Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 14 de 14
Filter
Add more filters










Publication year range
3.
Clin Chest Med ; 33(1): 123-49, 2012 Mar.
Article in English | MEDLINE | ID: mdl-22365251

ABSTRACT

The connective tissue diseases (CTDs) are inflammatory, immune-mediated disorders in which interstitial lung disease (ILD) is common and clinically important. Interstitial lung disease may be the first manifestation of a CTD in a previously healthy patient. CTD-associated ILD frequently presents with the gradual onset of cough and dyspnea, although rarely may present with fulminant respiratory failure. Infection and drug reaction should always be ruled out. A diagnosis of idiopathic ILD should never be made without a careful search for subtle evidence of underlying CTD. Treatment of CTD-ILD typically includes corticosteroids and immunosuppressive agents.


Subject(s)
Autoantibodies/blood , Connective Tissue Diseases/complications , Connective Tissue Diseases/diagnosis , Immunosuppressive Agents/therapeutic use , Lung Diseases, Interstitial/diagnosis , Lung Diseases, Interstitial/etiology , Lung/pathology , Adrenal Cortex Hormones/therapeutic use , Bronchoalveolar Lavage , Connective Tissue Diseases/drug therapy , Connective Tissue Diseases/immunology , Cough/etiology , Disease Progression , Dyspnea/etiology , Humans , Lung/diagnostic imaging , Lung Diseases, Interstitial/diagnostic imaging , Lung Diseases, Interstitial/drug therapy , Lung Diseases, Interstitial/immunology , Lung Diseases, Interstitial/pathology , Pulmonary Fibrosis/diagnosis , Pulmonary Fibrosis/etiology , Radiography , Respiratory Function Tests , Respiratory Insufficiency/etiology
4.
Clin Chest Med ; 32(4): 605-44, 2011 Dec.
Article in English | MEDLINE | ID: mdl-22054876

ABSTRACT

Lung cancer is the leading cause of cancer death in the United States and around the world. A vast majority of lung cancer deaths are attributable to cigarette smoking, and curbing the rates of cigarette smoking is imperative. Understanding the epidemiology and causal factors of lung cancer can provide additional foundation for disease prevention. This article focuses on modifiable risk factors, including tobacco smoking, occupational carcinogens, diet, and ionizing radiation. It also discusses briefly the molecular and genetic aspects of lung carcinogenesis.


Subject(s)
Lung Neoplasms , Age Factors , Air Pollution/adverse effects , Diet , Female , Genetic Predisposition to Disease , Global Health , Humans , Lung Neoplasms/epidemiology , Lung Neoplasms/etiology , Lung Neoplasms/prevention & control , Male , Obesity/complications , Occupational Exposure/adverse effects , Pulmonary Disease, Chronic Obstructive/complications , Risk Factors , Sex Factors , Smoking/adverse effects
5.
Clin Chest Med ; 31(3): 451-78, 2010 Sep.
Article in English | MEDLINE | ID: mdl-20692539

ABSTRACT

Pulmonary disease is a major source of morbidity and mortality in rheumatoid arthritis, manifesting most commonly as interstitial lung disease, airways disease, rheumatoid nodules, and pleural effusions. The diagnostic assessment of respiratory abnormalities is complicated by underlying risk for infection, the use of drugs with known pulmonary toxicity, and the frequency of lung disease related to rheumatoid arthritis itself. Evaluation and management of rheumatoid arthritis-associated pulmonary disease frequently necessitates a multidisciplinary approach.


Subject(s)
Arthritis, Rheumatoid/complications , Respiratory Tract Diseases/etiology , Abatacept , Anti-Inflammatory Agents/adverse effects , Antimetabolites/adverse effects , Arthritis, Rheumatoid/drug therapy , Gold/adverse effects , Humans , Immunoconjugates/adverse effects , Penicillamine/adverse effects , Respiratory Tract Diseases/diagnosis , Respiratory Tract Diseases/pathology , Respiratory Tract Diseases/therapy , Tumor Necrosis Factor-alpha/adverse effects
7.
Clin Chest Med ; 30(3): 509-23, ix, 2009 Sep.
Article in English | MEDLINE | ID: mdl-19700049

ABSTRACT

Obesity is becoming a worldwide problem of epidemic proportions, and its effect on the heart is increasingly being recognized. Obesity is often associated with an increased risk for heart failure. In this article, the authors review the evidence for obesity-related cardiomyopathy. The importance of metabolic disturbances in the development of cardiomyopathy in obese patients is highlighted. The authors also briefly explore whether obesity plays a role in the development of pulmonary hypertension. Better recognition and understanding of both obesity cardiomyopathy and pulmonary hypertension are needed in the obese patient population.


Subject(s)
Cardiomyopathies/diagnosis , Cardiomyopathies/etiology , Cardiomyopathy, Dilated/etiology , Hypertension, Pulmonary/etiology , Obesity/complications , Obesity/physiopathology , Body Mass Index , Cardiomyopathies/therapy , Cardiomyopathy, Dilated/diagnosis , Cardiomyopathy, Dilated/therapy , Humans , Hypertension, Pulmonary/physiopathology , Hypertension, Pulmonary/therapy , Obesity/therapy
8.
In Vivo ; 23(4): 635-7, 2009.
Article in English | MEDLINE | ID: mdl-19567400

ABSTRACT

Taxotere has recently been making a noticeable impact on breast, gastric, ovarian, prostate and non-small cell lung cancers. Its side effects include dyspnea, pruritus, skin rashes, fever and hypotension. The patient presented the less common, however potentially fatal, toxicity of pneumonitis. He initially presented with a flu-like illness and hypoxia that was unresponsive to antibiotic treatment and actually progressed. He presented 14 days after his second dose of taxotere, although in retrospect noted symptoms several days prior. Although some patients described in the literature have progressed to respiratory failure requiring mechanical ventilation, this patient responded to steroid treatment and withdrawal of taxotere.


Subject(s)
Adenocarcinoma/drug therapy , Antineoplastic Agents/adverse effects , Esophageal Neoplasms/drug therapy , Pneumonia/chemically induced , Taxoids/adverse effects , Aged , Docetaxel , Humans , Male , Pneumonia/diagnostic imaging , Radiography
9.
Clin Chest Med ; 25(1): 95-104, 2004 Mar.
Article in English | MEDLINE | ID: mdl-15062601

ABSTRACT

Noncardiogenic pulmonary edema, and, to a lesser extent, acute respiratory distress syndrome (ARDS), are common clinical manifestations of drug-induced lung diseases. Clinical features and radiographic appearances are generally indistinguishable from other causes of pulmonary edema and ARDS. Typical manifestations include dyspnea, chest discomfort, tachypnea, and hypoxemia. Chest radiographs commonly reveal interstitial and alveolar filling infiltrates. Unlike pulmonary edema that is due to congestive heart failure, cardiomegaly and pulmonary vascular redistribution are generally absent in cases that are drug-related. Rare cases of drug-induced myocarditis with heart failure and pulmonary edema have been described. Results from laboratory evaluation and respiratory function tests are nonspecific.


Subject(s)
Pulmonary Edema/chemically induced , Respiratory Distress Syndrome/chemically induced , Antineoplastic Agents/adverse effects , Chlorothiazide/adverse effects , Contrast Media , Diuretics , Ethchlorvynol/adverse effects , Humans , Hypnotics and Sedatives/adverse effects , Iatrogenic Disease , Immunosuppressive Agents/adverse effects , Lung/drug effects , Sodium Chloride Symporter Inhibitors/adverse effects , Tocolytic Agents/adverse effects , Tretinoin/adverse effects
10.
Semin Respir Crit Care Med ; 24(3): 233-44, 2003 Jun.
Article in English | MEDLINE | ID: mdl-16088545

ABSTRACT

Chronic cor pulmonale involves the enlargement of the right ventricle as a result of pulmonary hypertension due to pulmonary disorders involving the lung parenchyma, bellows function, or ventilatory drive. The right ventricular hypertrophy that occurs in chronic cor pulmonale is a direct result of chronic hypoxic pulmonary vasoconstriction and subsequent pulmonary artery hypertension, leading to increased right ventricular work and stress. We discuss methods by which hypoxic vasoconstriction and reduction in the pulmonary vascular bed lead to the development of pulmonary artery hypertension. This article reviews the interaction of the pulmonary vasculature and right ventricle in the non-diseased state as well as during disease exacerbations. Ventricular dependence and its contribution to the pathophysiology of right ventricular failure are also reviewed. In addition, we provide an overview of specific disease states that can result in the development of chronic cor pulmonale including chronic obstructive pulmonary disease (COPD), interstitial lung disease, sleep apnea, alveolar hypoventilation disorders, and primary pulmonary hypertension. We also review the current diagnostic studies used to evaluate and study cor pulmonale.

11.
Semin Respir Crit Care Med ; 24(3): 263-72, 2003 06.
Article in English | MEDLINE | ID: mdl-16088547

ABSTRACT

Pulmonary artery hypertension (PAH) is the primary cardiovascular complication encountered in chronic obstructive pulmonary disease (COPD). Cor pulmonale can range clinically from mild changes in right ventricular function to frank right heart failure. The prevalence of PAH increases as COPD worsens, and the development of PAH and cor pulmonale appears to affect survival of patients with COPD. Potential causes proposed to explain the development of PAH in COPD include gas exchange abnormalities, destruction of the pulmonary vascular bed, alterations in respiratory mechanics, changes in intrinsic pulmonary vessel tone, and increased blood viscosity. Standard clinical evaluation, including history, physical examination, spirometry, electrocardiography, and chest radiography, is generally inadequate in identifying right ventricular dysfunction. Noninvasive techniques, such as echocardiography, radionuclide ventriculography, and magnetic resonance imaging, have largely replaced invasive pulmonary artery catheterization in the initial assessment of cor pulmonale. The goals of therapy consist of attenuation of PAH, enhancement of right ventricular function, alleviation of clinical symptoms, and improvement in survival. The agents that have been most extensively evaluated for these purposes include oxygen, vasodilators, theophylline, and inotropic medications.

12.
Crit Care Clin ; 18(4): 781-803, 2002 Oct.
Article in English | MEDLINE | ID: mdl-12418441

ABSTRACT

SLE causes significant morbidity and mortality by multisystem organ involvement. Infections are the leading cause of morbidity and mortality in patients with SLE. Meticulous exclusion of infection is mandatory in patients with SLE, because infections may masquerade as exacerbation of underlying disease; and the immunosuppression used to treat severe forms of exacerbation of lupus can have catastrophic consequences in patients with infections. Corticosteroids are the first-line therapy for most noninfectious complications of SLE, with various adjuvant immunosuppressive agents such as cyclophosphamide being increasingly used in combination with plasmapheresis. Some recent series have shown an improved survival rate, but this improvement needs to be confirmed by further studies. Controlled trials comparing various therapeutic options are lacking, and optimal therapy has not been defined.


Subject(s)
Critical Care/methods , Lupus Erythematosus, Systemic/therapy , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/etiology , Cardiovascular Diseases/therapy , Central Nervous System Diseases/diagnosis , Central Nervous System Diseases/etiology , Central Nervous System Diseases/therapy , Gastrointestinal Diseases/diagnosis , Gastrointestinal Diseases/etiology , Gastrointestinal Diseases/therapy , Humans , Infections/complications , Infections/diagnosis , Infections/therapy , Lung Diseases/diagnosis , Lung Diseases/etiology , Lung Diseases/therapy , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/diagnosis
13.
Clin Chest Med ; 23(1): 1-25, 2002 Mar.
Article in English | MEDLINE | ID: mdl-11901905

ABSTRACT

Over the past century, lung cancer has gone from an obscure disease to the leading cause of cancer death worldwide. Initially an epidemic disease among men in industrialized nations, lung cancer now has become the leading cancer killer in both sexes in the United States and an increasingly common disease of both sexes in developing countries. Lung cancer incidence largely mirrors smoking prevalence, with a latency period of several decades. Other important risk factors for the development of lung cancer include environmental exposure to tobacco smoke, radon, occupational carcinogens, and pre-existing nonmalignant lung disease. Studies in molecular biology have elucidated the role that genetic factors play in modifying an individual's risk for lung cancer. Although chemopreventive agents may be developed to prevent lung cancer, prevention of smoking initiation and promotion of smoking cessation are currently the best weapons to fight lung cancer. No other malignancy has been shown to have such a strong epidemiologic relation between a preventable behavior and incidence of disease. Despite this knowledge, more than 20% of all Americans smoke, and tobacco use is exploding in developing countries. Based on current and projected smoking patterns, it is anticipated that lung cancer will remain the leading cause of cancer death in the world for decades to come.


Subject(s)
Lung Neoplasms/epidemiology , Lung Neoplasms/etiology , Smoking/adverse effects , Age Factors , Diet , Environmental Exposure/adverse effects , Female , Genetic Predisposition to Disease , Humans , Lung Diseases/complications , Lung Neoplasms/prevention & control , Male , Racial Groups , Risk Factors , Sex Factors , Smoking Cessation
14.
Clin Chest Med ; 23(1): 137-58, ix, 2002 Mar.
Article in English | MEDLINE | ID: mdl-11901908

ABSTRACT

Lung cancer is the leading cause of cancer deaths in the United States. The individual therapeutic approach and prognosis depends on accurate diagnosis and staging. Flexible bronchoscopy (FB) and transthoracic needle biopsy (TNB) are the most widely used techniques for this purpose. This article provides a critical overview of indications, diagnostic yield, and limitations of bronchoscopy and TNB in the diagnosis of lung cancer.


Subject(s)
Biopsy, Needle/methods , Bronchoscopy/methods , Lung Neoplasms/pathology , Bronchoscopy/trends , Endosonography/methods , Humans , Lung Neoplasms/diagnosis , Lung Neoplasms/diagnostic imaging , Neoplasm Staging
SELECTION OF CITATIONS
SEARCH DETAIL
...