Metallurgical industry workers in developing countries are often exposed to high concentrations of dusts and fumes that affect pulmonary function. The aim of this cross-sectional study is to assess the prevalence and severity of chronic obstructive pulmonary disease (COPD), the prevalence of symptoms, as well as, the link between workplace air pollution and COPD. A standardized questionnaire was used to collect data about smoking and socioeconomic status, past history of pulmonary diseases, current respiratory symptoms, education, and other variables. We have identified and assessed all risk factors and also have performed measurements of dynamic pulmonary function in 459 subjects-90% of iron-steel and ferrochrome industry workers. The prevalence of COPD oscillated from 19.6% up to 25.7% while severity varied from mild to very severe. Symptoms: prevalence varied from 12.0% to 46.3% while relative risk for developing COPD was 2.1-5.5 that of non-industry controls. Exposure markers' concentrations: for total suspended particles (TSP) oscillated from 0.375-25.5 mg/m 3 , particulate matter (PM10) from 0.25 to 10.5 mg/m 3 , and sulfur dioxide from 0.19-18.69 mg/m 3. In majority of cases its average exceeded threshold limit values. Our conclusion was that COPD prevalence and its symptoms are high in the population studied, and that there exists a well established occupational risk between workplace air pollution and COPD.
Background/aim The development of bronchopleural fistula (BPF) remains the most severe complication of lung resection, especially after pneumonectomy. Studies provide controversial reports regarding the benefits of flap reinforcement of the bronchial stump (FRBS) in preventing BPF’s occurrence. Methods This is a retrospective cohort study of 558 patients that underwent lung resection in a 12-year period (from 2007 to 2018). Ninety patients (16.1%) underwent pneumonectomy. Patient follow-up period varied from 1 to 12 years. Results Out of 558 patients in this study, 468 (83.9%) underwent lobectomy, and the remnant underwent pneumonectomy. In 114 cases with lobectomy, only 24.4% had FRBS, meanwhile in 56 cases with pneumonectomy only 62.2% had FRBS. BPF occurred in 8 patients with lobectomy (1.7%) and in 10 patients with pneumonectomy (11.1%). Among cases with post-pneumonectomy BPF, 6 (10.7%) had FRBS performed, while no FRBS was performed among patients with post-lobectomy BPF, although these data weren’t statistically (p > 0.05). In 24 patients (20 lobectomies and 4 pneumonectomies) with lung cancer (10.4%) neoadjuvant treatment was performed, in which 20 patients underwent chemotherapy and 4 underwent radiotherapy. FRBS was applied in each of the above 24 operative cases, but only in 4 of them the BPF was verified. Conclusion The idea of enhancing the blood supply through the FRBS for BPF prevention has gain traction. Although FRBS has been identified as valuable and effective method in BPF prevention following lung resection, our study results did not support this evidence.
bThis study shows that the addition of a consensus 4-locus set of hypervariable mycobacterial interspersed repetitive-unitvariable-number tandem repeat (MIRU-VNTR) loci to the spoligotyping-24-locus MIRU-VNTR typing strategy is a wellstandardized approach that can contribute to an improvement of the true cluster definition while retaining high typeability in non-Beijing strains.T he worldwide implementation of 24-locus mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) analysis has deeply contributed to the development of molecular epidemiology in the tuberculosis (TB) field (1, 2). It is considered the international standard for molecular typing (3, 4), sometimes supplemented by spoligotyping (5). Despite its remarkable advantages in terms of technical simplicity, reproducibility, and portability compared with IS6110 restriction fragment length polymorphism (RFLP) analysis (6), several studies have highlighted the relative lack of resolution power of MIRU-VNTR analysis (7), particularly for highly clonal strain groups, such as the Beijing lineage (8, 9).The introduction of whole-genome sequencing (WGS) for Mycobacterium tuberculosis strain typing, due to its ability to discriminate closely related strains, appears to be the optimal solution for achieving the highest possible resolution (10, 11). However, the wider use of WGS for routine epidemiology is still hampered by cost, especially in resource-limited settings, and by the lack of standardization and established quality assurance programs (1) (12).A possible transitional strategy might involve the inclusion of additional MIRU-VNTR markers to the standard set. In this regard, four novel MIRU-VNTR loci, i.e., 1982, 3232, 3820, and 4120, have recently been suggested for the subtyping of clustered samples belonging to the highly homogeneous Beijing lineage (8). Nevertheless, scarce information is available on the possible contribution of these markers to the improvement of discrimination among non-Beijing M. tuberculosis lineages.Our study aimed at assessing the epidemiological value and technical feasibility of the inclusion of this 4-locus set of hypervariable loci for subtyping non-Beijing M. tuberculosis strains identified as clusters by the standard spoligotyping-24-locus MIRU-VNTR typing strategy.A total of 220 M. tuberculosis samples collected in Albania during the 2010 National TB Drug Resistance Survey (DRS), were genotyped by 43-spacer spoligotyping, as previously described (13), and by 24-locus MIRU-VNTR analysis using the GenoScreen MIRU typing kit (GenoScreen, Lille, France) (2).To infer lineages and clusters, a combined spoligotyping-VNTR analysis was carried out using the MIRU-VNTRplus Web application (http://www.miru-vntrplus.org) (14), requiring 100% identity (both in spoligotype and MIRU profile) for grouping samples.The recently developed consensus 4-locus set of hypervariable MIRU-VNTR markers, based on the 1982 (alias QUB-18), 3232 (alias QUB-3232), 3820, and 4120 loci, was used for further analysis on all ...
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