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Query: UMLS:C0037116 (silicosis)
 1,822 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Individual susceptibility to silicosis is suggested by the lack of a uniform dose response relation and by the presence of immunological epiphenomena, such as increased antibody levels and associated diseases that reflect altered immune regulation. Human leucocyte antigens (HLA) are linked with immune response capability and might indicate a possible genetic susceptibility to silicosis. Forty nine silicotic subjects were identified from chest radiographs in a population based study in Leadville, Colorado. They were interviewed for symptoms and occupational history and gave a blood specimen for HLA-A, -B, -DR, and -DQ typing and for antinuclear antibody, immune complexes, immunoglobulins, and rheumatoid factor. Silicotic subjects had twice the prevalence of B44 (45%) of the reference population and had triple the prevalence of A29 (20%), both of which were statistically significant when corrected for the number of comparisons made. No perturbations in D-region antigen frequencies were detected. B44-positive subjects were older at diagnosis and had less dyspnoea than other subjects. A29-positive subjects were more likely to have abnormal levels of IgA and had higher levels of immune complexes. This study is the first to find significant HLA antigen excesses among a series of silicotic cases and extends earlier reported hypotheses that were based on groups of antigens of which B44 and A29 are components.
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PMID:Histocompatibility antigens in a population based silicosis series. 237 23

Respiratory infections of 19 subjects of advanced age and/or with underlying respiratory disease were treated with cefoperazone (CPZ) and its clinical effects were studied. Sixteen subjects suffered from respiratory tract infection and 3 subjects had pneumonia. The age of the subjects ranged from 39 to 77 years with the mean of 63.8, 7 of them being more than 70 years of age. The underlying respiratory diseases included chronic pulmonary emphysema in 6 subjects, diffuse panbronchiolitis in 3, bronchiectasis in 3, silicosis in 2 and one each of chronic bronchitis, pulmonary fibrosis, lung cancer and old pulmonary tuberculosis. One case, 75 years of age, had renal insufficiency. The daily dose of CPZ was 4 grams in 18 of the 19 subjects and the duration of administration ranged 5 to 22 days. The remaining 1 subject received 2 g of CPZ daily for 6 days. Clinical effects were judged from the changes in fever, cough, amount of sputum, dyspnea, rales, cyanosis, chest X-ray, white blood cell counts, CRP, erythrocyte sedimentation rates and results of sputum culture. Clinical effects were good in 16 subjects, fair in 1, and poor in 2. Bacteriological follow-up was carried out in 13 subjects. Infecting bacteria were eliminated from 5 subjects, reduced in 2 and, in 4 subjects, they were replaced by other bacteria. In 1 subject, P. aeruginosa was isolated from sputum even after the treatment with CPZ, and in another subject H. influenzae relapsed immediately after the cessation of the CPZ treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Effects of cefoperazone on respiratory infections of patients of advanced age and/or with underlying respiratory diseases]. 373 62

Respiratory symptoms, radiographic findings, and lung function were analyzed in 144 Finnish patients with silicosis. The prevalence of persistent phlegm production in these patients was 46% and that of dyspnea 87%. Impairment of the vital capacity (VC) and the diffusion capacity (DLCO) (less than 80% of predicted values) were found in 46 and 47% of the patients with simple silicosis, respectively. The mean DLCO was lower in patients with advanced simple silicosis (category 3) than in those with slight simple silicosis (categories 1 and 2). In category 3 the DLCO was impaired in 9 out of 12 patients, the impairment being below 65% of the predicted values in six of the nine. All patients with large opacities showed impairment in their lung function tests. Twenty-eight of the silicosis patients had referents matched for exposure to silica dust, age, and gender. The referents had no radiographic signs of silicosis. The patients experienced dyspnea more often than their referents, whereas no difference was found in the prevalence of persistent phlegm production. The mean values of VC, forced expiratory volume in 1 s (FEV1.0), and DLCO were lower in the patients than in the referents. The results indicate a high prevalence of dyspnea, restrictive impairment of lung function, and impaired diffusion capacity in the patients with simple or complicated (ie, large radiographic opacities) silicosis. The DLCO proved to be a rather sensitive lung function parameter for advanced simple silicosis.
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PMID:Symptoms and clinical findings in patients with silicosis. 400 97

After a period of 10 years the authors reexamined the respiratory health status of 381 dust-exposed males. Of the lung function values examined Raw, RV/TLC%, VC, TGV and PaO2 were found to be of significant prognostic importance. Among the radiological changes characteristic of silicosis the most serious B-C category, among the respiratory complaints dyspnoea accompanied by regular cough and expectoration, and among the physical changes extended rhonchi and rales accompanied by an emphysematous thorax are to be considered as most essential with respect to prognosis. Smoking habits significantly affected the total death rate, but did not prove to be significant with regard to respiratory death. In the development of bronchial obstruction recurrent febrile respiratory diseases proved to be more important than smoking habits and mild bronchitic complaints.
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PMID:Changes in clinical status and lung functions of patients with chronic respiratory diseases over 10 years. 643 34

To obtain additional data concerning uranium mining and nonmalignant respiratory diseases, we conducted a prevalence survey of 192 long-term New Mexico uranium miners. Survey procedures included spirometry, completion of a respiratory symptoms questionnaire, physical examination and interpretation of available chest x rays. Total duration of underground uranium mining was used as the exposure index. Of the major respiratory symptoms, only the prevalence of dyspnea increased significantly with duration of uranium mining. With linear multiple-regression analysis, small but statistically significant effects of mining were found for two spirometric parameters, the forced expiratory volume in one sec and the maximal midexpiratory flow. By the 1980 International Labor Organization (ILO) U/C classification, 12 of 143 participants with x rays available for interpretation had at least category 1/0 pneumoconiosis. The opacities were predominantly nodular and compatible with silicosis.
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PMID:Prevalence survey of respiratory abnormalities in New Mexico uranium miners. 669 66

A 60-year-old stonemason, suffering for many years from joint pains and exertional dyspnoea, developed a high fever with weight loss. Physical examination revealed reddening of light-exposed skin areas, fine rales and overly warm and reddened hand and knee joints. Abnormal laboratory findings were increased erythrocyte sedimentation rate of 66 mm/h, C-reactive protein concentration of 1 mg/dl, haemoglobin of 9.4 g/dl and white cell count of 3300/microliters. Urine contained albumin (100 mg/dl) and cylinders. Titres of both antinuclear and anti-ds-DNA antibodies were elevated (1:2560 and > 97 U/ml, respectively). The chest radiography showed enlarged hili, as well as reticular and nodular shadows which histologically showed silicosis. Systemic lupus erythematodes was diagnosed and the patient was treated with prednisone (2 mg/kg daily), the dosage being reduced to 12 mg daily within 3 months. When the joint pains recurred, azathioprine (50 mg daily) was added for 24 months. At present he is receiving prednisone (12 mg daily) and there has been no recurrence for 4 years.
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PMID:[Systemic lupus erythematosus and silicosis]. 785 45

Diagnosing of alveolitis is a puzzle of many pieces, based on clinical experience and keeping in mind the criteria of extrinsic allergic alveolitis. They are antigen-exposure, typical delayed postexpositional symptoms (cough, chills, fever, dyspnea, tiredness), and serological tests of precipitating antibodies. Helpful findings are X-ray of the chest, high resolution computer tomography, auscultation findings, lowered diffusing capacity, bronchoalveolar lavage with lymphocytes > 50% and low T4/T8-ratio, histology of periphere lung specimens, and occasional inhaled provocation. Differential diagnosis are toxic lung disorders, drug adverse effects, sarcoidosis, silicosis, autoimmune alveolitis, idiopathic fibrosing alveolitis. The most frequent failure in diagnosis are common viral cold, bronchopneumonia, sarcoidosis, chronic bronchitis, and miliar tuberculosis.
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PMID:[Diagnostic process of alveolitis--state of the art]. 787 67

In order to provide a better objective assessment of exertional dyspnea and functional impairment due to exposure to silica, 153 workers exposed to silica dust (workers) and 62 patients with silicosis (patients) were performed the medical questionnaires with special reference to exertional dyspnea and exercise testing on bicycle ergometer. Complaints of breathlessness were present in 77 (50%) workers and 53 (85%) patients. The findings of exercise tests indicated that there were definite correlations between index of dyspnea (ID), or breathing reserve (BR) and complaint of breathlessness in both the workers and patients. ID increased and BR decreased with the increasing degree of breathlessness. We defined ID > 70% or BR < 25 I/min as abnormal criteria and checked the ratios of dyspnea quantified objectively. Thus, 30% of the workers and 56% of the patients in this study were verified to have slight or moderate breathlessness, which were considerably lower than that derived from questionnaire on dyspnea. OUr results suggest that objective physiological measures like exercise testing may be of value in evaluating dyspnea in workers exposed to silica.
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PMID:Dyspnea and exercise testing in workers exposed to silica. 855 37

The Erasmus syndrome describes the association of generalised progressive scleroderma following exposure to silica with or without silicosis. This is a case report on four patients presenting with the Erasmus syndrome who were admitted to hospital. The analysis of the four cases enables an assessment of the cause of the dyspnoea during the course of the Erasmus syndrome. The dyspnoea presents more as scleroderma (pulmonary fibrosis in two cases, pulmonary artery hypertension in one case and localised thoracic skin disease in one case) than of pneumoconiosis. Pulmonary fibrosis should be considered where there is an association of progressive effort dyspnoea, fine crackles on auscultation and a radiological appearance either of honeycombing and/or a ground glass appearance predominantly in the posterior regions which does not exist in isolated cases of silicosis. The functional repercussion of the fibrosis is evident by a restrictive ventilatory defect which is not specific but more severe than in a case of silicosis alone. Bronchoalveolar lavage showed, in two cases of pulmonary fibrosis, an unusual polymorphonuclear neutrophilia during the course of the silicosis. The presence of ausculatory anomalies, the atypical aspects of pneumoconiosis on computed tomography and an unusual form of LBA should suggest the existence of pulmonary fibrosis associated with pneumoconiosis.
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PMID:[Erasmus syndrome: clinical, tomographic, respiratory function and bronchoalveolar lavage characteristics]. 908 2

We describe six cases of acute silicosis which were characterised by an intense exposure to pure silica; there was a rapid onset with diffuse abnormalities on the radiological image and severe respiratory abnormalities. The duration of occupational exposure to silica was four to eighteen years. Three patients presented with a cough associated with disabling dyspnoea (stage III and IV). The physical examination showed finger clubbing in three patients and rales and crepitations on auscultation in two patients. There was general debility in four of the cases with weight loss. The chest x-ray showed a rapid progress with confluence of the diffuse nodular opacities. Respiratory function tests showed a restrictive ventilatory defect (mean +/- standard error of mean: TLC 67 +/- 5%, Vital Capacity +/- 7%, FEV1 63.5 +/- 6%) and alteration in the transfer factor for carbon monoxide (DLCO: 49.5 +/- 5%). The initial broncho-alveolar lavage showed a lymphocytosis (23.6 +/- 4.2%) associated with an alveolar neutrophilia (7 +/- 2.5%). A lung biopsy was carried out in three patients and a transbronchial biopsy in one patient confirming the diagnosis of silicosis in three cases and of silicoproteinosis in one case. After a period of eighteen months to 14 years, four patients died either due to cardiopulmonary complications of their disease (two cases) or to intercurrent disorders (two cases). The last two patients are currently stable.
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PMID:[Acute silicosis. Clinical, radiologic, functional, and cytologic characteristics of the broncho-alveolar fluids. Observations of 6 cases]. 980 64


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