RESUMO
BACKGROUND: Approximately half of the world's population, and up to 90% of households in rural areas of developing countries, depend on biomass for cooking and heating. SETTING: The National Institute of Respiratory Diseases, México City. OBJECTIVE: To describe wood smoke-associated lung disease (WSLD). DESIGN: Description of the clinical, functional and radiological manifestations of patients with WSLD, and a comparison of pathological findings of patients who died of WSLD and smokers who died of chronic bronchitis. RESULTS: All patients with WSLD were non-smoking women with chronic bronchitis, in whom asthma, bronchiectasis, tuberculosis, congestive heart failure, extreme obesity and alfa-1 antitrypsin deficiency had been excluded. All patients used wood for cooking and had been exposed to wood smoke for a median of 45 years. Dyspnoea, airway obstruction, air trapping, increased airway resistance, pathological evidence of anthracosis, chronic bronchitis, centrilobular emphysema and pulmonary hypertension were present in most patients with WSLD. Bronchial squamous metaplasia was a common finding. There were no significant differences in the histopathological findings between patients with WSLD and smokers. Diffuse interstitial fibrosis was absent in all patients. CONCLUSIONS: Patients with WSLD have obstructive lung disease, chronic bronchitis, emphysema and pulmonary hypertension comparable to smokers.
Assuntos
Substâncias Perigosas/efeitos adversos , Pneumopatias/patologia , Lesão por Inalação de Fumaça/patologia , Fumaça/efeitos adversos , Madeira , Idoso , Doença Crônica , Fatores de Confusão Epidemiológicos , Culinária/métodos , Feminino , Humanos , Pneumopatias/induzido quimicamente , México , Pessoa de Meia-Idade , Exposição Ocupacional/efeitos adversos , Estudos Prospectivos , População Rural , Lesão por Inalação de Fumaça/induzido quimicamente , Fatores Socioeconômicos , Inquéritos e QuestionáriosAssuntos
Complicações do Diabetes , Insuficiência de Múltiplos Órgãos/diagnóstico , Pneumonia/diagnóstico , Choque Séptico/diagnóstico , Tuberculose Pulmonar/complicações , Idoso , Infecções Comunitárias Adquiridas/complicações , Infecções Comunitárias Adquiridas/diagnóstico , Tosse/etiologia , Dispneia/etiologia , Febre/etiologia , Humanos , Masculino , Insuficiência de Múltiplos Órgãos/etiologia , Pneumonia/complicações , Choque Séptico/etiologiaRESUMO
OBJECTIVE: To assess the frequency, histological type and the epidemiological pattern of lung cancer (LC), during a 40 year period, at the National Institute of Respiratory Diseases (INER). MATERIAL AND METHODS: This cross-sectional study was conducted in 1999. Data were abstracted from the INER's service reports for 1983-1996 and the surgical pathology archives for 1957-1996. Data from 1961 patients were analyzed, to obtain frequency measures on: the characteristics of INER LC patient admissions, age, sex, histological studies, specimens and diagnoses. RESULTS: Between 1983-1996, LC ranked eighth to second place in INER inpatient admissions. Results were grouped by decades. In the first two decades (1957-1976), 9% of patients were female; 32% in the third (1977-1986), and 38% in the last decade (1987-1996). Epidermoid cell carcinoma was more frequent in the two first decades (61%) and adenocarcinoma in the last two, (41% and 62%, respectively.) CONCLUSIONS: LC is currently more frequent in women, and adenocarcinoma is the most frequent neoplasia.
Assuntos
Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/patologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-IdadeRESUMO
Ferruginous bodies (FB) were quantified in lung digests from 270 autopsy cases over 20 years of age. The cases were autopsied in three different hospitals of the Secretaria de Salud, Mexico, DF. Two hundred seventy samples of peripheral lung tissue were digested in commercial bleach, and all morphologic types of ferruginous bodies were quantified. The results showed that numbers of ferruginous bodies per gram of dry tissue increased over the years: 4.2 FB/g in cases from 1975 to 42.5 FB/g in cases from 1988 (r = 0.86). Higher counts of ferruginous bodies were seen in males, smokers, and Mexico City dwellers. However, more than 70% of them presented less than 100 FB/g. Our study demonstrates that most of our cases had a nonoccupational exposure to fibers.
Assuntos
Amianto/análise , Exposição Ambiental/análise , Pneumopatias/patologia , Metaloproteínas/análise , Adulto , Idoso , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Exposição Ocupacional/análise , População Rural , Fatores Sexuais , Fatores de Tempo , População UrbanaRESUMO
The correlation between high counts of ferruginous bodies (FB) and pulmonary cancer was investigated. Autopsy cases between 1982 and 1988 were chosen, and studied at Instituto Nacional de Enfermedades Respiratorias. Two grams of lung tissue were digested with sodium hypochlorite. We found no differences in the histologic types of cancer: 18.0 FB per gram (FB/g) for the adenocarcinoma group and 16.0 FB/g for both the epidermoid and anaplastic groups. The asbestos core was predominant in all FB analysed (greater than 85%). Males, Mexico city residents and smokers showed to higher amounts of FB. We concluded that there is an environmental exposure to particles in the cases studied.
Assuntos
Adenocarcinoma/química , Carcinoma de Células Pequenas/química , Carcinoma de Células Escamosas/química , Neoplasias Pulmonares/química , Metaloproteínas/análise , Adulto , Amianto/análise , Autopsia , Carcinoma Pulmonar de Células não Pequenas/química , Feminino , Técnicas Histológicas , Humanos , Masculino , Fatores Sexuais , Fumar , Hipoclorito de Sódio , População UrbanaRESUMO
In this study we evaluated the usefulness of ferruginous bodies (FB) quantification in lung digest and histologic sections from 40 patients with a history of exposure to inorganic dusts. The patients were matched with 40 cases without occupational exposure. The samples of peripheral lung tissue were digested and all FB were quantified. Lung sections were also evaluated in order to confirm the presence of FB. The concentrations of FB in the patients were higher than the controls (Wilcoxon test, p < 0.001). The patients group showed a median concentration of 194.5 FB/g of dry lung tissue (FB/g) vs. 34.0 FB/g in the controls. Seventy percent of the patients had more than 100 FB/g vs. 27.5% in the controls cases. Pneumoconiosis was diagnosed in 19 patients, 17 had FB/g above 100 and only 4 were positive to FB in lung sections. We can conclude that lung digest and FB counts help to confirm exposures to inorganic dusts above the background values found in the general population. FB counts can help when the clinical file does not confirm the exposure.