Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019079 (hemoptysis)
 6,129 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

From 1984 to 1993, 48 thoracoabdominal aortic aneurysm resections were performed. The patient age ranged from 21 to 79 years (mean: 65.5 years), and the extent of the aneurysms were as follows: type I (most of descending and upper abdominal), 17 cases; type II (most of descending and most of abdominal), 3 cases; type III (distal descending and upper abdominal), 20 cases; and type IV (most or the entire abdominal aorta), 8 cases. Ten patients presented with ruptured aneurysms, 1 with hemoptysis, 20 with pain, and 20 with no symptoms. Operation was performed using simple aortic cross-clamping in 18 patients, distal perfusion via Gott shunt in 6, and heparinless left-heart bypass (Biomedicus pump) in 24. Intercostal or lumbar vessels were reimplanted into the graft in 13 patients. Aortic cross-clamp time was 25 to 115 minutes (mean: 49.6 minutes). Four of 10 patients (40%) with ruptured aneurysms and 3 of 38 (8%) patients with non-ruptured aneurysms died. Serious complications included paraparesis in 2 patients (5%), renal failure requiring dialysis in 2 (5%), stroke in 1 (2%), bleeding in 5 (12%), intraoperative cardiac arrest in 3 (7%), sepsis in 1 (2%), prolonged ventilation (longer than 3 days) in 11 (27%), and wound dehiscence in 2 (5%). Thoracoabdominal aneurysm resection remains a challenging problem but can be performed with acceptable risk in selected patients. Distal heparinless perfusion without a heat exchanger may help reduce the risk of paraplegia and renal failure.
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PMID:Experience with thoracoabdominal aortic aneurysm resection. 818 36

Between March 1982 and June 1992, 17 patients (age: 21-76 years) were diagnosed with pseudoaneurysm of the thoracic aorta (PTA). Four PTAs developed post-trauma while 13 developed after aortic or cardiac surgery. Unusual presentations included: dyspnea, hoarseness, dysphagia, massive hemoptysis (2 degrees to aortobronchial fistula), massive hematemesis (2 degrees to aorto-esophageal fistula), superior vena cava syndrome, paralyzed right hemidiaphragm, and herald bleeding from the sternotomy. The interval between initial operation and recognition of PTA varied from three months to eight years while the four posttraumatic PTAs presented 5 to 26 years postinjury. The sites of postoperative PTA were: the aortotomy (3), proximal vein graft anastomosis (4), aortic cannulation site (2), and distal anastomosis of ascending aortic graft replacement (4). Aortography was very sensitive, outlining the false aneurysm in 13/13. Five patients had transesophageal echo-cardiography with one false negative. Seven patients died (41%), three from postoperative PTAs from massive hemorrhage intraoperatively and four from sepsis and multiorgan failure following repair. We conclude that patients who have previously had aortic or cardiac surgery or a history of blunt chest trauma presenting with unusual cardiorespiratory symptoms should be aggressively evaluated for PTA. Due to the magnitude of the operative problems encountered, repair of PTA is associated with a significantly high rate of mortality.
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PMID:Pseudoaneurysms of the aorta after cardiac surgery or chest trauma. 825 35

A 69-year-old alcoholic man with pneumonia and sepsis due to Aeromonas hydrophila is presented. He died of suffocation by a copious amount of hemoptysis six hours after his first symptoms of abdominal pain, diarrhea and dyspnea. Aeromonas hydrophila was isolated from blood and bronchial secretion. A fulminant form of pneumonia could develop in patients with predisposing underlying conditions such as alcoholism with chronic hepatitis and diabetes mellitus. Aeromonas hydrophila pneumonia may be characterized by hemoptysis and rapid clinical deterioration with a high mortality rate.
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PMID:Fulminant pneumonia and sepsis due to Aeromonas hydrophila in an alcohol abuser. 879 58

Vinorelbine, docetaxel and cisplatin have documented single-agent activity in non-small-cell lung cancer (NSCLC); a multicenter phase II trial was initiated in order to evaluate the tolerance and efficacy of their combination. A total of 24 chemotherapy-naive patients with measurable stage IIIB or IV NSCLC and performance status (PS; WHO) 0-2 entered the study. Vinorelbine (20 mg/m2 i.v.) was given on days 1 and 15, cisplatin (60 mg/m2) on day 1, and docetaxel (100 mg/m2) on day 16, in cycles of 28 days. Recombinant human granulocyte colony-stimulating factor (150 microg/m2 s.c.) was administered prophylactically from day 17 to day 27. One pathological complete (4%) and six partial responses (25%) were documented (overall response 29%; 95% CI 11.6-49.2%). A total of five patients (21%) had stable and 12 (50%) progressive disease. The median duration of response was 28 weeks and the median time to tumor progression 36 weeks; the median survival was 20 weeks. Grade 3-4 neutropenia occurred in 16 patients (67%) while 13 of them (54%) developed febrile neutropenia. Grade 4 mucositis occurred in two patients (8%) and one of them also presented grade 4 diarrhea. There were four treatment-related deaths: two from sepsis, one from massive hemoptysis due to a pulmonary abscess and one from acute myocardial ischemia 7 days post-chemotherapy. In conclusion, the high incidence of neutropenic episodes and treatment-related deaths led to an early discontinuation of patient enrollment. This combination, in the schedule and the doses used, could not be recommended for off protocol treatment of patients with advanced NSCLC.
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PMID:Combination chemotherapy with docetaxel, vinorelbine and cisplatin as first-line treatment of advanced non-small-cell lung cancer: a multicenter phase II study of the Greek Cooperative Group for Lung Cancer. 985 99

After the advent of chemotherapy for pulmonary tuberculosis, the operation of thoracoplasty became rare in the developed countries. However, this was not the case in developing countries like India. Between July 1992 and June 1997, we performed thoracoplasty in 139 patients. Indications of surgery were tubercular empyema (84 patients), pyogenic empyema (33 patients), post-operative empyema with bronchopleural fistula (8 patients), drug resistant pulmonary tuberculosis (2 patients) and recurrent haemoptysis (2 patients). Successful outcome in the form of control of sepsis, closure of bronchopleural fistula, sputum conversion and control of haemoptysis was achieved in most cases. There were four deaths in the entire series. We conclude that with the persisting problem of pulmonary tuberculosis in the developing countries, thoracoplasty is still an operation of continued relevance.
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PMID:Thoracoplasty: an obsolete procedure? 1043 20

The management of pulmonary aspergilloma is still a topic of discussion. Demonstrating several cases of pulmonary aspergilloma, their clinical course and their follow-up, we try to contribute some arguments for the preference of an early operation. Between 1992 and 1998, 18 patients underwent thoracotomy for treatment of pulmonary aspergilloma. The most common indication for operation were hemoptysis [6] and indeterminate mass [6]. Lobectomy was the most frequent operation [11]. Underlying diseases were bronchiectasis [10], tuberculosis [3], carcinoma [2], blebs [2], and epitheloid granuloma. Two patients had postoperative complications, another three died later in the clinical course because of liver failure, septicemia, and persisting air leakage and sepsis. We recommend early resection of symptomatic, cavitating aspergilloma in the simple form and even with an inflammatory reaction of the surrounding tissue. Especially low-risk patients profit highly from an early operation. High-risk patients should be operated on only in cases of life-threatening complications.
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PMID:Pulmonary aspergilloma - clinical findings and surgical treatment. 1059 66

Bronchiectasis is primarily the result of airway injury and remodeling attributable to recurrent or chronic inflammation and infection. The underlying etiologies include autoimmune diseases, severe infections, genetic abnormalities, and acquired disorders. Recurrent airway inflammation and infection may also be the result of allergic or immunodeficiency states such as allergic bronchopulmonary mycoses or HIV/AIDS. Bronchiectasis should be included in the differentiation diagnosis of any patient with chronic respiratory complaints such as cough and sputum production. Early clinical manifestations may be subtle. Hallmarks of severe bronchiectasis include fetid breath, chronic cough, and sputum production. The associated chronic respiratory infections and airway sepsis are punctuated by episodes of acute exacerbation. Prompt recognition and treatment of bronchiectasis may allow for prevention of disease progression and irreversible loss of lung function. This review of severe non-cystic fibrosis bronchiectasis describes the current pathophysiology, clinical presentations, and management of bronchiectasis. We review how impaired airway clearance and the inability to resolve infection and inflammation creates a vicious cycle of recurrent injury. The common clinical features of bronchiectasis and findings are presented and illustrated by radiographic images. The common species and significance of various organisms often recovered from the distal airways including: tuberculous and environmental mycobacteria, aspergillus, and bacteria such as Pseudomonas aeruginosa will be covered. Management strategies including sputum surveillance, sputum clearance, antimicrobial therapy including antifungal and antimyobacterial agents as well as the evidence for the use of inhalational and anti-inflammatory therapies such as corticosteroids are also discussed. Recommendations for the work-up and therapy of complications including hemoptysis and respiratory failure are presented.
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PMID:Severe bronchiectasis. 1471 69

On September 11, 2001, the Connecticut Department of Public Health (CDPH) initiated daily, statewide syndromic surveillance based on unscheduled hospital admissions (HASS). The system's objectives were to monitor for outbreaks caused by Category A biologic agents and evaluate limits in space and time of identified outbreaks. Thirty-two acute-care hospitals were required to report their previous day's unscheduled admissions for 11 syndromes (pneumonia, hemoptysis, respiratory distress, acute neurologic illness, nontraumatic paralysis, sepsis and nontraumatic shock, fever with rash, fever of unknown cause, acute gastrointestinal illness, and possible cutaneous anthrax, and suspected illness clusters). Admissions for pneumonia, gastrointestinal illness, and sepsis were reported most frequently; admissions for fever with rash, possible cutaneous anthrax, and hemoptysis were rare. A method for determining the difference between random and systemic variation was used to identify differences of >/=3 standard deviations for each syndrome from a 6-month moving average. HASS was adapted to meet changing surveillance needs (e.g., surveillance for anthrax, smallpox, and severe acute respiratory syndrome). HASS was sensitive enough to reflect annual increases in hospital-admission rates for pneumonia during the influenza season and to confirm an outbreak of gastrointestinal illness. Follow-up of HASS neurologic-admissions reports has led to diagnosis of West Nile virus encephalitis cases. Report validation, syndrome-criteria standardization among hospitals, and expanded use of outbreak-detection algorithms will enhance the system's usefulness.
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PMID:Hospital admissions syndromic surveillance--Connecticut, September 200-November 2003. 1571 28

A 71-year-old man presented with hemoptysis due to chronic contained rupture of the descending thoracic aorta after sepsis by Escherichia coli complicated with transrectal biopsy of the prostate, and underwent urgent graft replacement. The aorta had an almost normal caliber and ruptured into the left lung without abscess. The perforated site of the lung was filled with gelatin-resorcinol-formaldehyde glue, and the defect of the aortic wall was closed. Without graft infection, lung abscess, or sepsis, the patient was discharged followed by 1 month's intravenous administration of cefazolin and piperacillin sensitive to Escherichia coli after the surgery.
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PMID:Chronic contained rupture of the descending thoracic aorta due to infection by Escherichia coli. 1602 72

Lung resection is uncommon in children because of its limited indications. We reviewed and analyzed the records of 31 children who underwent pulmonary resection between 1994 and 2001. The mean age was 7 years (range 1.6-12 years), and genders were equal. Bronchiectasis, lung abscess, necrotizing pneumonia, and destroyed lung were seen in 14, 12, 3, and 2 patients, respectively. Bronchial stenosis and inflammation of the bronchus was found endoscopically in four patients, and a foreign body in one patient. The indications for surgery in chronic sepsis were: recurrent respiratory tract infections, severe bronchiectasis, recurrent hemoptysis, destroyed lung parenchyma, and lung abscess, while the indications for surgery in acute infections were: failed medical treatment, or empyema. A lobectomy was done on 15 patients, lobectomy and lingulectomy on 4, lobectomy and decortications on 10, and pneumonectomy on 2 with no operative deaths. Intra-operative and post-operative complications were seen in 2 and 4 patients, respectively. Mean follow-up was 3.9 years (range 1.5-5 years). Twenty-eight patients were asymptomatic and three had improved. Respiratory function remained unchanged in 14 children. Mediastinal shift and lung overinflation occurred after pneumonectomy. These results show that lung resection can be done safely in pulmonary infection refractory to conservative medical therapy. Pulmonary resection does not alter respiratory function since the resected segments do not contribute to ventilation.
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PMID:Lung resection in children for infectious pulmonary diseases. 1607 33


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