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)

We studied a distinctive group of young intravenous Ritalin abusers with profound obstructive lung disease. Clinically, they seemed to have severe emphysema, but the pathologic basis of their symptoms had not been investigated previously. Seven patients have died and been autopsied: in four, the lungs were fixed, inflated, dried, and examined in detail radiologically, grossly, microscopically, and by electron probe X-ray microanalysis. All seven patients had severe panlobular (panacinar) emphysema that tended to be more severe in the lower lung zones and that was associated with microscopic talc granulomas. Vascular involvement by talc granulomas was variable, but significant interstitial fibrosis was not present. Five patients were tested for alpha-1-antitrypsin deficiency and found to be normal, as were six similar living patients. These findings indicate that some intravenous drug abusers develop emphysema that clinically, radiologically, and pathologically resembles that caused by alpha-1-antitrypsin deficiency but which must have a different pathogenesis. Talc from the Ritalin tablets may be important, but the mechanism remains to be elucidated.
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PMID:Panlobular emphysema in young intravenous Ritalin abusers. 200 Oct 78

Forty-eight patients over the age of 70 with spontaneous pneumothorax (SP) are analyzed. The severity of the clinical picture is conditioned by the presence of earlier lung lesions, particularly related to emphysema, and by the degree of respiratory failure prior to SP. Treatment guidelines are listed. Pleural drainage/aspiration, applied in all cases, was of no avail in 69%. Tetracycline was injected into the pleural space of 23 patients, with failure recorded in 35%. Talc was applied by thoroscopy in 5 patients, to no avail. Video-assisted endoscopic surgery was carried out in 4 patients, with good results in 3. Surgery with access by lateral thoracotomy was carried out in 20 patients, with a single failure that was explained by the patient's condition.
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PMID:[Treatment of spontaneous pneumothorax in patients over 70 years of age]. 795 36

Talc is a mineral widely used in the ceramic, paper, plastics, rubber, paint, and cosmetic industries. Four distinct forms of pulmonary disease caused by talc have been defined. Three of them (talcosilicosis, talcoasbestosis, and pure talcosis) are associated with aspiration and differ in the composition of the inhaled substance. The fourth form, a result of intravenous administration of talc, is seen in drug users who inject medications intended for oral use. The disease most commonly affects men, with a mean age in the fourth decade of life. Presentation of patients with talc granulomatosis can range from asymptomatic to fulminant disease. Symptomatic patients typically present with nonspecific complaints, including progressive exertional dyspnea, and cough. Late complications include chronic respiratory failure, emphysema, pulmonary arterial hypertension, and cor pulmonale. History of occupational exposure or of drug addiction is the major clue to the diagnosis. The high-resolution computed tomography (HRCT) finding of small centrilobular nodules associated with heterogeneous conglomerate masses containing high-density amorphous areas, with or without panlobular emphysema in the lower lobes, is highly suggestive of pulmonary talcosis. The characteristic histopathologic feature in talc pneumoconiosis is the striking appearance of birefringent, needle-shaped particles of talc seen within the giant cells and in the areas of pulmonary fibrosis with the use of polarized light. In conclusion, computed tomography can play an important role in the diagnosis of pulmonary talcosis, since suggestive patterns may be observed. The presence of these patterns in drug abusers or in patients with an occupational history of exposure to talc is highly suggestive of pulmonary talcosis.
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PMID:Pulmonary talcosis: imaging findings. 2015 72

Although numerous medical associations publish various guidance recommendations in order to introduce common procedures and rules for the management of spontaneous pneumotorax (SPNO), no general consensus has been reached in this area. The major controversy remains in the treatment of the 1st episode of primary SPNO (PSPNO), there is a strong disagreement between advocates of a single, one-step aspiration method and advocates of pleural cavity drainage. Furthermore, some authors promote miniinvasive surgical revision. On the other hand, there is a relative concesus regarding the management of PSPNO relapses, i.e. indication for videothoracoscopic procedure, if feasible considering the patient's condition. Similarly, there is an agreement concerning individual indications for videothoracoscopy in PSPNO. There is a tendency to prefer least injuring of the organism, resulting in procedures which use a single incision, so called uniportal procedures, and in the use of thoracoscopes and instruments measuring from 2 mm to the maximum of 5 mm in a diameter in so called needlescopic videothoracoscopies. The videothoracoscopic procedure itself, as a standard, includes lung surgery - i.e. removal of the pathology causing pneumothorax, and preventive procedure on parietal pleura, and recently on visceral pleura, as well. Endostapler non-anatomical resection is the commonest lung procedure, while pleuroabrasion or its combination with partial apical pleurectomy are the commonest pleurodesis procedures. Talc pleurodesis features certain comeback after some time. Recently, some authors have turned their attention to, so called, tenting - i.e. strengthening of the endangered visceral pleura parts with absorbable polymers to prevent development of new subpleural blisters or emphysema bulae responsible for the disease recurrence. Drainage of the pleural cavity is the method of choice in the management of the first episode of the secondary SPNO (SSPNO). SSPNO relapses and complications are managed by surgical intervention and, contrary to that in PSPNO, with higher rates of thoracotomy procedures compared to VTS procedures, which is due to inability of these patients to undergo unilateral lung respiration. When this intervention is not feasible, chemical pleurodesis with introduction of a drain using talc, autologous blood or tetracycline derivates is performed. Catamenial pneumotorax with high relaps rates requires videothoracic revision already at its first occurence, accompanied by the causative factor removal, pleurodesis and induction of hormonal amenorrhea.
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PMID:[Are there any news in the management of spontaneous pneumothorax?]. 2244 72

The purpose of this article is to report a case of hemoptysis occurring in combination with secondary spontaneous pneumothorax following chemical pleurodesis by talc. A Japanese male with cancer of renal pelvis was found with the left pneumothorax and multiple lung metastases. A computed-tomography scan revealed severe emphysema throughout the lungs. Talc pleurodesis was employed to arrest air leakage. The patient developed hemoptysis 45 minutes after talc injection into the thorax. This is the first report of hemoptysis following talc pleurodesis. The agent could induce severe inflammation in capillary vessels of the lung following visceral pleura infiltration.
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PMID:Hemoptysis following Talc Pleurodesis in a Pneumothorax Patient. 2912 33