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Article: Prediction of malignancy in mediastinal lymph nodes during endobronchial ultrasound: A comparative validation study.

Şafak Alıcı, Nur / Alıcı, İbrahim Onur

Turk gogus kalp damar cerrahisi dergisi

2023 Volume 31, Issue 1, Page(s) 63–68

Abstract: ... by Shafiek et al., Alici et al., and Canada Lymph Node Score (CLNS). Endobronchial ultrasoundguided ... Diagnostic performances of proposed tools were quite remarkable. Among them, Alici algorithm had a higher ...

Abstract	Background: In this study, we aimed to compare the diagnostic performances of three existing prediction tools in visually identifying a malignant lymph node. Methods: Between April 2016 and January 2021, a total of 827 lymph nodes of 259 patients (211 males, 48 females; mean age: 61.1±7.2 years; range, 41 to 79 years) who underwent endobronchial ultrasound procedure for diagnosis and/or staging of lung cancer and diagnosis of mediastinal lymphadenopathy of unknown origin were retrospectively analyzed. This external validation study was designed to compare the diagnostic yields of the prediction tools developed by Shafiek et al., Alici et al., and Canada Lymph Node Score (CLNS). Endobronchial ultrasoundguided transbronchial needle aspiration results and predictions were compared to gold-standard tool. Results: Overall, endobronchial ultrasound-guided transbronchial needle aspiration had a sensitivity, specificity, positive and negative predictive value, and accuracy of 95.6%, 100%, 100%, 97.6%, and 98.4%, respectively. Diagnostic performances of proposed tools were quite remarkable. Among them, Alici algorithm had a higher sensitivity and negative predictive value, which were matched by excellent specificity and positive predictive value offered by CLNS ≥3 and Shafiek tool. The area under the curve value of CLNS ≥3 was higher than Shafiek tool and CLNS ≥2. Conclusion: Conventional prediction tools relying on simple real-time sonographic features were found to be consistent by the means of diagnostic performance in this external validation dataset. Despite being inferior to cytology, their superior performance was proven with defined individual strengths and weaknesses.
Language	English
Publishing date	2023-01-30
Publishing country	Turkey
Document type	Journal Article
ISSN	1301-5680
ISSN	1301-5680
DOI	10.5606/tgkdc.dergisi.2023.22276
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Article ; Online: Risk Factors for Mortality in Denim Sandblasters Silicosis: Selecting Candidate for Lung Transplantation.

Nadir Öziş, Türkan / Şafak Alıcı, Nur / Alıcı, İbrahim Onur / Ergün, Dilek / Avcı, Emine / Hoca, Nevin Taci / Yılmaz, Ömer Hınç

Turkish thoracic journal

2021 Volume 22, Issue 1, Page(s) 50–56

Abstract: Objective: This study aimed to review the risk factors for silicosis together with survival analysis and a perspective for lung transplantation with data from a single center.: Material and methods: We reviewed the medical records of denim ... ...

Abstract	Objective: This study aimed to review the risk factors for silicosis together with survival analysis and a perspective for lung transplantation with data from a single center. Material and methods: We reviewed the medical records of denim sandblasters who were referred to our center between January 2006 and December 2011 and evaluated 219 patients with a history of denim sandblasting with a minimum follow-up period of 5 years until 2016. We analyzed several personal and occupational features, together with functional and radiologic data. Results: Of the 219 denim sandblasters, 107 (49%) had been diagnosed with silicosis. In the logistic regression analysis, the duration of exposure was the only independent risk factor for the development of silicosis, indicating a 9% increased risk of silicosis for every month of exposure (p<0.001; odds ratio 1.09; 95% confidence interval 1.050-1.132). Of the patients, 7 (3%) died. A forced expiratory volume in the first second of <44% and a forced vital capacity of <47% were associated with an increased risk of mortality. Mortality was significantly higher in the international labor office category 3 patients, and 5-year survival rates of patients with A, B, and C lung opacities were 88%, 67%, and 25%, respectively. Conclusion: Silicosis still kills young workers. Severe radiologic involvement and decreased lung volumes are related to mortality, and lung transplantation is the only therapeutic option.
Language	English
Publishing date	2021-01-01
Publishing country	Turkey
Document type	Journal Article
ISSN	2149-2530
ISSN (online)	2149-2530
DOI	10.5152/TurkThoracJ.2021.19151
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Article: Three-year' experience of a tertiary level occupational diseases clinic.

Çımrın, Arif / Demiral, Yücel / Alıcı, Nur Şafak / Coşkun Beyan, Ayşe

Tuberkuloz ve toraks

2020 Volume 67, Issue 4, Page(s) 285–291

Abstract: Introduction: We aimed to evaluate the diagnosis of patients who applied on the first three years of our clinic, in order to contribute to the state of occupational diseases (OD) in Turkey.: Materials and methods: The study is a cross-sectional study, ...

Title translation	Üç yıllık meslek hastalıkları kliniği deneyimi.
Abstract	Introduction: We aimed to evaluate the diagnosis of patients who applied on the first three years of our clinic, in order to contribute to the state of occupational diseases (OD) in Turkey. Materials and methods: The study is a cross-sectional study, between November 2013 and December 2016, 862 subjects were accepted for the evaluation. Gender, age, application ways, the reason of referral, workplace, exposure time and possible risks for the patients were evaluated through a file examination. Result: Total of 708 (82.1%) was male and 154 (17.9%) were female. The mean age of the subjects was 38.3 ± 7.7 years; the mean term of employment was 126.6 ± 87.3 (1-420) months. The most common cause of referral was the suspicion of occupational pulmonary diseases (64.3%) with 554 workers. 435 workers (50,6%) were diagnosed to have an OD, 78 workers (9.0%) were diagnosed with work-related diseases. The most common diagnoses of OD; 169 (38.9%) pneumoconiosis, 71 (16.3%) occupational asthma, 38 (8.7%) cervical disc hernia, 24 (5.5%) lumbar disc hernia, 24 (5.5%) hearing loss, 19 (4.3%) cubital/carpal tunnel, and 15 (3.4%) workers have lead intoxication. Conclusions: Dust, chemicals, ergonomic risks and noise still remain as important occupational health risks in Turkey. It is seen that the existing occupational diseases monitoring system is inadequate to identify and manage the health problems of the workers. An effective and comprehensive occupational disease monitoring system should be established and legal regulations should be planned.
MeSH term(s)	Adult ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Occupational Diseases/diagnosis ; Occupational Diseases/epidemiology ; Occupational Exposure/statistics & numerical data ; Occupational Health/statistics & numerical data ; Pneumoconiosis/diagnosis ; Pneumoconiosis/epidemiology ; Turkey/epidemiology ; Workplace/statistics & numerical data
Language	English
Publishing date	2020-02-12
Publishing country	Turkey
Document type	Journal Article
ZDB-ID	2468802-2
ISSN	0494-1373
ISSN	0494-1373
DOI	10.5578/tt.68897
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Article: Welder's lung and brain MRI findings in manganese-exposed welders.

Alici, Nur Şafak / Nadir Öziş, Türkan / Çeliker, Gülay / Birlik Aktürk, Tülin

La Medicina del lavoro

2022 Volume 113, Issue 6, Page(s) e2022049

Abstract: Background: Biomarkers of manganese (Mn) exposure and manganism are poorly understood. Blood Mn levels are often used to assess exposure, while brain Mn accumulation may be demonstrated by pallidal hyperintensity at magnetic resonance imaging (MRI). Mn- ... ...

Abstract	Background: Biomarkers of manganese (Mn) exposure and manganism are poorly understood. Blood Mn levels are often used to assess exposure, while brain Mn accumulation may be demonstrated by pallidal hyperintensity at magnetic resonance imaging (MRI). Mn-containing electrodes used in manual metal arc welding may be associated with the welder's lungs. Methods: A cross-sectional study was set up to compare T1 intensity in basal ganglia at MRI and Mn blood levels in subjects with or without pneumoconiosis. Clinical, radiological, pulmonary function and laboratory parameters were assessed among 154 welders referred to our hospital for suspected pulmonary pathology. Results: The study group included 123 male welders with pneumoconiosis (79.9%) and 31 welders without pulmonary damage (20.1%). The cases without pneumoconiosis were younger (38.5±6.6 vs 42.1±7.1, p=0.012). Cases with pneumoconiosis had blood lower Mn levels [13.5 (10-21)] as compared to those without pneumoconiosis [18.5 (7.8- 34)], p=0.035. In the same groups, the cases with high blood Mn levels were 49 (39.8%) and 18 (58.1%) p= 0.052, respectively. Brain MRI hyperintensity was found in 86 (55.8%) subjects with welder's lung 63 (51.2) but also in 23 (74.2) individuals without welder's lung. MRI hyperintensity in basal ganglia was significantly related to high blood Mn (p<0.005). Conclusion: This is the first study evaluating blood Mn levels of welders and their correlation with pulmonary and neurological effects. Poor working conditions may be associated with exposure to Mn and fibrogenic fumes leading to chronic lung diseases and hyperintensity in brain MRI suggesting Mn accumulation.
MeSH term(s)	Humans ; Male ; Manganese/adverse effects ; Cross-Sectional Studies ; Lung ; Magnetic Resonance Imaging ; Brain/diagnostic imaging
Chemical Substances	Manganese (42Z2K6ZL8P)
Language	English
Publishing date	2022-12-07
Publishing country	Italy
Document type	Journal Article
ZDB-ID	123678-7
ISSN	0025-7818
ISSN	0025-7818
DOI	10.23749/mdl.v113i6.13143
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Article ; Online: COVID-19 as an occupational disease

Nur Safak Alici / Ayse Coskun Beyan / Cebrail Simsek

Eurasian Journal of Pulmonology, Vol 22, Iss 4, Pp 90-

2020 Volume 100

Abstract: During the pandemic of coronavirus in our country and in the world, workers and particularly health-care personnel, the frontline fighters, are known to develop the disease and even die due to exposure in the process. According to international ... ...

Abstract	During the pandemic of coronavirus in our country and in the world, workers and particularly health-care personnel, the frontline fighters, are known to develop the disease and even die due to exposure in the process. According to international definitions and our national legislation, if health-care personnel are infected while they are performing their job and at their workplace, the condition will be defined as an occupational accident and the disease as an occupational disease. Accident at work and occupational diseases are preventable health conditions. Reporting is mandatory. The first thing coming to mind as a result of such reporting is to acquire compensation and similar rights. Yet, the main purpose of notification of an accident at work and occupational diseases should be recording and identifying which conditions cause health issues in which sectors, and planning interventions for prevention. This review paper evaluates the pandemic of coronavirus disease 2019, the identification of conditions required for occupational disease diagnosis, especially in health-care personnel, the necessary procedures following diagnosis, the return to work recommendations, and the preventive strategies especially for health-care personnel from the view of occupational exposure.
Keywords	covid-19 ; corona virus ; occupational diseases ; Internal medicine ; RC31-1245 ; covid19
Subject code	360
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
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Article: Pneumoconiosis in different sectors and their differences in Turkey.

Alıcı, Nur Şafak / Çımrın, Arif / Coşkun Beyan, Ayşe

Tuberkuloz ve toraks

2017 Volume 64, Issue 4, Page(s) 275–282

Abstract: Introduction: Pneumoconiosis which is one of the ancient diseases, still affects many workers throughout the world despite "existing" control programs. We add data from a single center reviewing risk factors for pneumoconiosis; evaluate functional and ... ...

Title translation	Türkiye'de sektörlere göre pnömokonyoz ve farklı özellikleri.
Abstract	Introduction: Pneumoconiosis which is one of the ancient diseases, still affects many workers throughout the world despite "existing" control programs. We add data from a single center reviewing risk factors for pneumoconiosis; evaluate functional and radiological findings in different sectors. Materials and methods: We reviewed medical records of patients diagnosed with pneumoconiosis who were admitted to our center between the years 2013 and 2015. Several personal and occupational features, together with functional and radiologic data, were collected. Result: 60 were young males. Twenty-four of the cases (39.3%) worked at dental technician, 24 cases (39.3%) were ceramic workers, 5 cases (8.2%) were sandblasters, 2 cases (3.3%) were welders, 3 cases (4.9%) were miners, and 3 cases (4.9%) were marble cutters. The sectors in which the exposure started at the earliest ages were dental technicians and sandblasters, while the shortest working time was in sandblasting. The dental technicians were younger than the ceramic workers at the age of diagnosis (Kruskall-Wallis p= 0.003). The exposure time of the sandblasters was significantly shorter, especially than the ceramic workers (Kruskall-Wallis p= 0.002). The cases have been referred to us with pneumoconiosis suspicion based on the radiographic findings in the PA chest roentgenogram performed during the periodic examinations at their work place; but unlike other studies, in our study, following the HRCT assessment, cases which did not present any visible pathology in the re-evaluation of their PA chest roentgenogram, but had HRCT findings have been diagnosed as pneumoconiosis. Among the 44 cases in which micro-nodules had been detected at their HRCT, 15 of them had been previously classified as profusion of small opacities 0/1 according to their PA chest roentgenogram findings. It has been seen that the HRCT findings differ among sectors. Ceramics workers and sandblasters had significantly more micro-nodules, while dental technicians had significantly more mediastinal lymphadenopathies (Chi square, p= 0.004 and p= 0.007 respectively). When the relationship between the existence of big opacities and complaints was studied, statistically significant weight loss was detected in cases which had C opacities (chi square p= 0.01). Statistically significant FEV1 decrease was observed in cases which had weight loss (independent samples t-test p= 0.046). It has been observed that when the profusion of small opacities increased, while there was no statistically significant functional status change in non-smokers, a significant functional impairment was observed in smokers. Conclusions: Pneumoconiosis still exists in Turkey. Even a short exposure time as 2 years can cause pneumoconiosis. Workers in different sectors had different functional, radiological properties and smoking can affect the diseases' course. There are serious limitations related to the surveillance of both the workplace environment and the employees' health in Turkey. Without institutional preventive measures, personal protection and surveillance examinations, occupational hazards will continue to cause premature deaths. Pneumoconiosis in different sectors is a prototype of uncontrolled industry in the developing world.
MeSH term(s)	Adult ; Cross-Sectional Studies ; Dental Technicians ; Female ; Humans ; Male ; Middle Aged ; Occupational Diseases/epidemiology ; Occupational Diseases/etiology ; Occupational Diseases/prevention & control ; Pneumoconiosis/epidemiology ; Pneumoconiosis/etiology ; Pneumoconiosis/prevention & control ; Radiography, Thoracic ; Risk Factors ; Smoking ; Turkey/epidemiology ; Workplace ; Young Adult
Language	English
Publishing date	2017-04-17
Publishing country	Turkey
Document type	Journal Article
ZDB-ID	2468802-2
ISSN	0494-1373
ISSN	0494-1373
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Article ; Online: Continuing practice is needed to maintain competency in endobronchial ultrasound-guided transbronchial needle aspiration

Nur Safak Alici / Ibrahim Onur Alici

Eurasian Journal of Pulmonology, Vol 20, Iss 3, Pp 118-

2018 Volume 121

Abstract: BACKGROUND: It has been accepted that after training, a competent endobronchial ultrasound (EBUS) operator should perform at least twenty procedures per year. However, the literature supporting this subject is scarce. This study focuses on the return ... ...

Abstract	BACKGROUND: It has been accepted that after training, a competent endobronchial ultrasound (EBUS) operator should perform at least twenty procedures per year. However, the literature supporting this subject is scarce. This study focuses on the return performance of an experienced bronchoscopist after a 5-year long break. The aim of this study is to reveal a possible decrease in the diagnostic performance after discontinued practice. MATERIALS AND METHODS: The data of patients who have undergone EBUS-guided transbronchial needle aspiration (EBUS-TBNA) for mediastinal or hilar lesions (lymphadenopathies and masses) between April and September 2016 were reviewed retrospectively. All consecutive patients were involved in the study. All EBUS-TBNA procedures were performed by a single experienced bronchoscopist who have returned after a 5-year long break and restarted to perform EBUS. The patients were divided into two groups: first twenty cases and subsequent eighty cases. The diagnostic performance of EBUS was compared between the two groups. RESULTS: One hundred consecutive patients were included (2.89 lesions per patient) in the study. Demographic and sonographic data were not different between the two groups. In overall, EBUS-TBNA was diagnostic in 281 (97.2%) of 289 lesions. The sensitivity values of EBUS-TBNA in the first and second groups were 92.9% and 98.3%, respectively. The difference was statistically significant (P = 0.048). CONCLUSIONS: This study shows the need for continuing practice in EBUS. An operator should perform at least twenty procedures per year to maintain competency.
Keywords	Endobronchial ultrasound ; training ; transbronchial needle aspiration ; Internal medicine ; RC31-1245
Subject code	796
Language	English
Publishing date	2018-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
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Article: Assessment of work-related Asthma cases: Our three-year experience.

Beyan, Ayse Coskun / Alici, Nur Safak / Cimrin, Arif

Pakistan journal of medical sciences

2017 Volume 33, Issue 5, Page(s) 1230–1235

Abstract: Objective: Work-related asthma (WRA) is one of the most common occupational diseases. In this study, we aimed to review diagnosing procedures and the characteristics of patients who were diagnosed with WRA.: Methods: Between November 2013 and June ... ...

Abstract	Objective: Work-related asthma (WRA) is one of the most common occupational diseases. In this study, we aimed to review diagnosing procedures and the characteristics of patients who were diagnosed with WRA. Methods: Between November 2013 and June 2016; 214 patients were referred to our clinic with WRA suspicion by an occupational health specialist, personal visit, chest disease specialists [61 (28%), 51 (23%), and 102 (47%) respectively]. Occupational history, functional and radiological assessment, skin prick test, PEF monitoring were done. Results: Fifty-four patients (25%) were diagnosed with OA, and 24 (11%) with WEA, total 78 workers were diagnosed with WRA. Twenty-five (32.1%) had allergic rhinitis, 13 (16.7%) had allergic dermatitis, and 8 (10%) had both diseases. Conclusion: WRA can be seen in many areas. Complaints are the basic route for admission to physician, and the diagnosis can be delayed for a long time as one year. Lower rates of referral by occupational health physicians are the signs of limitations on management of cases. Non-specific BPT and skin prick test for selected cases would be sufficient besides occupational history and clinical examination for the diagnosis of WRA. PEF assessment, one of the most important tests for the diagnosis of WRA, must be performed.
Language	English
Publishing date	2017-11-02
Publishing country	Pakistan
Document type	Journal Article
ZDB-ID	2032827-8
ISSN	1681-715X ; 1682-024X ; 1017-4699
ISSN (online)	1681-715X
ISSN	1682-024X ; 1017-4699
DOI	10.12669/pjms.335.12923
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Article: Dental Technicians' Pneumoconiosis; Illness Behind a Healthy Smile - Case Series of a Reference Center in Turkey.

Alici, Nur Şafak / Beyan, Ayşe Coşkun / Demıral, Yücel / Çimrin, Arif

Indian journal of occupational and environmental medicine

2018 Volume 22, Issue 1, Page(s) 35–39

Abstract: Background: Dental laboratories include many hazards and risks. Dental technicians working in an unfavorable work environment in Turkey and other parts of the world may develop pneumoconiosis as a result of exposure to dust, depending on exposure time. ... ...

Abstract	Background: Dental laboratories include many hazards and risks. Dental technicians working in an unfavorable work environment in Turkey and other parts of the world may develop pneumoconiosis as a result of exposure to dust, depending on exposure time. In this study, we aimed to investigate the clinical and laboratory findings of dental technicians. Materials and methods: The study consists of a case series. Between 2013 and 2016, a total of 70 who were working as a dental technician and referred to our clinic with suspicion of occupational disease were evaluated. Comprehensive work-history, physical examination complaints, functional status, chest X-ray, and high-resolution computed lung tomography (HRCT) findings were evaluated. Results: In all, 46 (65.7%) of the 70 dental technicians were diagnosed with pneumoconiosis. About 45 (97.8%) subjects were male and 1 (2.2%) was female. The mean age of starting to work was 15.89 ± 2.79 (11-23) years. The mix dust exposure time was 176.13 ± 73.97 (18-384) months. Small round opacities were most common finding. In 16 patients, high profusion being 2/3 and above were identified, and large opacity was detected in 11 patients. The radiological profusion had a weak negative correlation with FEV 1 and FVC (correlation coefficient - 0.18, Conclusion: The presence of pneumoconiosis continues in dental technicians in Turkey, especially because there is an early childhood apprenticeship culture and almost all workers in this period have the history of sandblasting.
Language	English
Publishing date	2018-04-27
Publishing country	India
Document type	Journal Article
ZDB-ID	1456082-3
ISSN	1998-3670 ; 0973-2284 ; 0019-5278
ISSN (online)	1998-3670
ISSN	0973-2284 ; 0019-5278
DOI	10.4103/ijoem.IJOEM_41_18
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Article ; Online: COVID-19 as an occupational disease

Alici, NurSafak / Beyan, AyseCoskun / Simsek, Cebrail

Eurasian Journal of Pulmonology

2020 Volume 22, Issue 4, Page(s) 90

Keywords	covid19
Language	English
Publisher	Medknow
Publishing country	in
Document type	Article ; Online
ZDB-ID	2999947-9
ISSN	2148-5402 ; 2148-3620
ISSN (online)	2148-5402
ISSN	2148-3620
DOI	10.4103/ejop.ejop_50_20
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