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• W2156876264 abstract "We refer to the case presented by Yoram Dekel and colleagues in the Vol. 10, No. 4 issue of the Journal, which sets out prima facie evidence of talc inhalation from “excessive cosmetic use of talc” as prime suspect in a 42year old woman’s demise. We would plead that the proximal cause of death is far from established. The rapid progression of pancardiac failure in a patient with a recent onset of pulmonary hypertension and cor pulmonale is unconvincing. Documented pulmonary hypertension is attributed to interstitial fibrosis, but this is not backed up by X-ray findings. Neither left heart function before the final crisis nor systemic blood pressure are reported and, despite a normal left ventricular scan, left heart hypertrophy was found at autopsy. Cardiac enzymology is omitted. This leaves the interpretation of acute cardiomyopathy either of dilatory or viral etiology undecided. The crystals found at microscopy are actually compatible with other sheet silicates apart from talc. “Talc particles were exceedingly large and not of the usual granular configuration” but cosmetic-grade talc is highly purified. It is significant that aluminium was found as this element distinguishes talc from the aluminium silicate pyrophillite [Al2 (Si4O10) (OH2)], which is similar to most talcs [Mg3(Si2O5)2 (OH)2], is used in the construction and automobile industries and causes pyrophillitosis. Both minerals have the same hardness and specific mass volume (2.6-2.9 g/cm). The “elemental analysis” (Figure 5) does not clearly indicate if peaks refer to quantities or energy states, and which method of spectrometry was used to identify talc from related phyllosilicate particulates. Cement inhalation, e.g., would be hard to rule out outside occupational settings without the use of spectrometry. As other environmental exposures cannot be totally excluded from the scant description of the case (an estimate of the quantity of particulate matter found is not reported), most of the evidence against cosmetic talc, without “scene of crime” sampling, remains circumstantial." @default.
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• W2156876264 date "2005-09-01" @default.
• W2156876264 modified "2023-09-27" @default.
• W2156876264 title "A case of fulminant “Talc pneumoconiosis”: Where is the smoking gun?" @default.
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• W2156876264 doi "https://doi.org/10.1007/bf02893398" @default.
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