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Diffuse Lung Diseases (Emphysema, Airway and Interstitial Lung Diseases)
Published in de Azevedo-Marques Paulo Mazzoncini, Mencattini Arianna, Salmeri Marcello, Rangayyan Rangaraj M., Medical Image Analysis and Informatics: Computer-Aided Diagnosis and Therapy, 2018
Marcel Koenigkam Santos, Oliver Weinheimer
Diffuse pulmonary diseases may be classified into two large groups of conditions: obstructive and restrictive diseases. This classification is based mainly on clinical features (symptoms and physical examination) and pulmonary function testing. While patients with obstructive disease have airflow limitation/obstruction, patients with restrictive disease have pulmonary expansion limitation/restriction. The most common causes of obstructive disease are chronic obstructive pulmonary diseases (COPD), which includes emphysema and chronic bronchitis, asthma, bronchiectasis and cystic fibrosis (CF). Major conditions causing restrictive lung disease are represented by the interstitial lung diseases (ILD), such as idiopathic pulmonary fibrosis (IPF), pulmonary involvement by autoimmune diseases (systemic sclerosis, rheumatoid arthritis, lupus) and adverse drug reactions. Both groups share the same main symptoms of shortness of breath, cough and exertion. Pulmonary function tests (PFT), such as spirometry, plethysmography and diffusing capacity of the lung for carbon monoxide (DLCO) are used to differentiate obstructive from restrictive lung disease, as well as to assess disease severity and progression. But there are some conditions and situations that may challenge the correct diagnosis and also make adequate assessment of disease severity difficult, even with satisfactory clinical function tests. Some patients may present heterogeneous and mixed patterns of disease, showing restriction associated with obstruction at different degrees. Most clinical tests give only a global picture of the disease and cannot show a regional (right × left lung, basal × apical) or compartmentalized-based (airway, airspace, interstitial, vascular) analysis. For some diseases, PFT has a low sensitivity to detect initial alterations. Instead, pulmonary imaging can present morphological and function information, objectively and in a regional or compartmentalized fashion for the evaluation of diffuse lung diseases, being represented especially by the high resolution computed tomography (HRCT) (Maffessanti and Dalpiaz 2006, Webb and Higgins 2010).
Characterization of nanoparticles in aerosolized photocatalytic and regular cement
Published in Aerosol Science and Technology, 2019
Kiattisak Batsungnoen, Nancy B. Hopf, Guillaume Suárez, Michael Riediker
Exposure to regular cement is associated with lung function decline at elevated exposures (Nordby et al. 2016). The majority of the particle material found in both regular and photocatalytic cement was CaO. Inhaled CaO dust can cause inflammation in the upper respiratory tract due to its alkalinity (Toxicology data network (TOXNET) 2014). The second most abundant particle material was silica (SiO2). Exposure to crystalline silica can lead to health effects such as silicosis, tuberculosis, chronic bronchitis, COPD and lung cancer (IARC 1997; Merget et al. 2002; Kaewamatawong et al. 2005; Napierska et al. 2010). Amorphous silica is associated with reversible inflammation, granuloma formation and emphysema (McLaughlin, Chow, and Levy 1997; Merget et al. 2002; Kaewamatawong et al. 2005). Cement dust as such has been associated with impaired lung function, inflammation, bronchitis, chronic obstructive pulmonary disease, restrictive lung disease, and pneumoconiosis (Maciejewska and Bielichowska-Cybula 1991; Meo 2004; Penrose 2014; Eom et al. 2017). None of these toxicological assessments were made with nano-sized particles. We therefore concluded that exposures to these nano-sized particles could lead to unexplained effects on human health, and consequently, safety and environmental burden should not be neglected (Oberdörster, Oberdörster, and Oberdörster 2005; Maynard et al. 2006). The inhalation pathway is considered the major route of nanoparticle exposure, and the lungs and pleura are the major primary targets for adverse effects (Oberdörster, Oberdörster, and Oberdörster 2005; Donaldson and Poland 2012). It is difficult to say how nano-TiO2 might change health hazards already associated with cement exposure, but this should be considered when assessing exposure risks among cement workers.