relation between NYHA classification and cardiopulmonary exercise test in evaluating disability in workers with CHF

Evaluation of cardiac impairment is challenging since it involves an often difficult assessment of subjective complaints. We studied 25 workers with Chronic Heart Failure [CHF] to assess the degree of impairment and correlate our results with clinical findings, echocardiographic findings and resting ventilatory functions. Full medical history was taken and they were subjected to, physical examination, ECG, CBC, chest x-rays, echocardiography, resting ventilatory function tests and cardiopulmonary exercise test. This study showed that all the parameters of the resting ventilatory pulmonary function were reduced. The results of cardiopulmonary exercise tests showed lowered VO2max and oxygen pulse, more or less normal HRR and elevated VE/ VCO2 at rest and maximum exercise.Correlation coefficient between exercise parameters and both the grade of dyspnea according to NYHA classification and echocardiographic findings were not statistically significant. It is important to evaluate cardiopulmonary responses to exercise in workers with CHF besides NYHA classification and Echo grading for proper assessment of impairment and disability and follow-up of the treatment. Preoperative and postoperative cardiopulmonary exercise tests are recommended for all patients indicated for cardiac operation

Environment and occupation as risk factors in a group of mesothelioma patients

This work studies the effect of environmental and occupational exposures on a group of mesothelioma patients from the National Cancer Institute in Cairo, Egypt, as well as their effects on certain pulmonary function tests. From October 1997 through April 1998, twenty-two mesothelioma patients were interviewed and examined. Information was collected about sociodemographic characteristics. Also, the subjects' environmental and occupational exposures were investigated. These patients were diagnosed pathologically by biopsy from the tumor site. Computerized Tomography scanning of chest was done to all patients. Pulmonary function tests including ventilatory functions, diffusion tests and blood gases were done to all patients. Fifty nine percent of are living in El Maasara near to the large factory using asbestos cement. I.e. [residential exposure]. On trying to find out the effect of combined risk factors [occupation and environment] on the occurrence of the disease, it was found that those patients with combined risks complain at an earlier age period with a mean of [40 +/- 11.66] years in comparison to the other groups with no statistically significant difference. Patients with occupational and environmental risks had the least occupational duration than the other groups and the difference was statistically significant. By C T scan, 63.64% of cases had right pleural effusion and 36.63% had left pleural effusion. Ventilatory function tests showed that 45.45% of cases had restrictive pattern, 36.37% had combined restriction arid obstruction, and 18.18% had an obstructive pattern. Diffusion test using carbon monoxide [DL co] showed diffusion defects in 80.95% of the examined group., Blood gases show a decrease in the Pa O2 with a mean of [74.73% - 9.15]. Although we are able to identify clear residential exposure to asbestos in 60% of cases, other cases [40%] could be exposed to other risk factors as viruses, erionite and ionizing radiation

Evaluation and follow up of true and pseudo cholinesterase enzymes in workers exposed to pesticides

This present study was designed to evaluate the level of true and pseudo cholinesterase, establish a baseline or reference level and follow up of the level of enzymes during exposure, in workers applying and formulating anticholinesterase pesticides [organophosphates and carbamates], aiming at designing a comprehensive programming for prevention of pesticide intoxication. This study included thirty four workers exposed to organophosphate and carbamate compounds. Twenty five workers, present in one of the major companies formulating pesticides in, EL Nasr Company for Intermediate chemicals in Abou Rawash, and nine workers, present in the Kalioubia branch of the Agricultural Credit and Developmental Bank. The exposed group was matched with twenty control males with the same average age and socioeconomic status. Both exposed and control subjects were subjected twice to: [1] A questionnaire including present, past and family history. [2] Complete medical and neurological examination. [3] Biochemical analysis including: a -The level of true and pseudo cholinesterase. b - Liver function tests. c - Complete blood picture. Determination of cholinestrase is done by using a new technique [organophosphate kits] in the field using only a drop of blood from the thumb of the exposed workers. [Non invasive]. The study showed a statistically significant difference between the mean and standard deviation of the baseline values of true cholinesterase, also there is a statistically significant depression in both cholinesterases after exposure. The percentage of decrease of true and pseudo cholinesterase from baseline values were 28.06% and 21.61% respectively. The results of liver function tests showed a statistically nonsignificant decrease in the level of proteins and albumin and a statistically significant increase in the level of SGPT and alkaline phosphatase enzymes. Hematological findings revealed a statistically significant decrease in the level of hemoglobin. Identification of high risks population, determination of cholinesterase baseline for all workers before starting exposure, periodic surveillance at least once each season