Inflammatory, Hypersensitivity and Immune Lung Diseases, including Parasitic Diseases.
Fred W Wright in Radiology of the Chest and Related Conditions, 2022
In the pneumonic cases, chest radiographs show patchy alveolar infiltrates, which rapidly progress to frank consolidation, which may be lobar or rounded in type. Basal linear collapse is not infrequent. Multiple areas of the lungs may be affected. Cavitation is not uncommon. Small pleural effusions seem common but larger effusions seem to be related to concomitant cardiac failure. Complicating empyemas are rare. The radiographic extent of the disease seems to bear little relationship to eventual recovery. In mild cases spontaneous recovery often occurs. In others it may respond to erythromycin, sometimes with added rifampicin or deoxycycline, but these do not always prevent severe lung involvement or its spread to the lungs. More recently cipofloxacin has been used and has proved successful in outbreaks in France. Radiographic resolution tends to lag behind clinical improvement. In a few cases the disease may lead to pulmonary fibrosis.
General Surgery
Tjun Tang, Elizabeth O'Riordan, Stewart Walsh in Cracking the Intercollegiate General Surgery FRCS Viva, 2020
How is lymphoedema staged?Lymphoedema is staged using the International Society of Lymphology (ISL) lymphoedema stagingStage 0: Subclinical lymphoedema. No obvious swelling despite impaired lymph transport.Stage I: Limb swelling which resolves with limb elevation.Stage II: Limb swelling and pitting oedema not responsive to elevation. As the condition progresses patients may develop tissue fibrosis. Increased risk of soft-tissue infections.Stage III: Fibrotic tissue, oedematous limb, no pitting. Associated with skin changes including: thickening, hyperpigmentation, fat deposition, papillomas and deep skin folds.
Hypersensitivity Pneumonitis
Lourdes R. Laraya-Cuasay, Walter T. Hughes in Interstitial Lung Diseases in Children, 2019
Pulmonary function studies can be used to follow the functional course of hypersensitivity pneumonitis in children after cessation of exposure (CE) to the offending antigens in the inhaled dust. Caution should be exercised in utilizing pulmonary function data to predict prognosis in the first 2 months after CE. In the initial 2 months period following CE, hypoxemia at rest or with exercise is present and is probably related to both interstitial and bronchiolar lesions noted on lung biopsies.13 The persistence of hypoxemia after 2 months following CE was considered an unfavorable prognostic indicator in the series of children with HP reported by Chiron et al.13 The length of time for the functional recovery in those children appeared to be related to the degree of impairment in the initial pulmonary function studies.13 Functional sequelae were found to persist in the midterm (2 to 8 months) and long-term (greater than 8 months) period following CE; the presence and severity of these sequelae were greater in children over 10 years of age. Lung biopsy data in the initial period after CE can also be useful in the prognostic evaluation of patients with hypersensitivity pneumonitis. The presence of fibrosis appears to be associated with an unfavorable prognosis.13 Avoidance of inhaled organic antigens or even the use of corticosteroids may have little effect in the chronic form of hypersensitivity pneumonitis with irreversible pulmonary damage, fibrosis, and/or obstructive bronchiolitis.14
Adverse pulmonary effects after oral exposure to copper, manganese and mercury, alone and in mixtures, in a Spraque-Dawley rat model
Published in Ultrastructural Pathology, 2023
M Draper, Mj Bester, M Van Rooy, Hm Oberholzer
In conclusion, all the heavy metal groups demonstrated toxic effects on pulmonary morphology and ultrastructure that will most likely alter physiological functioning. In all experimental groups, the metals had a negative impact on the pulmonary tissue with Cu + Hg and Mn causing the most severe and second most severe effects on pulmonary morphology, respectively. The Cu + Hg group demonstrated great yellow-red birefringence in the pulmonary tissue, indicating the development of late fibrosis. Fibrosis directly affects the physiological functioning of tissue and organs, while indirectly affecting organ systems and the functioning of the body leading to associated disease. Ultrastructurally, the pulmonary tissue had the highest sensitivity to the triple mixture group that caused the most alterations to elastin and collagen fiber bundles. Overall, Mn in any mixture caused deleterious effects with the Mn + Hg group showing the highest toxicity, which is probably mediated by increased ROS production that causes damage to membranes and the mitochondria.
Kidney tissue elastography and interstitial fibrosis observed in kidney biopsy
Published in Renal Failure, 2022
Mehmet Sami Islamoglu, Sibel Gulcicek, Nurhan Seyahi
The demographic characteristics, clinical, and laboratory findings of the patients are given in Table 1. The patients were middle-aged with an average age of 41.4 years and with a slight predominance of the male gender. In the evaluation of the creatinine and GFR levels, we observed that the patients did not develop end-stage renal disease but had overt proteinuria. Table 2 shows the comparison of the patients based on the presence of fibrosis. The elastography measurements in the transverse sections revealed a kidney stiffness of 12.83 ± 9.80 kPa in the fibrosis group and 7.76 ± 5.16 kPa in the non-fibrosis group (n = 51), exhibiting a significant difference between the groups (p = .046). The whole cohort had a mean total histological score of 4.49 ± 3.3, a glomerular score of 2.64 ± 1.85, a tubular score of 1.45 ± 1.48, and a vascular score of 0.22 ± 0.25. The total histological score was found to be positively correlated with age (r = 0.428, p = .001), creatinine level (r = 0.759, p < .001), global sclerosis percentage (r = 0.874, p < .001), and proteinuria (r = 0.316, p = .017), whereas it showed a negative correlation with GFR (r = –0.537, p < .001). No correlation was observed between the transverse elastography measurements and the total histological score (r = 0.006, p = .967) (Table 3).
Review of galectin-3 inhibitors in the treatment of nonalcoholic steatohepatitis
Published in Expert Review of Clinical Pharmacology, 2021
Atef Al Attar, Ani Antaramian, Mazen Noureddin
Along with its multifaceted nature in biological processes, Gal-3 is strongly associated with fibrogenesis. Fibrosis is a complex process influenced by various factors, such as genetics, chronic inflammation, acute injury, and triggered by multiple signaling cascades [25]. When Gal-3 is disrupted genetically, it can reduce or almost abolish fibrosis development in various organs [22]. These findings have led many to manipulate the expression of Gal-3 in animal models to determine the extent of fibrosis reduction or loss. Several mechanisms have been proposed, from Gal-3 activation of quiescent fibroblasts to myofibroblasts, the classic transition of tissue fibrosis, to an increased expression and secretion of Gal-3 from alternative activated macrophages, creating a feedback loop that maintains macrophage activation [22,26] (Figure 1). It is thought that upon injury, myofibroblasts get activated via transforming growth factor beta-dependent pathway (TGF-B) (Figure 1)[25].