BACKGROUND: Indonesia is among countries with a high incidence of multi drug-resistant tuberculosis (MDR-TB) globally. In this study, we aim to determine the prevalence of silico-tuberculosis among TB patients and to investigate the association of radiographic silicosis and the role of drug supervisor as well as other socio-clinical factors, in the development of MDR-TB in Indonesia. METHODS: A hospital-based study in West Java among 148 MDR-TB patients (case) and 164 drug-sensitive/DS-TB patients (control) was conducted. Chest x-rays were evaluated by two radiologists and one NIOSH B reader according to the ILO Classification. Face-to-face interviews were conducted using structured questionnaires to collect patients' information, including the task of drug supervisor. RESULTS: Findings indicate that supportive drug supervisor reduces the risk of developing MDR-TB, but silicosis showed no significant association. Nevertheless, in this study we found that 17 cases (5.4%) had silico-tuberculosis mostly exhibited as ILO profusion 3; predominated by q shape, 52.9% with large opacities and dominated by size A. Other factors significantly associated with the risk of developing MDR-TB were marital status, low income, longer traveling time to hospital, unsuccessful previous treatment and suffering drug side effects. CONCLUSION This study reveals that one of preventive healthcare strategy to protect TB patients from developing MDR-TB is supportive drug supervisor. While, the development of MDR-TB was not significantly influenced by silicosis; however, there is a notable prevalence of silicosis as determined by chest radiography, highlighting the critical need for dust control, occupational hygiene, and health screening for high-risk populations.
Indonesia/epidemiology* ; Humans ; Silicosis/diagnostic imaging* ; Male ; Tuberculosis, Multidrug-Resistant/etiology* ; Middle Aged ; Adult ; Female ; Prevalence ; Risk Factors ; Aged ; Antitubercular Agents/therapeutic use*

Objective: To evaluate the right ventricular function using two-dimensional speckle tracking echocardiography (2-D STE) and analyze the associated risk factors of right ventricular dysfunction in patients with silicosis. Methods: All 104 patients with silicosis treated in the Department of Occupational Medicine and Toxicology in Beijing Chao-Yang Hospital, Capital Medical University from May 2021 to September 2022 were enrolled in this study in October 2022. The clinical information of patients such as general data, arterial blood gas analysis and pulmonary function test were collected. The right ventricular function of patients was evaluated by 2-D STE-derived right ventricular free wall longitudinal strain (RVFWLS) and conventional echocardiographic-derived parameters, including right ventricular fractional area change (RVFAC), tricuspid annular plane systolic excursion (TAPSE) and doppler tissue imaging-derived tricuspid lateral annular systolic velocity (S'), respectively. Based on their RVFWLS, the patients were divided into right ventricular dysfunction group and normal right ventricular function group. Risk factors for right ventricular dysfunction in patients with silicosis were analyzed using binary logistic regression analysis. Results: A total of 104 silicosis patients were enrolled, with aneverage age (65.52±11.18) years old, among whom including 57 cases diagnosed with stage Ⅰ/Ⅱ silicosis and 47 cases diagnosed with stage Ⅲ silicosis. 26 (25.00%) patients concurrent right ventricular dysfunction. The abnormal rates of RVFAC, TAPSE and S' in patients were 16.35% (17 cases), 21.15% (22 cases) and 6.73% (7 cases), respectively. The RVFAC and TAPSE in right ventricular dysfunction group were lower than those in normal right ventricular function group, and the incidence of pulmonary arterial systolic pressure ≥36 mmHg was higher than that in normal right ventricular function group (P<0.05). Logistic regression analysis showed that arterial partial pressure of oxygen (OR=0.932, 95%CI: 0.885-0.981, P=0.007) was the protective factor, and the forced expiratory volume in 1 second (FEV(1)) /forced vital capacity (FVC) ratio<70% (OR=5.484, 95%CI: 1.049-28.662, P=0.044) and stage Ⅲ silicosis (OR=6.343, 95%CI: 1.698-23.697, P=0.007) were the risk factors for silicosis patients concurrent right ventricular dysfunction. Conclusion: The incidence of right ventricular dysfunction is higher in patients with stage Ⅲ silicosis than that in patients with stage Ⅰ/Ⅱ silicosis. Using 2-D STE can help the early detection of silicosis with right ventricular dysfunction. Hypoxemia, airflow limitation and the stage Ⅲ silicosis are the risk factors for silicosis patients concurrent right ventricular dysfunction.
Humans ; Middle Aged ; Aged ; Ventricular Dysfunction, Right/etiology* ; Ventricular Function, Right ; Echocardiography ; Risk Factors ; Silicosis/diagnostic imaging*

Humans ; Lung ; Pneumoconiosis/diagnostic imaging* ; Retrospective Studies ; Silicosis/diagnostic imaging* ; Tomography, X-Ray Computed

OBJECTIVETo investigate the value of tissue Doppler imaging (TDI) in the diagnosis of right ventricular hypertrophy in patients with silicosis complicated by chronic pulmonary heart disease.

METHODSA total of 50 cases of silicosis complicated by chronic pulmonary heart disease in our hospital underwent conventional electrocardiography (ECG) and TDI. The detection rates for right ventricular hypertrophy by two methods were compared.

RESULTSOf 50 cases of silicosis complicated by chronic pulmonary heart disease, 19 were diagnosed with right ventricular hypertrophy by ECG, with a detection rate of 38.0%; 29 were diagnosed with right ventricular hypertrophy by TDI, with a detection rate off 58.0%. Statistical analysis suggested that TDI leads to a significantly higher detection rate for right ventricular hypertrophy in patients with silicosis complicated by chronic pulmonary heart disease (χ² = 4.006, P = 0.036).

CONCLUSIONBoth TDI and ECG can be used for detecting right ventricular hypertrophy in patients with silicosis complicated by chronic pulmonary heart disease, but the detection rate is higher when TDI is employed. In addition, ECG cannot directly reflect the increase in pulmonary artery pressure. Therefore, TDI is more suitable for the diagnosis of right ventricular hypertrophy in patients with silicosis complicated by chronic pulmonary heart disease and provides a strong diagnostic basis for the clinical treatment of silicosis complicated by pulmonary heart disease.

Chronic Disease ; Echocardiography, Doppler ; Electrocardiography ; Humans ; Hypertension, Pulmonary ; complications ; Hypertrophy, Right Ventricular ; complications ; diagnostic imaging ; Pulmonary Heart Disease ; Silicosis ; complications ; diagnostic imaging

In order to investigate the fine distinction of the tomographic images and the dominant anatomic distributions, we carefully reviewed and analyzed the features and predominant anatomic distribution of forty-nine pneumoconiosis patients with confirmed diagnosis on multi-detector row CT (MDCT). It was found that the round and small opacity p and irregular small opacity were mostly shown in the MDCT features of pneumoconiosis, while the large opacity and progressive massive fibrosis (PMF) were less frequently depicted in the MDCT. Distributions of round and small opacity and irregular small opacity in the six lung lobes were significantly different (P < 0.01). The most common p opacity was significantly seen in the upper and lower left lungs as well as in the upper right lung's opacity was in the upper left lung as well as lower left and right lungs. The large opacity commonly distributed in upper left and right lungs, while the PMF was often shown in both of two lungs. The results demonstrated that the MDCT could be an effective modality for detecting tiny lesions and anatomic distribution of pneumoconiosis, and it would be helpful for early diagnosis and accurate staging of the pneumoconiosis disease.
Adult ; Aged ; Early Diagnosis ; Female ; Humans ; Lung ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Multidetector Computed Tomography ; methods ; Pneumoconiosis ; diagnostic imaging ; pathology ; Silicosis ; diagnostic imaging ; pathology

Adult ; Aged ; Electrocardiography ; Humans ; Male ; Middle Aged ; Radiography, Thoracic ; Silicosis ; complications ; diagnostic imaging

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Silicosis ; diagnostic imaging ; Tomography, Spiral Computed

Adult ; Aged ; Humans ; Male ; Middle Aged ; Radiographic Image Enhancement ; Silicosis ; diagnostic imaging ; Tomography, X-Ray Computed ; methods

Adult ; Humans ; Male ; Middle Aged ; Mining ; Molybdenum ; Pulmonary Ventilation ; physiology ; Radiography, Thoracic ; Respiratory Function Tests ; Silicosis ; diagnostic imaging ; physiopathology

Adult ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Biopsy ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Lung ; diagnostic imaging ; metabolism ; pathology ; Lung Diseases, Interstitial ; metabolism ; pathology ; Silicosis ; diagnostic imaging ; metabolism ; pathology ; Tomography, X-Ray Computed ; Vimentin ; metabolism