in the clinic as lung cancer between January 2014 and December 2016 were retrospectively evaluated. These cases were divided into 2 groups: patients who were ≤55 years of age and patients >55 years of age. The clinical, radiological, and demographic findings; histopathological type and stage of cancer; treatment modalities used; and survival data were analyzed and compared.[¤]RESULTS[|]A total of 323 cases, 85 (26.3%) of them aged ≤55 years and 238 (73.7%) aged >55 years, were included in the study. The stage and histopathological type of lung cancer, smoking history, gender, oncological and surgical treatment modalities used, and survival characteristics were similar in both groups (p>0.05).[¤]DISCUSSION AND CONCLUSION[|]Since the 2 groups of lung cancer patients formed on the basis of the age limit of 55 years were similar in many respects, and because the number of cancer cases increases in 5-year subgroups under the age of 55 years, screening for lung cancer may be recommended for those under 55 years, especially in cases with risk factors.[¤]

Sarcomatoid carcinoma of the lung is a rare, poorly differentiated, low-grade carcinoma in the non-small cell lung cancer (NSCLC) group. It is a very aggressive tumor; the 5-year survival rate in patients with sarcomatoid carcinoma does not exceed 20%. There are a limited number of retrospective screenings of sarcomatoid carcinoma cases and case reports in the literature. The diagnosis, treatment, and prognostic features of sarcomatoid carcinoma are not well known compared with other NSCLCs. However, studies of sarcomatoid carcinoma have demonstrated that the prognosis is poor and response to standard chemotherapy treatment is not as good as seen with other NSCLCs. Presently described is a rare case diagnosed by thoracic ultrasonography-guided transthoracic biopsy.

INTRODUCTION[|]The aim of the present study was to determine diagnostic success of thoracic ultrasonography (US)-guided transthoracic fine needle aspiration biopsy (TTFNAB) performed by chest physicians for anterior mediastinal lesions.[¤]METHODS[|]Patients with anterior mediastinal lesions observed with US-guided TTFNAB performed in our clinic between December 2010 and January 2016, were included in the study. Details of clinical, demographic, and radiographic findings of the patients, sonographic appearance and size of the lesions, diagnosis based on US-guided TTFNAB results, final diagnosis, method of final diagnosis, and complications were recorded. Thoracic US was performed by an experienced chest physician using Logiq 7 system (GE Healthcare, Inc. Chicago, IL, USA) with 3.5 MHz convex transducer in abdominal mode.[¤]RESULTS[|]Fourteen patients with mean age of 47.5+-13 years were included in the study. Twelve cases (85.7%) were diagnosed with US-guided TTFNAB. Remaining 2 (14.3%) cases could not be diagnosed with this method. The final diagnosis in those 2 cases was squamous cell carcinoma and lymphoma. Lesions in study were both malignant (n=12; 85.7%) and benign (n= 2; 14.3%). Sensitivity and specificity of US-guided TTFNAB were calculated as 85.7% and 100%, respectively. Pneumothorax was observed in only 1 case.[¤]DISCUSSION AND CONCLUSION[|]US- guided TTFNAB is an easy, accessible, and inexpensive diagnostic method with high diagnostic efficiency, low complication rate, and no radiation exposure.[¤]

Septic pulmonary embolism (SPE) is an infective pulmonary disease that develops secondary to any source of infection and presents with signs and symptoms such as pulmonary infiltrates, fever, chest pain, and cough. SPE can be defined as a thrombus containing microorganisms embedded in fibrin that moves from an infectious focus and settles in pulmonary arteries. It usually causes multiple or bilateral nodular, cavitary, or wedge-shaped infiltrates, usually settled in the peripheral and neighborhood vessels of lung parenchyma. A patient diagnosed with SPE is presented as a case study in the literature since it is a rare condition.

Glioblastoma multiforme (GBM), comprised of astrocytes, is the most common brain tumor of the central nervous system. Although extracranial metastasis of GBM is very rare (

Objective Obstructive sleep apnea syndrome (OSAS) patients are thought to experience increased resistive load due to both anatomical and functional changes. This can possibly contribute to respiratory muscle dysfunction. We aimed to measure daytime maximal inspiratory and expiratory pressures, in order to find out respiratory muscle functions in OSAS. Materials and Methods Patients admitted to our sleep laboratory for one-year period were prospectively analysed. All the cases had undergone overnight polysomnography. All cases had pulmonary function tests performed by the same experienced technician in the morning following sleep study. The study population consisted of 51 (37.8%) female and 84 (62.2%) male patients, with a mean age of 47. Results Apnea hypopnea index (AHI) was found to be correlated with forced expiratory volume in one second (FEV1) and forced volume vital capacity (FVC) values and FVC%. FEV1/FVC, maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) values did not seem to be correlated with AHI. FVC (L), FVC%, FEV1, FEV1%, MIP, MIP% and MEP were similar in patients with and without OSAS. OSAS patients had significantly lower MEP% values. FVC, FEV1 and MEP% showed significant differences in different stages of the disease. Other parameters were similar in all groups. Conclusion In this study we demonstrated that maximal expiratory muscle strength of awake OSAS patients was lower, whereas inspiratory muscle strength was similar in subjects with and without OSAS.

Background: Asymmetric dimethylarginine (ADMA) has emerged as a risk marker for many conditions related to pulmonary hypertension (PH); however, little is known about ADMA and symmetric dimethylarginine (SDMA) plasma concentrations in chronic obstructive pulmonary disease (COPD). Our interest centers on the role of ADMA in regulation of endothelial function in COPD and secondary PH. The aim of the present study was to evaluate the serum ADMA, SDMA, and L-arginine concentrations in COPD and its association with PH. Methods: Patients with diagnosis of COPD underwent pulmonary function tests, echocardiography, and laboratory investigations including ADMA, SDMA, and L-arginine. Results: Serum concentrations of ADMA, SDMA, and L-arginine tend to increase as COPD progresses. Patients with PH had higher concentrations of ADMA, SDMA, and L-arginine compared to cases with normal pulmonary arterial pressure (PAP); the difference was not statistically significant. Conclusions: Our results show that increased ADMA, SDMA, and L-arginine concentrations are associated with increased PAP measurements in patients with COPD, however, the relationship is not statistically significant.

PURPOSE: The purpose of this study is to investigate the effect of homogeneous/heterogeneous (necrotic) involvement and maximum standardized uptake value (SUVmax) value of the lesion on positron emission tomography-computed tomography (PET-CT) of patients who underwent fiberoptic bronchoscopy (FOB) for prediagnosis of lung cancer and biopsy for endobronchial lesion on the diagnostic success of biopsy procedure. METHODS: Between January 2014 and December 2016, patients with final diagnosis of pulmonary malignancy as determined by FOB biopsy and patients who failed to be diagnosed by FOB biopsy and diagnosed with pulmonary malignancy by a different diagnostic method were examined. These patients were divided into two groups as those with diagnosis by FOB biopsy (Group 1) and those who failed to be diagnosed by this method and diagnosed with pulmonary malignancy by a different diagnostic method (Group 2). The SUVmax values of the two groups were compared with lesion characteristics of homogeneous, heterogeneous involvement/presence of necrotic component as shown by PET-CT. Group data were assessed by Chi-square test and Mann–Whitney U-test. In all tests, P < 0.05 was considered significant. FINDINGS: A total of 193 participants with a mean age of 61 ± 9.4 were included in the study. There were 128 (66.3%) cases in Group 1 and 65 (33.7%) cases in Group 2. The mean SUVmax value was 16.4 in Group 1 and 15.1 in Group 2. There was no statistically significant difference between the two groups (P = 0.329). Homogeneous involvement was present in 103 (80.3%) cases in Group 1 versus 42 (64.6%) cases in Group 2. In the presence of homogeneous PET-CT involvement, diagnosis rate by biopsy was significantly higher (P = 0.016). CONCLUSION: We concluded that the high SUVmax value of the mass lesion on PET-CT did not increase the diagnostic value of the biopsy procedure in patients prediagnosed with lung cancer and that the diagnostic success of FOB biopsy was poor in cases where PET-CT showed heterogeneous involvement of the mass lesion.