Occupational Risks and Safety Precautions for COVID-19 in Workers With Rheumatic Diseases

Akgun, Metin/0000-0003-3404-4274WOS: 000577379900028PubMed: 32976225[No abstract available

Occupational Risks and Safety Precautions for COVID-19 in Workers With Rheumatic Diseases

Akgun, Metin/0000-0003-3404-4274WOS: 000577379900028PubMed: 32976225[No abstract available

Exhaled Breath Analysis in Diagnosis of Malignant Pleural Mesothelioma: Systematic Review

Malignant pleural mesothelioma (MPM) is mainly related to previous asbestos exposure. There is still dearth of information on non-invasive biomarkers to detect MPM at early stages. Human studies on exhaled breath biomarkers of cancer and asbestos-related diseases show encouraging results. The aim of this systematic review was to provide an overview on the current knowledge about exhaled breath analysis in MPM diagnosis. A systematic review was conducted on MEDLINE (PubMed), EMBASE and Web of Science databases to identify relevant studies. Quality assessment was done by the Newcastle-Ottawa Scale. Six studies were identified, all of which showed fair quality and explored volatile organic compounds (VOC) based breath profile using Gas Chromatography Coupled to Mass Spectrometry (GC-MS), Ion Mobility Spectrometry Coupled to Multi-capillary Columns (IMS-MCC) or pattern-recognition technologies. Sample sizes varied between 39 and 330. Some compounds (i.e, cyclohexane, P3, P5, P50, P71, diethyl ether, limonene, nonanal, VOC IK 1287) that can be indicative of MPM development in asbestos exposed population were identified with high diagnostic accuracy rates. E-nose studies reported breathprints being able to distinguish MPM from asbestos exposed individuals with high sensitivity and a negative predictive value. Small sample sizes and methodological diversities among studies limit the translation of results into clinical practice. More prospective studies with standardized methodologies should be conducted on larger populations.status: publishe

Pitfalls of using the ILO classification for silicosis compensation claims

Background The International Labour Organization (ILO) Classification of Radiographs of Pneumoconioses is used as the primary tool to determine compensation for pneumoconiosis in Turkey. Aims We aimed to evaluate how the ILO classification applied, but obtaining chest radiographs in the workplace for screening until the completion of compensation claim files by the referral centres, based on the ILO reading. Methods The study included 320 digital chest radiographs previously taken for screening from eight different ceramic factories and having finalised claim files by referral centres. We used an expert reference panel consisting of five ILO readers to re-evaluate all the radiographs independently using ILO standard films and reached a conclusion based on the agreement among at least three readers. The evaluation primarily included technical quality and silicosis diagnosis with an ILO 1/0 or above small profusion. The results were compared with previous findings. Results Sixty-three (20%) chest radiographs were unacceptable for classification purposes according to the ILO technical quality grades. Among the remaining 257 chest radiographs, we diagnosed 103 with silicosis (40%), while the referral centres diagnosed 182 (71%). A discrepancy was found between our results and previous evaluations. We diagnosed silicosis in 50% and 17% of the previous silicosis and normal evaluations, respectively. Conclusions Our findings suggest that the use of the ILO classification for compensation claims may be problematic due to the way of its implementation in Turkey in addition to its subjectivity.Turkish Thoracic Society (TTS)The study was funded by Turkish Thoracic Society (TTS). The opinions, findings and conclusion expressed in this publication are those of authors and not necessarily those of TTS

CONJUNCTIVAL BIOPSY AS A FIRST CHOICE TO CONFIRM A DIAGNOSIS OF SARCOIDOSIS

WOS: 000393274000001PubMed ID: 27758983Background: Sarcoidosis is a granulomatous systemic disease of unknown aetiology. The diagnosis needs histological confirmation of the presence of non-caseating granulomata. One option is a conjunctival biopsy. The aims of this study were to evaluate conjunctival biopsy for the diagnosis of sarcoidosis with respect to its sensitivity and to assess its cost effectiveness by comparison with other histopathological diagnostic procedures. Methods: Patients were identified from the database of the Interstitial Lung Disease Clinic (ILDC) of the Chest Department of Ege University Hospital from May 2008 to June 2014. The patients who had biopsy procedures performed for the definitive diagnosis of sarcoidosis were assessed. Their diagnostic procedures and the cost of procedures were recorded. The cost per positive result for each procedure was calculated. Results: In total, 280 patients were followed up with a diagnosis of sarcoidosis, of whom 174 had histological confirmation; these constitute the study population. There were 127 females and 47 males with a median age of 46 years (range 14-78 years). Forty three patients had conjunctival biopsy and we could establish a diagnosis in 54% of these by means of conjunctival biopsy. Moreover, we showed that this biopsy can provide positive result for sarcoidosis patients who lack abnormal eye findings. Additionally, it is cost effective approach and without complications. Conclusion: This study re-asserts the value of conjunctival biopsy, which was described in the past but is not commonly used nowadays. In the presence of suggestive clinic and radiologic findings, we recommend conjunctival biopsy as the first choice for the histopathological confirmation of sarcoidosis

The relationship between particulate matter and childhood respiratory complaints and peak expiratory flows in Harran agricultural area

Background. In recent years, many studies have evaluated the increasing incidence of asthma and chronic respiratory diseases among children living close to rural areas with pesticide application. Pesticide exposure in 266 children (126 girls and 140 boys) in Sanliurfa, a cotton-producing province in Turkey, was explored in this work. Four different villages spread over 40 km(2) were included. Methods. Measurements of peak expiratory flow (PEF) in 266 children were conducted in late June, before intensive pesticide applications in the cotton-producing fields. The measurements were repeated for 72 of 266 children after pesticide application in late August. PEF, particulate matter with diameter less than 2.5 mu m (PM2.5), particulate matter with diameter less than 10 mu m (PM10), temperature, humidity, and wind speed were measured. Results. After pesticide application, mean PM2.5 and PM10 values were significantly increased compared to before pesticide application (p < 0.001 for both parameters). After pesticide exposure, nasal discharge, sneezing, burning and itching in the eyes, cough, sputum production, wheezing, shortness of breath and chest tightness were significantly increased (p < 0.001). The mean PEF value was demonstrated to decrease significantly after pesticide application (p < 0.001). Moreover, significant negative correlations were noted between PEF and PM10 and between PEF and PM2.5 (p < 0.001). Conclusions. Intensive pesticide application causes respiratory dysfunction and increased respiratory complaints in children living near the affected agricultural areas, and impacts quality of life adversely. The results of this work can be used to develop an early warning system and methods to prevent respiratory disorders in children residing in the study area.Turkish Thoracic SocietyThe authors wish to express their thanks to the Turkish Thoracic Society for providing financial support for this work.WOS:0006461794000102-s2.0-85105220171PubMed: 3392911

Colistin therapy for nosocomial pneumonia and nephrotoxicity

WOS: 00020937040223

Evaluation of nephrotoxicity and prognosis in patients treated with colistin due to hospital-acquired pneumonia

Introduction: Colistimethate sodium (CMS) is frequently used in the treatment of nosocomial multidrug-resistant gram-negative infections. Nephrotoxicity is the most important side effect. The aim of this study is to evaluate the effect of colistin on nephrotoxicity and to assess prognosis in patients treated with CMS due to hospital-acquired pneumonia (HAP). Materials and Methods: Patients treated with CMS for HAP due to multidrug-resistant Pseudomonas aeruginosa or Acinetobacter baumannii were included in this cohort study. Results: We evaluated 281 patients treated with two different brands of CMS whose administration dose is different: imported (n=58, low dose/kg) and domestic (n=223, high dose/kg). Nephrotoxicity developed in 175 patients (62.3%). The median age (73 vs. 66 years, p=0.004) and mortality rates were higher (66.9% vs. 52.8%, p=0.022) in patients having nephrotoxicity. The patients receiving high dose/kg had higher nephrotoxicity rate (67.7% vs. 41.4%, p < 0.001). The clinical, bacteriological response and mortality rates of the whole group were 52.0%, 61.0%, 61.6%, respectively. The clinical and bacteriological response rates were similar in the different dose groups. Multivariate analysis showed that nephrotoxicity was associated with domestic brand depending on use of high dose (OR=3.97), advanced age (beta=0.29, p=0.008), male gender (OR=2.60), hypertension (OR=2.50), red blood cells transfusion (OR=2.54), absence of acute kidney injury (OR=10.19), risk stage of RIFLE (OR=11.9). Conclusion: Nephrotoxicity is associated with the use of high dose colistin, age, gender, hypertension, red blood cells replacement and RIFLE stage. The mortality rate is higher in patients developing nephrotoxicity

Unclear Issues Regarding COVID-19

Scientists from all over the world have been intensively working to discover different aspects of Coronavirus disease 2019 (COVID-19) since the first cluster of cases was reported in China. Herein, we aimed to investigate unclear issues related to transmission and pathogenesis of disease as well as accuracy of diagnostic tests and treatment modalities. A literature search on PubMed, Ovid, and EMBASE databases was conducted, and articles pertinent to identified search terms were extracted. A snow-ball search strategy was followed in order to retrieve additional relevant articles. It was reported that viral spread may occur during the asymptomatic phase of infection, and viral load was suggested to be a useful marker to assess disease severity. In contrast to immune response against viral infections, cytotoxic T lymphocytes decline in SARS-CoV-2 infection, which can be partially explained by direct invasion of T lymphocytes or apoptosis activated by SARS-CoV-2. Dysregulation of the urokinase pathway, cleavage of the SARS-CoV-2 Spike protein by FXa and FIIa, and consumption coagulopathy were the proposed mechanisms of the coagulation dysfunction in COVID-19. False-negative rates of reverse transcriptase polymerase chain reaction varied between 3% and 41% across studies. The probability of the positive test was proposed to decrease with the number of days past from symptom onset. Safety issues related to infection spread limit the use of high flow nasal oxygen (HFNO) and continuous positive airway pressure (CPAP) in hypoxic patients. Further studies are required to elucidate the challenging issues, thus enhancing the management of COVID-19 patients