Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We studied 196 patients with suspicion of pulmonary embolism (PE) to evaluate the role of clinical pattern, with special reference to gender and age, in raising the suspicion. Results are that clinical and instrumental patterns, although not specific for PE, may show highly frequent symptoms and signs such as dyspnea (52%), chest pain (60%), enlargement of descending pulmonary artery (49%), diaphragmatic elevation (41%), enlargement of azygos vein (46%) and hypoxia (mean value 68 +/- 13 mm Hg) that allow to suspect PE in most patients and, therefore, to recruit more patients for diagnosis. Moreover, this study shows that gender and age may only partially influence the possibility of raising the suspicion of PE. Indeed, only hemoptysis is significantly (p < 0.02) more frequent in males; only pleuritic chest pain is significantly (p < 0.02) more frequent in youngs; few instrumental findings, such as 'sausage-like' descending pulmonary artery (p < 0.001), enlargement of cardiac shadow (p < 0.01), and hypoxia (p > 0.03) are significantly more frequent in elderly patients. Finally, a characteristic clinical and instrumental pattern of PE may allow to select a subset of patients at higher risk; in fact, previous PE, prolonged immobilization (p < 0.01) and thrombophlebitis (p < 0.001), sudden dyspnea and cough (p < 0.05), 'sausage-like' descending pulmonary artery (p < 0.001), diaphragm elevation (p < 0.02), enlargement of heart shadow, pulmonary infarction and Westermark sign (p < 0.001), S-T segment depression (p < 0.001), and hypoxia (p < 0.001) are findings significantly more frequent in patients with confirmed PE.
 ...
PMID:Gender, age and clinical signs in patients suspected of pulmonary embolism. 817 65

Three weeks following a toothache, a 56-year-old man developed cough, sputum, fever, and pleuritic chest pain. He had mild periodontal disease and his chest radiographs and chest computed tomographic (CT) scans showed multiple pulmonary nodules. The CT scan strongly suggested septic pulmonary embolism. Aspirated pus from one of the nodules yielded pure growth of Streptococcus intermedius. Lesions resolved with antimicrobial therapy. The usual predisposing factors for septic pulmonary embolism were absent, and, the isolation of S intermedius from the pus, the antecedent toothache, and periodontal disease all suggested the gingiva as the source. We hypothesize that periodontal infection led to bacteremia, seeding of the lungs, and multiple anaerobic pulmonary abscesses, akin to reported instances of infective endocarditis from dental foci without any prior dental procedures. To our knowledge, this presentation of septic pulmonary embolism is unprecedented.
 ...
PMID:Septic pulmonary embolism due to periodontal disease. 825 94

We compared arterial blood gas analysis and 99mTc-MAA lung perfusion scintigraphy before and after endoscopic injection sclerotherapy (EIS) in 17 cases of esophageal varices complicating liver cirrhosis. EIS was performed by the intra-variceal injection method with 5% ethanolamine oleate (EO) as the sclerosant agent. In blood gas analysis, the mean values of partial arterial oxygen tension (PaO2) and oxygen saturation (SaO2) were decreased, and the mean value of alveolar-arterial O2 difference (AaDO2) was increased, compared with before EIS while breathing room air. On lung perfusion scintigram, the pulmonary blood flow was markedly decreased, demonstrating hypoperfusion and/or perfusion defect, compared with before EIS in most the cases. It was suggested that pulmonary embolism and/or pulmonary circulatory disturbance occurred after EIS. It is important to note that pulmonary circulatory disturbances potentially may occur after EIS without any accompanying symptoms such as dyspnea, cough, or hemoptysis.
 ...
PMID:[Pulmonary circulatory disturbance following endoscopic injection sclerotherapy]. 836 22

We studied 196 patients with suspicion of pulmonary embolism (PE), subsequently confirmed in 98 by positive pulmonary angiography and excluded in 98 by normal or near-normal perfusion lung scan. Patients had a clinical questionnaire for history, and, soon after. a radiograph, blood gas analysis, and an ECG. Clinical and instrumental signs were matched in patients with confirmed and unconfirmed PE to find those more frequent in embolic patients and, thus, more characteristic of PE. The following were: previous PE, immobilization and thrombophlebitis (p < 0.05); dyspnea and cough (p < 0.05); enlarged descending pulmonary artery (DPA), enlarged right heart, pulmonary infarction, Westermark sign (p < 0.001), and elevated diaphragm (p < 0.05); hypoxemia. No ECG sign was more frequent in PE. Thereafter, all variables were processed separately with a logistic multiple regression analysis and those significantly associated to PE were tested in a final logistic model that was able to predict the actual result of angiography or scintigraphy; accordingly, previous PE, immobilization, thrombophlebitis, enlarged DPA, pulmonary infarction, Westermark sign, hypoxemia were significantly associated with a high risk of PE (from 2.8 to 15 times greater than in patients without these signs). Therefore, we may conclude that clinical assessment and noninvasive tests may help to detect patients at higher risk for PE where heparin coverage should be started while waiting for conclusive diagnostic procedures.
 ...
PMID:A way to select on clinical grounds patients with high risk for pulmonary embolism: a retrospective analysis in a nested case-control study. 857 15

The clinical and laboratory features in 62 patients with acute pulmonary embolism were analized. There were 26 males, and 36 females with mean age of 63 +/- 11 (range 37 to 90). The clinical symptoms include: dyspnea (92%), chest pain and/or chest tightness (65%), cough (50%), wheezing (29%), leg swelling (32%), hemoptysis (24%), syncope (18%), leg pain (10%). Clinical signs include: tachypnea (respiratory rate > or = 20 per minute) (79%), tachycardia (37%), deep vein thrombosis (29%), cyanosis (8%), fever (> 38.5 degrees C) (2%). The possible predisposing factors include: immobilization (18%), surgery (5%), deep vein thrombosis, ever(5%), malignancy (5%), pulmonary embolism, ever (3%). Arterial blood gas analysis (while patients breathed room air) revealed mean PH of 7.46 +/- 0.06, mean PO2 of 64.5 +/- 12.1 mmHg, mean PCO2 of 35.3 +/- 4.6 mmHg, mean Alveolar-arterial O2 difference of 36.5 +/- 16.6 mmHg. The electrocardiographic changes include; nonspecific ST-T change (61%), sinus tachycardia (20%), S1Q2T3 pattern (15%), atrial fibrillation (16%), incomplete right bundle branch block (10%), complete right bundle branch block (8%), atrial premature contraction (7%), paroxysmal supraventricular tachycardia (2%). The chest x-ray findings include: cardiomegaly (48%), regional hypovascularity (31%), atelectasis (5%), pleural effusion (5%), wedge-shaped infiltrate (3%), elevated diaphragm (6%). Venous plethysmography was performed in 49 of 62 patients. Of these 49 patients, 28 patients revealed positive finding. Of these 28 patients with positive finding, 18 patients had clinical evidence of deep venous thrombosis. The in-hospital mortality rate was 10% (6/62).
 ...
PMID:[Pulmonary embolism: clinical and laboratory features in 62 patients]. 904 62

We report a 67-year-old man who developed pulmonary hypertension as an initial clinical manifestation of occult gallbladder adenocarcinoma. He had a 6-week history of persistent dry cough followed by progressive dyspnea on exertion. Physical examination and chest roentgenogram revealed signs of precapillary pulmonary hypertension. He died of shock 1 h after pulmonary angiography, which failed to show any intravascular filling defects. Autopsy disclosed a mucin-producing small adenocarcinoma (2 cm diameter) and a gallstone in the gallbladder with a few small metastases to peri-aortic, peri-bronchial and mediastinal lymph nodes. Macroscopically, there was no gross thrombotic pulmonary embolism or pulmonary metastases. However, microscopically, more than 60% of the small pulmonary arteries less than 1 mm in diameter were occluded with pulmonary tumor microemboli. This case emphasizes the need to include tumor pulmonary embolism in the differential diagnosis of pulmonary hypertension whether or not there is evidence of an underlying malignant tumor.
 ...
PMID:Subacute pulmonary hypertension due to pulmonary tumor microembolism as a clinical manifestation of occult gallbladder adenocarcinoma. 907 Sep 64

A case of successfully treated fungal tricuspid infective endocarditis with repeated pulmonary embolism is reported. A 60-year-old man had received along term intravenous hyperalimentation for the treatment of the complication after hepatopancreatoduodenectomy, associated with Candida sepsis. He was once discharged, successfully treated with antifungal agents. But he was readmitted to our hospital due to fever, cough and chest pain. Blood culture revealed Candida tropicalis. Pulmonary scintigraphy and angiography revealed multiple infarcts of the right lung, and echocardiography showed vegetation on the tricuspid valve. Because of exacerbation of shortness of breath, tricuspid valvuloplasty and thromboembolectomy in the pulmonary arteries was performed. Postoperative course was uneventful and he had a marked improvement of dyspnea after operation.
 ...
PMID:[A case of successfully treated fungal tricuspid infective endocarditis with repeated pulmonary embolism]. 925 38

A 67-yr-old woman with a history of myocardial infarct was admitted to emergency for marked dyspnea, nonproductive cough, nausea and fever. The thorax X-ray revealed a bilateral alveolar and interstitial infiltration pattern with basal accentuation. The cardiac examinations were normal. Technegas ventilation and Tc-99m-macroaggregated albumin (MAA) perfusion scans were performed to rule out pulmonary embolism. Bilateral multiple ventilation defects with normal perfusion was observed. The patient had been taking nitrofurantoin for four days for a bladder infection. Hypersensitivity to nitrofurantoin was suspected and the drug was discontinued. An antihistaminic and anxiolytic medication was started. The majority of the clinical symptoms disappeared within 24 hours. The control chest X-rays disclosed a marked improvement. Ventilation and perfusion scans obtained 48 hours after nitrofurantoin withdrawal were normal. The drug-related pulmonary reactions should be taken into account in patients on medication. Reversible ventilation defects can be the only lung-scintigraphic finding encountered in acute pulmonary nitrofurantoin reaction.
 ...
PMID:Transient reverse ventilation-perfusion mismatch in acute pulmonary nitrofurantoin reaction. 931 Jan 79

A 38-year-old female is described, who was admitted with increasing respiratory distress, cough and visible blood stasis in the jugular veins. The most likely diagnosis in this young women taking oral contraceptives was pulmonary embolism, however, a ventilation-perfusion lung scan was normal. Echocardiography showed a dilated right ventricle and increased systolic pulmonary pressure. Despite administration of oxygen and intravenous heparin the patient died in circulatory collapse before further investigations could be initiated. Post-mortem examination revealed diffuse adenocarcinoma of the stomach (linitis plastica) with metastasis to local lymphnodes, lymphangiosis carcinomatosa of the liver, pancreas and spleen and tumour cell masses within the lumen of small pulmonary arteries leading to variable occlusions of the vessels. Fibrocellular intimal proliferation was found, leading to further obstruction and increased resistance to flow through the pulmonary vascular bed and to subacute cor pulmonale.
 ...
PMID:Lethal pulmonary hypertension in a young woman caused by unrecognized haemangiosis carcinomatosa. 962 64

The case of a 14-year-old girl with Behcet syndrome is described. Besides painful and recurrent oral ulcerations, the patient had a cough and intermittent hemoptysis. The initial chest roentgenogram revealed bilateral parahilar opacities. CT and MRI scans of the thorax showed bilateral thrombosing aneurysms of the pulmonary arteries. Pulmonary blood flow imaging was performed after technegas ventilation lung scanning and Tc-99m MAA injection using a first-pass radionuclide angiography procedure. Altered blood flow in the left pulmonary artery was shown. Bilateral and well-defined ventilation/perfusion mismatched areas suggested a high probability of pulmonary embolism. Little additional information was obtained on subsequent contrast pulmonary angiography. The high incidence of pulmonary artery hypertension and associated vascular injury risk makes pulmonary angiography an unsafe procedure in patients with pulmonary Behcet syndrome. The need for pulmonary angiography could be obviated in such cases with the use of high-precision MRI and ventilation/perfusion lung scanning, including radionuclide pulmonary angiography.
 ...
PMID:Bilateral pulmonary artery aneurysms in a patient with Behcet syndrome: evaluation with radionuclide angiography and V/Q lung scanning. 981 58


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>