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

A combined epidemiological and intervention study was conducted on 207 swine confinement farmers with matched comparison subjects. The objectives of the study were to define, in detail, the nature and disease determinants in this exposed group and to explore methods of disease prevention. This 5 year prospective study included three annual medical assessments of workers and complementary work environment assessments. Between the first and second assessment periods, an in-depth educational intervention was conducted. An industrial hygiene consultation intervention was conducted between the second and third measurement periods. Outcome measurements included changes in knowledge, attitudes, and behavior following educational intervention. Additionally, the outcomes measured included changes in medical and environmental assessment over the 3 year assessment periods. Results of the baseline respiratory symptoms assessment are reported here. Nearly 20% of swine confinement workers reported chronic cough, and 25% reported phlegm (American Thoracic Society questionnaire). Both symptoms were significantly more prevalent in the confinement workers compared to a blue collar comparison group, but only phlegm production was more prevalent compared to nonconfinement farmers. Work-related symptoms were reported much more frequently than chronic symptoms (e.g., 87% of confinement workers reported work-related cough). Bronchitis as well as airways reactivity were all significantly more prevalent in confinement workers compared to nonconfinement workers. Smoking seemed to have an additive effect with confinement exposure. Bronchitis and chest tightness symptoms were reported to be more severe upon return to work after an absence of 7 days or more. Finally, 34% of workers reported episodes of organic dust toxic syndrome.
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PMID:Preventing respiratory disease in swine confinement workers: intervention through applied epidemiology, education, and consultation. 222 Aug 28

We report a case of anomalous continuation of the inferior vena cava with azygos vein, defect of left pericardium, and dysgenesis of lobes of the lungs. A 43-year-old man came to our hospital, complaining of dyspnea and cough with blood in the sputum. The chest roentgenogram showed moderate cardiomegaly with deviation to the left side of the thorax. Therapy with diuretics and bronchodilators reduced his complaints. A bronchogram and fiberoptic bronchoscopy showed double bronchial branches to the right upper lobe, one from the trachea and the other from the right main bronchus, and a blind pouch of the left lobe. Thoracic computed tomography showed the heart just behind the sternum. Venography showed anomalous continuation of the inferior vena cava and dilated azygos vein. We could not find such a complicated anomaly of the thoracic vessels and bronchus in an adult in the literature, so we believe that it is important to reconfirm the position of major vessels or organs before a thoracic procedure.
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PMID:Anomalous inferior vena cava with azygos continuation, dysgenesis of lung, and clinically suspected absence of left pericardium. 230 78

The American Thoracic Society (ATS) respiratory disease questionnaire for adults was translated by two fluently bilingual Quebec health professionals into simple, everyday French easily understood by an adult population of varying age and educational background. After independent assessment by professional translators, it was field-tested on 165 silicon carbide production workers. Responses to the ATS cough questions were significantly related to those obtained by a semiquantitative estimate of cough frequency. ATS questions on cough and phlegm were significantly associated with the physical sign of productive cough on request. A significant association was found between answers to questions on mild or moderate breathlessness and self-evaluation of breathing on a linear scale. Workers with cough, wheeze, or breathlessness had significantly lower percent-predicted FEV1, and FEV1 decreased as the severity of breathlessness increased. Highly significant, dose-dependent associations with current cigarette smoking habit were found for cough, phlegm and wheeze. Significant, dose-dependent associations with phlegm, wheeze and mild breathlessness also occurred with exposure to sulfur dioxide. All of these relationships are similar to findings from studies of English-speaking populations. Minor problems with the original English ATS questionnaire were discovered on translation, and suggestions for improvements were made. Preliminary experience with this French translation suggests that it is a useful, comparable version of the English ATS questionnaire.
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PMID:Evaluation of the ATS respiratory diseases questionnaire among French-speaking silicon carbide workers. 231 Oct 54

A case of tuberculous pericarditis successfully managed with medical treatment alone was reported. A 78-year-old male was admitted because of cough, dyspnea and fever. Chest X-P and echocardiogram revealed massive pericardial effusion. His clinical symptoms and signs suggested cardiac tamponade. Mycobacterium tuberculosis was detected from pericardial fluid. ADA activity in pericardial fluid was high. Thoracic CT scan showed tracheobronchial, pretracheal, paratracheal and superior mediastinal lymph-node swelling. The diagnosis of tuberculous pericarditis was confirmed. Anti-tuberculous therapy consisting of INH, RFP, EB in combination with prednisolone was started. One month later pericardial effusion was controlled and six months later he was in good clinical condition without surgical treatment.
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PMID:[A case of tuberculous pericarditis]. 231 58

Seven dogs with pulmonary lymphomatoid granulomatosis were reviewed. The disease occurred in six large-breed and one small-breed dogs. The dogs were five to 14 years old (mean, 8.4; median, 7), and four of seven dogs were males. Three dogs had been previously treated with adulticide therapy for canine dirofilariasis. Clinical histories included a progressive respiratory disease characterized by varying degrees of cough, dyspnea, exercise intolerance, and weight loss. Thoracic radiographic features included hilar lymphadenopathy, pulmonary masses of varying sizes, and mixed pulmonary patterns of lobar consolidation with ill-defined interstitial and alveolar pulmonary infiltrates. Cardiovascular changes compatible with chronic dirofilariasis were present in three dogs. The clinical course was usually progressive and fatal. The survival time ranged from six days to four years (mean, 12.5 mos; median, 3 mos). Gross and histologic features included mass lesions with areas of necrosis that replaced normal pulmonary architecture. Cytologically, these lesions were characterized by infiltration with pleomorphic, angioinvasive mononuclear cells that often resulted in vascular obliteration. The infiltrating cells resembled large lymphoid cells that possessed large hyperchromatic nuclei and small amounts of cytoplasm. Systemic lymphoid neoplasia with peripheral lymphadenopathy was diagnosed in two dogs. In both cases, lymph-node cytology was similar to the cellular infiltrates found in the lungs and consistent with a diagnosis of lymphomatoid granulomatosis. These features are compared with previously reported cases of canine lymphomatoid granulomatosis and those features identified in a similar disease described in man.
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PMID:Pulmonary lymphomatoid granulomatosis in seven dogs (1976-1987). 236 26

Chronic bronchopneumonia associated with microlithiasis was diagnosed in a 9-year-old domestic shorthair cat with a 3-month history of coughing and dyspnea. Thoracic radiography revealed multifocal patchy alveolar infiltrates in all lung fields. Numerous acellular, concentrically laminated, periodic acid-Schiff-positive microliths were seen in mucus from tracheal washing. Microliths were composed primarily of calcium carbonate. A definite cause could not be identified. There was no response to treatment and the cat was euthanatized. Marked type-II alveolar cell proliferation, peribronchiolar smooth muscle proliferation, and alveolar microlithiasis were seen histologically. Microliths are rarely encountered in tracheal washings from companion animals. Their pathophysiologic properties and meaning remain to be established.
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PMID:Microlithiasis associated with chronic bronchopneumonia in a cat. 270 8

The American Thoracic Society respiratory symptom questionnaire (ATS-Q) is widely used and has provided valuable information in epidemiologic studies. To determine the influence of psychological status on respiratory symptoms, we compared subjects' ATS-Q responses to their Ilfeld Psychiatric Symptom Index (PSI) scores. To minimize the potential confounding effect of respiratory disease on the association between respiratory and psychological status, from a population-based survey of 3,628 subjects, we studied only the 600 "healthy" subjects, defined by the following characteristics: between 14 and 55 yr of age; never-smokers; no diagnoses of respiratory, heart, kidney, thyroid disease, or anemia; and normal spirometry (defined as an FEV1 and FVC greater than 80% of predicted). Associations were found between respiratory symptoms (cough, phlegm, wheeze, dyspnea) and PSI subscales (anxiety, anger, depression, and cognitive disturbance). Adjusted odds ratios for respiratory symptoms ranged from 1.13 to 2.15 for every 10% increase in PSI score. Psychological status is an important determinant of respiratory symptoms and therefore must be taken into consideration when interpreting results of epidemiologic studies using questionnaire information.
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PMID:The influence of psychological status on respiratory symptom reporting. 272 53

Thyroid tumors were diagnosed in 26 dogs between 1977 and 1984. A total of 23 of the 26 tumors were carcinomas, and 3, detected as incidental findings at necropsy, were adenomas. The median patient age was 9.5 years. Dogs of the Beagle breed were affected most commonly (5 dogs). The most common physical abnormalities in carcinoma patients were cervical swelling, dyspnea, and coughing. A total of 25 of 26 dogs were clinically euthyroid. Aspiration cytology provided diagnostic information in 8 of 17 cases. In dogs with thyroid carcinoma, a cervical soft tissue lesion was identified consistently by use of radiography and scintigraphy with sodium pertechnetate. Pulmonary metastases were detected radiographically in 8 of 21 dogs with thyroid carcinoma. Thoracic nuclear imaging confirmed the radiographic findings in 11 of 14 dogs. Surgical excision of the thyroid mass was the primary treatment for 17 dogs with carcinoma. Eight dogs died within 2 years (median, 7 months) of surgery because of primary tumor regrowth or metastases. Four dogs were alive at a range of 3 to 48 months after surgery, and 4 dogs died from unrelated causes. Necropsy of 7 dogs with thyroid carcinoma revealed neoplastic infiltration of the cervical blood vessels and pulmonary metastases in each dog. The most common histologic patterns of thyroid carcinoma were solid or compact cellular (11 dogs) and mixed solid-follicular tumors (8 dogs). Dogs with a solid carcinoma had a median survival time of 10.5 months (6 dogs), and dogs with a mixed solid-follicular tumor had a median survival time of 8 months (3 dogs).
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PMID:Clinical and pathologic features of thyroid tumors in 26 dogs. 301 18

To clarify the association between spirometry variability and respiratory morbidity and mortality, the authors analyzed data for miners examined in the first round of the National Coal Study, 1969-1971, and they compared groups of miners who failed with those who met each of two spirometry variability criteria: a 5% criterion recommended by the American Thoracic Society, and a 200 ml criterion used in prior research studies. Compared with miners who met the 5% criterion (the best two forced vital capacities must be within 5% or 100 ml of one another), the group that failed had a lower mean for forced expiratory volume in one second (FEV1), and odds ratios for cough, phlegm, wheeze, shortness of breath, and death of 1.75, 1.67, 1.76, 2.71, and 1.30, respectively. The findings for the 200 ml criterion (the best two FEV1s must be within 200 ml of one another) were somewhat different. The group that failed versus the group that met this criterion had a higher mean for FEV1, and odds ratios for cough, phlegm, wheeze, shortness of breath, and death of 1.13, 1.07, 1.15, 1.43, and 0.94, respectively. Although the findings differ for the two criteria, the findings demonstrate that increased spirometry variability is associated with poorer health.
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PMID:Spirometry variability criteria--association with respiratory morbidity and mortality in a cohort of coal miners. 349 12

Thoracic symptoms were noted in 38 (86%) out of 44 patients with hepatic amoebiasis and dominated the clinical picture in 4 (9%), causing dangerous delay in initiating appropriate treatment. Thoracic amoebiasis characteristically presents as a febrile illness with cough, chest pain, and point tenderness in an intercostal space or the right upper quadrant of the abdomen. Haemoptysis, diarrhoea, and dysentery are uncommon, occurring in approximately equal proportions (9%). The most important factor in clinical recognition is awareness of the possibility of the lesion. Chest radiography, serological tests, and therapeutic trials give corroborative evidence. In endemic areas thoracic amoebiasis should always be considered in the evaluation of obscure, especially right-sided, respiratory symptoms.
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PMID:Intrathoracic manifestations of amoebiasis. 724 69


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