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    Does Platelet Indices Play a Role in the Distinction of Pulmonary Embolism Clinical Forms?
    (2017) Telo, Selda; Kirkil, Gamze; Kaman, Dilara; Gulcu Bulmus, Funda
    The aim of this study is to investigate the changes in platelet indexes, including mean platelet volume (MPV), platelet distribution width (PDW) and platelet count (PC), in patients with acute pulmonary embolism (PE), in addition to evaluating the diagnostic value in clinical forms. Material and methods: The study consisted of 84 patients with PE and the control group consisted of 40 healthy subjects. PE patients were divided into two groups in accordance with the clinical forms as 60 submassive and 24 nonmassive. The differences in platelet count, MPV, PDW, PC, D-dimer, and other indicators were analyzed between the two groups. Venous peripheral blood samples to measure the MPV, PDW and PC were acquired on admission. Results: MPV levels were found to be statistically higher in the submassive group compared to the nonmassive group and the control group (p0.01 and p0.001, respectively). PDW levels were found to be statistically higher in the submassive group compared to the non-massive group and control group (p=0.027 and p0.001, respectively). PC was significantly lower in the submassive group compared to the non-massive group and control group (p=0.022 and p0.001, respectively). It was determined that a positive correlation existed between the MPV and right ventricular diameter (RVD) (r=0.27, p0.01). Conclusion: High MPV and PDW levels and low PC may be indicators of the severity of acute PE. Also, the correlation between the MPV and RVD suggests that MPV can be used as a marker of right ventricular function.
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    The role of endobronchial ultrasound-guided transbronchial needle aspiration in the differential diagnosis of isolated mediastinal and/or hilar lymphadenopathy
    (Wiley, 2021) Temiz, Dilek; In, Erdal; Kuluozturk, Mutlu; Kirkil, Gamze; Artas, Gokhan; Turgut, Teyfik; Deveci, Figen
    Introduction Isolated mediastinal and/or hilar lymphadenopathy (IMHL) has become an increasingly common finding as a result of the increased use of thoracic imaging modalities. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is accepted as the first step diagnostic method in the differential diagnosis of IMHL. Objective To determine the diagnostic yield of the procedure and to analyze clinical and sonographic findings that can be used to differentiate the etiology of lymph node pathologies. Methods Patients who underwent EBUS-TBNA procedure between March 2017 and March 2020 were included in this retrospective study. Demographic data, symptoms, comorbid diseases, and EBUS findings were obtained from the records of the patients. Results EBUS-TBNA provided a diagnosis in 88 patients out of 120 patients (granulomatous diseases n = 54, malignant diseases n = 21, and anthracotic lymph nodes n = 13), and 32 patients had a negative EBUS-TBNA. 22/32 negative EBUS-TBNA samples were true negatives (reactive lymphadenopathy). The sensitivity of the procedure was 89.8% while negative predict value was 68.7%, diagnostic yield of 91.6%. Patients with reactive lymph nodes had significantly more comorbidities (77.3%-19.4%, p < .001) and a lower number of lymph node stations (1.6 +/- 0.8-2.7 +/- 0.9, p < .001). Patients with anthracotic lymph nodes were older and mostly consisted of females (11/13, p < .001). Conclusion EBUS-TBNA has high-diagnostic efficiency in the differential diagnosis of IMHL. The number and size of lymph node stations can provide useful information for differential diagnosis. Clinical follow-up can be a more beneficial approach in patients with reactive and anthracotic lymph nodes before invasive sampling.