Peri Arbak

Comparison of serum CA 19.9, CA 125 and CEA levels with severity of chronic obstructive pulmonary disease.

Objective: To investigate serum levels of CA 19.9, CA 125 and carcinoembryonic antigen (CEA) in patients with different stages of chronic obstructive pulmonary disease (COPD). Patients and Methods: Fifty-three consecutive patients (50 males, 3 females, mean age 67.6 ± 10.1 years) with COPD were included in this study. Serum levels of CA 19.9, CA 25 and CEA were determined by the chemiluminescent immunometric method. Based on values obtained from pulmonary function tests, the patients were divided into 3 groups: moderate (21), severe (18) and very severe (14). Data were analyzed with a Kruskal-Wallis one-way analysis of variance test and Mann-Whitney U test. Results: The mean serum levels of CA 125 and CA 19.9 were significantly higher in patients with very severe COPD (p = 0.013 and p = 0.017, respectively) than in patients with severe and moderate COPD (p < 0.05). Patients with cor pulmonale had significantly high mean serum levels of CEA, CA 19.9 and CA 125 (p < 0.05). Patients using a long-acting β-agonist and theophylline showed significantly higher mean serum levels of CA 125 than patients who were not (p < 0.05). Conclusion: Data showed that the increased serum tumor markers in patients with COPD might be due to the severity of COPD, medication and cor pulmonale.

Reduced plasma fetuin-A levels in patients with obstructive sleep apnoea

To the Editors:nnObstructive sleep apnoea syndrome (OSAS) has been increasingly linked to cardiovascular disease. fetuin-A is an inhibitor of vascular calcification and an anti-inflammatory cytokine. We tested the hypothesis that plasma levels of fetuin-A are decreased in patients with OSAS.nnWe studied 119 patients with OSAS and 35 controls. Participants were recruited and studied at the sleep unit at Hospital Universitari Son Espases, Palma de Mallorca, Spain. Serum levels of fetuin-A, glucose, triglycerides, cholesterol, high-density lipoprotein (HDL) cholesterol, creatinine, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma glutamyltransferase (GGT) were determined.nnPlasma fetuin-A levels were significantly lower in patients with OSAS than in controls (mean±sd 368±66 versus 445±53 ng·mL−1, p=0.015). In multivariate analysis, fetuin-A levels were independently associated with OSAS (p=0.034). OSAS is associated with reduced levels of fetuin-A and fetuin-A could be one of the contributing factors for the development of cardiovascular complications in OSAS patients.nnThere is evidence that patients with OSAS have an increased risk for cardiovascular diseases [1]. The mechanisms underlying this association are unclear but candidate mechanisms include endothelial dysfunction, oxidative stress, systemic inflammation and metabolic dysregulation [2]. Vascular calcification has recently received much attention because of its relationship with cardiovascular disease [3, 4]. Chronic inflammation may promote vascular calcification and recent studies have demonstrated a relationship between vascular calcification and endothelial dysfunction [5, 6].nnFetuin-A is a circulating protein mostly synthesised in the liver [7, 8] that is known to be an important inhibitor of vascular calcification and a potent anti-inflammatory cytokine [8–10]. Fetuin-A is considered to be a mediator that links chronic inflammation to cardiovascular diseases [11]. However, previous studies investigating the role of fetuin-A in patients with cardiovascular disease …

Look closer to welders’ lung

IntroductionnWelding produces miscellaneous gases and particles that has various impact on respiratory system and long term exposure may result welderslung. The aim of this study is to describe the radiological findings of welders and make an awereness for welders radilogical findings.nnnMaterials and MethodsnThe clinical and radiological findings of welders who had hospital applications with respiratory symptoms between January 2010-January 2017 were evaluated retrospectively.nnnResultnA total of 16 male welders with mean age 37 ± 8 years had the mean duration of welding occupation 12 ± 7 years. The most common symptoms were coughing (87%), sputum production (63%) and dyspnoea (63%).Thirteen welders were working in shipyards and 3 in construction business and other workplaces. Three (19%) patients had rhonchi on physical examination and these patients had decreased FEV1/FVC values below 70% on spirometry. Poorly-defined centrilobular micronodules that were not clearly visible on chest radiographs observed on thorax high resolution computed tomography. Bronchoscopy was performed to 7 patients. Iron-positive pigment granules and ferruginous bodies were revealed in 3 patients bronchoalveolar lavage.nnnConclusionsnWelders chest X-ray deserve a closer look. In pulmonary radiology, there may be radiographical findings ranging from small ill defined nodules to groundglass opacites. Physcians should look more careful to welders chest X-ray and incase of suspicious findings best can be detected on high HRCT. An awareness for the radiological findings will also reduce interventional procedures in these patients hereby, occupational history must be included in daily practice of physicians.