PubMed · 11793604
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H Wilkens, G W Sybrecht. 2001. [COPD: stage-appropriate therapy].. https://doi.org/10.1007/s001080170017
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Up to now, neither chest radiograph nor high-resolution computed tomography (HRCT) has much to offer to the diagnosis of patients with chronic bronchitis (CB). A lot of HRCT findings can be observed, but they cannot be regarded as specific for pure CB. Their evaluation is often subjective, and measurements are poorly reproducible. In order to better characterise the HRCT features of CB, further efforts are warranted. The finding of bronchial wall thickening may even be considered nonsensitive as well as nonspecific. CB should not only be equated with narrowing of the airway since thickness of the bronchial wall may vary among different stages of development. Small pits can often be detected along the inner surfaces of the large bronchi in patients with CB using volumetric thin-section CT. Sometimes, multiple pits give rise to the accordion-like appearance that was described using bronchography. In our experience, they often occur in patients with long-lasting CB. A better comprehension of the large airways abnormalities is important because it is likely that the same pathophysiologic process that causes small-airway obstruction also takes place in larger airways, where it has less functional effect.
AIMS: To assess the persistence of respiratory symptoms in ex-miners after cessation of mining exposure. METHODS: Population-based cross-sectional study using a postal questionnaire comparing prevalence of symptoms between ex-miners who had stopped mining at least 1 year before the study and referents not occupationally exposed to irritants or dust. Age, smoking and a family history of asthma were considered as possible confounders in the analysis. RESULTS: A total of 206 ex-miners and 4,560 referents participated. Ex-miners had on average been working as miners for 13 years and had stopped mining 16 years before the study. Chronic productive cough and physician-diagnosed chronic bronchitis were significantly more common among ex-miners (P < 0.05 and <0.01, respectively). Furthermore, there was a trend that other respiratory symptoms were more common in ex-miners. CONCLUSION: Ex-miners had an increased risk of chronic productive cough and physician-diagnosed chronic bronchitis many years after they had stopped working as a miner.
INTRODUCTION: Dyspnoea is the major symptomatic complaint of patients with chronic obstructive pulmonary disease (COPD). Awareness of an unpleasant respiratory sensation, occurs through a complex system of ventilatory control where, as in pain perception, supra-bulbar structures play a major role. In the hyperventilation syndrome, dramatic episodes of dyspnea can occur without any change in peripheral afferent signals and thus do not predictably represent a real deterioration in pulmonary function in patients who also have COPD. CASE REPORT: We report the observation of a patient with GOLD stage 0 COPD who demonstrated a major limitation of daily activities due to supra-bulbar influences on respiratory control which triggered repetitive periods of hyperventilation and generated almost constant dyspnea. CONCLUSIONS: Hyperventilation syndrome can be difficult to diagnose in patients with respiratory disease, although, in most cases, the discrepancy between the severity of symptomatic complaint compared to the degree of alteration of lung function in combination with specific tests may suggest the diagnosis.