Can ChatGPT pass the thoracic surgery exam?

BACKGROUND: The capacity of ChatGPT in academic environments and medical exams is being discovered more and more every day. In this study, we tested the success of ChatGPT on Turkish-language thoracic surgery exam questions. METHODS: ChatGPT was provided with a total of 105 questions divided into seven distinct groups, each of which contained 15 questions. Along with the success of the students, the success of ChatGPT-3.5 and ChatGPT-4 architectures in answering the questions correctly was analyzed. RESULTS: The overall mean score of students was 12.50 ± 1.20, corresponding to 83.33%. Moreover, ChatGPT-3.5 managed to surpass students' score of 12.5 with an average of 13.57 ± 0.49 questions correctly on average, while ChatGPT-4 answered 14 ± 0.76 questions correctly (83.3%, 90.48%, and 93.33%, respectively). CONCLUSIONS: When the results of this study and other similar studies in the literature are evaluated together, ChatGPT, which was developed for general purpose, can also produce successful results in a specific field of medicine. AI-powered applications are becoming more and more useful and valuable in providing academic knowledge.

The effect of high standard uptake value in lung cancer metastatic lesions on survival.

AIM: To assess how metastatic lesions with a higher maximum standard uptake value than the primary tumor affect survival in patients with lung cancer. METHODS: The study enrolled 590 stage-IV lung cancer patients treated at Afyonkarahisar Health Sciences University Hospital between January 2013 and January 2020. We retrospectively collected data on histopathological diagnosis, tumor size, metastasis site, and maximum standard involvement values of primary metastatic lesions. Lung cancers with the maximum standard uptake value of the primary tumor higher than that of the metastatic lesion were compared with lung cancers with the maximum standard uptake value of the primary tumor lower than that of the metastatic lesion. RESULTS: In 87 (14.7%) patients, the maximum standard uptake value was higher in the metastatic lesion than in the primary lesion. These patients experienced significantly higher mortality risk in both univariate and multivariate survival analyses (adjusted hazard ratio 2.25 [1.77-2.86], <0.001) and had shorter median survival (5.0 [4.2-5.8] vs 11.0 [10.2-11.8] months, P<0.001). CONCLUSIONS: The maximum standard uptake value could be a potential new prognostic factor for survival in lung cancer.

Management of life-threatening tracheal emergencies.

OBJECTIVE: Tracheal pathologies are life-threatening in all age groups and may result in death if urgent action isn't taken. The aim of this study was to present cases of rare and life-threatening tracheal pathologies and discuss the management of these in the light of literature. METHODS: A retrospective analysis was made of 8 patients who underwent surgery for emergency tracheal pathologies in our clinics between 2013 and November 2018. The patients were evaluated in terms of age, gender, etiology, symptoms, location of pathology, surgical approach, treatment technique, and length of hospital stay. RESULTS: Of the 8 cases with tracheal pathology, 4(50%) had tracheal rupture, 3(37.5%) had tracheal stenosis due to prolonged post-intubation, and one (12.5%) had a tracheal tumor. The cases with tracheal rupture comprised 2 females and 2 males with a mean age of 28.5 years (range, 16-48 years). The cases with tracheal stenosis were 2 females and 1 male with a mean age of 29.3 years (range, 25-36 years). The patient with a tracheal tumor was 34 years old and had been diagnosed late. Preoperative mortality as a result of hypoxia was seen in one case with carina rupture. No postoperative morbidity or mortality were observed in all 7(87.5%) cases who underwent surgery. CONCLUSION: Early diagnosis, treatment, determination of the location and form of the pathology is very important in tracheal pathologies. In surgical treatment, wide resection should be avoided as much as possible, and the surgical approach should be determined according to the shape of the pathology, wiht end-to-end anastomosis and/or primary repair applied when possible. KEY WORDS: Surgery, Tacheal tumor, Tracheal stenosis, Tracheal rupture.

A very rare fatal complication: bilateral reexpansion pulmonary edema after treatment of single side total pneumothothorax.

Reexpansion pulmonary edema is a rare but fatal clinical condition that develops during the treatment of pneumothorax, pleural effusion and collapsed lung after atelectasis. A 31-year-old male patient was referred to our clinic with the complaint of stinging back pain that started 3 days ago and dyspnea developed during the last 24 hours. Physical examination and radiologic examinations revealed total pneumothorax in the right hemithorax. After tube thoracostomy, his general condition deteriorated and bilateral reexpension edema developed in the lungs. The patient was admitted to the intensive care unit and was discharged on the 5th day after medical treatment. Our case is the first case of bilateral reexpansion pulmonary edema seen after unilateral spontaneous pneumothorax when literature review is performed. In order to emphasize the importance of rapid diagnosis and treatment, it is presented in the light of the literature.