Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace / Fondazione clinica del lavoro, IRCCS [and] Istituto di clinica tisiologica e malattie apparato respiratorio, Università di Napoli, Secondo ateneo
-
Monaldi Arch Chest Dis · Apr 2000
ReviewBronchiolitis obliterans syndrome after lung transplantation: medical treatment.
Obliterative bronchiolitis (OB) or the clinical correlate bronchiolitis obliterans syndrome (BOS) is the main cause of late morbidity and mortality after heart-lung and lung transplantation. Although several risk factors for the development of OB/BOS have already been identified, very effective preventive therapy remains Utopian, although there has been much improvement in recent years. ⋯ The current treatment options, however, are rather anecdotal and mostly single-centre experiences. Therefore, multicentre studies are definitely needed to try to identify the most appropriate drug regimen either to prevent and to treat obliterative bronchiolitis/bronchiolitis obliterans syndrome.
-
Monaldi Arch Chest Dis · Apr 2000
ReviewPathology of emphysema in chronic obstructive pulmonary disease.
Emphysema is an almost constant finding in the lungs of chronic obstructive pulmonary disease patients. Several types of emphysema are recognized by pathologists, but only the centrilobular (CLE) and panlobular (PLE) emphysemas are found in association with smoking. ⋯ In contrast, in PLE: 1) the destruction of the lung is even; 2) the small airways appear less narrowed and less inflammed than in CLE; 3) the compliance of the lung is increased and related to the extent of the emphysema; and 4) the decrease in flow is related mainly to the loss of elastic recoil and not to the abnormalities in the airways. The authors would propose that centrilobular emphysema and panlobular emphysema are distinct entities, centrilobular emphysema an airborne disease related to airway reactivity, panlobular emphysema a blood-borne disease related to abnormalities in lung protective mechanisms against inflammatory insults.
-
The relationship between asbestos exposure, lung cancer and asbestosis is reviewed. Studies have demonstrated the risk of lung cancer to be raised in asbestos-exposed workers whether asbestosis is present or not. ⋯ Consensus opinion recommends that attribution of lung cancer to asbestos exposure should be based on clinical and occupational histories. The risk of lung cancer in those who both smoke and are exposed to asbestos is increased in a multiplicative way, putting subjects at very great risk.