The Impact of Early Phase COVID-19 Vaccination on Hospitalized COVID-19 Patients.

The number of cases of coronavirus disease-2019 (COVID-19) globally is over 225 million, and disease-related deaths are over 4 million. The type, prevalence, and antibody susceptibility of the virus variants of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) and the vaccination rate and coverage are considered critical factors in the progress of COVID-19. We aimed to compare the clinical and laboratory parameters of the patients hospitalized due to COVID-19 in pre-vaccination and post-vaccination periods. We conducted this retrospective cross-sectional study in a tertiary clinic in Turkey. The files of the patients over the age of 18, whose real-time polymerase chain reaction (RT-PCR) tests were positive and who were hospitalized before (November-December 2020, Group 1) and after (March-April 2021, Group 2) COVID-19 vaccination were scanned. Patients' demographical data, clinical severity, laboratory parameters, thorax computed tomography involvement, and mortalities were recorded. The obtained data were compared among the groups. 601 patients (344 male, 57% and 257 female, 43%) were included in the study. It was observed that the patients in the Group 2 were younger (60.71 ± 14.06 vs. 66.95 ± 14.57, p < 0.001), and a significant decrease in mortality [83 (28.6%) vs.139 (44.6%), p = 0.001] were observed in Group 2. The number of patients who needed ventilatory support and the rate of pulmonary involvement was lesser in Group 2, but the difference was non-significant. C-reactive protein, D-dimer, procalcitonin levels were significantly lower in Group 2 patients. Our study shows that the age and mortality of hospitalized COVID-19 patients decreased significantly after vaccination. An increase in the number of booster doses in individuals with advanced age (age > 75) and comorbidity (especially malignancy) may contribute to the control of the disease and immunity in this population.

Comparison of full-face and oronasal mask effectiveness in hypercapnic respiratory failure patients with non-invasive mechanical ventilation.

Introduction: Non-invasive mechanical ventilation (NIMV) is a successful treatment modality in hypercapnic respiratory failure. Patient compliance and mask selection are the most important factors in the success of NIMV. In our prospective randomized study, we aimed to investigate the efficacy of full-face and oronasal masks in the treatment of patients with hypercapnic respiratory failure who underwent NIMV and to investigate the mask compliance of the patients. Materials and Methods: In this prospective randomized study, 60 patients with hypercapnic respiratory failure were divided into two groups; the full face mask group (n= 30) and the oronasal mask group (n= 30). Arterial blood gas values and respiratory rates were measured before the treatment and at the 1st, 6th, 24th, and 72nd hours of the treatment. The compliance of the patients with the treatment was evaluated with the patient compliance scale (PCS) at the 1st, 6th, and 24th hours of the treatment. Result: Eight patients from the full-face mask group were excluded because of mask-face mismatch and claustrophobia, and two patients from the oronasal mask group due to persistent hypercapnia. In the full face mask group, improvement in pH was observed at the 1st and 24th hours of treatment (p= 0.042, p= 0.033), and PCO2 decreased at the 72nd hour of treatment (p= 0.024). There was no difference in patient compliance and respiratory rate between groups. The complaints of burning sensation and pressure in the eyes were higher in the full face mask group (p= 0.025), and pressure ulcers were more common in the oronasal mask group (p= 0.025). Conclusions: The reduction in PCO2 and improvement in pH were greater with a full face mask. Pressure sores were less common with a full face mask. In our study, no difference was found in terms of patient compliance between groups. It should be noted that choosing a full face mask in patients with high compliance will increase the success in the treatment of hypercapnic respiratory failure.

The relationship between serum uric acid level and uric acid/creatinine ratio with chronic obstructive pulmonary disease severity (stable or acute exacerbation) and the development of cor pulmonale.

BACKGROUND: There are studies reporting that uric acid elevation is a marker for hypoxemia and pulmonary hypertension secondary to some diseases. AIM: The aim of this study is to investigate the relationship between serum uric acid level and uric acid/creatinine ratio with chronic obstructive pulmonary disease (COPD) exacerbation, hypoxemia in exacerbation and development of cor pulmonale. METHODS: A total of 96 COPD patients who were admitted to Ondokuz Mayis University Faculty of Medicine emergency department and Chest Diseases outpatient clinic and whose written consent was obtained were included in our study. Forty-three of these patients were in the period of exacerbation (Group 1), and 53 were in the stable period (Group 2). Complete blood count, blood biochemistry (including serum uric acid level) and arterial blood gas analysis were performed in our patients. In addition, spirometry and echocardiography findings were examined. RESULTS: Serum uric acid level of patients in the period of exacerbation group (Group 1) was 6.97 ± 1.34 and in stable COPD group (Group 2) was 4.30 ± 1.01 (P < .05). Uric acid/creatinine ratios in Group 1 was 8.00 ± 2.06; in Group 2, it was 5.52 ± 1.57 (P < .05). In patients with hypoxemia, serum uric acid level and uric acid/creatinine ratio were significantly higher than nonhypoxemic patients (P < .05). Serum uric acid level and serum uric acid/creatinine ratio of Group 1 were significantly higher than Group 2 (P < .001). Serum uric acid level and serum uric acid/creatinine ratio of patients who developed cor pulmonale were significantly higher than patients without cor pulmonale (P < .05). CONCLUSION: Serum uric acid level and uric acid/creatinine ratio were found to be higher in patients with exacerbation of COPD and those developing cor pulmonale. Consequently, it suggests that serum uric acid level and serum uric acid/creatinine ratio may be a stimulating laboratory test for the severity of COPD and the development of COPD induced cor pulmonale.

The performance of critical flicker frequency on determining of neurocognitive function loss in severe obstructive sleep apnea syndrome.

This study aimed to compare the critical flicker frequency (CFF) and the mail-in cognitive function screening instrument (MCFSI) tests' effectiveness in diagnosing neurocognitive function losses in patients having severe obstructive sleep apnea syndrome (OSAS). A total of 85 subjects (47 patients with a diagnosis of severe OSAS and 38 healthy controls) were included into the study. MCFSI scores greater than or equal to five and CFF scores less than 39 Hz were considered abnormal. Demographic and polysomnographic parameters of patients with OSAS were studied, and correlations between the MCFSI, CFF scores and Epworth Sleepiness Scale (ESS) scores were analysed. The mean age of the patients was 49.6 ± 12.0 years. In the OSAS group, the CFF score was found to be low when compared with the control group, while the MCFSI score was found to be high. Pathological CFF scores (<39) were found in 13 patients (27.7%) in the OSAS group, while pathological MCFSI scores (≥5) were found in 19 patients (40.4%). CFF scores were found to be low in only 26% of the patients with OSAS who were found to have high MCFSI scores. MCFSI scores were high in only 38% of the patients with OSAS who were found to have low CFF scores. There was a significant correlation between ESS and CFF scores. In conclusion, the usefulness of the CFF test in determining cognitive function loss in patients with OSAS needs to be demonstrated via studies which utilize a larger sample size.

The cough frequency among call center workers: "call center cough".

INTRODUCTION: Call centers are places where numerous people work together always speaking in a closed environment, and the most common complaint about admission to a doctor by call center employees is a cough and other respiratory system symptoms. MATERIALS AND METHODS: In this study, we aimed to demonstrate the relationship of call center employees between work and cough complaints and cough incidence with a questionnaire that consists of eleven questions and evaluates epidemiologic features, cough complaints of call center employees. RESULT: 132 people were accrued to this study and the female/male ratio was 102/30. Mean age was 26.4 ± 2.7 (min-max; 21-39) years, mean working time at the call center was 2.6 ± 1.2 (min-max; 0.1-8) year and mean daily working hours was 8.1 ± 1.1 hour. 40 (30.3%) participants had cough complaint before beginning, 89 (67.4%) participants had cough complaint after to work at a call center work (p= 0.004). CONCLUSIONS: Cough is more prevalent in call center employees. Pulmonary medicine specialist and occupational medicine practioner keep their mind unexplaned cough with infections or other reasons might be a warning and early symptoms of sick building syndrome or other building related diseases or voice abusing on call center operators.

Investigation of pepsin levels in bronchial lavage in patients with interstitial lung disease and chronic cough.

AIM: Pepsin is an enzyme that helps digest protein secreted only from the gastric chief cell in an inactive state. Pepsin is a good marker for acidic gastroesophageal reflux (GER). Its presence in sputum or saliva is considered pathologic. In GER, cough is stimulated by broncho-esophageal neurogenic reflex and aspiration of gastric contents into the airways. GER is the most common cause of cough. Gastric acid reflux is also thought to play a role in Interstitial Lung Disease (ILD) etiology. In many studies, pepsin and bile acid levels in bronchial lavage were high in patients with interstitial lung disease and chronic cough. In our study, we aimed to evaluate pepsin levels in bronchial lavage in patients with ILD and chronic cough and to investigate the relationship between symptoms and reflux treatment. METHODS: Between January 2021 and February 2022, 212 patients who underwent bronchoscopy in our tertiary clinic were evaluated. These patients were divided into three groups: 52 patients with interstitial lung disease, 81 patients with chronic cough, and 79 patients who underwent bronchoscopy with a pre-diagnosis of lung cancer as the control group. Bronchial lavage obtained by bronchoscopy was analyzed for pepsin levels. RESULTS: Shortness of breath and cough were the most common symptoms in all three groups. Pepsin levels were 16.71 ± 8.6 ng/ml in the chronic cough group, 15.6 ± 8.9 ng/ml in the ILD group, and 10.58 ± 5.4 ng/ml in the lung cancer (control) group. Pepsin levels in the ILD and chronic cough group were statistically significantly higher than in the lung cancer group (p:0.00). There was no statistical difference between the ILD group and the chronic cough group regarding pepsin levels. It was found that pepsin levels were lower in the three groups who received anti-reflux treatment. There was no difference in pepsin levels between ILD subgroups. CONCLUSION: Pepsin levels in bronchial lavage were higher in the ILD and chronic cough groups. This suggests that reflux may be involved in the etiology of chronic cough and ILD. Low pepsin values in patients receiving anti-reflux therapy have shown that occult reflux may occur. In our study, the high level of pepsin in bronchial lavage, especially in the chronic cough and ILD group, may be instructive in the etiology and treatment planning of the disease.

Longitudinal pulmonary functional loss in cotton textile workers: a 5-year follow-up study.

BACKGROUND: Occupational exposure to cotton dust causes several diseases affecting the lungs, but only limited information is available on effects of long-term exposure. In this study, we aimed to evaluate longitudinal changes in selected parameters of pulmonary function in textile workers. MATERIAL AND METHODS: This prospective cohort study began with 196 textile workers in 2006 and was completed in 2011 with 49 workers. We used standardized tests for pulmonary function on participants on the first day of the workweek in June of 2006 and 2011. Environmental samples of cotton dust were gathered with a vertical elutriator. Loss of pulmonary function was assessed based on gender and smoking status. RESULTS: The mean number of years participants worked in the textile factory was 7.61 ± 1.83 years, and the mean age was 35.3+5.8 years. The annual FEV1 loss of all workers was 53.2 ml, giving a ratio of annual FEV1 loss to baseline FEV1 of 1.4%. Pulmonary function parameters of all participants in 2011 were significantly lower than those in 2006 (for all, p<0.05). In both surveys, pulmonary function in current smokers was lower, but this difference was not significant (p>0.05). CONCLUSIONS: This study provides the first data on pulmonary functional loss in Turkish textile workers and supports the findings of other cohort studies that workers with long-term exposure to cotton dust may lose some pulmonary function. The ratio of annual FEV1 loss to baseline FEV1 appears to be a more accurate and comparable method than annual FEV1 loss for evaluating pulmonary functional loss.

The affecting factors and comparison of tuberculin skin test in peritoneal dialysis and hemodialysis patients.

Compared with the general population, patients with chronic renal failure have increased tuberculosis (TB) prevalence and mortality rates. In this study, we aimed to investigate tuberculin skin test (TST) positivity rates in hemodialysis (HD) and peritoneal dialysis (PD) patients and the factors influencing TST positivity. Ninety-two HD patients and 44 PD patients who had been on HD and PD treatment for at least 3 months were recruited into the study. TST was administered in all patients. Positivity was defined as an induration diameter >10 mm. At least 5 mm of induration following skin testing together with a chest radiography indicating previous infection was defined as latent TB infection. TST positivity rates, diameter of TST indurations, and serum albumin levels in HD patients were higher than the PD patients. TST induration size was not correlated with any other parameters in both HD and PD groups. TST-positive patients had higher albumin levels and lower leukocyte count than the TST-negative patients. In TST-positive patients, albumin level was correlated with the duration of dialysis but TST induration size was not correlated with the lymphocyte count and albumin level. In our study, TST positivity of patients was found in 30.4% of HD patients, 9% of PD patients, and 23.5% of total patients. It is still recommended to use TST for the screening test of TB. We found a significant relationship between TST and albumin level. It should be remembered that TST response may be lower in PD patients, especially in cases in which TB is suspected.

The approach of smokers to the new tobacco law and the change in their behaviour.

INTRODUCTION: The aim of our study is; to assess the approach of smokers to tobacco law, examine changes in their smoking related behaviors after the new law and determine the factors associated with these changes. MATERIALS AND METHODS: Data collected by questionnaire including 30 question. We applied the questionnaire to 1509 current smokers, and ex-smokers who quitted smoking after the law. SPSS packet programme was used for analyses. RESULTS: Participants consisted of 419 (28.0%) female, 1090 (72.0%) male with an average age of 33.6 ± 10.5 years. Although 80% of them knew that passive smoking is harmful to non-smokers, rate of smoking at home and in the car were very high. 869 (58.0%) of participants supported the law. 87 (5.8%) smokers quitted smoking after the law, 316 (20.9%) reduced. While health problems (37.3%) were the most frequent reason for quitting, restriction of smoking area had the most effect to reduce (54.2%). CONCLUSION: We satisfied that; the new tobacco law encouraged smokers to quit smoking. In addition, the majority of smokers supported the law.

Acute silicosis in teflon-coated pan manufacturing due to metal sandblasting.

Sandblasting is one of the occupational causes of silicosis. This report details three cases diagnosed as silicosis caused by sandblasting in Teflon-coated pan manufacturing: Case 1--A 24-year-old man admitted with dyspnea and cough; Case 2--An 18-year-old man admitted with shortness of breath and fever; and Case 3--A 25-year-old man admitted with dyspnea and weight loss. Chest examinations of the first and second cases revealed crackles in both lungs, but the third case was normal, no crackles. Chest x-rays showed bilateral reticulonodular densities and hilar enlargement in all cases. They were clinically and radiologically diagnosed as silicosis due to occupational exposure. All cases had worked in the sandblasting unit at a Teflon-coated pan manufacturing factory for one to three years. Silicosis is a preventable occupational lung disease, but no effective treatment is available for the disease yet. Improving workplace conditions is the most effective way to prevent silicosis.

[The assessment of knowledge about recent tobacco law number 5727 among our university students, academic and administrative staff]. / Üniversitemiz ögrencileri ile akademik ve idari personel arasinda 5727 sayili yeni tütün yasasina iliskin bilgi düzeyi degerlendirmesi.

In this study we investigated the level of knowledge and ideas of the university students and staff, about the last stage of Tobacco Law No. 5727, which came into force on 19 July 2009 in our country. This is descriptive questionnaire survey. Study's universe was consisting of the students 2009-2010 academic year studying in our universities and academic and administrative staff. A total of 2271 people were included the study. In our study, smoking prevalence was 21.3%. The prevalence for narghile smoking as 4.8% was the highest among students. 94.9% of participants thought that passive smoking increased the risk for human health. Asked whether the banned places, the most correct answers were; the school (97.0%), bank branches (96.3%) and hospitals (96.2%) as the most incorrect answers were; in the garden of hospital (55.7%), garden of private education (53.4%) and the school playground (46.1%). 87.6% of the participants were supporting the new tobacco law. 61.3% of smokers were supporting the law (p= 0.000). 54.3% of narghile-smokers support the law, and this rate was lower than cigarette smokers. Overall, tobacco law is known and supported between our students and staff. More information and supervision should be given about the banned places like school garden and private course gardens which were the high rate of false knowledge. The support to law among students is lower than staff. Similarly narghile use among students is often more. The community should be informed also about the other tobacco products.

QuantiFERON-TB Gold test for screening latent tuberculosis infection in hemodialysis patients.

Hemodialysis patients are at increased risk of latent tuberculosis infection (LTBI) compared with the general population. QuantiFERON-TB Gold (QFT-G) for LTBI detection is more promising than tuberculin skin test (TST) in hemodialysis patients. The aim of this study is to determine whether the QFT-G is more sensitive than the TST in hemodialysis patients in LTBI. Eighty nine hemodialysis patients were evaluated for latent tuberculosis infection with the TST and QFT-G. Blood was obtained for QFT-G, and then TST was administered to all patients. Demographic information, laboratory tests, chest radiography results and BCG vaccination status were collected on standardized patient medical files. Forty patients had positive QFT-G results. 56 patients had TST induration above 5 mm, 28 patients above 10 mm. 61 patients had BCG vaccination scar. Statistically significant correlation was detected between TST and QFT-G (p< 0.05). In the BCG non-vaccinated subgroup, TST was positive in 8 (29%) patients and the QFT-G was positive in 11 (39%). Among the 21 non vaccinated patients with results for both tests, the concordance between the TST and QFT-G was 82%, k= 0.61, p= 0.001. We found good agreement between the TST and QFT-G test for LTBI in non vaccinated hemodialysis patients, whereas we found poor agreement in vaccinated patients. Because BCG vaccination is widely used in our country, the QFT-G test might be more useful for the diagnosis of LTBI than TST in hemodialysis patients who are suspected to have LTBI.

Prevalence of and factors affecting pulmonary hypertension in hemodialysis patients.

BACKGROUND: Pulmonary hypertension (PH) has been reported to be high among end-stage renal disease (ESRD) patients. OBJECTIVES: The aim of this study was to investigate the role of arteriovenous fistula (AVF) flow in the pathogenesis of PH and the prevalence of PH in patients with chronic renal failure (CRF) and to suggest other possible etiologic factors. METHODS: The prevalence of PH was prospectively estimated by Doppler echocardiography in 116 ESRD patients on regular hemodialysis (HD). Laboratory and clinical variables were compared between patients with and without PH (groups 1 and 2, respectively). PH was defined as systolic pulmonary artery pressure (SPAP) over 30 mm Hg. Patients with PH underwent further evaluation by 2 pulmonologists. AVF flow was measured by Doppler ultrasonography. Blood tests including arterial blood gases, hemoglobin, serum calcium, phosphorus and parathyroid hormone were determined. RESULTS: PH was found in 25 (21.6%) patients (group 1) with an SPAP of 37.9 ± 2.8 mm Hg. Mean AVF flow was increased (1,554 ± 207.60 ml/min) in group 1. Left ventricular ejection fraction (LVEF) was significantly different between the 2 groups (55.3 ± 11.5 and 64.4 ± 40, respectively; p < 0.05). Neither significant primary lung disease nor parenchymal lesions were detected in group 1. PH showed a significant difference for cigarette smoking (p < 0.05). In group 1 the prevalence of cigarette smoking was higher. The main etiology of CRF was diabetes mellitus with a ratio of 44% in group 1. CONCLUSION: Our study demonstrated a surprisingly high prevalence of PH among patients receiving long-term HD. PH was related to high AVF flow, low LVEF and cigarette smoking. AVF flow and cigarette smoking are important correctable causes of PH. Early detection is important in order to avoid the serious consequences.

Oddi sphincter fibrosis due to chemotherapy agents in small cell lung cancer: case report.

A 62-year-old, man patient was diagnosed as small cell lung cancer. Cisplatin (80 mg/m(2), first day) and etoposide (100 mg/m(2), three days) chemotherapy was started for once 21 days. As the patient received third course of chemotherapy, jaundice and hyperbilirubinemia were detected. Hepatic ultrasonography showed dilated choledochus and intrahepatic biliary tract. Hepatic markers and serologic tests for viral hepatitis were found as normal. Finally endoscopic retrograde cholangiopancreatography (ERCP) was performed. Endoscopic sphincterotomy was performed in the first ERCP and two days later, second ERCP was performed and oddi sphincter was seen as fibrotic and stenotic and stent was placed. One day after the stent placement, direct bilirubin was found as 6.2 mg/dL and 10 days later laboratory parameters were detected as normal. Oddi sphincter fibrosis occurred due to lung cancer chemotherapy treatment is an interesting case for fibrosis not having been reported due to cisplatin or etoposide before.

Extraction of pins from the airway with flexible bronchoscopy.

BACKGROUND: Tracheobronchial foreign body aspiration is a worldwide health problem which often results in life threatening complications. Standard flexible bronchoscopy (FB) is used increasingly in the treatment of tracheobronchial foreign body aspiration in adults and older children, especially in the removal of aspirated foreign bodies which have entered into the peripheral bronchi. OBJECTIVES: In the present study, we discuss how to minimize complications and increase the success rate of FB in the aspiration of pins, and recommend techniques to facilitate the application. METHODS: The study was performed at a community hospital in Van, the Harran University Hospital in Sanliurfa and the Sutcuimam University Hospital in Kahramanmaras, Turkey. Between 2000 and 2005, 23 female patients between the ages of 12 and 23, who were admitted to the clinics and diagnosed as having tracheobronchial headscarf pin aspirations were included in our study to evaluate the efficiency of FB. Diagnosis of the patients was established by history, FB and radiological methods. All patients received transoral FB under local anesthesia. RESULTS: FB was successfully applied in all cases. During removal, the pins in 2 patients dropped at the proximal trachea and subglottic zone, and were ingested into the gastrointestinal track. In both cases, the pins were spontaneously excreted from the body in the stool within one day. No other complication was detected in the other patients during or following bronchoscopy. CONCLUSIONS: Our study suggests that FB is a safe, easy and successful method used in the removal of foreign bodies, such as pins, from the tracheobronchial trees. By employing FB, indications of thoracotomy and other invasive methods can be reduced especially in the cases of pins localized in distal airways and in the evaluation of suspected foreign bodies.

The Effect of Working in a Smoke-Free Workplace on use of Smoking and Smokeless Tobacco.

OBJECTIVES: The aim of this study was to evaluate whether smokeless tobacco (Maras powder) use increased among smokers working at smoke-free workplaces or not. MATERIAL AND METHODS: In Kahramanmaras city, 242 male workers who were current or former smokers, working at strictly smoke-free workplaces were included in this study. A total of 21 questions, including the Fagerstrom Test for Nicotine Dependence, were asked. RESULTS: All the participants were male with a mean age of 29.33±6.66 years, and the age range was 17-55 years. Current smokers were 90 (37.2%) and former smokers were 152 (62.8%). Former smokers were asked the reason why they quit smoking; the predominant reasons were the health hazards of smoking and the financial burden of cigarettes. The quitting rate was significantly higher among married participants (p=0.023). Maras powder users were 184 (76%), users who never smoked were 54 (22.3%), and former users were 4 (1.7%). We asked the Maras powder users if they had been using it before the smoking bans, and 96 workers (51.1%) answered "no." The question "Did the use of Maras powder increase with smoking bans"? was asked, and 118 workers (62.8%) answered "yes." The level of education among Maras powder users was significantly lower than non-users (p=0.001). CONCLUSION: Working in smoke-free workplaces is associated with increased rates of quitting smoking and also with increased use of Maras powder, a local form of oral smokeless tobacco.

High-sensitivity C-reactive protein in patients with metabolic syndrome.

High-sensitivity C-reactive protein (CRP) has been shown to predict cardiovascular disease. Metabolic syndrome has been found to play a critical role in the development of cardiovascular disease. The purpose of this report is to assess the relationship between CRP and the metabolic syndrome. A total of 50 patients with metabolic syndrome and 40 healthy persons were included in the study. Plasma concentrations of CRP were measured by means of particle-enhanced immunonephelometry with the Behring nephelometer using N Latex CRP mono reagent. CRP levels were higher in patients with metabolic syndrome than control group (10.6 +/-5.4 mg/L vs 3.5 +/-0.8 mg/L, p<0.001). In partial correlation, plasma CRP positively correlated with body mass index (p<0.001), waist circumference (p<0.001), waist-to-hip ratio (p<0.01), total cholesterol (p<0.001), LDL-cholesterol (p=0.033), triglyceride (p=0.023), and fasting blood glucose (p=0.043) in patients with metabolic syndrome. HDL-cholesterol did not significantly correlate with CRP (p>0.05). In multiple regression analysis, body mass index (p<0.01), waist circumference (p<0.01), and fasting blood glucose (p<0.01) showed independent correlations with plasma CRP. CRP levels were found higher in patients with metabolic syndrome. These results suggest that abdominal obesity is the critical correlates of elevated plasma CRP levels found in patients with metabolic syndrome. These patients carrying high risk for cardiovascular events must be followed closely.

Organophosphate intoxication as a consequence of mouth-to-mouth breathing from an affected case.

We report three cases of organophosphate (OP) poisoning. One patient was a 19-year-old woman who drank OP compounds in an attempt at suicide. The other two patients became intoxicated on the way to the hospital during mouth-to-mouth breathing. The first patient died in the emergency department, and the other two were taken to the ICU. There, they were treated with atropine and pralidoxime. Three days later, all symptoms and signs had disappeared, and they were discharged from the hospital satisfactorily.

The role of oxidative stress in bronchoconstriction due to occupational sulfur dioxide exposure.

BACKGROUND: We previously showed that apricot sulfurization workers (ASW) are exposed to high concentrations of SO(2), resulting in an asthma-like syndrome. The aim of this study was to evaluate whether oxidative stress plays a role in the pathogenesis of asthma-like syndrome due to the high concentrations of SO(2) exposure in agricultural environment. METHODS: Serum antioxidant enzyme activities and malondialdehyde (MDA) concentrations, which are markers of lipid peroxidation, and pulmonary function tests (PFT) were measured in 40 volunteer ASW and compared to 20 healthy control subjects. RESULTS: The superoxide dismutase (SOD, 2.2+/-0.6 vs. 3.2+/-0.7 U/ml), glutathione peroxidase (GSH-Px, 0.6+/-0.3 vs. 1.1+/-0.3 U/ml) and catalase (107.6+/-27.4 vs. 152.6+/-14.3 k/l) activities in ASW were significantly (p<0.0001) lower than controls, whereas the malondialdehyde concentration (4.1+/-0.9 vs. 1.9+/-5.3 nmol/l) was higher in ASW (p<0.0001). ASW had significant decreases in pulmonary function parameters after exposure. CONCLUSION: These results show that occupational exposure to high concentrations of SO(2) enhances oxidative stress and lipid peroxidation may be considered as a new mechanism of SO(2)-induced bronchoconstriction.

The role of nitric oxide and cytokines in asthma-like syndrome induced by sulfur dioxide exposure in agricultural environment.

BACKGROUND: We previously demonstrated that apricot sulfurization workers are exposed to high concentrations of SO(2), subsequently causing asthma-like syndrome. This study investigated the effects of SO(2) exposure on serum TNF-alpha, IL-1beta, IL-6, IL-8, nitrite and nitrate levels to understand the mechanism of SO(2)-induced bronchoconstriction in asthma-like syndrome. METHODS: We measured the serum levels of the cytokines, direct nitrite, total nitrite and nitrate obtained from 40 volunteer workers after an hour of exposure to SO(2) and 23 healthy controls. RESULTS: The concentrations of the cytokines, direct nitrite, total nitrite and nitrate were significantly (p<0.0001) higher in the workers than in the controls. The mean serum concentrations of TNF-alpha, IL-1beta, IL-6, IL-8, direct nitrite, total nitrite and nitrate were 430.60+/-397.03 pg/ml, 436.67+/-316.31 pg/ml, 752.11+/-394.95 pg/ml, 262.12+/-287.99 pg/ml, 7.75+/-3.34 micromol/l, 115.72+/-48.78 micromol/l and 107.97+/-46.19 micromol/l in the workers, while they were 9.83+/-3.12 pg/ml, <5 pg/ml, 7.49+/-1.27 pg/ml, 9.38+/-1.99 pg/ml, 2.17+/-0.77 micromol/l, 59.91+/-7.56 micromol/l and 57.74+/-7.20 micromol/l in the controls, respectively. CONCLUSION: These results show that TNF-alpha, IL-1beta, IL-6, IL-8 and nitric oxide may play a role in the pathogenesis of bronchoconstriction in asthma-like syndrome due to the SO(2) exposure.