1.Prevalence of diffuse parenchymal lung disease patterns on chest x-ray and reported respiratory symptoms among salon hairdressers in the National Capital Region: An analytical crosssectional study
Kristine Joy V. de Leon ; Jose Ronilo Juangco
Health Sciences Journal 2024;13(2):69-78
INTRODUCTION:
Exposure to chemical agents in salon products, such as ammonia and formaldehyde, poses significant respiratory health risks for hairdressers. This study aimed to assess the prevalence of Diffuse Parenchymal Lung Disease Patterns (DPLD) observed in chest X-rays of hairdressers in the National Capital Region and to document their reported respiratory symptoms.
METHODS:
An analytical, cross-sectional study was conducted involving 100 hairdressers who underwent plain chest X ray examinations to identify any of the 12 recognized DPLD patterns. Participants also accomplished a self administered questionnaire detailing their demographic information, working conditions, health histories and current respiratory symptoms.
RESULTS:
Thirty nine percent of participants showed DPLD patterns on chest X-rays, primarily fine reticular opacities (69.23%) and coarse reticular opacities (25.64%). Positive associations (RR>1) were linked to over five years of work, lack of PPE, daily exposure to hair iron steam, respiratory symptoms, and salon vapor exposure of exceeding five hours daily. Symptoms reported included shortness of breath (27%) and throat irritation (15%). Logistic regression confirmed a significant link between DPLD and positive respiratory symptoms.
CONCLUSION
This study highlights the risk of structural lung abnormalities and respiratory symptoms among hairdressers, emphasizing the need for improved workplace safety, consistent PPE use and routine medical screenings to reduce occupational health risks.
Human
;
Lung diseases, interstitial
2.A case of interstitial lung and liver disease caused by MARS1 gene mutation.
Wen-Jing PENG ; Yan ZHU ; Lai-Shuan WANG ; Wei LU ; Lin YANG ; Li ZHU
Chinese Journal of Contemporary Pediatrics 2023;25(11):1186-1190
The patient is a female infant, 4 months and 9 days old, who was admitted to the hospital due to recurrent fever, cough, and hepatomegaly for over a month. The patient was a healthy full-term infant with a normal birth history. At 2 months and 22 days after birth, she developed recurrent fever, cough, and respiratory distress. Chest imaging revealed diffuse bilateral lung lesions, and fiberoptic bronchoscopy showed interstitial changes in both lungs. These suggested the presence of interstitial lung disease. The patient also presented with hepatomegaly, anemia, hyperlipidemia, hypothyroidism, and malnutrition. Genetic testing indicated compound heterozygous variations in the MARS1 gene. This mutation can cause interstitial lung and liver disease, which is a severe rare disorder that typically manifests in infancy or early childhood. It is inherited in an autosomal recessive manner and characterized by early-onset respiratory insufficiency and liver disease in infants or young children. Since its first reported case in 2013, as of June 2023, only 38 related cases have been reported worldwide. This article reports the multidisciplinary diagnosis and treatment of interstitial lung and liver disease in an infant caused by MARS1 gene mutation.
Female
;
Humans
;
Infant
;
Cough
;
Hepatomegaly/pathology*
;
Liver Diseases
;
Lung/pathology*
;
Lung Diseases, Interstitial/pathology*
;
Mutation
3.A non-small cell lung carcinoma patient responded to crizotinib therapy after alectinib-induced interstitial lung disease.
Wenjia SUN ; Jing ZHENG ; Jianya ZHOU ; Jianying ZHOU
Journal of Zhejiang University. Medical sciences 2023;52(5):583-587
A 54-year-old, non-smoking woman was diagnosed as stage ⅣB adenocarcinoma with widespread bone metastasis (cT4N2M1c) in the First Affiliated Hospital, Zhejiang University School of Medicine. Immunohistochemistry result showed the presence of anaplastic lymphoma kinase (ALK) gene rearrangement; next-generation sequencing (NGS) indicated EML4-ALK fusion (E6:A20) with concurrent CCDC148-ALK (C1:A20), PKDCC-ALK (Pintergenic:A20)and VIT-ALK (V15:A20) fusions. After 32 weeks of alectinib treatment, the patient complained cough and exertional chest distress but had no sign of infection. Computed tomography (CT) showed bilateral diffuse ground glass opacities, suggesting a diagnosis of alectinib-related interstitial lung disease (ILD). Following corticosteroid treatment and discontinuation of alectinib, clinical presentations and CT scan gradually improved, but the primary lung lesions enlarged during the regular follow-up. The administration of crizotinib was then initiated and the disease was stable for 25 months without recurrence of primary lung lesions and ILD.
Female
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Humans
;
Middle Aged
;
Carcinoma, Non-Small-Cell Lung/drug therapy*
;
Crizotinib/therapeutic use*
;
Lung Neoplasms/drug therapy*
;
Anaplastic Lymphoma Kinase/therapeutic use*
;
Lung Diseases, Interstitial/diagnosis*
4.Research progress on the role and mechanism of 5-hydroxytryptamine and M2 macrophages in pulmonary interstitial fibrosis.
Yiming DENG ; Changwen DENG ; Xiaoping ZHU
Chinese Critical Care Medicine 2023;35(9):1004-1008
Idiopathic pulmonary fibrosis (IPF) is a progressive and fatal interstitial lung disease, the cause is not yet clear. Pathological manifestations are abnormal repair changes resulting from sustained lung injury. Macrophages have been identified as playing a key role in IPF pathogenesis. In different local microenvironments, macrophages can exhibit either classically activated (M1) or alternately activated (M2) phenotypes. M1 plays a key role in promoting inflammatory response and is involved in the process of causing alveolar tissue injury. M2 is involved in wound healing and stopping lung inflammation. Previous studies have shown that activation of 5-hydroxytryptamine (5-HT) signaling is enhanced in pulmonary fibrosis and that 5-HT receptors play an important role in the observed pro-fibrotic effects. As a multifunctional signaling molecule, 5-HT is closely related to lung macrophage polarization, early lung tissue injury, abnormal proliferation and repair, and late extracellular matrix (ECM) deposition. This article reviewed the role of 5-HT and M2 macrophages in the pathogenesis of IPF and the possible regulatory mechanism of 5-HT, in order to provide a reference for further research.
Humans
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Serotonin
;
Macrophages
;
Lung Diseases, Interstitial/pathology*
;
Lung/pathology*
;
Idiopathic Pulmonary Fibrosis
;
Fibrosis
5.Diffuse lung involvement in rheumatoid arthritis: a respiratory physician's perspective.
Hui HUANG ; Ruxuan CHEN ; Chi SHAO ; Zuojun XU ; Paul J WOLTERS
Chinese Medical Journal 2023;136(3):280-286
The lungs are one of the most common extra-articular organs involved in rheumatoid arthritis (RA), which is reported to occur in up to 60% to 80% of RA patients. Respiratory complications are the second leading cause of death due to RA. Although there is a wide spectrum of RA-associated respiratory diseases, interstitial lung disease is the most common manifestation and it impacts the prognosis of RA. There has been progress in understanding the management and progression of rheumatoid arthritis-associated interstitial lung disease (RA-ILD) and RA-associated respiratory diseases recently, for example, opportunistic pulmonary infectious diseases and toxicity from RA therapies. From a chest physicians' perspective, we will update the diagnosis and treatment of RA-associated ILD, methotrexate-associated lung disease, and the complication of Pneumocystis jiroveci pneumonia in RA in this review.
Humans
;
Arthritis, Rheumatoid/complications*
;
Methotrexate/therapeutic use*
;
Lung Diseases, Interstitial/complications*
;
Prognosis
;
Lung
6.Research progress of thyroid hormone in pulmonary fibrosis.
Bao Yan LIU ; Yong WANG ; Yan LIU ; Juan LI ; Ping CUI ; Jin HE
Chinese Journal of Industrial Hygiene and Occupational Diseases 2023;41(1):62-66
Pulmonary fibrosis is end-stage of variety of heterogeneous interstitial lung disease, characterizedby excessive proliferation of fibroblasts and extracellular matrix deposition and destruction of lung parenchyma. Thyroid and lung are derived from the same endodermal cells, thyroid hormone affect the occurrence、development and prognosis of the chronic obstructive pulmonary disease, lung cancer and other lung diseases, This article reviews the role and mechanism of thyroid hormone in pulmonary fibrosis in order to provide new idea for the study of the role and mechanism of thyroid hormone in silicosis.
Humans
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Pulmonary Fibrosis/pathology*
;
Lung/pathology*
;
Silicosis
;
Lung Diseases, Interstitial
;
Fibroblasts
;
Thyroid Hormones
;
Fibrosis
8.A concise review of diagnosis and evaluation of interstitial lung abnormalities.
Chinese Journal of Industrial Hygiene and Occupational Diseases 2023;41(5):396-400
Interstitial lung abnormalities (ILAs) refer to the subtle or mild signs of ILAs pulmonary parenchyma on chest HRCT scans, which are not yet sufficient to diagnose a certain interstitial lung disease, may be potentially compatible an early stage of the diseases. The signs of ILAs usually includes ground-glass opacities, reticular abnormakicies, honeycombing, traction bronchiectasis or non-emphysematous cysts. This article reviews the research progreses in the definition and classification, risk factors, prognosis, comorbidities and management of ILAs in combination with domestic and foreign literatures.
Humans
;
Lung/diagnostic imaging*
;
Tomography, X-Ray Computed
;
Lung Diseases, Interstitial/diagnosis*
;
Prognosis
;
Diagnosis, Differential
9.Potential biomarkers for diagnosis and disease evaluation of idiopathic pulmonary fibrosis.
Qing WANG ; Zhaoliang XIE ; Nansheng WAN ; Lei YANG ; Zhixian JIN ; Fang JIN ; Zhaoming HUANG ; Min CHEN ; Huiming WANG ; Jing FENG
Chinese Medical Journal 2023;136(11):1278-1290
Idiopathic pulmonary fibrosis (IPF) is a chronic progressive lung disease characterized by progressive lung fibrogenesis and histological features of usual interstitial pneumonia. IPF has a poor prognosis and presents a spectrum of disease courses ranging from slow evolving disease to rapid deterioration; thus, a differential diagnosis remains challenging. Several biomarkers have been identified to achieve a differential diagnosis; however, comprehensive reviews are lacking. This review summarizes over 100 biomarkers which can be divided into six categories according to their functions: differentially expressed biomarkers in the IPF compared to healthy controls; biomarkers distinguishing IPF from other types of interstitial lung disease; biomarkers differentiating acute exacerbation of IPF from stable disease; biomarkers predicting disease progression; biomarkers related to disease severity; and biomarkers related to treatment. Specimen used for the diagnosis of IPF included serum, bronchoalveolar lavage fluid, lung tissue, and sputum. IPF-specific biomarkers are of great clinical value for the differential diagnosis of IPF. Currently, the physiological measurements used to evaluate the occurrence of acute exacerbation, disease progression, and disease severity have limitations. Combining physiological measurements with biomarkers may increase the accuracy and sensitivity of diagnosis and disease evaluation of IPF. Most biomarkers described in this review are not routinely used in clinical practice. Future large-scale multicenter studies are required to design and validate suitable biomarker panels that have diagnostic utility for IPF.
Humans
;
Idiopathic Pulmonary Fibrosis/diagnosis*
;
Biomarkers
;
Lung Diseases, Interstitial
;
Lung
;
Bronchoalveolar Lavage Fluid
;
Disease Progression
;
Prognosis
10.Correlation between dyslipidemia and rheumatoid arthritis associated interstitial lung disease.
Qi WU ; Yue Ming CAI ; Juan HE ; Wen di HUANG ; Qing Wen WANG
Journal of Peking University(Health Sciences) 2023;55(6):982-992
OBJECTIVE:
To study the correlation between dyslipidemia and rheumatoid arthritis associa-ted interstitial lung disease (RA-ILD) by retrospective analysis of the clinical data.
METHODS:
The clinical data of patients with rheumatoid arthritis (RA), who were hospitalized in the Department of Rheumatism and Immunology of Peking University Shenzhen Hospital from January 2015 to July 2020 and fulfilled the criteria of the 2010 Rheumatoid Arthritis Classification Criteria established by American College of Rheumatology/European League Against Rheumatism collaborative initiative, were collected and analyzed.
RESULTS:
There were 737 RA patients included, of whom 282(38.26%)were with interstitial lung disease (ILD). The median time from the onset of the first RA-related clinical symptoms to the onset of ILD was 13 years (95%CI 11.33-14.67). By multivariate Logistic regression analysis, we found that low-density lipoprotein cholesterol (LDL-C) was an independent risk factor for RA-ILD (OR 1.452, 95%CI 1.099-1.918, P=0.009), whereas high-density lipoprotein cholesterol (HDL-C) was a protective factor for RA-ILD (OR 0.056, 95%CI 0.025-0.125, P < 0.001). The RA patients with high LDL-C or low HDL-C had higher incidence of ILD than that of the RA patients with normal LDL-C or HDL-C(57.45% vs. 36.96%, P < 0.001; 47.33% vs. 33.81%, P < 0.001, respectively). The median time of ILD onset in the RA patients with low HDL-C was shorter than that of the RA patients with normal HDL-C [10.0(95%CI 9.33-10.67)years vs.17.0 (95%CI 14.58-19.42) years, P < 0.001]. HDL-C level was negatively correlated with disease activity. Among the RA-ILD patients, the patients with low HDL-C had higher percentage of usual interstitial pneumonia (UIP) then that of the patients with normal HDL-C (60.00% vs. 53.29%, P=0.002). The RA-ILD patients with high LDL-C had higher incidence rate of decrease in forced vital capacity (FVC) than that of the RA-ILD patients with normal LDL-C (50.00% vs. 21.52%, P=0.015). The RA-ILD patients with low HDL-C had higher incidence rate of decrease in FVC (26.92% vs. 16.18%, P=0.003) and carbon monoxide diffusion (80.76% vs. 50.00%, P=0.010) than that of RA-ILD patients with normal HDL-C.
CONCLUSION
LDL-C was possibly a potential independent risk factor for RA-ILD. HDL-C was possibly a potential protective factor for RA-ILD. HDL-C level was negatively correlated with disease activity of RA. The median time of ILD onset in the RA patients with low HDL-C was significantly shorter than that of the RA patients with normal HDL-C.
Humans
;
Retrospective Studies
;
Cholesterol, LDL
;
Arthritis, Rheumatoid/complications*
;
Lung Diseases, Interstitial/complications*
;
Dyslipidemias/epidemiology*


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