Diagnosis of asbestosis. Clinical, radiological and lung function data in 42 patients.
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Biomedical subjects
Publications and source records attributed to A Agusti-Vidal.
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The development of acute respiratory failure (ARF) in patients with hematologic disorders (HDs) is a life-threatening condition which does not respond well to intensive therapy. We present our experience in the use of intensive therapy for a group of 30 patients suffering from leukemia (21 cases), bone-marrow aplasia (6 cases), or lymphoma (3 cases). Seven had undergone bone-marrow transplantation. All 30 patients were hypoxemic and responded poorly to the administration of high oxygen concentrations via face mask. All were admitted to our intensive respiratory unit (IRU), where 26 received oxygen via mechanical ventilation, and 4 received continuous positive airway pressure (CPAP). Definitive diagnosis was established in 19 (63%) patients. A premortem diagnosis obtained in 8 (26%) cases did not change therapy. The diagnostic accuracy of serology and transbronchial biopsy was low. Of the 6 (20%) patients who recovered from ARF, only 2 were discharged from the hospital. The remaining 24 (80%) patients died in the IRU.
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The association of pulmonary fibrosis and primary biliary cirrhosis (PBC) remains controversial. To determine the frequency of pulmonary fibrosis in PBC, a carefully selected series of 14 PBC patients, seven patients with Sicca complex, and 14 control subjects have been studied. Seven of the 14 patients with PBC had Sjögren's syndrome, four of whom had some clinical evidence of pulmonary disease. Evaluation of ventilatory capacity, gas transfer factor, arterial blood gases, and lung mechanics were performed. Gas transfer was reduced in patients with PBC associated with Sjögen's syndrome and in patients with the Sicca complex. These results suggest that the respiratory, clinical, ad functional abnormalities found in PBC are related to the presence of an associated Sjögen's syndrome.
Maximal expiratory flow-volume (MEFV) curves were measured in 1044 healthy nonsmoking volunteers living in the Barcelona area, as part of a larger interhospital project to obtain reference values of pulmonary function tests. Forced vital capacity (FVC), one-second forced expiratory volume (FEV1), FEV1/FVC, %, forced maximal mid-expiratory flow (FEF25-75%), peak expiratory flow rate (PEF) and maximal expiratory flow at 50 and 75% of FVC (MEF50% and MEF25% respectively) were obtained and expressed at BTPS conditions. Techniques and equipments followed both the recommendations of the American Thoracic Society (ATS) and of the European Community for Coal and Steel (ECCS). Prediction equations for age 20 through 70 were calculated for both sexes from a final sample composed of 870 adult subjects, 443 males and 427 females. Simple linear equations using height, age and body weight predicted all spirometric variables as well as more complex equations except MEF25%. Logarithmic equations were proposed for MEF25% to correct for the heteroscedasticity shown in a simple linear model. To our knowledge, this study provides reliable spirometric equations from a large urban Mediterranean sample which were lacking so far in the literature.
Forced spirometry, including maximal flow-volume (MEFV) curves, were evaluated in 35 non-smoking asbestos female workers submitted to a short heavy chrysotile textile exposure and compared to a case by case matched population. Exposed women presented certain respiratory signs and symptoms; they also had significantly lower forced vital capacities and maximal flow rates at higher (PEF), mid (MEF50%) and lower lung volumes (MEF25%) than women not exposed to asbestos. Duration of exposure to asbestos showed a significant negative correlation with FVC, FEV1, PEF, MEF50% and MEF25%. It is concluded that short heavy exposure to chrysotile is deleterious, causing significant reduction in lung volumes. Moreover, a significant reduction in airflow rates was also apparent.