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Query: UMLS:C0019079 (
hemoptysis
)
6,129
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Five children (aged 11 to 19 years) with lifelong chronic mucocutaneous candidiasis had 12 episodes of esophageal and/or laryngeal candidiasis documented by endoscopy. Symptoms included
hoarseness
(8/12), dysphagia (6/12), and
hemoptysis
(1/12). There was poor correlation between oral lesions and esophageal or laryngeal involvement. On fiberoptic endoscopy, the esophagus was involved alone in four episodes (33%), the larynx in two episodes (17%), and both structures in six episodes (50%). In six of eight instances, the esophagram was nondiagnostic or markedly underestimated the extent of inflammation. Intravenous amphotericin B or miconazole resulted in the resolution of these infections for variable periods of time. Repeat endoscopy was used to follow the course of the disease. Aerosolized amphotericin B was effective on one occasion in clearing candidal lesions of the larynx and one small area of the left mainstem bronchus. Oral topical therapy was not beneficial. Since the signs and symptoms of laryngitis or esophagitis are often minimal or absent and complications, including strictures, may arise from chronic inflammation, periodic endoscopy and systemic therapy may be necessary.
...
PMID:Candida esophagitis and laryngitis in chronic mucocutaneous candidiasis. 742 28
Much literature supports the value of performance-based tests for obtaining an overall assessment of clinical skills; however, these tests can also identify specific deficits in medical curriculum and student learning. This study, conducted over a period of 2.5 years, used standardized patients to identify deficiencies in medical students' evaluation of a patient with "hoarseness and cough." Each of 230 students performed a physical examination and took a medical history, and each was evaluated on 29 items according to predetermined criteria. We conclude the following: (1) When examining a patient complaining of
hoarseness
and cough, students frequently did not screen for
hemoptysis
, thyroid problems, and otalgia; (2) Overall test performance correlated positively with the time of year of the rotation, but screening for certain items (including
hemoptysis
, thyroid problems, and otalgia) appeared not to depend on rotation; (3) Several important items significantly differentiated the more knowledgeable student from the less knowledgeable student.
...
PMID:Use of standardized patients to identify deficits in student performance and curriculum effectiveness. 802
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.
...
PMID:Traumatic asphyxia. 813 32
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.
...
PMID:Pseudoaneurysms of the aorta after cardiac surgery or chest trauma. 825 35
Bronchial carcinoid tumors (BCT) are the most frequent primary pulmonary neoplasms of childhood. Seventeen of 208 patients diagnosed as having BCT at the Massachusetts General Hospital were between 10 and 21 years of age. We reviewed our records of the 17 patients and 8 other pediatric cases and compared their findings with those of seven large series of adults. Distribution was equal between the sexes. The average age at diagnosis was 17 years; 4 patients were < or = 15 years old. The duration of symptoms prior to diagnosis varied from 2 weeks to 2.6 years, with a median duration of 8.5 months. In contrast to adults, no child was asymptomatic. The majority of children presented with wheezing and atelectasis in addition to the characteristic adult triad of cough,
hemoptysis
, and pneumonitis. Five patients presented with weight loss and one patient presented with
hoarseness
. One of the 17 pediatric patients presented with Cushing's syndrome and a functional BCT. Twelve of 14 patients were disease free for 9 months to 34 years after surgical resection. We conclude that BCT should be suspected in children with pneumonitis resistant to therapy, atelectasis, wheezing, and
hemoptysis
. Surgical resection will result in symptom-free recovery in the majority of cases in spite of low-grade malignancy.
...
PMID:Bronchial carcinoid tumors in pediatric patients. 838 19
In order to assess the role of a staging fiberoptic bronchoscopy in the preoperative assessment of an indeterminate solitary pulmonary nodule (SPN), we reviewed our experience in 33 SPNs identified among 1,269 bronchoscopies performed at the Albert Einstein Medical Center between 1985 and 1989. All lesions were less than 4 cm in greatest diameter and were not associated with symptoms of weight loss, chest pain,
hemoptysis
, localized wheezing, or
hoarseness
. A tissue diagnosis was established in 25 patients, 23 of whom had a malignant SPN. This study failed to detect a single case in which a fiberoptic bronchoscopic examination of the airway discovered a lesion that would preclude surgery and potentially curative resection. We recommend the abandonment of a staging bronchoscopy in the evaluation of a patient with an indeterminant SPN in whom history, physical examination, laboratory, and imaging studies fail to document contraindications to surgery. No additional useful information is derived and a substantial cost savings to the patient can be realized if the procedure is eliminated.
...
PMID:The role of staging bronchoscopy in the preoperative assessment of a solitary pulmonary nodule. 763 62
From 1977 to 1992, 23 patients with primary tumors of the trachea were reviewed. Nineteen of these patients had squamous cell carcinomas, 2 had adenoid cystic carcinomas, 1 had a small cell carcinoma, 1 had a poorly differentiated carcinoma, and 1 had a pleomorphic adenoma. The prognosis of squamous cell, small cell and poorly differentiated carcinomas appeared to be grave, especially in association with vocal cord palsy (26%). Short-term survival occurred in 7 to 9 patients with tumors in the upper-middle third of trachea and 4 of them had concurrent acute respiratory distress. Cough (65.2%), dyspnea (91.3%), and
hemoptysis
(47.8%) were the most common symptoms. For patients with
hoarseness
, dysphagia, and cervical lymphadenopathy, the prognosis was poor (p < 0.0010). Two patients (8.7%) had multiple malignancies and all died within 1 year. Smoking was not only a risk factor as reported in previous studies, but also a significant prognostic factor (p = 0.0020) in our series. Emergent irradiation ( < 40 Gy in our cases) was useful in alleviating acute respiratory distress, but worthwhile survival was only obtained by the combination of surgery and radiation therapy (p = 0.0200, compared with surgery or irradiation, respectively). There was a significant correlation between prognosis and histologic type, tumor location, clinical presentation, smoking history and management, but not roentography or tumor size. These factors can be used to assess the survival of patients with primary tracheal tumors.
...
PMID:Descriptive study of prognostic factors influencing survival of patients with primary tracheal tumors. 852 32
Gemcitabine is a novel nucleoside analogue with activity in solid tumours. This study assessed the objective response rate to gemcitabine given weekly intravenously at a dose of 1250 mg/m2 for 3 weeks followed by 1 week of rest (one cycle) in chemonaive patients with inoperable non-small cell lung cancer (NSCLC). 161 patients with NSCLC were recruited from 10 sites in nine countries. Most patients had stage IIIb (31.3%) or IV (64.6%) disease, and 93.8% had a performance status of 0 or 1 according to the WHO scale. Of 151 evaluable patients, there were 3 complete responses and 30 partial responses lasting at least 4 weeks for an objective response rate of 21.8% (95% CI 15.5-29.3%). All responses were validated by an extramural Oncology Review Board. The mean duration of response was 8.8 months. The mean survival for all patients (16.1% of patients still alive 26 months after last patient started treatment) was 11.5 months. Improvements were also observed in secondary efficacy parameters such as performance status, weight, analgesic requirement, pain, and other disease-related symptoms including cough, dyspnoea,
haemoptysis
, anorexia, somnolence and
hoarseness
. Haematological and non-haematological toxicity was mild given the biological activity of gemcitabine. This study confirms gemcitabine as one of the most active agents in NSCLC with the added benefit of a modest toxicity profile and ease of administration on an out-patient basis. Gemcitabine is a suitable candidate for combination chemotherapy in patients with NSCLC.
...
PMID:Activity of gemcitabine in patients with non-small cell lung cancer: a multicentre, extended phase II study. 866 35
Fifty-one patients with established pulmonary tuberculosis underwent clinical evaluation and endoscopic examination of the larynx to determine the manifestations of laryngeal involvement. There were 46 males and 5 females (mean age 38 years). Fever, cough and
haemoptysis
were the prime pulmonary complaints while
hoarseness
, weak voice and episodic dyspnoea were the main laryngeal symptoms. Sites of laryngeal lesions included true vocal cords, arytenoids and false vocal cords. Oedema, pallor, ulcers, vocal cord immobility and thickening were the main laryngeal lesions observed. Twenty-four (47%) cases showed morphological changes in the larynx. The presentation pattern was consistent with the classical description and predilection for laryngeal involvement was not demonstrated.
...
PMID:Laryngeal involvement in pulmonary tuberculosis. 900 Aug 28
Lung cancer is the most common malignant cancer in males and it's incidence is rapidly rising in females. Factors linked to this are associated with cigarette smoking, urbanization along with atmospheric pollution. The lack of success in the treatment of lung cancer has to do with in many cases late diagnosis at the stage when surgical treatment is not possible and radio and chemotherapy being of minimal effectiveness. The WHO has proposed the following classification of lung cancer: 1. Squamous cell carcinoma; 2. Small cell carcinoma; 3. Adenocarcinoma; 4. Giant cell carcinoma; 5. Adeno-squamous cell carcinoma 6. Carcinoid. 7. Carcinoma of mucous gland. 8. Others. Early physical signs of lung cancer are: cough (50-80% of patients), dyspnea (10-15%), chest pain (15-20%),
hemoptysis
(20-50%), recurrent pneumonia and bronchitis (30-50%). More serious clinical signs associated with growth of the neoplasm are
hoarseness
, pleural effusion, vena cava superior syndrome, and Pancoast's syndrome. The growing neoplasm secrets many biochemical substances, which are them activity passed on the bloodstream or make their way into the blood as a result of degeneration of the tumor. These substances may then be detected in the patient's plasma and act as markers of malignant disease. The characteristics of these markers is varied, e.g.: hormones, enzymes and tissue antigens. Methods used in the diagnosis of lung-cancer which should be stressed, are apart from the obvious physical examination are chest x-rays, ultrasound, CAT scans, nuclear magnetic resonance, PET scans, and scintigraphy. Fine needle aspiration in changes in the peripheral regions, cytology of sputum, bronchial lavage, cytogenetic analysis. This underlines the need for prophylaxis, particularly the cessation of cigarette smoking.
...
PMID:[Current capabilities and procedures for diagnosing lung neoplasms]. 919 23
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