Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0008031 (chest pain)
 17,248 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Varicella pneumonia during pregnancy may be relatively mild or rapidly fatal. Diagnosis is based on the usual criteria for varicella in association with signs and symptoms of respiratory distress: dyspnea, tachypnea, cough, chest pain, and hemoptysis, with characteristic x-ray findings. Treatment should be directed toward maintaining blood oxygen saturation at as near normal as possible (monitored by serial blood gas determinations). The occurrence of congenital varicella is unpredictable, but an infant born within four days of the mother's development of the varicella skin rash is at high risk, with the outcome being fatal in five percent of cases.
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PMID:Varicella pneumonia during pregnancy. 42 71

Twenty-two patients were given progressively increasing doses of Cytembena to determine toxicity patterns and to establish a dosage which produces definite but clinically tolerable toxicity when the drug is given by intravenous injections in a 5-day intensive course. Toxicity consisted primarily of nausea, vomiting, arm pain, and transiently decreased renal function. At higher doses, an "autonomic-storm" phenomenon was observed consisting of hypertension, tachycardia, tachypnea, hyperperistalsis, frequent explosive defecation, facial flushing and paresthesias, and chest pain with accompanying ischemic EKG changes. There was no evidence of mucocutaneous, hepatic, or hematologic toxic effects. Toxicity was dose-related, first being recognized at a daily dose of 300 mg/m2 and becoming clinically intolerable at a daily dose of 475 mg/m2. No permanent damage was observed in any of the organ systems monitored. An acceptable treatment regimen for most patients is 400 mg/m2/day for 5 days. Patient discomfort can be reduced by dividing each day's dose into two intravenous injections given at an interval of at least 6 hours. Coronary artery disease and impaired renal function should be contraindications to Cytembena therapy, and caution should be employed in the patients with significant impairment of liver function. Two of 22 patients, both with far-advanced carcinoma and previous chemotherapy failures, showed a favorable objective response to Cytembena therapy. Phase II studies to assess the magnitude of the drug's antineoplastic activity seem warranted.
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PMID:A phase I study of cytembena. 94 91

Venous air embolism is a well-recognized complication of central venous catheterization. Although previous reports have documented venous air embolism occurring in a number of ways, including during initial catheterization, when catheters crack or are disconnected, and after catheter removal, no reports mention the possibility of air embolism occurring when a guide wire without a catheter was in place. A patient is presented who displayed signs and symptoms of venous air embolism (tachypnoea, chest pain, and arterial hypoxaemia) during central venous catheter manipulation while a guide wire alone was in place. Pulse oximetry was used to detect hypoxaemia and suggest an aetiology for the patient's clinical symptoms. It is postulated that a previously described gasp reflex or some sort of sustained negative pressure manoeuvre caused venous air embolism around the guide wire and accounted for the patient's signs and symptoms. During central venous catheter placement, a high index of suspicion for venous air embolism should be maintained, pulse oximetry should be used, the skin entrance site should be kept covered by an occlusive dressing, and the patient should be positioned head-down.
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PMID:Central venous air embolism without a catheter. 203 95

A case of pulmonary embolism associated with diabetes insipidus is reported in an 18-year-old male. The patient, who had been treated with DDAVP for diabetes insipidus and hydrocortisone for hypocorticism for two years after first operation for the removal of craniopharyngioma, was admitted with recurrence of that tumor. Diabetes insipidus immediately after second operation was controlled with intermittent drip infusion of a small amount of aqueous pitressin under monitorings of body weight hourly using a patient weighing system to keep the weight changes within +/- one kilogram. Serum and urine electrolytes levels, osmolarity, and free water clearance were also monitored every three hours to maintain water-electrolytes balances appropriately. Postoperative course had been uneventful except that CSF rhinorrhea occurred 7 days after operation. The patient was, then, kept in bed with horizontal plane to avoid further leakage of CSF. Two days later, he developed chest pain suddenly with tachypnea, tachycardia, and general cyanosis. The arterial-BGA showed PaO2 of 53.5mmHg and PaCO2 of 35.3mmHg in room air. The definite diagnosis of pulmonary embolism was made by technetium microaggregate lung perfusion scans and by pulmonary angiograms. The patient was treated with heparin, 15000IU/day, and urokinase, 720000IU/day. The symptoms due to pulmonary embolism had improved gradually within a couple of weeks. Recent articles have shown an unexpected high incidence of deep vein thrombosis and pulmonary embolism in neurosurgical patients associated with the elevation of blood coagulability. Brain tumors, especially suprasellar mass with hypothalamic dysfunction have been suggested to cause thromboembolic disorders frequently. The clinical course was described and factors causing pulmonary embolism on this patient was discussed.
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PMID:[A case of pulmonary embolism with diabetes insipidus developed after removal of craniopharyngioma]. 233 47

We describe the case of pulmonary embolism from metallic mercury after an deliberate intravenous injection in a drug addict. Metallic mercury embolisation is extremely rare and it is very important to remark the role of elementary mercury in chronic poisoning. In most reported cases, including our patient, the clinical pathologic manifestations are not so important. The reported symptoms are chest pain, tachypnea, gastrointestinal-tract disorder and one case of bloody diarrhea. Intravenous injection causes a local endothelial damage. After embolization the mercury may remain within the pulmonary interstitium and the alveoli, where may develop in sterile abscesses and granulomatous foreign body reactions. The mercury may remain localized as a depot of elemental mercury or may be oxidized to the soluble mercuric ion and may be distributed to other body tissues and may produce chronic poisoning. This toxicity causes damages, particularly to the kidneys (glomerular-nephritis), but does not cause changes in renal function (follow-up 10 years).
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PMID:[A case of embolism caused by metallic mercury in a drug addict]. 248 39

The antibiotic era has changed the incidence, causal factors, and gravity of empyema. Between 1977 and 1988, 27 children with empyema were surgically managed. Ten cases occurred after an operation (8 esophageal and 2 abdominal). There were 15 girls and 12 boys. The age range was newborn to 12 years. Symptoms included fever, cough, tube drainage postoperatively, anorexia, weight loss, chest pain, tachypnea, and lymphadenitis. Multiple aerobic and anaerobic organisms were cultured. Treatment included thoracentesis and antibiotics, tube thoracostomy, tube thoracostomy and bronchoscopy, decortication, or decortication with lobectomy. The total hospital stay averaged 28.3 days, and after decortication, 11.6 days. Empyemas in children frequently have multiple organisms and should be treated with broad-spectrum antibiotics while awaiting culture results. Thoracentesis and tube thoracostomy are often ineffective in curing the disease. Decortication can abbreviate hospital stay if performed promptly for persistent pleural sepsis.
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PMID:Management of empyema in children. 258 99

Seventeen cases of pediatric malignant neoplasm with pulmonary and/or pleural lesions shown by chest radiography at initial diagnosis were reviewed and analyzed. Respiratory symptoms such as dyspnea, tachypnea, and chest pain were observed on admission in approximately one-half of them. The initial chest radiography showed pleural lesions in 7 of the 17, pulmonary lesions in 8, and both pulmonary and pleural lesions in 2. Unilateral or bilateral pleural fluids were observed in all of the seven patients with pleural lesions, and malignant cells were confirmed in the pleural fluid of all patients. The radiographic patterns of the eight patients with pulmonary lesions were solitary nodule in two, multiple nodules in two, diffuse miliary nodules in three, and diffuse honeycomb in one. Histological examination of the pulmonary lesion was performed in six patients at the initial diagnosis or after death, while in the remaining two primary or other metastatic sites were examined. The two patients with both pulmonary and pleural lesions showed multiple nodules or infiltrates with pleural fluid on chest radiography. Increased malignant cells were detected in the pleural fluid of both patients. In all cases, the lesions gradually or rapidly disappeared with multidrug chemotherapy. The review confirms the need for a combination of complete radiographic and pathological analysis at the time of initial diagnosis of malignant neoplasm in children to distinguish other causes such as infectious complications.
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PMID:Pulmonary and pleural involvements at initial diagnosis in children with malignant neoplasm. 278 53

Fracture of the neck of the femur (FNF) is a common disorder in the elderly. A total of 618 cases consisting of 117 males and 501 females, whose age was 65 years or more, were enrolled in a prospective study. A total of 45 cases among them revealed pulmonary complications. These were divided into the following three groups: Group 1 (4.7%) who had respiratory disease(s) or symptoms prior to the fracture; Group 2 (1.9%), diagnosed as having pulmonary thromboembolism (PTE). In Group 3 (0.6%), PTE was a possible diagnosis but it was not distinguished from pneumonia in precise. In the patients of group 2 and 3, respectively, the following respiratory symptoms were observed: dyspnea (31.3%), productive cough (25%), syncope (12.6%), chest pain (6.3%), tachycardia (46.7%), and tachypnea (50%). An abnormal chest roentgenogram was found 56.4% in both group 2 and 3. Seven patients in group 2 showed remarkable reduction of PaO2 on admission, however these all recovered within 7 days without any thrombolytic treatment. The prevalence of PTE caused by FNF in the elderly was close to that in younger cases, but the clinical symptoms were less in the former.
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PMID:[Pulmonary complications subsequent to fractured neck of the femur in the elderly]. 279 69

Four hundred and fifty-three adults in 25 British hospitals entered a prospective study of community-acquired pneumonia. A microbiological diagnosis was established in 67 per cent; Streptococcus pneumoniae (34 per cent). Mycoplasma pneumoniae (18 per cent) and Influenza A virus (7 per cent) were the commonest microorganisms. Our observations support the view that most of those in the microbiologically negative group (33 per cent) had S. pneumoniae infection. In addition to cultures of blood and sputum the most useful initial tests were for sputum pneumococcal antigen and serum mycoplasma specific IgM. Twenty-six patients (5.7 per cent) died, seven within 48 h of admission. Multivariate analyses showed age, absence of chest pain, absence of vomiting, previous treatment with digoxin, tachypnoea, diastolic hypotension, confusion, leucopenia, leucocytosis, and raised blood urea levels were significantly correlated with death. Patients had a 21-fold increased risk of death if they had two of the following: admission respiratory rate greater than or equal to 30/min, admission diastolic BP less than or equal to 60 mmHg, urea greater than 7 mmol/l during admission. Mortality was not related to aetiology except that all three patients with combined Influenza A virus and Staphylococcus aureus infection died. Nine patients had legionella pneumonia; none died. No patients who died from pneumococcal pneumonia, mycoplasma pneumonia or staphylococcal pneumonia had received an appropriate antibiotic before admission. Such deaths are possibly preventable. Assisted ventilation was used in 22 patients of whom 14 survived. Hospital stay in survivors averaged 10.8 days; after six weeks 79 per cent were fit for normal activities, and 55 per cent showed resolution of radiographic signs of pneumonia. We recommend that antibiotics should be given as early as possible and chosen always to cover S. pneumoniae, and in addition M. pneumoniae during outbreaks, and S. aureus during influenza epidemics.
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PMID:Community-acquired pneumonia in adults in British hospitals in 1982-1983: a survey of aetiology, mortality, prognostic factors and outcome. The British Thoracic Society and the Public Health Laboratory Service. 311 95

Significant chest wall deformities occur in two thirds of children with Marfan syndrome (MS). The symptoms, physical findings, and surgical outcome of 11 patients with MS and severe pectus excavatum who required operative repair were reviewed. The diagnosis of MS was made before the pectus repair in six patients, at the time of evaluation of pectus in two patients, and after the repair in three patients. Symptoms included dyspnea upon exertion, tachypnea, and chest pain. Physical findings included aortic root enlargement or valvular disease, mitral valve disease, ligamentous disease, congestive heart failure, and ocular disease. All patients had severe pectus deformities with a narrow anteroposterior diameter in the midline, as well as a broad chest defect that extended bilaterally to the midclavicular line. The heart was shifted into the left side of the chest in all patients. A Ravitch-type pectus repair with a stainless steel substernal strut was used in eight patients, with one patient suffering a late recurrence; in three patients no strut was used, and all three had recurrence. There were no postoperative complications. In the postoperative follow-up of seven patients, symptomatic improvement of cardiopulmonary performance was noted. Four of the patients required subsequent open heart surgery, including replacement of the aortic valve in one patient, and composite grafts of the ascending aorta in three patients. Postoperative cardiac arrest was the only major open heart complication. All four patients recovered and did well after surgery, showing significant cardiac and pulmonary functional improvement.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Surgical management of children and young adults with Marfan syndrome and pectus excavatum. 323 81


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