Background: The aim of this paper was to evaluate the availability of FRAX for assessing osteoporosis risk, and to demonstrate the importance of vitamin D levels in COPD patients. Methods: Fourty-six males who fulfilled the COPD diagnostic criteria defined by GOLD were included. Age, race, BMI, physical activity frequency, smoking and dietary habits, age at COPD diagnosis, disease duration, fractures history, and medications use were determined. Levels of 25(OH)D were detected. BMD was measured by DXA at lumbar spine, femoral neck, and entire femur, and classified according to ISCD. FRAX score was calculated. Control group was composed of 40 non-smoker individuals without previous history of pulmonary diseases. Results: 25(OH)D levels were significantly different between patients and controls. In the COPD group, a statistically significant difference in vitamin D levels was detected among the A, B, C, and D grades, while no such significant differences in FRAX scores were detected. 25(OH)D levels were significantly low in COPD patients with disease exacerbations and hospitalizations in the previous one year. No correlation was detected between vitamin D levels and the FRAX score. A positive correlation was observed between vitamin D levels and T-score. FRAX scores were higher and vitamin D levels were lower in osteoporotic COPD patients than in non-osteoporotic COPD patients. Conclusion: Using FRAX for assessing osteoporosis in COPD can reduce fracture risk and allow adequate treatment. Since vitamin D levels are related to exacerbations and hospitalizations, vitamin D supplementation may be needed in COPD patients, especially in those with high FRAX scores.

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Aim:The aim of this study wass to compare the cytological features of pleural exudative fluids by conventional smear (CS) method and cell block (CB) method and also to assess the utility of the combined approach for cytodiagnosis of these effusions.Materials and Methods:In all, 113 pleural exudative fluid samples were subjected to evaluation by both CS and CB methods over a period of 2 years. Cellularity, architecture patterns, morphological features, and yield for malignancy were compared, using the two methods. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for diagnosis of malignancy were calculated for both the methods, using histology as a gold standard.Results:CB method provided higher cellularity, better architectural patterns, and additional yield for malignancy when compared with CS method. For 22 (40%) patients, histologic subtype was determined with CB especially for adenocarcinoma. The sensitivity, specificity, positive, and negative predictive values of cytology and CB were 48%, 100%, 100%, 67.8% and 59.2%, 100%, 100%, 72.8%, respectively.Conclusion:CB technique definitively increased detection of malignancy in pleural fluid effusion when used as an adjunct to CSs. Also, CB provides material suitable for molecular genetic analysis for targeted therapies especially in the treatment of adenocarcinoma.

Objective The purpose of this study was to determine the diagnostic value of pleural fluid lactate dehydrogenase (LDH)/pleural fluid adenosine deaminase (ADA) ratio in differentiating pleural effusions owing to tuberculous pleurisy (TBP) and parapneumonic effusion (PPE). Patients and methods The data of 272 patients (140 patients with TBP and 132 patients with PPE) between January 2012 and October 2018 were analyzed retrospectively. Demographic data of all patients; concurrent serum glucose, albumin, protein, and LDH values; and pleural fluid pH, glucose, albumin, protein, and ADA results have been reviewed. Results Pleural fluid ADA values were statistically significantly higher in the TBP group than PPE (P<0.001). The median values of pleural fluid LDH/ADA ratio between TBP and PPE groups were 16.10 (12.53) and 32.90 (34.45), respectively, which was found to be significantly lower in TBP group (P<0.001). Pleural fluid LDH/ADA ratio’s sensitivity, specificity, positive predictive value, and negative predictive value were 90, 59.85, 70.4, and 84.9%, respectively, in the diagnosis of TBP for values less than 28 (P<0.001). Conclusion The ratio of pleural fluid LDH/ADA determined from routine biochemical analysis predicts TBP at value of 28. Measurement of this parameter may help clinicians distinguish between TBP and PPE.