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

In a Zurich autopsy study comprising 7947 adults (over 20-year-olds), cor pulmonale was diagnosed in 8.9% (709 cases). In more than half of the cases the cor pulmonale was caused by lung diseases associated with chronic bronchitis and emphysema or with fibrosis of the lung. In 7 cases recurrent thromboembolism was the sole cause of cor pulmonale, whereas in 103 cases additional lung diseases were involved. 7 cases could be attributed to primary pulmonary hypertension. Cor pulmonale is, as a rule, the result of multiple lung conditions. The lesions of pulmonary vessels in cor pulmonale are produced either by parenchymatous lung changes (such as pneumoconiosis, sarcoidosis, etc.) or by pulmonary hypertension.
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PMID:[Pathologic anatomy of cor pulmonale. Results of autopsies]. 85 27

There is remarkably little information about the direct relationship of physiological abnormality in coal workers' pneumoconiosis with structural changes in the lung and there are major difficulties in attempting such a correlation. The general population, including coal workers, has a regrettably high prevalence of pulmonary functional abnormalities attributable to chronic bronchitis or to emphysema occurring either separately or together. The pathological basis for the functional impairment in chronic bronchitis and possible functional sequelae to the anatomical changes of emphysema are not clearly understood, making it extremely difficult to identify separately the functional effects associated with coal workers' pneumoconiosis. Any study of coal workers' pneumoconiosis must take into account the background population. The published investigations relating the functional abnormalities and pathological changes in the lung in coal workers' pneumoconiosis are reviewed. The relationship of functional change to emphysema, chronic bronchitis, cor pulmonale and the specific lesions of coal workers' pneumoconiosis are dealt with. There is great need for further work in this field, both in the form of simple studies of pathological changes in miners' lungs as well as more complex attempts to correlate such pathological surveys with physiological abnormalities in life.
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PMID:Physiological/pathological correlations in coal workers' pneumoconiosis. 121 51

A cohort study of approximately 68,000 persons employed during 1972 to 1974 at metal mines and pottery factories in south central China was conducted to evaluate mortality from cancer and other diseases among workers exposed to different levels of silica and other dusts. A follow-up of subjects through December 31, 1989 revealed 6,192 deaths, a number close to that expected based on Chinese national mortality rates. There was, however, a nearly 6-fold increase in deaths from pulmonary heart disease (standard mortality ratio, 581; 95% confidence interval 538 to 626), and a 48% excess of mortality from nonmalignant respiratory diseases (standard mortality ratio, 148; 95% confidence interval, 139 to 158), primarily because of a more than 30-fold excess of pneumoconiosis. Pulmonary heart disease and noncancerous respiratory disease rates rose in proportion to dust exposure. Cancer mortality overall was not increased among the miners or pottery workers. There was no increased risk of lung cancer, except among tin miners, and trends in risk of this cancer with increasing level of dust exposure were not significant. Risks of lung cancer were 22% higher among workers with than without silicosis. The findings indicate that respiratory disease continues to be an occupational hazard among Chinese miners and pottery workers, but that cancer risks are not as yet strongly associated with work in these dusty trades.
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PMID:Mortality among dust-exposed Chinese mine and pottery workers. 131 52

The Medical Research Council and the Nocturnal Oxygen Therapy Trial studies clearly demonstrated that long-term oxygen therapy (LTOT) for more than 15 h/day improved mortality and morbidity in a well-defined group of patients with chronic obstructive pulmonary disease. There are no similar randomised control studies in patients with other hypoxaemic lung diseases such as pulmonary fibrosis and pneumoconiosis. The prescription of oxygen for other restrictive lung disorders is complicated by hypoventilation requiring mechanical support as well as oxygen and should be restricted to special centres. The clearest indications for LTOT are for patients with cor pulmonale, hypoxic chronic bronchitis and emphysema, and in terminally ill patients who require palliation. Before LTOT is considered, the patient must be clinically stable and on appropriate optimum therapy such as antibiotics, bronchodilators, physiotherapy and having stopped smoking tobacco. Many patients first present for LTOT with profound hypoxaemia and hypercapnia during an infective, often oedematous exacerbation of their lung disease. Assessments should occur during convalescence when the patient is clinically stable. They should be shown to have a PaO2 less than 7.3 kPa and/or a PaCO2 greater than 6 kPa on two occasions at least 3 weeks apart. FEV1 should be less than 1.5 litres, and there should be a less than 15% improvement in FEV1 after bronchodilators. All patients should be assessed by an experienced chest physician. Patients with a PaO2 between 7.3 and 8 kPa who have polycythaemia, right heart failure or pulmonary hypertension may gain benefit from LTOT but this is still to be clearly proven.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Indications for long-term oxygen therapy. 151 74

Of 577 patients with pneumoconiosis who died in 1964-1988 cor pulmonale was revealed on necropsy in 334, i.e. in 57.8%. In 120 it was the cause of death, i.e. in 20.7% (and it remains the most frequent cause of death). The mean age of the patients who died from cor pulmonale does not differ significantly from the rest of the group. The prevalence of cor pulmonale in different forms of pneumoconiosis did not differ significantly. Emphysema of the lungs was revealed in 71.2% of the patients who died from cor pulmonale. Embolization of the lungs was not more frequent in those who died with cor pulmonale; ischaemic heart disease was significantly less frequent in patients with cor pulmonale than in the rest of the group. Death from cor pulmonale is still the most frequent cause of death among occupational diseases.
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PMID:[Cor pulmonale in patients with pneumoconiosis]. 203 10

A cohort of 3971 white miners in South Africa, born between 1 January 1916 and 31 December 1930 who were alive on 1 January 1970 and currently working in the East Rand-Central Rand-West Rand mining areas, was followed up for nine years, when the 3426 survivors were aged from 48 to 62. Fifteen (0.4%) had been lost to view and 530 had died (13.4% of the 3956 whose vital status was determined). Based on the occupational histories of a 30% sample of the cohort it was known that the vast majority were gold miners. An estimated 93% had worked more than 85% of their mining service in gold mines. Standardised mortality ratios were calculated as the ratios of the deaths observed in the cohort to those expected on the basis of concurrent mortality in the reference population--the total white male population in the Republic of South Africa. There was little sign of a "healthy worker effect"; of several possible reasons, one is that the white miner in South Africa had adopted certain unhealthy life styles, another is that the reference population was otherwise inappropriate. The SMR for all causes of death (117.6) was raised because of excess mortality due to the following causes: lung cancer (161.2), chronic respiratory diseases (165.6), and acute and chronic nephritis (381.0). A case-referent analysis was carried out on those miners in the cohort who had spent at least 85% of their service in gold mines. For lung cancer, smoking was the main contributory factor towards disease. For chronic respiratory diseases bronchitis, emphysema, asthma, pneumoconiosis, and pulmonary heart disease), smoking was also the main risk factor, but there was an association wih cumulative dust exposure. Raised blood pressure, smoking, and adiposity were associated with ischaemic heart disease as was the duration of service underground. Study of comprehensive medical histories in all 530 deaths, including necropsy in most cases, showed that none was directly due to pneumoconiosis or to tuberculosis.
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PMID:Mortality of middle aged white South African gold miners. 377 38

Acute respiratory failure is a common life-threatening condition in old age. Structural alterations, progressive loss of lung functional reserves and weakening of pulmonary defense mechanisms are the main factors responsible. The aging lung itself contributes only little to the increased risk, but if combined with chronic lung disease, such as bronchitis, asthma, fibrosis, tuberculosis, pneumoconiosis, severe deterioration of lung function may occur. In many cases, respiratory failure results from an accumulation of the following factors: aging lung, chronic lung disease, cor pulmonale, acute complication. Today, chronic obstructive lung disease (COLD) is one of the most important conditions leading to ventilatory failure in the elderly. Carcinoma of the lung and other manifestations of malignant diseases may also be important. Treatment of the acute respiratory failure in the elderly must include three components: 1. treatment of the acute complication triggering the crisis, 2. treatment of the underlying chronic disease, 3. treatment of concomitant extrapulmonary diseases. After recovery, special attention must be directed towards preventing repeated respiratory failure.
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PMID:[Pneumologic emergency conditions in geriatrics. With special reference to risk factors]. 650 Apr 59

Pertinent pathological features of lungs obtained at autopsies from 99 coal miners were compared with those observed in the lungs of 268 male town dwellers of comparable age who were not occupationally related to the coal mining or other industries at risk for development of pneumoconiosis. The degree of anthracotic pigment deposition and severity of type of pigmented lesion with its accompanying reticulum fiber formation and fibrosis were significantly greater in lungs of miners. There was a high degree of overlap in degree of pigment deposition, particularly those quantitated as grades 1 and 2 and in lesions regarded as types 1 and 2. The greatest divergence was observed for prevalence of nodular pulmonary lesions (type 4). There was also a considerable divergence in the type 3 alteration characterized by nonnodular aggregates of carbon-laden macrophages accompanied by minimal reactive fibrosis. It appears that an objective pathological diagnosis of coal workers' pneumoconiosis (CWP) can be rendered only by the demonstration of type 4 lesions. Approximately 25% of coal miners exhibited unequivocal features of CWP. No significant differences concerning incidence or types of emphysema or frequency of chronic cor pulmonale were encountered between the two populations.
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PMID:Objective pathological diagnosis of coal worker's pneumoconiosis. 723 Mar 68

Controlled studies have demonstrated that the correction of tissue hypoxia increases survival and reduces pulmonary hypertension in patients with chronic obstructive pulmonary disease (COPD) receiving oxygen therapy 15 h/day or longer. Long-term oxygen therapy (LTOT) is recommended to any patient with COPD who has a PaO2 of < or = 7.3 kPa. In most countries, the PaO2 threshold is 8kPa in patients with chronic hypoxemia (PaO2 > or = 55 mm Hg) with associated hematocrit > or = 55%, pulmonary hypertension or cor pulmonale. Desaturations during sleep or exercise should be investigated, although a consensus as to whether and how these episodes should be treated has yet to be reached. The indications for LTOT in restrictive lung diseases, such as interstitial pulmonary fibrosis and pneumoconiosis, remain controversial. In many countries, oxygen is not prescribed if the patient is a current smoker. Breathlessness without hypoxemia should not be considered an indication for LTOT. The oxygen is usually administered through nasal cannula. Venturi type masks, nasopharyngeal and transtracheal catheters are associated with several drawbacks. Oxygen is usually supplied by the relatively cheap oxygen concentrator. Liquid oxygen is favored when a portable source is an important requirement. Many questions remain unanswered concerning the duration of added survival, the effect of LTOT on physiological parameters such as pulmonary artery pressure, respiratory failure in non-COPD patients, exercise and nocturnal desaturations.
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PMID:Long-term oxygen therapy. 808 39

Cor pulmonale has been reported in the past to be associated with pneumoconiosis as an end-stage complication. However, whether the association can be demonstrated among cases of pneumoconiosis acquired in more recent decades is not clear. We examined the relation between these conditions using data summarized in hospital records in Ontario for males discharged between 1979 and 1990 with a diagnosis of chronic cor pulmonale or one of the pneumoconioses. Based on the age-specific frequency rates, cor pulmonale was diagnosed 17 (95% confidence interval 13-22) times more frequently than expected among men diagnosed with pneumoconiosis than among other men admitted to hospital. Our investigation indicates that cor pulmonale still appears to be associated with dust exposure in the workplace, and it demonstrates the usefulness of hospital discharge information in addressing questions in occupational health. However, we recommend that hospital medical records be examined to confirm the diagnoses and to determine the smoking histories of these men.
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PMID:Cor pulmonale and pneumoconiotic lung disease: an investigation using hospital discharge data. 821 44


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