Centrilobular fibrosis: an underrecognized pattern in systemic sclerosis.

Background: The impressive association of lung involvement and gastroesophageal reflux in scleroderma raises the possibility of a cause-effect relationship.

Objectives: To determine clinical, radiological and histopathological features of systemic sclerosis (SSc) patients according the presence or absence of centrilobular fibrosis (CLF).

Methods: Twenty-eight SSc patients with lung involvement were submitted to open lung biopsy and the specimens classified for the presence of CLF (bronchocentric distribution of the lesions and intraluminal matter according to the classification of idiopathic interstitial pneumonia).

[Imaging in occupational lung diseases].

This chapter consists of a review of the literature regarding radiographic and tomographic characteristics of the principal occupational respiratory diseases (silicosis and asbestosis). Special attention is given to the practical relevance of high-resolution computed tomography, which is the most sensitive and specific method of identifying and quantifying the extent of pleural and parenchymal lesions related to such diseases.

Pleural plaques in asbestos-exposed workers: reproducibility of a new high-resolution CT visual semiquantitative measurement method.

Objective: To assess the reproducibility of a new high-resolution computed tomography (CT) visual semiquantitative method for pleural plaques in asbestos-exposed workers.

Material And Methods: We performed thin-section CT in 752 chrysotile asbestos mining workers and ex-workers. Institutional review board approval and signed written informed consent from subjects were obtained.

High-resolution CT in silicosis: correlation with radiographic findings and functional impairment.

Objective: To assess high-resolution computed tomography (HRCT) findings in silicosis and to better define the role of HRCT in early detection of parenchymal abnormalities in silica-exposed workers.

Methods: Forty-one stone carvers were evaluated with chest radiographs (CR), HRCT, and pulmonary function tests (PFT). Inter-reader agreement was calculated using the kappa statistic (k).

Contribution to the natural history of paracoccidioidomycosis: identification of the primary pulmonary infection in the severe acute form of the disease--a case report.

Several aspects of the pathogenesis of paracoccidioidomycosis (PCM) have not yet been fully clarified. We describe a patient with an overwhelmingly acute form of PCM who presented with clinically apparent pulmonary infection that spontaneously subsided while yeast cells disseminated systemically. This case may help to explain the paradox of the absence of pulmonary involvement in the acute disseminated form of PCM.

Thin-section CT abnormalities and pulmonary gas exchange impairment in workers exposed to asbestos.

Purpose: To evaluate the relationship between abnormalities at thin-section computed tomography (CT) and indexes of pulmonary gas exchange impairment at rest and during moderate exercise in workers exposed to asbestos.

Materials And Methods: Eighty-two workers with long-term exposure to asbestos and abnormal thin-section CT findings underwent respiratory physiologic measurements at rest (lung diffusing capacity, Dlco) and during exercise (oxygen uptake-corrected alveolar-arterial pressure difference for oxygen, DeltaP[A-a]O(2)/VO(2)). CT results were compared with physiologic measurements of impairment in gas exchange (Dlco < 70% predicted value and/or DeltaP[A-a]O(2)/VO(2) > 20 mm Hg.

Randomized trial comparing pulmonary alterations after conventional with venovenous bypass versus piggyback liver transplantation.

During the anhepatic phase of conventional liver transplantation (LT), the inferior vena cava (IVC) is cross-clamped and venovenous bypass (VVB) is usually indicated for diversion of IVC and portal blood flow. VVB can theoretically lead to pulmonary complications due to the contact of the blood with the surfaces of the circuit. In the piggyback method, preservation of the IVC avoids VVB.

High prevalence of silicosis among stone carvers in Brazil.

Background: In the city of Petrópolis, Brazil, artisans carve souvenirs from a variety of silica-containing minerals. The finding of pulmonary massive fibrosis in one of the workers motivated an investigation of the prevalence of silicosis in this group.

Methods: Between January 2000 and June 2002, a cross-sectional study was performed.