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

The various forms of bronchoplastic and angioplastic procedures are the best means of avoiding pneumonectomy. Essential indications are limited respiratory reserve and central site of a malignancy. In a retrospective study 248 broncho- and angioplastic operations carried out in the years 1973 to 1983 were analyzed. Reference date for the analysis of survival was January 1986. In consequence the minimum period of follow-up was two years. For all patients (n = 248) the 5-year-survival was 22% with a 30-day-lethality of 13%. The 5-year-survival of all bronchial sleeve resections operated radically (stage I and II of the TNM-classification) (n = 44) was 42% with a 30-day-lethality of 7%. The 5-year-survival of all bronchoplastic operations of stage I and II (n = 88) was 38% with a 30-day-lethality of 14%. Improved suture material and surgical techniques caused a reduction of operative lethality from 23% to 8% during the described period. In the first thirty postoperative days the following complications caused death: Hemoptysis (n = 5), insufficiency of the anastomosis (n = 3), right heart failure (n = 5), pulmonary embolism (n = 4) and sepsis (n = 1).
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PMID:[Bronchoplastic and angioplastic operations in bronchial carcinoma]. 282 31

The authors report a case of broncho-pulmonary squamous cell carcinoma developed in a 59-year old woman who for 11 years had been suffering from systemic scleroderma for which she never consulted. The carcinoma was revealed by haemoptysis, dyspnoea and weight loss. It extended secondarily to the pleura. The authors have reviewed the literature on non-alveolar squamous cell carcinoma. They conclude that this type of cancer is rarely diagnosed before death and has a very poor prognosis.
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PMID:[Combination of scleroderma and non bronchiolo-alveolar bronchial carcinoma. Report of a case and short review of the literature]. 285 Nov 61

The case histories of the 49 patients who died in a series of 165 patients admitted to the Medical Unit between 1958 and 1984 with polyarteritis nodosa (PAN) were reviewed. The causes of death of the 29 men and 20 women, mean age 51.44 +/- 7.4 years, were classified into 6 groups. Infection accounted for 26.5% (13/49) of deaths, the initial site of infection being pulmonary, complicated by septicaemia in 6 cases. Cardiovascular events were responsible for death in 24.4% (11/49): terminal cardiac failure (4 cases), myocardial infarction (1 case), ventricular tachycardia (1 case), stroke (1 case), pulmonary embolism (2 cases), fulminant hemoptysis (1 case). Gastrointestinal complications were the cause of death in 16.3% (8/49): ischemic necrosis (5 cases), acute pancreatitis (2 cases), oesophageal ulceration (1 case). Renal failure was observed in 10.2% (5/49), all occurring before 1972: acute renal failure (3 cases), chronic renal failure (2 cases). Cancer was the cause of death in 10.2% (5/49): primary bronchial carcinoma (2 cases), laryngeal carcinoma (1 case), carcinoma of the vulva (1 case), bone metastases (1 case). Finally, 14.2% (7/49) could not be classified in the preceding groups. Sudden death occurred in 3 patients, shock in 1 patient, multivisceral PAN in 2 patients and anaphylactic shock in 1 patient. Three of the 12 patients who had post-mortem studies had signs of progressive vasculitis. The results are compared with other reports in the literature and the pathogenic mechanisms are discussed. The infections and cardiovascular deaths occurred early or late and were not related to the state of the activity of the vasculitis. Immunosuppressive treatment seems to play an important role in their pathogenesis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Causes of death in systemic vasculitis of polyarteritis nodosa. Analysis of a series of 165 patients]. 290 28

Opinion has been divided as to the benefit of bronchoscopy in cases of haemoptysis but normal chest radiograms. In this study such patients were compared with a reference group of haemoptysis patients with X-ray changes. Of the former group 44 underwent bronchoscopy, but after a follow-up of 57 months malignancy has been found in only one case, as compared with a malignancy rate of 47 per cent in the reference group. Thus it is concluded that bronchoscopy is to be recommended in cases of haemoptysis and X-ray changes, whereas non-invasive investigation should suffice in patients under 40 years of age and without X-ray changes, though the risk of malignancy increases with age, particularly in smokers and ex-smokers.
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PMID:[Benefits of bronchoscopy in hemoptysis and normal pulmonary X-rays in patients over 40 years of age]. 292 7

Trimetrexate glucuronate (TMTX) is a methotrexate (MTX) analog that is active against transport-deficient MTX-resistant tumor cells. We performed a phase I study of TMTX administered by daily bolus for 9 consecutive days since this schedule is one of the most active in experimental murine tumor models. The drug was administered in this fashion every 4 weeks for at least two cycles. Fifteen patients with refractory metastatic cancers were studied and all had received prior chemotherapy. The dose-limiting toxicity was a rapidly reversible thrombocytopenia first seen at a daily dose of 4.0 mg/m2 which occurred 7 days after the end of TMTX administration. There was great inter- and intrapatient variability in the platelet nadirs observed in the six patients treated at 4.0 mg/m2. One patient died of massive hemoptysis during a platelet nadir at that dose level. Granulocyte counts never dropped below 1500/mm3. Only one patient had significant non-hematological toxicity: a radiation recall skin toxicity along with a self-limited maculopapular rash. One patient with melanoma and lung metastases treated at 4.0 mg/m2 had a partial response. TMTX plasma levels were measured by HPLC every 3 days prior to daily dosing in patients receiving 4 mg/m2 to determine whether drug accumulation occurred during this prolonged administration schedule. Nadir drug levels varied from less than 0.02 to 0.35 microM and did not seem to increase during the 9-day schedule in individual patients. By comparison with other phase I trials, the hematologic toxicity of TMTX seems to be schedule-dependent, with less drug being tolerated and more severe thrombocytopenia observed with more protracted treatment protocols. A firm phase II starting dose for daily bolus X 9 schedules is difficult to recommend in view of the variable toxicity observed in the patients treated at 4.0 mg/m2 daily, who, in addition, had all been extensively pretreated. A reasonable starting dose might be 3.0 mg/m2 daily with built-in dosage increases or decreases.
Cancer Chemother Pharmacol 1987
PMID:A phase I study of trimetrexate, an analog of methotrexate, administered monthly in the form of nine consecutive daily bolus injections. 295 89

The authors identified all newly diagnosed lung cancer cases in New Hampshire and Vermont for the period 1973 through 1976 and abstracted clinical data on presenting symptoms and findings from their hospital records. Microscopy slides were also reviewed, when possible, to confirm cell type. The most frequent presenting symptoms were weight loss (46%) and cough (45%). Other common symptoms were dyspnea (37%), weakness (34%), chest pain (27%), and hemoptysis (27%). The presence of symptoms and findings was in general related to disease stage but bore little relationship to cell type. These results differ from those of previously reported case series that were based on surgical, radiation therapy, or Veterans Hospital groups, but the current data agree closely with those from another population-based series in Finland.
Cancer 1985 Oct 15
PMID:Presenting conditions of 1539 population-based lung cancer patients by cell type and stage in New Hampshire and Vermont. 299 57

A total of 3 patients with germ cell cancer had pulmonary emboli while receiving cisplatin-containing chemotherapy. In addition to cisplatin, 1 patient was receiving etoposide plus doxorubicin, 1 vinblastine plus bleomycin and 1 etoposide plus bleomycin at the time of the vascular event. One patient died of cardiovascular collapse, while the other 2 presented with severe shortness of breath, hemoptysis and pleuritic chest pain. A review of vascular complications of cisplatin-containing chemotherapy is presented. Awareness and early recognition of pulmonary emboli in patients receiving these chemotherapeutic agents may minimize treatment-related morbidity and mortality.
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PMID:Pulmonary emboli as a complication of germ cell cancer treatment. 303 37

The clinical manifestations, predisposing factors, and diagnostic approach to 29 young men and 35 elderly men with pulmonary tuberculosis admitted to a Veterans Administration hospital were compared. Elderly men had a higher number of underlying conditions such as atherosclerosis, previous gastrectomy, and malignancy, whereas alcoholism was more prevalent in the younger group. The classic symptoms and signs of tuberculosis were noted in a significantly higher proportion of the younger group: fever (62 percent versus 31 percent), weight loss (76 percent versus 34 percent), night sweats (48 percent versus 6 percent), sputum production (76 percent versus 48 percent), and hemoptysis (40 percent versus 17 percent) (p less than 0.05). Abnormal mentation was more common in the elderly group (31 percent versus 10 percent) (p less than 0.05). Radiographic findings were similar in both groups. Mortality related to tuberculosis was 20 percent in elderly men versus 3 percent in the younger men (p less than 0.05). Tuberculosis is frequently not considered in the differential diagnosis when elderly patients present with multiple medical problems and nonspecific complaints. Since there are differences in the clinical presentation and the outcome of pulmonary tuberculosis in elderly patients, a high index of suspicion for the disease should be maintained.
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PMID:Pulmonary tuberculosis in elderly men. 310 41

We reviewed the clinical outcome of 58 patients with hemoptysis associated with either a hematologic or solid malignancy. Pulmonary hemorrhage causing death (fatal hemoptysis) occurred in 36 percent of these patients. Fatal hemoptysis occurred in six of eight patients with a hematologic malignancy and a fungal pneumonia. Examination of pathologic specimens from five of these patients revealed fungal invasion of blood vessels. An inflammatory response was absent in three, suggesting that granulocytes are not required for fungal-induced tissue destruction. In patients with a bronchogenic tumor, fatal hemoptysis occurred in six of seven patients with a necrotic squamous cell carcinoma. In contrast, hemoptysis was fatal in only two of ten patients with metastatic lung disease. We conclude that hemoptysis in cancer patients with a fungal pneumonia is an ominous sign that may warrant aggressive interventions to prevent a fatal complication.
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PMID:Factors associated with fatal hemoptysis in cancer patients. 318 Aug 51

Only a small fraction of sudden unexpected deaths are caused by neoplastic disease and thus subject ot medicolegal autopsy. The medicolegal autopsy forms an opportunity to study not only medically diagnosed and treated neoplasms, but also the natural evolution of untreated disease. In a series of 7,020 consecutive medicolegal autopsies in northern Sweden, we found 171 cases with malignant and/or intracranial neoplasms. In 41 cases, sudden death was caused by previously unknown tumors. The most common mechanisms of death in this group were disseminated cancer, intracranial tumors, pulmonary thromboembolism, hemoptysis, and aspiration of blood, and the most common locations were the bronchi and the lung. In some of these cases, the mechanism was sometimes dramatic, raising a question of violent death or intoxication. In 30 cases, sudden unexpected death was caused by previously known tumors, and also in this group disseminated cancer was the most common cause of death, and the most common locations were the bronchi and the lung. In 22 cases, tumors were found suicidal cases; in 14 of these, the tumor was considered to be a major causative factor to the suicide, while in eight cases the tumor was considered to be an incidental finding. The expected number of cancers in the 1,060 suicides investigated in this series was 27, according to the official cancer prevalence data. Thus, a possible over-representation of suicides among persons with cancer seems doubtful and needs further exploration.
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PMID:Neoplastic disease in a medicolegal autopsy material. A retrospective study in northern Sweden. 318 71


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