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Biomedical subjects

G Hillerdal

Publications and source records attributed to G Hillerdal.

At least 91 records · Page 5Linked to original sources
PubMed1984

Rarity of mineral fibre pleurisy among persons exposed to Finnish anthophyllite and with low risk of mesothelioma.

Endemic pleural plaques are reported from many parts of the world. In Central Europe and in Finland no connection with malignant mesotheliomas has been found, whereas this tumour is often encountered in areas in Turkey where endemic plaques also occur. There seem, however, to be differences in the radiological appearances found in these areas. In the present study chest radiographs of 317 persons with pleural plaques from the endemic area of Finland were scrutinized. It was found that 4.7% showed a blunted costophrenic angle unilaterally and 0.9% bilaterally. The prevalence of sequelae of pleurisy is statistically very highly significantly lower than in people with pleural plaques in Turkey. As the risk of mesothelioma appears to be low in Finland, the results are in accordance with the hypothesis that the risk of mesothelioma in a given population is higher if in that population there is a high incidence of benign asbestos pleurisy.

Adolescent↗
PubMed1984

Sarcoidosis: epidemiology and prognosis. A 15-year European study.

A 15-year study of patients with sarcoidosis is presented. In most patients, the disease was discovered at a general health screening examination. The mean total incidence among persons 15 yr of age or older was 19 per 100,000 per year (21.7 for women and 16.5 for men). There was a peak incidence in both sexes between the ages of 20 and 34, and in older women, there was a second but lower and broader peak. The frequency of symptoms was greater in older women than in other patients. The accumulated lifetime risk of sarcoidosis was 1.3% for women and almost 1% for men. Patients with Stage I sarcoidosis, i.e., with bilateral hilar adenopathy alone, had the best prognosis, with 50% of the patients showing a normal radiographic picture 15 months after the discovery of the disease. Among patients with Stage II sarcoidosis (both bilateral hilar adenopathy and pulmonary infiltration), it was 36 months before 50% returned to normal radiographically. Resolution of all radiographic evidence of the disease could still occur many years after the first pathologic findings were made on chest films.

Adolescent↗
PubMed1984

Disseminated pulmonary aspergillosis in a previously healthy young woman.

A young woman presented with widespread bilateral infiltrates on chest X-ray and a high fever. Investigations for bacterial, mycobacterial, and fungal infections were negative. A biopsy of the lung showed granulomas, and corticosteroid medication was given on vital indication because of the rapidly progressive disease. There was a dramatic response, with regression of the chest X-ray changes and the fever and the patient was discharged on her own request with a tentative diagnosis of acute sarcoidosis. One month later she was admitted in an alarming state with almost completely consolidated lung and died a few hours later. Autopsy revealed generalized aspergillosis. Renewed extensive investigation of the earlier lung biopsy revealed hyphae. After her death, the case history of an elder brother was traced and revealed that he had died at early age in a generalized granulomatous disease. Although no definite diagnosis can be made, it seems likely that both siblings suffered from a defect in the immune system, probably chronic granulomatous disease of the autosomal recessive type. This disease is sometimes found in young adults without a clear history of earlier infections.

Adult↗
PubMed1984

Pleural changes and exposure to fibrous minerals.

The pleura is a main target for various reactions related to asbestos exposure. However there are great radiological and clinical differences between the various reactions, and there is also increasing evidence that they have different prognoses. The main reactions are pleural plaques on the one hand and acute pleurisy and diffuse pleural fibrosis on the other. In a population with a low mesothelioma risk, the anthophyllite-exposed population of Northern Karelia in Finland, there are very few reactions of the second type, while plaques are very common. In Turkey, where the exposure is to erionite, the mesothelioma level is extremely high, and reactions of type two are very common in the exposed population. Thus it seems that careful discrimination of the various pleural changes can have prognostic value. There are also indications that plaques do not have any relation to a disturbed immunologic system, while pleurisy and diffuse pleurisy have.

Aluminum Silicates↗
PubMed1983

Tobacco consumption and asbestos exposure in patients with lung cancer: a three year prospective study.

During the three years 1979-81, all patients with bronchial carcinoma of World Health Organisation types I to IV were given a questionnaire to determine occupation, smoking habits, and exposure to asbestos. Chest x rays were screened for the presence of pleural plaques. Of the men, 96.2% were current or ex-smokers, as were 71% of the women. In those who had never smoked 70% had an adenocarcinoma. In smokers the risk of getting other types was greater, but the risk of getting an adenocarcinoma was also considerably increased compared with the normal population. Of the men, 35.8% were occupationally exposed to asbestos and 15.6% were carriers of radiological plaques, a frequency five to six times greater than expected. Practically all asbestos exposed patients with lung tumours were smokers or ex-smokers and their total tobacco consumption was as high as that of non-exposed patients. The average latency from first exposure to asbestos to diagnosis of the lung tumour was 37 years. Even if strict regulations are warranted for the use of asbestos, this cannot prevent future asbestos cancers resulting from exposure that has already occurred. Elimination of smoking seems the only way to reduce such tumours.

Adenocarcinoma↗
PubMed1983

Radiological study of pleural changes in relation to mesothelioma in Turkey.

In some villages in central Turkey pleural changes occur as a result of environmental exposure to mineral fibres. In most cases the fibre is asbestos but in some cases the non-asbestos fibre erionite, a zeolite, is responsible. The incidence of malignant mesothelioma is much higher in "erionite villages" than in "asbestos villages" despite similar frequencies of pleural changes. In this study chest radiographs from 466 people from asbestos villages, 549 from erionite villages, and 382 controls were compared. The frequency of pleural calcification was about the same in the two groups of villages studied, but the minor fissures were visible to a greater degree in erionite cases. In people from erionite villages "atypical" pleural calcification, due to calcification of the visceral rather than the parietal pleura, was more common. These differences may indicate that the fibres have different lengths and diameters.

Adult↗
PubMed1983

Ankylosing spondylitis lung disease--an underdiagnosed entity?

During the last 10 years, 14 cases of ankylosing spondylitis (AS) with upper lobe changes were diagnosed. This is certainly an underestimation, since AS is often not noted in the case records even when diagnosed. Two recent cases were earlier undiagnosed, and only on specific questioning did the patients admit symptoms, though they were both HLA B27 positive and had X-ray changes of the sacro-iliacal joints typical of the disease. Thus, if not carefully sought, the diagnosis can be missed. A literature review revealed 160 published cases. The lung lesions can be complicated by superinfections of fungi or non-tuberculous mycobacteria or even mycobacterium tuberculosis.

Aspergillosis↗
PubMed1983

Pleural plaques in Sweden among immigrants from Finland - with an editorial note.

In the county of Uppsala, Sweden, all detected cases of pleural plaques have been investigated with reference to asbestos exposure. Up to June, 1981, the number of men found to have pleural plaques were 1030 and the number of women 42. A disproportionately high percentage, especially of the women and the younger men, were born in Finland. Also, the Finnish-born had been exposed to asbestos to a significantly lower degree. They came from all parts of Finland - not only from the area where anthophyllite asbestos is found and where endemic plaques are common. Thus, some other factor must have caused these plaques among the Finns.

Adolescent↗
PubMed1982

Adult respiratory distress syndrome and diabetes.

Non-cardiac pulmonary edema in a woman with long-lasting diabetes resulted in a distressing pulmonary fibrosis. It is suggested that pulmonary edema of non-cardiac origin might be more common in diabetes because of increased capillary permeability in this disease. Early recognition is important, and steroid treatment should be instituted to prevent development of pulmonary fibrosis.

Blood Gas Analysis↗
PubMed1982

Mites living in hay: an important allergen source?

Fifty-two farmers and 21 non-farmers with symptoms related to hay contact were investigated. Skin prick tests (SPT) and RAST were performed with an extract made of barn dust (BDE) consisting of hay remnants. At microscopy, the barn dust was found to contain large amounts of dead mites, most of them identified as Lepidoglyphus destructor and Acarus siro. Twenty-one patients (9 farmers and 12 non-farmers) had positive RAST or BDE, with a good correlation to the case histories. Other allergies, especially to Dermatophagoides pteronyssinus, pollens, and animal danders were also common among patients. However, there was no correlation between positive SPT and RAST to BDE and any other allergen tested. This indicates that BDE contains distinct allergens, most likely of mite origin.

Allergens↗
PubMed1982

Asbestos exposure and upper lobe involvement.

In a study of 1,251 persons with asbestos-related pleural and parenchymal changes, 16 had slowly progressive changes of the upper lobes, involving both pleura and parenchyma, with shrinkage of the lobes. In addition there were 41 cases with less advanced apical changes. Tuberculosis and other possible causes were excluded. It is hypothesized that the changes rate due to asbestos disease.

Asbestos↗