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Possible Role of Chest Ultrasound in the Assessment of Costo-Phrenic Angle Lesions Prior to Medical Thoracoscopy: A Retrospective Pilot Case Series. Diagnostics (Basel) 2022; 12:diagnostics12112587. [PMID: 36359431 PMCID: PMC9689413 DOI: 10.3390/diagnostics12112587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/17/2022] [Accepted: 10/20/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Pleural malignancy (PM) and malignant pleural effusion (MPE) represent an increasing burden of diseases. Costo-phrenic angle (CPA) could be involved by malignant small nodularities or thickenings in the case of MPE. The aim of this study was to evaluate whether lung ultrasound (LUS), performed prior to medical thoracoscopy (MT), could detect pleural abnormalities in CPA not easily detectable by chest computed tomography scan (CCT). Methods: Patients suspected for PM and MPE were retrospectively recruited. Patients underwent both LUS examination with a linear array and CCT prior to diagnostic medical thoracoscopy. LUS pathological findings in CPA were compared with pathological findings detected by CCT. Findings were confirmed by subsequent MT, the gold standard for PMs. Results: Twenty-eight patients were recruited. LUS detected 23 cases of pleural abnormalities in CPA. CCT was detected 12 pleural abnormalities. Inter-rater agreement between the two techniques was minimal (Cohen’s Kappa: 0.28). MT detected PMs in CPA in 22 patients. LUS had a sensitivity of 100% and specificity of 83%. CCT had a sensitivity of 54% and specificity of 100%. A better sensitivity for CCT was reached analysing only all abnormalities > 5 mm (64.3%). Conclusions: LUS examination, in the case of PMs, could change and speed up diagnostic workup.
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2
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Sandal A, Ecin SM, Koyuncu A, Durhan G, Akpinar MG, Demir AU, Cöplü L. Environmental asbestos exposure and nonmalignant pleural findings: a retrospective evaluation of a five-year chest CT repository. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2021; 77:734-743. [PMID: 34817303 DOI: 10.1080/19338244.2021.2004987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This registry-based case-control study aimed to assess the association between asbestos deposits in the birthplace and/or residence and nonmalignant pleural findings, namely pleural plaques (PPs) and pleural thickening (PT), on chest CT scans. In total, 39,472 CT scans obtained over five years in a tertiary referral hospital in Ankara, Turkey, were evaluated. Cases involving patients with PP (n = 537), PT (n = 263), PP&PT (n = 69), and controls (n = 543) from the same study base without those conditions were included. Each case group was compared to controls using unconditional logistic regression. The presence of asbestos deposits in the district of birthplace (adjusted OR = 2.13, 95% CI: 1.35-3.37) and both birthplace and residence (aOR = 4.32, 95% CI: 2.26-8.27) was significantly related to the PPs. As the importance of environmental asbestos exposure in Turkey continues, future prospective studies could contribute to developing screening strategies.
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Affiliation(s)
- Abdulsamet Sandal
- Occupational Diseases Clinic, Ankara Gazi Mustafa Kemal Occupational and Environmental Diseases Hospital, Ankara, Turkey
| | - Seval Müzeyyen Ecin
- Occupational Diseases Clinic, Mersin City Training and Research Hospital, Mersin, Turkey
| | - Adem Koyuncu
- Occupational Diseases Clinic, Ankara Kecioren Sanatorium Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Gamze Durhan
- Department of Radiology, Hacettepe University, Ankara, Turkey
| | | | - Ahmet Ugur Demir
- Department of Chest Diseases, Hacettepe University, Ankara, Turkey
| | - Lütfi Cöplü
- Department of Chest Diseases, Hacettepe University, Ankara, Turkey
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3
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Joean O, Kayser MZ, Valtin C, Ewen R, Gottlieb J. Characteristics and clinical implications of pleural effusions after lung transplantation: A retrospective analysis of 195 thoracocenteses in 113 patients. Clin Transplant 2021; 35:e14267. [PMID: 33615592 DOI: 10.1111/ctr.14267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/30/2021] [Accepted: 02/17/2021] [Indexed: 12/20/2022]
Abstract
Despite advances in lung transplantation (LTx), morbidity, and mortality are high. We hypothesized that pleural effusions requiring thoracocentesis lead to poor outcomes after LTx. We performed a single-center retrospective analysis of thoracocenteses after initial hospital discharge in LTx patients between March 2008 and September 2020 to identify risk factors, etiologies, and outcomes. Of the 1223 patients included, 113 patients (9.2%) required a total of 195 thoracocenteses. The cumulative incidence of thoracocentesis was 10.6% at 1 year and 14.2% at 5 years after transplantation. We observed a bimodal distribution of pleural effusion onset with a threshold at 6 months. Late-onset effusions were mostly of malignant or cardiac origin. We observed a high rate of nonspecific effusions (41.5%) irrespective of the timepoint post-transplantation. Patients with late-onset effusions had significantly lower survival compared to a matched controlled group (HR 2.43; 95% CI (1.27-4.62). All pulmonary function parameters were significantly decreased in patients requiring thoracocentesis compared to matched controls. Male sex and re-transplantation were risk factors for pleural effusions. In conclusion, pleural effusions requiring thoracocentesis occur frequently in LTx patients and lead to a reduced long-term allograft function. Late-onset effusions are associated with a lower survival.
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Affiliation(s)
- Oana Joean
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany.,Biomedical Research in End-stage and Obstructive Lung Disease, Member of the German Center for Lung Research, Hannover, Germany
| | - Moritz Z Kayser
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany.,Biomedical Research in End-stage and Obstructive Lung Disease, Member of the German Center for Lung Research, Hannover, Germany
| | - Christina Valtin
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
| | - Raphael Ewen
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
| | - Jens Gottlieb
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany.,Biomedical Research in End-stage and Obstructive Lung Disease, Member of the German Center for Lung Research, Hannover, Germany
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4
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Araki T, Washko GR, Schiebler ML, O'Connor GT, Hatabu H. The Framingham Heart Study: Populational CT-based phenotyping in the lungs and mediastinum. Eur J Radiol Open 2020; 7:100260. [PMID: 32984450 PMCID: PMC7495061 DOI: 10.1016/j.ejro.2020.100260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 08/24/2020] [Indexed: 01/22/2023] Open
Abstract
The Framingham Heart Study (FHS) is one of the largest and established longitudinal populational cohorts. CT cohorts of the FHS since 2002 provided a unique opportunity to assess non-cardiac thoracic imaging findings. This review deals with image-based phenotyping studies from recent major publications regarding interstitial lung abnormalities (ILAs), pulmonary cysts, emphysema, pulmonary nodules, pleural plaques, normal spectrum of the thymus, and anterior mediastinal masses, concluding with the discussion of future directions of FHS CT cohorts studies in the era of radiomics and artificial intelligence.
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Affiliation(s)
- Tetsuro Araki
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - George R Washko
- Department of Pulmonology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Mark L Schiebler
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | | | - Hiroto Hatabu
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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5
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West GH, Sokas RK, Welch LS. Change in prevalence of asbestos-related disease among sheet metal workers 1986 to 2016. Am J Ind Med 2019; 62:609-615. [PMID: 31168870 DOI: 10.1002/ajim.22998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND A medical screening program began in 1986 for sheet metal workers exposed to asbestos, primarily while working alongside insulators applying spray-on asbestos materials, a practice banned in 1973. Exposure continues during maintenance, renovation, and repair. METHODS Radiographic abnormalities among 26 397 sheet metal workers examined from 1986 to 2016 were analyzed by year of entry into the trade. Logistic regression was used to examine risk factors for parenchymal and pleural abnormalities among the overall study population and among the subcohort who entered the trade after 1973. RESULTS Prevalence of parenchymal disease was 17.4% for those starting work before 1950 compared with 0.8% for those starting work after 1973 (adjusted prevalence odds ratio [pOR] = 26.65, 95% confidence interval [CI] = 18.46-38.46). For each calendar year after 1973, entering the trade 1 year later was associated with an estimated 12.7% decreased odds of acquiring asbestos-related disease (adjusted pOR = 0.873, 95% CI = 0.832-0.916). CONCLUSION Sheet metal workers who began work after the US implemented environmental and occupational regulations develop asbestos-related disease at much reduced rates, consistent with regulatory projections made for nonmalignant asbestos-related disease by the Occupational Safety and Health Administration at the time. Cancer remains a concern among this cohort, and lung cancer screening recommendations should consider year of entry into the trade. This study highlights the importance of regulatory intervention and of continued surveillance.
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Affiliation(s)
- Gavin H. West
- CPWR—The Center for Construction Research and TrainingSilver Spring Maryland
| | - Rosemary K. Sokas
- CPWR—The Center for Construction Research and TrainingSilver Spring Maryland
- Department of Human Science, School of Nursing and Health StudiesGeorgetown UniversityWashington District of Columbia
| | - Laura S. Welch
- CPWR—The Center for Construction Research and TrainingSilver Spring Maryland
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6
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Tamura A, Funakoshi M, J-P NA, Hasegawa K, Ishimine A, Koike A, Tannai N, Fujii M, Hattori M, Hirano H, Nakamura K, Funakoshi M, Satomi K, Yamashita Y, Fukuchi Y, Suganuma N. Potential asbestos exposure among patients with primary lung cancer in Japan. J Occup Health 2018; 60:236-245. [PMID: 29563365 PMCID: PMC5985347 DOI: 10.1539/joh.2017-0199-oa] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective: To investigate the extent of asbestos exposure among patients with primary lung cancer in Japan. Methods: A retrospective estimation of potential asbestos-exposed individuals, as determined by the presence of pleural plaques identified on chest computed tomography (CT), was conducted on 885 pathologically confirmed primary lung cancer patients (mean age 71.3 years, 641 males). All patients were diagnosed at 29 hospitals across Japan between 2006 and 2007. Since these hospitals belong to the Japan Federation of Democratic Medical Institutions (MIN-IREN), an organization of medical institutions for workers, the study subjects may contain a higher proportion of workers than the general population. Results: Pleural plaques were identified in 12.8% of subjects (15.8% in males and 4.9% in females), consisting exclusively of cases older than 50 years. They were found most frequently on the chest wall pleura (96.5%), followed by the diaphragm (23.9%) and mediastinum (9.7%). Calcifications were seen in 47 cases (41.6%). The highest prevalence of pleural plaques was seen among workers from construction-related fields (37.7%). No distinct lung cancer histology was observed in patients with pleural plaques. Coexistence of pleural plaques and small irregular opacities was observed in 2.5% of subjects. Conclusion: In a Japanese population representing more workers than general Japanese, 12.8% of patients with primary lung cancer may have experienced asbestos exposure at some time in the past. Special medical attention should be paid to individuals with a history of employment in construction-related occupations, as workers in this sector showed the highest prevalence of pleural plaques.
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Affiliation(s)
- Akihiko Tamura
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Kyushu Institute for Social Medicine
| | - Mitsuhiko Funakoshi
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Kyushu Institute for Social Medicine
| | - Naw Awn J-P
- Department of Environmental Medicine, Kochi Medical School, Kochi University
| | - Kichinori Hasegawa
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Chiba Kensei Hospital
| | - Atsushi Ishimine
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Kin-ikyo Chuo Hospital
| | - Akio Koike
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Saitama Cooperative Hospital
| | - Noriyuki Tannai
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Tachikawa Sogo Hospital
| | - Masami Fujii
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Shiba Hospital
| | - Makoto Hattori
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Jouhoku Hospital
| | - Harukazu Hirano
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Koyo Seikyo Hospital
| | - Kenji Nakamura
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Osaka Institute of Social Medicine
| | - Masanobu Funakoshi
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Shioe Clinic
| | - Kazuhiko Satomi
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Mizushima Kyodo Hospital
| | - Yoshihito Yamashita
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Kokubu Seikyo Hospital
| | | | - Narufumi Suganuma
- Department of Environmental Medicine, Kochi Medical School, Kochi University
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LeMasters G, Lockey JE, Hilbert TJ, Levin LS, Burkle JW, Shipley R, Perme C, Meyer CA, Rice CH. A 30-year mortality and respiratory morbidity study of refractory ceramic fiber workers. Inhal Toxicol 2017; 29:462-470. [DOI: 10.1080/08958378.2017.1394931] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Grace LeMasters
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - James E. Lockey
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Department of Internal Medicine (Pulmonary Division), University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Timothy J. Hilbert
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Linda S. Levin
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jeff W. Burkle
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Ralph Shipley
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Charles Perme
- Department of Radiology, King’s Daughters Medical Center, Ashland, KY, USA
| | - Cristopher A. Meyer
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Carol H. Rice
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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8
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Araki T, Hunninghake GM, Christiani DC, Hatabu H. Author reply: 'Response to: Pleural abnormalities in the Framingham Heart Study: prevalence and CT image features' by Araki et al. Occup Environ Med 2017; 75:77-78. [PMID: 29122924 DOI: 10.1136/oemed-2017-104823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 10/18/2017] [Indexed: 11/04/2022]
Affiliation(s)
- Tetsuro Araki
- Department of Imaging, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Gary M Hunninghake
- The Pulmonary and Critical Care Division, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - David C Christiani
- Department of Environmental Health, Harvard T.H Chan School of Public Health, Boston, Massachusetts, USA
| | - Hiroto Hatabu
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
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9
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Franzblau A, Antao VC, Pinheiro G, Larson T. Response to: 'Pleural abnormalities in the Framingham Heart Study: prevalence and CT image features' by Araki et al. Occup Environ Med 2017; 75:77. [PMID: 29055889 DOI: 10.1136/oemed-2017-104640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 10/02/2017] [Indexed: 11/04/2022]
Affiliation(s)
- Alfred Franzblau
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Vinicius C Antao
- Healthcare Research Institute, Hospital for Special Surgery, New York City, New York, USA
| | - Germania Pinheiro
- Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry, Atlanta, Georgia, USA
| | - Theodore Larson
- Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry, Atlanta, Georgia, USA
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