Prevalence and Risk Factors of Work-Related Asthma in Hospital Cleaning Workers.

OBJECTIVE: This study aimed to determine the prevalence and evaluate the risk factors of work-related asthma among professional hospital cleaning workers. MATERIAL AND METHODS: In total, 278 cleaning workers were interviewed (response rate: 75.7%), and pulmonary function tests were performed. The presence of asthma and its work-relatedness was evaluated. Serial peak expiratory flow measurements were planned according to symptoms increased at work or spirometric findings. RESULTS: Totally 40 cleaning workers had asthma (14.3%); of these, 17 (6.1%) had work-related asthma, and 23 (8.2%) had non-work- related asthma. Non-work-related asthma and work-related asthma were significantly associated with the females(odds ratio 95% CI: 3.0, 1.1-8.4, and 3.2, 1.0-10.3, respectively). Non-work-related asthma was significantly associated with a family history of asthma (odds ratio 95%CI: 5.1, 2.0-13.2 and 2.8, 0.99-7.9, respectively) and limescale remover use at work (odds ratio, 95% CI: 0.21, 0.04-0.97, and 1.7, 0.5-5.2, respectively). Only 7 (28.0%) of 25 cleaning workers who were suggested serial peak expiratory flow measurements could complete the measurements. Of those, measurements of 2 cleaning workers were consistent with occupational asthma. CONCLUSION: The negative association between limescale remover use at work and non-work-related asthma suggested health selec- tion bias (avoidance behavior) due to the asthmatic effects of these chemicals.

[Pollen food allergy syndrome]. / Polen gida allerjisi Sendromu.

Pollen food allergy syndrome, is a type I cross-reaction mediated by IgE antibodies between an aeroallergen and a plant-derived antigen. Main symptoms are typically consist of localized oral symptoms such as numbness of the lip or mouth, itching, tingling and swelling of lips, tongue, palate and pharynx without systemic symptoms. Patients with seasonal allergic rhinitis, asthma or both more frequently experience pollen food allergy syndrome. Because most patients have mild symptoms and the improvement by avoiding food, the true incidence is unknown. In this review, we aimed to discuss characteristics, diagnosis and treatment of pollen food allergy syndrome according to existing literature.

Evaluation of Pregnancy-Associated Plasma Protein-A Levels in Patients with Chronic Obstructive Pulmonary Disease and Associations with Disease Severity.

Chronic obstructive pulmonary disease (COPD) represents a systemic disorder characterized by chronic airflow limitation and an increased inflammatory response of the airways. Comorbidities are frequent in COPD and it is crucial to predict these in early stage for adequate management of COPD. Recent studies have reported that elevated levels of pregnancy-associated plasma protein-A (PAPP-A), a zinc-binding metalloproteinase, detected in patients with asthma, lung cancer, and pulmonary embolism and independently associated with cardiovascular events. We aimed to assess serum PAPP-A levels in COPD and the associations between disease severity. The study population consisted of 75 COPD patients and 35 healthy subjects as a control group. PAPP-A levels were measured by using ultrasensitive enzyme-linked immunosorbent assay. Elevated levels of PAPP-A were observed in patients with COPD on comparison with the controls (p = 0.000). The levels in stage 1 (34.73 ± 22.97) and stage 2 (48.29 ± 53.35) were significantly higher than stage 3 (20.58 ± 22.98) and stage 4 (27.36 ± 21.46) (p = 0.049). Increased PAPP-A levels may be a useful marker in management of COPD that seeks to prevent the development of comorbidities such as adverse cardiovascular diseases.

[Sedation for fiberoptic bronchoscopy: review of the literature]. / Fiberoptik bronkoskopide sedasyon: Literatürün gözden geçirilmesi.

Fiberoptic bronchoscopy (FOB) is a procedure which has an important role in the diagnosis and treatment of lung diseases and is widely used in clinical practice. It is an invasive procedure and can cause cough, shortness of breath, nose and throat irritation. Stress during bronchoscopy can cause release of catecholamines, which may lead to tachycardia, vasoconstriction and possible myocardial ischemia in patients with impaired cardiopulmonary function. Current guidelines for bronchoscopy recommend offering sedation to patients, with the aim of improving patient comfort and reducing complications. For this purpose, the most frequently used sedatives are benzodiazepines, opioids, propofol and fospropofol which are either administered alone or in combination. In this review, we aimed to evaluate various drugs used for sedation during bronchoscopy.

A new diagnostic marker for acute pulmonary embolism in emergency department: mean platelet volume.

OBJECTIVE: To investigate the diagnostic importance of mean platelet volume (MPV) on acute pulmonary embolism (APE) in the emergency Department (ED). METHODS: Subjects were selected from patients admitted to ED with clinically suspected APE. Demographic, anthropometric and serologic data were collected for each patient. RESULTS: A total of 315 consecutive patients were analyzed, including 150 patients (53.44 ± 15.14 y; 92 men/58 women) in APE group and 165 patients (49.80 ±13.76y; 94 men/71 women) in the control group. MPV in the APE group was significantly higher than in the control group (9.42±1.22 fl vs. 8.04±0.89 fl, p<0.0001). The best cut-off values for MPV when predicting APE in patients with clinically suspected APE presenting at the ED were 8.55 fl (sensitivity 82.2%; specificity 52.3%). CONCLUSIONS: MPV is a helpful parameter for the diagnosis of APE in ED, for the first time in the literature.

Two cases of tracheal disease misdiagnosed as difficult-to-treat asthma.

Initial management of patients with difficult-to-treat asthma must begin with confirmation of the diagnosis. We present 2 cases of tracheal disease misdiagnosed as difficult-to-treat asthma. After systemic evaluation, tracheomalacia and tracheobronchial narrowing due to diffuse calcification of the cartilaginous rings were found as mimicking asthma.

[Could plasma D-dimer levels be a predictive marker for prognosis in lung cancer?]. / Plazma D-dimer düzeyleri akciger kanserinde prognoz için bir belirteç olabilir mi?

INTRODUCTION: Plasma concentrations of circulatory markers of hemostatic activation which may be associated with tumor growth and dissemination have been shown to predict prognosis in malignancy. The present study was designed to investigate the prognostic value of plasma D-dimer level in lung cancer. MATERIALS AND METHODS: Plasma levels of the D-dimer in 138 lung cancer patients [98 non-small cell lung cancer (NSCLC), 40 small cell lung cancer (SCLC)] were measured before the initiation of any therapy and each chemotherapy. RESULTS: There were 124 (89.9%) men and 14 (10.1%) women with a mean age of 62.8 years (range 38-84). There were no statistically significant differences among the histopathologic types for NSCLC patients. Stage IIIA NSCLC group had statistically significant higher D-dimer level than stages I-II and IV. D-dimer levels were increased significantly after 4 cycles of chemotherapy in progressive disease. The median survival times in NSCLC patients were 26.6 months (95% CI, 17.6-35.6) and 15.9 months (95% CI, 4.2-27.7; p= 0.037) respectively, for patients with a low D-dimer level (≤ 1.2 ng/L) and a high D-dimer level (> 1.2 ng/L).With the cox-regression analysis, the plasma level of D-dimer and tumour stage were identified as independent predictive factors of the survival. CONCLUSION: These results suggest that plasmalevel of D-dimer can act as a predictive factor of decreased survival and a poor response to the treatment in lung cancer.

[Interstitial lung disease associated with connective tissue diseases: diagnosis and treatment approaches]. / Bag dokusu hastaliklarina bagli gelisen interstisyel akciger hastaligi: Tani ve tedavi yaklasimlari

Connective tissue diseases are a diverse group of immunologically mediated systemic disorders that often lead to thoracic changes. There are huge differences between epidemiological studies depending upon method of ascertainment and selection criteria regarding the incidence of respiratory involvement due to connective tissue diseases. However, increased mortality and morbidity develops pulmonary involvement due to connective tissue diseases. Interstitial lung disease constitute an important group in this respect and it is estimated that the overall incidence of 15%. Today, still diagnosis, treatment, follow-up, prognosis of IInterstitial lung disease due to Connective tissue diseases (CTD-ILD) related clinical problems have been experienced. The diagnostic methods of disease include clinical approach, pulmonary function tests, high-resolution computed tomography, bronchoalveolar lavage and surgical lung biopsy. Treatment and selection of drugs are still controversial. In this review, a CTD-ILD, separately for each diagnosis, pulmonary function tests and radiological features, prognosis and treatment approaches were evaluated.