Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034067 (emphysema)
 11,506 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Bronchoalveolar lavage has been used for 15 yrs to investigate the role of proteinases and antiproteinases in the pathogenesis of emphysema, but the results are confused by numerous technical factors, many of which may prove insurmountable. Even if the problems can be overcome, the technique will probably not prove sensitive enough to provide a true insight into the pathogenesis of emphysema in man. Nevertheless, the studies with this technique have provided important information and methodologies that have advanced our scientific, if not pathological, knowledge. Perhaps further applications of the knowledge obtained, to cellular and genetic studies, will eventually establish the true mechanisms involved in determining whether a smoker remains "healthy" or develops disabling disease. Lavage may have played a major role in the study of emphysema, if for no other reasons than to establish the fact that the pathogenesis of the disease is far from clear.
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PMID:Bronchoalveolar lavage and the study of proteinases and antiproteinases in the pathogenesis of chronic obstructive lung disease. 836 90

Emphysema is a disabling disease, for which there is no curative therapy available today. Lung transplantation offers a valuable option for a very selected number of patients, however, due to the enormous organ shortage, only few patients can be offered such a therapy. Recently there has been important resurgence of interest in lung volume reduction surgery and as a consequence, we have embarked in such a program since may 1997. We have now performed unilateral lung volume reduction surgery in 29 emphysema patients (25 on the right and 4 on the left side). Twenty-four patients were already discharged home. There has been no perioperative mortality. The mean hospital stay was 19.8 +/- 11.4 days (range, 8-47 d). Twenty patients of whom we already have follow-up data during 6 months (m) form the further basis of this report. Six weeks after the procedure the FEV1 increased from 0.82 +/- 0.28 L (28 +/- 8%) to 1.05 +/- 0.39 L, a mean increase of 28%. There was a further increase of the FEV1 to a maximum of 1.06 +/- 0.42 L at 6 m, a mean maximum increase of 29% (p = 0.0046, ANOVA). Similarly, the FVC increased from 2.80 +/- 1.10 L to 3.15 +/- 1.00 L, a mean increase of 12.5%. A further increase was also obtained at 6 m and was 19.6% (3.35 +/- 1.05 L, p = 0.014, ANOVA). The maximum decrease in RV was obtained at 3 m (from 5.91 +/- 1.37 L to 4.37 +/- 0.85 L (p = 0.0001, ANOVA), a mean decrease of 26%. The maximum TLC decrease was demonstrated at 3 m (from 8.71 +/- 1.71 L to 7.60 +/- 1.56 L (p = 0.002, ANOVA), a mean decrease of 12.8%. Afterwards there was again a gradual raise of the TLC. The six minute walking distance increased from 231 +/- 31 m to 272 +/- 34 m (p = NS) after pulmonary rehabilitation and to 416 +/- 77 m at 3 m and 415 +/- 18 m at 6 m (p = 0.0002, ANOVA) after the operation. The quality of life (measured with a standardized questionnaire, the Nottingham Health Profile) improved significantly in several domains (e.g. mobility, pain, energy, emotions and social) at 3 m postoperatively. There was one late death (at 6 m) due to an unknown cause. The actuarial survival rate was therefore 100% at 3 m and 95% at 12 m. In conclusion, unilateral thoracoscopic lung volume reduction surgery is a new and safe treatment modality for patients suffering from severe end-stage emphysema. The objective and subjective improvement is marked and the mortality is very low. Rigid selection criteria are, however, necessary to be able to guarantee an optimal result.
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PMID:Lung volume reduction surgery (LVRS) for emphysema: initial experience at the University Hospital Gasthuisberg. Leuven LVRS Group. 1098 23

Coal mine and silica dust cause significant respiratory disease in spite of modern dust control regulations. Susceptible individuals in exposed populations may develop fibrosing lung disease, obstructive airways disease, including chronic bronchitis and emphysema, or lung cancer. A careful occupational history that elicits exposure to respiratory hazards is the cornerstone of an accurate diagnosis. Treatment involves removal from exposure, supportive care, pulmonary rehabilitation, and when disabling disease is present, assistance obtaining compensation.
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PMID:Update on respiratory disease from coal mine and silica dust. 1251 67

In the program of research into the natural history of coalworkers' pneumoconiosis now being carried out in Great Britain, emphasis is being put upon the importance of sharpening and validating means for early diagnosis, and upon the need for follow-up studies upon properly selected population samples. Existing information from morbidity and mortality figures from chronic bronchitis and emphysema in Great Britain suggests that atmosphere pollutants are important etiological factors. A parallel is drawn between the course of events in pneumoconiosis, in which dust retention in the lungs does not greatly disable until complicated by tuberculous infection, and a hypothesis that bronchitis is a hypersecretion of bronchial mucus caused by atmospheric irritants and does not disable but encourages secondary infection which may cause emphysema. This hypothesis requires testing by follow-up studies of population samples exposed to various environmental influences. It is suggested that in order to bring this common and disabling disease under control, clinicians must widen their interests beyond the confines of the hospital walls.
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PMID:Chronic disabling respiratory disease; ends and means of study. 1348 5

Chronic obstructive pulmonary disease (COPD) was diagnosed in three women aged 39, 41 and 41 years who were all heavy smokers. They presented with symptoms of dyspnoea. At the time of diagnosis they already had advanced pulmonary emphysema and signs of systemic impairment. At the last follow-up one woman had a very limited range of action, the second was awaiting a lung transplant after several periods of hospitalization, and the third had died. Nowadays pneumologists are increasingly encountering severe COPD in young female patients. Increased tobacco consumption in women has run parallel to the rising mortality rates from COPD in females over the last decades. Cigarette smoking is probably associated with a higher risk of obstructive lung disease in women than in men. Moreover women with COPD maintain exercise capacity longer than men with similar degrees of airway obstruction, leading to a risk of them waiting too long before seeking medical help. Actions aimed at discouraging smoking especially in adolescence are without doubt the intervention of choice for prevention of this highly disabling disease.
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PMID:[Severe chronic obstructive pulmonary disease in young women who smoke]. 1501 54

Emphysema is a progressive, disabling disease. Emphysematous bullae form as a result of local areas of alveolar weakness and parenchymal remodeling. They grow as a result of preferential inflation during inspiration and elastic recoil of the surrounding lung tissue. Isolated apical bullae can be a consequence of illicit drug use, as was suspected in this patient. In the case of cocaine and marijuana smoking, direct drug toxicity or drug-induced vasoconstriction presumably contributes to bullae development. LVRS is often used to treat patients with bullae and severe underlying emphysema, although these patients are difficult to assess and their disease course is hard to predict. LVRS is associated with a higher morbidity and mortality. The best candidates for surgery have enlarged, well-localized bullae and minimal underlying lung disease. Early postoperative results include relief of shortness of breath, improved lung function, increased energy level and physical mobility, and improved ability to function during daily activities. LVRS may decrease the need for supplemental oxygen as soon as a few weeks after surgery, and benefits may be sustained for years. The best results are seen in patients with large bullae that cause the greatest compression of almost normal underlying lung. However, clinical and symptomatic improvement may be greater than actual spirometric measurements.
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PMID:Reduced lung function and bullae resulting from illicit drug use. 2174 55

Silicosis is an incurable occupational lung disease caused by inhaling particles of respirable crystalline silica. These particles trigger inflammation and fibrosis in the lungs, leading to progressive, irreversible, and potentially disabling disease. Silica exposure is also associated with increased risk for lung infection (notably, tuberculosis), lung cancer, emphysema, autoimmune diseases, and kidney disease (1). Because quartz, a type of crystalline silica, is commonly found in stone, workers who cut, polish, or grind stone materials can be exposed to silica dust. Recently, silicosis outbreaks have been reported in several countries among workers who cut and finish stone slabs for countertops, a process known as stone fabrication (2-5). Most worked with engineered stone, a manufactured, quartz-based composite material that can contain >90% crystalline silica (6). This report describes 18 cases of silicosis, including the first two fatalities reported in the United States, among workers in the stone fabrication industry in California, Colorado, Texas, and Washington. Several patients had severe progressive disease, and some had associated autoimmune diseases and latent tuberculosis infection. Cases were identified through independent investigations in each state and confirmed based on computed tomography (CT) scan of the chest or lung biopsy findings. Silica dust exposure reduction and effective regulatory enforcement, along with enhanced workplace medical and public health surveillance, are urgently needed to address the emerging public health threat of silicosis in the stone fabrication industry.
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PMID:Severe Silicosis in Engineered Stone Fabrication Workers - California, Colorado, Texas, and Washington, 2017-2019. 3155 49