Asbestosis

Asbestosis Pulmonary fibrosis caused by asbestos inhalation is called asbestosis. Pneumonicoza is a general term for diseases of the lungs caused by inhalation and storage of mineral powders.
Asbestoza is a chronic inflammatory medical condition affecting the parenchymal tissue of the lungs caused by inhalation and retention of asbestos fibers. It usually occurs after exposure to large amounts of time or vacuuming the asbestos fibers and is an occupational disease. Patients may experience severe dyspnea and are at increased risk of developing certain malignancies including lung cancer and mesothelioma.
Signs and symptoms of asbestosis does not occur until after a waiting period, a few decades. The main symptom is installing a dispnei, especially during exercise. Advanced cases of asbestosis can lead to respiratory failure. On auscultation rales can be heard.
There is no cure for this disease. Oxygen therapy at home is often necessary to relieve symptoms and correct hypoxia. Symptomatic supportive treatment includes respiratory physiotherapy to remove secretions from the lungs by postural drainage, chest percussion and vibration application. Medication can be prescribed nebulizers to humidify secretions and chronic obstructive pulmonary disease to treat.
Enter the annual immunization for influenza and pneumococcal pneumonia. Patients should be informed about the risk of developing cancer and smoking cessation is recommended.
Pathogenesis Asbestos fibers are long and thin, being curved or straight. Fibers are called serpentine curves and the straight amphibole. Scientists recognize five different amphibole: amositul, antofilitul, tremolite, and crocidolite actinolitul. Beryl is by far the most common type of asbestos fiber produced in the world.
Production and use of asbestos has increased greatly in the years 1877 and 1967. In 1930 and 1940, scientists have recognized a link between exposure to asbestos and asbestosis. In 1950 it was established that asbestos is a predisposing factor for carcinoma bronhogenic and malignant mesothelioma.
Cumulative dose of inhaled fibers in a period of time and type, size and durability of fiber carcinogenicity and fibrogenicitatea influence. Asbestosis incidence varies with the cumulative dose of inhaled fibers, with higher dose is how both increase the risk of asbestosis. All types of asbestos fibers in lungs fibrogenice. Amfibolele in particular are more carcinogenic to the pleura. Fibres below 3 micrometres in diameter are fibrogene because they can penetrate cell membranes. Than 5 micrometers long fibers are incompletely phagocytized and remain in the lungs, releasing cytokines.
Page appears to forking alveolar inflammation and is characterized by the influx of alveolar macrophages. Asbestos-activated macrophages produce a variety of growth factors, including fibronectin that interacts with fibroblast proliferation. Oxygen free radicals are then released by macrophages, lezind proteins and lipid membranes and supports the inflammatory process. Individuals may differ in succeptibilitatea to asbestos and lung fucntie cleaning the still of varying factors. People who smoke have an increased risk of spoilage due to asbestosis mucociliare cleaning of asbestos fibers.
Signs and symptoms Due to development depending on the dose asbestosis symptoms appear only after a latent period of over 20 years. Latency period may be shorter after intense exposures. Dyspnea on effort is the most common symptom and worsens as the disease progresses. Patients may have a nonproductive cough. A productive cough suggests bronchitis or concurrent respiratory infection. Patients may experience nonspecific chest discomfort, especially in advanced cases.
Physical Exam: Rales are the most important sign during patient examination. They are persistent and are described as dry and fine rales cellophane. Are best heard at the lungs lower back and side areas. Initial phase is finally listening to inspiration. However, in advanced cases rales may be heard during the entire inspiratory phase. Occasionally this rales precedes radiographic abnormalities of the lung and respiratory tests. Rales may be missing a third of patients.
Digital Hipocratismul is observed in 42% of cases. It is not associated with disease severity. Reducing coastal tours in advanced cases is correlated with restrictive respiratory impairment and reduced vital capacity. In advanced cases patients may be associated with pulmonary heart these signs: cyanosis, jugular vein distention, reflux hepatojugular and pedal edema.
Diagnosis Laboratory studies: The diagnosis of asbestosis is made in the presence of three characteristics: exposure to asbestos, with a latent period, evidnetierea fibrosis by radiography, physical examination and tests of specific respiratory capacity affected with or without biopsy or bronchoalveolar lavage with evdentierea fibers.
Imaging Studies: Chest radiograph showed infiltrates reticulonodulare observed especially in the lungs. The diagnosis of asbestosis requires multiple elements, radiography is valuable prodictiva modest positive. When combined with abnormal signs (rales) and respiratory fucntiei tests abnormal, positive predictive value increases. Bilateral pleural thickening can be observed. A calcified plaque located in the diaphragmatic pleura is an indicator of exposure to asbestos but not diagnostic. Other locations of asbestos tiles are 9 ribs bilaterally. Seldom can determine those application pleural atelectazii round peripheral edges that can simulate a lung tumor. In advanced stage disease of honey-combs occur through the fusion of cystic spaces and interstitial infiltrates of small lung fields.
Computed tomography is useful in defining abnormalities effusion (effusion, thickening, plaques, malignant mesothelioma, atelectazii round) and the evidence is suggestive of a parenchymal density bronhogenic carcinoma.
Respiratory tests: reduction of diffusing capacity may precede changes in lung volume. The first sign is abnormal physiological hypoxemia during exercise. Total lung capacity is reduced as asbestosis and other restrictive diseases. Using spirometry vital capacity seems low.
Oximetry, assessment of oxygenation is important because uncorrected hypoxemia cause hypertension and pulmonary heart. It will measure lung gas.
Bronchoalveolar lavage in diagnosis asbestosis has limited applications. It is useful in identifying infection with diffuse infiltrates, which simulates bronhogenic asbestosis and carcinoma diagnosis. It can bring qualitative information on asbestos fibers.
Fibre optic bronchoscopy is done to facilitate the lavage. It is indicated for airway examination when radiological studies are suggestive of carcinoma bronhogenic. Transbronhoscopica lung biopsy is not recommended for diagnosing asbestosis.
Histological examination: diagnosis of asbestosis and asbestos bodies, requires visualization of fibrosis in electron microscopy. Corpora of asbestos fibers develop asbestos-shirt ferritin protein and a characteristic aspect of the boat. These alone are not diagnostic for the disease because they are discovered occasionally in healthy individuals.
The differential diagnosis is made with the following conditions: silicosis, sarcoidosis, idiopathic pulmonary fibrosis, hypersensitivity pneumonitis, dermatomyositis, vascular collagenosis.
Treatment Control expuenrii to asbestos at work is the most effective way to prevent asbestosis. Termination of exposure to asbestos once it is imperative that diagnosis is made because the exposure increases the rate of progression. However the disease can progress and outside exposure. Smokers must stop smoking cigarettes.
Treatment includes treatment of respiratory infections and immunization against influenza and pneumococcal pneumonia. It will make prompt antibiotic therapy if lung infections. It will assess the status of oxygenation in resting and exercising. If testing detects hypoxemia at rest or additional effort will be prescribed oxygen. Medications are not effective in treating asbestosis. Corticosteroids and immunosuppressants do not change the course of the disease.
Prognosis: Asbestosis can cause pulmonary hypertension, cor pulmonale, right heart failure. Progressive respiratory failure shows the cumulative risk factors depending on the amount of asbestos inhaled, the degree of dyspnea, smoking cigarettes, lung and pleural damage, honey combs visible on X-rays and the large number of cells in bronchoalveolar lavage imflamatorii. The risk of lung cancer is high in these patients, and mesothelioma, cancer of the esophagus, biliary system and kidneys.