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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The experience with 45 patients with lung abscess over a three-year period at the University College Hospital (UCH), Ibadan, is presented. This study confirms the rarity of this disease among Nigerian children and its prevalence in young adults in the third and fourth decades of life. The most common presenting symptoms were purulent cough, chest pain, fever, and life-threatening hemoptysis which was the sole indication for emergency operation in 14 out of 16 patients who were treated surgically. The predominance of these abscesses in the right lung, especially in the superior segment of the lower lobe, supports the fact that aspiration of infected material, following depressed level of consciousness, esophageal obstruction, foreign bodies, and oral sepsis form the major causative factors in patients with lung abscess. The frequent association of sickle cell disease, bronchiectasis, hypertension, and pulmonary aspergilloma contribute significantly to the morbidity and mortality attendant to this disease in our environment. Twenty-nine patients were treated medically with five deaths and 16 patients were treated surgically with six deaths. The high operative mortality (37.5 percent) in this series was due to the extreme emergency conditions under which these patients were operated.
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PMID:Lung abscess: a review of three-years' experience at the University College Hospital, Ibadan. 42 74

Examination of the bronchial artery system by means of contrast materials and pneumo-angiography has made it possible to determine the extent of the pathological process and to provide an answer to some of the problems raised by chronic non-specific diseases. When free passage is disturbed in the bronchi and alveolar ventilation is abolished, arterial blood will reach through the arterio-arterial anastomosis the branches of the pulmonary arteries, followed by a local hypertension in the affected region and a high oxygen saturation in the terminal branches of the pulmonary artery. In the case of bronchiectasis, the capillary circulation in the bronchial wall decreases because of the extension of the bronchial system which leads to the development of sclerosis and thus to a deterioration of the drainage function of the bronchus.
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PMID:Angiography of the bronchial and pulmonary arteries in chronic non-specific lung diseases. 55 86

Degradation of prostaglandins (PGs) during passage through the human pulmonary circulation was investigated by measuring the transpulmonary plasma PGF2 alpha difference during continuous intravenous infusion of PGF2 alpha (5-10 mug/min). Seven patients with cardiological disorders and two patients with extensive pulmonary abnormalities were investigated during diagnostic cardiac catheterization. PGF2 alpha levels were measured by radioimmunoassay. The seven cardiac patients were found to have transpulmonary PGF2 alpha differences of 47-88%, indicating metabolism of the PG in the lungs. A patient with extensive bronchiectasis had an apparently normal transpulmonary PGF2alpha difference despite gross abnormalities in routine lung function tests. A patient with primary pulmonary arterial hypertension showed no metabolism of PGF2alpha in the pulmonary circulation. The results show that PG degradation is an aspect of normal lung function and suggest that it becomes imparied when extensive pulmonary vascular damage exists.
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PMID:Degradation of porstaglandin F2alpha in the human pulmonary circulation. 101 42

The gross findings of 49,144 autopsies performed at two major hospitals in Rome were reviewed. There were 297 patients who were found to have atherosclerotic abdominal aortic aneurysm (AAA). The aneurysm was intact in 220 (74 per cent) and ruptured in 77 (26 per cent). The occurrence of aneurysm rupture was correlated to 17 variables by univariate and multivariate statistical analysis. Covariates found to be independently predictive of the rupture of AAA were the size of the aneurysm (p less than 0.001), arterial hypertension (p less than 0.001) and the presence of bronchiectasis (p less than 0.025.). Over-all, bronchiectasis was more common among patients with AAA than in the age-adjusted and sex-adjusted control population. The simultaneous presence of bronchiectasis and AAA suggests the presence of some inherited or acquired tendency to have ectasia of the connective tissue, aneurysm formation and rupture development.
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PMID:Factors influencing the rupture of abdominal aortic aneurysms. 192 75

In patients with cystic fibrosis, plain chest radiographs may suggest the presence of bronchiectasis, bronchoceles, hilar adenopathy, or pulmonary arterial hypertension. We compared computed tomography (CT) with conventional chest radiography in 12 patients. CT clearly reveals the cause of increased linear markings, nodular lesions, and enlarged hila as seen on plain chest radiographs. It showed that nine patients had hilar adenopathy, five had enlarged pulmonary arteries, and 11 had bronchiectasis. Bronchoceles, a finding that may influence therapy, were seen on seven CT scans but on only four of the plain films.
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PMID:Cystic fibrosis: a comparison of computed tomography and plain chest radiographs. 293 78

A 68-year-old man with arterial hypertension and diabetes mellitus suffered a stroke with hemiparesis. The ischemic infarction was demonstrated by computer assisted tomography and angiography. At the site of the original infarction a large brain abscess developed several months later and caused the patient's death. A secondary hematogenous infection of the necrotic area (in this case Staphylococcus aureus, probably from bronchiectasis) seems likely. Other cited case reports show that after cerebral necrosis of various origin the possibility of a secondary brain abscess should be considered.
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PMID:[Brain abscess--a possible complication of cerebral infarction?]. 670 86

We have studied nine male patients (age 18 to 68 years) with radiographic and physiologic evidence of an abnormally small lung on one side (three right and six left). All had had a childhood pneumonia or bronchiolitis and eight had chronic or recurrent bronchitis and exertional dyspnea. Radiography showed two of the small lungs to be hypolucent while seven were hyperlucent. Bronchography revealed evidence of bilateral chronic bronchitis in all with saccular bronchiectasis in three. Angiography showed strikingly diminished vascularity to the smaller lung. Spirometry revealed airway obstruction in seven of the patients. All had pulmonary arterial hypertension. Radiospirometry showed that the small lung had on the average 30% of the total ventilation but only 15% of the perfusion. Washout of 133 Xe was extremely slow in radiolucent regions. We suggest the name "crippled lung" syndrome for this entity because it is purely descriptive and encompasses several clinical variants. It also avoids the pitfalls of etiologic implication (acquired-congenital). Clinical or subclinical bronchitis seems to be common in these patients and the prime goal in therapy must be to combat the tendency towards airway infection.
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PMID:Crippled lung: variations on a theme by Macleod. 720 92

The analysis of data obtained in the investigation of functions of the pulmonary blood flow in 44 patients prior to and following segmentary and combined resections of the lungs fulfilled for bronchiectasis has shown that almost all the patients with bronchiectasis have the disturbed hemodynamics of the small circulation circuit. The direct relation was shown between the duration of the disease, spread of the pathological process and the degree of lung hypertension. It has been found that a resection within the limits of 6 lung segments fails to exert a negative influence on hemodynamics of the small blood circulation circuit and allows prevention of progressing pulmonary hypertension in most of the patients.
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PMID:[Pulmonary blood flow in bronchiectasis patients before and after lung resection]. 726 66

Lung transplantation is proposed for young patients with a severe disease that can be expected to be fatal within less than two or three years. The main indications are chronic respiratory failure induced by chronic obstructive lung disease, cystic fibrosis or pulmonary fibrosis, and severe primary or secondary (Eisenmenger syndrome) pulmonary hypertension. The type of transplantation, determined after an exhaustive work-up ruling out all contraindications, is generally a single lung transplantation if there is no bronchial infection or two-lung transplantation or heart-lung transplantation in case of bronchiectasis or pulmonary artery hypertension. Survival at 1, 3 and 5 years is 72, 57 and 43% respectively. Transplantation improves exercise capacity, quality of life and lung function. It normalizes hematosis in case of chronic respiratory failure and pulmonary hemodynamics in case of pulmonary hypertension. The risk of complications, dominated by infections and rejections, requires careful clinical, functional and endoscopic follow-up. Bacterial infections are frequent during the first weeks. The frequency of opportunistic infections can be reduced by anti-infectious prophylaxis strategies. The rejection can occur as an acute episode, frequent during the first 100 days, or is sometimes asymptomatic. Chronic rejection or obliterating bronchiolitis is the main mid-term complication after lung transplantation and is responsible for the low long-term survival rate with recurrent secondary infections due to frequent bronchial colonization with Pseudomonas aeruginosa. Improved prognosis of lung transplantation requires the development of new immunosuppressive agents with lower risk of infection and chronic rejection observed with current treatments.
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PMID:[Lung transplantation: indications, techniques and results]. 1113 60

A cystic fibrosis (CF) heterozygote incidence higher than in the general population has been repeatedly reported in conditions which include clinical features found in CF, like pancreatitis, disseminated bronchiectasis, and allergic bronchopulmonary aspergillosis. Some cases may be explained by an unidentified compound heterozygosity; others could be manifesting heterozygotes. This study was aimed at detecting the incidence of CF-related clinical features in a population of carriers. A group of 261 obligate heterozygotes (mean age, 44 years) and a control group, composed of 201 individuals negative for a standard mutation panel (mean age, 36 years), were surveyed for possibly CF-related conditions (asthma, bronchiectasis, pneumothorax, allergic bronchopulmonary aspergillosis, sinusitis, nasal polyps, gallstones, liver cirrhosis, diabetes, pancreatitis, bone fractures, plus hypertension). A questionnaire was administered, and the accuracy of the statements was evaluated by phone interviews. There was no difference between heterozygotes and controls, with the exception of hypertension (carriers 28/261, controls 7/201, p = 0.004), and, in males, nasal polyps (carriers 7/126, controls 0/102, p value = 0.0178), and, again, hypertension (carriers 17/126, controls 5/102, p value = 0.0407). To avoid age bias, 126 heterozygotes matched to controls of the same gender and age were separately processed: these two groups showed no significant differences. CF-related clinical manifestations in obligate CFTR mutation heterozygotes are not more represented than in individuals with a low risk of being carriers.
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PMID:A pilot survey of cystic fibrosis clinical manifestations in CFTR mutation heterozygotes. 1178 92


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