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BACKGROUND: There has been little in the way of study of nonagenarians with acute kidney injury (AKI, defined in lines with KDIGO guidelines), but the rise in their life expectancy makes further study of this population necessary. The aim of this study is to assess mortality in nonagenarians with AKI during hospitalization. METHODS: In this retrospective study, patients with AKI during hospitalization between 2013-2014 were included. At baseline, epidemiological variables, comorbidities and treatments were collected. Analytics and mortality were studied during hospitalisation. Univariate analysis was carried out to evaluate mortality-associated variables. A logistic regres-sion analysis was carried out to demonstrate independent predictors for mortality. RESULTS: Two hundred and sixty-four nonagenarian patients were included. Mean age was 93±3 years, 73 (27.7?%) of whom were men. During hospitalization, 79 patients (29.9?%) died. Comorbidities related to mortality were history of heart failure (p?=?0.018), diastolic dysfunction (p?0.042) and higher dependence according to the modified Barthel index (p?=?0.003). The clinical variables related to mortality at hospital admission were lower systolic (p?=?0.016) and diastolic blood pressure (p?=?0.013), higher white blood cell count (p?=?0.003), greater severity of AKI (p?=?0.003) and L-?lactic (p?=?0.005). In an adjusted multivariate analysis, history of heart failure (OR?=?2.31, 95%CI: 1.07-5.00, p?=?0.036), depend-ence according to the Barthel index (OR?=?0.80, 95%CI: 0.67-0.97, p?=?0.016) and L-?lactic acid (OR?=?1.31, 95%IC: 1.06-1.61, p?=?0.005) were independent predictors of mortality. CONCLUSION: Heart failure, dependence according to the Barthel index and L-?lactic acid at admission are independent predictors of mortality in nonagenarians hospitalized with AKI.
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Injúria Renal Aguda , Injúria Renal Aguda/epidemiologia , Idoso de 80 Anos ou mais , Mortalidade Hospitalar , Hospitais , Humanos , Masculino , Prognóstico , Estudos Retrospectivos , Fatores de RiscoRESUMO
TRIAL DESIGN: This is a phase III, double-blind, randomized, controlled trial. METHODS: In this trial, patients with laparoscopic colectomy were assigned to either low pressure (LP: 7 mmHg) or standard pressure (SP: 12 mmHg) at a ratio of 1 : 1. The aim of this trial was to assess the impact of low-pressure pneumoperitoneum during laparoscopic colectomy on postoperative recovery. The primary endpoint was the duration of hospital stay. The main secondary endpoints were postoperative pain, consumption of analgesics and postoperative morbidity. RESULTS: Some 138 patients were enrolled, of whom 11 were excluded and 127 were analysed: 62 with LP and 65 with SP. Duration of hospital stay (3 versus 4 days; P = 0.010), visual analog scale (0.5 versus 2.0; P = 0.008) and analgesic consumption (level II: 73 versus 88 per cent; P = 0.032; level III: 10 versus 23 per cent; P = 0.042) were lower with LP. Morbidity was not significantly different between the two groups (10 versus 17 per cent; P = 0.231). CONCLUSION: Using low-pressure pneumoperitoneum in laparoscopic colonic resection improves postoperative recovery, shortening the duration of hospitalization and decreasing postoperative pain and analgesic consumption. This suggests that low pressure should become the standard of care for laparoscopic colectomy. TRIAL REGISTRATION: NCT03813797.
The aim of this trial was to assess the impact of low-pressure pneumoperitoneum during laparoscopic colectomy. The study proved that using low pressure in laparoscopic colonic resection improves postoperative recovery, decreasing length of hospitalization, postoperative pain and analgesic consumption.
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Colectomia/métodos , Neoplasias Colorretais/cirurgia , Laparoscopia/métodos , Complicações Pós-Operatórias/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Método Duplo-Cego , Feminino , Seguimentos , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade/tendências , Pressão , Estudos Prospectivos , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND: Laparoscopy, by its minimally invasive nature, has revolutionized digestive and particularly colorectal surgery by decreasing post-operative pain, morbidity, and length of hospital stay. In this trial, we aim to assess whether low pressure in laparoscopic colonic surgery (7 mm Hg instead of 12 mm Hg) could further reduce pain, analgesic consumption, and morbidity, resulting in a shorter hospital stay. METHODS AND ANALYSIS: The PAROS trial is a phase III, double-blind, randomized controlled trial. We aim to recruit 138 patients undergoing laparoscopic colectomy. Participants will be randomly assigned to either a low-pressure group (7 mm Hg) or a standard-pressure group (12 mm Hg). The primary outcome will be a comparison of length of hospital stay between the two groups. Secondary outcomes will compare post-operative pain, consumption of analgesics, morbidity within 30 days, technical and oncological quality of the surgical procedure, time to passage of flatus and stool, and ambulation. All adverse events will be recorded. Analysis will be performed on an intention-to-treat basis. TRIAL REGISTRATION: This research received the approval from the Committee for the Protection of Persons and was the subject of information to the ANSM. This search is saved in the ID-RCB database under registration number 2018-A03028-47. This research is retrospectively registered January 23, 2019, at http://clinicaltrials.gov/ed under the name "LaPAroscopic Low pRessure cOlorectal Surgery (PAROS)". This trial is ongoing.
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Colectomia/métodos , Colo/cirurgia , Laparoscopia/efeitos adversos , Pneumoperitônio Artificial/métodos , Reto/cirurgia , Ensaios Clínicos Fase III como Assunto , Colectomia/efeitos adversos , Colo/fisiopatologia , Método Duplo-Cego , França , Humanos , Tempo de Internação , Dor Pós-Operatória/etiologia , Pneumoperitônio Artificial/efeitos adversos , Complicações Pós-Operatórias/etiologia , Pressão , Ensaios Clínicos Controlados Aleatórios como Assunto , Recuperação de Função Fisiológica , Reto/fisiopatologia , Fatores de Tempo , Resultado do TratamentoRESUMO
In interface instabilities, deformations first grow exponentially, then enter a nonlinear regime affecting amplitude and symmetry. Most extant studies have focused on amplitude alone. Here, we study a 2D Rayleigh-Taylor instability for an initial sinusoidal deformation, analyzing its amplitude and asymmetry over time. For the latter, we define a metric based on the zero crossings of the interface. We develop a weakly nonlinear model and compare it to experimental data. It shows that our asymmetry metric complements the amplitude for an improved description of the instabilities' nonlinear phases.
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INTRODUCTION: Alpha-1 antitrypsin deficiency is associated with the occurrence of pulmonary emphysema. The aim of this study is to describe the characteristics of patients with alpha-1 antitrypsin deficiency associated pulmonary emphysema. METHODS: We describe a prospective cohort study including adult patients with alpha-1 antitrypsin deficiency associated pulmonary emphysema confirmed by CT scan living in France. Patients' clinical and functional characteristics, quality of life measures and management were recorded every 6 months during a five-year period. RESULTS: 201 patients were included from 56 centres between 2005 and 2008. The characteristics of 110 patients have been analysed. Mean age was 50 years (SD:11.8), 62.7% were males, 90% were tobacco smokers. The main functional results (% predicted) were: FEV1: 42.8 (19.6), CPT: 128.3 (21.7), CRF: 167.0 (46.0), 6 minute walking distance (meters): 413 (130). 51 (46.4%) patients received augmentation therapy. Augmentation therapy was administered weekly (37.5%), twice a month (35.4%) or monthly (25.5%). Study centre was the only factor associated with the likelihood to received augmentation therapy. CONCLUSIONS: The clinical and functional characteristics as well as management of these patients varied markedly. There is a need for a standardization of the management of patients with alpha-1 antitrypsin deficiency associated pulmonary emphysema.
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Enfisema Pulmonar/etiologia , Deficiência de alfa 1-Antitripsina/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Enfisema Pulmonar/epidemiologia , Testes de Função Respiratória , Fumar/epidemiologia , Inibidores da Tripsina/uso terapêutico , alfa 1-Antitripsina/uso terapêutico , Deficiência de alfa 1-Antitripsina/tratamento farmacológico , Deficiência de alfa 1-Antitripsina/epidemiologiaRESUMO
INTRODUCTION: Alpha one antitrypsin deficiency is a rare genetic disorder occurring principally in patients with the PiZZ phenotype. This deficiency can lead to pulmonary emphysema which impairs quality of life and which may progress to respiratory failure. The diagnosis is based on the presence of emphysema typically with a basal preponderance and airflow obstruction and is confirmed by measuring A1AT levels. A1AT replacement is the only specific therapy for this condition. OBSERVATION: We describe the 1st patient with A1AT deficiency treated in this way in France. The patient was 52 years old at the start of treatment with A1AT replacement, initially in hospital and then at their place of residence. Treatment was initiated in the context of progressive breathlessness, the presence of emphysema and confirmation of the biochemical deficit. The patient received 4 g of AIAT per week in combination with inhaled corticosteroids and ongoing physical rehabilitation. Follow up over 20 years has revealed a slowing in the decline in spirometric measurements. No problems with tolerating the treatment have been reported. CONCLUSION: In this clinical case replacement therapy appeared to show clinical benefits and was well tolerated.
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Inibidores da Tripsina/uso terapêutico , Deficiência de alfa 1-Antitripsina/tratamento farmacológico , alfa 1-Antitripsina/uso terapêutico , Corticosteroides/uso terapêutico , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Enfisema Pulmonar/tratamento farmacológico , Enfisema Pulmonar/genéticaAssuntos
Hipersensibilidade a Drogas/prevenção & controle , Imunossupressores/administração & dosagem , Imunossupressores/efeitos adversos , Doenças do Tecido Conjuntivo/tratamento farmacológico , Humanos , Imunoglobulinas Intravenosas/administração & dosagem , Imunoglobulinas Intravenosas/efeitos adversosRESUMO
AIMS: To assess cytokeratin (CK) and thyroid transcription factor (TTF)-1 expression in primary epithelial lung tumours by comparison with non-pulmonary carcinomas and to correlate it with their histological type and grade. METHODS AND RESULTS: Immunohistochemistry using antibodies against CKs 5/6, 7, 19, 20 and TTF-1 was applied to 165 primary and 37 secondary epithelial lung tumours. CK5/6 is a sensitive and specific marker of lung squamous carcinomas being positive in 100% of cases. CK7 is a common marker of primary lung adenocarcinomas (100% of cases) but with a lower specificity since it is also observed in other primary lung carcinomas (70% of large-cell neuroendocrine carcinomas, 40% of large-cell carcinomas, 23% of squamous carcinomas) but also in 27% of non-pulmonary adenocarcinomas. Addition of an anti-CK20 may be useful to prove or disprove the pulmonary origin of an adenocarcinoma when there is a history of colon cancer. CK19 is ubiquitous but a predominant or exclusive 'dot-like' pattern is very suggestive of high-grade neuroendocrine carcinoma. TTF-1 is a very sensitive and specific marker to document the pulmonary origin of an adenocarcinoma if a thyroid origin is excluded. Its expression in neuroendocrine lung tumours depends on the tumour grade. CONCLUSIONS: Immunohistochemical expression of CKs and TTF-1 may be correlated with histological type and grade of lung primary epithelial tumours and may allow them to be distinguished from non-pulmonary carcinomas.
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Adenocarcinoma/metabolismo , Biomarcadores Tumorais/metabolismo , Carcinoma de Células Escamosas/metabolismo , Queratinas/metabolismo , Neoplasias Pulmonares/metabolismo , Proteínas Nucleares/metabolismo , Fatores de Transcrição/metabolismo , Adenocarcinoma/secundário , Idoso , Carcinoma de Células Escamosas/secundário , Feminino , Humanos , Técnicas Imunoenzimáticas , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Fator Nuclear 1 de TireoideRESUMO
PURPOSE: To describe the clinical features, biological datas and outcome of patients with systemic sarcoidosis and splenomegaly. METHODS: A retrospective analysis of 17 patients presenting splenomegaly and sarcoidosis with histological proof. RESULTS: Splenomegaly was clinically perceptible in 13 patients, with a spleen size that extended 4 cm or more below the costal margin in 11 patients. It was painful in five cases. The more frequent clinical features are constitutional symptom (fever in 9 cases) and hepatomegaly (N =7). Chest X-ray showed bilateral hilar lymphadenopathy in nine patients and no abnormality in five cases. Serum angiotensin converting enzyme levels were elevated in 81% of cases. Thrombopenia (N =5) and hypersplenism (N =5) were also observed. Corticosteroid were given to 88% with a good clinical and biological response including a decrease in the spleen volume. Corticotherapy and splenectomy (performed in two patients to rule out lymphoma) didn't change outcome of disease. Sarcoidosis is often chronical (82%) and extensive. CONCLUSION: Splenomegaly may be present in sarcoidosis. Management is not standardized. Corticosteroid is indicated for symptomatic or massive splenomegaly. Splenomegaly is frequently in chronic and extensive sarcoidosis.
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Corticosteroides/uso terapêutico , Sarcoidose/complicações , Esplenectomia , Esplenomegalia/tratamento farmacológico , Esplenomegalia/etiologia , Adulto , Diagnóstico Diferencial , Feminino , Febre/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Estudos Retrospectivos , Esplenomegalia/cirurgia , Resultado do TratamentoRESUMO
INTRODUCTION: The aim of our study was to describe the main characteristics of bronchioloalveolar carcinoma (BAC) in the light of the latest WHO classification. The clinical, pathological and radiological features of 16 consecutive resected cases of early BAC (stage IA) were reviewed. METHODS: Retrospective pathology of 249 adenocarcinomas over a 32 months period. RESULTS: Computerised tomography (CT) features which supported a diagnosis of BAC included a peripheral location, irregular margins forming a star pattern, pleural tagging, ground-glass attenuation and an air bronchogram. Immunochemistry was positive in all cases for cytokeratins 7 and 19, EMA and TTF-1, but was only variably positive for ACE, P53 and MIB-1. For 14 out of 16 patients clinical outcome was favourable with no evidence to date of recurrence since surgery. Of the others, one developed extra-thoracic metastases and the other a local recurrence requiring further surgery. CONCLUSION: Recognising these characteristics of BAC is important as early diagnosis and treatment of this condition can be associated with an excellent prognosis.
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Adenocarcinoma Bronquioloalveolar/patologia , Neoplasias Pulmonares/patologia , Adenocarcinoma Bronquioloalveolar/classificação , Adenocarcinoma Bronquioloalveolar/diagnóstico , Adenocarcinoma Bronquioloalveolar/cirurgia , Adulto , Idoso , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Imuno-Histoquímica , Pulmão/patologia , Neoplasias Pulmonares/classificação , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Pneumonectomia , Prognóstico , Radiografia Torácica , Estudos Retrospectivos , Fatores de Tempo , Tomografia Computadorizada por Raios X , Organização Mundial da SaúdeAssuntos
Pneumopatias/diagnóstico por imagem , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , RadiografiaRESUMO
The aim of this prospective pharmacovigilance study was to assess the incidence and the preventability of adverse drug reactions (ADRs) leading to hospital admissions. All patients admitted to the Toulouse University Hospital through the medical admission ward during four non-consecutive weeks were included in the study. Characteristics of patients admitted for a suspected ADR (cases) were compared with those admitted for other reasons (controls). All cases were reviewed by both a pharmacologist and an emergency medicine specialist. Among a total of 671 admissions, 44 ADRs were identified. The incidence of hospital admissions for ADRs was 6.1 per 100 admissions [4.4-8.3]. Cases were exposed to a higher number of drugs (3.6 vs. 1.7; p < 0.001). Some classes of drugs were significantly associated with a higher risk of ADRs: antineoplastic, anti-infectious or musculoskeletal drugs. Haematological, metabolic and electrolytic, liver/gastrointestinal or cutaneous disorders were causes of admissions significantly more frequently related to ADRs. Using Imbs's preventability scale, 65 per cent of ADRs were categorized as 'definitely unpreventable', 26 per cent 'potentially preventable' and 9 per cent 'definitely preventable'. These results underline the frequency of ADRs leading to hospitalization, with 35 per cent which are more than likely preventable. Further studies are needed to validate this preventability scale in order to obtain an easier, more reliable and more reproducible tool.
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Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Tratamento Farmacológico/normas , Serviço Hospitalar de Emergência/normas , França , Hospitais Universitários , HumanosRESUMO
OBJECTIVE: Hypersensitivity pneumonitis due to dry sausage mould has been reported in workers who brush off the excess mould which coats dry sausage. Prevalence of symptoms and sensitization to mould among these pork-butchery workers is unknown. The aim of the study was to assess the clinical, radiographic, functional, and immunological features in exposed and non-exposed workers in semi-industrial pork butcheries. PATIENTS AND METHODS: Symptoms, and serum precipitins against mould extracts, were studied in workers in semi-industrial pork butcheries. Of 600 workers asked to participate, 123 (20.5%) were included. Fifty-nine workers, exposed to dry (raw) sausage mould and Penicillium nalgiovense were compared with 64 non-exposed subjects, for symptoms, chest X-rays, spirometry and CO-transfer measurements. Precipitating antibodies were detected by immunoelectrophoresis and electrosyneresis. RESULTS: Sneezing, cough, dyspnoea, nasal obstruction, headache, and discomfort were significantly more frequent in the exposed group at work and after work than in the control group (P < 0.05). The prevalence of precipitating antibodies for sausage mould was higher in the exposed group (37%) than in the non-exposed group (9%) (P < 0.01). The mean number of precipitating lines measured by electrosyneresis was higher in exposed workers than in non-exposed workers for mould extract (1.09 vs 0.28, P < 0.05) and for Penicillium nalgiovense (1.77 vs 0.33, P < 0.05). No specific X-ray opacity or lung function impairment was found in either group. CONCLUSIONS: Clinical symptoms and sensitization to Penicillium nalgiovense are frequent among workers exposed to mould during brushing in dry sausage plants.
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Alveolite Alérgica Extrínseca/fisiopatologia , Indústria Alimentícia , Fungos/patogenicidade , Produtos da Carne/microbiologia , Exposição Ocupacional/efeitos adversos , Precipitinas/sangue , Adulto , Alveolite Alérgica Extrínseca/epidemiologia , Alveolite Alérgica Extrínseca/etiologia , Humanos , Exposição Ocupacional/análise , Prevalência , Inquéritos e QuestionáriosRESUMO
A statistical study of the detection process demonstrates that the free parameter is essential to compute the counting efficiency in both CIEMAT/NIST and TDCR methods. An analysis of the computed counting efficiencies shows the uselessness of old definition of the figure of merit. A new definition is required and we adopt the idea of taking quantities related with the output of the photomultiplier. In addition, we justify the application of the chemical quenching simulation with the electronic variation of the photomultiplier gain. Finally, we describe a new procedure to determine the figure of merit and the optimum ionization-quenching factor from the pulse spectrum of different radionuclides. The robustness of the new procedure is tested with three different sets of stopping power for low-energy electrons.
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The CYFRA 21-1 assay detects circulating fragments of cytokeratin 19, which is a sensitive marker for the diagnosis of lung cancers, particularly squamous cell carcinomas and adenocarcinomas. Epidermis-type proteins, such as cytokeratins 1, 2, 10/11 and 14 or filaggrin, are also expressed in squamous cell carcinomas. These could also be pertinent tumor markers, ideally as sensitive as CYFRA 21-1 and more specific for squamous cell lung cancer. To verify this hypothesis, using monoclonal antibodies produced in our laboratory, we developed immunoassays specific for these proteins. After optimization, the immunoassays were evaluated in sera from 91 controls and 138 patients with squamous cell lung cancer and compared to conventional tumor markers (CEA, SCC Ag and CYFRA 21-1). Less than 14% of the sera were above the lower limit of detection of the cytokeratin- and filaggrin-specific immunoassays. Moreover, part of these positive sera were induced by the presence of interfering heterophilic antibodies in sera. Thus, in patients with squamous cell lung cancer, we confirmed the high diagnostic sensitivity of CYFRA 21-1 (55.6%) but were unable to detect significant levels of epidermis-type cytokeratins or filaggrin.
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Antígenos de Neoplasias/sangue , Biomarcadores Tumorais/sangue , Carcinoma de Células Escamosas/sangue , Proteínas de Filamentos Intermediários/sangue , Queratinas/sangue , Neoplasias Pulmonares/sangue , Proteínas de Neoplasias/sangue , Fragmentos de Peptídeos/sangue , Serpinas , Anticorpos Monoclonais/imunologia , Especificidade de Anticorpos , Antígenos de Neoplasias/análise , Antígenos de Neoplasias/imunologia , Biomarcadores Tumorais/imunologia , Calibragem , Antígeno Carcinoembrionário/análise , Carcinoma de Células Escamosas/patologia , Diferenciação Celular , Ensaio de Imunoadsorção Enzimática , Epiderme/química , Proteínas Filagrinas , Humanos , Proteínas de Filamentos Intermediários/imunologia , Queratina-19 , Queratinas/imunologia , Pneumopatias/sangue , Neoplasias Pulmonares/patologia , Proteínas de Neoplasias/imunologia , Sensibilidade e EspecificidadeRESUMO
STUDY OBJECTIVE: To assess the effects of emphysema on the apex-to-base gradient of lung density (D) and lung mass (M) and to explore the relationship between M and lung function. METHODS: CT scans of whole lungs were performed in 12 healthy subjects and 29 patients who were breathing at functional residual capacity, after which lung function tests were performed. Whole D and M and regional D (RLD) and M (RLM) were calculated. The degree of emphysema was scored. RESULTS: The RLM for each height did not differ significantly between patients with disease and healthy subjects, while RLD was significantly lower in the patients with disease. A less marked nonlinear, increasing, craniocaudal gradient of D was observed in the group with disease, suggesting that the distension increases progressively from the apex to the base. RLD and RLM in the 40 to 90% lung height differed significantly among patients in the emphysema group with normal, high, and low M compared to the healthy subjects. M did not differ significantly between patients with centrilobular and panlobular emphysema, which was thought to stem from the marked variations in the results. Vital capacity was lower in the patients with low M. CONCLUSIONS: The lower RLD in the group with low M was due to both lung overinflation and to tissue loss, while in the groups with high or normal M, it was due only to lung overinflation.
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Pulmão/diagnóstico por imagem , Enfisema Pulmonar/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Idoso , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Pulmão/patologia , Masculino , Pessoa de Meia-Idade , Enfisema Pulmonar/patologia , Enfisema Pulmonar/fisiopatologia , Mecânica RespiratóriaRESUMO
BACKGROUND: Low-complement urticarial vasculitis is an uncommon condition associating urticaria, glomerulonephritis, obstructive ventilatory disorders, and anti-Ciq antibodies. CASE REPORT: We report a case in a 34-year-old woman who developed urticaria with purpura, membranoproliferative glomerulonephritis (creatinine 238 mumol/l) and bronchial obstruction with bronchectasia. Total complement and the C3 fraction were low. Anti-C1q antibodies were found in the serum and anti-DNA antibodies were negative. Aggravation of the respiratory and renal failure progressed despite corticosteroid therapy, leading to death at 4 months. DISCUSSION: Bronchial obstruction in low-complement urticarial vasculitis results from emphysema and is often life-threatening. Our case exhibited an unusual feature due to the lack of radiodetectable emphysema, the presence of bronchectasia and the rapid degradation of the respiratory function.
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Proteínas do Sistema Complemento/deficiência , Urticária/imunologia , Vasculite/imunologia , Adulto , Autoanticorpos/sangue , Biópsia , Bronquiectasia/imunologia , Bronquiectasia/patologia , Complemento C1q/imunologia , Evolução Fatal , Feminino , Mesângio Glomerular/imunologia , Mesângio Glomerular/patologia , Glomerulonefrite/imunologia , Glomerulonefrite/patologia , Humanos , Glomérulos Renais/imunologia , Glomérulos Renais/patologia , Síndrome , Tomografia Computadorizada por Raios X , Urticária/patologia , Vasculite/patologiaRESUMO
BACKGROUND: characterize To the effects of high asbestos exposure during annual periods of insulation. METHOD: 170 ex-workers underwent clinical examination, spirometry, standard chest X-rays and high-resolution computed tomography (HRCT). Asbestos exposure was retrospectively assessed for latency, duration, and intensity. RESULTS: Sixty-six percent of these workers were annually exposed to high concentrations of asbestos dust. Respiratory symptoms were mild. One hundred and nineteen subjects had pleural or pulmonary changes on HRCT, compatible with asbestos exposure. Localized pleural thickening was found in 113 subjects (66.5%); pulmonary nodules or lines in 35 (20.6%). The presence of pleural plaques was linked to intensity of asbestos exposure (P <.01), and length of employment (P <.05). Parenchymal lesions were related to intensity (P <.05) and duration of exposure (P <.05). Lung function of subjects with X-ray changes was not significantly altered. CONCLUSIONS: Annual asbestos exposure led to a high prevalence of pleural plaques and to mild parenchymal anomalies.