Pleural fluid neopterin levels in tuberculous pleurisy.

OBJECTIVES: Neopterin is produced by stimulated macrophages under the influence of gamma interferon of lymphocyte origin. It is regarded as a biochemical marker of cell-mediated immune response. This study was designed to assess the diagnostic value of pleural fluid neopterin levels in tuberculous pleurisy in comparison with adenosine deaminase activity. DESIGN AND METHODS: Pleural fluid adenosine deaminase (ADA) activity and neopterin levels were measured in 16 patients with tuberculous pleurisy (TP) and 19 patients with malignant pleurisy (MP). ADA activity was determined by a colorimetric method, whereas neopterin levels were determined by a reversed-phase liquid chromatography technique. All values were given as median (min-max). RESULTS: The mean age was 45.43+/-20.39 years in the TP group and 60.42+/-11.02 years in the MP group (p=0.026). The median pleural fluid ADA activity was 51.75 U/L (3.50-62.40 U/L) in the TP group and was 2.30 U/L (1-8.20 U/L) in the MP group. The difference was statistically significant (p<0.001). The median pleural fluid neopterin levels were 13.15 nmol/L (1.86-59.50 nmol/L) and 2.44 nmol/L (0.92-27.60 nmol/L) in the TP group and the MP group, respectively (p=0.021). In order to evaluate the diagnostic value of pleural fluid neopterin concentrations, receiver-operating-characteristic curve analysis was performed. CONCLUSION: Pleural fluid neopterin concentration is significantly higher in TP when compared to MP, however when compared, its clinical use as a diagnostic marker is not valuable as ADA.

Across-shift lung function variation in cottonseed oil workers.

BACKGROUND: The effects of cotton dust on pulmonary function among workers employed in cotton-spinning mills are well known. However, little data exist on the prevalence of this disorder in 'non-textile' cotton industries, including cottonseed oil mills, where high levels of exposure to dust have been demonstrated. AIMS: This study was performed in order to determine the across-shift and across-week decline of FEV(1) and respiratory symptoms among workers in a cottonseed oil mill. METHODS: Sixty-six exposed and 48 unexposed workers of a cottonseed oil mill in Turkey were investigated by questionnaire and lung function test (LFT). LFTs were performed before and after shift on all the working days of the week. Acute airway response was defined as an across-shift decline in FEV(1) of 5% or more on the first working day. RESULTS: Smoking was the only risk factor for having respiratory symptoms. Acute airway response was more frequently observed in the exposed group as compared to the unexposed group (OR = 6.2, 95% CI = 2.3-16.7). The median across-shift decline in FEV(1) on the first day (120 ml) significantly improved on the following days (10, 50, 60 and -30 ml). CONCLUSION: Smoking appears to be the main risk factor for having respiratory symptoms. Cottonseed dust may cause an acute pulmonary function decline on the first working day, but not on the following days of the week. This decline is associated with respiratory symptoms in exposed workers.

Smoking habit among the relatives of patients with serious smoking-related disorders.

OBJECTIVE: To assess smoking habit and awareness of smoking as a potential cause of disease among relatives of patients with serious smoking-related disorders. DESIGN AND SETTING: A survey using a face-to-face interview-assisted questionnaire at the Ege University Hospital between October 1998 and March 1999. SUBJECTS: We interviewed 242 relatives of patients with serious smoking-related disorders, of whom 56.6% were female and 43.4% male. The mean age was 41.2 +/- 13.2 years (15-75). One relative per patient completed the questionnaire and the chosen relative took care of the patient during his illness and accompanied him during hospital visits. MAIN OUTCOME MEASURES: We assessed the relationship between smoking habit and the perception of smoking as a potential cause of illness by the relatives. Statistical analysis was performed by chi(2) test. RESULTS: The prevalence of smoking among relatives was 37.6% [49.5% males (n = 105) and 28.5% females (n = 137), p = 0.0003] and an additional 20.2% were ex-smokers. Of the relatives, 86.4% knew that the diseases were directly related to smoking, and 37.8% of these people were smokers and 21.5% ex-smokers. Only 7.2% reported that they had quit smoking after being influenced by the diseases of the patients. The decision to quit was statistically unrelated to the awareness of smoking as the cause of disease. Of all the relatives, 69.2% had tried to quit at least once, 86.8% considered quitting, and 89.0% considered using professional help for smoking cessation. CONCLUSION: The findings show that even though this group of smokers is aware of the harmful effects of smoking they cannot successfully quit smoking; however, the majority reconsider quitting and receiving professional help.