<%=header_description %> <%=header_description %> Kitinazlar ve akciğer hastalıkları Chitinases and lung diseases

Some skin lesions may accompany malignancies. Acanthosis nigricans, one such lesion, is a paraneoplastic dermatosis characterized by hyperpigmented and velvety verrucose plaques observed as symetric eruptions. With this report, we aim to present a rare case of concomitant lung cancer and acanthosis nigricans. Malignant acanthosis nigricans is most commonly associated with intra-abdominal malignancies. A 65-year-old patient who had hyperpigmented, hypertrophic and symmetric verrucose lesions at the flexor surfaces of the lower and upper extremities, face, palms and the axillary region. Thoracic computed tomography demonstrated a hypodense mass lesion with a dimension of cm at the center of basal segment bronchi of the left pulmonary lobe. Fiberoptic bronchoscopy showed that the access to the lower left lobe was almost completely obstructed by the endobronchial lesion. The result of the histopathologic examination of the endobronchial tissue biopsy was reported as non-small cell (adenocarcinoma) lung cancer. Result of the histopathologic analysis of the punch biopsy of the skin lesions was reported as acanthosis nigricans .There are no pathognomonic dermatological findings for lung cancer. In conclusion, there are skin lesions that accompany lung cancer and we believe that these should be considered for differential diagnosis.

Smoking,pregnancy,regular tobacco cigarette,electronic cigarette,risk factors

Ultrasonographic elastography is an imaging technique that measures tissue elasticity or stiffness. We aim to demonstrate that Endobronchial Ultrasound (EBUS) elastography is superior to traditional EBUS in the early, accurate differentiation of granulomatous and malignant mediastinal lymph nodes. Material and methods: In this study, we evaluate the role of Endobronchial Ultrasound elastography in predicting granulomatous and malignant hilar and mediastinal lymph nodes or masses. We also assess its correlation with lymph node morphology, thoracic computed tomography (CT), Positron Emission Tomography - Computed Tomography (PET-CT), pathological tissue diagnosis. Results: A total of 83 consecutive patients (56 males) with a mean age of 62.13 ± 11 years (20 to 80 years) who underwent transbronchial needle aspiration biopsy guided by EBUS were included. A total of 177 lymph nodes were evaluated. Among the patients, 88 were diagnosed with malignancy and 71 with sarcoidosis via EBUS-guided TBNA. A significant positive correlation (p < 0.01) was observed between elastography score III and predominantly Stage IV adenocarcinoma diagnosis, lymph node size, border features, presence of necrosis, and elevated FDG uptake. In granulomatous mediastinal lymph nodes diagnosed with histopathological sarcoidosis, a positive correlation was found between elastography scores I and II, while no correlation was established with the disease stage (p > 0.05). Conclusions: Our study has demonstrated that EBUS elastography is important in distinguishing granulomatous and malignant lymph nodes and masses, thereby enhancing diagnostic accuracy. It can provide deeper insights into the biological behavior of lymph nodes and may reveal the potential benefits of elastography in future studies, even for lymph nodes measuring 1 cm or smaller.

Clinical Protocol,COVID-19,mortality,pneumonia,scoring methods,risk factor scores

Aims: During the Coronavirus Disease 2019 (COVID-19) pandemic, early identification of especially severe and critical cases may improve prognosis. In this context, laboratory parameters play an important role. This study investigated the relationship between the serum C-reactive protein (CRP)/albumin ratio (CAR) and disease prognosis in patients with COVID-19. Methods: This study included patients who were hospitalized with a possible or confirmed diagnosis of COVID-19 at the Chest Diseases Clinic of the University of Health Sciences Dışkapı Yıldırım Beyazıt Training and Research Hospital Health Practice and Research Center between March 1, 2020, and March 31, 2021. Data on the patients were retrospectively reviewed using the hospital’s record system. A total of 444 patients were included in the study and divided into two groups: those with a diagnosis of severe disease (n=141) and those without (n=303). The serum CAR was compared between the two groups. In addition, the relationship between CAR and demographic, clinical, and laboratory findings was evaluated. Results: The mean CAR in the group with severe disease was found to be 36.1, while it was 17.1 in the group without severe disease, and the difference was statistically significant (p<0.001). ROC analyses showed that CAR had higher area under the curve (AUC) values compared to CRP alone in predicting severe disease, the development of complications, need for respiratory support or intensive care, and mortality. The optimal threshold values identified for CAR were as follows: 26.06 for predicting severe disease (sensitivity 66%, specificity 64%), 26.04 for complications (sensitivity 61%, specificity 62%), 26.06 for intensive care need (sensitivity 63%, specificity 62%), 25.21 for need for respiratory support (sensitivity 60%, specificity 60%), and 27.2 for mortality (sensitivity 62%, specificity 59%). These findings demonstrate that an increased CAR level is significantly associated with poor prognosis in COVID-19 patients. The Relationship Between Serum C-Reactive Protein to Albumin Ratio and the Severity of COVID-19 Conclusion: The data obtained indicate that the CRP to albumin ratio (CAR) is a potential biomarker for predicting severe disease and poor prognosis in COVID-19 patients. Therefore, integrating CAR into the clinical evaluation process may contribute to the early identification of high-risk patients and the timely implementation of appropriate treatment approaches.