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Query: UMLS:C0006271 (bronchiolitis)
 5,174 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In this study is reviewed the experience at Papworth Hospital, Cambridgeshire, and Great Ormond Street Hospital, London, with combined heart-lung transplantation. Between April 1984 and June 1989, 73 patients have undergone heart-lung transplantation. Donors and recipients were carefully matched with regards to serology, morphology and cytomegalovirus compatibility. Heart preservation was based on use of cold St. Thomas' cardioplegic solution; a pulmonary preservation fluid has been developed that allows distant organ procurement with a single pulmonary artery flush technique (Papworth solution). The recipients were: 21 pts with Eisenmenger's syndrome, 15 pts with pulmonary hypertension, 37 pts with pulmonary disease (including 22 cystic fibrosis). The results are: no surgical mortality; no acute cardiac rejection episodes. Twenty-three patients died (16 with infections, 3 with obliterative bronchiolitis, 2 with cerebral embolism and 2 others). The actuarial survival rate at one year is 73.2%; 63% at two years and 47.4% at four years. The use of transbronchial biopsy of the lung has provided accurate early and safe diagnosis of pulmonary rejection. Development in organ preservation and patient management, as well as careful selection of recipients and donors, have led to the effective use of resources and thereby to these good results.
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PMID:[Clinical applications of the heart-lung transplant. Clinical results 5 years after the start of the program at Papworth]. 262 Aug 7

Chloral hydrate is commonly used to sedate infants for pulmonary function tests and other investigations. However, sedation is generally not recommended for infants with acute wheezing illnesses. The commonly used dose range exceeds the maximum recommended dose; however, the effects of this dosage regimen during pulmonary function testing have not been studied. The present study shows that 70-100 mg/kg of chloral hydrate, a dose commonly used to sedate infants for pulmonary function testing, causes a fall in arterial oxygen saturation and a decrease in clinical score of infants recovering from acute viral bronchiolitis, but not in infants with clinically stable cystic fibrosis. These findings suggest that wheezy infants with baseline SaO2 less than or equal to 94% are more susceptible to central respiratory depression following sedation with chloral hydrate. The results of the present study raise serious doubts about the advisability of sedation with chloral hydrate, in the currently used doses, in wheezy infants.
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PMID:Effect of chloral hydrate on arterial oxygen saturation in wheezy infants. 322 57

The aim of this case report is to draw the attention to the occurrence of cystic fibrosis (C.F.) in a Korean infant and thus increase the awareness for the diagnosis. The male infant was presented with a history of recurrent bronchiolitis manifested by severe cough, wheeze and dyspnea from three weeks of age, in whom the diagnosis of C.F. was clinically suspected and was confirmed by demonstration of two elevated sweat chloride levels (97 mEq/L and 99 mEq/L) in the patient. The diagnosis was delayed because the main manifestations of C.F. were the same as the main symptoms of common diseases such as cough, diarrhea and failure to thrive. C.F. is probably underdiagnosed in Korean population both because the diagnosis is not considered since the disease is thought to be uncommon or even not to occur and because diagnostic facilities including the quantitative iontophoresis sweat test are lacking.
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PMID:Cystic fibrosis--a case presented with recurrent bronchiolitis in infancy in a Korean male infant. 326 64

Cystic fibrosis of the pancreas is considered to be rare in the Japanese population. Forty-five cases from the Japanese literature (1951-1983) are reviewed and one autopsy case added. The patient was a 17-year-old Japanese male with recurrent episodes of pulmonary infection. His sweat test was positive (sodium 332 mg/l, chloride 316 mg/l). No particular hereditary trait was identified. Autopsy findings showed cystic dilatation of pancreatic ducts and ductules with mucous hypersecretion. Acini of the pancreas were replaced by fibrosis, while islands of Langerhans remained. These findings were compatible with cystic fibrosis of the pancreas (mucoviscidosis). The lungs showed chronic hypertrophic bronchitis and acute obliterating bronchiolitis. Cystic dilatation and hypersecretion were seen in the esophageal glands, Brenner's glands, and enteric glands. Goblet-cell hyperplasia was seen in the enteric glands. Central fatty metamorphosis and focal bile duct proliferation were seen in the liver. No obvious intralobular cholestasis was present. The epithelium of the gall bladder was highly columnar.
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PMID:Cystic fibrosis of the pancreas: report of a Japanese autopsy case. 383 17

Bronchial hyperreactivity is a common report in several respiratory tract diseases such as bronchial asthma, chronic bronchitis and cystic fibrosis. Atopic patients and children who suffered lung diseases in early life (laryngotracheobronchitis, bronchiolitis, bronchopulmonary dysplasia) may have also persistent abnormalities in pulmonary function that frequently include bronchial hyperreactivity. A review of the actual literature, specially concerning with the clinical aspects of bronchial hyperreactivity in children and with the possible etiopathogenetic mechanism is presented.
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PMID:[Bronchial hyperreactivity. III. Clinical manifestations]. 384 95

Thoracic gas volume (Vtg) was measured in a whole-body, infant plethysmograph in 46 infants with recurrent wheezing after bronchiolitis, 25 infants with cystic fibrosis, and 6 infants without overt lung disease during the first 13 months of life. When related to weight or length, 56.5% of the bronchiolitic infants had low Vtg values, which were more than 2 SD below their predicted normal. The Vtg of the other groups was normal or above. The bronchiolitic infants with Vtg values in the normal range had more severe airways obstruction and it is probable that their Vtg values were also underestimated. Investigation of possible sources of technical or experimental error failed to reveal any explanation for the low Vtg in the bronchiolitic infants. In 5 infants, Vtg determined plethysmographically was correlated linearly to functional residual capacity determined by helium dilution, although Vtg values were greater in all. The administration of albuterol or treatment with steroids failed to make significant changes in Vtg in the bronchiolitic infants. It is suggested that there is a physiologic basis for the presumed underestimation of Vtg in wheezy infants after bronchiolitis, either because of uneven alveolar pressure changes within the chest leading to the effective exclusion of a portion of the lung volume or because there are some alveolar units with very low compliance that change little in volume during respiratory efforts against an occlusion. These results call into question the validity of the plethysmographic measurement of Vtg or airway resistance in these infants. If the error in Vtg is due to uneven alveolar pressure changes, it is suggested that the calculated specific airway conductance is probably correct.
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PMID:Can thoracic gas volume be measured in infants with airways obstruction? 394 21

Four adult patients with biopsy-proven bronchiolitis were identified and prospectively evaluated. Each patient presented with the rapid onset (weeks to months) of severe respiratory disease that was clinically distinct from asthma, chronic bronchitis, bronchiectasis, cystic fibrosis, and emphysema. Bronchiolitis patients were evaluated by pulmonary function testing and bronchoalveolar lavage (BAL) before and after two months of treatment with 1 mg/kg/day of prednisone. Initial BAL results of bronchiolitis patients were compared to those of cigarette smokers with chronic bronchitis (n = 4), asymptomatic cigarette smokers (n = 5), and normal nonsmoking volunteers (n = 5). Neutrophils comprised 53 +/- 13 percent of the cells recovered by BAL in bronchiolitis patients but only 3 +/- 2 percent of the cells in chronic bronchitis patients, 1.5 +/- 0.6 percent of the cells in asymptomatic smokers, and 0.3 +/- 0.3 percent of the cells in normal volunteers (p less than 0.01, all comparisons). Moreover, prednisone produced a striking decrease in lower respiratory tract neutrophils (53 +/- 13 percent to 8 +/- 3 percent, p less than 0.05) in all bronchiolitis patients while lung function either improved (two patients) or remained unchanged (two patients). These findings suggest a central role for the neutrophil in bronchiolitis and argue that BAL may be clinically useful in the diagnosis and management of these patients.
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PMID:Adult bronchiolitis. Evaluation by bronchoalveolar lavage and response to prednisone therapy. 400 57

Hypoxemia, hypercarbia, and cor pulmonale ultimately occur in most patients with chronic lung disease. Although oxygen therapy may reduce or delay the development of pulmonary hypertension and myocardial failure in these patients, its use is thought to lead to CO2 narcosis and apnea. The effect of O2 administration during sleep has been examined in 12 patients (seven with cystic fibrosis, three with bronchopulmonary dysplasia, one with bronchiolitis obliterans, and one with severe hypersensitivity pneumonitis) using skin surface O2 (Roche) and CO2 (Radiometer) electrodes. Both electrodes were calibrated over wet gas and applied at 44 C. Ten patients had chronic hypercarbia (PaCO2 62 +/- 19 torr; range 46 to 103 torr) when awake. Humidified oxygen was administered by nasal cannula, Venturi mask, or head hood. Oxygen flow was increased every 20 minutes from 80 minutes or until the patient awoke. In eight of ten patients with hypercarbia and in the two normocarbic patients, skin surface carbon dioxide tension (PsCO2) increased by 10% or less as the skin surface oxygen tension (PsO2) was increased. In the remaining two patients with hypercarbia (both had cystic fibrosis) PsCO2 increased 18% and 24% as PsO2 was increased. These last two patients with depressed responsiveness to CO2 could not be separated from the other patients by clinical or laboratory criteria. It is concluded that the skin surface blood gas tensions are a simple and reproducible method for adjusting oxygen therapy in patients with chronic lung disease, and although the response to oxygen varies from patient to patient, most patients with chronic hypercarbia retain their central responsiveness to CO2 during sleep and for them O2 therapy is probably safe.
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PMID:Effect of oxygen administration during sleep on skin surface oxygen and carbon dioxide tensions in patients with chronic lung disease. 678 98

A retrospective study of 90 infants and young children with cystic fibrosis and 90 age matched controls without cystic fibrosis revealed no essential histologic differences in their tracheobronchial mucous gland reactions with and without pulmonary infection. Although the secretory response to specific stimuli (especially Pseudomonas or staphylococcal infection) varied in individual cases, every change seen in cystic fibrosis was present in the controls. Inactive or normally active mucous glands were usually present in the cystic fibrosis and control infants in the absence of infection. Moderate mucous gland activity in the absence of overt infection was not pathognomonic of cystic fibrosis; it was seen in both groups in response to an irritative stimulus, such as aspirated blood or gastric contents. Mucous gland secretions contained both acid and neutral mucins in the presence of infection, with no real distinction between the cystic fibrosis infants and controls, differing from the predominantly acid mucins in infected polyps of older children. Reparative squamous metaplasia in the tracheobronchial tract occurred more frequently in infants with cystic fibrosis than in controls. Although cystic fibrosis did predispose to progressive pulmonary disease (bronchiolitis, bronchiectasis), similar lung lesions were found in other metabolic and chronic disorders.
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PMID:Similarity of the tracheobronchial mucous glands and epithelium in infants with and without cystic fibrosis. 720 54

The purpose of this study was to compare the pathogens obtained by oropharyngeal suction (OPS) and bronchoalveolar lavage (BAL) in children with chronic pulmonary infections. Forty-four children (mean age of 6.1 years; range 4 months to 15 years) were included in the study (27 children with recurrent localized lung infection, 5 with bronchiectasis, 5 with cystic fibrosis, 2 with foreign body aspiration, 2 with bronchiolitis obliterans, and 3 with recurrent episodes of cough and shortness of breath). In 27 out of 44 BAL samples (61%) bacterial cultures were positive. The sensitivity of OPS in detecting the same BAL pathogen was 89% (24/27 samples), the specificity was 94% (16/17 samples), and the predictive value was 91% (40/44 samples). Hemophilus influenzae beta-lactamase negative was the main organism recovered from BAL in non-cystic fibrosis patients with recurrent or persistent pneumonia. We conclude that OPS is a simple and efficient noninvasive procedure which may be helpful in the diagnosis and treatment of recurrent or chronic pulmonary infection.
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PMID:Sensitivity and specificity of oropharyngeal suction versus bronchoalveolar lavage in identifying respiratory tract pathogens in children with chronic pulmonary infection. 747 80


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