Introduction:This study aimed to describe the high-resolution computed tomography (HRCT) features of culture-confirmed hospital-acquired pneumonia caused by Enterococcus, an uncommon infection rarely characterized radiologically. Materials and Methods:We retrospectively reviewed HRCT scans of adults with microbiologically proven enterococcal pneumonia at two tertiary centers between 2019 and 2024. Patients with other pathogens, pulmonary malignancy, pulmonary edema or hemorrhage, or poor-quality images were excluded. Two thoracic radiologists independently evaluated predefined CT features, with consensus reached in cases of discrepancy. Interobserver agreement was measured using Cohen's kappa (κ). Result:Among 105 patients screened, 20 met the inclusion criteria (12 males, 8 females; mean age 62.9 years). The most common CT findings were groundglass opacities and pleural effusions (each in 70%), followed by consolidation (60%), bronchial wall thickening (60%), and intralobular reticulations (50%). Centrilobular nodules were identified in 45%, interlobular septal thickening in 40%, bronchiectasis in 30%, mediastinal lymphadenopathy in 20%, and empyema in 5%. Abnormalities were usually bilateral with lower-lobe predominance, and mixed features were often observed within the same lobe. On follow-up, 10 (50%) patients improved radiographically, whereas 10 (50%) showed disease progression and died despite treatment. Interobserver agreement was high, ranging from κ= 0.68 to κ= 1.00, indicating substantial to almost perfect concordance across features. Conclusions:Enterococcal pneumonia occurs mainly in older, comorbid, and critically ill patients and is associated with high mortality. HRCT commonly demonstrates ground-glass opacities, consolidation, and pleural effusions. Although pleural effusion appeared more frequent than in other bacterial pneumonias, the imaging findings overall were nonspecific, and microbiological confirmation remains essential for diagnosis.
Introduction:Tracheobronchopathia osteochondroplastica (TBPO) is a rare condition characterized by the abnormal growth of cartilage within the trachea and main bronchi, leading to airway obstruction. The exact cause of TBPO is unknown, but it is thought to be associated with chronic inflammation of the airways and abnormal cartilage metabolism. Since there is not a standardization, the treatment of the condition depends on disease symptoms, infection status and the severity of the airway obstruction. Here, we aimed to present three cases of severe TBPO successfully managed in our interventional pulmonology unit applying argon plasma coagulation and mechanical debulking with rigid bronchoscopy, as well as the literature review.
Introduction:Asthma, a multifaceted chronic inflammatory disorder, concerns more than 300 million people worldwide. Recent developments have classified asthma into predominantly Type 2 (T2) high and T2 low categories. Specific biomarkers, more so for T2 inflammation, determine the nature of inflammation. Fractional exhaled nitric oxide (FeNO) has been presented as a reliable and non-invasive biomarker of T2, eosinophilic, airway inflammation. The synthesis of nitric oxide (NO) occurs through three isoforms of nitric oxide synthase (NOS), with inducible NOS being predominantly expressed in inflammatory conditions, particularly in response to cytokines like IL-4 and IL-13. Elevated FeNO levels have been related to disease activity and have guided clinical decisions regarding corticosteroid and biologic therapies. FeNO measurement has been found to be effective in diagnosing asthma and assessing treatment response and adherence. The practicality of FeNO as a prognostic tool for exacerbation risk is highlighted in recent studies. In particular, FeNO measurements may help establish individualized treatment approaches and optimized treatment modalities, including biological treatment based on inflammation profiles. However, despite its advantages, the results of FeNO levels can be faked by many factors, such as genetics, environmental conditions, and concomitant diseases. Considering all of these, it seems helpful to integrate FeNO measurement into clinical practice in comprehensive asthma management with cautious interpretation, thus improving patient outcomes.
Introduction:Accurate lung field segmentation in chest radiographs is essential for reliable computer-aided diagnosis of pulmonary diseases. This study aimed to systematically benchmark baseline, lightweight, and attention-based U-Net architectures while integrating explainable artificial intelligence (AI) to evaluate both segmentation performance and anatomical focus. Materials and Methods:We conducted a comparative evaluation of three U-Net variants-baseline U-Net, attention U-Net, and shallow U-Net-using the chest X-ray Masks and Labels dataset. All models were trained under identical conditions with five-fold cross-validation and evaluated using accuracy, Intersection over Union (IoU), and Dice coefficient. Gradient-weighted Class Activation Mapping (Grad-CAM) was applied to visualize model attention and assess whether network activations were anatomically localized within lung regions. All architectures were implemented in TensorFlow. Result:U-Net and attention U-Net achieved the highest segmentation performance (Dice ≈ 0.97, IoU ≈ 0.94), with Grad-CAM activations consistently localized to lung fields, indicating reliable anatomical focus. The shallow U-Net showed slightly lower accuracy (Dice= 0.96, IoU= 0.92) but demonstrated faster inference and broader sensitivity to internal parenchymal structures, which may facilitate future disease-focused pulmonary analysis. Conclusions:This study highlights the trade-offs between segmentation accuracy, computational efficiency, and model interpretability across U-Net variants. By combining quantitative benchmarking with explainable AI-based analysis, our results provide performance insights, supporting the development of trustworthy AI tools for chest radiograph analysis.
Introduction:Acute exacerbation (AE) of interstitial lung disease (ILD) is associated with high short-term mortality. Although decreases in serum albumin are frequently observed around AE onset, the clinical significance of shortterm dynamic changes in albumin has not been fully evaluated. We investigated whether changes in serum albumin around AE onset are associated with short-term outcomes. Materials and Methods:We conducted retrospective study including patients diagnosed with ILD between May 2015 and June 2025. Among patients who developed AE, laboratory data obtained at AE onset and 1-3 months prior were analyzed. Changes in serum total protein (ΔTP) and albumin (ΔAlb) were calculated. Associations between these changes and 30-day mortality, as well as prognosis factor, were examined. Correlations between albumin levels at AE onset and lactate dehydrogenase (LDH) were also evaluated. Result:In 103 ILD patients, both TP and albumin significantly decreased at AE onset compared with pre-AE levels. Patients who died within 30 days showed a greater decline in albumin than survivors, whereas ΔTP was not associated with mortality. Albumin levels at AE onset were inversely correlated with LDH levels (ρ= -0.381), suggesting an association with acute physiological stress that may partly reflect enhanced protein catabolism. Marked hypoalbuminemia at the time of AE onset was an unfavorable factor. Conclusions:At the onset of AE, there was a rapid and marked decrease in serum albumin levels, which was associated with a poor prognosis. This dynamic change might reflect increased catabolism, but further research is needed to determine its causal relationship.
Hypersensitivity pneumonitis (HP) is an immune-mediated interstitial lung disease that develops in susceptible individuals following exposure to identifiable or unidentified antigens. Traditionally, HP was classified into acute, subacute, and chronic forms. However, the 2020 ATS/JRS/ALAT guideline introduced a new dichotomous classification into non-fibrotic and fibrotic HP, emphasizing the presence or absence of fibrosis as the key determinant based on radiologic and histopathologic findings. The 2021 CHEST expert panel statement further refined the diagnostic algorithm by integrating exposure history, high-resolution computed tomography patterns, and bronchoalveolar lavage lymphocytosis into a probability-based diagnostic framework. Most recently, the 2025 German S2k guideline proposed an extended three-tiered system-acute, chronic nonfibrotic, and chronic fibrotic HP-and provided updated recommendations for diagnostic pathways and antifibrotictherapy. In light of these evolving perspectives, this review aims to comprehensively discuss the diagnostic and therapeutic strategies for HP, comparing and contrasting the approaches and key recommendations across maj & ouml;r international guidelines.
Introduction:Tuberculosis (TB) remains one of the leading infectious causes of mortality worldwide. The interaction between lipid metabolism and immune response plays a crucial role in TB pathogenesis. High-density lipoprotein (HDL) and other lipid parameters have increasingly attracted attention for their associations with inflammatory markers and survival. This study aimed to investigate the relationship between serum lipid levels, inflammatory markers, and survival in patients with TB. Materials and Methods:Data from TB and non-tuberculous mycobacteria (NTM) patients followed at Ege University Faculty of Medicine Hospital between January 2017 and January 2024 were retrospectively analyzed. Lipid profile [HDL, low-density lipoprotein (LDL), total cholesterol, triglycerides] and inflammatory parameters (C-reactive protein, erythrocyte sedimentation rate, ferritin, albumin, lymphocyte count) were recorded at diagnosis. Lipid levels were categorized into tertiles based on interquartile distribution. Groups were compared in terms of inflammatory response, clinical features, and survival. Result:A total of 148 patients were included in the study, comprising 127 TB and 21 NTM cases. Median age was 59.0 years [Interquartile range (IQR): 45.0-71.0] in the TB group and 64.0 years (IQR: 38.0-72.0) in the NTM group. Among TB patients, 62.2% were male (n= 79). Mortality among TB patients was 17.3% (n= 22). Patients with low HDL levels had significantly higher CRP and ferritin levels and lower albumin levels (p< 0.05). LDL and total cholesterol levels were similarly associated with CRP, albumin, and lymphocyte count. A significant association was observed between HDL levels and sex, with low HDL levels being more frequent among males (p< 0.001). Increasing HDL and triglyceride levels were associated with a trend toward improved survival (p= 0.063; linear trend p= 0.041). No significant associations were found between lipid levels and cavity formation, pulmonary versus extrapulmonary involvement, or acid-fast bacilli smear results (p< 0.05). In multivariable analysis, older age and lower serum albumin levels were independently and significantly associated with mortality (p< 0.005). Conclusions:In patients with TB, serum lipid profiles show significant associations with systemic inflammatory markers. Low HDL levels were accompanied by a more pronounced inflammatory response. However, lipid biomarkers were not independently associated with mortality, suggesting that they may serve as complementary markers in the assessment of the inflammatory process rather than as direct prognostic indicators.
Introduction:Lung adenocarcinoma is a heterogeneous malignancy characterized by diverse molecular profiles that influence prognosis and treatment response. Identifying noninvasive imaging biomarkers capable of predicting genetic alterations may support early diagnosis and facilitate personalized therapeutic strategies. Materials and Methods:In this retrospective study, 225 patients with lung adenocarcinoma who underwent baseline 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) imaging and molecular mutation testing were evaluated. Tumor metabolic activity was quantified using the maximum standardized uptake value (SUVmax) of the primary lesion. The relationship between SUVmax and molecular alterations, including epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK), ROS proto-oncogene 1 receptor tyrosine kinase (ROS1), Kirsten rat sarcoma viral oncogene homolog mutations, and programmed deathligand 1 (PD-L1) expression, was analyzed. Result:EGFR mutation-positive tumors demonstrated significantly lower SUVmax values compared with mutation-negative tumors. In contrast, PD-L1- positive tumors were associated with higher SUVmax values. No significant correlation was identified between SUVmax and ALK or ROS1 alterations. Conclusions:Tumor metabolic activity measured by PET/CT may reflect specific molecular characteristics of lung adenocarcinoma. PET/CT-derived metabolic parameters, particularly when integrated with artificial intelligence and radiomics, could serve as non-invasive predictors of molecular alterations and help guide individualized treatment strategies. Prospective multicenter studies are warranted to validate these findings and confirm their clinical applicability.
Introduction:The simplified pulmonary embolism severity index (sPESI) is extensively used for bedside risk assessment in acute pulmonary embolism (PE). Nevertheless, its effectiveness is constrained by the dichotomization of physiological variables and a primary validation focus on 30-day outcomes only. We developed a machine learning (ML) extension to enhance prognostic precision and extend risk stratification to 12 months, using only bedside data. Materials and Methods:In a retrospective cohort of 2547 adults with computed tomography pulmonary angiography confirmed PE, we developed logistic regression (LR), XGBoost, and multi-layer perceptron (MLP) models using a 10-item hybrid extension of sPESI that retained continuous age, heart rate, systolic blood pressure, and oxygen saturation alongside the six binary sPESI indicators. Models were trained and optimized using 12-month all-cause mortality as the target and were evaluated against 30, 180, and 365-day mortality on a held-out test set. Result:Discrimination with the conventional sPESI attenuated over time (AUC= 0.727, 0.689, and 0.665 at 30 days, 180 days, and one year, respectively). The 10-item ML extension significantly enhanced prognostic performance compared with the conventional 6-item sPESI across all horizons (all p< 0.05). At the primary 12-month horizon, LR, XGBoost, and MLP achieved AUCs of 0.720, 0.726, and 0.712, respectively (vs. 0.665 for sPESI). At 30 days, the peak discrimination reached 0.796 (XGBoost). Moreover, ML increased 30-day specificity to 0.326-0.395 compared to 0.131 for sPESI, while maintaining high sensitivity (0.930-0.982). SHapley Additive exPlanations analyses demonstrated horizon-linked attribution shifts, with acute hemodynamic markers dominating early mortality predictions and age and malignancy emerging as the primary drivers at 12 months under horizonspecific evaluation. Conclusions:Preserving continuous physiological resolution within a familiar clinical framework enables ML to capture both acute instability and latent long-term vulnerability from the index presentation data alone. This bedsidefeasible pathway enhances long-horizon risk stratification and individualizes the management of patients.
Introduction:The incidence and microbiological characteristics of coronavirus disease-2019 (COVID-19) associated ventilator-associated pneumonia (VAP) remain a clinical concern. The present study investigates the risk factors associated with VAP and compares the clinical and microbiological characteristics between the patients with and without COVID-19. Materials and Methods:This retrospective case-control study was conducted in a tertiary intensive care unit (ICU) between March 2020 and February 2023. Patients with COVID-19 were identified through positive SARS-CoV-2 polymerase chain reactionresults, while non-COVID-19 patients served as controls. Demographic characteristics, comorbidities, clinical parameters, and microbiological data were analyzed. Risk factors for VAP were determined using multivariate logistic regression analysis. The Kaplan-Meier method was used to estimate the cumulative probability of VAP. Result:A total of 327 mechanically ventilated patients were enrolled, of whom 154 developed VAP. COVID-19 emerged as an independent predictor of VAP, conferring a 2.47-fold increased risk (p= 0.008). COVID-19 VAP patients had a higher prevalence of acute respiratory distress syndrome (ARDS) (p< 0.001), increased corticosteroid use (p= 0.004) and lower APACHE scores (p< 0.001). Both ICU and hospital case fatality rates were significantly increased in COVID-19 VAP patients. Klebsiella pneumoniae was the predominant pathogen in COVID-19 VAP patients, followed by Acinetobacter baumannii as the second most common pathogen. Conclusions:COVID-19 is a significant risk factor for VAP, with distinct clinical and microbiological characteristics compared to non-COVID-19 VAP. The greater occurrence of ARDS, corticosteroid use, and multidrug-resistant organisms in COVID-19-associated VAP highlights the urgent need for individualized antimicrobial strategies aimed at reducing infection-related morbidity and mortality.
Introduction:Primary salivary gland-type lung cancers are extremely rare, accounting for less than 1% of all lung tumors. Hyalinizing clear cell carcinoma (HCCC) of the lung, an even rarer subtype, presents diagnostic challenges due to its similarity to other endobronchial lesions, such as carcinoid tumors or mucoepidermoid carcinoma. Here, we aimed to present a case of a 53-yearold male non-smoker who presented with recurrent respiratory symptoms. Initial chest X-ray showed consolidation, and subsequent computed tomography (CT) revealed a left lower lobe endobronchial nodule with postobstructive pneumonia. Positron emission tomography-CT imaging demonstrated mild F-18 fluorodeoxyglucose uptake, and bronchoscopy with biopsy led to the diagnosis of HCCC. The patient underwent a left lower lobectomy, and histopathological analysis confirmed the diagnosis. The fiveyear follow-up was unremarkable, with no signs of recurrence. This case underscores the importance of considering HCCC in the differential diagnosis of endobronchial lesions, particularly in non-smokers.
Introduction:Tuberculosis (TB) and non-tuberculous mycobacteria (NTM) are socioeconomically important infectious diseases. Diagnosis is supported by radiological examinations following the evaluation of clinical symptoms. Definitive diagnosis is made microbiologically or histopathologically. TB and NTM infections progress with different radiological findings such as cavitary and nodular infiltrations. In our study, it was aimed to investigate which criteria are stronger radiological determinants of which disease in microbiologically positive TB and NTM cases. Materials and Methods:In our study, 417 cases that were positive for TB and NTM infections in the five-year microbiology laboratory were evaluated. The symptoms, sociodemographic, laboratory and radiological findings of the cases were obtained retrospectively from epicrisis information. Patients with NTM growth were examined according to ATS/IDSA NTM Infection diagnostic criteria. Result:There was a male sex predominance in both groups, and mean age was similar between the groups. The TB group was observed to present with more systemic symptoms, while the NTM group presented with more pulmonary symptoms. In radiological evaluation, the most common findings in both groups were nodules, consolidation, cavitation, and lymphadenopathy. The appearance of a tree in bud was also a common radiological finding in the TB group. When the two groups were compared, the presence of emphysema and atelectasis was significantly higher in the NTM group. Conclusions:In the diagnosis of TB and NTM infections, after taking a detailed anamnesis, care should be taken especially in terms of NTM infections in patients with radiological parenchymal damage.
Introduction:First-line immunotherapy, alone or with chemotherapy, has revolutionized the treatment of metastatic non-small cell lung cancer (NSCLC). However, with multiple approved regimens, the optimal therapeutic choice is undefined due to a lack of direct comparative trials. This network meta-analysis was conducted to establish a hierarchy of efficacy for five landmark immunotherapy-based regimens to inform clinical and policy decisions. Materials and Methods:A network meta-analysis of five pivotal phase III trials (KEYNOTE-024, KEYNOTE-189, KEYNOTE-407, CheckMate 9LA, IMpower 110), all recently reimbursed in our country, was performed. We synthesized overall survival (OS) data for the total population and across subgroups defined by histology (squamous vs. non-squamous) and PD-L1 expression (<1%, 1-49%, ≥50%), with chemotherapy as the common comparator. Result:Pembrolizumab-based therapies ranked consistently high. In nonsquamous NSCLC, pembrolizumab-chemotherapy was highest-ranked and significantly superior to the nivolumab-based combination (HR: 0.76, 95% CI: 0.58-0.99). In squamous disease, the combination of nivolumab, ipilimumab, and chemotherapy emerged as the highest-ranked regimen (SUCRA: 78.3%). By PD-L1 status, pembrolizumab monotherapy was topranked for ≥50% expression (SUCRA: 82.8%), while pembrolizumabchemotherapy was superior for the 1-49% subgroup (SUCRA: 87.5%). For PD-L1 negative (<1%) patients, a subgroup with substantial heterogeneity, no regimen showed a statistically significant OS benefit over chemotherapy. Conclusions:Our analysis indicates pembrolizumab-based regimens, as monotherapy or with chemotherapy, offer the most robust and highestranking survival advantage across most key NSCLC subgroups. These findings provide a critical, evidence-based framework to guide individualized first-line treatment selection.
Introduction:This study aimed to perform the segmentation of honeycomb cysts, traction bronchiectasis, and emphysematous lung parenchyma in highresolution computed tomography (HRCT) examinations using the deep learning method of artificial intelligence. Materials and Methods:The study included the cross-sectional images of 265 patients diagnosed with usual interstitial pneumonia between 2017 and 2021. Minimum intensity projection (MinIP) was performed on axial sections in the parenchymal window. Emphysema areas, traction bronchiectasis, and honeycomb cysts were segmented and labeled on the axial HRCT images. The dataset was divided into three parts, namely training, validation, and testing, at a ratio of 80, 10, and 10%, respectively. The results were calculated by selecting 50% as the threshold value for the intersection over union (Jaccard index) statistic. Result:Of the 265 patients included in the study, 184 (69.4%) were male and 81 (30.6%) were female. Mean age of the patients was 73 ± 10 years. In the test group segmented as emphysema, the sensitivity, precision, F1 score, area under the curve (AUC), and accuracy values were calculated as 0.81, 0.90, 0.85, 0.86, and 0.75, respectively. In the test group segmented as traction bronchiectasis, the sensitivity, precision, F1 score, AUC, and accuracy values were found to be 0.95, 0.76, 0.85, 0.80, and 0.75, respectively. In the test group segmented as honeycomb cysts, the sensitivity, precision, F1 score, AUC, and accuracy values were 0.96, 0.92, 0.94, 0.88, and 0.90, respectively. Conclusions:In this study, we successfully utilized the U-Net architecture, a deep learning technology, to accurately segment honeycomb cysts in MinIP images, one of the parameters that will help classify interstitial lung diseases (ILDs). We anticipate that our study will guide future studies on the classification of ILDs.
The therapeutic landscape for patients with previously untreated epidermal growth factor receptor (EGFR)-mutated advanced non-small cell lung cancer (NSCLC) has significantly evolved, with novel treatment options now available beyond osimertinib monotherapy. The addition of platinum-pemetrexed chemotherapy to osimertinib has demonstrated improved progression-free survival, particularly in patients with central nervous system metastases. Recently, amivantamab-lazertinib combination has shown superior overall and progression-free survival compared to osimertinib monotherapy in the MARIPOSA trial. However, these efficacy improvements are accompanied by increased toxicity. Interstitial lung disease (ILD) remains a class effect across EGFR-targeted therapies, whereas venous thromboembolism (VTE) has emerged as a notable safety concern specifically associated with amivantamablazertinib combination. Although prophylactic strategies can reduce the risk of these complications, their impact on patients' quality of life and the ability to continue treatment must be carefully considered. Individualized treatment decisions, based on clinical features such as CNS involvement, tumor burden, and patient frailty, are essential to optimize therapeutic outcomes while minimizing adverse effects. This article highlights the evolving first-line treatment strategies in EGFR-mutated advanced NSCLC, with a particular focus on ILD and VTE risks.
Introduction:Pulse oximeter is commonly used by chronic obstructive pulmonary disease (COPD) patients for long-term oxygen therapy (LTOT) to monitor oxygen levels. This study investigated the association between oximeter use, anxiety severity, symptom burden, and healthcare utilization in this population. Materials and Methods:This prospective observational study included 110 individuals with COPD who underwent LTOT. Data were collected on pulmonary function, modified Medical Research Council (mMRC) scores, and daily pulse oximeter use. Anxiety severity was assessed using the Beck Anxiety Inventory (BAI). Healthcare utilization in the previous year, including outpatient-treated and inpatient-treated exacerbations, intensive care unit admissions, and non-exacerbation-related hospital admissions, was analyzed. Linear regression analysis was performed to identify the independent predictors of nonexacerbation-related hospital admissions. Result:Among the participants, 68 (61.8%) reported using a home pulse oximeter. There were no significant differences in BAI scores (p= 0.678), oxygen therapy duration (p= 0.530), or mMRC scores (p= 0.251) between the groups. However, non-users had significantly higher rates of non-exacerbation-related hospital admissions than users (p< 0.001). In multivariable analysis, not using pulse oximeter independently predicted more non-exacerbationrelated admissions (B= 1.63, 95% CI: 0.94-2.32, p< 0.001), whereas anxiety and physiological measures were not significant. Conclusions:Pulse oximeter use was not associated with anxiety or symptom severity among the patients with COPD receiving LTOT. However, non-use of pulse oximeter was independently associated with increased non-exacerbation-related hospital admissions. These findings suggest that pulse oximeter may support patient self-management and reduce unnecessary healthcare utilization, without contributing to anxiety.
Introduction:Eosinophilia is a hematologic finding that may indicate a wide range of underlying conditions, from common allergic diseases to rare and potentially life-threatening disorders such as hypereosinophilic syndrome (HES), eosinophilic granulomatosis with polyangiitis (EGPA), and systemic mastocytosis. A structured diagnostic approach is crucial to identify the underlying etiology and guide appropriate treatment. Materials and Methods:This retrospective cross-sectional study evaluated 232 adult patients with peripheral blood absolute eosinophil counts ≥1000 cells/µL, who were referred to a tertiary immunology and allergy clinic between January 2018 and December 2022. Demographic, clinical, and laboratory data were analysed. Diagnoses were grouped according to eosinophil count severity: Mild (1000-1499 cells/µL), moderate (1500-4999 cells/µL), and severe (≥5000 cells/µL). Diagnoses were based on established international guidelines, supported by laboratory, radiological, immunological, and genetic investigations. Result:The most commonly observed diagnoses included atopic diseases (53.4%), with allergic bronchopulmonary aspergillosis (ABPA, 11.6%), nonsteroidal anti-inflammatory drug-exacerbated respiratory disease (6%), and chronic eosinophilic pneumonia (3%) occurring less frequently. Rare conditions included EGPA (1.7%), HES (1.7%), parasitic infections (1.3%), systemic mastocytosis (0.4%), and Gleich syndrome (0.4%). Innate immune defect was detected in 0.4%. Molecular testing identified myeloid variant HES in four patients (FIP1L1-PDGFRA and PDGFRB mutations). The etiology remained undetermined in 19.8% of the patients. Atopic diseases were the most frequent diagnosis across all eosinophilia severity groups (38.3% vs. 14.2% vs. 0.8% p< 0.001 respectively). Conclusions:Atopic diseases are the most common cause of eosinophilia in adults, but clinicians must remain vigilant for less common but clinically significant diagnoses such as ABPA, HES, EGPA, and systemic mastocytosis. Managing eosinophilia effectively depends on a multidisciplinary strategy that incorporates algorithm-based decision-making to support accurate diagnosis.
Introduction:Health literacy encompasses patients' abilities to access healthcare, comprehend health information, and make decisions based on that knowledge. We aimed to examine the relationship between dyspnea levels, acute exacerbations, hospitalizations, disease severity and comorbidities of chronic obstructive pulmonary disease (COPD) patients according to their health literacy levels. Materials and Methods:A total of 106 COPD patients were prospectively enrolled in our study. Demographic data, history, pulmonary function tests, COPD severity, comorbidities, health status, quality of life and the factors determining the course of the disease in the last year were collected. We also measured patients' health literacy using the Turkish version of the European Health Literacy scale. Result:Our findings revealed that elderly COPD patients (p= 0.04) with advanced disease stages (p< 0.001), higher Charlson Comorbidity Index and Saint George Hospital Respiratory Questionnaire scores (p< 0.001), and lowincome (p= 0.02) had lower levels of health literacy. Moreover, patients with lower health literacy experienced more frequent exacerbations (p= 0.01), more severe exacerbations (p< 0.001), and higher rates of hospitalization (p< 0.001). Logistic regression analysis unveiled that GOLD stages (OR: 11.62, 95% CI: 3.36-26.25), and recent severe exacerbations within the last year (OR: 14.24, 95% CI: 5.41-38.13) stood out as the most strongly associated risk factors for poor health literacy. Conclusions:COPD patients with low health literacy have a higher risk of severe disease. Recognizing the concept of health literacy and identifying risk factors associated with low health literacy are crucial steps in enhancing education, care, and social support for COPD patients. It emphasizes the need for tailored interventions and support for COPD patients, especially those with lower health literacy.
