Objective: To determine the correlation and/or discrepancies between positron emission tomography (PET-CT) findings, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and surgery in the staging of non-small cell lung carcinoma. Material and methods: Data were evaluated retrospectively from a prospective interventional endoscopy database. Positive results with EBUS-TBNA was the first end point and all cytology negatives were confirmed with mediastinoscopy/surgery. Results: Four hundred and eighty three patients were included and 1017 lymph nodes (LNs) were sampled in the study. One hundred and twenty eight LNs were excluded (positive with EBUS-TBNA). Four hundred and sixty five LN (52.3%) were found benign with EBUS-TBNA; however, only 15 of these were confirmed to be malignant by surgery (1.7%). The sensitivity, specificity, PPV, NPV and diagnostic accuracy of EBUS-TBNA were 96.5, 100, 100, 96.7 and 98.3%, respectively. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of PET-CT for maximum standardized uptake value (SUVmax) 2.5 were 90.1, 29.2, 55.3, 75.4, 59.2%, respectively. A cut-off SUVmax of 5.2 was detected with 74.8% sensitivity, 84% specificity, 82.0% PPV, 77.5% NPV and 79.5% accuracy (area under the curve (AUC) of 0.818, 95% CI 0.791–0.843, p<.001). Conclusion: EBUS is a reliable, repeatable and safe technique with a high diagnostic accuracy and should be performed quickly to avoid superfluous time loss in the staging of lung cancer.

Background: Atrial fibrillation (AF) frequently occurs in individuals with hypercapnic type 2 respiratory failure and has the potential to adversely affect patient outcomes. This study sought to investigate the clinical features and prognostic significance of atrial fibrillation in patients admitted to the intensive care unit with hypercapnic type 2 respiratory failure. Methods: This retrospective, single-center study included 200 adult patients diagnosed with hypercapnic type 2 respiratory failure between May 2022 and May 2023. Patients were grouped according to whether atrial fibrillation was present or not. Demographic, laboratory, and echocardiographic findings, comorbidities, and outcomes were compared. Kaplan–Meier survival analysis and Cox regression were used to identify mortality predictors. Results: AF was present in 50.5% of patients. Those with AF were older, had higher Charlson Comorbidity Index scores, and a greater prevalence of heart failure (p < 0.001). No significant differences were found in arterial blood gas values. AF patients had higher urea, creatinine, and BNP levels, and lower hemoglobin, lymphocyte, eosinophil, and monocyte counts (p < 0.05). Echocardiography showed more severe tricuspid and mitral regurgitation, lower ejection fractions, and higher systolic pulmonary pressures in the AF group. About 20% of AF patients were not receiving anticoagulants at ICU admission. AF was associated with shorter survival (49.6 ± 4.07 vs. 61.4 ± 3.8 days, p = 0.031) and 1.6-fold higher mortality risk (HR: 1.60, 95% CI: 1.04–2.47). Advanced age and low hemoglobin were independent predictors of mortality. Conclusions: AF is frequent among patients with type 2 respiratory failure and is linked to increased mortality. Despite known complications, treatment remains underutilized. AF should be actively screened during ICU admissions for respiratory failure.

Background: Tuberculosis (TB) is still a severe problem in underdeveloped and developing countries. Diagnostic tests are unavailable in every health institution, and TB culture can take up to 45 days. Therefore, there is a need for cheaper, faster, and easily accessible diagnostic methods that can guide the diagnosis. This study aimed to determine whether red blood cell distribution width (RDW), C-reactive protein (CRP)-lymphocyte ratio (CLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR) can be used as biomarkers in the diagnosis of pulmonary TB in patients with no comorbidities. Material and Methods: Files of microbiologically confirmed 122 patients with pulmonary TB and 153 patients in whom pulmonary TB was excluded were retrospectively reviewed. Out of them, patients with comorbidities were excluded from the study. Eighty-one patients with TB and 100 controls were included in the study. Results: The lymphocyte, eosinophil, and LMR levels remained significantly lower in the TB group, while neutrophil, monocyte, RDW, platelet, and PLR levels were higher in the same group. Conclusion: In those patients suspicious of pulmonary TB, higher levels of RDW, PLR, and CLR, whereas lower levels of eosinophil, PDW, and LMR may predict the diagnosis of pulmonary TB in previously healthy individuals.