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

A case of acute laryngo-tracheal obstruction in a 12-year old boy is presented. A live leech was removed from the larynx under general anaesthesia. A high index of suspicion of leeches as foreign bodies in children with acute onset of respiratory distress associated with hemoptysis and early surgical intervention is emphasized.
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PMID:Leech--an unusual cause of (laryngo-tracheal) obstruction. 191 22

We have used flexible fibreoptic bronchoscopy using sedation and local anaesthesia in 50 children aged 2-19 years (median 10) using an Olympus BFP20 instrument. Indications were opportunistic pneumonias (n = 11), persistent atelectasis (n = 11), recurrent pneumonia (n = 7), miscellaneous lower airway disease (n = 7), recurrent wheezing (n = 3), haemoptysis (3), to diagnose infection or rejection of heart-lung transplants (n = 3), stridor (n = 2), suspected airway compression (n = 1), evaluation of tracheostomy (n = 1), and suspected foreign body (n = 1). In 43 cases (86%) the diagnosis was related to the primary indication. In five (10%) unrelated abnormalities were found, and five (10%) were normal. In 13 (26%) treatment was altered as a result of flexible fibreoptic bronchoscopy. Complications were transient respiratory arrest (n = 2), hypoxia (n = 2), pneumonia (n = 2), and laryngospasm (n = 1). All complications were followed by complete recovery. Our results suggest that flexible fibreoptic bronchoscopy is safe. Advantages over rigid bronchoscopy include greater visual range, fewer complications, and the avoidance of a general anaesthetic. Though invasive it can yield important diagnostic and therapeutic information.
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PMID:Fibreoptic bronchoscopy without general anaesthetic. 203 4

Laryngospasm during the emergent phase of anesthesia is a respected complication well known to any PACU nurse. One complication of laryngospasm is noncardiac pulmonary edema (NCPE). NCPE can be a catastrophic complication of anesthesia. A case report is presented to illustrate the signs and symptoms of laryngospasm and NCPE. The physiology of hemoptysis and hypoxemia is reviewed. The mechanism of laryngospasm-induced pulmonary edema is described. The need for PACU nurses to comprehend the pathophysiology and implications of laryngospasm and hypoxemia is paramount when determining proper treatment. PACU nurses should be particularly alert to and aware of this complication.
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PMID:Laryngospasm-induced pulmonary edema: case report. 238 66

Direct current therapy (DC therapy), consisting of the application of electric current directly to the lesion, with chemotherapy using BLM was performed in 4 advanced inoperable lung cancer patients in whom chemotherapy and radiotherapy were not effective or could not be performed. Fluoroscopically two electrodes were inserted percutaneously into the tumor under local anesthesia. The distance between the two electrodes was about 3-4 cm. About 10 volts of direct current for 1 hour (totally over 40 coulombs) was passed between them using a DC treatment processor model 85 (Inter Nova Co., Ltd.), and simultaneously 15-30 mg of BLM was administered intravenously according to the general condition of the patient. The histologic type was adenocarcinoma in 3 cases and there was 1 large cell carcinoma. This treatment was performed once in 3 cases and twice in another. A reduction of tumor size was recognized in 3 cases (2 adenocarcinomas and 1 large cell carcinoma). In another adenocarcinoma case it was not measurable in size because of infiltrative shadow but histologically tumor destruction was recognized within a short period after DC therapy. The complications were mainly slight fever and light pain during the procedure. There was one small amount of hemoptysis and one pneumothorax but it was not necessary to perform special treatment for these complications. DC therapy with chemotherapy is based on our basic experimental experience that some anticancer agents accumulate around the electrodes in lung tissue when direct current is passed. In addition, current itself has cytocidal effects in some cases. Our clinical experience suggested the usefulness of this therapy to treat lung cancer lesions locally.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Direct current therapy with chemotherapy for the local control of lung cancer]. 248 18

Laser technology and the endoscope have been combined for the palliation of obstructive tracheobronchial malignant lesions. The neodymium-yttrium-aluminum-garnet (Nd-YAG) laser was used to treat 249 patients (447 operations), and the CO2 laser was used on 34 patients (59 operations). Hemorrhage, the major complication in both groups of patients, was more easily controlled with the Nd-YAG laser. One patient in the CO2 laser group died, and one patient in the group being treated with Nd-YAG laser bronchoscopy died. The Nd-YAG laser can be applied more efficiently through a fiber system, with better optic control and secure hemostasis. The commonest indications for treatment were dyspnea, obstructive pneumonia, and hemoptysis. Extrinsic compression was the most frequent reason for failure. The Nd-YAG laser, most often applied through open rigid bronchoscopes under general anesthesia, has become our treatment of choice for the palliation of tracheobronchial malignancy.
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PMID:Endoscopic treatment of tracheobronchial malignancy. Experience with Nd-YAG and CO2 lasers in 506 operations. 258 Dec 12

Thirty-six malignant and four benign endotracheal and endobronchial lesions were treated using Nd:YAG laser through flexible bronchoscope from November 1985 to July 1987 at the University Hospital in Louisville, Kentucky. Progressive dyspnea and hemoptysis were primary indications for the procedures. The majority of patients were treated under general anesthesia using intravenous agents. Most patients required two treatment sessions for complete endobronchial tumor ablation. The mean hospital stay was 48 hours. Two patients died postoperatively; one died of myocardial infarction and another of progressive respiratory failure. The mean survival was 13 weeks. Sixty-three percent of patients treated were improved as measured by Karnofsky Performance Status. Mean change in Performance Status between pre- and post-laser treatment was 100% (from 30 to 60). We conclude that therapeutic laser bronchoscopy is a useful adjunctive treatment in selected patients with obstructing or bleeding lung tumors.
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PMID:Endobronchial Nd:YAG laser surgery. 272 32

The smoking of clove cigarettes has been associated with 13 cases of serious illness in the United States, including hemorrhagic pulmonary edema, pneumonia, bronchitis, and hemoptysis. We describe a patient in whom, after she smoked a clove cigarette, pneumonia complicated by lung abscess developed. Her lung disease may have been caused by aspiration pneumonia as a consequence of pharyngolaryngeal anesthesia from clove cigarette smoke. Clove cigarettes appeal to adolescents experimenting with smoking practices and may influence the development of later smoking habits.
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PMID:Clove cigarettes. The basis for concern regarding health effects. 277 82

Eleven patients with acute and/or chronic tonsillitis, who presented with a spontaneous tonsillar hemorrhage are reported and discussed. Two patterns of hemorrhage were noted: 1. diffuse, parenchymal bleeding and 2. localized bleeding from dilated surface vessels. Pharyngeal culture for group A beta-hemolytic Streptococcus was positive in six patients (55%). Monospot, heterophile antibodies, complete blood cell count, prothombin time, partial thromboplastin time, and viral studies did not consistently demonstrate any abnormality. Two patients, however, did have an elevation in liver enzymes. In five patients, the bleeding stopped spontaneously; in five patients the bleeding was controlled with local chemical cautery. In two patients, Avitene was used for hemostasis. One other patient's bleeding was controlled by electrocautery while the patient was under anesthesia for endoscopic evaluation of hemoptysis. Two patients required blood transfusions; one of these patients had a history of factor IX deficiency. Four case histories are discussed in detail to illustrate the varied clinical presentation and some pitfalls in diagnosing and managing this rarely reported complication of tonsillitis. Possible mechanisms for the pathophysiology include increased tonsillar blood flow, necrosis of tonsillar surface cells, and trauma to dilated surface vessels. No common bacterial or viral etiology could be determined in this rare, but potentially serious, complication of tonsillitis.
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PMID:Hemorrhagic tonsillitis. 290 17

After presensitization with IV hematoporphyrin derivative (HpD), neoplasms in the tracheobronchial tree of 18 patients were treated by photodynamic therapy (PDT) with 630-nm light from a tunable dye argon laser system delivered through quartz fibers passed through the biopsy channel of a flexible bronchoscope under local anesthesia. Tumor effect was measured by complete response (CR)--no visible tumor in area treated, partial response (PR)--tumor size or degree of obstruction reduced by more than 50% and some response (SR)--tumor or degree of obstruction reduced by more than 20% but less than 50%. One month or less after 30 treatments to 26 areas in 18 patients, there was 40% CR, 57% PR, and 3% SR. All tumors showed at least some response. Since many of these patients had end-stage disease, the effect on the clinical condition and symptoms were evaluated using the Karnofsky Performance Status (KPS), oxygen requirements, and the presence or absence of respiratory symptoms. One month after treatment, 61% were clinically improved, with an increase of the average KPS from 48 to 61. Three patients with stage III primary lung cancer improved from being severely disabled requiring hospitalization to normal activity with effort and lived an average of 3.5 months. One patient with metastatic colon cancer was palliated from bedrest with continuous oxygen to normal activity with no oxygen for 12 months. A patient with hemoptysis and carcinoma in situ remains biopsy- and symptom-free for 34 months. A patient with hemoptysis and cough from breast cancer metastases maintained CR, biopsy- and symptom-free for 7 months. A patient with hemoptysis from recurrence at the bronchial stump maintained CR, biopsy- and symptom-free for 13 months. Six patients with Stage III primary lung cancer with average KPS of 27 (severe) died in the hospital and lived an average of 5 weeks (two CR, two PR, two SR). One patient with atelectasis of the right lower lobe re-expanded 14 days after treatments began.
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PMID:Photodynamic therapy of endobronchial tumors. 294 45

Six cases of pharyngeal leech (identified as Myxobdella africana) are reported from a highland area of North Kenya. Three patients were severely anaemic and one died. There have been sporadic reports of leech infestation of man in East and Central Africa but these reports lack correct identification of the leech. This paper includes a detailed account of the systematics of the leech and of its habitat. The leeches were ingested accidentally by drinking water from two infested water sources. The major symptoms were a feeling of something in the throat, epistaxis and haemoptysis. On examination, pharyngeal blood was a consistent feature although the leech was rarely seen on initial inspection. Examination under anaesthesia was usually successful in locating and removing the leech. Prompt blood transfusion was life-saving in two cases. The water sources were used by both cattle and man; the cattle may also be parasitized by leeches. Methods of improving the water sources were discussed with community leaders.
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PMID:Severe anaemia and death due to the pharyngeal leech Myxobdella africana. 360 42


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