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Sonoelastographic strain ratio contributes to differentiate IGM from malignant breast lesions, thus has potential to influence clinical decision making for further biopsies.

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Background Guidelines recommend performing biomarker tests for epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK), BRAF and ROS proto-oncogene-1(ROS1) genes and protein expression of programmed death ligand-1(PD-L1) in patients with non-small lung cell carcinoma (NSCLC). Studies reported that endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) can provide sufficient material for cancer biomarker analyses, but there are still concerns about the subject. Aim The purpose of the study was to assess the adequacy of EBUS-TBNA for testing lung cancer biomarkers. Methods We retrospectively reviewed patients with NSCLC whose EBUS-TBNA was analysed for EGFR, ALK, ROS-1, BRAF and PD-L1 expression between December 2011 and December 2020. Results A total of 394 patients were enrolled in the study. EGFR mutation and ALK fusion were the most common studied biomarkers. EBUS-TBNA adequacy rate for biomarker tests was found 99.0% for EGFR, 99.1 for ALK, 97.2% for ROS1, 100% for BRAF and 99.3% for PD-L1 testing. Multivariate analysis revealed the histological type, history of treatment for NSCL, size, or 18-fluorodeoxyglucose uptake of sampled lesion did not show any association with TBNA adequacy for biomarker testing. Conclusion EBUS-TBNA can provide adequate material for biomarker testing for EGFR, ALK, ROS-1, BRAF and PD-L1 expression.

<b><i>Objective:</i></b> The red cell distribution width (RDW) is an inexpensive, readily available prognostic indicator of several diseases. RDW has been assessed as a prognostic biomarker in patients with idiopathic pulmonary fibrosis (IPF) in only one study; furthermore, the relationship between the RDW and combined pulmonary fibrosis emphysema (CPFE) has yet to be reported. <b><i>Subjects and Methods:</i></b> This single-center study was conducted between January 2015 and December 2018 in the Atatürk Chest Diseases and Chest Surgery Education and Research Hospital. Baseline characteristics, laboratory results, and survival status of patients were recorded. <b><i>Results:</i></b> The RDW value was significantly higher in the CPFE group than in the IPF group (median [IQR 25–75]; 16.8 [15.5–19] vs. 15.3 [13.7–16.8], <i>p</i> = 0.028). High RDW values were correlated with carbon monoxide diffusion capacity (DLCO) (<i>r</i>: −0.653 <i>p</i> = 0.001), 6-minute walking test (6MWT) distance (<i>r</i>: −0.361 <i>p</i> = 0.017), arterial partial oxygen pressure (PaO₂) (<i>r</i>: −0.692 <i>p</i> &#x3c; 0.001), and systolic pulmonary arterial pressure (SPAP) (<i>r</i>: 0.349 <i>p</i> = 0.022) in patients with fibrotic lung disease. The RDW value was significantly higher in the exitus group than in the survivors (median [IQR 25–75]; 18.4 [15.4–19] vs. 15.2 [13.5–17.2], <i>p =</i> 0.016). A univariate Cox regression analysis identified DLCO, SPAP, PaO₂, and RDW as potential covariates of mortality. In a multivariate analysis, the DLCO (HR 1.21, 95% CI 1.11–1.47, <i>p =</i> 0.012) and RDW level (HR 1.65, 95% CI 1.09–2.47, <i>p</i> = 0.023) remained independent predictors of mortality. <b><i>Conclusion:</i></b> High RDW values appear to be a simple prognostic factor in patients with IPF or CPFE.

Introduction Guidelines recommend using a pulse oximeter rather than arterial blood gas (ABG) for COVID‐19 patients. However, significant differences can be observed between oxygen saturation measured by pulse oximetry (SpO 2 ) and arterial oxygen saturation (SaO 2 ) in some clinical conditions. We aimed to assess the reliability of the pulse oximeter in patients with COVID‐19. Methods We retrospectively reviewed ABG analyses and SpO 2 levels measured simultaneously with ABG in patients hospitalised in COVID‐19 wards. Results We categorised total 117 patients into two groups, in whom the difference between SpO 2 and SaO 2 was ≤4% (acceptable difference) and >4% (large difference). A large difference group exhibited higher neutrophil count, C‐reactive protein, ferritin, fibrinogen, D‐dimer and lower lymphocyte count. Multivariate analyses revealed that increased fibrinogen, increased ferritin and decreased lymphocyte count were independent risk factors for a large difference between SpO 2 and SaO 2 . The total study group demonstrated the negative bias of 4.02% with the limits of agreement of −9.22% to 1.17%. The bias became significantly higher in patients with higher ferritin, fibrinogen levels and lower lymphocyte count. Conclusion Pulse oximeters may not be sufficient to assess actual oxygen saturation, especially in COVID‐19 patients with high ferritin and fibrinogen levels and low lymphocyte count with low SpO 2 measurements.

Introduction: Guidelines recommend using a pulse oximeter rather than arterial blood gas (ABG) for COVID-19 patients. However, significant differences can be observed between oxygen saturation measured by pulse oximetry (SpO2) and arterial oxygen saturation (SaO2) in some clinical conditions. We aimed to assess the reliability of pulse oximeter in patients with COVID-19 Methods: We retrospectively reviewed ABG analyses and SpO2 levels measured simultaneously with ABG in patients hospitalized in COVID-19 wards. Results: We categorized total 117 patients into two groups; in whom the difference between SpO2 and SaO2 was 4% (acceptable difference) and >4% (large difference). Large difference group exhibited higher neutrophil count, C-reactive protein, ferritin, fibrinogen, D-dimer and lower lymphocyte count. Multivariate analyses revealed that increased fibrinogen, increased ferritin and decreased lymphocyte count were independent risk factors for large difference between SpO2 and SaO2. The total study group demonstrated the negative bias of 4.02% with the limits of agreement of −9.22% to 1.17%. The bias became significantly higher in patients with higher ferritin, fibrinogen levels and lower lymphocyte count. Conclusion: Pulse oximeters may not be sufficient to assess actual oxygen saturation especially in COVID-19 patients with high ferritin and fibrinogen levels and low lymphocyte count low SpO2 measurements.