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Cystic fibrosis (CF), a common fatal genetic disease, is a multisystem disorder whose pathogenesi... more Cystic fibrosis (CF), a common fatal genetic disease, is a multisystem disorder whose pathogenesis has recently been linked to defects in CFTR, a newly discovered protein. CFTR is a molecular channel which controls chloride concentration in secretions of the sweat glands and the respiratory, GI, and reproductive tracts. Defective forms of CFTR, arising from various mutations in its gene, are responsible for the inadequate hydration of mucus, pancreatic juice, and other exocrine secretions. The result is dysfunction of the lungs, pancreas, and other involved organs. This article describes the diagnosis, clinical features, and approach to management of CF.
Wegener's granulomatosis is a multisystem life threatening vasculitis which poses particu... more Wegener's granulomatosis is a multisystem life threatening vasculitis which poses particular concerns when it involves a pregnant patient. We present two patients whose pregnancies were complicated by Wegener's granulomatosis and review previously reported patients whose pregnancies were also complicated by WG.
Wegener's granulomatosis is a multisystem life threatening vasculitis which poses particular ... more Wegener's granulomatosis is a multisystem life threatening vasculitis which poses particular concerns when it involves a pregnant patient. We present two patients whose pregnancies were complicated by Wegener's granulomatosis and review previously reported patients whose pregnancies were also complicated by WG.
Data on respiratory symptoms and pulmonary function were obtained for 2736 Portland cement plant ... more Data on respiratory symptoms and pulmonary function were obtained for 2736 Portland cement plant workers and 755 controls. Personal dust samples contained a geometric mean concentration of 0 57 mg/m3 for respirable dust and 2-90 mg/m3 for total dust. Cement workers and controls had similar prevalences of symptoms, except that 5 4% ofthe cement workers had dyspnoea compared with 2-7% of the controls. The mean pulmonary function indices were similar for the two groups. Among cement plant workers, the prevalence of chronic phlegm increased with tenure whereas the prevalence of wheezing increased with both tenure and current dust level. Other symptoms and pulmonary function indices were not significantly related to exposure.
An epidemiologic study of the respiratory effects of Portland cement dust was conducted. The coho... more An epidemiologic study of the respiratory effects of Portland cement dust was conducted. The cohort consisted of 2,736 cement workers at 16 facilities in the United States. The comparisons consisted of 2,213 individuals in activities not involving dust exposure. Spirometry testing was performed. Respiratory-symptom questionnaires were administered. Chest x-rays were taken and examined. Personal sampling for total and respirable dust, quartz, and oxides of sulfur and nitrogen was performed. Cement workers had a significantly elevated adjusted-odds ratio for dyspnea, rounded and irregular small x-ray opacities, and pleural abnormalities. None of the ventilatory-function variables were significantly different between cement workers and the comparisons. The authors conclude that cement dust exerts little adverse effect on respiratory symptoms and ventilatory function. To determine whether the increase in x-ray abnormalities represents pneumoconiosis or another pathological process would...
Journal of Occupational & Environmental Medicine, 1997
To investigate the prevalence of pneumoconiosis in Portland cement workers, a controlled cross-se... more To investigate the prevalence of pneumoconiosis in Portland cement workers, a controlled cross-sectional survey was conducted. Chest radiographs of approximately 2640 Portland cement workers showed prevalence rates of about 1% for rounded and for irregular small opacities and about 2% for pleural abnormalities. After age and smoking adjustment, the overall prevalences were still significantly elevated over controls, but when examined separately by smoking status, the significant increases were confined to smokers. Although statistically significant, the prevalences were only elevated about 1% in cement workers, compared with controls. A statistically significant relationship with exposure was found for pleural abnormalities but not for rounded or irregular small opacities. Thus a weak association exists between pulmonary radiographic abnormalities and employment in US Portland cement plants, and there appears to be a dose-response relationship between exposure and pleural abnormalities.
Arapid, cost-effective method for the evaluation of lower respiratory specimen has become increas... more Arapid, cost-effective method for the evaluation of lower respiratory specimen has become increasingly important in the diagnosis of pulmonary diseases in immunocompromised patients. In the past, the technically demanding, time-consuming, and expensive Gomori-methenamine-silver (GMS) stain was the principal means for the evaluation of these specimens. In this study, we compared the GMS stain with a new rapid, three-stain protocol for the evaluation of lower respiratory specimens. Lower respiratory specimens were obtained by bronchoalveolar lavage (BAL). Conventional WrighVGiemsa and Gram stains were utilized, as well as a contemporary strain, calcofluor white (CW). A cell count was performed on the BAL specimens, and cytospins were stained by the three stains. The calcofluor white-stained slides were examined with an epi-fluorescent microscope, whereas the other stains were evaluated with a conventional light microscope. Gomorimethenamine-silver (GMS), acid-fast bacillus (AFB), and Papanicolaou (PAP) stains were performed as controls. Thirty-two BAL procedures were performed in 20 (63%) male patients and 12 (37%) female patients. The clinical diagnosis was pneumonia in 31 Yo of the patients, malignant hematologic disease in 28%, acute respiratory distress syndrome (ARDS) in 9%, and acquired immunodeficiency syndrome (AIDS) in 28%. Of these specimens, 78% were adequate for interpretation and 22% were inadequate. Bacteria were found in 50% (16132) of all BALs, fungi were found in 9 % ( 3 / 3 2 ) , and Pneumocystis carinii was found in 9% (31 32). Gram-positive bacteria were most frequently found in patients with pneumonia (8O%, 4/5), whereas P carinii was identified in patients with AIDS. There were no false-positive results. One CW stain was equivocal for P carinii due to high fluorescent background. Laboratory implementation of the rapid, three-staining technique was accomplished without difficulty in microbiology and hematology laboratory sections. Specimen evaluation with the rapid staining protocol was technically easy to perform; however, experience in ultraviolet fluorescent microscopy was crucial for interpretation of CW stain. All results were available in 2 hr, cost was reduced by 30%, and the assays were available 7 daydweek. Further studies are ongoing to substantiate the sensitivity, specificity, and predictive value of this technique, as well as clinical guidelines for its optimal utilization. o 1996 Wtley-Liss. Inc.
We present a case of Nd:YAG laser treatment of nearly total airway obstruction by malignant tumor... more We present a case of Nd:YAG laser treatment of nearly total airway obstruction by malignant tumor in which an endobronchial fire occurred. The patient survived without complications of the fire and was followed-up until death over 22 months after the fire. The events leading to the fire are presented and recommendations provided to prevent similar occurrences.
Cystic fibrosis (CF), a common fatal genetic disease, is a multisystem disorder whose pathogenesi... more Cystic fibrosis (CF), a common fatal genetic disease, is a multisystem disorder whose pathogenesis has recently been linked to defects in CFTR, a newly discovered protein. CFTR is a molecular channel which controls chloride concentration in secretions of the sweat glands and the respiratory, GI, and reproductive tracts. Defective forms of CFTR, arising from various mutations in its gene, are responsible for the inadequate hydration of mucus, pancreatic juice, and other exocrine secretions. The result is dysfunction of the lungs, pancreas, and other involved organs. This article describes the diagnosis, clinical features, and approach to management of CF.
Wegener's granulomatosis is a multisystem life threatening vasculitis which poses particu... more Wegener's granulomatosis is a multisystem life threatening vasculitis which poses particular concerns when it involves a pregnant patient. We present two patients whose pregnancies were complicated by Wegener's granulomatosis and review previously reported patients whose pregnancies were also complicated by WG.
Wegener's granulomatosis is a multisystem life threatening vasculitis which poses particular ... more Wegener's granulomatosis is a multisystem life threatening vasculitis which poses particular concerns when it involves a pregnant patient. We present two patients whose pregnancies were complicated by Wegener's granulomatosis and review previously reported patients whose pregnancies were also complicated by WG.
Data on respiratory symptoms and pulmonary function were obtained for 2736 Portland cement plant ... more Data on respiratory symptoms and pulmonary function were obtained for 2736 Portland cement plant workers and 755 controls. Personal dust samples contained a geometric mean concentration of 0 57 mg/m3 for respirable dust and 2-90 mg/m3 for total dust. Cement workers and controls had similar prevalences of symptoms, except that 5 4% ofthe cement workers had dyspnoea compared with 2-7% of the controls. The mean pulmonary function indices were similar for the two groups. Among cement plant workers, the prevalence of chronic phlegm increased with tenure whereas the prevalence of wheezing increased with both tenure and current dust level. Other symptoms and pulmonary function indices were not significantly related to exposure.
An epidemiologic study of the respiratory effects of Portland cement dust was conducted. The coho... more An epidemiologic study of the respiratory effects of Portland cement dust was conducted. The cohort consisted of 2,736 cement workers at 16 facilities in the United States. The comparisons consisted of 2,213 individuals in activities not involving dust exposure. Spirometry testing was performed. Respiratory-symptom questionnaires were administered. Chest x-rays were taken and examined. Personal sampling for total and respirable dust, quartz, and oxides of sulfur and nitrogen was performed. Cement workers had a significantly elevated adjusted-odds ratio for dyspnea, rounded and irregular small x-ray opacities, and pleural abnormalities. None of the ventilatory-function variables were significantly different between cement workers and the comparisons. The authors conclude that cement dust exerts little adverse effect on respiratory symptoms and ventilatory function. To determine whether the increase in x-ray abnormalities represents pneumoconiosis or another pathological process would...
Journal of Occupational & Environmental Medicine, 1997
To investigate the prevalence of pneumoconiosis in Portland cement workers, a controlled cross-se... more To investigate the prevalence of pneumoconiosis in Portland cement workers, a controlled cross-sectional survey was conducted. Chest radiographs of approximately 2640 Portland cement workers showed prevalence rates of about 1% for rounded and for irregular small opacities and about 2% for pleural abnormalities. After age and smoking adjustment, the overall prevalences were still significantly elevated over controls, but when examined separately by smoking status, the significant increases were confined to smokers. Although statistically significant, the prevalences were only elevated about 1% in cement workers, compared with controls. A statistically significant relationship with exposure was found for pleural abnormalities but not for rounded or irregular small opacities. Thus a weak association exists between pulmonary radiographic abnormalities and employment in US Portland cement plants, and there appears to be a dose-response relationship between exposure and pleural abnormalities.
Arapid, cost-effective method for the evaluation of lower respiratory specimen has become increas... more Arapid, cost-effective method for the evaluation of lower respiratory specimen has become increasingly important in the diagnosis of pulmonary diseases in immunocompromised patients. In the past, the technically demanding, time-consuming, and expensive Gomori-methenamine-silver (GMS) stain was the principal means for the evaluation of these specimens. In this study, we compared the GMS stain with a new rapid, three-stain protocol for the evaluation of lower respiratory specimens. Lower respiratory specimens were obtained by bronchoalveolar lavage (BAL). Conventional WrighVGiemsa and Gram stains were utilized, as well as a contemporary strain, calcofluor white (CW). A cell count was performed on the BAL specimens, and cytospins were stained by the three stains. The calcofluor white-stained slides were examined with an epi-fluorescent microscope, whereas the other stains were evaluated with a conventional light microscope. Gomorimethenamine-silver (GMS), acid-fast bacillus (AFB), and Papanicolaou (PAP) stains were performed as controls. Thirty-two BAL procedures were performed in 20 (63%) male patients and 12 (37%) female patients. The clinical diagnosis was pneumonia in 31 Yo of the patients, malignant hematologic disease in 28%, acute respiratory distress syndrome (ARDS) in 9%, and acquired immunodeficiency syndrome (AIDS) in 28%. Of these specimens, 78% were adequate for interpretation and 22% were inadequate. Bacteria were found in 50% (16132) of all BALs, fungi were found in 9 % ( 3 / 3 2 ) , and Pneumocystis carinii was found in 9% (31 32). Gram-positive bacteria were most frequently found in patients with pneumonia (8O%, 4/5), whereas P carinii was identified in patients with AIDS. There were no false-positive results. One CW stain was equivocal for P carinii due to high fluorescent background. Laboratory implementation of the rapid, three-staining technique was accomplished without difficulty in microbiology and hematology laboratory sections. Specimen evaluation with the rapid staining protocol was technically easy to perform; however, experience in ultraviolet fluorescent microscopy was crucial for interpretation of CW stain. All results were available in 2 hr, cost was reduced by 30%, and the assays were available 7 daydweek. Further studies are ongoing to substantiate the sensitivity, specificity, and predictive value of this technique, as well as clinical guidelines for its optimal utilization. o 1996 Wtley-Liss. Inc.
We present a case of Nd:YAG laser treatment of nearly total airway obstruction by malignant tumor... more We present a case of Nd:YAG laser treatment of nearly total airway obstruction by malignant tumor in which an endobronchial fire occurred. The patient survived without complications of the fire and was followed-up until death over 22 months after the fire. The events leading to the fire are presented and recommendations provided to prevent similar occurrences.
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Papers by H. Abrons