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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An analysis of the features of lower respiratory diseases (LRD) associated with Respiratory Syncytial Virus (RSV) in 21 children aged 1-23 months, indicated that the clinical features did not differ appreciably from those described for LRD due to other infective agents. It was however, remarkable that none of the children was grossly malnourished, neither was there any death. The final respiratory diagnoses were bronchiolitis alone (6 cases), bronchopneumonia (6 cases), empyema/pleural effusion (3 cases, including one with bronchopneumonia), lobar pneumonia (3 cases, including one with associated bronchopneumonia). Streptococcus pneumonia and Klebsiella pneumoniae respectively, were isolated from blood culture in the two cases with lobar pneumonia alone. One child had laryngotracheobronchitis (croup) alone and another, croup associated with bronchiolitis and bronchopneumonia. Radiologically, the single most common lesion was patchy consolidation (8 cases) followed by hyper-inflation (6 cases); in one case, there was no observable lesion on the chest radiograph. All the 6 children who had bronchiolitis alone were aged 12 months and below, and were well nourished; conversely, 8 of the 12 children with pneumonia alone or in addition to other lesions and both children with pleural effusion, were older than 12 months and underweight. Other viral agents were identified in 8 (38%) of the cases. Complications included heart failure in 4 cases and a combination of anaemia and heart failure in one child with empyema. In a child with symptom complex and radiological features suggestive of acute obstructive lower respiratory infection with immunofluorescence evidence of RSV infection, age and nutritional status are important factors in determining the need for antibiotic therapy pending the outcome of bacterial cultures.
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PMID:Respiratory syncytial virus--associated lower respiratory diseases in hospitalised pre-school children in Ibadan. 749

Tracheobronchoplastic procedures formed part of the operation for lung cancer in 41 patients of a Regional Hospital in Russia over the past 2 and a half years. Twenty-nine patients underwent sleeve lobectomy; in a further 12 patients, right pneumonectomy was combined with resection of other mediastinal structures. In 16 patients, sleeve lobectomy was indicated by the high risk of pneumonectomy. Involvement of the carina in the tumour indicated its resection. High frequency jet ventilation was a particular feature of anaesthesia for carinal resection. Omentopexy was used in 10 patients to prevent dehiscence of the bronchial anastomosis. Postoperative complications were encountered in 10 patients. The most frequent, in patients, was dehiscence of the tracheobronchial anastomosis after resection of the carina. Five patients died after operation, the causes of death being dehiscence of anastomosis, pneumonia, empyema, and acute heart failure. Despite the frequency of complications, tracheobronchoplastic operations are often the only possible option in the surgery of extensive lung cancer.
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PMID:Some problems of tracheobronchoplasty for lung cancer in a Regional Hospital in Russia. 786 92

Bronchoplasty and pulmonary angioplasty(PA-plasty) have been performed in recent years for lung cancer invading the bronchus and pulmonary artery. We evaluated the results and complications in patients who underwent such operations. There were 23 cases of bronchoplasty performed between 1988 and October 1993. Of these 23 cases, 9 underwent PA-plasty with bronchoplasty. There were 8 males and 1 female (mean 65.6 year-old). There were 8 patients with primary lung cancer(sq 5, ad 1, la 1, and sm 1) and 1 with metastatic lung tumor of colon cancer. One patient was in p-stage II, 6 in p-stage III, and 1 in p-stage IV. Seven patients underwent right upper lobectomy, 1 did the right upper and middle bilobectomy, and 1 did a left upper lobectomy. Bronchoplasty was performed using sleeve resection in 8 patients, and a wedge resection in 1 patient. PA-plasty was performed using sleeve resection and end to end anastomosis in 2 cases, and using side wall resection and plasty in 7 patients after clamp. Of 9 patients in whom both broncho- and PA-plasty were performed, there was one with the resected bronchial stump of cancer-positive. Total resection of the cancer was possible in the remaining 8 patients. Postoperative complications included 2 pneumonia, 2 empyema, and 1 each, acute cardiac failure, pulmonary thrombus, and chylothorax. The patients with empyema required re-operation using omentopexy or thoracoplasty. Long-term results showed that 2 patients died because of recurrence. Another patient died of respiratory failure. The remaining 6 patients were alive without any evidence of cancer. Pneumonectomy was avoided and the combination of PA-plasty and bronchoplasty was performed instead. However, the incidence of postoperative complications was high, indicating that utmost care must be exercised in the postoperative management of these patients.
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PMID:Evaluation of cases with combined bronchoplasty and pulmonary arterioplasty for the treatment of lung cancer. 858 90

We report a prospective multi-centre study of the clinical course and hospital management of thoracic empyema in 119 patients (mean age 54.8). The commonest presenting symptom was malaise (75%), 55% were febrile; 31% were previously well with no predisposing condition. Initial treatments were antibiotics alone (5), needle aspirations (46), intercostal tube drainage (61), rib resection (3) and decortication (4). Overall, intercostal drainage was used in 77 patients (16 failed aspirations), surgical rib resection in 24 (1 failed aspirations, 20 failed drainage), and surgical decortication in 28 (6 failed aspirations, 17 failed drainage). Only 4 patients received intrapleural fibrinolytic agents. Aspiration and drainage were likely to fail if the empyema was > 40% of the hemithorax. Median time from treatment start to discharge was: aspirations, 26 days; drainage, 23 days; resection 11 days; decortication, 12 days. Overall 21 patients died (12 with empyema as the major cause); two had been surgically treated. Mortality correlated with age, diabetes, heart failure, and low serum albumin at admission. Infecting organisms, identified in 109 patients (92%) included anaerobes (37), Str. melleri (36), and Str. pneumoniae (28). Six months after discharge, all but six survivors had regained their previous health.
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PMID:The clinical course and management of thoracic empyema. 873 15

Due to our dissatisfaction with the mutilation caused by the skin-lined open thoracostomy, we have developed a dedicated prosthesis that is expected to avoid or to substitute for the classic operation. The prosthesis is a corrugated silicone tube with an oval flange at one end (to fix it internally) and a mobile ring on the other (to fix it externally). It is inserted at the bottom of the empyematic cavity after 3 cm of a rib is removed. We have used it in 20 patients whose empyema was secondary to pneumonia (12) or complications of pneumonectomy (4), lobectomy (2), decortication (1), or pleuroscopy (1). Six of those patients have already been cured and their prosthesis removed after 54 to 305 days. In 1 with a persistent postpneumonectomy bronchopleural fistula the device was removed after 299 days and the patient was submitted to a limited thoracoplasty. Six other patients still have unresolved cavities and have been using the prosthesis for 63 to 302 days. Seven patients died of their underlying disease (bilateral pneumonia, 2; acquired immunodeficiency syndrome, 2; mesothelioma, 1; heart failure and pulmonary embolism, 1; unknown, 1) after using the prosthesis for 11 to 160 days. In those patients from whom the prosthesis already has been removed, the scar looks like those commonly seen after removal of an ordinary chest tube. Based on these early favorable results we feel most encouraged to persist in this research. Nevertheless, we are aware that a larger number of patients and a longer follow-up will be necessary before we may make definitive recommendations.
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PMID:A dedicated prosthesis for open thoracostomy. 914 62

We report the isolation of Clostridium tetani (along with Fusobacterium mortiferum) from empyema pus. The patient, a 68 year old retired farmer from rural NSW, had recently undergone cholecystectomy, had heart failure and developed an empyema. He improved after drainage of the empyema and penicillin therapy, but died suddenly during convalescence.
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PMID:Isolation of Clostridium tetani from anaerobic empyema. 983 18

Pleural involvement is frequently seen among patients hospitalized in Intensive Care Units (ICU). In most cases, patients are hospitalized with or will develop scarce transsudative effusion secondary to cardiac failure or atelectasis. Other pleural issues in ICU concern pneumothorax in ventilated patients (barotrauma), empyema following nosocomial pneumonia or investigation procedures. More rarely hemo(pneumo)thorax or chylothorax will be diagnosed. As a rule, acute pleural pathologies rarely justify hospitalization in the ICU, depending on the etiologic mechanism or concomittant clinical signs of intolerance (respiratory insufficiency, collapsus, coma...). After tube thoracostomy, most patients will be managed in the respiratory ward to monitor the drainage, to begin etiologic diagnosis and to discuss a possible surgical intervention, usually a few weeks or months after the ICU.
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PMID:[Management of acute pleural diseases in intensive care units]. 1061 48

A 50-year-old man with symptoms of bi-ventricular heart failure was transferred to our hospital with a diagnosis of extracardiac tumor. He had a 10 year history of untreated diabetes. Chest computed tomography (CT) revealed an extracardiac mass in the right atrio-ventricular groove. Cardiac catheterization revealed an elevated mean right atrial pressure of 18 mmHg, mean pulmonary wedge pressure of 16 mmHg, and the right ventricular pressure curve demonstrated typical dips and plateaus. At surgery, there was severe adhesion between the pericardium and epicardium, and the pericardium was severely thickened and contained turbid pus. In the left thoracic cavity, there was large amount of pleural effusion and pus. Therefore, the patient was diagnosed with purulent pericarditis caused by left empyema. The thickened pericardium at the anterior portion of the heart was resected, however resection of the remaining portion was abandoned because the adhesion was so tight. After surgery, the patient underwent irrigation of the heart and left thoracic cavity by 1% povidone iodine solution and 0.5 mg/ml of imipenem for 7 days. Bacteriologic culture of the pus from the pericardium revealed anaerobic gram negative bacteria. After 4 months of antibiotics infusion, his C reactive protein became negative and the patient was subsequently discharged from our hospital.
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PMID:Purulent pericarditis presenting as an extracardiac mass in a patient with untreated diabetes. 1063 94

The case was 54-year-old male with some risks such as chronic heart failure, atrial fibrillation, and liver chirrhosis. He was admitted because of severe back pain and diagnosed as empyema by preoperative thoracentesis. By thoracoscopic procedures under local anesthesia, fibrinopurulent tissues were cleaned as much as possible and 3 of chest tubes were replaced. The final diagnosis was Bacillus cereus pyothorax by bacterial cultures of pleural effusion. Intrathoracic cavity was cleaned with physiological saline solution. The patient made favorable progress and recovered. Thoracoscopic surgery under local anesthesia with thoracic irrigation was so effective and safe methods to control the infection.
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PMID:[Usefulness of the thoracoscopic surgery under local anesthesia and irrigation for the patient with Bacillus cereus empyema; report of a case]. 1770 30

The excess production or depleted absorbtion of pleural fluid is the major mechanism of pleural effusion formation. Primary lung pathologies or pathologies that originated from the other organs can be cause of pleural effusion. The search for suitable, practical and ideal treatment is continued at the present day. We have reviewed 94 patients with pleural effusion that have been treated by 10F catheter with local anesthesia in 2007-2008. The patient with dispenea, massive effusion or reoccurrent pleural effusion have been administrated pleural catheter through 7th or 8th intercostal interspace with local anesthesia. The mean age of patients (58 male, 36 female) was 57.2 (26-94). The most common etiologic causes were primary broncho carcinoma (34 cases 36.1%), cardiac failure (11 cases 11.1%) and empyema (eight cases 9.5%). Fifty three (56.3%) have been administrated pleurodesis because of treatment failure or reoccurrence. In 19 of these cases (20.2%), pleurodesis was successful. Pleurodesis agent was talc or tetracycline according to patients pain threshold. The treatment methods of pleural effusion include thoracentesis, thoracoscopy, tube thoracostomy and catheters with permanent tunnel. The simple and small-diameter catheters are administrated easily with minimal morbidity and no mortality. It's not only used in malign effusion but also used in benign effusion. Finally, simple catheter can be first treatment choice in short-term therapy and alternative choice in long-term therapy because of it's administrating facility, effectiveness in pleurodesis and cost-effectiveness.
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PMID:[Minimally invasive approach in the pleural fluids]. 2051 32


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