Murat Kavas

Respiratory Symptoms and Pulmonary Functions of Workers Employed in Turkish Textile Dyeing Factories

Dyes are known to be a causative agent of occupational asthma in workers exposed to them. We have evaluated respiratory symptoms among textile workers. The study population comprised 106 exposed workers and a control (unexposed) group. Data were collected by a questionnaire. PFTs (Pulmonary Function Test) were performed. Among the exposed workers 36.8% defined phlegm. Respiratory symptoms were not significantly different between two groups. The employment duration of the exposed workers with phlegm was longer than those without phlegm (p = 0.027). The mean % predicted of FEF25–75 of the exposed workers was found to be significantly lower than the control (unexposed) group (p = 0.01). Our study suggests that textile dyeing might cause respiratory symptoms in workers.

Binasal cannula versus face mask for oxygen therapy in patients with chronic pulmonary disease.

Oxygen therapy, which is ordered frequently for patients with chronic pulmonary disease, remains a cornerstone of modern medical practice. This study was conducted to compare the efficiency and comfort of a binasal cannula versus a face mask during oxygen therapy. Sixty hypoxemic patients participated in this randomized controlled study. While each patient was hypoxemic, arterial blood gas analysis was performed before oxygen supplementation was begun. Arterial oxygen saturation was continuously monitored during oxygen therapy with a face ask or a binasal cannula. Subjects were allowed to return to their oxygen saturation level in room air before the device for oxygen treatment was changed. The same procedure was then repeated with the other device. Patient comfort was evaluated through the use of a questionnaire that was completed after each treatment period. The mean age±standard deviation was 62±13 y. No statistically significant difference was noted in oxygen saturation levels achieved with the 2 devices. The binasal cannula reached target oxygen levels (P=.007) more quickly than the face mask. The binasal cannula was reported to be significantly more comfortable (P=.0001), and had significantly fewer reports of dyspnea and restlessness, and was less of a nuisance (P=.019, P=.0001, and P=.0001, respectively). The binasal cannula was preferred for oxygen therapy by 71% of study patients. Although the efficiency of the 2 devices did not differ remarkably, Transmission and reproduction of this material in whole or part without prior written approval are prohibited. the binasal cannula was regarded as a more comfortable and time-saving device for delivery of oxygen therapy to hypoxic patients.

Metachronous Lung Cancer Developing after 11 Years of Chemo-Radiotherapy in a Patient with Non-Small Cell Lung Carcinoma

The success rate of the chemo-radiotherapy is low for the patients with lung cancer. The risk of second primary malignancy (SPM) in lung cancer survivors is also not well reported in the literature. A 77-year-old male patient was given chemo-radiotherapy (KT_RT) 11 years ago because of the low respiratory function of the non-small cell lung cancer in the right lung. He applied to hospital for complaining cough. NSCLC was diagnosed and doctors performed left lower lobectomy to the patient. We presented the case in which the patient was cured after chemo-radiotherapy which is an extremely rare condition and the development of a second tumor 11 years later.

Analysis of Age Distribution and Disease Presentation of 1269 Patients with Sarcoidosis

Objective While the incidence of sarcoidosis peaks between 20 and 39 years, it is comparatively low in elderly subjects. We sought to determine whether there are age-dependent differences in the demographic and laboratory characteristics of patients with sarcoidosis. Materials and Methods We retrospectively collected information from our database using the International Classification of Disease (ICD) diagnostic code D86 between 2008 and 2014. Patients were divided into three groups: 20-39 years old (Group 1), 40-59 years old (Group 2), and 60-80 years old (Group 3). Results A total of 3988 patients with code of D86 were included in the study. After the exclusion of non-eligible patients, the number of cases in Groups 1, 2, and 3 were 276, 641, and 352, respectively. The groups were compared according to demographic characteristics, ICD diagnostic codes, and laboratory parameters. The ratio of female patients was significantly higher in Group 3 than in Groups 1 and 2 (p=0.000). There was no difference in diagnostic codes of the ICD subgroups between groups (p=0.19). While the level of blood-urea nitrogen was significantly higher in Group 3 patients than in other groups (p=0.000), serum angiotensin-converting enzyme (ACE) values were found to be significantly low in Group 3 (p=0.010). The mean ACE values did not differ between females and males (50.8±39.3 and 59.1±45.5 mg/dL, respectively) (p=0.18). Conclusion The majority of patients with sarcoidosis were female in all age groups and pulmonary sarcoidosis was the most common presentation of the disease. Elderly patients (≥60 years) with sarcoidosis had lower serum ACE levels than younger patients.

Familial Sarcoidosis: An Analysis of Twenty-Eight Cases

INTRODUCTION Sarcoidosis is a multisystemic disease with unknown etiology; it is histologically characterized by non-caseating granulomas (1). Ethnic factors and genetics are thought to play a role in the etiology of the disease (2, 3). Although familial predisposition is known in sarcoidosis, its inheritance pattern has not yet been defined. In African-Americans, familial history appears to be an especially common risk factor for sarcoidosis (4). The first familial sarcoidosis case worldwide was identified in two sisters in Germany in 1923 (5). The prevalence of familial sarcoidosis has been reported to be 4.3% in Japan, 4.7% in Finland, 5.9% in the USA, and 17% in African-Americans (6, 7).

EEG in Sarcoidosis Patients Without Neurological Findings.

Sarcoidosis is a multisystem granulomatous disease affecting nervous system in 5% to 10% of patients. Magnetic resonance imaging (MRI) is accepted as the most sensitive method for detecting neurosarcoidosis. However, the most common findings in MRI are the nonspecific white matter lesions, which may be unrelated to sarcoidosis and can occur because of hypertension, diabetes mellitus, smoking, and other inflammatory or infectious disorders, as well. Autopsy studies report more frequent neurological involvement than the ante mortem studies. The aim of this study is to assess electroencephalography (EEG) in sarcoidosis patients without neurological findings in order to display asymptomatic neurological dysfunction. We performed EEG on 30 sarcoidosis patients without diagnosis of neurosarcoidosis or prior neurological comorbidities. Fourteen patients (46.7%) showed intermittant focal and/or generalized slowings while awake and not mentally activated. Seven (50%) of these 14 patients with EEG slowings had nonspecific white matter changes while the other half showed EEG slowings in the absence of MRI changes. We conclude that EEG slowings, when normal variants (psychomotor variant, temporal theta of elderly, frontal theta waves) are eliminated, may be an indicator of dysfunction in brain activity even in the absence of MRI findings. Hence, EEG may contribute toward detecting asymptomatic neurological dysfunction or probable future neurological involvement in sarcoidosis patients.

OSA with intertitial lung diseases

INTRODUCTION: The incidence of obstructive sleep apnea (OSA) in interstitial lung disease (ILD) has been reported at different frequencies in several studies. The aims of our study were to evaluate the frequency of OSA in ILD and to analyze the relationship between polysomnography (PSG) findings and pulmonary function, , parenchymal involve-ment, and Epworth Sleepiness Scale (ESS) scores. METHODS: ILD patients with parenchymal involvement were evaluated. All of the patients had pulmonary function tests (PFT ), chest X-ray, PSG, ESS scoring, and 6-minutes walking test(6MWT). RESULTS: We enrolled 52 patients to the study but study was completed with 47patients. 21 of 47 (44,6 % )were female and 26 of 47 (55,4 %) were male. 16 patients had the diagnosis of interstitial pulmonary fibrosis(IPF ),31 patients had other interstisial lung diseases (ILD). 82,9 % (n=39 )of participants had OSA. 10 of 39 had positional OSA and 6 had sleep related hypoxemia diagnosis.7 Patients had mild,8 had moderate and 8 had severe OSA of the remainers most of whom were in the moderate or severe group. Elapsing time of Spo2 below 89% during sleep was coherent to pulmonary involvement with diffuse radiological extensiveness. (p=0,03 ). 20 of 39 ILD patients having OSA had DLCO OSA was determined significantly higher in all ILD but especially in IPF patients (p=0,006 ) who had male predominance (p=0,04 )and older age (p=0,01 ) CONCLUSION: OSA is prevalent in patients with IPF. Formal sleep evaluation and polysomnography should be considered by primary care physicians in all patients with IPF.

Idiopathic Chronic Eosinophilic Pneumonia: Retrospective Analysis of 17 Cases from a Single Center in Turkey

Objective: Idiopathic chronic eosinophilic pneumonia (ICEP) is a rare eosinophilic lung disorder with an unknown etiology and is characterized by subacute or chronic respiratory and general symptoms, alveolar and/or peripheral eosinophilia, and the accumulation of eosinophils in the lungs. We aimed to present diagnostic test results and follow-up outcomes of 17 patients who were diagnosed with ICEP in our hospital in light of literature.

Venous hemangioma of the anterior mediastinum

Mediastinal hemangiomas are rare tumors, with an incidence of 0.5% or less. We herein present a case of venous hemangioma in the anterior mediastinum. A 61‐year‐old man was admitted to our hospital complaining of dyspnea. Computed tomography scan of the thorax showed a 2.5 × 3.2 × 2 cm mass in the anterior mediastinum. Using a median sternotomy approach, the tumor was completely removed. Pathological examination confirmed a venous hemangioma.

Clinical and pathological characteristics of patients with bronchial anthracosis and anthracofibrosis

Objective: To analyse the demographic, clinical, radiologic and pathologic features of the patients who underwent bronchoscopy for various diagnostic indications and detected anthracosis and/or anthracofibrosis. Material and Methods: A total of 1322 patients underwent bronchoscopy during a period of 15 month. Of these,only 107 patients with anthracosis and/or anthracofibrosis were included in the study. Results: The mean age of the patients was 66.12 ±12.57 years.57% of patients were male and 43% were female. 26.5% were current smokers, 22.5% were exsmokers and 51% were non-smokers. The most frequent occupation was found as beinghousewife (41.1 %).There was no occupational exposure at 10.7%of the patients. Biomass exposure was found in 88,5% of the patients because of the fuel used for heating or in the kitchen. Regarding geographical location,we found that 42.3% of patients were from Black Sea region,27% from East Anatolian Region.88.3% of the patients had complaints. Cough and dyspnea were the main complaints.Radiographic findings of the chest xray at presentation were variable as,follows: consolidation, atelectasia, pleural effusion and mass. Anthracofibrosis and deformation was seen at 21.6 % of the patients.Twelve patients were diagnosed as tuberculosis and 10 patients were diagnosed as lung cancer. Of these, 2 had smallcell cancer, 3 had squamouscell cancer, 4 had adenocarcinom and 1 had nontyped nonsmallcell ca. Conclusion: Indoor and occupational biomass exposure is frequently seen in our country. Anthracosis and/or anthracofibrosis detected cases should be evaluated and followed up closely especially in terms of tuberculosis and malignancy.