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

Major fracture of the intrathoracic airway following closed chest trauma is a potentially lethal injury which can be repaired successfully if the diagnosis is made early, Cough, dyspnea cyanosis, hemoptysis, mediastinal emphysema, or pneumothorax not responding to drainage via intercostal tube and a deterioration of the patient's clinical condition out of proportion to the apparent closed chest injury, should alert the clinician to the possiblity of this entity. This report describes the findings in a patient with a longitudinal disruption of the entire intrathoracic trachea and the findings in a second patient with complete transection of the right main bronchus. Each was repaired primarily, with eventual recovery, The principles of management of this difficult group of injuries are reviewed.
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PMID:Major airway injury in closed chest trauma. 87 56

The involvement of the pulmonary vessels by tumour emboli may lead to a clinical picture defined as 'subacute cor pulmonale'. Information about this syndrome has been limited to case reports and a few series. A study of 214 autopsied cancer patients was undertaken to investigate the clinical signs and symptoms of tumour involvement of the pulmonary vessels (TIPV). The lungs were removed as a block and 15 sections (3 from each lobe) were analyzed. Clinical data about right ventricular failure, dyspnoea, cough, pleuritic chest pain, cyanosis, engorgement of jugular veins, peripheral oedema, haemoptysis and haemoptoic sputum were obtained from the medical records of each patient. Tumour emboli were detected in 89 cases, and no respiratory symptoms were recorded in 39. The presence of dyspnoea and cyanosis were highly significant in the group with TIVP, and right ventricular failure and peripheral oedema showed slight significant differences between the patients with and without TIPV. The classical picture of subacute cor pulmonale was observed in 13 patients and TIPV was considered to be the main cause of death in 29 cases. Our results indicate that although the development of subacute cor pulmonale was rare in patients with cancer, TIPV may be suspected when the patient presents respiratory distress and should be included in the differential diagnosis of dyspnoea in cancer patients.
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PMID:Clinical aspects of tumour involvement of the pulmonary vessels. 141 97

Foreign bodies can become lodged anywhere in the air passages, depending on their size, shape, and makeup. Symptoms of laryngeal foreign body inhalation can vary greatly but usually include one or more of the following: hoarseness, croupy cough, stridor, wheezing, dyspnea, cyanosis, hemoptysis, aphonia, odynophagia, or a subjective feeling of the presence of a foreign substance. Foreign body inhalation occurs most often in children and the elderly. The symptoms of bronchial foreign body inhalation are very similar to those of laryngeal foreign body inhalation. Usually, after the initial expression of acute symptoms, a period of quiescence follows during which little or no evidence of a problem is manifest. It is during this period of subtle symptoms that treatment is often mistakenly directed toward an infectious cause. The authors describe two unusual cases, one of laryngeal and one of bronchial foreign body ingestion. They also discuss their diagnosis and management.
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PMID:Airway foreign bodies: a diagnostic challenge. 206 Nov 4

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

Every time the tuberculosis is present and it is to be included in the differentialdiagnosis if the occasion arrises. In the anamnesis it is necessary to pay attention to specific diseases and the risk groups like patients with "21-day-cough", silicotics, "Contrast-articularis bronchitics", diabetics, so-called "persons with fibrotic lesions" and patients with frequent influenzal infections. The symptoms unclear gastric distress, want of appetite, indifferent loss in weight, uneasiness, slight vertigo and fast tiredness already give further references. Breath-pain, haemoptysis and subfebrile temperatures are already severe symptoms. A thorax X ray-photograph, tuberculin test, heamogram, sedimentation test and intensive search for mycobacteria, belong to the diagnosis. In extrapulmonary foci the search for mycobacteria is to try by swab, puncture, control of urine and menstrual blood. It is possible, that a histologic corroboration will be necessary. Unclear fever, headache and vomiting with or without dyspnoea, cyanosis and diaphragmatic lowness indicate a ocular reflection, liver biopsy and, in special case, a lumbar puncture without delay. Sooner or later the course of an unrecognized phthisis can result in death. It is necessary to fill up the gap between welltime diagnosis and death by unknown tuberculosis. That means: Thorough knowledge of matter, insight into the disease-course and inducement of all necessary diagnostic possibilities.
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PMID:[Diagnosis and course of tuberculosis especially from the viewpoint of clinically unknown deaths]. 407 12

One hundred six consecutive patients with injuries to the tracheobronchial tree who were admitted to the emergency room of the Tulane Medical Center Hospital or the Charity Hospital of Louisiana at New Orleans over a period of almost 20 years were analyzed retrospectively. Penetrating trauma of the neck or chest was reported in 100 of the patients, and only 6 had blunt trauma to the neck or thorax as the cause of injury. There were 18 deaths among the 106 patients (16.98%), including 11 (13.75%) of 80 with injuries of the cervical trachea. Seven (53.8%) of 13 with principal injuries of the thoracic trachea died; all 13 patients with major bronchial injuries survived. On admission to the emergency room, all patients had signs of airway compromise such as tachypnea, dyspnea, cyanosis, subcutaneous emphysema, or an abnormal respiratory pattern. Severe airway compromise was evident in 46 patients; 24 (23%) were treated with oral or nasal intubation, 19 (18%) with emergency tracheostomy, and 3 (2%) with intubation of a tracheal injury. Hemoptysis was an unreliable signal of serious injury, being present in only 28 of the patients. Patients who had major vascular injuries combined with trachea involvement were generally not salvageable. In regard to morbidity and mortality, the most common preventable errors were delay in diagnosis and treatment of tracheobronchial injuries, missed esophageal injuries, massive aspiration of blood, and abdominal vascular injuries.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Management of airway trauma. I: Tracheobronchial injuries. 407 2

The objective of this study was to determine the long-term survival pattern and variables affecting long-term survival and complications occurring during follow-up of patients with Eisenmenger syndrome. A retrospective study of patients diagnosed with Eisenmenger syndrome were followed up. A tertiary care centre was used and it provided superspeciality services in various disciplines. The subjects included 201 patients with Eisenmenger syndrome--diagnosed by a combination of echocardiography and a peripheral arterial oxygen saturation study and/or cardiac catheterisation with or without angiocardiography--worked up and followed up for variable duration over a period of 16 years from 1976 to 1992. One hundred nine patients were females and 92 were males--age of presentation varied from 3 months to 62 years (mean +/- standard deviation 19.23 +/- 12.62 years). A total of 12 different anatomic lesions were seen--the most common three being ventricular septal defect (33.33%), aterial septal defect (29.85%), and patent ductus arteriosus (14.23%). History, physical examination, chest skiagram and electrocardiogram established only the presence of pulmonary arterial hypertension except where differential cyanosis indicating ductus was discernible or the degree of splitting of second heart sound provided some clue to the level of shunt. Contrast echocardiography, completed in 25.4% established the level of shunt in all patients. In others the diagnosis was confirmed by cardiac catheterisation. Twenty patients died during a mean follow-up period of 54.6 +/- 54.47 months. Sudden cardiac deaths (30%), congestive heart failure (25%) and haemoptysis (15%) were the most predominant causes of death. Only one patient died during puerperium.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Prognosis for patients with Eisenmenger syndrome of various aetiology. 796 Feb 65

Four patients showing classic physical stigmata of traumatic asphyxia were studied. Cervicofacial cyanosis and edema, subconjunctival hemorrhage, and multiple ecchymotic hemorrhage of the face, neck, and upper part of the chest were documented. Admission Glasgow coma scale scores ranged from 8 to 15. All but one had no associated injury. Skin discoloration resolved within 3 weeks. Complete resolution of subconjunctival hemorrhage occurred 1 month later. In our series, sore throat, hoarseness, dizziness, numbness, and headaches were common. Profound lower leg pitting edema, hemoptysis, hemotympanum, and transient visual loss were noted. Chest radiographic findings were normal in all patients. Microscopic hematuria was noted in one patient. Diagnosis is made from the history and characteristic appearance of the patient. Treatment is directed to the associated injury. Oxygen supplement with head elevation to 30 degrees is the mainstay of treatment. If the patient survives the initial insult, the prognosis is excellent.
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PMID:Traumatic asphyxia. 813 32

Traumatic asphyxia is a commonly used designation of a syndrome related to severe compressive trauma to the thorax. It is characterized by cranial cyanosis, subconjunctival hemorrhage, vascular engorgement of the head, mucosal petechiae, hemoptysis, esophageal and rectal hemorrhage, hematuria, and varying degrees of cerebral dysfunction. By 1985 approximately 210 cases had been reported world-wide. We present an illustrative case in a 24-year-old man.
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PMID:[Traumatic asphyxia]. 822 93

The clinical and laboratory features in 62 patients with acute pulmonary embolism were analized. There were 26 males, and 36 females with mean age of 63 +/- 11 (range 37 to 90). The clinical symptoms include: dyspnea (92%), chest pain and/or chest tightness (65%), cough (50%), wheezing (29%), leg swelling (32%), hemoptysis (24%), syncope (18%), leg pain (10%). Clinical signs include: tachypnea (respiratory rate > or = 20 per minute) (79%), tachycardia (37%), deep vein thrombosis (29%), cyanosis (8%), fever (> 38.5 degrees C) (2%). The possible predisposing factors include: immobilization (18%), surgery (5%), deep vein thrombosis, ever(5%), malignancy (5%), pulmonary embolism, ever (3%). Arterial blood gas analysis (while patients breathed room air) revealed mean PH of 7.46 +/- 0.06, mean PO2 of 64.5 +/- 12.1 mmHg, mean PCO2 of 35.3 +/- 4.6 mmHg, mean Alveolar-arterial O2 difference of 36.5 +/- 16.6 mmHg. The electrocardiographic changes include; nonspecific ST-T change (61%), sinus tachycardia (20%), S1Q2T3 pattern (15%), atrial fibrillation (16%), incomplete right bundle branch block (10%), complete right bundle branch block (8%), atrial premature contraction (7%), paroxysmal supraventricular tachycardia (2%). The chest x-ray findings include: cardiomegaly (48%), regional hypovascularity (31%), atelectasis (5%), pleural effusion (5%), wedge-shaped infiltrate (3%), elevated diaphragm (6%). Venous plethysmography was performed in 49 of 62 patients. Of these 49 patients, 28 patients revealed positive finding. Of these 28 patients with positive finding, 18 patients had clinical evidence of deep venous thrombosis. The in-hospital mortality rate was 10% (6/62).
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PMID:[Pulmonary embolism: clinical and laboratory features in 62 patients]. 904 62


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