Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034069 (pulmonary fibrosis)
 7,050 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report six cases in which patients presented with acute dyspnoea following injections of either vindesine or vinorelbin. These patients were receiving chemotherapy in association with cisplatin, mitomycin, and vindesine or vinorelbin, for inoperable bronchial cancer. Three of the patients had evidence of airflow obstruction before these incidents. The clinical picture suggested bronchospasm and appeared in the two hours following an injection of the vinca alkaloid and a significant time away from the administration of the mitomycin. Additional respiratory support was necessary in one patient, the bronchial spasm stopped spontaneously in three cases, and following bronchodilator in two. The respiratory toxicity of vinca alkaloids (vindesine, vinblastin) was observed in 4% of the cases, uniquely when they were associated with mitomycin. Vinorelbin seems to possess the same respiratory toxicity. The bronchospasm, sometimes very severe, seems to occur in the two hours following the injection in the case of the cytotoxics and some time after the administration of mitomycin. The recurrence of the bronchospasm is a constant feature when the vinca alkaloid is readministered. This side effect is different to the pulmonary fibrosis due to mitomycin. Clinical follow up and spirometry is thus necessary in those patients receiving chemotherapy in which vinca alkaloids and mitomycin are associated and the regime should be followed after each administration of a vinca derivative. After the first episode of dyspnoea, it is probably wise to stop the administration of these anti-mitotics to prevent any further respiratory side-effects which could be more severe.
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PMID:[Acute bronchospasm due to periwinkle alkaloid and mitomycin association]. 834 75

The effects of chlorpromazine hydrochloride (CPZ) on paraquat (PQ) poisoning were examined using male and female beagle dogs. Twenty-six dogs were divided into 3 groups of 21 PQ-poisoned dogs and a control group of 5 saline-treated dogs. Thirty minutes after the 21 dogs were given 20 mg PQ dichloride/kg body weight sc, groups of 7 dogs received 3 mg CPZ/kg im, 5 mg CPZ/kg im or 0.5 ml saline/kg im daily for 5 d. PQ-treated dogs exhibited dyspnea. Serum angiotensin I converting enzyme (AICE) activity of the PQ-treated dogs was elevated during days 1-3. Lung AICE activity of the PQ-treated dogs was slightly lower than the control group. Lung hydroxyproline content was not elevated in either dying or surviving dogs. Based on our biochemical evaluations, PQ-induced pulmonary fibrosis did not occur during the 24 d of this study. From days 2-12 post-PQ dosing, all the dogs in the PQ + CPZ (3 mg/kg) group died. Dogs in the PQ + CPZ (5 mg/kg) group and the PQ + saline group had 6/7 and 5/7, respectively, die from days 2-24. The survival rate of the PQ + CPZ-treated dogs was not prolonged when compared to the PQ + saline group. The expected CPZ-induced increased in survival times, concurrent reductions in mortality rates, and effects on serum and lung AICE activities were not observed.
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PMID:Chlorpromazine and paraquat poisoning. 838 36

Several organs (lung, skin, thyroid, heart, bone marrow) are potential targets of cobalt (Co). Whereas there is no doubt that inhalation of Co alone may cause bronchial asthma, its role in the occurrence of hard metal disease is still controversial because most cases were reported in workers exposed not only to Co but also to other substances such as tungsten carbide, titanium carbide, iron, silica and diamond. To assess whether exposure to pure Co dust (metal, oxides, or salts) may lead to adverse health effects a cross sectional study was carried out among 82 workers in a Co refinery. The results were compared with those in a sex and age matched control group. The Co group had been exposed for 8.0 years on average (range 0.3-39.4). The geometric mean time weighted average exposure assessed with personal samplers (n = 82) was about 125 micrograms/m3 and 25% of the values were higher than 500 micrograms/m3. The concentrations of Co in blood and in urine after the shift were significantly correlated with those in air. Concentration of Co in urine increased during the workweek. A slight interference with thyroid metabolism (decreased T3, T4, and increased TSH), a slight reduction of some erythropoietic variables (red blood cells, haemoglobin, packed cell volume) and increased white cell count were found in the exposed workers. The exposed workers complained more often of dyspnoea and wheezing and had significantly more skin lesions (eczema, erythema) than control workers. Within the exposed group a dose-effect relation was found between the reduction of the forced expiratory volume in one second/vital capacity and the intensity of current exposure to Co assessed by the measurement of Co in air or in urine. The prevalence of dyspnoea was related to the dustiness of the workplace as reflected by statistically significant logistic regression between this symptom and the current levels of Co in air and in urine. No difference between lung volumes, ventilatory performances, carbon monoxide diffusing capacity, and serum myocardial creatine kinase and procollagen III peptide was found between the Co and control groups and no lung abnormalities were detected on the chest radiographs in both groups. The results suggest that exposure to high airborne concentrations of Co alone is not sufficient to cause pulmonary fibrosis. This finding is compatible with experimental studies indicating that interaction of other airborne pollutants with Co particles play a part in the pathogenesis of parenchymal lung lesions.
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PMID:Epidemiological survey of workers exposed to cobalt oxides, cobalt salts, and cobalt metal. 839 78

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

Rare earth pneumoconiosis is an uncommonly reported disease caused by the inhalation of dust containing lanthanides, also known as rare earth metals, which are common industrial materials. The pathologic manifestations and natural history of this disorder are incompletely understood. We describe a male patient with a 35-year history of optical lens grinding, an occupation associated with exposure to cerium oxide, a rare earth metal-containing compound. The patient presented with progressive dyspnea and an interstitial pattern on chest X-ray; open lung biopsy showed interstitial fibrosis histologically indistinguishable from usual interstitial pneumonitis. However, scanning electron microscopy with energy-dispersive X-ray analysis demonstrated numerous particulate deposits in the lung, of which the majority contained the rare earth metal cerium alone or in combination with other elements. Our case is one of the first to describe rare earth pneumoconiosis associated with pulmonary fibrosis in the occupational setting of optical lens manufacture. Besides reinforcing the contention that rare earth metals are potentially harmful, our case suggests that such agents may be causally related to the development of pulmonary fibrosis.
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PMID:Rare earth (cerium oxide) pneumoconiosis: analytical scanning electron microscopy and literature review. 855 76

Idiopathic pulmonary haemosiderosis (IPH) is a rare disease characterized by recurrent episodes of intrapulmonary bleeding, chronic iron deficiency anaemia and pulmonary fibrosis. IPH is a diagnosis made by exclusion of other causes. It occurs in both adults and children. Other conditions than IPH can cause pulmonary haemosiderosis. The etiology is unknown, but might be an immunological mechanism causing a defect in the basement membrane of the pulmonary capillary. IPH should be suspected in patients with recurrent episodes of coughing, haemoptysis, dyspnoea and anaemia. Chest X-ray shows pulmonary infiltrates during an acute attack. Examination of sputum or lung biopsy discloses large numbers of haemosiderin-laden pulmonary macrophages. The mortality-rate is high, but the prognosis is difficult to evaluate because many patients survive for a long time either with a course of recurrent attacks or with chronic symptoms, such as dyspnoea and persistent anaemia. Steroids may improve the condition of the patient during a bleeding episode.
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PMID:[Idiopathic pulmonary hemosiderosis]. 863 26

To assess the feasibility of treatments for patients with small cell lung cancer (SCLC) showing a poor performance status (PS, Eastern Cooperative Oncology Group; ECOG 3 or 4), we retrospectively reviewed the outcome for 13 SCLC patients showing poor PS treated at the National Cancer Center Hospital between January 1984 and May 1994. The main factors which contributed to poor prognosis were superior vena cava (SVC) syndrome, massive pleural effusion, tracheal stenosis due to lymph node swelling, pericardial effusion and pulmonary fibrosis (causing dyspnea in combination), brain metastasis resulting in neurological disturbance, cachexia, Eaton-Lambert syndrome causing muscle weakness, retroperitoneal lymph node metastasis causing abdominal pain, peritoneal effusion due to abdominal lymph node swelling, vertebral metastasis causing paraplegia, and dermatomyositis/polymyositis (DM/PM) causing muscle weakness. All of the patients received chemotherapy with or without radiotherapy. The PS of 8 patients improved with treatment, but no improvement was seen in 5. We analyzed these 13 patients and considered the treatments for those with poor PS. Chemo-radiotherapy was tolerable in SCLC patients showing PS 3, and improved their PS if severe conditions or combined disease did not arise concurrently. It was further suggested that PS 4 patients with severe conditions or combined disease should not be given the treatments.
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PMID:Retrospective analysis of the treatment of patients with small cell lung cancer showing poor performance status. 865 51

Long-term home oxygen therapy has been shown to benefit patients with hypoxemic chronic obstructive pulmonary disease. However, to obtain the expected maximal benefit it is important for the oxygen to be used correctly and for a sufficient length of time. We examined compliance with home oxygen therapy in patients with chronic obstructive pulmonary disease, pulmonary fibrosis, late sequelae of pulmonary tuberculosis, and pulmonary hypertension who used oxygen concentrations. Compliance was defined as the ratio of the amount of oxygen used to the amount prescribed. The average daily length of time the concentrator actually ran was measured from the concentrator meters. These were read every 6 months by an engineer from the company that installed the concentrator. Factors thought to affect compliance were studied. These factors included age, the degree of dyspnea, arterial blood gases, and pulmonary function. Weak positive correlations were found between compliance and age and between compliance and PaCO2. A weak negative correlation was observed between compliance and PaO2. Compliance in patients with chronic obstructive pulmonary disease was higher than in patients with pulmonary fibrosis or pulmonary hypertension. Among those given prescriptions for 24-hr oxygen therapy, compliant patients had more severe dyspnea on excertion than did noncompliant patients. These data suggest that the compliant patients had more severe gas exchange problems.
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PMID:[Compliance with long-term home oxygen therapy]. 871 90

Acute pulmonary reactions to nitrofurantoin are an uncommon side effect of therapy and can cause minor or life-threatening pulmonary dysfunction. Symptoms include fever, chills, cough, pleuritic chest pain, dyspnea. Rarely, pleural effusion and/or pulmonary hemorrhage may occur. Diagnosis is made by clinical suspicion and exclusion of other causes of respiratory compromise. Bronchoalveolar lavage (BAL) may be used to rule out infectious etiologies, and an increase in BAL fluid eosinophils is suggestive of drug-induced toxicity. The acute reaction to nitrofurantoin is believed to be mediated by an immune mechanism. Treatment is mainly discontinuation of the drug, however, corticosteroid therapy is recommended for severe reactions. A chronic reaction associated with long-term treatment with nitrofurantoin has also been reported and causes irreversible pulmonary fibrosis. Nitrofurantoin is commonly used to treat urinary tract infections during pregnancy. Despite the known pulmonary side effects of nitrofurantoin, there is no report of this toxicity occurring in pregnant patients. We present a case of respiratory failure occurring in a woman at 16 weeks' gestation who was being treated with nitrofurantoin for a urinary tract infection.
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PMID:Nitrofurantoin-induced pulmonary toxicity during pregnancy: a report of a case and review of the literature. 877 75

Chronic respiratory failure is defined on the basis of gas exchange in the lung. Recent studies have suggested serious clinical problems in patients with disabling dyspnea not necessarily related to gas exchange. Home oxygen therapy not only prolongs life expectancy but also improves the quality of daily life. In Japan, pulmonary emphysema, sequelae of pulmonary tuberculosis, and interstitial pneumonia/pulmonary fibrosis are the 3 major diseases currently treated by home oxygen therapy. Respiratory failure caused by interstitial pneumonia/pulmonary fibrosis and lung cancer is on the increase and is also treated by home oxygen therapy. Clinical problems on mechanisms and treatment of chronic respiratory failure are reviewed from recent data.
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PMID:Current status and research on chronic respiratory failure in Japan. 883 92


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