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        "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Respiratory pathology induced by low frequency noise &#40;LFN&#44; &#60;500 Hz&#44; including infrasound&#41; is not a novel subject given that in the 1960&#39;s&#44; within the context of U&#46;S&#46; and U&#46;S&#46;S&#46;R&#46; Space Programs&#44; other authors have already reported its existence&#46; Within the scope of vibroacoustic disease &#40;VAD&#41;&#44; a whole-body pathology caused by excessive exposure to LFN&#44; respiratory pathology takes on specific features&#46; Initially&#44; respiratory pathology was not considered a consequence of LFN exposure&#59; but today&#44; LFN can be regarded as a major agent of disease that targets the respiratory system&#46; The goal of this report is to put forth what is known to date on the clinical signs of respiratory pathology seen in VAD patients&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Data from the past 25 years of research will be taken together and presented&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">In persons exposed to LFN on the job&#44; respiratory complaints appear after the first 4 years of professional activity&#46; At this stage&#44; they disappear during vacation periods or when the person is removed form his &#47;her workstation for other reasons&#46; With long-term exposure&#44; more serious situations can arise&#44; such as&#44; atypical pleural effusion&#44; respiratory insufficiency&#44; fibrosis and tumours&#46; There is no correlation with smoking habits&#46; In LFN--exposed animal models&#44; morphological changes of the pleura&#44; and loss of the phagocytic ability of pleural mesothelial cells &#40;explaining the atypical pleural effusions&#41;&#46; Fibrotic lesions and neo-vascularization were observed along the entire respiratory tract&#46; Fibrosis lesions and neovascularisation were observed throughout the respiratory tract of the animals seen&#46; Pre-malignant lesions&#44; metaplasia e displasia&#44; were also identified&#46;</p> <span class="elsevierStyleSectionTitle">Discussion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">LFN is an agent of disease and the respiratory tract is one of its preferential targets&#46; The respiratory pathology associated with VAD needs further in-depth studies in order to achieve a greater understanding&#44; and develop methods of pharmacological intervention&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Enquadramento</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A patologia respirat&#243;ria induzida pela exposi&#231;&#227;o a ru&#237;do de baixa frequ&#234;ncia &#40;RBF&#44; &#8804;500 Hz&#44; incluindo os infra-sons&#41; n&#227;o constitui novidade dado que&#44; desde 1960&#44; no &#226;mbito dos programas espaciais dos EUA e da Uni&#227;o Sovi&#233;tica&#44; diversos autores divulgaram a sua exist&#234;ncia&#46; No contexto da doen&#231;a vibroac&#250;stica &#40;VAD &#8211; <span class="elsevierStyleItalic">vibroacoustic disease</span>&#41;&#44; uma patologia sist&#233;mica causada pela exposi&#231;&#227;o excessiva a RBF&#44; as les&#245;es respirat&#243;rias apresentam caracter&#237;sticas pr&#243;prias&#46; Inicialmente&#44; esta patologia respirat&#243;ria n&#227;o foi tida como uma consequ&#234;ncia da exposi&#231;&#227;o ao ru&#237;do&#59; no entanto&#44; hoje&#44; o RBF &#233; considerado um agente muito importante de doen&#231;a respirat&#243;ria&#46; O objectivo deste trabalho &#233; sistematizar e actualizar todos os dados sobre a patologia respirat&#243;ria observada na VAD&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Ao longo dos &#250;ltimos 25 anos&#44; recolheu-se informa&#231;&#227;o&#44; de modo continuado&#44; de indiv&#237;duos e modelos animais expostos a RBF&#46; Todos estes dados s&#227;o aqui compilados&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Em indiv&#237;duos expostos a ru&#237;do no trabalho&#44; as queixas br&#244;nquicas aparecem nos primeiros 4 anos de actividade e&#44; nesta fase&#44; reduzem ou desaparecem quando de f&#233;rias ou removidos do seu local de trabalho por outros motivos&#46; Com a exposi&#231;&#227;o prolongada&#44; poder&#227;o surgir situa&#231;&#245;es mais graves&#44; como derrames pleurais&#44; insufici&#234;ncia respirat&#243;ria&#44; fibrose pulmonar e carcinomas do aparelho respirat&#243;rio&#46; N&#227;o existe correla&#231;&#227;o com h&#225;bitos tab&#225;gicos&#46; Em modelos animais expostos a RBF&#44; apresentavam-se altera&#231;&#245;es morfol&#243;gicas da pleura e perda da capacidade fagoc&#237;tica das c&#233;lulas mesoteliais &#40;explicando os derrames pleurais observados&#41;&#46; Foram observadas les&#245;es de fibrose e neovasculariza&#231;&#227;o ao longo de todo o aparelho respirat&#243;rio dos animais expostos&#46; Tamb&#233;m se identificaram les&#245;es pr&#233;-malignas&#44; metaplasia e displasia&#46;</p> <span class="elsevierStyleSectionTitle">Conclus&#245;es</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">O RBF &#233; um agente de doen&#231;a e tem como alvo preferencial o aparelho respirat&#243;rio&#46; A patologia respirat&#243;ria associada &#224; VAD necessita&#44; ainda&#44; de muito estudo para que uma maior compreen&#231;&#227;o possa ser alcan&#231;ada e interven&#231;&#245;es farmacol&#243;gicas possam ser pensadas&#46;</p>"
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Vol. 13. Issue 1.
Pages 129-135 (January - February 2007)
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Vol. 13. Issue 1.
Pages 129-135 (January - February 2007)
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Respiratory pathology in vibroacoustic disease: 25 years of research
O aparelho respiratório na doença vibroacústica: 25 anos de investigação
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Nuno A.A. Castelo Branco1, José Reis Ferreira2, Mariana Alves-Pereira3
1 Médico Anatomopatologista, presidente do Conselho Científico, Centro da Performance Humana, Alverca
2 Médico Pneumologista, Unidade de Estudo Funcional Respiratório, Hospital da Força Aérea, Lisboa
3 Engenheira Biomédica, ERISA – Universidade Lusófona
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Abstract
Background

Respiratory pathology induced by low frequency noise (LFN, <500 Hz, including infrasound) is not a novel subject given that in the 1960's, within the context of U.S. and U.S.S.R. Space Programs, other authors have already reported its existence. Within the scope of vibroacoustic disease (VAD), a whole-body pathology caused by excessive exposure to LFN, respiratory pathology takes on specific features. Initially, respiratory pathology was not considered a consequence of LFN exposure; but today, LFN can be regarded as a major agent of disease that targets the respiratory system. The goal of this report is to put forth what is known to date on the clinical signs of respiratory pathology seen in VAD patients.

Methods

Data from the past 25 years of research will be taken together and presented.

Results

In persons exposed to LFN on the job, respiratory complaints appear after the first 4 years of professional activity. At this stage, they disappear during vacation periods or when the person is removed form his /her workstation for other reasons. With long-term exposure, more serious situations can arise, such as, atypical pleural effusion, respiratory insufficiency, fibrosis and tumours. There is no correlation with smoking habits. In LFN--exposed animal models, morphological changes of the pleura, and loss of the phagocytic ability of pleural mesothelial cells (explaining the atypical pleural effusions). Fibrotic lesions and neo-vascularization were observed along the entire respiratory tract. Fibrosis lesions and neovascularisation were observed throughout the respiratory tract of the animals seen. Pre-malignant lesions, metaplasia e displasia, were also identified.

Discussion

LFN is an agent of disease and the respiratory tract is one of its preferential targets. The respiratory pathology associated with VAD needs further in-depth studies in order to achieve a greater understanding, and develop methods of pharmacological intervention.

Key-words:
Low frequency noise
infrasound
fibrosis
pleural effusion
bronchoscopy
lung cancer
respiratory drive
Resumo
Enquadramento

A patologia respiratória induzida pela exposição a ruído de baixa frequência (RBF, ≤500 Hz, incluindo os infra-sons) não constitui novidade dado que, desde 1960, no âmbito dos programas espaciais dos EUA e da União Soviética, diversos autores divulgaram a sua existência. No contexto da doença vibroacústica (VAD – vibroacoustic disease), uma patologia sistémica causada pela exposição excessiva a RBF, as lesões respiratórias apresentam características próprias. Inicialmente, esta patologia respiratória não foi tida como uma consequência da exposição ao ruído; no entanto, hoje, o RBF é considerado um agente muito importante de doença respiratória. O objectivo deste trabalho é sistematizar e actualizar todos os dados sobre a patologia respiratória observada na VAD.

Métodos

Ao longo dos últimos 25 anos, recolheu-se informação, de modo continuado, de indivíduos e modelos animais expostos a RBF. Todos estes dados são aqui compilados.

Resultados

Em indivíduos expostos a ruído no trabalho, as queixas brônquicas aparecem nos primeiros 4 anos de actividade e, nesta fase, reduzem ou desaparecem quando de férias ou removidos do seu local de trabalho por outros motivos. Com a exposição prolongada, poderão surgir situações mais graves, como derrames pleurais, insuficiência respiratória, fibrose pulmonar e carcinomas do aparelho respiratório. Não existe correlação com hábitos tabágicos. Em modelos animais expostos a RBF, apresentavam-se alterações morfológicas da pleura e perda da capacidade fagocítica das células mesoteliais (explicando os derrames pleurais observados). Foram observadas lesões de fibrose e neovascularização ao longo de todo o aparelho respiratório dos animais expostos. Também se identificaram lesões pré-malignas, metaplasia e displasia.

Conclusões

O RBF é um agente de doença e tem como alvo preferencial o aparelho respiratório. A patologia respiratória associada à VAD necessita, ainda, de muito estudo para que uma maior compreenção possa ser alcançada e intervenções farmacológicas possam ser pensadas.

Palavras-chave:
Ruído de baixa frequência
infra-sons
fibrose
derrame pleural
broncoscopia
cancro do pulmão
sensibilidade ao CO2
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