scholarly journals Early Signs of Atypical Pneumoconiosis in a Dental Technician in Italy: a Case Report

2021 ◽  
Author(s):  
Mara Maria Tiraboschi ◽  
Emma Sala ◽  
Matteo Ferroni ◽  
Andrea Tironi ◽  
Andrea Borghesi ◽  
...  
Keyword(s):  
Work Environment ◽  
Respiratory Symptoms ◽  
Chest Ct ◽  
Case Presentation ◽  
X Ray ◽  
Work Related ◽  
Dental Technician ◽  
Bronchial Aspirate ◽  
Advanced Stages ◽  
Dental Professionals

Abstract BACKGROUND Dental technicians are at high risk of pneumoconiosis, usually driven by inhalation of mixed dusts, including metals. An etiological diagnosis is not easy to be performed, particularly in advanced stages. CASE PRESENTATION We describe the case of an atypical early pneumoconiosis occurring in a 47-year-old dental technician who developed early respiratory symptoms shortly after beginning work. She described the work environment as dusty and lacking relevant primary prevention tools. A chest CT showed multiple peripheral pseudonodular lesions in both lower lobes; bronchoalveolar lavage (BAL) and bronchial aspirate (BAS) evidenced numerous macrophages with reflective metal bodies included into the cytoplasm, that at scanning electron microscopy coupled to Energy Dispersive X-Ray Analysis resulted Zirconium and Aluminum, whereas Tungsten (W) was localized outside cells. End of shift urinary concentrations of W were substantially raised as compared to pre-shift (1,1 vs 0,2 µg/L). CONCLUSIONS We concluded for diagnosis of early work-related pneumoconiosis due to abnormal occupational exposure to metals. The case demonstrates the need also for dental professionals to comply with industrial hygiene standards and to be monitored by occupational health physicians.

scholarly journals Early signs of pneumoconiosis in a dental technician in Italy: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mara Maria Tiraboschi ◽  
Emma Sala ◽  
Matteo Ferroni ◽  
Andrea Tironi ◽  
Andrea Borghesi ◽  
...  
Keyword(s):  
Work Environment ◽  
Respiratory Symptoms ◽  
Chest Ct ◽  
Case Presentation ◽  
X Ray ◽  
Work Related ◽  
Dental Technician ◽  
Bronchial Aspirate ◽  
Advanced Stages ◽  
Dental Professionals

Abstract Background Dental technicians are at high risk of pneumoconiosis, usually driven by inhalation of mixed dusts, including metals. An etiological diagnosis is not easy to be performed, particularly in advanced stages. Case presentation We describe the case of an early pneumoconiosis occurring in a 47-year-old dental technician who developed respiratory symptoms shortly after beginning work. She described the work environment as dusty and lacking relevant primary prevention tools. A chest CT showed multiple peripheral pseudonodular lesions in both lower lobes; bronchoalveolar lavage and bronchial aspirate evidenced numerous macrophages with reflective metal bodies included into the cytoplasm, that at scanning electron microscopy coupled to Energy Dispersive X-Ray Analysis resulted Zirconium and Aluminum, whereas Tungsten (W) was localized outside cells. End of shift urinary concentrations of W were substantially raised as compared to pre-shift (1.1 vs. 0.2 µg/L). Conclusions We concluded for diagnosis of early work-related pneumoconiosis due to abnormal occupational exposure to metals. The case demonstrates the need also for dental professionals to comply with industrial hygiene standards and to be monitored by occupational health physicians.

scholarly journals A case of pleuroperitoneal communication in which establishing a laparoscopic pneumoperitoneum was useful for the detection of a fistula

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Takehiko Manabe ◽  
Kenji Ono ◽  
Soichi Oka ◽  
Yuichiro Kawamura ◽  
Toshihiro Osaki
Keyword(s):  
Thoracic Surgery ◽  
Surgical Repair ◽  
Abdominal Cavity ◽  
Case Presentation ◽  
X Ray ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted ◽  
Pleuroperitoneal Communication ◽  
Small Pore ◽  
Chest X Ray

Abstract Background Pleuroperitoneal communication (PPC) is rarely observed, accounting for 1.6% of all patients who undergo continuous ambulatory peritoneal dialysis (CAPD). Although there have been several reports concerning the management of this condition, we have encountered several cases in which control failed. We herein report a valuable case of PPC in which laparoscopic pneumoperitoneum with video-assisted thoracic surgery (VATS) was useful for supporting the diagnosis and treatment. Case presentation The patient was a 58-year-old woman with chronic renal failure due to chronic renal inflammation who was referred to a nephrologist in our hospital to undergo an operation for the induction of CAPD. Post-operatively, she had respiratory failure, and chest X-ray and computed tomography (CT) showed right-sided hydrothorax that decreased when the injection of peritoneal dialysate was interrupted. Therefore, PPC was suspected, and she was referred to our department for surgical repair. We planned surgical treatment via video-assisted thoracic surgery. During the surgery, we failed to detect any lesions with thoracoscopy alone; we therefore added a laparoscopic port at her right-sided abdomen near the navel and infused CO2 gas into the abdominal cavity. On thoracoscopy, bubbles were observed emanating from a small pore at the central tendon of the diaphragm, which was considered to be the lesion responsible for the PPC. We closed it by suturing directly. Conclusions VATS with laparoscopic pneumoperitoneum should be considered as an effective method for inspecting tiny pores of the diaphragm, especially when the lesions responsible for PPC are difficult to detect.

scholarly journals OP0317-PARE THE CONTEMPORARY WORK-RELATED BURDEN OF DISEASE FOR PEOPLE WITH RHEUMATIC DISEASES IN GREECE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 193.1-194
Author(s):  
K. Koutsogianni ◽  
F. Asimakopoulou ◽  
E. Repa ◽  
I. Papadakis ◽  
M. Chatziioannou ◽  
...  
Keyword(s):  
Work Environment ◽  
Working Conditions ◽  
Rheumatic Diseases ◽  
Burden Of Disease ◽  
Work Life ◽  
Work Setting ◽  
Work Related ◽  
Flexible Schedule ◽  
Financial Income ◽  
State Pension

Background:EULAR recommendations emphasize the importance of suitable working conditions for people with Rheumatic diseases (RD). Thus, opportunities and choices at work need to be increased for people with rheumatic diseases. Conversely, the COVID-19 pandemic has challenged the working population and particularly those with chronic conditions, such as those with RD. However, there is still a lack of reliable data.Objectives:To depict contemporary real-life data regarding the work-related burden of disease among Greek patients with RD. To develop a White Paper with proposals to the State in order to facilitate people with rheumatic diseases to rejoin or be retained in the work force.Methods:A 24-item quantitative questionnaire was uploaded in the website and social media of REUMAZEIN to capture patients’ responses in respect to work life. The questionnaire was online accessible for a 45-day period (15/8-30/9/2020).Results:The responses of 503 adult people with RD (M/F/NA 94/408/1), were available for analysis. Their age was stratified in decades (18-20 0.6%,21-30 5.99%, 31-40 22.36%, 41-50 38.92%, 51-60 22.16% and over 60 9.58%); totally, 83.44% were in the “work-reproductive” period. The predominant RD types were RA 30.3%, SLE 22.8%, AS 20.2% and PsA 20.2%, respectively. Nearly 90% were on medication, namely 40% on biologics, 33% on methotrexate (as a monotherapy or combined therapy), 16.2% on steroids. A minority were either on alternative therapies (2.8%) or off medication (7.5%), respectively. Most of the people were still employed (72.9%) on a full-time schedule (57.7%) and 4.8% on a part-time one, due to their RD. The rest of them (27.1%) were out of work either due to RD (17%) or retirement (1.7%) or for unrelated to the RD reasons (8.4%). The main source of financial income was personal work (52.4%), followed by a family member support (31.1%), while 11% had either a state pension (8%) or a subsidy (3.2%). In respect to the daily house-keeping, half of them (59.3%) had a varying difficulty (mild 36.3%, severe 23%) and 0.8% considered themselves as “unable”. The diagnosis was mostly established (81%) prior to the work onset. Post-diagnosis, RD had not affected their working schedule in 47.2%, 17% continued to work with respective adaptations but 30% had quitted or resigned from their work 1-7 years later. RD was notified to the work environment by 85%. As for a compassionate work management, 46% reported no change, 28% an improved policy but 28% a worse one. The development of relative adaptations in the work setting (as chairs, devices, flexible schedule) were considered as favorite factors easing the work by 85%. 17% reported an employer’s knowledge on RD related working legislation, 43% the contrary and another 38.7% wished for a future employer’s awareness. Most of the participants (58.9%) had no personal information on this field but were eager to get it. The uneventful impact of RD on finding or keeping a job was registered by 77.4% and 66.9%, respectively. During COVID, most of the participants (53%) have not asked for an RD-related leave and only 24.2% chose to telework, a policy that raised mutual satisfaction in 19%. Of note, the working conditions have not mainly been altered (67%) after the end of the 1st quarantine.Conclusion:This study highlighted that although RD predominate in females, women are more willing to participate in such projects (F 90%). The financial income was mainly based on a personal or a family member work reimbursement (83%), while 11% depended on a state pension or subsidy. The majority has notified the RD to their work environment (85%) while another 85% considered as favorite factors easing the work, several adaptations in the work setting such as chairs, devices, flexible schedule etc. Interestingly, 60% of the participants were unaware of the beneficial legal work rights and nearly 70% of them believe that RD is an obstacle for employment or working maintenance. COVID has not dramatically impaired their work life although the use of teleworking should be strengthened.Disclosure of Interests:None declared.

Are work-related stressors associated with diagnosis of more advanced stages of incident breast cancers?

2007 ◽  
Vol 19 (3) ◽  
pp. 297-303 ◽  
Author(s):  
Naja Rod Nielsen ◽  
Claudia Stahlberg ◽  
Katrine Strandberg-Larsen ◽  
Tage S. Kristensen ◽  
Zuo-Feng Zhang ◽  
...  
Keyword(s):  
Breast Cancers ◽  
Work Related ◽  
Advanced Stages ◽  
Work Related Stressors

Discriminatory Aspects of Pre-employment Screening: Low-Back X-ray Examinations in the Railroad Industry

1979 ◽  
Vol 5 (3) ◽  
pp. 197-214
Author(s):  
Paul H. Rockey ◽  
Jane Fantel ◽  
Gilbert S. Omenn
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Screening Program ◽  
Job Applicants ◽  
Radiation Hazard ◽  
Low Back ◽  
Negative Consequences ◽  
X Ray ◽  
Work Related ◽  
Increased Risk

AbstractIn screening the majority of job applicants, most of this nation's railroads administer a low-back X-ray examination in an attempt to ascertain the likelihood that the applicant will sustain future work-related low-back pain or injury. Many applicants are rejected for employment on the basis of the X-ray findings. The railroads apparently perceive this screening program as a cost-effective means (1) of decreasing the incidence of compensation claims for work-related injuries, brought against the rail-roads under the Federal Employers' Liability Act (FELA), (2) of reducing the number of lost workdays resulting from low-back pain or injury, and (3) of protecting particularly susceptible workers from job-related hazards.The authors of this Article submit that low-back X-ray examinations are poor predictors of future low-back pain or injury. They assert that the railroads' use of such examinations misclassifies a substantial number of job applicants as being at increased risk for such pain or injury, and, in consequence, unfairly denies them employment. Furthermore, the authors claim, the screening program has other negative consequences. For example, applicants rejected for railroad employment on the basis of X-ray findings may as a result have difficulty finding jobs in other industries. In addition, they state, there is a potential radiation hazard to examinees. Moreover, both the railroads and those applicants accepted for employment may inappropriately be reassured by normal findings.On balance, the authors conclude, the screening program has a negative social value. The authors suggest that the program, in effect, erroneously labels many applicants as handicapped, and then denies them employment. Such persons might have legal recourse under federal and state statutes prohibiting employment discrimination against the handicapped.

Treating rare tumors with the assistance of the expert virtual consultation system: two cases of juvenile granulosa cell tumors

2021 ◽  
pp. 030089162110523
Author(s):  
Shushan Hovsepyan ◽  
Lusine Hakobyan ◽  
Armen Mkhitaryan ◽  
Monica Terenziani ◽  
Andrea Ferrari ◽  
...  
Keyword(s):  
Granulosa Cell ◽  
Limited Data ◽  
Blood Disorders ◽  
Cooperative Study Group ◽  
Case Presentation ◽  
Granulosa Cell Tumors ◽  
Rare Tumors ◽  
Consultation System ◽  
Limited Experience ◽  
Advanced Stages

Background: The lack of internationally recognized guidelines for very rare tumors, such as juvenile granulosa cell tumors (JGCTs), which are nonepithelial, unusual ovarian tumors, is a challenge for pediatric oncologists, especially in developing countries with limited resources and experience in treating rare tumors. Methods: We report clinical data of 2 girls with JGCTs treated at the Pediatric Cancer and Blood Disorders Center of Armenia with the assistance of the EXPeRT (European Cooperative Study Group for Pediatric Rare Tumors) international cooperation panel. Case presentation: Two girls (16 and 15 years old) with JGCTs of the ovaries, stage Ic, underwent surgery and, with consultation through an online advisory board ( http://vrt.cineca.it/ ), received 4 cycles of chemotherapy according to the PEI regimen (cisplatin, etoposide, ifosfamide). Conclusion: Very rare tumors, especially in advanced stages, have limited data and a low survival rate. International collaboration with the EXPeRT group is beneficial for physicians with limited experience and facilitates research in pediatric oncology.

Impact of considering non-occupational radiation exposure on the association between occupational dose and solid cancer among French nuclear workers

2017 ◽  
Vol 75 (3) ◽  
pp. 199-204 ◽  
Author(s):  
Lucie Fournier ◽  
Enora Cléro ◽  
Eric Samson ◽  
Sylvaine Caër-Lorho ◽  
Dominique Laurier ◽  
...  
Keyword(s):  
Occupational Exposure ◽  
Cancer Risk ◽  
Radiation Exposure ◽  
Cancer Mortality ◽  
Environmental Radiation ◽  
Occupational Radiation Exposure ◽  
X Ray ◽  
Work Related ◽  
The Mean ◽  
Occupational Radiation

ObjectivesThe French nuclear worker cohort allows for the assessment of cancer risk associated with occupational radiation exposure, but workers are also exposed to medical and environmental radiation which can be of the same order of magnitude. This study aims to examine the impact of non-occupational radiation exposures on the dose-risk analysis between occupational radiation exposure and cancer mortality.MethodsThe cohort included workers employed before 1995 for at least one year by CEA, AREVA NC or EDF and badge-monitored for external radiation exposure. Monitoring results were used to calculate occupational individual doses. Scenarios of work-related X-ray and environmental exposures were simulated. Poisson regression was used to quantify associations between occupational exposure and cancer mortality adjusting for non-occupational radiation exposure.ResultsThe mean cumulative dose of external occupational radiation was 18.4 mSv among 59 004 workers. Depending on the hypotheses made, the mean cumulative work-related X-ray dose varied between 3.1 and 9.2 mSv and the mean cumulative environmental dose was around 130 mSv. The unadjusted excess relative rate of cancer per Sievert (ERR/Sv) was 0.34 (90% CI −0.44 to 1.24). Adjusting for environmental radiation exposure did not substantially modify this risk coefficient, but it was attenuated by medical exposure (ERR/Sv point estimate between 0.15 and 0.23).ConclusionsOccupational radiation risk estimates were lower when adjusted for work-related X-ray exposures. Environmental exposures had a very slight impact on the occupational exposure risk estimates. In any scenario of non-occupational exposure considered, a positive but insignificant excess cancer risk associated with occupational exposure was observed.

scholarly journals Therapeutic effect of cycloserine combined with anti-tuberculosis drugs in the treatment of multidrug-resistant tuberculosis

2022 ◽  
Vol 20 (2) ◽  
pp. 419-424
Author(s):  
Yang Zhao ◽  
Mabin Si ◽  
Zhihui Li ◽  
Xiulei Yu
Keyword(s):  
Ct Scan ◽  
Multidrug Resistant ◽  
Chest Ct ◽  
Case Detection Rate ◽  
X Ray ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Before And After ◽  
Mdr Tb ◽  
Chest X Ray

Purpose: The present study analyzes the comprehensive therapeutic effect of cycloserine, in combination with anti-tuberculosis drugs using chest X-ray and chest CT (computed tomography) scan techniques. Methods: A total of 90 patients, diagnosed with multidrug resistant tuberculosis (MDR TB) were subjected to chest x-ray and CT scan before and after treatment in the two groups. Different views such as sagittal, coronal, lung window and multiplanar imaging of mediastinal window were taken. Some parameters such as case detection rate (CDR) in chest X-ray and CT scan and comprehensive curative effect were observed in two groups. Further, the changes in chest CT signs in addition to absorption of focus, cavity closure and changes in CT extra pulmonary signs were also observed. Results: The clinical profile of the patients and the course of disease were statistically insignificant (p > 0.05). Total effectiveness rate and case detection rate (CDR) values exhibited a significant difference between the groups (p < 0.05). Lung consolidation, nodules and cavities significantly improved in both groups before and after the treatment (p < 0.05). Both groups showed significant improvements in extrapulmonary signs in CT scan (p < 0.05) after the treatment. Conclusion: Based on the study outcomes, the CT scan method has good potentials for diagnosing and treating MDR TB at the early stages. Further, it can clarify the signs and outcomes of the disease at early stages, thus providing the medical fraternity a great opportunity to cure the disease.

scholarly journals Hoarseness of Voice as a Rare Presentation of Tuberculosis: A Case Report Study

2019 ◽  
Vol 7 (19) ◽  
pp. 3262-3264
Author(s):  
Taher Felemban ◽  
Abdullah Ashi ◽  
Abdullah Sindi ◽  
Mohannad Rajab ◽  
Zuhair Al Jehani
Keyword(s):  
Laryngeal Carcinoma ◽  
Incidental Finding ◽  
Chain Reaction ◽  
Rare Presentation ◽  
Case Presentation ◽  
X Ray ◽  
History Of ◽  
Chest X Ray ◽  
Polymerase Chain ◽  
Laryngeal Tuberculosis

BACKGROUND: Having hoarseness of voice as the first clinical manifestation of tuberculosis is rare. This atypical presentation causes some confusion since other more common conditions, such as laryngeal carcinoma, present similarly and might require more invasive tests to confirm the diagnosis. CASE PRESENTATION: A 38-year-old male presented to the otorhinolaryngology clinic with a four-month history of change in voice. Laryngoscopy demonstrated a right glottic mass, raising suspicion of laryngeal cancer. The computed tomography showed a mass and incidental finding of opacities in lung apices. Chest x-ray demonstrated findings suggestive of tuberculosis. Polymerase chain reaction and culture of sputum samples confirmed the diagnosis and the patient was started on anti-tuberculosis treatment. CONCLUSION: Despite accounting for only 1% of pulmonary tuberculosis cases and having a similar presentation to laryngeal carcinoma, we recommend considering laryngeal tuberculosis when evaluating hoarseness of voice in endemic areas.

scholarly journals Inverse T-shaped sternotomy as novel thoracoplasty for severe chest deformation and tracheal stenosis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hirofumi Tomita ◽  
Akihiro Shimotakahara ◽  
Naoki Shimojima ◽  
Hideo Ishihama ◽  
Miki Ishikawa ◽  
...  
Keyword(s):  
Intellectual Disabilities ◽  
Tracheal Stenosis ◽  
Respiratory Symptoms ◽  
Subacute Sclerosing Panencephalitis ◽  
Periventricular Leukomalacia ◽  
Stable Condition ◽  
Stage Iv ◽  
Brachiocephalic Artery ◽  
Case Presentation ◽  
Severe Motor

Abstract Background Patients with severe motor and intellectual disabilities often suffer from tracheal stenosis due to chest deformation and brachiocephalic artery compression, which sometimes leads to serious complications, such as dying spell and tracheobrachiocephalic artery fistula. We herein described our experience of performing a novel and simple thoracoplastic procedure combined with brachiocephalic artery transection in two patients with severe chest deformation and tracheal stenosis. Case presentation The patients were a 12-year-old female with cerebral palsy due to periventricular leukomalacia and a 21-year-old male with subacute sclerosing panencephalitis stage IV in the Jabbour classification following a laryngotracheal separation. Both patients showed severe chest deformation and symptoms of airway stenosis resulting in dying spells. The sternum was laterally transected between the manubrium and the sternal body, and a manubriotomy was performed longitudinally, ending with an inverse T-shaped sternotomy. Since the clavicle and the first rib remained attached to the halves of the divided manubrium, the sternum was allowed to be left open, resulting in improvement of the mediastinal narrowing and tracheal stenosis. Postoperative computed tomography (CT) showed that the distance between the halves of the manubrium was maintained at 10–11 mm, and that the mediastinal narrowing in both patients improved; the sternocervical spine distance increased from 20 mm to 22  and 13 mm to 16 mm, respectively. The patients’ tracheal stenosis below the sternal end of the clavicle and the manubrium and respiratory symptoms improved, and the patients are currently at home in a stable condition with no chest fragility and no upper limb movement disorder 1 year after surgery. Conclusions Our observations suggested that the inverse T-shaped sternotomy combined with brachiocephalic artery transection may relieve symptoms of tracheal stenosis due to severe chest deformation in patients with severe motor and intellectual disabilities.

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