Factors that Impact Susceptibility to Fiber-Induced Health Effects

Asbestos and related fibers are associated with a number of adverse health effects, including malignant mesothelioma (MM), an aggressive cancer that generally develops in the surface serosal cells of the pleural, pericardial, and peritoneal cavities. Although approximately 80% of individuals with MM are exposed to asbestos, fewer than 5% of asbestos workers develop MM. In addition to asbestos, other mineralogical, environmental, genetic, and possibly viral factors might contribute to MM susceptibility. Given this complex etiology of MM, understanding susceptibility to MM needs to be a priority for investigators in order to reduce exposure of those most at risk to known environmental carcinogens. In this review, the current body of literature related to fiber-associated disease susceptibility including age, sex, nutrition, genetics, asbestos, and other mineral exposure is addressed with a focus on MM, and critical areas for further study are recommended

Mycobacterium smegmatis pneumonia

Mycobacterium smegmatis is a non-tuberculous mycobacterium that is usually associated with soft tissue or wound infections in humans. Pulmonary infections secondary to this pathogen are rarely seen and occur only in patients with an underlying condition, such as lipoid pneumonia. This report presents the first case of M, smegmatis pneumonia in an otherwise healthy individual who had no predisposing condition

Functional Capacity In Severe Chronic Obstructive Pulmonary Disease

Objective: To investigate the functional capacity in patients with severe chronic obstructive pulmonary disease (COPD) and healthy subjects. Methods: The present study was conducted in the School of Physical Therapy and Rehabilitation, Department of Chest Medicine, Medical School, Hacettepe University, Ankara, Turkey, from June 2002 to July 2003. Forty-five male patients with severe (23 moderately severe, 22 very severe) COPD and 45 healthy controls participated in the study. Pulmonary function tests and 6-minute walk test (6MWT) were performed. The Borg score and heart rate were measured before and after the test. External work of walking was calculated as the product of body weight and walked distance. Functional dyspnea was measured using the modified Medical Research Council (MRC) dyspnea scale. Results: Both distance and external work of 6MWT were significantly lower in severe COPD patients than healthy subjects (p 0.05). Patients with very severe impairment had a significantly lower percentage of predicted 6MWT distance (p < 0.05). In these patients, 6MWT distance was correlated significantly with forced expiratory flow in one second (FEV1), MRC score, and Borg score whereas external work of walking correlated with age, FEV1, forced expiratory flow from 25-75%, MRC, and resting Borg score (p < 0.05). Conclusion: Severe COPD patients had a significantly impaired functional capacity as compared to their healthy counterparts. Patients with FEV1 < 35% have a lower percentage of functional capacity. Both distance and external work of 6MWT are influenced by large and small airway function, level of breathlessness reported during daily activity or scored during an exercise test in patients with FEV1 < 35%.Wo

Factors Determining Self-Efficacy In Chronic Obstructive Pulmonary Disease

Objective: We investigated the factors determining self-efficacy in patients with chronic obstructive pulmonary disease (COPD). Methods: Thirty male patients with COPD and 30 healthy controls participated in the study. Pulmonary function tests, 6-minute walk test (6MWT), modified Borg scale, modified Medical Research Council (MRC) dyspnea scale, Hospital Anxiety and Depression Scale (HADS), Activities of Daily Living Questionnaire (ADL-Q), and COPD Self-Efficacy Scale (CSES) were used for the evaluation. The study was performed between September 2003 and May 2004 at the Department of Chest Medicine, School of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey. Results: The COPD patients expressed higher depression and dyspnea level and impaired activities of daily living than healthy controls (p < 0.05). Duration of disease and the ADL-Q score was significantly correlated with all subscales of CSES (p < 0.05). Borg score and anxiety score were significantly related with negative affect, weather/environment, and behavioral risk factors subscales of CSES (p < 0.05). Lung function was significantly related with physical exertion and behavioral risk factors, and 6MWT distance was significantly correlated with weather/environment and behavioral risk factors subscales (p < 0.05). The MRC score was correlated with weather/environment score (p < 0.05). The ADL-Q score and disease duration accounted for 76% of the variance in self-efficacy (p < 0.05). Conclusion: Level of impaired activities of daily living due to respiratory limitation and the number of years since diagnosis are independent variables that predict self-efficacy, or level of confidence in engaging specific behaviors that lead to specific desired outcomes in COPD.Wo

Endobronchial lipoma in a patient with Churg-Strauss syndrome

Churg-Strauss syndrome (CSS) is a disorder characterized by hypereosinophilia and systemic vasculitis complicating a preexisting asthma. We report here a case of CSS with an endobronchial lesion, initially considered to be an endobronchial granuloma of CSS, which was finally diagnosed as a lipoma, a very rare benign tumor of the tracheobronchial tree. To our knowledge, this is the first case in the literature presenting with these two rare entities

SURVEY OF THE ALLERGIC STATUS OF PATIENTS WITH BRONCHIAL-ASTHMA IN TURKEY - A MULTICENTER STUDY

WOS: A1995RG81200012PubMed ID: 7573836Patients diagnosed with bronchial asthma (BA) were prospectively enrolled to assess their allergen spectra and atopic status. The patients came from five major cities (Ankara, Izmir, Samsun, EIazig, and Adana) in different regions of Turkey. Atopic status, total IgE levels, and allergen spectra were determined in 1149 patients and 210 controls who were spouses of the patients sharing the same environment but not consanguinity with the patients. Total IgE levels were significantly higher in the asthmatic patients. For both groups, total IgE levels were higher in both atopic and male subjects. Atopy rates were 42% in asthmatics and 26.1% in controls, declining notably by age in both groups. The most commnon allergen in both groups was house-dust mite (HDM), which was more frequently detected in coastal regions (Samsun, Izmir, and Adana). Allergen spectra of the patients included HDM, pollens, cockroach, pet animals, and molds in decreasing order of frequency. Phleum pratense and Artemisia vulgaris were the most common pollens in all regions, whereas Olea europaea was the most common in Izmir. Pollen sensitivity was least frequent in Elazig. For all of the regions, pet sensitivity was less common than, and mold sensitivity was comparable to, that of Western countries. In conclusion, BA patients in Turkey displayed significant differences in their allergen spectra and total IgE levels from control subjects and BA patients in Western countries

Life Threatening Chylous Pleural and Pericardial Effusion in a Patient with Behcet'S Syndrome

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Malignant Pleural Mesothelioma Caused by Environmental Exposure to Asbestos or Erionite in Rural Turkey - Ct Findings in 84 Patients

OBJECTIVE. Malignant pleural mesothelioma in rural Turkey frequently results from environmental exposure to tremolite asbestos or fibrous zeolite (erionite). The aim of this study was to determine the CT features of malignant pleural mesothelioma in patients exposed to asbestos or erionite. MATERIALS AND METHODS. The CT scans of 84 patients with proved malignant pleural mesothelioma were retrospectively evaluated. Twenty patients (24%) had been exposed to erionite and 64 patients (76%) had been exposed to asbestos. The CT scans were interpreted by seven observers who did not know the clinical or pathologic findings. RESULTS. CT scans showed either unilateral pleural thickening or pleural nodules/masses in all patients. Pleural nodules were present in 25 patients (30%) and pleural masses in 44 patients (52%). Pleural effusion was found in 61 patients (73%), mediastinal pleural involvement in 78 (93%), pleural calcifications in 52 (62%), involvement of the interlobar fissures in 64 (76%), and volume contraction in 61 (73%). Reduced size of the hemithorax was significantly correlated with chest wall involvement. On the basis of CT findings, the preassigned staging was changed in 21 patients (25%), including 44% of the patients with disease that had been classified as stage 1. CT findings were not significantly different between the patients exposed to erionite and those exposed to asbestos. CONCLUSION. The most common CT findings in cases of malignant pleural mesothelioma were unilateral pleural thickening or pleural nodules/masses with or without effusion. CT provided valuable information on the extent of the disease, which was important for staging. Although the CT features are not pathognomonic, they provide valuable clues to the diagnosis in patients who have been exposed to mineral fibers.WoSScopu

Breathlessness in a patient with rheumatoid vasculitis.

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