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Query: UMLS:C0729233 (Thoracic)
 6,478 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Restrictive lung disease is often first detected when patients complain of dyspnea on exertion. Many forms of exercise testing are available, from simple hallway oximetry to the more formal and more complex cardiopulmonary exercise test. Although the use of exercise for diagnosis, treatment, and predicting outcomes is largely understudied in this population, it has recently been shown to be of value in some settings. Exercise testing may be a valuable diagnostic tool in determining the extent of lung disease in sarcoidosis. Medinger et al. reported that the symptom-limited exercise test detected pulmonary dysfunction earlier than history, physical examination, chest radiography, and spirometry alone. Furthermore, Delobbe et al. noted that in patients with biopsy-proved sarcoidosis, cardiopulmonary exercise testing was a more sensitive indicator of early lung disease than pulmonary function tests. The American College of Chest Physicians/American Thoracic Society have published an updated consensus statement for cardiopulmonary exercise testing. Christensen et al. reported that patients with restrictive lung disease may be at risk for hypoxemia with light exercise while on an airplane, and suggest that these patients be considered for in-flight oxygen therapy. Lastly, Herridge and the Canadian Critical Care Trial Group used the 6-minute walk test to prove that survivors of acute respiratory distress syndrome have significant functional limitation 1 year after discharge from the intensive care unit largely secondary to neuromuscular sequelae. Exercise testing appears to be a valuable tool in evaluating, treating, and predicting outcomes in patients with restrictive lung disease. Further study will help to support its use in other restrictive lung diseases.
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PMID:Role of exercise evaluation in restrictive lung disease: new insights between March 2001 and February 2003. 1290 12

Idiopathic pulmonary fibrosis (IPF), synonymous with cryptogenic fibrosing alveolitis (CFA), is a progressive and usually fatal disease of unknown cause characterized by sequential acute lung injury with subsequent scarring and end-stage lung disease. Historically, IPF/CFA encompassed a heterogeneous group of different histological and clinical entities arising in an idiopathic setting. Recently, the American Thoracic Society (ATS) and European Respiratory Society (ERS) core committee has redefined diagnostic criteria for both IPF/CFAand idiopathic interstitial pneumonias confining the term IPF/CFA to patients with a histological pattern of usual interstitial pneumonia on lung biopsy. This review attempts to refine the clinico-radiological-pathological features that together define IPF/CFA as it is understood today, and to summarize the rationale of new therapeutic approaches based on the current understanding of the pathogenetic mechanisms.
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PMID:Idiopathic pulmonary fibrosis/cryptogenic fibrosing alveolitis. 1459 83

The problem of multidrug-resistance is urgent because the part of these patients undergoes treatment failure after chemotherapy. In such cases the operations are performed. In 1998-2002 in the Department of Thoracic Surgery of Republic Santariskes Tuberculosis and Lung Disease Hospital 739 thoracic operations were performed for the patients with pulmonary tuberculosis. Because of multidrug-resistant pulmonary tuberculosis 355 patients (48%) were operated on, radical operations were performed to 190 patients (53.5%) and for 165 (46.5%) - palliative. Positive outcome was documented for 324 patients (91.3%); 31 patients (8.7%) died. Various postoperative complications were confirmed in 76 cases (21.4%) when multidrug-resistance was determined. CONCLUSIONS. When multidrug-resistance is developed, clinic or radiological dynamics of tuberculosis process is not positive, after 3-4 months is it necessary to discuss the question of the operation. In case of monolateral process the radical operations with the type of resection are performed, but in case of widespread process and various complications palliative operations are performed. The treatment with antituberculotic drugs when patient is operated on because multidrug-resistance is continued for 22-24 months.
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PMID:[Multidrug-resistance: the modern problem of surgical treatment of pulmonary tuberculosis]. 1507 21

Factors, including air pollution, influencing the prevalence of respiratory symptoms were investigated in a cross-sectional study in policemen and their wives (530 couples) in Bangkok. Information on respiratory symptoms was obtained using the American Thoracic Society Division of Lung Diseases (ATS-DLD) questionnaire. Effects of working and residential locations were evaluated using a multiple logistic model adjusted for several potential confounding factors. In the policemen the increased risk of frequent cough or phlegm was related to smoking (OR=2.19, 95% CI: 1.47-3.26) and working in heavy traffic locations (OR=1.27, CI: 1.01-1.61), whereas in their wives it was related to their residential locations (OR=1.53, CI: 1.10-2.13).
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PMID:Effects of working and residential location areas on air pollution related respiratory symptoms in policemen and their wives in Bangkok, Thailand. 1508 Mar 86

The International Union Against Tuberculosis and Lung Disease (UNION) has a decade of experience in conducting short courses on research methods for the promotion of lung health. In a parallel initiative, the UNION has collaborated with the American Thoracic Society (ATS) to develop courses on international respiratory epidemiology that have been expanded by the ATS throughout Latin America. The two initiatives have similar aims, and the courses offered by the two organisations have intentionally been similar in terms of focus and complementary in regions targeted. The target regions of the UNION, drawing on several decades of experience in offering short courses on tuberculosis, have been Africa, the Black Sea Rim, the Middle East and Asia, while the target regions of the ATS have been Central and South America. This workshop aimed first to provide an opportunity for those who have taught on the courses and those who have participated to share their experiences and learn from them, and second to provide a basis on which to develop a strategic plan for future courses. This report summarises the contributions of the workshop participants and the conclusions reached.
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PMID:Capacity building for research: report on a UNION Strategic Planning Workshop. Report of a workshop held during the International Union Against Tuberculosis and Lung Disease World Conference on Lung Health, Montreal, Canada, 7 October 2002. 1526 Feb 87

Mycobacterium avium complex (MAC) is ubiquitous. It is found in various freshwater and saltwater sources around the world, including hot water pipes. Although the organism was identified in the 1890s, its potential to cause human disease was only recognized 50 years later. Only a minority of people exposed to the organism will acquire MAC lung disease, usually those with underlying lung disease or immunosuppression. MAC may, however, cause progressive parenchymal lung disease and bronchiectasis in patients without underlying lung disease, particularly in middle-aged and elderly women. Preliminary data suggest that the interferon-gamma pathways may be deficient in elderly women with MAC lung disease. Other groups of patients who are more likely to harbor MAC in their lungs include patients with a cystic fibrosis or an abnormal alpha(1)-antiproteinase gene and patients with certain chest wall abnormalities. Treatment results continue to be disappointing, and the mortality of patients with MAC lung disease remains high. A PubMed search identified 38 reports of the treatment of MAC lung disease. Apart from the British Thoracic Society study, the only published controlled investigation, the studies published since 1994 have included a macrolide, either clarithromycin or azithromycin, usually in combination with ethambutol and a rifamycin. If success is defined as eradication of the organism without relapse over a period of several years after treatment has been discontinued, the reported treatment success rate with the macrolide containing regimens is approximately 55%. The prolonged treatment period, side effects, and possibly reinfection rather than relapse are responsible for the high failure rate.
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PMID:Mycobacterium avium complex pulmonary disease in patients without HIV infection. 1588 75

The relationship between silicosis and tuberculosis is well known. Also other mycobacteria such as Mycobacterium kansasii often occur in association with pneumoconiosis. However, there are few reports describing an association of M. avium-intracellulare complex (MAC) lung disease and pneumoconiosis. The purpose of the present study is to describe clinical features of MAC respiratory infection associated with pneumoconiosis. Eleven patients with MAC respiratory infection associated with pneumoconiosis (all men, 6 with silicosis and 5 with welders' pneumoconiosis) were collected. A determination of whether or not MAC caused pulmonary disease was made using the 1997 criteria required by the American Thoracic Society. Radiologically, cavity formation as well as upper lung field predominance of MAC disease were observed in 8 of 11 cases (72.7%). Two of 11 patients died of respiratory failure. Our present study clearly demonstrates that clinical features of MAC respiratory infection associated with pneumoconiosis were different from MAC without underlying diseases.
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PMID:Clinical features of eleven cases of Mycobacterium avium-intracellulare complex pulmonary disease associated with pneumoconiosis. 1530 35

Progressive non-malignant lung disease (PNMLD) is a common cause of morbidity and mortality in the UK. In 1999, chronic lung disease--including chronic obstructive pulmonary disease (COPD), tuberculosis, pulmonary circulatory disease, pneumonoconiosis, sarcoidosis and cystic fibrosis--killed almost 39,000 (British Thoracic Society, 2000), while it is estimated that 600,000 people in the UK have COPD, the most common non-malignant lung disease (BTS, 2001).
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PMID:Palliative care for people with end-stage non-malignant lung disease. 1573 98

Genetic studies in familial lung fibrosis have demonstrated an association with surfactant protein C genes: two mutations have been found resulting in protein misfolding and causing type-II epithelial cell injury. Remarkably, different histological patterns were observed in the affected subjects, suggesting the influence of modifier genes and/or environmental factors. Surfactant protein C gene variations have not, however, been associated with sporadic cases, i.e. idiopathic pulmonary fibrosis (IPF). Susceptibility to IPF probably involves a combination of polymorphisms related to epithelial cell injury and abnormal wound healing. To date, the genetic associations with IPF that have been reported in different cohorts include the genes encoding tumour necrosis factor (TNF; -308 adenine), interleukin-1 receptor antagonist (+2018 thymidine) and association with severity and progression (interleukin-6/TNF receptor II and transforming growth factor-beta1 (TGFB1; +869 cytosine)), but none of these associations have been replicated by others. Unlike in IPF, immunological inflammation seems to be more prominent in the pathogenesis of scleroderma lung fibrosis, being an autoimmune disease with specific autoantibodies, such as antitopoisomerase antibodies, in patients with diffuse lung disease, and anticentromere antibodies, in patients with pulmonary vascular disease. Antitopoisomerase antibody positivity is associated with the carriage of human leukocyte antigen DRB1*11 and DPB1*1301 alleles, suggesting the recognition of a specific amino-acid motif. Extended haplotype analysis also supports the conclusion that TNF may be the primary association with anticentromere positivity. Intriguingly, associations with TGFB1 and genes involved in extracellular matrix homeostasis have been reported in this disease. In conclusion, significant steps forward have been taken in the understanding of the genetic contribution to fibrosing lung diseases, but major challenges lay ahead. It is the present authors' opinion that only a combined approach studying large numbers of familial and sporadic cases, all clinically well phenotyped, using multiple distinct cohorts, and genotyped according to relevant gene ontologies will be successful. It will be necessary to be particularly vigilant with regard to phenotype; the absence of very strong reproducible associations may be because of the rigidity of phenotype definition, coupled with the possibility that idiopathic pulmonary fibrosis may still be a heterogeneous group of diseases, despite the more rigid definition set out by the European Respiratory Society/American Thoracic Society statement.
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PMID:Genetics of fibrosing lung diseases. 1586 52

This study is aimed to evaluate the incidence of silicosis and the relation of it with personal and work-related factors among workers exposed to silica in ceramic factory. Workers were evaluated by respiratory symptoms, physical examination, pulmonary function and radiological findings. Occupational and Enviromental Pulmonary Disease Evaluation Questionnaire of the Turkish Thoracic Society Enviromental and Occupational Pulmonary Diseases Working Group was used. 365 of 626 workers had exposure to silica and the rest 261 were concerned as control group. There was no difference between mean age, duration of work and smoking pack year among the groups (p> 0.05). Cough and sputum rates were higher in silicosis group FEV1 and FVC values were lower in silica group but this was not statistically significant. When the two subgroups of silica group (the workers in high dust concentration and the ones in low concentration) were compared, the high concentrated group had significantly more sputum but the other symptoms and pulmonary functional parameters were not different significantly. 24 workers had parenchymal densities adjusted with pneumoconiosis. The workers with the pneumoconistic finding, had a higher mean age and longer duration of work. As a conclusion, ceramic industry has risk for silicosis. And the risk increase by time and age.
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PMID:[Evaluation of silicosis in ceramic workers]. 1610 Jun 51


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