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

The clinical characteristics most relevant to the decision to treat for a pulmonary exacerbation with antibiotics in cystic fibrosis patients were determined. Variables including age, increased cough frequency and sputum production, new crackles and wheezing, asthma, symptomatic sinusitis, hemoptysis, decreased lung function, weight loss, and new acquisition of Pseudomonas aeruginosa were collected in a large prospective multicenter database (Epidemiologic Study of Cystic Fibrosis). During a 12-month baseline period, data from 11692 patients were compared with data collected during the subsequent 6-month study period. Because pulmonary function assessments were unavailable for patients <6 years of age, separate analyses were done for those <6 and >or=6 years of age. The outcome of interest was any antibiotic treatment in the 6-month study period reported as indicated for an exacerbation. Characteristics with the most discriminatory power were determined using stepwise multiple logistic regression. For patients <6 years of age, the strongest independent associations with treatment for a pulmonary exacerbation were new crackles, increased cough frequency, decline in weight, and increased sputum production. For those patients >or=6 years of age, the strongest independent associations were a relative decrease in percent predicted forced expired volume in 1 sec, increased cough frequency, new crackles, and hemoptysis. The presence of three or more of these key characteristics was strongly associated with the occurrence of a treated exacerbation. The reproducibility of the model over time was confirmed by application to a subsequent set of data. This model has potential for use as an outcome measure in clinical trials, and to assist in treatment decisions for individual patients.
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PMID:Pulmonary exacerbations in cystic fibrosis. 1509 22

Bronchiectasis is a common disease in the developing world. While the aetiology of bronchiectasis is diverse, many patients suffer from idiopathic disease. Although the pathogenesis of bronchiectasis is poorly understood, there are three distinct pathogenic elements, namely infection, inflammation and enzymatic actions. These interact to perpetuate airway destruction in many cases. There are four patient stereotypes: rapidly progressive, slowly progressive, indolent disease and haemoptysis-predominant. The diagnosis of bronchiectasis is best made with high resolution computed tomography, which should be followed by delineation of aetiology and evaluation of disease severity. Management of bronchiectasis is unsatisfactory and there are no disease-modifying drugs or treatment guidelines. Specific therapy to correct an underlying defect should be instituted whenever possible, although established disease often continues to deteriorate relentlessly. Treatment with prolonged, high-dose antibiotics is useful for exacerbations and probably also for some severely affected patients with frequent exacerbations who habour Pseudomonas aeruginosa in their airways. Commencement of long-term nebulised aminoglycoside, elective in-patient intravenous antibiotic therapy, long-term oral antibiotic or low-dose macrolide therapy requires special considerations. Inhaled corticosteroid therapy reduces chemokine expression in bronchiectasis in vivo, and may be useful for some patients. For severely affected patients, the use of non-invasive positive-pressure ventilation with supplementary oxygen sometimes helps. The lack of enthusiasm about bronchiectasis has already resulted in a lack of research in the treatment of this frustrating disease, and such research needs to be encouraged.
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PMID:Bronchiectasis: not an orphan disease in the East. 1518 38

Bronchiectasis is characterized with irreversible dilatation according to destruction of epithelium, elastic and muscular layer. Most important cause of bronchiectasis is chronic bacterial infections. Pseudomonas aeruginosa colonisation is frequently seen in bronchiectatic patients. We aimed to find out P. aeruginosa colonisation frequency and clinical, radiological and spirometric reflections due to colonisation. We analysed 83 cases retrospectively. Mean age was 58.2 and 54.2% of them were female. Bronchiectasis were localised 19.3% in left lung, 19.3% right and 61.4% bilaterally. 29 (35.8%) normal, 28 (34.6%) obstructive, 7 (8.6%) restrictive, 17 (21%) mixed type disorders are detected in spirometric measures. Sputum culture performed in 50 cases. No microorganism colonisation determined in 30 (60%) cases, P. aeruginosa colonisation 16 (32%), Haemophilus influenzae 2 (4%), 1 (2%) Streptococcus pneumoniae and Proteus mirabilis 1 (2%) cases. P. aeruginosa colonisation determined more frequent in males (p<0.05). No significant correlation detected between colonisation and age or smoking habits (p>0.05). In cases with colonisation; clubbing and hemoptysis were significantly frequent (p<0.05). Only peribronchial thickening was significantly correlated with colonisation in radiological findings (p<0.05). In blood gase analysis PaO2, oxygen saturation were lower and PaCO2 higher in cases colonised with P. aeruginosa but it was not statisticaly significant (p>0.05). Hospitalization rate was higher in P. aeruginosa colonised cases (p>0.05). It is an important problem about mortality because of higher hemoptysis and hospitalisation requirement rate in P. aeruginosa colonised cases.
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PMID:[Pseudomonas aeruginosa colonisation in bronchiectatic patients and clinical reflections]. 1720 22

Few reports are currently available on the surgical management of bronchiectasis. We report our experience with 8 cases of bronchiectasis. The indications of pulmonary resection were recurrent pneumonia and/or hemoptysis in spite of medical treatment and the extent mainly limited to the unilateral lung. With the exception of one patient, who died from postoperative pneumonia, all patients showed improvement in symptoms. However, in two cases, hemoptysis recurred; these patients had cystic bronchiectasis, Pseudomonas aeruginosa infections and minimal disease in the contralateral lung, which accounted for the recurrence of hemoptysis. A few reports indicated that cystic bronchiectasis and incomplete resection were adverse prognostic factors and that Pseudomonas aeruginosa infections were related to the development of new bronchiectasis. However, according to some other reports, these factors were not adverse prognostic factors. It is thought that the analysis of many cases is required to determine the indication of lung resection and the appropriate type of resection for bronchiectasis; however, it is difficult to conduct randomized control studies. Since the accumulation of case reports is also considered to be important, we report our series of cases.
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PMID:[Surgical management of eight cases of bronchiectasis]. 1731 35

The authors reviewed adult cystic fibrosis patients followed in the Pulmonology Unit from 1994-2004 (n=8), five female and three male, aged 20-34 years old (median= 27 years). Patients were diagnosed at 18 months - 31 years old by sweat testing (positive in six patients) and genotyping (four patients homozygous for Delta F508 mutation). Respiratory involvement was characterised by sinusitis and bronchiectasis. Pulmonary involvement was accompanied by functional abnormalities and gas exchange impairment in the majority of the patients. Bronchial tree was colonised permanently in five patients: Pseudomonas aeruginosa in four and Staphilococcus aureus in four (three patients affected by both agents simultaneously). The main causes of exacerbation were respiratory infections and haemoptysis. Non-respiratory involvement was variable. Four patients had digestive involvement (one with hepatic cirrhosis), one had renal failure and only one had a sperm count to document infertility. Four patients had osteopaenia. Treatment included chest physiotherapy, bronchodilators, dornase alfa, mucolytics, digestive enzymes, vitamins, antibiotics and oxygen therapy. At review, one had left follow-up, one had died, one was awaiting lung transplant and the others evidenced no difference in clinical characteristics. In this group of patients the severity of the pulmonary disease was not related to a late diagnosis. It can be explained by the diversity of cystic fibrosis presentation in adults.
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PMID:[Cystic fibrosis in adults]. 1763 73

Bronchiectasis is characterized by the dilation and progressive destruction of the bronchial wall. Its actual importance lies in two points: the increased number of diagnoses due to increased chronic diseases and the use of new diagnostic tools, and its negative impact on quality of life and lung function of patients and the negative prognosis of the causative disease. In practical terms, the treatment of bronchiectasis in adults is based on eight basic pillars: treatment of the etiology if it is known, treatment of the bronchial colonization or infection by potentially pathogenic microorganisms including Pseudomonas aeruginosa (inhaled or systemic antibiotics), treatment of bronchial secretions (chest physiotherapy and mucolytics), treatment of bronchial inflammation (inhaled steroids and macrolides) and hyperresponsiveness (inhaled steroids and bronchodilators), treatment of systemic manifestations (malnutrition), treatment of exacerbations (oral antibiotics, removing secretions and the associated bronchospasm), treatment of complications (hemoptysis, respiratory failure and mucous plugs), and finally, surgical treatment (lung transplantation or resection surgery).
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PMID:[Bronchiectasis treatment in adults]. 1936 21

A 71-year-old man was admitted to Kanto Central Hospital with hemoptysis. He had had chronic sinusitis and deafness since childhood. Situs inversus, bronchiectasia, and diffuse panbronchiolitis had been also diagnosed at the age of 59. Chest computed tomography demonstrated a 5-cm mass in the anterior mediastinum as well as a 4-cm mass in the upper lobe of the right lung. A transbronchial lung biopsy of the right lung tumor revealed squamous cell carcinoma. Electron microscopic examination of the bronchial epithelial cilia revealed a total defect of both inner and outer dynein arms, leading to a diagnosis of primary ciliary dyskinesia. Biopsy of the mediastinal tumor was not performed. After concurrent chemoradiation therapy, the lung cancer decreased in size partial remission (PR) and the mediastinal tumor disappeared complete remission (CR). Later, a cavity formed in the tumor, where a Pseudomonas aeruginosa infection occurred. He died 1 year after the diagnosis of lung cancer was established. There have been 5 reported cases of Kartagener syndrome complicated with lung cancer, but to the best of our knowledge there have been no reports of Kartagener syndrome with mediastinal tumor.
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PMID:[Kartagener syndrome with lung cancer and mediastinal tumor]. 2056 Apr 40

We present a 54-year old man with a pulmonary infectious cavity continuing to a cutaneous fistula. Before he was admitted to our hospital, he had undergone open-window surgery for a left thoracic empyema due to the rupture of pulmonary suppuration of the left upper lobe. He had then undergone thoracoplasty with the plombage of the cavity using left pectoralis major muscle. However, this procedure had failed and the external fistulous wound remained infected by Pseudomonas aeruginosa and occasional massive bleeding from the cavity occurred. He underwent en bloc left upper lobectomy for the external fistulous wound. The pedicled left latissimus dorsi muscle flap was transposed to fill the dead space and reinforce the bronchial stump. He remained in good health and did not experience intrathoracic infection or haemoptysis.
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PMID:External fistulous wound with Pseudomonas aeruginosa infection and massive bleeding following rupture of pulmonary suppuration. 2241 98

A 59-year-old woman developed mild recurring hemoptysis once a week for several months after a fall with trauma to the chest. Sixteen years earlier she had undergone a right pneumonectomy at a hospital elsewhere for sequelae of pulmonary tuberculosis. Bronchoscopy, performed because of the recent hemoptysis, showed material in the pneumonectomy stump. The material had a gelatinous appearance, green color with a pale margin, and oblique striations. The material was removed by grasping with forceps and withdrawing the bronchoscope. Grocott methanamine silver stain was positive for septate, nonpigmented fungal organisms. Anatomic pathology microscopy also showed mucous, acute inflammatory cells, and necrotic tissue. Cytopathology of washings from the bronchial stump showed rare degenerated benign bronchial epithelial cells and fungal hyphae. Acid fast bacilli smears and cultures were negative. Bacterial cultures showed 3+ Pseudomonas aeruginosa. The patient had no further hemoptysis.
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PMID:Fungal colonization of a pneumonectomy stump. 2316 55

Multiple endobronchial polyps are a rare finding. We describe a case of multiple benign endobronchial polyps in a 60-year-old woman who presented with a chronic cough and occasional hemoptysis. Chest computed tomography revealed bilateral basal cylindrical bronchiectasis, with filling defects in both main bronchi. Bronchoscopy revealed the presence of polyps in the distal trachea, both main bronchi, and in the lobar and segmental bronchi of all lobes of both lungs, with lesions from 2 to 10 mm in diameter. Larger lesions were treated with argon plasma coagulation. Histopathology was consistent with benign fibroepithelial polyps. Culture from bronchial washings isolated Pseudomonas aeruginosa, and the patient was treated with ciprofloxacin followed by a prolonged course of azithromycin. Symptoms improved, and repeat bronchoscopy at 3 and 6 months revealed complete resolution of all polyps.
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PMID:Multiple endobronchial polyps. 2316 85


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