ABSTRACT
BACKGROUND: Anthracosis and anthracofibrosis are attributed to the deposition of carbon particles along with fibrosis, adhesion, narrowing, and collapse. There has been no study on the characteristics of the pleural fluid in anthracosis. The present study analyzed the biochemical characteristics of pleural effusion in patients with pulmonary anthracosis. PATIENTS AND METHODS: The study is a cross-sectional study which included patients who were referred to the Afzalipour Hospital in Kerman, eastern Iran. Between April 2018 and October 2019, patients who had undergone bronchoscopy and were diagnosed with anthracosis and pleural effusion were selected through the census method. The characteristics of the pleural fluid were analyzed for protein, albumin, LDH, PH, Triglyceride, cholesterol, glucose, and cytology. Concomitant blood samples were examined for LDH, albumin, total protein, and glucose. After it was specified whether the pleural effusion was transudative or exudative, patients with lymphocyte-dominant exudative pleural fluid became candidates for thoracoscopy. RESULT: 106 patients (6.21 %) of 1705 patients had anthracosis and anthracofibrosis; 37 of these patients (34.9 %) had coexisting pleural effusion. 31 patients gave written informed consent for thoracentesis. The mean age of the patients was 76.48 ± 8.81. In addition, 67.74 % of the patients were female. Pleural effusion was transudative in 29 (93.54 %). Except for one case, all patients had diffuse anthracofibrosis and 67.74 % of the patients had a history of baking bread. CONCLUSION: According to the findings of this study, most cases had transudative lymphocyte-dominant pleural fluid with mostly diffuse anthracofibrosis. In addition, this condition is more prevalent in women, with a prevalence of approximately twice that of men.
ABSTRACT
BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is a major cause of mortality and morbidity throughout the world. Although the cause of COPD exacerbations can be bacterial or viral, use of antibiotics in exacerbations remains controversial. Procalcitonin serum level dramatically increases in bacterial infections, but not in viral or noninfectious febrile diseases. The aim of this study is to investigate whether the measurement of procalcitonin can be used to differentiate bacterial from non-bacterial causes of COPD exacerbations. MATERIALS AND METHODS: Sixty-eight COPD patients admitted to the emergency department of Masih Daneshvari Hospital due to COPD exacerbation were studied. At admission and before prescribing antibiotics, we obtained sputum and blood samples for sputum gram staining and culture and measured serum C-reactive protein and procalcitonin. All results were analyzed by SPSS software version 22. RESULTS: A total of 68 patients including 51 males and 17 females were studied. From 38.2% of patients a respiratory pathogen was isolated from their sputum and 23.5% of patients had elevated serum procalcitonin values. Using Fisher exact test, we found strong correlation between elevated procalcitonin levels above 0.5 ng/ml and sputum culture results (P < 0.01). We also found strong correlation between elevated procalcitonin levels above 0.5 ng/ml with abnormal C-reactive protein levels in a group of patients with positive sputum culture, using Fisher exact test (P <0.01). CONCLUSION: As sputum culture and microbiologic studies are time consuming and sometimes expensive, it seems that procalcitonin could be a reliable marker of bacterial infection in COPD exacerbation, although we recommend a larger study with larger sample to consolidate the finding of this study.
