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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-two cases of sub-tentorium cerebral abscesses were observed in children. The first clinical symptoms were those of intracranial hypertension, disorders of consciousness, specially somnolence, fever and low general condition. Focal neurological signs were frequent but appeared later. A cerebral abscess should be suspected when such symptoms occur in children with heart disease or with respiratory infection. Simple investigations like examination of the fundi, X-ray of the skull and EEG give valuable clues. In case of such a clinical picture, lumbar puncture is useless and often dangerous. The best diagnostic test is a cerebral scintigram.
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PMID:[Sub-tentorial cerebral abscesses in children; a report of 22 cases]. 66 21

Thirty-seven (1-6%) tracheas from 2170 children showed squamous metaplasia. (Cases with tracheo-oesophageal fistula and congenital heart disease were excluded). The metaplasia extended into the bronchi in 15 cases. Features of pulmonary retention were present in seven cases. Respiratory infection, probably viral, seemed to be the most significant causative factor in 20 children, including those with cystic fibrosis. Tracheal instrumentation was a possible factor in 11 cases but oxygen therapy alone did not seem important. The metaplasia was almost certainly congenital in one child and probably in two others but no stillborn infants showed metaplasia. In many children the metaplasia seemed to be due to a combination of factors.
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PMID:Squamous metaplasia of the tracheal epithelium in children. 94 Nov 6

Chronic cough may be the sole presenting manifestation of bronchial asthma (reference 3; Corrao et al, 1979), and "cough variant asthma (CVA)" has been used to categorize such patients. In order to clarify the clinical picture of CVA, we evaluated the clinical history, laboratory data, sputum cytology and pulmonary function in 14 subjects (5 males and 9 females, aged 14 to 65 years) compatible with the following diagnostic criteria: (1) chronic cough persistent for more than 8 weeks, (2) no wheeze nor dyspnea, (3) no rales, (4) no past history of asthma, (5) bronchial hyperreactivity to methacholine proven by Takishima's method (reference 13), (6) effectiveness of bronchodilators against cough, (7) normal chest X-ray film, (8) afebrile and negative CRP, (9) absence of sinusitis and postnasal drip, or if present, they are proved not to be responsible for the cough, and (10) no other causes of cough such as heart disease, prescription of ACE inhibitors, current smoking. The results were as follows. 1) Many of the subjects were atopic, with positive skin tests to one or more common allergens in 10 subjects, elevated serum IgE in 4 subjects, and past history and family history of atopy in 4 and 7 subjects, respectively. 2) Respiratory infection preceded the onset of CVA in 3 subjects. 3) Cough was generally nocturnal, but 2 subjects coughed only in the daytime. 4) FEV1.0% was decreased (less than 70%) in only 2 subjects, whereas V25 was decreased (less than 80% of predicted value) in 11 out of 12 evaluable subjects, which suggested peripheral airway obstruction.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical study on cough variant asthma]. 150 83

Branhamella catarrhalis is an aerobic Gram-negative diplococcus. It has been traditionally regarded as an oropharyngeal commensal and until recently was only identified as a pathogen in cases of bronchopulmonary infections. The aim of this study was to analyse the characteristics of the respiratory infections caused by B. catarrhalis and to know the antibiotic susceptibility of this microorganism. We retrospectively studied 32 lower respiratory tract infections, caused by B. catarrhalis (20 cases of bronchial infection and 12 cases of pneumonia), diagnosed between 1988-1989 in our hospital. All patients had an underlying disease; chronic obstructive pulmonary disease (COPD) and chronic heart disease being the most frequent. The aetiological diagnostic procedures were: sputum culture in 28 cases (15 in pure culture and 13 mixed), protected specimen brush (PSB) in three cases and transthoracic needle aspiration (TNA) in one case. Twenty B. catarrhalis isolates were penicillin and ampicillin-resistant, 11 in the pneumonia group and 9 in the bronchial infection group. All isolates were sensitive to amoxycillin-clavulanic acid and second generation cephalosporin. In our group four patients died. We conclude that B. catarrhalis is a not infrequent cause of respiratory infection, particularly in COPD patients, and that the high incidence of antibiotic resistance to penicillin and ampicillin should be taken into account before considering an empirical antibiotic treatment.
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PMID:Branhamella catarrhalis respiratory infections. 162 25

To determine observer agreement for a clinical score and oximetry in lower respiratory infection in children less than 2 yr of age, a convenience sample of 56 infants hospitalized with bronchiolitis or pneumonia was assessed independently by two observers. A total of 12 infants had chronic lung disease of prematurity or congenital heart disease. Infants in whom oxygen supplementation could not be discontinued for at least 5 min were excluded. A severity score was assigned for each of four categories (respiratory rate, retractions, wheeze, and general appearance). A total for each patient was obtained by summing the score for each category. Oxygen saturation was measured using a Nellcor oximeter. Agreement beyond chance was measured using the kappa statistic. The relationship between observers for total score and oximetry and the mean total score and mean oximetry value for each patient was expressed as a Pearson correlation coefficient. A total of 56 infants and children were studied: 2 had pneumonia, 11 had an exacerbation of pulmonary signs and symptoms with their underlying cardiac or pulmonary disease, and 43 had bronchiolitis. Kappa was 0.48 for general assessment, 0.38 for respiratory rate, 0.31 for wheeze, and 0.25 for retractions. All values were statistically significantly greater than 0 at p less than 0.01. Correlations for total score and for oximetry were 0.68 and 0.88, respectively. The median difference between oximetry readings was 1. The correlation coefficient between total score and oximetry was -0.04. The limited agreement for clinical signs makes comparison of patient illness severity between studies difficult.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Observer agreement for respiratory signs and oximetry in infants hospitalized with lower respiratory infections. 173 71

Respiratory infections result from complex interactions between the infectious organism and the host, and exposure to environmental pollutants may alter host resistance. The atmospheric pollutants implicated in respiratory infections include acidic aerosols, particles, nitrogen dioxide, ozone, sulfur dioxide, and household allergens. An extensive epidemiological literature has been established linking environmental tobacco smoke to increased occurrence of lower respiratory tract infections in children; exposure to smoke from cooking and heating fires may also increase the risk of serious infections. Experimental evidence suggests that exposure to nitrogen dioxide and acidic aerosols may impair specific host defense mechanisms. Individuals with underlying lung or heart disease, as well as infants and the elderly, are among those most susceptible to the effects of environmental pollutants. Efforts should be directed toward reducing the exposure of children to environmental tobacco smoke and products of unvented combustion while investigations continue.
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PMID:Environmental factors and atmospheric pollutants. 180 97

Occupants of 482 long-stay and 33 short-stay beds in 11 Leicester City Council homes for the elderly were studied during a 30-week period from September 1988 to March 1989 to determine the incidence, aetiology, morbidity, and mortality of acute upper respiratory tract viral infections and the use of influenza vaccine. Influenza immunization rates by home ranged from 15.4 to 90% (mean 45%). There were no differences in the distribution of medical conditions by home. The highest immunization rates were seen in people with chest disease (77%), heart disease (60%), diabetes (56%), and those with three medical conditions (75%). There was an average of 0.7 upper respiratory episodes per bed per annum with a mortality of 3.4% (6/179). Half of all episodes were seen by a general medical practitioner and 81 of 90 (90%) referrals were prescribed antibiotics costing approximately 7.50 pounds per patient. Lower respiratory tract complications developed during 45 (25%) of 179 episodes including 3 of 12 coronavirus infections, 3 of 9 respiratory syncytial virus infections, 2 of 4 adenovirus infections, 1 of 11 rhinovirus infections, but none of 5 influenza infections. Respiratory infections were caused mostly by pathogens other than influenza virus during the influenza period documented nationally. This highlights the role of coronaviruses, respiratory syncytial virus, and unidentified agents in the elderly, and questions the assumptions made in American estimates on the impact of influenza and the value of influenza vaccines.
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PMID:Acute upper respiratory tract viral illness and influenza immunization in homes for the elderly. 224 24

Is respiratory infection mortality in Down's syndrome (DS) individuals due mainly to their congenital heart disease (CHD) or to other factors which subject most mentally retarded persons to risk? Detailed clinical and autopsy records of 137 institutionalized DS patients and 480 non-DS controls over 31 years yielded 42 DS subjects and 13 non-DS controls with congenital heart disease. These were compared to 20 DS patients and 20 controls without CHD. The DS and non-DS patients were matched for age, sex and IQ. DS patients had more CHD; controls had more pulmonary oedema. In neither group was there association between heart disease and death from respiratory infection. Nor did pulmonary oedema contribute importantly to such deaths. Such mortality, however, was associated with young age, short institutionalization and bedridden status. We conclude that respiratory infection death in DS individuals is due not primarily to heart disease but to factors which lead to mortality in the general population of retarded people.
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PMID:The relationship of congenital heart disease and respiratory infection mortality in patients with Down's syndrome. 315 99

Accurate prevalence and incidence figures do not exist on a global basis, yet available data suggest that acute respiratory infections in children represent a problem of enormous magnitude. World Health Organization (WHO) data from 88 countries representing 1/4 of the world's population indicate that there are over 666,000 deaths annual from acute respiratory infections. Assuming that nonreporting countries have similar mortality rates, it can be calculated that there are at least 2.2 million deaths from acute respiratory infections throughout the world each year. Despite the enormity of the problem, relatively little is known about the factors that contribute to these deaths in children or adults, or about the extent to which they are due to unusual severity of the disease, lack of access to the health care system, and institutional or social factors. The causative agents are unknown. More knowledge is needed to mount an effective program for the prevention and treatment of acute respiratory infections. In Costa Rica mortality from this disease is 12 times higher in malnourished infants than in those of normal weight. Data from Papua, New Guinea indicate that Streptococcus pneumoniae and Hemophilus influenzae are common etiologic agents. More data of this kind are needed from different countries. Also needed is information on the availability and use of adequate medical care. People in developed countries run a greater risk of dying from lung cancer and cardiovascular diseases than do people in developing countries, but the chances of dying from acute respiratory infections generally exceed those of dying from lung cancer or cardiovascular disease in the developing countries. When evaluating the seriousness of a public health problem it is important to consider the number of years of life that have been lost as well as morbidity and mortality. If there are 2.2 million deaths in the world from acute respiratory infections in children under the age of 1 year, then each year there are almost 200 million death years lost because of acute respiratory infections in the world. Thus, on a global scale acute respiratory infections represent a public health problem of greater magnitude than either heart disease or cancer. The fact that the annual WHO budget for heart disease is at least 50 times higher than the budget for all forms of respiratory disease represents seriously misplaced priorities. Properly organized research programs into the etiologic agents involved in acute respiratory infection, together with data collection on other contributing factors, are required so that effective prevention and treatment programs can be initiated.
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PMID:Acute respiratory infections in children. A global public-health problem. 670 Jun 93

This is a report of ten infants and small children with congenital obstructive lesions of the distal trachea and main bronchi. Four were successfully resected. One with a distal segment stenosis required tracheal resection at age 6 wk, another with stenosis of the distal half of the trachea at age 18 mo, and 2 (1 with distal stenosis and 1 with tracheal hamartoma) at age 4 yr. All 4 are presently free of symptoms and their anastomoses have grown without stricture. A child with coil-spring mucosal stenosis of the left main bronchus developed an excellent airway following bronchoscopic removal of the folds, and a baby with tracheomalacia was successfully treated with a rib splint on a segment of distal tracheomalacia, but she died later of associated cyanotic congenital heart disease. Four babies died with airway obstruction in the newborn period. Two with critical distal stenoses died before tracheal reconstruction could be performed. Two died following emergency resections in which all of the congenital stenosis could not be removed. In both, stenotic trachea remained despite operation. All of these infants had complete cartilage rings the entire length of the trachea. Congenital lesions of the distal trachea may become suddenly life-threatening at birth or during the onset of a respiratory infection. An abrupt or insidious onset of airway symptoms requires an expeditious diagnostic evaluation to define the tracheobronchial anatomy, and the operating team has to be prepared for emergency tracheal reconstruction.
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PMID:Reconstructive surgery for obstructing lesions of the intrathoracic trachea in infants and small children. 716 73


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