Silicosis medical therapy: Difference between revisions

Jump to navigation Jump to search
No edit summary
m (Template)
 
(13 intermediate revisions by 2 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Silicosis}}
{{Silicosis}}
{{CMG}}
{{CMG}} {{AE}} {{AV}}


==Overview==
==Overview==
Silicosis is an irreversible condition with currently no cure. Treatment options currently focus on alleviating the symptoms and preventing complications.
Silicosis is an irreversible condition with currently no cure. Treatment options currently focus on alleviating the symptoms and preventing complications.
==Medical Therapy==
==Medical Therapy==
* Patients with an evidence of silicosis on chest x-ray should avoid further exposure to silica
* There is no evidence-based medical therapy for the treatment of silicosis.
*Generally, management of silicosis aims to manage other respiratory comorbidities (e.g. [[COPD]] or [[tuberculosis]]) and to treat silicosis-associated complications.
* Management goals include avoidance of exposure to silica, optimization of respiratory function, and preventive care.


===Management of Acute Silicosis===
*A modest short-term randomized clinical trial demonstrated that [[systemic steroids]] may be effective in the management of [[steroids]], but the benefit has not been well-established<ref name="pmid1735256">{{cite journal| author=Goodman GB, Kaplan PD, Stachura I, Castranova V, Pailes WH, Lapp NL| title=Acute silicosis responding to corticosteroid therapy. | journal=Chest | year= 1992 | volume= 101 | issue= 2 | pages= 366-70 | pmid=1735256 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1735256  }} </ref>
*[[Lung lavage|Whole-lung lavage]] is recommended in acute silicosis to improve gas exchange and eliminate residual alveolar debris, although not routinely recommended because of the ill effects<ref name="pmid23632425">{{cite journal| author=Stafford M, Cappa A, Weyant M, Lara A, Ellis J, Weitzel NS et al.| title=Treatment of acute silicoproteinosis by whole-lung lavage. | journal=Semin Cardiothorac Vasc Anesth | year= 2013 | volume= 17 | issue= 2 | pages= 152-9 | pmid=23632425 | doi=10.1177/1089253213486524 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23632425  }} </ref>
===Management of Chronic Silicosis===
*Systemic [[steroid]] therapy are not recommended for the indication of chronic silicosis alone. However, systemic [[steroids]] may be administered to patients who are diagnosed with silicosis and have other indications like [[COPD]] flare up for the use of [[steroids]]<ref name="pmid2008993">{{cite journal| author=Sharma SK, Pande JN, Verma K| title=Effect of prednisolone treatment in chronic silicosis. | journal=Am Rev Respir Dis | year= 1991 | volume= 143 | issue= 4 Pt 1 | pages= 814-21 | pmid=2008993 | doi=10.1164/ajrccm/143.4_Pt_1.814 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2008993  }} </ref>


===Supportive therapy===
===Supportive therapy===
*Smoking cessation
*[[Smoking cessation]]
* [[Bronchodilator]]s to facilitate breathing if airflow limitation present on spirometry.
*[[oxygen|Supplemental oxygen]] is administered to prevent complications of chronic [[hypoxemia]]
*Vaccination against influenza and pneumococcus
*[[Bronchodilator]]s may facilitate breathing if airflow limitation is present on [[spirometry]].
*Supplemental oxygen (if indicated) to prevent complications of chronic hypoxemia
 
 
 
 
 
* [[Lung transplantation]] to replace the damaged lung tissue is the most effective treatment, but is associated with severe risks of its own.
Tamoxifen citrate has been used for the treatment of breast cancer for its selective estrogen receptor modulator action. It also inhibits the production of transforming growth factor-beta (TGF-b) and insulin-like growth factor [2,3]. TGF-b has important roles in the formation of fibrosis such as the modulation of inflammation, wound repair, and immunity by decreasing lymphocyte proliferation and encouraging growth of fibroblasts [4]. These effects have been studied in postoperative adhesions [5], keloid fibroblast proliferation, and reducing collagen production [6,7]. In this study, we aimed to investigate possible effects of tamoxifen on progression, prevention, and treatment of the fibrotic pulmonary silicosis disease considering the anti-fibrotic effect shown in aforementioned studies<ref name="pmid25218282">{{cite journal| author=Yoldas O, Karaca T, Bilgin BC, Yilmaz OH, Simsek GG, Alici IO et al.| title=Tamoxifen citrate: a glimmer of hope for silicosis. | journal=J Surg Res | year= 2015 | volume= 193 | issue= 1 | pages= 429-34 | pmid=25218282 | doi=10.1016/j.jss.2014.08.013 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25218282  }} </ref>


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


[[Category:Needs content]]
[[Category:Pulmonology]]
[[Category:Pulmonology]]
[[Category:Occupational diseases]]


{{WH}}
{{WH}}
{{WS}}
{{WS}}

Latest revision as of 15:38, 8 June 2016

Silicosis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Silicosis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Silicosis medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Silicosis medical therapy

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Silicosis medical therapy

CDC on Silicosis medical therapy

Silicosis medical therapy in the news

Blogs on Silicosis medical therapy

Directions to Hospitals Treating Silicosis

Risk calculators and risk factors for Silicosis medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aparna Vuppala, M.B.B.S. [2]

Overview

Silicosis is an irreversible condition with currently no cure. Treatment options currently focus on alleviating the symptoms and preventing complications.

Medical Therapy

  • There is no evidence-based medical therapy for the treatment of silicosis.
  • Generally, management of silicosis aims to manage other respiratory comorbidities (e.g. COPD or tuberculosis) and to treat silicosis-associated complications.
  • Management goals include avoidance of exposure to silica, optimization of respiratory function, and preventive care.

Management of Acute Silicosis

  • A modest short-term randomized clinical trial demonstrated that systemic steroids may be effective in the management of steroids, but the benefit has not been well-established[1]
  • Whole-lung lavage is recommended in acute silicosis to improve gas exchange and eliminate residual alveolar debris, although not routinely recommended because of the ill effects[2]

Management of Chronic Silicosis

  • Systemic steroid therapy are not recommended for the indication of chronic silicosis alone. However, systemic steroids may be administered to patients who are diagnosed with silicosis and have other indications like COPD flare up for the use of steroids[3]

Supportive therapy

References

  1. Goodman GB, Kaplan PD, Stachura I, Castranova V, Pailes WH, Lapp NL (1992). "Acute silicosis responding to corticosteroid therapy". Chest. 101 (2): 366–70. PMID 1735256.
  2. Stafford M, Cappa A, Weyant M, Lara A, Ellis J, Weitzel NS; et al. (2013). "Treatment of acute silicoproteinosis by whole-lung lavage". Semin Cardiothorac Vasc Anesth. 17 (2): 152–9. doi:10.1177/1089253213486524. PMID 23632425.
  3. Sharma SK, Pande JN, Verma K (1991). "Effect of prednisolone treatment in chronic silicosis". Am Rev Respir Dis. 143 (4 Pt 1): 814–21. doi:10.1164/ajrccm/143.4_Pt_1.814. PMID 2008993.

Template:WH Template:WS