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.A presente revisão apresenta as características radiográficas e tomográficas das principais doenças ocupacionais respiratórias (silicose e asbestose). Em especial, enfatiza-se a relevância prática da tomografia computadorizada de alta resolução, método mais sensível e específico para a detecção e quantificação da extensão das lesões pleuroparenquimatosas a elas relacionadas.Universidade Federal de São Paulo (UNIFESP)Memorial Sloan-Kettering Cancer CenterUniversidade de São Paulo Faculdade de Medicina Hospital das ClínicasUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de DiagnósticoUNIFESP, EPM, Depto. de DiagnósticoSciEL

AVALIAÇÃO DA UTILIZAÇÃO DE RECURSOS DE ENSINO ON-LINE RELACIONADOS A DIFERENTES ESTILOS DE APRENDIZAGEM

O presente trabalho apresenta os resultados de uma pesquisa que objetivou a criação de recursos on-line para apoio ao ensino de uma disciplina presencial de cursos de engenharia, com foco na criação de objetos de aprendizagem que pudessem atender aos diferentes estilos de aprendizagem dos estudantes. A partir da identificação dos estilos de aprendizagem de cada aluno, realizou-se a avaliação do seu comportamento com relação aos diferentes objetos. Mais do que avaliar o comportamento dos estudantes, o principal foco do trabalho foi desenvolver recursos de ensino que pudessem responder aos diferentes perfis de aprendizagem, de modo a contribuir para a melhoria do processo de ensino-aprendizagem

Lung Diffusing Capacity Relates Better to Short-Term Progression on HRCT Abnormalities Than Spirometry in Mild Asbestosis (vol 54, pg 185, 2011)

State Univ Campinas UNICAMP, Occupat Hlth Area, Campinas, SP, BrazilMed Sch Jundia, Jundia, SP, BrazilUniv São Paulo, Sch Med, Div Pulm, InCor HC, São Paulo, BrazilUniv British Columbia, Vancouver Gen Hosp, Dept Radiol, Vancouver, BC V5Z 1M9, CanadaFed Univ São Paulo UNIFESP, Dept Radiol, BR-04023062 São Paulo, BrazilFed Univ São Paulo UNIFESP, Div Resp, BR-04023062 São Paulo, BrazilFed Univ São Paulo UNIFESP, Dept Radiol, BR-04023062 São Paulo, BrazilFed Univ São Paulo UNIFESP, Div Resp, BR-04023062 São Paulo, BrazilWeb of Scienc

Lung Diffusing Capacity Relates Better to Short-Term Progression on HRCT Abnormalities Than Spirometry in Mild Asbestosis

Background Pulmonary function tests (PFT), particularly spirometry and lung diffusing capacity for carbon monoxide (DL(CO)), have been considered useful methods for the detection of the progression of interstitial asbestos abnormalities as indicated by high-resolution computed tomography (HRCT). However, it is currently unknown which of these two tests correlates best with anatomical changes over time. Methods In this study, we contrasted longitudinal changes (3-9 years follow-up) in PFTs at rest and during exercise with interstitial abnormalities evaluated by HRCT in 63 ex-workers with mild-to-moderate asbestosis. Results At baseline, patients presented with low-grade asbestosis (Huuskonen classes I-II), and most PFT results were within the limits of normality. In the follow-up, most subjects had normal spirometry, static lung volumes and arterial blood gases. In contrast, frequency of DL(CO) abnormalities almost doubled (P < 0.05). Twenty-three (36.5%) subjects increased the interstitial marks on HRCT. These had significantly larger declines in DL(CO) compared to patients who remained stable (0.88 vs. 0.31 ml/min/mm Hg/year and 3.5 vs. 1.2%/year, respectively; P < 0.05). In contrast, no between-group differences were found for the other functional tests, including spirometry (P > 0.05). Conclusions These data demonstrate that the functional consequences of progression of HRCT abnormalities in mild-to-moderate asbestosis are better reflected by decrements in DL(CO) than by spirometric changes. These results might have important practical implications for medico-legal evaluation of this patient population. Am. J. Ind. Med. 54:185-193, 2011. (c) 2010 Wiley-Liss, Inc.Coordination for Improvement in Higher Education, Brazil (CAPES)Brazilian Research National Council (CNPq)Research Foundation of the State of Sao Paulo (FAPESP)S.A. Associated Mining (SAMA)[2P-04559-98

Relationship between induced sputum cytology and inflammatory status with lung structural and functional abnormalities in asbestosis

Background Asbestosis is associated with lung cellular and immunological abnormalities. Induced sputum cytology and local and systemic markers of inflammation may be helpful to characterize disease status and progression in these patients. Methods Thirty-nine ex-workers with asbestosis on high-resolution CT (HRCT) and 21 non-exposed controls were evaluated. Sputum cytology and IL-8 in serum and sputum were related to lung function impairment. Results Subjects with asbestosis had reduced sputum cellularity but higher macrophagel neutrophil ratio and % macrophage as compared with controls. Sputum and serum IL-8 were also higher in patients with asbestosis (P < 0.05). In addition, evidence of lung architectural distorption on HRCT was associated with increased levels of serum IL-8. Interestingly, absolute macrophage number was negatively correlated with total lung capacity (r = -0.40; P = 0.04) and serum IL-8 to lung diffiusing capacity (r = -0.45; P = 0.01). Conclusions Occupationally exposed subjects with asbestosis on HRCT have cytologic abnormalities in induced sputum and increased local and systemic pro-inflammatory status which are correlated to functional impairment