20 años en enfermedad intersticial pulmonar / 20 years in pulmonary interstitial disease

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Experimental asbestos studies in the UK: 1912-1950.

The asbestos industry originated in the UK in the 1870s. By 1898, asbestos had many applications and was reported to be one of the four leading causes of severe occupational disease. In 1912, the UK government sponsored an experimental study that reported that exposure to asbestos produced no more than a modicum of pulmonary fibrosis in guinea pigs. In the 1930s, the newly established Medical Research Council, with assistance from industry, sponsored a study of the effects of exposing animals to asbestos by injection (intratracheal and subcutaneous) and by inhalation in the factory environment. Government reports, publications, and contemporary records obtained by legal discovery have been reviewed in the context of the stage of scientific development and the history of the times. Experimenters were engaged in a learning process during the 1912-1950 period, and their reports of the effects of asbestos were inconsistent. Pathologists who studied the effects of asbestos experimentally, at whole animal, tissue and cellular levels, advanced experimental methodology and mechanistic knowledge. In the hands of public relations experts, however, research was exploited to preserve an industry and perpetuate preventable diseases, a practice that continues to this day.

Fibrosis pulmonar idiop tica: aspectos clínicos, radiológicos, fisiológicos e histológicos / Idiopathic pulmonary fibrosis: clinical, radiological, physiological and histological aspects

Se reportan 12 casos de fibrosis pulmonar idiop tica,de los cuales 8 correspondían al sexo femenino y 4 al masculino, con un predominio de edad a partir de los 40 años. Un paciente presentaba artritis reumatoidea y dos eran diabéticos. La duración de la enfermedad fue menor de 1 año en la mayoría y el síntoma principal fue disnea, tos seca y síntomas constitucionales tales como fatiga, artralgias y pérdida de peso. Radiológicamente se encontró infiltrado reticulonodular basal bilateral en 8 pacientes y patrón de panal de abeja en 4. Enfermedad restrictiva pura, enfermedad mixta con predominio de restricción y patrón mixto fueron los hallazgos espirométricos en la mayoría de casos. Un paciente presentó pruebas espirométricas normales. A todos los pacientes se les efectuó biopsia pulmonar la cual se obtuvo a través de toracoscopía en 8 y por medio de biopsia a cielo abierto en 4. Histológicamente los hallazgos fueron fibrosis sin descamación, fibrosis con descamación leve, fibrosis con descamación moderada y fibrosis con descamación crónica en 3 casos en cada grupo. Diez pacientes recibieron tratamiento con prednisona, 4 antimicrobianos de amplio espectro, 5 metilxantinas y 3 isoniazida en forma profil ctica. La evolución de los pacientes ha mostrado mejoría clínica y funcional en 8, ningún cambio en 2 y fallecieron 2

Idiopathic pulmonary fibrosis: a historical review.

Hamman and Rich are generally considered to have been the first to describe idiopathic pulmonary fibrosis (IPF) as a new clinical and pathological entity. However, several earlier reports in the German-language literature described autopsy findings consistent with IPF from a contemporary point of view. The author discusses these and later reports in a review of the history, diagnosis and treatment of the disease.