Asuman Aslan Kara

This study aimed to evaluate the prevalence and risk factors of small airway dysfunction (SAD) in patients with pneumoconiosis and to emphasize its role in early stage and disease monitoring. Data including demographics, ILO pneumoconiosis classification, and pulmonary function tests were analyzed. SAD was defined by at least two pulmonary function parameters-maximal mid-expiratory flow (MMEF), forced expiratory flow at 50% (FEF50), and 75% (FEF75)-below 65% of predicted values. SAD was identified in 59% of patients (n = 118). Compared to stage 1, the risk of SAD was fourfold higher in stage 2 (p = 0.037, OR = 4.119) and nearly 14-fold higher in stage 3 pneumoconiosis (p = 0.008, OR = 13.714). Progressive massive fibrosis increased SAD risk by nearly seven times (p = 0.010, OR = 6.884). These results highlight that SAD is common and may occur early in pneumoconiosis, underscoring its importance in patient monitoring protocols.

Aims: To investigate the diagnostic value of purivate kinase isoenzyme-M2 (M2-PK) levels and their relationship with tumor histological type in patients diagnosed with lung cancer. Methods: In this prospective study, 98 cases diagnosed with lung cancer (Study group) and 90 cases with lung cancer excluded (Control group) were included. The study group consisted of people over the age of 18 who had been diagnosed with lung cancer and had not received any treatment for the tumor. The control group consisted of 45 people who had been diagnosed with any lung disease but did not have lung cancer, and 45 of them were completely healthy people. Those with benign lung disease apart from lung cancer were named as control group-1 and healthy control group was named as control-group-2. Plasma samples with 5 cc of EDTA were taken from all subjects and these samples were quickly frozen at – 80 degrees and stored in this way until laboratory analysis could be performed. Commercial kit based on the sandwich ELISA principle (ScheBo Biotech Ag, Tumor M2-PK ELISA kit, Germany) was used to determine plasma M2-PK levels. The M2-PK values of the samples were calculated on the basis of the standard graph. Results: M2-PK levels were measured and compared in the lung cancer group, control group-1 with non-lung cancer lung disease and healthy control group-2. M2-PK levels were found to be significantly higher in the lung cancer group than in the control group-1 (p<0.0001) and control-group-2 (p<0.0001). When M2-PK levels were compared in all three groups, they were statistically significant in the lung cancer group (p<0.001). In our study, the diagnostic cut off value was found to be 8.9 IU/ml using ROC curve. At this cut-off value, plasma m2-pk level was calculated as 100% sensitivity and 97.8% specificity in showing lung cancer. When compared, there was no statistically significant difference between histopathological diagnoses, stage of the disease and M2-PK levels in the lung cancer group. Conclusion: As a result of this study, it has been shown that tumor M2-PK can be used in the differentiation of lung cancers from other benign lung lesions and as a marker in patients with suspected lung cancer.

Objective: Pneumoconiosis is an irreversible, progressive parenchymal lung disease caused by inhalation of mineral dust. Inhaled particles in the working environment can cause inflammation and fibrosis in the lung, affecting all respiratory tracts, including the large and small airways. Our study aimed to evaluate the frequency and risk factors of small airway dysfunction (SAD) in patients diagnosed with pneumoconiosis. Methods: The study population consisted of 331 patients diagnosed with pneumoconiosis between 01/01/2018 and 31/05/2023. Pneumoconiosis was diagnosed with a history of occupational inorganic dust exposure, radiologic findings compatible with pneumoconiosis, and exclusion of other diagnoses. Two readers evaluated the chest radiographs of the patients according to the International Classification of Pneumoconiosis Radiographs of the International Labor Organization. SAD was defined as at least two FEF50, FEF75, and FEF25-75 measurements below 65% of their predicted values. Results: SAD was found in 47.7% of the patients. There was a statistically significant difference between age and the prevalence of SAD, but there was no statistically significant difference between smoking status and the prevalence of SAD. It was observed that 41.9% of the patients with pneumoconiosis who had never smoked had SAD. As the cigarette pack-years increased, the incidence of SAD increased. SAD was presented 38.7% in Stage 1, 50.7% in Stage 2, and 57.6% in Stage 3 pneumoconiosis cases. SAD was seen in 35.1% of pneumoconiosis cases without PMF. In pneumoconiosis patients with PMF, the frequency of SAD increased with increasing opacity size. Conclusion: It was found that the frequency of SAD increased as the stage of pneumoconiosis increased. In patients with pneumoconiosis, SAD was observed in both smokers and never smokers, independent of large airway obstruction. Therefore, early small airway dysfunction should be considered when monitoring the health of patients with pneumoconiosis.

Objective: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a new method for the diagnosis and staging of lung disease, and its use is increasing worldwide. It has been used as a means of diagnosing lung cancer in its initial stages, and there are data supporting its use for the diagnosis of benign lung disease. The aim of this study was to share our experience with EBUS-TBNA and discuss its diagnostic value. Methods: We retrospectively analyzed the results related to 159 patients who underwent EBUS-TBNA at our pulmonary medicine clinic between 2010 and 2013. We recorded the location and size of lymph nodes seen during EBUS. Lymph nodes that appeared to be affected on EBUS were sampled at least twice. We recorded the diagnostic results of EBUS-TBNA and (for cases in which EBUS-TBNA yielded an inconclusive diagnosis) the final diagnoses after further investigation and follow-up. Results: We evaluated 159 patients, of whom 89 (56%) were male and 70 (44%) were female. The mean age was 54.6 ± 14.2 years among the male patients and 51.9 ± 11.3 years among the female patients. Of the 159 patients evaluated, 115 (84%) were correctly diagnosed by EBUS. The diagnostic accuracy of EBUS-TBNA was 83% for benign granulomatous diseases and 77% for malignant diseases. Conclusions: The diagnostic value of EBUS-TBNA is also high for benign pathologies, such as sarcoidosis and tuberculosis. In patients with mediastinal disorders, the use of EBUS-TBNA should be encouraged, primarily because it markedly reduces the need for mediastinoscopy.