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Query: UMLS:C0032273 (pneumoconiosis)
 1,578 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

It has recently been suggested that the inhalation of coal in the absence of complicated coal workers' pneumoconiosis (CWP) or smoking can lead to disabling airways obstruction. The cause of such obstruction has been variously attributed to emphysema or bronchitis. The frequency of significant airways obstruction in a group of United States coal miners seeking compensation for occupationally induced pulmonary impairment was therefore determined. In a sample of 611 "Black Lung" claimants there was only one subject who was a non-smoker and who in the absence of other non-occupationally related diseases,--for example, asthma and bronchiectasis--had sufficient airways obstruction to render it difficult for him to carry out hard labour. An alternative explanation for his reduced ventilatory capacity other than coal dust or smoking may be available. If the inhalation of coal dust in the absence of smoking and complicated CWP ever induces sufficient ventilatory impairment to preclude a miner from working, it is indeed rare.
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PMID:Airways obstruction, coal mining, and disability. 784 72

High-resolution computed tomography (HRCT) may show parenchymal abnormalities in patients with normal or questionable findings on the chest radiograph; and because it provides an accurate assessment of the pattern and distribution of lung disease, it also improves the accuracy of the differential diagnosis. HRCT may be able to distinguish areas of potentially reversible disease from irreversible fibrosis and be a helpful guide to the optimal type and site of lung biopsy. This review summarizes the current indications for HRCT of the chest in the assessment of patients with acute lung disease, chronic infiltrative lung disease, pneumoconiosis, bronchiectasis, and emphysema.
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PMID:High-resolution computed tomography of the chest: current indications. 832 Jul 62

We examined 21 miners by means of standard chest radiography, high-resolution computerized tomography (HRCT), pulmonary function tests, and resting arterial blood gas levels. Using the ILO/UC classification of pneumoconiosis, 7 miners had category 1/0 or 2/1 simple coal workers' pneumoconiosis (CWP). By HRCT, nodules were identified in 12 miners; 4 of 9 were classified as category 0/0 CWP; 2 of 5, 0/1 CWP; 5 of 6, 1/0 CWP; and 1 of 1, 2/1 CWP by chest radiograph. Focal emphysema was identified by HRCT in 7 miners; 4 of 9 were classified as 0/0 CWP; 2 of 5, 0/1 CWP; and 1 of 6, 1/0 CWP by standard chest radiography. Four miners with definite nodules confirmed by HRCT had focal emphysema, while three without nodules had focal emphysema. Pulmonary function testing was not different between miners with or without CWP by standard chest radiography, nor was it different between miners with or without definite nodules evidenced by HRCT. No difference in resting oxygenation was found between any group of miners. The presence of focal emphysema confirmed by HRCT did not significantly affect pulmonary function tests on resting arterial blood gas values. There was, however, a significantly lower FEV1 and mean forced expiratory flow during the middle half of forced vital capacity with lifetime nonsmoking miners. The presence of CWP on chest radiography was significantly correlated with smoking cigarettes but not the years of mining. The presence of nodules on HRCT approached a significant correlation with cigarette smoking, but focal emphysema did not. For detecting evidence of coal dust accumulation in lung parenchyma and identifying focal emphysema, HRCT was more sensitive than standard chest radiography. However, despite earlier detection of parenchymal abnormalities, abnormal pulmonary function attributable to coal dust could not be identified.
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PMID:High-resolution CT in simple coal workers' pneumoconiosis. Lack of correlation with pulmonary function tests and arterial blood gas values. 840 84

High-resolution CT (HRCT) scans were performed on 156 patients, using a bone-reconstruction algorithm, 1.5 mm sections at 4 cm intervals from apex to base of the lungs and a 512 x 512 matrix. The patients either appeared to have a pathologic condition on chest film, or they presented positive clinical symptoms--i.e., cough, dyspnea, fever--and questionable/negative chest films. Since HRCT is capable of showing the secondary lobule, we employed it to study both its anatomy and the alterations that can modify its normal morphology--i.e., thickening of interlobular septa, reticular pattern, nodular pattern, high-density areas, sub-pleural lines, honeycomb pattern. HRCT findings in secondary lobules, airways, and pleura were examined. They were: lymphangitic spread of carcinoma, pulmonary fibrosis, sarcoidosis, pneumoconiosis, interstitial edema, inflammatory disorders, bronchiectasis, emphysema, and bullae. Even though some limitations still exist due to the non-specificity of HRCT findings, the latter is the best method currently available to recognize and locate interstitial conditions and, sometimes, to make a diagnosis--e.g., of lymphangitic spread of carcinoma, interstitial edema, fibrosis, emphysema, bronchiectasis. Moreover, HRCT can accurately locate pathologic areas for lung biopsy and can be used instead of chest radiographs in the follow-up.
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PMID:[High-resolution x-ray computed tomography in the study of the pulmonary parenchyma. Personal experience]. 850 18

The quantitative relationship between exposure to respirable coal mine dust and mortality from nonmalignant respiratory diseases was investigated in a study of 8,878 working male coal miners who were medically examined from 1969 to 1971 and followed to 1979. Exposure-related mortality was evaluated using Cox proportional hazards modeling for underlying or contributing causes of death and modified lifetable methods for underlying causes. For pneumoconiosis mortality, the lifetable analyses showed increasing standardized mortality ratios (SMRs) with increasing cumulative exposure category. Significant exposure-response relationships for mortality from pneumoconiosis (p < 0.001) and from chronic bronchitis or emphysema (p < 0.05) were observed in the proportional hazards models after controlling for age and smoking. No exposure-related increases in lung cancer or stomach cancer were observed. Pneumoconiosis mortality was found to vary significantly by the rank of coal dust to which miners were exposed. Miners exposed at or below the current U.S. coal dust standard of 2 mg/m3 over a working lifetime, based on these analyses, have an elevated risk of dying from pneumoconiosis or from chronic bronchitis or emphysema.
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PMID:Exposure-response analysis of mortality among coal miners in the United States. 890 15

High-resolution CT (HRCT) was performed in 25 patients with pneumoconiosis diagnosed as category 1 or 2 according to the ILO radiographic classification. The small opacities shown on HRCT images were classified as small branching structures (SBS) or small rounded opacities (SRO). Patients in these two groups were compared with respect to the distribution of small nodules, pulmonary function, arterial blood gas analysis, degree of exertional dyspnea, and alteration ratio of the lung field CT numbers between maximum inspiration and maximum expiration (%(I-E)). The small nodules in all patients of the SBS group were classified as type p. SBS were distributed evenly throughout the lungs, while SRO were mainly localized in the upper middle lobe. Pulmonary emphysema was observed in patients with SBS and was particularly common among patients in this group with an irregular septum (IS). No emphysematous lesions were detected in the SRO group. RV/ TLC was higher and exertional dyspnea was more severe in the SBS group than in the SRO group. It was considered that an increase of RV/TLC resulted in worsening of exertional dyspnea in the patients with SBS. The % (I-E) value was significantly lower in the SBS group than in the SRO group.
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PMID:[Clinical study of pneumoconiosis featuring small nodules and without large opacities on high-resolution CT]. 869 54

A 74-year-old man with giant bulla accompanied by pneumoconiosis and emphysema was treated by intracavity suction and drainage procedure using chemical irritant and fibrin glue. About one month later, the bulla disappeared and the patient symptomatically improved on discharge from hospital. Intracavity suction and drainage is safe and effective treatment of emphysematous bulla in patients considered to be a bad risk for formal thoracotomy.
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PMID:[Intracavity suction and drainage in a patient with giant bulla accompanied by pneumoconiosis and emphysema: a case report]. 874 65

Peak expiratory flow (PEF) presents a circadian rhythm with a maximum in the afternoon, and a significant variability in its diurnal variations has been reported in normal subjects and in chronic obstructive pulmonary disease (COPD). In order to investigate whether passive smoking, active tobacco smoking, COPD and interstitial lung disease (ILD) are associated with changes in the circadian rhythm of PEF, five groups of adult male subjects, comparable for age, weight and height, were studied: group A: 30 clinically healthy subjects who never smoked, group B: 30 subjects passively exposed to tobacco smoking, group C 30 heavy smokers (> 20 cigarettes daily for at least 5 years), group D: 30 patients with nonasthmatic COPD (emphysema and/or chronic bronchitis), and group E: 15 patients with ILD (pneumoconiosis). Active tobacco smoking and exposure to passive smoking were assessed by the determination of the urinary cotinine concentration. A portable spirometer was used to measure PEF over a whole day, at 0.00, 6.00, 8.00, 10.00, 12.00, 14.00, 16.00, 18.00, 20.00, 22.00, and 24.00 h, all subjects leading a normal life. The 'mean cosinor' method was used for statistical analyses; the PEF variability was evaluated by the amplitude percent mesor (daily mean). All groups showed diurnal fluctuations in PEF values with significant (p < 0.05) circadian rhythms. The peaks of PEF rhythms occurred in the early afternoon, without significant (p > 0.05) differences between the groups. The cosinor mean was significantly (p < 0.05) lower in heavy smokers, in passive smokers, and in COPD patients than in controls. Controls, passive smokers, heavy smokers, COPD and ILD patients presented a PEF amplitude percent mesor (95% confidence limits) of 6.26% (range 4.57-7.95), 7.79% (range 5.07-10.51), 12.60% (range 7.61-17.59), 17.19% (range 10.18-23.50), and 3.98% (range 2.09-5.87), respectively, with significant differences (p < 0.05) between all groups, except between controls and passive smokers. These data suggest that tobacco smoke, both passive and active, does not modify the circadian peak of PEF, but modifies significantly its mesor and amplitude. In this respect, heavy smokers have the same pattern of COPD: lower mesor and greater amplitude; passive smokers present an intermediate situation. An increased diurnal variability in PEF could be considered as an early index of tobacco smoke damage and of developing COPD. When studying diurnal PEF variability, active and passive smoking habits should be considered.
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PMID:Cosinor analysis of circadian peak expiratory flow variability in normal subjects, passive smokers, heavy smokers, patients with chronic obstructive pulmonary disease and patients with interstitial lung disease. 925 58

Coal fly ashes (CFA) are complex particles of a variable composition, which is mainly dependent on the combustion process, the source of coal and the precipitation technique. Toxic constituents in these particles are considered to be metals, polycyclic aromatic hydrocarbons and silica. The purpose of this review was to study the in vitro and in vivo data on coal fly ash and relate the studied endpoints to the role of (crystalline) silica, considering its recent classification as a human carcinogen. For most of the effects coal mine dust was chosen as a reference, since it contains up to 10% of crystalline silica (alpha-quartz) and is well studied both in vivo and in vitro. Most studies on fly ash toxicity were not designed to elucidate the effect of its silica-content nor did they include coal mine dust as a reference. Taking this into account, both in vitro and in vivo experimental studies show lower toxicity, inflammatory potential and fibrogenicity of CFA compared to silica and coal mine dust. Although in vitro and in vivo studies suggest genotoxic effects of fly ash, the data are limited and do not clarify the role of silica. Epidemiological studies in fly ash exposed working populations have found no evidence for effects commonly seen in coal workers (pneumoconiosis, emphysema) with the exception of airway obstruction at high exposure. In conclusion, the available data suggest that the hazard of coal fly ash is not to be assessed by merely adding the hazards of individual components. A closer investigation of 'matrix' effects on silica's toxicity in general seems an obligatory step in future risk assessment on fly ashes and other particles that incorporate silica as a component.
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PMID:Toxicity and occupational health hazards of coal fly ash (CFA). A review of data and comparison to coal mine dust. 937 25

This article illustrates problems in diagnosis and treatment of an atypical form of bronchial carcinoid. We described the case of a 49-year old man, exposed to granite dust and noise for 25 years who had suffered from frequent bronchitis inflammations and pneumonias for 5 years prior to the diagnosis. He was admitted to our clinic because of supposed occupational nature of hearing deficiency. Although a pneumoconiosis was excluded before the admission, we found clinical and X-ray features of the right lung emphysema with medium restrictive ventilation disturbances. Bronchoscopy was performed because of "bright" right lung and ventilation disturbances and it showed presence of the carcinoid. Unusual in this case were tiny anamnestical findings (mild dyspnea attacks after physical effort or nervousness) plus increasing frequency of reported from the childhood bronchitis and pneumonias and uncharacteristic "bright" right lung in X-ray. Therapeutical difficulties resulted from atypical histological form of the tumor, its diameter, polypous-infiltrative character, and inconvenient localization. In spite of late diagnosis of carcinoid and significant acceleration of respiratory decompensation symptoms after the diagnosis the attempt of surgical therapy was appropriate but unsuccessful. After the operation the patient was suffering long lasting lowering of arterial pressure (what was corrected with catecholamine infusions) probably as a result of serotonin secretion. However it was not established because of technical reasons.
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PMID:[Atypical case of bronchial carcinoid]. 959 57


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