American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Feb 1996
Early detection of lung involvement in lysinuric protein intolerance: role of high-resolution computed tomography and radioisotopic methods.
Pulmonary disease of unknown etiology is a potentially fatal complication in patients with lysinuric protein intolerance (LPI), an autosomal recessive disorder caused by the defective transport of cationic amino acids. Lung involvement was investigated in nine Italian LPI patients through pulmonary function tests and lung imaging studies consisting of conventional chest radiography, high-resolution computed tomography (HRCT), and perfusion and ventilation scintigraphy. One 10-yr-old patient died of severe respiratory insufficiency from alveolar proteinosis. ⋯ Radioisotope studies showed an uneven distribution of perfusion and ventilation, and confirmed the presence of segmental and/or diffuse pulmonary functional defects. No abnormalities of pulmonary function were evident, and answers to a questionnaire excluded primary coexisting lung disease. In patients with LPI, including those without clinical and functional impairment, HRCT and radioisotopic studies appear to be the most sensitive methods for the early diagnosis of lung disease and correct assessment of its progression.
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Am. J. Respir. Crit. Care Med. · Feb 1996
The determinants of pulmonary diffusing capacity in a national sample of U.S. adults.
Racial and gender differences in single-breath pulmonary diffusing capacity for carbon monoxide (DLCO) have previously received little attention. Between 1971 and 1975, the first National Health and Nutrition Examination Survey determined DLCO for 4,439 adults ages 25 to 74 residing in the United States, including 2,345 women and 438 blacks. The large sample permitted an evaluation of interactions and nonlinear relationships with DLCO, and its association with biomarkers of inflammation. ⋯ In current smokers, cigarettes per day and pack-years were predictive of DLCO even after control for FVC and controlling for these variables fully explained the difference in DLCO between never and current smokers. Peripheral neutrophil count, a biomarker of inflammation, was associated with reduced DLCO. Thus, substantial sex and race differences exist for DLCO within the general United States population.
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Am. J. Respir. Crit. Care Med. · Feb 1996
Occupational disease trends in black South African gold miners. An autopsy-based study.
The change in prevalence in silicosis and pulmonary tuberculosis in black South African gold miners dying from unnatural causes from 1975 to 1991 was studied. Data were analyzed for 16,454 black gold miners. Information on age at death, duration of service, year of autopsy examination, and the prevalence of silicosis and tuberculosis was collected. ⋯ A significant trend for tuberculosis, for year of autopsy, remained after adjustment for the other variables in the model, such as age and duration of service (p = 0.0046). In view of current labor stabilization in the South African mines, one can expect further increases in the prevalence of tuberculosis and silicosis. Lowering of dust levels in the mines is urgently required to prevent the increase of disease burden.