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

A retrospective study of 37 patients undergoing pulmonary resection, between 1975 and 1980, was performed to establish the incidence of wound infection and to determine contributory factors. Sixteen patients had suppurative lung disease while 11 had pulmonary tuberculosis. The majority of the patients received prophylactic antibiotic (Ampicillin and Cloxacillin) given intramuscularly or intravenously, prior to thoracotomy, and continued for several days post-operatively. Twenty of the 37 cases (54%) developed wound infection, defined as any purulent wound drainage in the post-operative period. The patients with infection (group A) did not differ from those without (group B) as regards presence of pyorrhoea or haemoptysis, the duration of operation or the quantity of blood infused during surgery. A significant difference in the duration of chest intubation was identified between group A (6 +/- 1.3 days) and group B (3 +/- 1.5 days) (P less than 0.001). The implication of the results towards the modification of post-operative management of patients is discussed.
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PMID:Post-operative wound infection in thoracic patients: a preliminary report. 284 53

Nocardia organisms were cultured from the sputum of 11 patients at the central hospitals in Harare, Zimbabwe, over a 12 month period. Pulmonary nocardiosis was diagnosed in one further patient on the basis of direct microscopy. Among the nine patients available for follow up, pulmonary nocardiosis was considered to be the major clinical problem in six. The patients usually presented with a chronic pulmonary infection with fever and cough without evidence of dissemination of underlying systemic disease. The chest radiograph showed consolidation in any part of the lung, and this was seen to extend slowly over several months. Prolonged diagnostic delay was a frequent problem. Haemoptysis, alcohol abuse, and empirical treatment for tuberculosis commonly featured in the history. Treatment with sulphonamides was generally successful in those patients who complied. Nocardiosis is a treatable lung disease that may be more common in developing countries than is currently recognised.
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PMID:Nocardiosis: a neglected chronic lung disease in Africa? 306 75

Between 1953 and 1984, 53 patients (40 male and 13 female) underwent thoracotomy for treatment of pulmonary aspergilloma. The median age was 58 years (range 4 to 86 years). Either underlying lung disease or immunologic risk factors were present in 49 patients (92%). Twenty-one patients (31%) had simple aspergilloma and 32 (47%) had complex aspergilloma. The most common indication for operation was an indeterminate mass, hemoptysis, or severe cough. Lobectomy, wedge excision, and pneumonectomy were the most frequent operations. Complications occurred in 78% of patients with complex aspergilloma and in 33% of patients with simple aspergilloma (p = 0.002). Operative mortality was 5% (one death) in patients with simple aspergilloma and 34% (11 deaths) in patients with complex aspergilloma (p = 0.01). Cause of death was respiratory failure in four patients, underlying pulmonary disease in three, aspergillosis in two, and other conditions in three. At follow-up, 84% of operative survivors with simple aspergilloma were alive and well compared with 43% of those with complex aspergilloma. Although operative mortality in patients with complex aspergilloma was high, 67% of the survivors had a good long-term result in terms of absence of symptoms, but they frequently died of underlying disease. In contrast, operation in patients with simple aspergilloma was done with low risk, and approximately 90% of survivors had a good late result. Late appearance of contralateral disease did occur and argues for rigorous postoperative surveillance.
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PMID:Pulmonary aspergilloma. Results of surgical treatment. 309 24

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

A fatal case of pulmonary berylliosis in a 42 year old male is described. The patient was exposed to beryllium while working in a chemical plant over a 9 year period, and presented two years after ceasing such employment. The berylliosis was diagnosed on open lung biopsy in 1971. The patient was commenced on steriod therapy at that time. He suffered progressive dyspnoea from severe restrictive lung disease over the next 14 years. A chest X-ray of June 1985 revealed a lesion in the left upper lobe suggestive of a mycetoma. Before any therapy could be instituted he suffered a massive haemoptysis and died. Post-mortem examination revealed two large mycetomata in the right and left upper lobes. Parenchymal histology showed evidence of chronic inflammation with non-caseating granulomata and the cavity wall showed localized invasion by Aspergillus fumigatus. It is possible that the long term steroid therapy with multiple boosters of treatment may have contributed to the development of the mycetoma. This is the first case report known to the authors of a fatal aspergilloma in association with chronic berylliosis treated with steroids.
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PMID:Pulmonary berylliosis on corticosteroid therapy, with cavitating lung lesions and aspergillomata--report on a fatal case. 332 91

Six cases of leptospirosis with pulmonary complications are reported. Three cases were accompanying an hepato-nephritis due to L. icterohaemorrhagiae. The first patient died with massive hemoptysis. The second, presenting a bilateral pneumopathy predominant on the left side, recovered after plasma exchange and hemofiltration. The third case concerned a pulmonary edema complicating a vascular refilling in a shock syndrome it simply recovered. The three other cases were observed in an anicteric leptospirosis: in two cases, L. Australis was responsible; in the last, L. icterohaemorrhagiae was involved. The first patient had a radiologic picture simulating miliary tuberculosis. The second had pulmonary edema complicating a vascular refilling in a shock syndrome. The last was an acute respiratory distress syndrome, treated with artificial ventilation with penicillin therapy and corticotherapy. All these 3 patients recovered. The diagnostic, physiopathologic and therapeutic problems of these pulmonary complications of leptospirosis are discussed. The lesional nature of the pulmonary edema is proved by the low pulmonary wedge pressures observed with the Swan-Ganz Catheter.
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PMID:[Respiratory complications of leptospirosis. Apropos of 6 cases, 3 of which show hemodynamic studies]. 340 72

Three hundred and sixteen patients with cystic fibrosis were seen at the Brompton Hospital during 1965-83; 178 (56.3%) of them were male and 136 female, and their ages ranged from 12 to 51 years. Most patients presented in infancy with respiratory symptoms and malabsorption, but 19 (6%) were diagnosed in adult life, three in their 30s. Pulmonary disease was almost universal (99.7%), being responsible for 97% of all deaths and three quarters of hospital admissions. All patients had developed a productive cough by the age of 21 and over half before the age of 5. Many complained of wheezing, but reversible airflow obstruction was present in only 40% of those tested. Minor haemoptysis was very common (62%), but major episodes less so (10%). Pneumothorax was seen in 61 cases (19%), and was often recurrent. Some irreversible airflow obstruction was present in all patients with pulmonary disease. Two patients have been followed for over 20 years without showing appreciable decline in lung function. Thirty five patients (11%) had no symptoms of malabsorption. Acute meconium ileus equivalent was seen in 16% and a chronic partial obstruction with episodic symptoms in a further 19%. Diabetes mellitus developed in 36 patients, 13 of whom were insulin dependent. Hepatomegaly was common (29%), often occurring without abnormal results in biochemical tests of liver function; only 1% of patients developed portal hypertension with varices and ascites. Skin reactions to at least one common allergen, including Aspergillus fumigatus, were positive in 70%, but very few patients suffered from hay fever or eczema. One hundred and twenty one patients have died, 97% from infection or other pulmonary complications, and 195 were alive in December 1983 (mean age 23 years). Seventy eight per cent of patients were in full time education or full or part time employment, or were housewives, and only 41 were unemployed for reasons for health. Many patients are married and 10 women have borne children. Most patients were admitted to hospital only three or four times during the period of follow up and 50 individuals (16%) have never been in hospital at all. The improvement in prognosis and quality of life for adults with cystic fibrosis should encourage a positive attitude in those who care for them.
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PMID:Cystic fibrosis in adolescents and adults. 343 96

A group of 306 patients with acute pulmonary hemorrhage were evaluated by means of bronchial arteriography and treated with transcatheter embolization. Specific causes for bleeding included lung abscess, chronic pneumonia, tuberculosis, lung cancer, and bronchiectasis. In 120 patients the hemoptysis was massive, with volumes exceeding 500 ml/day. The majority (n = 225) were treated during peak hemorrhage. Embolization was performed with one of three methods: particulate embolization with polyurethane or velour, obturation with the angiographic catheter combined with peripheral embolization by means of infused albumin macroaggregates, and regional infusion of sclerosing agents. Effective hemostasis was obtained initially in 278 patients (90.8%), including 87.5% of those treated during peak hemorrhage. In 26 of 28 cases without initial response, the pulmonary artery was the source of bleeding. Recurrent bleeding, within 1-4 days, requiring surgery was observed in 39 patients with initially successful hemostasis. Of 158 patients who were treated without surgery, subsequent episodes of hemoptysis occurred in 36. Combined methods of embolization may improve the efficacy of treatment of operable and inoperable patients with lung disease complicated by hemorrhage.
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PMID:Transcatheter embolization in the management of pulmonary hemorrhage. 356 15

Nine cases of rheumatoid arthritis with pleuropulmonary involvement illustrate the most common pulmonary symptoms of this disease: rheumatoid pleurisy, interstitial pneumopathy, pulmonary rheumatoid nodules and bacterial pleuropulmonary infections. Each of these pleuropulmonary manifestations may precede the joint disease and cause considerable diagnostic difficulties. Rheumatoid pleural effusion displays an interesting pathognomic constellation: low glucose- and elevated lactate-dehydrogenase concentration, acid pH, often pathologic C1q-binding assay, and characteristic cytomorphology of the pleural fluid. Interstitial pneumopathy is usually mild and slowly progressive. Additional spirometric tests to determine ventilation disturbances sometimes demonstrate airway obstruction. Lower-airway obstruction is probably not caused by the disease itself but may be due to other risk factors (eg cigarette smoking). Depending on their localization, intrapulmonary nodules may lead to severe complications (hemoptysis, bronchopleural fistula, pneumothorax, abscess formation). The possibility of pleuropulmonary infection must always be kept in mind as patients with rheumatoid arthritis have a higher susceptibility to infection.
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PMID:[Pleuropulmonary manifestations in chronic polyarthritis]. 356 53

The fiberoptic bronchoscope became commercially available nearly 20 years ago. This instrument has revolutionized the practice of respiratory medicine by providing the biggest single advance in diagnostic techniques for the chest in recent years. Its use is now widespread, and it has largely superseded the rigid bronchoscope. However, it is still preferable to use the rigid instrument for the investigation of suspected tracheal tumors, removal of foreign bodies and inspissated mucous plugs, for the management as opposed to the investigation of hemoptysis and, arguably, for the biopsy of vascular tumors such as adenomas. Radiologists should be aware of the uses and limitations of fiberoptic bronchoscopy, the relevance to management and diagnosis of abnormalities visible on the chest radiograph and computed tomography, and the complementary role it plays with other biopsy techniques that are used for the diagnosis of focal and diffuse lung disease.
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PMID:Fiberoptic bronchoscopy in thoracic diagnosis. 359 50


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