A Descriptive Study of a Turkish Pneumoconiosis Case-Series.

BACKGROUND: The study aimed to examine the conditions and factors affecting pneumoconiosis cases to determine the dimensions of the pneumoconiosis problem. METHODS: This retrospective study was conducted in a tertiary research hospital between January 1, 2014, and December 31, 2021. Five hundred ninety-seven patients with pneumo- coniosis were included in the study. RESULTS: Large opacities were detected in 157 cases. When we compared cases with and without Pulmonary Massive Fibrosis (PMF), age and concomitant pulmonary disease were higher in PMF cases, which also showed lower FEV1, FVC, and FEV1/FVC. PMF was more frequent in subjects with long dust exposure duration (more than 20 years) and concomitant pulmonary diseases, particularly tuberculosis. Three occupations, sandblasters, dental technicians, and ceramic workers, showed the earliest onset of pneumoconiosis. CONCLUSIONS: The study presents pneumoconiosis data in a mixed and large population and contributes to the imple- mentation of evidence-based policies and interventions for countries like Turkey striving to cope with the problem of pneumoconiosis.

Computed Tomography Findings in Progressive Massive Fibrosis: Analyses of 90 Cases.

PURPOSE: Radiological identification of lung masses in patients with pneumoconiosis is difficult. The aim of the study is to characterize Computed Tomography (CT) findings of Progressive Massive Fibrosis (PMF). METHODS: The data of pneumoconiosis patients, who were diagnosed with PMF between 2014-2019 in a tertiary hospital, were collected. Demographic data, work-related data, Pulmonary Function Test results and radiological imaging results were gathered. Separate evaluations were made for the right and left lungs, and the CT findings and measurement results were recorded. RESULTS: In 90% of our cases, PMF lesions were bilaterally located. Eighty-eight point five percent of the unilateral lesions were located in the upper lobe of the right lung. Enlarged lymph nodes were found in 83.3% and calcification was found in the lymph nodes in 63% of the cases. Band structures extending between the PMF lesion and the adjacent pleura were observed in 86% of the cases, and invagination in the lung parenchyma adjacent to the PMF was observed in 80% of the cases. CONCLUSION: In general, our findings were consistent with the radiologically defined PMF. In addition, pleural findings, which are not frequently studied in the literature except for asbestosis, were also described in the study. METHODS: The data of pneumoconiosis patients, who were diagnosed with PMF between 2014-2019 in a tertiary hospital, were collected. Demographic data, work-related data, PFT results and radiological imaging results were noted. Separate evaluations were made for the right and left lungs, and the CT findings and measurement results were recorded. RESULTS: In 90% of our cases, PMF lesions were bilaterally located. 88.8% of the unilateral lesions were located in the upper lobe of the right lung. Enlarged lymph nodes were found in 83.3% and calcification was found in the lymph nodes in 63% of the cases. Band structures extending between the PMF lesion and the adjacent pleura were observed in 86% of the cases, and invagination in the lung parenchyma adjacent to the PMF was observed in 80% of the cases. CONCLUSION: In general, our findings were consistent with the radiologically defined PMF. In addition, pleural findings, which are not frequently studied in the literature except asbestosis, were also described in the study.

Does dust-associated pulmonary alveolar proteinosis represent an autoimmune disorder?

The role of autoantibodies against granulocyte-macrophage colony-stimulating factor (GM-CSF) in the development of secondary pulmonary alveolar proteinosis (PAP) in patients exposed to occupational and environmental dust remains unclear. Herein, we describe two cases of secondary PAP who had GM-CSF antibodies and absence of STAT5 phosphorylation index, suggestive of a potential relationship between the appearance of GM-CSF antibodies and environmental dust exposure. However, whether the presence of GM-CSF antibodies is a part of the pathological process or represents an epiphenomenon is currently unknown. In this report, we would like to present two cases supporting these new data and briefly discuss the possible role of autoimmune mechanisms in the development of secondary PAP. Am. J. Ind. Med. 60:591-597, 2017. © 2017 Wiley Periodicals, Inc.

Progressive Massive Fibrosis Risk Factors: A Retrospective Cross-Sectional Study.

OBJECTIVE: This study aimed to determine the occupational and clinical characteristics of patients with progressive massive fibrosis (PMF) and factors related to the development and severity of PMF. METHODS: Personal, occupational, radiological, and functional findings of 129 patients diagnosed with PMF were evaluated. RESULTS: Sandblasting workers were found to be diagnosed with pneumoconiosis at an earlier age than those in other professions. The dust exposure durations of sandblasting and ceramic workers were significantly less than those of workers in other occupations. Statistically, a significant negative correlation was found between lung functions and small opacity size, small opacity profusion score, and large opacity size. No relationship was found between large opacity size and smoking status, concomitant tuberculosis, and duration of dust exposure. CONCLUSIONS: An effective surveillance system that considers factors that accelerate pneumoconiosis progression should be established.

The relationship between respiratory health and hard metal dust exposure: A cross-sectional study.

The frequency and severity of respiratory disorders among workers exposed to hard metal dust is not well known.The objective of this cross-sectional study is to report the prevalence of respiratory symptoms, functional status, and radiological findings in hard metal-exposed workers in Türkiye.Among 139 workers, 96 were machining workers, and 43 were industrial tool sharpening workers. Radiographic abnormalities compatible with pneumoconiosis were found 39% of the workers and were more in machining workers statistically significant.Also, in machining workers group, percentage of expected values of FVC was lower than industrial tool sharpening workers group. The prevalence of respiratory symptoms was 14.3%, and there was not a statistically significant difference in working groups. The study reveals that pulmonary symptoms, functional abnormalities, and radiological findings are mild. Assuming that reversibility may develop with avoidance from exposure when detected at this stage, early diagnosis of lung damage is essential.

Sarcoidosis in iron-steel industry: mini case series.

Sarcoidosis is a disease of unknown etiology. Despite the proposed connection between the development of sarcoidosis and exposure to environmental and toxic substances, no definitive associations could be established. Also, the role of silica and silicates in the etiology of this condition is currently unknown. Heat-treatment of silica results in the generation of tridymite and cristobalite forms and iron-steel industry represents one branch of industry in which silicone element is exposed to temperatures around 2000°C. Studies reporting on the incidence of sarcoidosis in the workers of iron-steel industry are scarce in number, and workers of this industrial branch are known to be exposed to silica in the form of cristobalite, nano-particulate silicone, metal oxides, and silicates. These substances, which have respiratory toxic properties and have been reported to be associated with autoimmune conditions, may also play a role in the pathogenesis of sarcoidosis. In our clinic, sarcoidosis was diagnosed in a total of 4 individuals, who works in the iron-steel industry. Through this report involving a series of patients with sarcoidosis, we also wanted to discuss the role of crystalline silica forms and silicates in the etiology of sarcoidosis, which is also considered to be an auto-immune condition. (Sarcoidosis Vasc Diffuse Lung Dis 2017; 34: 365-372).

Computed tomography findings in 66 patients with malignant pleural mesothelioma due to environmental exposure to asbestos.

We aimed to investigate the computed tomography (CT) findings of malignant pleural mesothelioma (MPM) caused by environmental asbestos exposure. We retrospectively reviewed CT scans of 66 patients, which were performed before any invasive procedure was done. Pleural effusion (80.3%), pleural thickening (77.2%), volume contraction (37.9%), involvement of mediastinal pleura (31.8%) and interlobar fissure (28.8%) were the most common CT findings of MPM. Although none of these findings are pathognomonic for MPM, they may provide valuable clues for the differential diagnosis, at least in patients with a history of asbestos exposure.

Lipid-laden alveolar macrophage index in sputum is not useful in the differential diagnosis of pulmonary symptoms secondary to gastroesophageal reflux.

BACKGROUND: Gastroesophageal reflux (GER) is frequently associated with pulmonary diseases. Esophageal acid-induced bronchoconstriction and recurrent microaspirations of gastric content are the proposed mechanisms. At present there is not a sensitive test available to prove a causal relationship between pulmonary symptoms and GER. In this study we aimed to investigate the value of a marker of aspiration: lipid-laden alveolar macrophage index (LLAM) in induced sputum, in the diagnosis of pulmonary symptoms highly suspected to be due to GER. METHODS: Twenty-two patients with the endoscopic diagnosis of erosive esophagitis who had various pulmonary symptoms that could not be attributed to any apparent etiology constituted the study group. Fifteen healthy volunteers with no prior diagnosis of gastroesophageal and lung disease constituted the control group. Subjects were questioned for pulmonary and abdominal symptoms and underwent physical examination, chest radiography, pulmonary function tests, and sputum induction. Prepared cytospins were stained with oil red-O to detect cytoplasmic lipid droplets and LLAM index was calculated. RESULTS: There was no statistically significant difference between the LLAM indexes of the study (1.9 +/- 3.3) and control group (4.2 +/- 4.5). LLAM index had a significant positive correlation with the duration of reflux symptoms (p=0.01, r=0.5). CONCLUSIONS: LLAM index is not found to be a valuable method in the differential diagnosis of pulmonary symptoms suspected to be due to GER.

Importance of serum SELDI-TOF-MS analysis in the diagnosis of early lung cancer.

BACKGROUND: Different methods of diagnosis have been found to be inefficient in terms of screening and early diagnosis of lung cancer. Cancer cells produce proteins whose serum levels may be elevated during the early stages of cancer development. Therefore, those proteins may be recognized as potential cancer markers. The aim of this study was to differentiate healthy individuals and lung cancer cases by analyzing their serum protein profiles and evaluate the efficacy of this method in the early diagnosis of lung cancer. MATERIALS AND METHODS: 170 patients with lung cancer, 53 under high risk of lung cancer, and 47 healthy people were included in our study. Proteomic analysis of the samples was performed with the SELDI-TOF-MS approach. RESULTS: The most discriminatory peak of the high risk group was 8141. When tree classification analysis was performed between lung cancer and the healthy control group, 11547 was determined as the most discriminatory peak, with a sensitivity of 85.5%, a specificity of 89.4%, a positive predictive value (PPV) of 96.7% and a negative predictive value (NPV) of 62.7%. CONCLUSIONS: We determined three different protein peaks 11480, 11547 and 11679 were only present in the lung cancer group. The 8141 peak was found in the high-risk group, but not in the lung cancer and control groups. These peaks may prove to be markers of lung cancer which suggests that they may be used in the early diagnosis of lung cancer.

Pulmonary alveolar microlithiasis with low fluorodeoxyglucose accumulation in PET/computed tomography.

Pulmonary alveolar microlithiasis (PAM) is an uncommon lung disease characterized by accumulation of intraalveolar calcifications. The disease can be diagnosed based on the radiological findings. We present a 27-year-old women with five-year history of shortness of breath. She was diagnosed with PAM due to the presence of the characteristic chest X-ray and thorax computed tomography (CT) findings. We performed (18)F-fluorodeoxyglucose (FDG)-PET/CT imaging in order to detect any evidence of inflamation in the lung before deciding an anti-inflammatory treatment. The lung regions with dense calcifications revealed low FDG uptakes (SUVmax: 2.7) and the lung regions without calcifications showed lower FDG uptakes. No further treatment modality was planned besides inhaler salbutamol. Herein, we discuss this rare entity with literature search.