Asian Intensive Reader of Pneumoconiosis program: examination for certification during 2008-2020.

This study examined physicians' participation and performance in the examinations administered by the Asian Intensive Reader of Pneumoconiosis (AIR Pneumo) program from 2008 to 2020 and compared radiograph readings of physicians who passed with those who failed the examinations. Demography of the participants, participation trends, pass/fail rates, and proficiency scores were summarized; differences in reading the radiographs for pneumoconiosis of physicians who passed the examinations and those who failed were evaluated. By December 2020, 555 physicians from 20 countries had taken certification examinations; the number of participants increased in recent years. Reported background specialty training and work experience varied widely. Passing rate and mean proficiency score for participants who passed were 83.4% and 77.6 ± 9.4 in certification, and 76.8% and 88.1 ± 4.5 in recertification examinations. Compared with physicians who passed the examinations, physicians who failed tended to classify test radiographs as positive for pneumoconiosis and read a higher profusion; they likely missed large opacities and pleural plaques and had a lower accuracy in recognizing the shape of small opacities. Findings suggest that physicians who failed the examination tend to over-diagnose radiographs as positive for pneumoconiosis with higher profusion and have difficulty in correctly identifying small opacity shape.

Clinical characteristics and quality of life of persistent symptoms of COVID-19 syndrome in Indonesia.

Introduction: Coronavirus disease-2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) manifests in a broad clinical spectrum. COVID-19 survivors report various symptoms up to several months after being infected. The purpose of this study was to determine the prevalence of persistent COVID-19 syndrome in Indonesia, the factors that influence the incidence, and the quality of life. Methods: This was a cross-sectional study with an online questionnaire conducted in January 2021. Inclusion criteria were: adult Indonesian citizens who had recovered from COVID-19, and were confirmed negative by RT-PCR of nasal swabs or had undergone an isolation period for a minimum of 14 days. Data analysis was performed by the Chi-square test, followed by multivariate analysis with the backward likelihood ratio method. Results: From a total of 385 respondents, 256 (66.5%) experienced persistent COVID-19 syndrome. The most prevalent symptoms were fatigue (29.4%), cough (15.5%), and muscle pain (11.2%). Of the five aspects of quality of life, the most commonly reported aspects were pain/discomfort and anxiety/depression. The risk of persistent COVID-19 syndrome was significantly higher in subjects with older age, comorbidities, higher clinical severity, previous treatment in hospital, presence of pneumonia, and those who had required oxygen therapy. In the multivariate analysis, the most influential factor for the incidence of persistent COVID-19 syndrome was pneumonia (aOR 2.31, 95% CI 1.29-4.11, p<0.002). Conclusions: The prevalence of the persistent COVID-19 syndrome in Indonesia was high, which affects the quality of life of COVID-19 survivors. Pneumonia was the main factor that influenced the incidence of persistent COVID-19 syndrome. Further research with a larger sample size and a longer study time is recommended to control COVID-19 and its impact on the health and quality of life of COVID-19 survivors.

Inter-observer agreement and accuracy in classifying radiographs for pneumoconiosis among Asian physicians taking AIR Pneumo certification examination.

This study examined inter-observer agreement and diagnostic accuracy in classifying radiographs for pneumoconiosis among Asian physicians taking the AIR Pneumo examination. We compared agreement and diagnostic accuracy for parenchymal and pleural lesions across residing countries, specialty training, and work experience using data on 93 physicians. Physicians demonstrated fair to good agreement with kappa values 0.30 (95% CI: 0.20-0.40), 0.29 (95% CI: 0.23-0.36), 0.59 (95% CI: 0.52-0.67), and 0.65 (95% CI: 0.55-0.74) in classifying pleural plaques, small opacity shapes, small opacity profusion, and large opacities, respectively. Kappa values among Asian countries ranging from 0.25 to 0.55 (pleural plaques), 0.47 to 0.73 (small opacity profusion), and 0.55 to 0.69 (large opacity size). The median Youden's J index (interquartile range) for classifying pleural plaque, small opacity, and large opacity was 61.1 (25.5), 76.8 (29.3), and 88.9 (23.3), respectively. Radiologists and recent graduates showed superior performance than other groups regarding agreement and accuracy in classifying all types of lesions. In conclusion, Asian physicians taking the AIR Pneumo examination were better at classifying parenchymal lesions than pleural plaques using the ILO classification. The degree of agreement and accuracy was different among countries and was associated with background specialty training.

Urinary Cotinine and Nicotine Dependence Levels in Regular Male Electronic Cigarette Users.

OBJECTIVE: Found in plasma, urine, and saliva, cotinine can be used as a biomarker for nicotine in electronic cigarette (e-cig) users. Nicotine is addictive and causes dependence. Thus, it becomes a problem in smoking cessation programs. This study aimed to determine the relationship between urinary cotinine (UCot) and nicotine dependence levels in regular male e-cig users. MATERIALS AND METHODS: This cross-sectional study consecutively included regular male e-cig users and nonsmokers. All subjects were interviewed and had their UCot levels measured using an enzyme-linked immunosorbent assay method. The regular e-cig users completed the Penn State Nicotine Dependence Index questionnaire. RESULTS: This study recruited 71 males aged 18-45 years divided into e-cig users and non-smokers group. The predominating characteristics in e-cig users are as follows: 23 males (67.6%) aged <30 years, the highest education of senior high school 25 (73.5%) and 25 (73.5%) subjects had occupation. The UCot levels among the e-cig users in the non-dependency group were lower than that of the medium-high dependency group (P = .008). The median value for UCot level in the regular e-cig users was higher than that of the non-smoker group (276.11 [58.01-284.15] ng/mL vs 5.21 [4.65-23.72] ng/mL, P < .001). Factors influencing the UCot levels of the e-cig users were age (P = .041), nicotine level of the e-cig liquid (P = .013), and the flavor of the e-cig liquid (eg, menthol or non-menthol; P = .040). CONCLUSION: UCot and nicotine dependence levels in the regular male e-cig users were significantly related. Nicotine dependence was found in 76.5% of the regular male e-cig users. The UCot levels in the e-cig users were significantly higher than in the non-smokers.

Adenocarcinoma of the lung with positive epidermal growth factor receptor mutation in pregnancy.

Lung cancer during pregnancy is a rare condition. We report a case of 28-year-old nonsmoker female, who was admitted to our hospital with massive left pleural effusion in the 21st week of gestation. Chest radiograph showed total left hemithorax opacity with contralateral mediastinal deviation. Pleural biopsy and cytological examination of pleural fluid revealed adenocarcinoma invasion with positive epidermal growth factor receptor mutation status. Cesarean section was performed at 32 weeks of pregnancy, and targeted therapy was given to this patient after delivery. Computed tomography of the thorax showed a mass lesion in the left hemithorax with liver metastases. Unfortunately, the patient died 10 days after delivery.

Comparison of lung function values of trained divers in 1.5 ATA hyperbaric chamber after inhaling 100% oxygen and regular air: a crossover study.

INTRODUCTION: Diving is an activity performed in more than 1 atmosphere absolute pressure (ATA) either underwater or in a hyperbaric chamber. We aimed to compare lung function values of trained divers in 1.5 ATA hyperbaric chambers after inhaling 100% oxygen and regular air. METHODS: This experimental study with crossover design involved 18 trained divers in 1.5 ATA hyperbaric room, which is equivalents to a 5-meter depth. The eighteen subjects as the supplementation group, using oro-nasal mask, inhaled 100% oxygen for 30 minutes followed by a one-day washout period. The subjects were then crossed-over into control group inhaling only regular air for 30 minutes. Lung function test was performed before and after supplementation. RESULTS: In eighteen subjects inhaling regular air, there was a significant difference (p < 0.05) in FEV1/FVC, PEF, FEF25, FEF50, and FEF75. Whereas in eighteen subjects inhaling 100% oxygen, significant difference (p < 0.05) was observed not only in FEV1/FVC, PEF, FEF25, FEF50 and FEF75, but also in FEV1. CONCLUSIONS: There were significant differences in lung function, especially in dynamic volume of trained divers in 1.5 ATA hyperbaric chamber after inhaling 100% oxygen and regular air for 30 minutes; while there were no significant differences in lung capacity (VC and FVC) in the both groups. Lung function returned to normal following supplementation with a 1-day washout period.

Spirometry findings among drug users in the Indonesian National Narcotics and illicit drug Bureau Rehabilitation Center.

BACKGROUND: The increasing prevalence of drug user in Indonesia is affecting the health sectors. The lungs health were affected by the use of the illicit drug. However, lung function among drug users is still unclear. METHODS: This descriptive-analytic study involves 144 drug users who met the inclusion criteria. Chest X-ray was performed to identify the subject with pulmonary tuberculosis to exclude from the study. Subjects were then undergone spirometry test and interviewed using questionnaires. RESULTS: One hundred and forty-four subjects were included in this study. One hundred and twenty-one (84.03%) were male and 128 subjects showed normal lung function. Proportion of abnormal spirometry was 10.4% (n = 15). The restriction was found in ten subjects, and obstruction was found in four subjects. There was significant correlation between the ratio of forced expiratory volume in 1 s to forced vital capacity (FEV1/FVC) and age (P = 0.000; r = -0.454, moderate correlation), time of using cannabis (P = 0.01; r = -0.345, weak correlation), time of using methamphetamine inhalation (P = 0.004; r = -0.25, weak correlation), duration of using heroin injection (P = 0.025; r = -0.337, weak correlation), time of using cigarette (P = 0.000; r = -0.365, weak correlation), and the amount of cigarette consumption/day (P = 0.04; r = -0.238, weak correlation). CONCLUSION: This study found that there was a weak correlation between declined FEV1/FVC with a time of smoking, the amount of cigarette consume per day, time of cannabis inhalation, time of methamphetamine inhalation, and time of heroin injection.