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Query: UMLS:C0034069 (pulmonary fibrosis)
 7,050 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A wide variety of types of pulmonary diseases and respiratory symptoms have been associated with gastroesophageal reflux (GER). Asthma, chronic bronchitis, bronchiectasis, and pulmonary fibrosis have all been linked to GER, but causal mechanisms have been difficult to establish. To characterize pulmonary function abnormalities in older children and young adults (age 7-23 years) with GER, lung function was evaluated in 22 patients being treated for reflux. The patients were divided into two groups: nine subjects (Group 1) had no history of pulmonary symptoms. Thirteen subjects (Group 2) had known pulmonary disease; all had diagnosed asthma, and five had a history of recurrent pneumonia. Lung volumes and spirometry were measured. Airway reactivity was assessed by measuring change in flows following isocapneic hyperventilation of subfreezing air. The presence of "small airway" disease was assessed by air-helium flow volume curves and the single breath oxygen test. Lung size, as indicated by measurement of total lung capacity, was normal in all patients. Flow rates, density dependence of maximal expiratory flow, single breath oxygen test, and tests of airway reactivity were abnormal only in Group 2 patients and were normal in the Group 1 patients. That not all children with GER have abnormal pulmonary function suggests that, if there is a causal relationship between GER and lung disease, it is multi-factorial in nature. Children with GER who do have lung disease have evidence of airway obstruction, maldistribution of ventilation, and increased airway reactivity, but do not have restricted lung volumes.
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PMID:Pulmonary function in older children and young adults with gastroesophageal reflux. 376 70

A survey of American College of Chest Physicians (ACCP) members was conducted to determine their degree of involvement in the diagnosis and prevention of occupational and environmental respiratory disease (OERD). Although the response rate was relatively low, the results are likely to be representative. Calculations based on the data estimate that in the prior year, chest physicians on the average saw 15 patients with OERD caused by work, 13 worsened by work, and 28 affected by the home environment. Asthma appears to be a more common occupational or environmental concern than pulmonary fibrosis. Chest physicians clearly perceived a need for more education in OERD. The survey also demonstrated that although many chest physicians perform routine industrial surveillance testing, it is often done without using standardized methods. Furthermore, chest physicians are actively involved with medical/legal aspects of OERD. Overall, the survey documents the role of chest physicians in the area of OERD and emphasizes significant educational needs.
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PMID:Role of chest physicians in detection and treatment of occupational and environmental respiratory disease. A practice survey. 770 30

Computed tomography (CT) is useful in evaluating bronchial and bronchiolar abnormalities. Common bronchial and bronchiolar abnormalities include bronchiectasis, asthma, bronchial obstruction, and various forms of bronchiolitis. Causes of bronchiectasis include cystic fibrosis, childhood viral infection, allergic bronchopulmonary aspergillosis, and pulmonary fibrosis. On CT scans, cystic fibrosis may manifest with bronchial wall thickening, bronchiectasis (usually cylindrical, with varicose and cystic forms seen in advanced cases), and mucus plugs in the bronchi. Allergic bronchopulmonary aspergillosis is characterized by central, varicose or cystic bronchiectasis, predominantly in the upper lobes, with mucoid impaction in the bronchi. Traction bronchiectasis may be seen on CT scans of pulmonary fibrosis. Asthma is characterized by bronchial wall thickening due to inflammation. Bronchial dilatation and air trapping may also be seen. Bronchiolitis obliterans is manifested by direct and indirect signs on CT scans; the former consist of centrilobular branching structures and nodules, and the latter consist of bronchiectasis and bronchiolectasis, mosaic perfusion, and air trapping. CT findings of bronchiolitis obliterans organizing pneumonia (also known as cryptogenic organizing pneumonia) include air-space consolidation and nodules, with occasional bronchial dilatation and pleural effusions.
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PMID:CT of bronchial and bronchiolar diseases. 799 28

Asthma is common, affecting 5% to 10% of adults; asthma is progressive, leading to irreversible obstruction in 80% of elderly patients; and asthma is complex, often complicated by coexisting lung diseases. This loss of lung function results from 4 independent pathologic conditions: (1) airway remodeling, especially in the small airways, from the lymphocytic-eosinophilic inflammation that characterizes asthma; (2) bronchiectasis; (3) postinfectious pulmonary fibrosis; and (4) emphysema and chronic bronchitis from tobacco smoke. Deterioration in lung function develops faster in nonallergic patients with intrinsic asthma during the period shortly after onset of asthma and in older patients. About 4% of patients die of asthma, and most are elderly. Death most often results from complications of irreversible obstruction or cardiotoxicity of bronchodilator therapy. More research is needed to improve therapy for preventing remodeling of small airways, to confirm the frequency of bronchiectasis and postinfectious fibrosis and to determine their causes, and to develop diagnostic criteria to identify these complications. Meanwhile, clinicians treating adult asthmatic patients need to be aggressive in preventing the damage from cigarette smoke; in immunizing for influenza and pneumococcus infection and identifying and treating respiratory infections, particularly at times of acute exacerbations; in diagnosing and managing bronchiectasis; and in objectively confirming the efficacy of asthma therapy to prevent illness from overtreatment with glucocorticoids and bronchodilators.
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PMID:The natural history of asthma in adults: the problem of irreversibility. 1019 98

This study reports a 3-year follow-up of a classic presentation of hypersensitivity pneumonitis (HP), originally reported elsewhere, after removal of the causative antigens. The literature is reviewed and this case is compared with outcomes of series previously reported. The patient was reevaluated by clinical, serologic, radiographic, and pulmonary function testing 3 years after removal of her home's contaminated humidifier, cleaning of the home, and administration of a course of prednisone. Repeat serologic measurements revealed positive serum precipitins only for Aspergillus flavus and Phoma herbarum, significantly fewer than her original panel, which revealed precipitating antibodies to her humidifier water and 10 other specific antigens. Pulmonary function tests remained stable. Physical exam revealed bibasilar rales. Computed tomography scan revealed pulmonary fibrosis, bronchiectasis, and honeycombing that was compared with 3 years earlier. Although most of the data obtained on reevaluation suggest remission, radiographic findings have not remitted. Long-term follow-up of parameters of HP disease activity do not always reveal consistent findings. This patient appears to be in a category of HP between the classic subacute and chronic stages.
Allergy Asthma Proc
PMID:Long-term evaluation of hypersensitivity pneumonitis: a case study follow-up and literature review. 1222 97

A case of hypersensitivity pneumonitis (HP) is presented and briefly discussed. The clinical characteristics, diagnosis, pathogenesis, and management of this syndrome are reviewed followed by clinical pearls and pitfalls for the practicing allergist. Most patients with acute HP recover completely with removal from the offending antigen. Treating symptoms only and not avoiding antigen triggers may lead to severe pulmonary fibrosis.
Allergy Asthma Proc
PMID:Hypersensitivity pneumonitis. 1654 77

Bronchiolitis has been known as one of the pathological features of lung injuries in mustard gas exposed patients.The purpose of this research was to evaluate the efficacy of interferon gamma-1b on the lung function in mustard gas exposed patients with bronchiolitis. In multicenter research interferon gamma-1b was effective in pulmonary fibrosis with unknown reason, but assessment of effect of interferon gamma-1b in the chemical injured patients has not so far been reported.Thirty six patients with bronchiolitis whose lung lesion had been diagnosed through the chest high resolution computerized tomography (HRCT) and pathological study were divided into two eighteen member case and control groups. The case group was treated for 6 months with a combination of 200 mug of interferon gamma-1b (given three times per week subcutaneously) and 7.5mg of prednisolone (given once a day), while the control group received their previous medications (prednisolone 7.5mg/day + salbutamol and beclomethasone spray PRN).In the two groups, FEV1 did not have statistical differences at base line (49.3+/-2.9 and 48.7+/-4.1, respectively, p = 0.6), whereas after treatment the data for FEV1 showed a significant increase in the case group (66.3+/-5.4) when compared with those in the control group (57.3+/-8.6, p=0.001). The findings of this study indicate that a 6-month treatment with interferon gamma -1b plus a low-dose of prednisolone is associated with the improvement of the lung function in mustard gas exposed patients with bronchiolitis.
Iran J Allergy Asthma Immunol 2005 Jun
PMID:The therapeutic effect of gamma interferon in chronic bronchiolitis due to mustard gas. 1730 27

Chronic cough is a common and frequently disruptive symptom which can be difficult to treat with currently available medicines. Asthma/eosinophilic airway disease and gastro-oesophageal reflux disease are most commonly associated with chronic cough but it may also trouble patients with chronic obstructive pulmonary disease, pulmonary fibrosis and lung cancer. Over the last three decades there have been a number of key advances in the clinical approach to cough and a number of international guidelines on the management of cough have been developed. Despite the undoubted benefit of such initiatives, more effective treatments for cough are urgently needed. The precise pathophysiological mechanisms of chronic cough are unknown but central to the process is sensitization (upregulation) of the cough reflex. One well-recognized clinical consequence of this hypersensitive state is bouts of coughing triggered by apparently trivial provocation such as scents and odours and changes in air temperature. The main objective of new treatments for cough would be to identify ways to downregulate this heightened cough reflex but yet preserve its crucial role in protecting the airway. The combined efforts of clinicians, scientists and the pharmaceutical industry offer most hope for such a treatment breakthrough. The aim of this chapter is to provide some rationale for the current treatment recommendations and to offer some reflections on the management of patients with chronic cough.
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PMID:Clinical cough II: therapeutic treatments and management of chronic cough. 1882 46

Asthma is a chronic inflammatory disorder of the airways. Type 2 T helper (Th) cell-dominated inflammation in the lung is a hallmark of asthma. Src homology 2 domain-containing protein tyrosine phosphatase (SHP)-1 is a negative regulator in the signaling pathways of many growth factor and cytokine receptors. However, a direct role of SHP-1 in the IL-4/IL-13 signaling pathway has not been established. In this study, we sought to define the function of SHP-1 in the lung by characterizing the pulmonary inflammation of viable motheaten (mev) mice, and to investigate the molecular mechanisms involved. Pulmonary histology, physiology, and cytokine expression of mev mice were analyzed to define the nature of the inflammation, and the gene-deletion approach was used to identify critical molecules involved. In mev mice, we observed spontaneous Th2-like inflammatory responses in the lung, including eosinophilia, mucus metaplasia, airway epithelial hypertrophy, pulmonary fibrosis, and increased airway resistance and airway hyperresponsiveness. The pulmonary phenotype was accompanied by up-regulation of Th2 cytokines and chemokines. Selective deletion of IL-13 or signal transducer and activator of transcription 6, key genes in the Th2 signaling pathway, significantly reduced, but did not completely eliminate, the inflammation in the lung. These findings suggest that SHP-1 plays a critical role in regulating the IL-4/IL-13 signaling pathway and in maintaining lung homeostasis.
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PMID:A critical role of SHP-1 in regulation of type 2 inflammation in the lung. 1895 67

Cordyceps sinensis is a medicinal fungus of Traditional Chinese Medicine. There are a wide range of reported uses of Cordycep sinensis in the literature. However, the production of Cordyceps sinensis is so limited that can not be widely used. Cultured Cordyceps sinensis (Bailing Capsule) and natural Cordyceps sinensis have similar chemical composition. Bailing Capsule possesses anti-inflammatory, anti-hypoxia, anti-tumor effect function and regulating the endocrine system, enhanced immune function, which has a protective effect on the kidney, lung, liver and other organs. Recently, Bailing capsule has some beneficial effects on pulmonary diseases, such as COPD, Pulmonary fibrosis, Asthma, which have been gradually applied to the clinical.
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PMID:[Pharmacological effects of Bailing capsule and its application in lung disease research]. 2124 39


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