Echocardiographic findings of pericardial involvement in patients with malignant pleural mesothelioma with a history of environmental exposure to asbestos and erionite.

OBJECTIVE: The aim of the present study was to evaluate the pericardial involvement in patients with malignant mesothelioma caused by exposure to different minerals. METHODOLOGY: Forty-two patients (mean age of 52 +/- 12 years) with malignant mesothelioma were examined with transthoracic echocardiography. Thirty-three (78.9%) patients had a history of environmental exposure to asbestos and nine (21.4%) had a history of environmental exposure to erionite. RESULTS: In 19 (45.2%) patients with malignant pericardial mesothelioma, pericardial involvement was determined by echocardiography. The other 23 (54.8%) patients had no pericardial involvement. Pericardial effusion was detected in nine (64.3%) patients and pericardial effusion was small in six (14.3%) patients, moderate in one (2.4%) patient and large in two patients. Thickening of the pericardium was observed in eight (19%) patients. In another two (7.1%) patients pericardial calcification was observed. Among the 33 patients who had been exposed to asbestos, 15 (45.5%) had pericardial involvement, and among the nine patients with a history of exposure to erionite, four (44.4%) had pericardial involvement. There was no difference in terms of pericardial involvement in different stages of the tumour (P > 0.05). CONCLUSIONS: Pericardial involvement is commonly seen in patients with malignant mesothelioma. Among patients exposed to asbestos or zeolite there was no difference in terms of pericardial involvement. Furthermore, pericardial involvement was not related with the stage of the tumour.

Prevalence of asthma and allergic diseases in Turkish university students in Ankara.

An epidemiological study was performed in the students of Hacettepe University from various parts of Turkey to find the prevalence of asthma and allergic diseases and search for geographical differences in Turkey. A questionnaire related with symptoms of asthma and allergic diseases was distributed to 4600 students and filled by 4331 students (1884 males, 43.5%-2447 females, 56.5%). Periodic prevalence of asthma or allergic disease during the last 12 months was 13.5%. The prevalence of awakening with chest tightness and/or feeling of retrosternal pressure in the last month was 2%. The current prevalences of the seasonal and perennial rhinoconjunctivitis, flexural eczema, food and drug intolerances, pollen and pet animal hypersensitivities were 6.4%, 1.6%, 0.8%, 4.5%, 3%, 5.2%, and 1% respectively. Drug, food, and pollen hypersensitivities were distinctively more common in the females, whereas wheezing was more common in males. Wheezing, wheezing associated shortness of breath, nocturnal asthma for the last 1 and 12 months were more common in the students from eastern region than those from western region. The highest asthmatic attack rate was reported in the eastern region. Seasonal rhinitis and pollen allergy were more prevalent in central region than northern region. No significant geographical difference was observed regarding the drug and pet hypersensitivities. Our study has shown the importance of asthma and allergic diseases as a public health problem. Explanation of the observed geographical differences aware for further studies.

Environmental fibrous zeolite (erionite) exposure and malignant tumors other than mesothelioma.

We studied the mortality in three villages in the Cappadocian region of Central Anatolia, Karain, Tuzköy, and Sarihidir, which were exposed to fibrous zeolite (erionite), a known carcinogen more potent than the amphibole asbestos. Between 1970 and 1994, there were 305 deaths in Karain, and 177 (58%) were cancer related, including 150 (49.2%) malignant pleural mesothelioma, seven (2.3%) malignant peritoneal mesothelioma, and six (1%) gastroesophageal carcinoma. Four deaths (1.3%) from lung cancer included two nonsmoking females. There were three cases (1%) of leukemia and six of other malignancies (1.9%). Between 1980 and 1994, there were 519 deaths in Tuzköy (T) and Sarihidir (S) (T = 432, S = 87). Of these, 257 were cancer related, and included 120 cases of malignant pleural mesothelioma and 64 cases of malignant peritoneal mesothelioma. Intraabdominal carcinoma was noted in 29 patients and 14 patients had lung cancer (four of whom were nonsmoking women). There were five cases of gastroesophageal cancer, five deaths due to leukemia, and 16 cases of various malignancies. These mortality figures support the hypothesis that erionite fibers cause cancer other than mesothelioma and lung cancer. Mineralogic analyses of the tissues should be performed to demonstrate this relationship.