Value of real-time endobronchial ultrasound-guided transbronchial needle aspiration

<b>Aim :</b> The diagnostic value of real-time convex-probe endobronchial ultrasound (CP-EBUS)-guided transbronchial needle aspiration (TBNA) in mediastinal pathologies, and the factors influencing it are not clearly known. This study has been designed to examine factors affecting the efficacy and diagnostic value of CP-EBUS-TBNA. <b>Methods :</b> Patients (<i>n</i> = 321) with mediastinal mass or enlarged lymph node in the mediastinum, participated in this study, conducted between April 2007 and May 2009. Samples were obtained from the lesions using the TBNA method, with the guidance of CP-EBUS. Histopathologic (in all samples) and microbiologic (in 151 patients&#x2032; samples) evaluations were carried out. Biopsy using an appropriate surgical method was taken when the result of the TBNA procedure was nondiagnostic. Thirty-four patients were excluded from the analysis due to several reasons. The diagnostic efficacy of the procedure was analyzed in the remaining 287 patients. <b>Results :</b> The diagnostic rate was 92&#x0025; (89.7&#x0025; for the benign diseases and 92.6&#x0025; for the malignant diseases (<i>P</i> = 0.59)). In granulomatous diseases, the rate was 96&#x0025; for sarcoidosis and 79&#x0025; for tuberculosis (<i>P</i> = 0.002). Patients in whom only one lymph node was sampled and in whom two or more lymph nodes were sampled had a diagnostic rate of 85&#x0025; and 95&#x0025;, respectively (<i>P</i> = 0.03). When left hilar nodes were sampled, a higher diagnostic rate was achieved (<i>P</i> = 0.01). <b>Conclusions :</b> CP-EBUS-guided TBNA has a high diagnostic rate. Sampling of at least two separate lymph nodes and the discovery of left hilar station in these lymph nodes increase the rate of diagnosis

Long-term follow-up and health-related quality of life in COVID-19 patients treated in hospital

Objective: To evaluate the persistence of symptoms and health-related quality of life of coronavirus disease-2019 patients. Method: The cross-sectional study was conducted from April to September 2020 at Health Sciences University, Yedikule Chest Hospital, Istanbul, Turkey, and comprised patients of either gender who had to be hospitalised and treated for coronavirus disease-2019. Those who had spent 3 months (46-90 days) post-discharge formed Group 1, those having spent 3-6 were in Group 2, while those with >6 months post-discharge were in Group 3. Data was collected over the telephone Using the European Quality of Life Scale with 5 dimensions and 5 levels. The variables likely to affect the persistence of symptoms and the quality of life questionnaire scores were analysed using SPSS 16. Results: Of the 225 subjects, 135(60%) were male and 90(40%) were female. The overall mean age was 55.7+/-19.91 years. There were 85(37.8%) participants in Group 1, 83(36.9%) in Group 2, and 57(25.3%) in Group 3. The age (p=0.09) and gender (p=0.23) distribution across the groups had no significant difference. Patients were called on an average 131.72+/-58.9 days after discharge (range: 46-279 days). Only 23.1% patients continued to show symptoms. Anxiety was the domain in which most patients 64(28.4%) reported deterioration. Conclusion: Most patients who have had coronavirus disease-2019COVID-19 after a long follow-up period did not show any symptoms or had any significant deterioration in their quality of life. Key Words: COVID 19, Post-discharge symptoms, Quality of life

Primary Pulmonary Synovial Sarcoma: A Very Rare Presentation

Synovial sarcoma (SS) is a rare tumor originating from mesenchymal tissue and accounting for approximately 5–10% of all soft tissue sarcomas. A rare case of primary pulmonary SS in an asymptomatic 18-year-old man admitted to our hospital for investigation of a 6 × 6.5 cm, oval-shaped, well-delineated pleural based peripheral mass in the left lower lobe in his thorax CT is presented. Left lower lobectomy was done. Immunohistochemically, tumor cells were positive for cytokeratin, epithelial membrane antigen (EMA), and vimentin so that the histopathological diagnosis was compatible with biphasic spindle cell type SS in the lung

Post-discharge mortality in the first wave of COVID-19 in Turkey

© 2022 Asian Pacific Journal of Tropical Medicine.Objective: To determine post-discharge mortality and associated factors of the first-wave multicenter Turkish Thoracic Society (TTD)-TURCOVID study. Methods: In this retrospective cohort study, we analyzed the data of 18 of 26 centers included in the first TTD-TURCOVID study, and 1 112 cases diagnosed with COVID-19 between 11 March and 31 July 2020 participated in the study. All causes of death after COVID-19 discharge were recorded. Results: The mean age of the patients was (51.07±16.93) years, with 57.6% male patients. In the cohort group, 89.1% of COVID-19 treatment locations were hospital wards, 3.6% were intensive care units (ICUs), and 7.2% were community outpatients. In the longterm follow-up, the in-hospital mortality rate was 3.6% (95% CI 2.64.8), the post-discharge mortality rate was 2.8% (95% CI 1.9-3.9), and the total mortality was 6.3% (95% CI 5.0-7.8). After discharge, 63.3% of mortality overall occurred during the first six months. Mortality rates in post-discharge follow-ups were 12.7% (95% CI 8.0-30.6) in cancer patients, 10.8% (95% CI 6.3-22.9) in chronic obstructive pulmonary disease patients, 11.1% (95% CI 4.4-22.7) in heart failure patients, 7.8 (95% CI 3.8-14.3) in atherosclerotic heart disease patients, and 2.3% (95% CI 0.8-5.6) in diabetes mellitus patients. In smokers/ex-smokers, the all-mortality rates were higher than in non-smokers. Conclusions: This multicenter study showed that patients over 65 years of age, males, former/active smoker, ICU stay, lung, heart disease, and malignancy should be followed up for at least the first six months after discharge due to COVID-19