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

Black sputum is produced when cavitation of progressive massive fibrosis occurs due to mycobacterial and anaerobic bacterial infections (67%) or ischaemic necrosis. The blackish or greyish sputum suggests cavitation of conglomerated masses; the acinar shadows in gravity dependent areas together with cavitary pneumoconiosis, make us suspect an insufficiency of bronchial clearing. Bronchoscopy confirms the diagnosis by showing the airway blocked by dark material. During melanoptysis the patient suffers respiratory failure which can be fatal. Close vigilance of the arterial blood gases is essential. Measures must be taken to maintain clear airways. Melanoptysis should be listed with the other complications of coal worker's pneumoconiosis.
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PMID:Massive melanoptysis: a serious unrecognized complication of coal worker's pneumoconiosis. 323 23

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

Interstitial pneumonia and recurrent pneumothorax developed in a 48-year-old man who had worked as a metal grinder. He died of respiratory failure despite having received antibiotics and steroids, and despite having undergone pleural sclerosis therapy. Giant cell interstitial pneumonia was diagnosed; innumerable bizarre giant cells engulfing black granules were found within the alveoli. The results of high-energy dispersion X-ray microanalysis indicated that the patient had hard metal pneumoconiosis associated with tungsten in the black granules. When he was admitted to the hospital, his serum CA19-9 and SLEX concentrations were abnormally high (2600 and 200 ng/ml, respectively). Immunohistochemical analysis of lung tissue was done with anti-CA19-9 and SLEX antibodies. CA19-9 staining revealed strong bronchialization and squamous metaplasia in contrast to type II hyperplasia. SLEX staining showed strong type II hyperplasia. Further investigations will be needed to determine the mechanism of elevated tumor-associated carbohydrate antigens in serum.
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PMID:[Giant cell interstitial pneumonia in a metal grinder with an abnormally high level of serum CA19-9]. 747 73

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

The paper reports a case of silicosis associated with idiopathic unilateral hyperlucent lung--MacLeod's disease (ML)--in a 65-year old miner. ML had not been diagnosed before this clinical observation and the patient had been exposed to silica dust for about 15 years as a truck operator in water supply tunnelling work in central Italy. Impaired ventilatory function due to left pulmonary dystrophy was the favouring or even the causal factor of dust accumulation in the functionally active right lung and of the tissue reaction to the dust, leading to interstitial fibrosis. A radiological diagnosis of p 1/0 pneumoconiosis was made according to the 1980 International Labour Office classification. Clinical, radiological and functional findings indicated the presence of respiratory failure as a result of the sum of silicotic and dystrophic lesions. Two combined pulmonary scintigraphic examinations with Tc99 perfusional and mTc-DPTA inhalatory methods revealed peculiar alterations: absence of ventilation associated with severe vascular impairment in the left lung, inequality of the ventilation/perfusion rate, due to pneumoconiosis, in the right lung. MacLeod's disease is rare, but must be considered as a mandatory contra-indication for work involving dust exposure risk since it is one of the predisposing factors which can cause an occupational disease even if environmental exposure standards are observed.
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PMID:[Pulmonary silicosis associated with MacLeod syndrome: a case report]. 811 52

Progressive massive fibrosis (PMF) secondary to pneumoconiosis involves the formation of fibrotic masses that eventually cause death from multiple complications. We present a rare but potentially serious complication in a patient with coal pneumoconiosis with PMF, in whom the appearance of paroxysmal melanoptysis was attributed to the cavitation of one of the pneumoconiotic masses. We emphasize the need for differential diagnosis to exclude other more common causes, as well as the use of bronchoscopy for diagnosis and confirmation. Strict control is needed to prevent possible respiratory failure when melanoptysis is massive.
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PMID:[Paroxysmal melanoptysis secondary to the cavitation of pulmonary pneumoconiosis conglomerate]. 907 36

A 56-year-old man had worked as a furniture painter and had been exposed to tonoko polishing powder for 30 years. He had complained of dyspnea on exertion for 7 years, and was admitted to our hospital in 1991. A chest X-ray film revealed large opacities and emphysematous changes in both lung fields. Tonoko pneumoconiosis was diagnosed after transbronchial lung biopsy. Home oxygen therapy was given because of progressive hypoxemia, but the patient died of respiratory failure. At autopsy, examination of the lungs showed severe emphysematous changes, and collapse of alveoli. Many gray masses resembling coating cement were seen especially in the upper lobes. Microscopical examination showed that the large opacities were composed of hyaline nodules, similar to silicotic nodules, with anthracosis. Scanning electron microscopy with X-ray microanalysis revealed a high concentration of titanium in the gray mass. A low dose of titanium would not be expected to induce fibrotic changes in the lung, but a high dose and long-term exposure might have that effect. Titanium contained in paint might have exacerbated tonoko pneumoconiosis in this patient.
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PMID:[Tonoko pneumoconiosis with deposition of titanium]. 897 79

Inhalation of dusts is an important cause of interstitial lung disease in the tropical countries such as India. While dusts of organic origin, such as the cotton dust causing byssinosis, generally cause bronchial or bronchiolar involvement and hypersensitivity pneumonitis, inorganic metallic dusts cause progressive pulmonary fibrosis. Silicosis, coal workers' pneumoconiosis, and asbestosis are the three most commonly recognized forms of pneumoconiotic pulmonary fibrosis. Pulmonary tuberculosis is an important complication seen in up to 50% of patients of silicosis in some reports from India. The presentation is generally chronic, although acute and accelerated forms of silicosis are known when the exposures are heavy. Breathlessness, dry cough, and general constitutional symptoms are commonly seen. Patients with silicotuberculosis or other forms of infection may also have significant expectoration, hemoptysis, fever, and rapid progression. Respiratory failure and chronic cor pulmonale occur in the later stages. The diagnosis is easily established if the occupational history is available. Dense nodular opacities on chest roentgenograms, which may be large in patients with massive pulmonary fibrosis, are characteristic. Emphysematous changes generally appear in advanced stages or in patients who smoke. Bronchoalveolar lavage and/or lung biopsy may occasionally be required to establish or exclude other causes of interstitial lung disease. Treatment is largely palliative, although a variety of drugs including corticosteroids and procedures such as whole lung lavage have been tried. None of these methods has yet been found successful in the treatment. Preventive safety steps, including removal of the patient from the site of exposure, are the only effective strategies to control disease progression.
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PMID:Dust-induced interstitial lung disease in the tropics. 1158 75

A 55-year-old man with arc welder's pneumoconiosis who presented with bilateral pneumonia was admitted to our hospital. Streptococcus pneumoniae and Aspergillus fumigatus were cultured from sputum on admission. The patient was treated with antibiotics and an anti-fungal agent, but his chest radiograph shadows became exacerbated, and he died of respiratory failure on the fourth day of hospitalization. Histological examination of postmortem lung tissue revealed necrotizing aspergillous pneumonia. The results of hemagglutination inhibition tests for influenza A (H3 N2) were x16 in September 1999, and x512 on the third day of hospitalization. We diagnosed this patient's condition as invasive pulmonary aspergillosis associated with influenza A viral infection. The suppression of cellular immunity, lymphocytopenia, and destruction of airways-mucociliary transport induced by influenza A viral infection were suspected to have predisposed him to aspergillus superinfection.
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PMID:[Invasive pulmonary aspergillosis following influenza A infection]. 1172 87

A 72-year-old man who had worked as a coal worker for 28 years and as a tunnel construction worker for 18 years was admitted because of fever, dyspnea, and appetite loss. Pneumoconiosis had been diagnosed when he was 64 years old and myelodysplastic syndrome at 71 years of age. After admission, the patient was treated with antibiotics and anti-fungal drugs but did not respond. Respiratory failure gradually worsened and he died. Autopsy specimens revealed that the cause of death was exacerbation of respiratory failure due to pulmonary proteinosis rather than pulmonary infection. This is a case of pulmonary proteinosis complicated with pneumoconiosis and myelodysplastic syndrome which, to our knowledge, is rare. We also considered the possibility that defective pulmonary macrophage function due to myelodysplastic syndrome and long-term silica inhalation played a part in the development of pulmonary alveolar proteinosis in this case.
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PMID:[A case of pulmonary alveolar proteinosis complicated with pneumoconiosis and myelodysplastic syndrome]. 1172 94


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