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Biomedical subjects

C B Sherman

Publications and source records attributed to C B Sherman.

27 records · Page 2Linked to original sources
PubMed1991

Health effects of cigarette smoking.

Cigarette smoking is associated with increased overall morbidity and mortality. Smoking is a cause of cancer of the lung, oral cavity, larynx, bladder, and renal pelvis and a contributing factor in the development of cancer of the pancreas, stomach, cervix, liver, penis, and rectum. Smokers are at greater risk for coronary artery disease, cerebrovascular disease, and atherosclerotic peripheral vascular disease. Cigarette smoking is the single most important risk factor for chronic obstructive pulmonary disease and is associated with lower levels of FEV1 and increased respiratory symptoms and infections. Women who smoke during pregnancy have an increased incidence of complications, especially intrauterine growth retardation. Peptic ulcer disease is more common in smokers than in nonsmokers. Finally, involuntary smoke exposure is associated in adults with an increased incidence of lung cancer and possibly greater mortality rates from ischemic heart disease and in children with more frequent lower respiratory tract illnesses and reduced lung growth.

Cardiovascular Diseases↗
PubMed1990

Early childhood predictors of asthma.

To investigate potential risk factors for the development of childhood asthma, the authors undertook a longitudinal study using a cohort of 770 children aged 5-9 years from East Boston, Massachusetts, that has been under study since 1975. The disease outcome considered was age at first onset of asthma, as determined by parental or self-reporting of a physician's diagnosis. Potential risk factors were evaluated specifically in relation to their presence antecedent to a diagnosis of asthma. Standardized questionnaires were used to obtain childhood illness histories, environmental exposures, and the asthmatic and atopic statuses of first-degree relatives. Ninety-one cases of asthma were identified from 1975 to 1988 (57 males and 34 females). Significant sex-adjusted relative risk estimates were seen for antecedent pneumonia, bronchitis, hay fever, sinusitis, parental asthma, and parental atopy. Neither bronchiolitis, eczema, croup, personal cigarette smoking, maternal smoking, paternal smoking, nor delivery complications bore an apparent relation to the development of asthma. A history of parental asthma or parental atopy did not significantly alter the sex-adjusted relative risk estimates for pneumonia, bronchitis, hay fever, or sinusitis. These results support the hypothesis that asthma is a multifactor disease whose expression is dependent on both familial and environmental influences.

Asthma↗
PubMed1989

Firefighting acutely increases airway responsiveness.

The acute effects of the products of combustion and pyrolysis on airway responsiveness among firefighters are poorly documented. To study this relationship, spirometry and methacholine challenge testing (MCT) were performed on 18 active Seattle firefighters before and 5 to 24 h after firefighting. Body plethysmography was used to measure changes in specific airway conductance (SGaw), and results of MCT were analyzed using PD35-SGaw, the cumulative dose causing a 35% decrease in SGaw. Subjects who did not react by the end of the protocol were assigned a value of 640 inhalational units, the largest cumulative dose. Fire exposure was defined as the total time (hours) spent without a self-contained breathing apparatus at the firesite and was categorized as mild (less than 1 h, n = 7), moderate (1 to 2 h, n = 5), or severe (greater than 2 h, n = 6). Mean age of the 18 firefighters was 36.7 +/- 6.7 yr (range, 25 to 51), with a mean of 9.1 +/- 7.9 active years in the trade (range, zero to 22). None was known to be asthmatic. After firefighting, FEV1 % predicted (%pred) and FEF25-75 %pred significantly decreased by means of 3.4 +/- 1.1% and 5.6 +/- 2.6%, respectively. The mean decline in PD35-SGaw after firefighting was 184.5 +/- 53.2 units (p = 0.003). This observed decline in PD35-SGaw could not be explained by decrements in prechallenge SGaw, FEV1, or FVC.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Use of oblique chest roentgenograms in detecting pleural disease in asbestos-exposed workers.

Oblique chest roentgenograms have been recommended by some for use in screening programs of asbestos-exposed workers to increase detection of pleural fibrosis not evident on posteroanterior (PA) films. As a screening test, identification of pleural abnormalities with oblique films is especially important in subjects without evidence of other asbestos-induced abnormalities on PA films, namely, parenchymal fibrosis. To evaluate the incremental value of oblique films in the identification of pleural fibrosis, a comparison was made between PA films read alone and PA films read with both oblique views in a systematic evaluation of 489 male pipefitters examined in a screening program. Analysis of the subsets of pipefitters with and without parenchymal fibrosis showed that 2.5% of workers with normal PA films (n = 326) and 13.0% of subjects with isolated parenchymal fibrosis on PA films (n = 46) had pleural fibrosis detectable only on oblique films. In only eight (1.6%) did the oblique view represent the sole evidence of an asbestos-related roentgenographic abnormality. We conclude that oblique films should not be routinely used in screening workers for evidence of asbestos-induced disease.

Adult↗
PubMed1987

Severe precocious emphysema in intravenous methylphenidate (Ritalin) abusers.

Intravenous (IV) drug abuse is known to cause pulmonary tale granulomatosis. Reports have documented a syndrome of pulmonary vascular sclerosis in long-term IV methylphenidate users. Although this would be expected to produce restrictive lung disease, we hereby report six patients who have severe obstructive lung disease. All had used IV methylphenidate for at least four years. One of these patients died of progressive respiratory insufficiency and the others are clinically disabled. Their symptoms and airflow obstruction are more severe than those of most patients with chronic obstructive pulmonary disease. In these individuals, we cannot say that precocious obstructive lung disease is not due to a combination of smoking and other factors, nor can we be certain that methylphenidate is the offending agent. However, this cluster of cases among methylphenidate abusers suggests that long-term IV exposure to this drug might lead to early severe obstructive lung disease.

Adult↗
PubMed1984

Neuroleptic malignant syndrome and dopaminergic blockade.

After receiving 90 mg of haloperidol and 100 mg of chlorpromazine hydrochloride within 25 hours, a 29-year-old man was found to have neuroleptic malignant syndrome (NMS), characterized by the acute onset of hyperpyrexia, extreme muscular rigidity, autonomic instability, and coma. Subsequently, rhabdomyolysis developed, with myoglobinuric renal failure and bilateral anterior tibial compartment syndromes. The patient's initial neuroleptic levels were in the therapeutic and nontoxic ranges. He was treated with supportive measures and his clinical improvement was paralleled by decreased neuroleptic levels, a return toward normal of an elevated prolactin level, and an increased responsiveness to a dopamine hydrochloride infusion. This supports an association between NMS and dopamine receptor blockade.

Adult↗
PubMedDate not supplied

Adult respiratory distress syndrome complicating Plasmodium falciparum malaria.

In people who do not have clinical immunity to malaria, infection with the malaria parasite could lead to severe complications. We describe a patient who had acute and severe lung injury from malaria. A 37-year-old woman had a 24-hour history of generalized weakness and chills 2 days after returning from Nigeria. She had received mefloquine as prophylaxis, but the patient did not take the medication. On admission, a thick blood smear revealed severe Plasmodium falciparum parasitemia. She was given doxycycline and quinine, but as her parasitemia resolved, dyspnea and hypoxemia developed and she consequently required placement of an endotracheal tube. Chest radiography results showed bilateral and diffuse infiltrate. This report shows that patients with P falciparum malaria should be monitored closely and transferred to an intensive care unit for additional management if respiratory distress develops. Physicians caring for patients who have recently traveled to malaria-endemic areas need to anticipate the possible development of malaria with all of its complications, including acute lung injury.

Adult↗
PubMedDate not supplied

Cardiopulmonary exercise testing to assess respiratory impairment in occupational lung disease.

Exercise testing can answer several pertinent questions for the physician. It can determine whether a worker's aerobic performance is limited by respiratory or by other factors. It can also help decide whether an individual can perform a job without undue physiologic limitations and fatigue. Exercise testing has its limitations. It cannot determine the etiology of the impairment nor can it make a specific diagnosis except in rare cases. Interpretation of exercise data is not always precise, especially when the VO2max is normal but several physiologic measurements are abnormal. The VO2max achieved under laboratory conditions is probably too simplistic an estimate of the complex energy requirements of any occupation. Future research is needed to develop portable devices to assess both aerobic and anaerobic potentials of workers on the job to better determine job-specific impairment and disability. Patients who have unexplained symptoms or abnormal, but not severely reduced, static pulmonary function tests benefit most from exercise testing. For now, the AMA criteria for impairment as defined by static and exercise pulmonary function testing are the most appropriate to follow. Exercise testing has provided valuable data for epidemiologic research. Descriptive and case-control studies have documented minor physiologic abnormalities and rare respiratory limitations in workers with asbestos exposure and simple coal worker's pneumoconiosis. Additional studies are necessary to further elucidate pathophysiologic findings in patients with asbestosis and other occupationally induced pulmonary diseases.

Asbestosis↗