Objectives: The aim of this study was to investigate retinal and choroidal microvascular changes in patients with axial spondyloarthritis (axSpA) treated with long-term anti-TNF therapy and NSAIDs and in healthy control subjects using optical coherence tomography angiography (SS-OCT-A). Methods: A total of 162 eyes from 81 participants were included: 52 eyes from 26 axSpA patients treated with anti-TNF therapy (≥5 years), 44 eyes from 22 axSpA patients treated with NSAIDs, and 66 eyes from 33 healthy control subjects. SS-OCT-A imaging was used to assess retinal thickness, ganglion cell layer thickness, retinal nerve fiber layer thickness, and the vessel densities of the superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC). Disease activity was assessed with ASDAS-CRP. Results: Both axSpA subgroups showed a significant expansion of the foveal avascular zone and reduced SCP and DCP densities compared to the controls. The CC vessel density was higher in axSpA patients than in healthy subjects. The anti-TNF group had a lower CC vascular density than the NSAIDs group. The disease duration correlated with a decreased central DCP density and increased paracentral SCP and CC densities. Conclusions: SS-OCT-A revealed subclinical retinal and choroidal changes in axSpA patients, highlighting the impact of chronic inflammation on the retinal vasculature. While anti-TNF therapy effectively controls systemic inflammation, it cannot completely prevent microvascular changes. Further studies are needed to assess the clinical relevance of these results.

Objective and aim: Interventional diagnostic procedures such as bronchoscopy and transthoracic needle aspiration can lead to significant complications, especially in more vulnerable patients. In our study, we aimed to evaluate the characteristics of patients with high diagnostic rates via sputum cytology, a non-invasive technique. Methods: This retrospective, nested case-control study included patients who were diagnosed with lung cancer and who underwent sputum cytology at least once in our tertiary referral hospital between 2012 and 2022. Results: There were no significant differences between the groups in terms of age, gender, comorbidities, presence of hemoptysis at admission, smoking history/smoking duration, endobronchial localization, clinical stage, maximum standardized uptake value (SUVmax), or long tumor diameter (p > 0.05). However, patients diagnosed with sputum cytology were more likely to have adenocarcinoma (81.2% vs. 27.7%, p < 0.001) and less likely to have unclassified non-small cell lung cancer (0% vs. 22.9%, p = 0.03). The mean length of survival for patients diagnosed with sputum cytology was shorter than that for those diagnosed with invasive procedures (34 vs. 160 months, p = 0.03). Conclusion: Our findings suggest that sputum cytology may have diagnostic efficacy for the adenocarcinoma subtype. Despite the similar clinical stages between the groups, the higher mortality observed in patients diagnosed with lung cancer via sputum cytology may warrant updates in the staging system.

Background/Aims: Patients with autoimmune inflammatory rheumatic diseases (AIIRDs) are particularly vulnerable to infections as a result of their underlying autoimmune conditions. This vulnerability is further exacerbated by immunosuppressive treatments and associated comorbidities. This study aims to evaluate influenza vaccination rates, hesitancy, and awareness among this patient population. Materials and Methods: This descriptive study included patients with AIIRD receiving treatment at rheumatology and pulmonary medicine outpatient clinics. Between January and April 2024, a questionnaire was administered to assess influenza vaccination rates, knowledge, and attitudes. Results: Of the patients, 34.3% had received at least 1 influenza vaccination, while only 13% were vaccinated annually. Additionally, 62.2% recognized that they were at risk for influenza infection due to their current illnesses and medications and believed that they should be vaccinated. However, 59.2% had not received any professional information about the influenza vaccine. Only 38.2% were aware that vaccination was available free of charge for their condition. Older age, prolonged medication use, extended duration since diagnosis, presence of comorbidities, awareness of influenza risk, and receiving information about vaccination were all significantly associated with having received at least 1 influenza vaccination. No statistical relationship was observed between the type of rheumatic disease and vaccination (P= .7803). Patients relying on social media, TV, or internet sources demonstrated greater vaccine hesitancy (P < .0001). Awareness of vaccination recommendations was significantly associated with medication type (P < .0001). Hesitancy was reported by 38.7% of all patients and 48% of unvaccinated patients, influenced by negative experiences during the COVID-19 vaccination process. Conclusion: Influenza vaccination coverage among patients with AIIRD remains suboptimal. Physician reminders during routine visits could enhance vaccination rates. Health authorities might consider implementing pop-up alerts in clinical systems to prompt physicians to recommend vaccination when prescribing immunosuppressive medications.

Kronik Obstrüktif Akciğer Hastalığı (KOAH), kalıcı solunum semptomları ve hava akımı kısıtlaması ile karakterize, yaygın, önlenebilir ve tedavi edilebilir bir hastalıktır. Standart tedavi seçeneklerine rağmen, birçok hasta hala sık alevlenme ve hızlı solunum fonksiyon kaybı yaşamaktadır. Bu derleme, Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) 2025 kılavuzunda güncellenen farmakolojik tedavi stratejilerine odaklanarak, dupilumab, ensifentrin ve roflumilast gibi yeni terapötik ajanların rolünü incelemektedir.

BACKGROUND AND AIM: This study aims to identify the factors influencing the decision to proceed with fiberoptic bronchoscopy (FB) or rigid bronchoscopy (RB) when the initial FB does not provide a diagnosis, and it assesses the outcomes of these procedures. METHODS: We performed a retrospective analysis of 158 patients who underwent diagnostic RB and 50 patients who underwent recurrent diagnostic FB among those diagnosed with malignant airway tumors. RESULTS: There were no significant differences in age, comorbidities, or anticoagulant use between the groups. When initial FB procedures were analyzed, the rate of procedure failure was higher in the RB group due to central airway obstruction and intraprocedural complications, whereas the rate of inconclusive diagnoses was significantly higher in the recurrent FB group (p<0.001). Likewise, the proportion of patients in the RB group who underwent only airway assessment or bronchial lavage during the first FB was higher (p<0.001). The recurrent FB group experienced more complications during the second procedure (p=0.005). The incidence of neuroendocrine tumors or tracheal lesions was higher in the RB group (p=0.005). Patients in the RB group also had higher hospitalization rates (59.5%) and longer stays (6.38 days) (p=0.001). Moreover, patients in the RB group received significantly faster diagnoses (p<0.001). CONCLUSIONS: Our findings suggest that for patients with central airway lesions, particularly those situated in the trachea, due to the risk of life-threatening complications such as hemorrhage during FB, and considering that recurrent FBs can prolong the time to diagnosis and increase the risk of complications, RB should be prioritized as the diagnostic approach.

Bariatric surgery, specifically sleeve gastrectomy, is one of the fastest-growing areas within the surgical field. As with all evolving medical practices, it can lead to unexpected complications. One such rare and significant complication is a gastrobronchial fistula, which typically results from anastomotic leakage. In most cases, antibiotic therapy is sufficient to manage this condition. The clinical presentation is often insidious, with patients remaining clinically stable. Here, we present the case of a 29-year-old female who required thoracotomy to treat a pulmonary abscess. This abscess was caused by a chronic leak from the sleeve gastrectomy staple line, occurring five years post-surgery.