Interstitial lung diseases in a lung cancer screening trial.

We assessed the prevalence of interstitial lung disease (ILD) in a cohort of smokers included in a lung cancer screening trial. Two observers independently reviewed, for the presence of findings consistent with ILD, the computed tomography (CT) examinations of 692 heavy smokers recruited by the Multicentric Italian Lung Detection (MILD) trial. Four CT patterns were considered: usual interstitial pneumonia (UIP), other chronic interstitial pneumonia (OCIP), respiratory bronchiolitis (RB) and indeterminate. Subsequently, the evolution of ILD in those subjects who had undergone a repeat CT examination after 3 yrs was assessed. The UIP pattern and the OCIP pattern were identified in two (0.3%) out of 692 and 26 (3.8%) out of 692 patients, respectively; 109 (15.7%) out of 692 patients showed CT abnormalities consistent with RB, while an indeterminate CT pattern was reported in 21 out of 692 (3%) patients. Age, male sex and current smoking status were factors associated with the presence of OCIP and UIP (combined) pattern, although the relationship did not attain statistical significance. A progression of the disease was observed in three (25%) out of 12 subjects with OCIP who underwent repeat CT after 3 yrs. Thin-section CT features of ILD, probably representing smoking-related ILD, are not uncommon in a lung cancer screening population and should not be overlooked.

Body and risk: cultural ambivalence towards radioactivity through the history of two protagonists.

Two women with profoundly different backgrounds were brought together in a destiny that saw their paths cross and join in the discovery of radioactivity: Marie Curie and Blanche Wittman. The former was one of the greatest women scientists of all time, the only woman to have won the Nobel Prize for science. Noted for her extraordinary humanitarian spirit, and despite scandal over an affair that saw her hounded by journalists, she dedicated most of her life to scientific research. The latter passed into history as the "Queen of Hysterics" during her hospitalisation in the famous Parisian asylum Pitié Salpêtrière. After her recovery, she became a close assistant of Marie Curie in the extraction of radium from pitchblende, until her death sixteen years of toil later. The discovery of radioactivity was the common denominator underlying the vicissitudes of their lives, the same radioactivity that was so acclaimed and of such incredible diagnostic and therapeutic potential while at the same time so underrated in the everyday life of the time that disregarded, almost disparagingly, the deleterious biologic effects it was capable of provoking. At the beginning of the twentieth century, those effects were in fact often underestimated or scarcely considered, and it was only after World War II that there came an awareness of the ambiguous properties of ionising radiation. After numerous studies on radiation exposure, much of the current debate concerns the possible effects of exposure to small doses, such as those delivered in most radiological examinations. The theories proposed include the unorthodox theory of hormesis, which requires careful reevaluation. Much light has been shed on radiology since the time of Blanche and Marie, but there still remain many shadows to dispel, and this can only be done by serious and constant scientific commitment.