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Query: UMLS:C0019079 (hemoptysis)
 6,129 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Five-thousand portable or posterior-anterior-lateral radiographs of acute care emergency department patients were interpreted. They revealed serious disease in 35% of patients with chest symptoms, in 27% of all patients examined, and in 18% of patients with noncardiorespiratory symptoms. The highest incidence of abnormal radiographs (42%-79%) occurred in patients with symptoms of congestive heart failure, dyspnea, hemoptysis, dysrhythmia, and hypertension. Asthma (14%) and trauma (5%) presented the lowest incidence of significant findings. Radiographs of patients suspected of having pneumonia were abnormal in 25% of cases, and in those patients with either cough or fever alone, the incidences of pneumonia were 13% and 18%. Whereas 24% of patients with dyspnea alone had radiographic findings of congestive heart failure, 52% of those with congestive heart failure diagnosed on clinical grounds had abnormal radiographs. The chest radiograph continues to be a significantly important examination in the diagnosis of disease, the prevention of overtreatment, and the redirection of clinical investigation in the acute care emergency department unit.
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PMID:Five thousand acute care/emergency department chest radiographs: comparison of requisitions with radiographic findings. 317 Nov 20

An accidental rupture of the pulmonary artery in a 77 year old female patient is reported. She was admitted for total mastectomy, but her past medical history revealed an old myocardial infarct, treated arterial hypertension and asthma. She was under heparin as well for her varicose veins. Her clinical examination revealed a patient in mild chronic heart failure. It was therefore decided to carry out invasive monitoring during surgery and the recovery period. A Swan-Ganz catheter was put up. Its progression was controlled by looking at the pressure curves. Several attempts were made to obtain a wedge pressure, with no success. During these attempts, the patient developed a cough followed by massive haemoptysis. Despite adequate resuscitative measures, the patient died before a surgical procedure could be attempted. Postmortem examination showed the rupture to be 9 cm away from the origin of the pulmonary artery. This unfortunate accident confirmed that the following three factors, all present in this patient, should call for extreme care in the setting-up of Swan-Ganz catheters: age greater than 60 years, pulmonary arterial hypertension and anticoagulant therapy.
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PMID:[Perforation of the pulmonary artery during the insertion of a Swan-Ganz catheter]. 320 33

We report a patient who developed asthma associated with exposure to cats. During his evolution he presented pulmonary infiltrates accompanied by eosinophilia in blood and sputum, hemoptysis and flu-like symptoms. The sera contained specific IgE and precipitating antibodies to cat epithelium. After a year without contact with cats, precipitating antibodies were negative, and a bronchial provocation test only demonstrated an immediate response.
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PMID:Cat sensitization provoking asthma and pulmonary infiltrates with eosinophilia. 322 49

Two cases are reported in which a denture fragment was lodged in the bronchus for a period of six years. Bronchial asthma which did not worsen immediately after inhalation and other misleading factors made the diagnosis more difficult in the first case, whilst the respiratory symptoms in the second case appeared only 4 years after inhalation. Haemoptysis 2 years later led to a bronchoscopy and the removal of the foreign body.
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PMID:Long-term presence of a denture fragment in the airway (a report of two cases). 327 45

A 17-year-old girl developed fever, cough and hemoptysis, as well as bouts of septic fever, dyspnea on exertion, cyanosis and weight loss. Opacification in the left lower lung was a persistent feature. Complement-fixation reaction to Aspergillus fumigatus was 1:80, and there were four precipitation lines against this fungus on immunoelectrophoresis. Aspergilli were also demonstrated in sputum and bronchial aspirate. Because the patient's condition deteriorated an atypical lingula resection was performed and cortisone treatment begun postoperatively. Subsequently all abnormal findings disappeared and the patient was cured. Two subsequent exposures to Aspergillum on the parental farm produced high fever, cough, dyspnea and thoracic pain. Histological examination of the lingular specimen revealed bronchocentric granulomatosis. In this case it was the rarely occurring morphological manifestation of an allergic bronchopulmonary aspergillosis without bronchial asthma.
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PMID:[Bronchocentric granulomatosis as a manifestation of allergic bronchopulmonary aspergillosis without bronchial asthma]. 359 64

The recognition of aspergillus in all its clinical disguises remains a challenge to clinicians in all fields of medicine. Fortunately, aspergillus has low pathogenicity for humans and requires very heavy inoculum of spores (aspergillary pneumonitis) in order to infect those whose pulmonary defense mechanisms, inherent structure, and physiology are intact. Patients with problems from aspergillus may be seen in either inpatient or outpatient clinical practice. The patient with fibrotic or cavitary lung disease finds himself at risk to be colonized and develop an aspergilloma (fungus ball). Conservative therapy (that is, antibiotics, pulmonary hygiene) or simple observation is often all that is required. With significant hemoptysis, surgical removal could be definitive treatment; but these patients often have such compromised pulmonary function that alternative therapies like infusion of antifungal agents locally are tempting. Part of the problem of the patient with asthma or COPD may actually be secondary to hypersensitivity to aspergillus (ABPA), which exacerbates bronchospasm and adds "pulmonary infiltrates" to the underlying disease. The recognition of this entity and then the judicious use of corticosteroids to control the symptoms will stabilize the clinical course of the disease. The immunocompromised patient may be relatively free of pulmonary disease.; but aspergillus, waiting until cytotoxic agents, corticosteroids, granulocytopenia, broad-spectrum antibiotics, and previous pneumonias destroy the local lung defense mechanisms, will then attack with a vengeance. The resultant invasive pulmonary aspergillosis requires treatment with amphotericin B, along with its own inherent toxicity.
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PMID:The many faces of pulmonary aspergillosis. 389 65

The results of bronchography in 96 consecutive patients investigated for haemoptysis at Papworth Hospital from 1975 to 1983 were reviewed. None of the patients included in this study gave a history suggestive of bronchiectasis and neither chest radiography nor fibreoptic bronchoscopy had shown a cause for the bleeding. Bronchography was performed through the fibreoptic bronchoscope and all included in the study showed both lungs adequately. The chest radiographic appearances were compared with the bronchographic findings. Seven of 12 patients with appearances suggesting old fibrosis showed bronchiectasis, as did eight of 10 with radiographic appearances suggestive of bronchiectasis. Eleven out of 74 patients with normal chest radiographs, however, also showed bronchiectasis. This group of 11 was compared with the other 63 but no clinical feature was found to be significantly associated with the presence of bronchiectasis. Although bronchography is now rarely used in the investigation of haemoptysis, this high yield (15%) of bronchiectasis indicates that its use should be reappraised. Follow up of the patients indicated that bronchography was not reliable at diagnosing peripheral bronchial carcinomas, which became evident later in two cases, and that asthma was present in 15 (24%) of the 63 patients with both normal chest radiographs and normal bronchograms.
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PMID:Does bronchography have a role in the assessment of patients with haemoptysis? 406 Jan 7

Gastroesophageal reflux (GER) is a functional entity which is defined as "the involuntary reflux of the gastric contents in the oesophagus, without vomiting and without the involvement of either the gastric, abdominal or diaphragmatic muscles". It is therefore a question of a syndrome which is independent of the anatomical abnormalities in the cardio-tuberositic region (i.e. hiatal hernia). It may also show itself through digestive symptoms, thoracic pains, ENT symptoms and breathing complications. The presence of the latter has been clearly established in certain circumstances: --in infants, GER can cause obstructive apneas, which are responsible for sudden inexplicable deaths (SID): GER and SID have very similar epidemiological characteristics; polygraphic recordings showed that a reflux may immediately precede the onset of obstructive apnea; the instillation of 0.1 N hydrochloric acid in the oesophagus of children with GER causes an apnea. Medical or surgical treatment of the reflux prevents the recurrence of these accidents; --in adults, and older children, GER is responsible for coughs, recurring bronchopneumopathies and asthma; long-term recordings of the oesophageal pH have proved that there is a time-relationship between the two events. Scintigraphic studies have shown the pulmonary contamination by a radioactive isotope placed in the stomach the previous evening. GER has been equally suspected for conditions such as lung abscess, bronchiectasis and hemoptysis, but here it is more difficult to prove. With certain pulmonary fibroses, histological lesions have been compared with those observed during inhalation bronchopneumopathies, but it is difficult to establish a link with a reflux; --functional respiratory studies have not produced a specific functional entity for patients with GER; --careful medical treatment or surgical correction of GER lead to the sedation of respiratory symptoms (RS) in the majority of cases; --the association frequency of a GER and of RS is difficult to establish because of the diversity of the means of diagnosis employed in the past and also because of the heterogeneity of the studied populations, but the frequency is nevertheless high, indeed significantly higher than the prevalence of GER in the general population. The mechanisms which link GER and RS are not well known: first of all, there is the failure of normal antireflux mechanisms and also certain hormonal, alimentary (coffee, alcohol, tobacco, etc.) and therapeutic (theophylline, betamimetics) factors, which facilitate the reflux.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Gastroesophageal reflux and pulmonary disease]. 636 Feb 60

A 47-year-old man with a history of mild asthma presented with hemoptysis attributed to a large multiloculated cavitary mycetoma. Peripheral blood eosinophilia of 43 percent led to the diagnosis of allergic bronchopulmonary aspergillosis (ABPA). Treatment of ABPA with prednisone led to resolution of an upper lobe infiltrate and a dramatic reduction in the total serum IgE level. Evaluation over a two-year period did not demonstrate enlargement of the cavity or disseminated aspergillosis.
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PMID:Allergic bronchopulmonary aspergillosis and aspergilloma. Long-term follow-up without enlargement of a large multiloculated cavity. 669 Feb 37

The clinical and immunologic features of ten patients with allergic bronchopulmonary aspergillosis (ABPA), observed over periods varying from 12 months to 10 years, are reported. Acute attacks of ABPA were characterized by several, or all of: increased cough and sputum, haemoptysis, pleuritic pain, expectoration of sputum plugs, and increasing airways obstruction. Peripheral blood eosinophilia and acutely elevated serum IgE levels were seen in all patients during acute attacks, sputum eosinophilia and recovery of Aspergillus in sputum was less common. However, blood eosinophilia was not present in all attacks of ABPA and sputum eosinophilia varied similarly from one attack to another. Six patients with previously documented multiple precipitin lines have had no demonstrable precipitins to Aspergillus on several occasions between attacks, three of these patients have also been negative during attacks. Five of the six patients have again developed positive precipitin lines. The total number of episodes in these ten patients was fifty two, three patients have had more than nine acute attacks of ABPA. There is no seasonal variation in this group of patients. Since diagnosis, only three patients have had an attack-free interval longer than 12 months. Two patients are steroid-dependent because of severe asthma, and nine have symptoms of bronchiectasis.
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PMID:Experience with allergic bronchopulmonary aspergillosis: some unusual features. 669 71


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