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23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The diagnosis of childhood illness by maternal health interview surveys is widely used to estimate the prevalence of childhood morbidity in developing countries. To determine the validity of interview-based diagnoses, and to define simple, sensitive and specific diagnostic algorithms, we compared symptoms and signs reported by mothers during structured interviews with physicians' diagnoses for 271 children on the Philippine island of Cebu. The 271 children had 318 physician diagnosed illnesses: 105 acute lower respiratory infections (ALRI), 121 diarrhoeas, 36 measles, 50 upper respiratory infections (URTI), 5 roseola infantums and one milaria rubria. An algorithm for measles (age greater than or equal to 120 days, rash and fever greater than or equal to 3 days and fading of rash) had a sensitivity and specificity of 94%. For ALRI an algorithm of cough, dysponea and fever had a sensitivity of 82%, but specificity was lower in comparison with URTI (58%) than with children who had no respiratory illness (79%). Inclusion of signs of respiratory distress (flaring of nostrils, intercostal retraction) raised the specificity to 83-84%, but reduced sensitivity to 68%. Diagnosis of diarrhoea based on frequent loose or liquid stools had a sensitivity of 95-97% and specificity of 80% in children with or without concomitant non-diarrhoeal illnesses. Addition of questions on numbers of stools (greater than or equal to 6 per day), and no signs of dehydration increased specificity to 95% but reduced the sensitivity to 84-86%. However, specific signs of dehydration were not well reported by the mothers.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Validation of the diagnosis of childhood morbidity using maternal health interviews. 206 19

We compared previously healthy prematurely born infants with full-term infants hospitalized with respiratory syncytial virus (RSV) infection to evaluate the role of prematurity on the clinical course of the illness. During a 5-yr period (1984 to 1989), 484 previously healthy patients were admitted to the hospital with RSV infection. No differences were found in the presenting symptoms of respiratory distress, cough, fever or shock, although the premature group was more likely to present with apnea (p less than .001). Chest roentgenograms revealed that premature infants had a higher incidence of atelectasis/infiltrate and hyperinflation (p less than .05). Premature infants had longer hospital stays as well as a higher Physiologic Stability Index and Therapeutic Intervention Score (p less than .001). They were also more likely to receive supplemental oxygen, ICU admission, mechanical ventilation, and nothing by mouth status (p less than .001). We conclude that premature birth increases the risk of more severe and prolonged RSV disease.
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PMID:Does prematurity alter the course of respiratory syncytial virus infection? 224 9

Forty-one cases of empyema thoracis admitted in hospital during April, 1985 to August, 1987 were studied. Majority were males (65.9%) and were of less than 2 years of age (70.7%). Right side (60.9%) was predominantly involved. Abdominal distension (43.9%) was very characteristic, with other usual features like fever, cough and respiratory distress. A large majority of them were victims of malnutrition (73.2%) and anaemia (53.7%) with haemoglobin level ranging from 5-9 g/dl. Mortality was high (17.1%). Therapy with parenteral cloxacillin and gentamicin and continuous intercostal tube drainage accounted for loss of 15.8 bed days (average period of hospitalisation). Staph aureus was the principal aetiopathogen (68.3%). No anaerobe could be isolated. Strains of staphylococci were mostly resistant to penicillin and ampicillin but sensitive to gentamicin, cloxacillin and erythromycin.
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PMID:Clinicobacteriological study of empyema thoracis in infants and children. 226 63

Congenital abnormal communications between separated pulmonary tissue and the oesophagus are rarities. Only about 50 cases have been reported in the literature. For all different forms the term of bronchopulmonary foregut malformation (BPFM) was first applied by Gerle and his coworkers in 1968. Major symptoms of this condition involved respiratory distress, cough, dyspnea, vomiting and repeated pneumonia. This paper presents reports of two own patients. In both cases was confirmed a bronchopulmonary foregut malformation in the lower right thorax with ectopic main bronchus communicating into the distal oesophagus. According to the literature we describe our own experience and discuss embryologic pathogenesis and surgical consequences for children.
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PMID:[Bronchopulmonary foregut malformations with communication to the esophagus]. 229 61

Pulmonary infection due to the filariform larvae of Strongloides stercoralis may occur in immunocompromised patients residing in endemic areas of the United States. Such infection usually presents as dyspnea with a cough that sometimes results in bloody sputum. Although the chest roentgenogram often reveals a patchy bilateral alveolar infiltrate, acute respiratory distress is unusual. We report a patient who experienced severe exacerbation of his underlying obstructive lung disease that was associated with chest infiltrates and recovery of S stercoralis from his sputum. Although initial improvement was accomplished with Thiobendazole treatment, a re-exacerbation occurred when antiparasitic therapy was completed. The persistence of his infection is correlated to factors that are commonly employed in the treatment of COPD but may be overlooked as predisposing causes of hyperinfection with S stercoralis.
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PMID:Exacerbation of chronic obstructive pulmonary disease due to hyperinfection with Strongyloides stercoralis. 234 69

The clinical signs associated with intramural tracheal obstructions in two horses and a donkey were respiratory distress and coughing, which were aggravated by exercise and excitement. The obstructions were at the level of the thoracic inlet and consisted either of flattening of the cartilage rings in the dorsoventral plane or of cartilage rings having a scroll-like conformation. They appeared to be developmental in origin and to have been present for a considerable time before the onset of clinical signs. Endoscopy and radiography were helpful in the diagnosis of the condition.
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PMID:Tracheal obstructions in two horses and a donkey. 234 17

Respiratory syncytial viral infection is the leading cause of acute lower respiratory tract disease in infants and young children. Presenting symptoms include rhinorrhea, nasal congestion, a low grade fever, and a cough. Hypoxemia and respiratory acidosis are the most common presentation for infants requiring intensive care. Critical care nurses must skillfully assess the infant's clinical status and response to medical treatment, implement and enforce isolation procedures, and remain sensitive to the emotional and psychologic needs of RSV-infected infants and their families. They must be knowledgeable regarding the latest research and recommendations concerning isolation policies and safe administration of ribavirin therapy in order to maximize the care for infants experiencing acute respiratory distress caused by RSV infection.
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PMID:Respiratory syncytial viral infection in infants: nursing implications. 235 86

A 68-year-old man with rheumatoid arthritis developed methotrexate-induced lung disease. He presented with fever, cough, respiratory distress and pulmonary infiltrates, which were initially mistaken for pneumonia. Alertness to this rare and dangerous complication of methotrexate treatment will reduce possible damage and help maintain its place as a leading medication for rheumatoid arthritis.
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PMID:[Pulmonary disease induced by methotrexate]. 238 60

Neodymium-yttrium-aluminum-garnet laser treatments were performed in 70 patients aged 62 +/- 10 (1 SD) years for incomplete malignancy-induced obstruction of the trachea or main bronchi, or both, associated with uncontrolled cough, dyspnea, atelectasis/pneumonia, and hemoptysis. Forty-three patients had been treated with surgical techniques, chemotherapy, or radiotherapy, or all three, while 27 patients were untreated before laser therapy because of acute respiratory distress. Laser treatment produced palliative improvement in 81% of the treated group (35 of 43), with survival of 4.3 +/- 3.9 months. Unsuccessfully laser-treated patients survived 0.7 +/- 0.4 month (p less than .05). Eighty-five percent of the untreated patients (23 of 27) showed postlaser improvement, with survival of 8.5 +/- 6.9 months. Unsuccessfully laser-treated patients survived 1.4 +/- 0.6 months (p less than .05). Twenty-three of the 27 previously untreated patients underwent radiation therapy after laser treatment. Laser treatments also were administered to 23 patients aged 61 +/- 13 years with complete obstruction of the main bronchi. Of this group, 17 patients had been treated and 6 had not been treated before the laser therapy. Laser treatment was successful in 47% of the treated patients (8 of 17), but there was no difference (p greater than .05) in survival between successfully and unsuccessfully treated patients (3.0 +/- 2.5 vs. 2.9 +/- 4.6 months). Similarly, laser treatment was successful in 50% of the untreated patients (3 of 6), and there was also no difference (p greater than .05) in survival between successfully and unsuccessfully treated patients (3.4 +/- 3.5 vs. 3.5 +/- 2.8 months).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Neodymium-yttrium-aluminum-garnet laser in lung cancer. 243 45

Radiation pneumonitis is a life-threatening result of therapeutic thoracic irradiation, yet its mechanisms are poorly understood. We studied the effects of unilateral lung irradiation (3,000 rad) in sheep from the immediate response to the later development of radiation pneumonitis. We defined radiation pneumonitis by its diagnostic clinical feature, radiographic infiltration of the irradiated zone with a straight margin corresponding to the radiation port. The immediate response in the few hours after irradiation was characterized by cough, labored respiration, hypoxemia (arterial PO2 decreased 19 Torr), mild pulmonary hypertension (pulmonary arterial pressure increased 20%), and lymphopenia. Hemodynamics and gas exchange returned to normal by day 2 but became abnormal again before or during radiation pneumonitis at 32 +/- 2 days. Respiratory distress, hypoxemia, and pulmonary hypertension recurred during radiation pneumonitis. Bronchoalveolar lavage during radiation pneumonitis contained increased neutrophils (19 +/- 4%, control = 7%), increased protein (0.27 +/- 0.1 g/dl, control = 0.12 +/- 0.03), and severely impaired ability to lower surface tension. Alveolar macrophages from both lungs during unilateral radiation pneumonitis exhibited impaired generation of superoxide after phorbol myristate (only a 30% increase). Normal control alveolar macrophages increased superoxide production after stimulation greater than 400%. We conclude that unilateral lung irradiation in sheep causes a mild immediate response followed by radiation pneumonitis at 1 mo. Unilateral radiation pneumonitis in this model is associated with ipsilateral neutrophilic alveolitis, increased bronchoalveolar lavage protein, and impaired surfactant function, as well as bilateral functional abnormalities of alveolar macrophages.
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PMID:Unilateral radiation pneumonitis in sheep: physiological changes and bronchoalveolar lavage. 254 Jan 44


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