Increased risk of tuberculosis in health care workers: a retrospective survey at a teaching hospital in Istanbul, Turkey

BACKGROUND: Tuberculosis (TB) is an established occupational disease affecting health care workers (HCWs). Determining the risk of TB among HCWs is important to enable authorites to take preventative measures in health care facilities and protect HCWs. This study was designed to assess the incidence of TB in a teaching hospital in Istanbul, Turkey. This study is retrospective study of health records of HCWs in our hospital from 1991 to 2000. RESULTS: The mean workforce of the hospital was 3359 + 33.2 between 1991 and 2000. There were 31 cases (15 male) meeting the diagnostic criteria for TB, comprising eight doctors, one nurse and 22 other health professionals. Mean incidence of TB was 96 per 100,000 for all HCWs (relative risk: 2.71), 79 per 100,000 for doctors (relative risk: 2.2), 14 per 100,000 for nurses and 121 per 100,000 (relative risk: 3.4) for other professionals. The mean incidence of TB in Turkey between 1991 and 2000 was 35.4 per 100,000. Incidence of TB was similar in the Departments of Chest Diseases and Clinical Medicine but there were no TB cases in the Basic Science and Managerial Departments. CONCLUSION: HCWs in Turkey who work in clinics have an increased risk for TB. Post-graduate education and prevention programs reduce the risk of TB. Control programs to prevent nosocomial transmission of TB should be established in hospitals to reduce risk for HCWs

Evaluation of patients with fibrotic interstitial lung disease: Preliminary results from the Turk-UIP study

OBJECTIVE: Differential diagnosis of idiopathic pulmonary fibrosis (IPF) is important among fibrotic interstitial lung diseases (ILD). This study aimed to evaluate the rate of IPF in patients with fibrotic ILD and to determine the clinical-laboratory features of patients with and without IPF that would provide the differential diagnosis of IPF. MATERIAL AND METHODS: The study included the patients with the usual interstitial pneumonia (UIP) pattern or possible UIP pattern on thorax high-resolution computed tomography, and/or UIP pattern, probable UIP or possible UIP pattern at lung biopsy according to the 2011 ATS/ERSARS/ALAT guidelines. Demographics and clinical and radiological data of the patients were recorded. All data recorded by researchers was evaluated by radiology and the clinical decision board. RESULTS: A total of 336 patients (253 men, 83 women, age 65.8 +/- 9.0 years) were evaluated. Of the patients with sufficient data for diag-nosis (n=300), the diagnosis was IPF in 121 (40.3%), unclassified idiopathic interstitial pneumonia in 50 (16.7%), combined pulmonary fibrosis and emphysema (CPFE) in 40 (13.3%), and lung involvement of connective tissue disease (CTD) in 16 (5.3%). When 29 patients with definite IPF features were added to the patients with CPFE, the total number of IPF patients reached 150 (50%). Rate of male sex (p<0.001), smoking history (p<0.001), and the presence of clubbing (p=0.001) were significantly high in patients with IPE None of the women <50 years and none of the men <50 years of age without a smoking history were diagnosed with IPE Presence of at least 1 of the symptoms suggestive of CTD, erythrocyte sedimentation rate (ESR), and antinuclear antibody (FANA) positivity rates were significantly higher in the non-IPF group (p<0.001, p=0.029, p=0.009, respectively). CONCLUSION: The rate of IPF among patients with fibrotic ILD was 50%. In the differential diagnosis of IPF, sex, smoking habits, and the presence of clubbing are important. The presence of symptoms related to CTD, ESR elevation, and EANA positivity reduce the likelihood of IPF

Increased risk of tuberculosis in health care workers: A restrospective survey at a teaching hospital in Istanbul, Turkey

Background: Tuberculosis (TB) is an established occupational disease affecting health care workers (HCWs). Determining the risk of TB among HCW is important to enable authorites to take preventative measures in health care facilities and protect HCWs. This study was designed to assess the incidence of TB in a teaching hospital in Istanbul, Turkey. A retrospective study of health records of HCWs in our hospital from 1991 to 2000

THE VALUE OF LABIAL BIOPSY IN THE DIFFERENTIAL DIAGNOSIS OF SARCOIDOSIS AND SJOGREN'S SYDROME AND IMMUNOHISTOCHEMICAL ANALYSIS

The aim of this study was the evaluation of the value of labial biopsy in the differential diagnosis of sarcoidosis and Sjogren's Syndrome and the value of immunohistochemical markers such as CD3, CD4, CD8, and CD20 at the immunopathogenesis. Fifteen labial salivary gland biopsies from patients affected by primary Sjogren's syndrome, and 15 labial salivary gland biopsies from patients affected by sarcoidosis, were included in the study. In all patients, biopsies were carried out as a diagnostic procedure either for sicca syndrome or sarcoidosis

ADULT ONSET STILL'S DISEASE WITH PLEUROPERICARDITIS

We present a case of adult onset Still's disease (AOSD) revealed by pleuropericarditis. A 33 yr old man was admitted with fever, fatigue, chest and back pain. Radiological and laboratory investigations showed pleuropericarditis with leucocytosis, anemia, high erthyrocyte sedimentation rate and serum C-reactive protein level. Pleural fluid consisted predominantly of lymphocytes. Cytological and microbiological analysis were inconclusive and empiric antituberculous therapy with methylprednisolone was started. The symptoms improved. When steroid doses were reduced, clinical and laboratory findings worsened. Thoracoscopic pleural biopsy was obtained and it showed chronic fibrinous pleuropericarditis. Hepatosplenomegaly and history of arthralgia, high ferritin levels, negative ANA, RF, were consistent with AOSD. Antituberculosis therapy was stopped. Methotrexate was started. Since the diagnosis of AOSD requires the exclusion of specific etiologies of pleuropericarditis, it may be defined with some delay in time

An unusual radiographic finding in pulmonary parenchymal endometriosis - A case report

Thoracic endometriosis is an uncommon disorder. In most cases, the diagnosis is based. on history alone and radiographic findings depend on the menstrual cycle. CT findings include ill-defined or well-defined opacities, nodular lesions, cavities, cystic changes and bullous formation. We report a case of pulmonary parenchymal endometriosis with an unusual radiographic finding