En_2. Pneumoconiozele Curs II

8/15/2019 En_2. Pneumoconiozele Curs II

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The oldest occupational diseasesThe oldest occupational diseases

(confirmed by studies of prehistoric(confirmed by studies of prehistoric bodies of ippocrates and Pliny bodies of ippocrates and Pliny

E!yptian mummies"E!yptian mummies"

#ernadino $ama%%ini &' ) father of#ernadino $ama%%ini &' ) father of

occupational medicineoccupational medicine

describes diseases minersdescribes diseases miners


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*efinition*efinition

) *ata submissions are lun! disease+) *ata submissions are lun! disease+

accumulation of dust in the lun!s follo,ed byaccumulation of dust in the lun!s follo,ed by

lun! tissue reaction to their presence-lun! tissue reaction to their presence-

The t,o conditions are mandatory+ no oneThe t,o conditions are mandatory+ no one

e.cluded pneumoconiosis/e.cluded pneumoconiosis/

po,ders 0e+ #a ) pulmonary tattoos po,ders 0e+ #a ) pulmonary tattoos

#e determined !ranuloma no deposit#e determined !ranuloma no deposit


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The se1erity of pneumoconiosis 23The se1erity of pneumoconiosis 23

shutter/shutter/

e1olutionary pace and intensity of fibrosis/e1olutionary pace and intensity of fibrosis/ po,der properties/ po,der properties/

their concentration in the ,or4place/their concentration in the ,or4place/

the type of reaction they produce/the type of reaction they produce/


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Mineral po,dersMineral po,ders

) 5erosols inert particles are able to remain) 5erosols inert particles are able to remain

suspended lon!er in a !aseous medium/suspended lon!er in a !aseous medium/

by si%e2 by si%e2 o1er &6 (e.cept asbestos ) 7896"o1er &6 (e.cept asbestos ) 7896"

+76 8 &6 (respirable fraction ) :8;6"+76 8 &6 (respirable fraction ) :8;6"

under +76under +76


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5fter their ori!in25fter their ori!in2

a" inor!anic po,der 8 mineral


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*efense Mechanisms*efense Mechanisms

chemical neutrali%ationchemical neutrali%ationneutrali%in! en%ymeneutrali%in! en%yme

immunolo!ical defenseimmunolo!ical defense

tracheobronchial clearancetracheobronchial clearanceal1eolar clearanceal1eolar clearance

Policard (&>?'"Policard (&>?'"

: years old -?4! dust ------: years old -?4! dust ------ -?89 !r ------ incineration/ >98>>@ efficiency-?89 !r ------ incineration/ >98>>@ efficiency


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To.ins soluble N:+


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Mucus is a 1iscous fluid secreted by2Mucus is a 1iscous fluid secreted by2

8 5t- mucipare (!oblet" --- irritati1e stimuli8 5t- mucipare (!oblet" --- irritati1e stimuli

8 ;@ ,ater 8 ;@ electrolytes+ lipids+ proteins+ carbohydrates+8 ;@ electrolytes+ lipids+ proteins+ carbohydrates+

amino acids+ electrolytes+ I!+ MP


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Cilia ) formations at most- bronchial ciliatedCilia ) formations at most- bronchial ciliated

epitheliumepithelium

,indpipe to the decreasin! number of small,indpipe to the decreasin! number of small

air,ays/air,ays/

They can mo1e in the pro.imal direction/They can mo1e in the pro.imal direction/

,ater dama!e- ciliary,ater dama!e- ciliary

Mec efficiency-Mec efficiency-ClearanceClearance

mucus prop-reolo!icemucus prop-reolo!ice


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Cl- accelerated 8 cou!hCl- accelerated 8 cou!h

8 E.pectorants+ mucolytics8 E.pectorants+ mucolytics

8 Methyl.anthines+ Aadrener!ice di!italis8 Methyl.anthines+ Aadrener!ice di!italis

8 $espiratory physiotherapy8 $espiratory physiotherapy

8 Postural draina!e8 Postural draina!e

Cl- diminished 8 smo4in!Cl- diminished 8 smo4in!

8 E.treme climate8 E.treme climate

8 =iral infections+ asthma+ T#+8 =iral infections+ asthma+ T#+

COP*+ cystic fibrosisCOP*+ cystic fibrosis 8 Irritatin! !ases8 Irritatin! !ases

8 Opiates+ atropine8 Opiates+ atropine


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Clearance al1eolar Clearance al1eolar

menus distal respiratory bronchiolitis+ al1eolarmenus distal respiratory bronchiolitis+ al1eolarducts+ al1eolar sacs"ducts+ al1eolar sacs"

secreted by the al1eolar pneumocytes surfactant IIsecreted by the al1eolar pneumocytes surfactant II

$ole2 8 anti8infecti1e defense (M5 and increase the$ole2 8 anti8infecti1e defense (M5 and increase the potential of pha!ocyte PMN" potential of pha!ocyte PMN"

8 #act neutrali%e proteases+ cellular and8 #act neutrali%e proteases+ cellular andchemical substances inhaled/chemical substances inhaled/

8


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Pneumoconio%ele are mechanismsPneumoconio%ele are mechanisms

for e.ceedin! clearencefor e.ceedin! clearence

Pneumoconiosis Colla!en silicosis+ asbestosis+Pneumoconiosis Colla!en silicosis+ asbestosis+

pro!ressi1e massi1e fibrosis/ pro!ressi1e massi1e fibrosis/

Pneumoconiosis noncolla!enous2 anthracosis+Pneumoconiosis noncolla!enous2 anthracosis+

barito%a+ stano%a barito%a+ stano%a


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Pneumoconiosis colla!ensPneumoconiosis colla!ens

inhalation of dust arise from fibrino!en/inhalation of dust arise from fibrino!en/continuous destructi1e process of lun!continuous destructi1e process of lun!

architecture/architecture/

inBuries are permanent+ pro!ressi1e+ andinBuries are permanent+ pro!ressi1e+ andconsists in a reaction of moderate intensityconsists in a reaction of moderate intensitycolla!ens emphatic/colla!ens emphatic/

e1ol1in! after stoppin! e.posure/e1ol1in! after stoppin! e.posure/

1entilatory is accompanied by functional1entilatory is accompanied by functionaldisorders/disorders/

Im disabled-Im disabled-


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Classification radiolo!icalClassification radiolo!ical

pneumoconio%elor pneumoconio%elor

#IT ) ILO#IT ) ILO

$ound small opacity2

up to &-; mm are coded ,ith p/

bet,een &-; and : mm encodes D/

bet,een : and & mm encodes r-


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Lar!e opacitiesLar!e opacities

A = diameter of the opacity of the surface isA = diameter of the opacity of the surface is

betweenbetween

1-5 cm;1-5 cm;

B = opacities in both lun field co!ersB = opacities in both lun field co!ers

areate, ma"imum 1#3 of the riht lunareate, ma"imum 1#3 of the riht lun

field;field;

$ summation opacity surfaces e"ceedin 1#3$ summation opacity surfaces e"ceedin 1#3

of riht lun field.of riht lun field.


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Cate!ory profusionCate!ory profusion) 5 :8di!it numerical system that desi!nates) 5 :8di!it numerical system that desi!nates

profusion cate!ory pneumoconiotice opacity profusion cate!ory pneumoconiotice opacityor density-or density-

Cate!ory & denotes reduced presence ofCate!ory & denotes reduced presence ofopacities+ pulmonary te.ture is perfectlyopacities+ pulmonary te.ture is perfectly1isible-1isible-

Cate!ory 7 8 many ,ith te.ture pulmonaryCate!ory 7 8 many ,ith te.ture pulmonaryopacities are partly 1isible-opacities are partly 1isible-

Cate!ory : 8 opacities are 1ery numerous+Cate!ory : 8 opacities are 1ery numerous+in1isible pulmonary te.ture-in1isible pulmonary te.ture-


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5dditional


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5dditional


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es ) e!!shell calcifications in hilar ores ) e!!shell calcifications in hilar or

mediastinal lymph nodesmediastinal lymph nodes

fr ) rib fracturesfr ) rib fractures

hi ) ili increase or (and" the increasedhi ) ili increase or (and" the increased

opacityopacity

id ) diaphra!matic 1a!ue outline ed!eid ) diaphra!matic 1a!ue outline ed!e

ih ) bad heart shaped silhouetteih ) bad heart shaped silhouette

me ) mesotheliomame ) mesothelioma

5dditional


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5dditional

En_2. Pneumoconiozele Curs II

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