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

1. Laennec's lung disease lasted for at least 20 years. Its stigmata included chronic cough, sputum production and intermittent wheeze. 2. Laennec had long term stigmata commonly associated with chronic bronchiectasis, sinusitis, physical frailty, and short stature (5ft 2in). 3. Chronic diarrhoea of at least 20 years duration is not strongly associated with tuberculosis. 4. During Laennec's last illness his physicians equivocated as to whether he had respiratory disease at all. Bronchial breathing at the apex, if indeed present, could have been caused by compensatory emphysema secondary to middle lobe bronchiectasis rather than to active tuberculosis. 5. Laennec did not have haemoptysis in his final illness. 6. Laennec's last illness, a wasting illness characterised by intermittent fevers, cardiac murmur, and persistent tachycardia followed a dental manipulation. The painful "abdominal abscess" noted by Laennec's colleagues may actually have been splenomegaly. These features suggest endocarditis. The cardiac murmurs associated with pulmonary hypertension secondary to bronchiectasis are not usually audible at a remote distance from the patient. Endocarditis was a disease largely unknown to physicians of the early 19th century before Osler clarified its pathology in the 1880s.
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PMID:Rene Laennec: his brilliant life and tragic early death. 266 72

Once regarded as a disease of infants and young children, cystic fibrosis now also must be considered a disease of adolescents and young adults. Disease complications and management, including hemoptysis, pneumothorax, sinusitis, pancreatic deficiency, and intestinal obstruction, are discussed in this review. In addition, a practical approach to the clinical evaluation, follow-up, and treatment of the older cystic fibrosis patient is presented for the physician who has not had extensive experience in managing these patients. Current research in identifying the CF gene, basic defect, and the use of heart-lung transplants is discussed.
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PMID:Cystic fibrosis in adults: diagnosis and management. 332 53

Eleven patients with Wegener's granulomatosis were seen at this Institute over a period of 20 years. There were six men and five women. The average age of presentation was 38.3 years, and the mean duration of symptoms was 10.5 months. Constitutional symptoms (82%), cough (82%), ocular symptoms (64%), arthralgias (55%), rhinorrhoea (55%), haemoptysis (45%), nasal granuloma (45%), otorrhoea (36%), sinusitis (36%), skin lesions (27%), and renal failure (27%) were the clinical manifestations encountered. All patients had an elevated ESR, and 55% had leucocytosis. Proteinuria and haematuria were observed in 64% and 55% respectively. Chest radiographs were abnormal in 82%. In four patients the disease had a fulminant course and the patients died before adequate treatment was given. Two patients received corticosteroids alone and have since been lost to follow up. Five (45%) received adequate cytotoxic therapy and have done well for 8-46 months (mean, 24.8 months) after diagnosis. Wegener's granulomatosis in India is apparently similar to that seen elsewhere, but the high incidence of tuberculosis interferes with early diagnosis and treatment.
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PMID:Wegener's granulomatosis in north India. An analysis of eleven patients. 343 65

Cystic fibrosis is the most common fatal inherited disease of Caucasians. At present, cystic fibrosis accounts for most cases of chronic progressive pulmonary disease and for many other clinical features in the first three decades of life. Thus, it is a challenge to both pediatricians and internists, particularly chest physicians. The diagnosis is based on the triad of chronic obstructive pulmonary disease, pancreatic insufficiency, and increased levels of electrolytes in the sweat. The cardinal test for confirmation of the diagnosis is the "sweat test," which is an excellent discriminant for cystic fibrosis, even in adults. Ancillary features of cystic fibrosis may be of diagnostic assistance (eg, nasal polyposis, Pseudomonas aeruginosa in sputum, azoospermia, and others). Treatment of the pulmonary disease must be emphasized. Choice of antibiotics should be based on the results of sputum culture, but P aeruginosa is the most common pathogen. Removal of secretions by regular postural drainage and percussion is an integral part of the program. Pneumothorax, massive hemoptysis, cor pulmonale, and other complications may be encountered. Sinusitis is almost universal, and nasal polyposis is frequently present. Pancreatic insufficiency occurs in over 80 percent of the patients with cystic fibrosis and may result in intestinal malabsorption. Massive salt loss through the sweat in hot weather, a distinctive type of biliary cirrhosis without jaundice, gallbladder abnormalities, cholelithiasis, and diabetes mellitus also may be found. Of special importance are intestinal obstructive complications (meconium ileus in newborn infants with cystic fibrosis and intestinal obstruction due to fecal accumulation or intussusception in adults). Azoospermia is present in 95 percent of men and there is reduced fertility in women; however, pregnancy does occur in cystic fibrosis. This chronic and ultimately fatal disease produces a predictable set of psychosocial complications.
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PMID:Diagnosis and treatment of cystic fibrosis. An update. 637 70

Cystic fibrosis (CF) is the most common serious genetic condition in the White population groups. Thirty-three White patients (mean age 20 years, range 14-32 years) seen at an adult CF clinic at the Johannesburg Hospital between January 1980 and January 1983 are reviewed. All had elevated sweat chloride levels. There was a family history of CF in 45,5% of the cases. Most were of normal height but significantly underweight. Chronic obstructive pulmonary disease was present in 94% of the patients. Pulmonary infections played a major role in both symptomatic exacerbations and progressive lung disease. Most frequently, mucoid Pseudomonas aeruginosa and/or Staphylococcus aureus were cultured from the sputum. The management of infective exacerbations is discussed. Other respiratory complications included cor pulmonale, haemoptysis, recurrent pneumothorax and sinusitis. Chest radiographs and pulmonary function tests are also analysed. Gastro-intestinal complications included pancreatic exocrine insufficiency (94%), intestinal obstruction, cholelithiasis, and liver disease. Insulin-dependent diabetes occurred in 9%. Five pregnancies were recorded in 4 patients. By January 1983 there had been 7 deaths (mean age 19,4 years). Most of the patients are highly motivated, with few psychological problems, and appear to be well-functioning and integrated members of society.
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PMID:Experience at an adolescent and adult cystic fibrosis clinic. An analysis and overview. 671 Feb 79

The objectives of this study were to determine the risk for coughing as an adverse reaction to angiotensin converting enzyme (ACE) inhibitors under everyday circumstances in a large population and to study whether this adverse effect is more common in women. A population-based case-control study was used. The study was set in the practices of 161 Dutch general practitioners (GPs), in which all consultations, morbidity, mortality, medical interventions and prescriptions were registered during 4 consecutive 3-month periods in 4 consecutive groups of 40-41 GPs. The subjects were 2436 patients with incident coughing and up to 3 controls per case were obtained (total group: 7348 controls), matched for GP and a contemporary consultation in the same 3 months. All cases and controls were 20 years or older and had no notification of respiratory infections, influenza, tuberculosis, asthma, chronic bronchitis, emphysema, congestive heart failure, sinusitis, laryngitis, haemoptysis or respiratory neoplasms during the 3-month period. The results showed that cases were 3.6 times as likely as controls to have been exposed to ACE inhibitors (95% CI: 2.4-5.5) but after adjustment for potential confounders the odds ratio was 2.5 (95% CI: 1.6-3.9). The crude odds ratio for males was 2.7 (95% CI: 1.4-5.1) and for females 4.2 (95% CI: 2.4-7.5). The adjusted odds ratio for males was 1.8 (95% CI: 0.9-3.5) and for females 2.7 (95% CI: 1.5-4.8).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Angiotensin converting enzyme inhibitor associated cough: a population-based case-control study. 776 16

From 1983 to 1991 only isolated cases of aspergillosis in AIDS patients were reported; since 1991, an increasing number of cases have been reported suggesting a recent emergence of this fungal infection. Aspergillosis occurs about 10 to 25 months after AIDS diagnosis in patients with CD4 below 50/mm3. Neutropenia and/or steroid therapy, which are known as predisposing factors in aspergillosis, are noticed in about one half of the patients. Previous pulmonary infection, especially pneumocystosis, are very common. Clinical signs are typical of an invasive pulmonary aspergillosis: constant fever, cough, dyspnea, frequent thoracic pains and haemoptysis. Radiologic signs frequently indicate an interstitial infiltration. Nodular and cavitating lesions, pleural effusions, thoracic lymph node enlargement are often present. Diagnosis procedures are realised on bronchoalveolar lavage by direct examination, culture and antigen detection. Aspergillus fumigatus is the most usually species detected. Post-mortem diagnosis is frequent. Invasive bronchial aspergillosis, localised infections (aspergilloma, otitis, sinusitis) or disseminated infections (nervous system, heart, kidney, lymph nodes, thyroid) are also described. Prognosis is poor even with treatment (amphotericin B or itraconazole). An earlier diagnosis and treatment of the bronchial colonization could probably improve this prognosis.
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PMID:[Aspergillosis in acquired immunodeficiency syndrome]. 787 56

Wegener granulomatosis is characterized by focal necrotizing granulomatosis of the upper respiratory and pulmonary tracts, by a necrotizing vasculitis and focal necrotizing glomerulonephritis. Clinical symptoms typically include intractable sinusitis or persistent nasal obstruction, serous otitis media, hemoptysis and pleurisy. These symptoms can also be accompanied by intermittent fever, weight loss, myalgia and sensory neuropathy. The oral lesions, including palatal ulceration, lingual ulceration, aphthae, nonhealing extraction sockets, gingivitis, have been infrequently described. Wegener's granulomatosis occasionally presents in the early stages as a characteristic hyperplastic gingivitis, named by the authors "strawberry gums", which fails to respond to conventional periodontal therapy. A case is reported, in which this clinically distinctive gingivitis was the presenting lesion with the serous otitis, illustrating that less frequently occurring entities, such as Wegener's granulomatosis, should be considered in the differential diagnosis of localized gingival lesions which fail to respond to conventional therapy.
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PMID:[Wegener's syndrome (or granulomatosis). A clinical case]. 816 31

A 23-year-old male presented with bilateral sclerokeratitis. He reported recent bronchitis, sinusitis, dyspnea on exertion, hemoptysis, arthralgias and myalgias. Wegener's granulomatosis was diagnosed by a positive antineutrophil cytoplasmic autoantibody (ANCA) test and a nasal and subglotic biopsy showing granulomatous inflammation. Treatment with cyclophosphamide, systemic corticosteroids and trimethoprim/sulfamethoxazole resulted in resolution of the sclerokeratitis and remission of the disease.
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PMID:Wegener's granulomatosis presenting with sclerokeratitis diagnosed by antineutrophil cytoplasmic autoantibodies (ANCA). 848 70

A 20-year-old male was admitted with fever and hemoptysis. Agammaglobulinemia was found, with bronchiectasis and sinusitis. Clinical and laboratory evidence included immunological examinations, bone marrow and small intestinal biopsies. Results suggested a diagnosis of X-linked agammaglobulinemia. After treatment with antibiotics and intravenous human immunoglobuline, the clinical symptoms demonstrated progressive improvement. The case is reported along with a review of the literature.
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PMID:X-linked agammaglobulinemia: a case report. 885 85


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