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Query: UMLS:C0027947 (neutropenia)
 17,527 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We investigated the lung injury that occurs following reexpansion of a unilateral pneumothorax and determined the effect of superoxide dismutase (SOD) infused immediately prior to reexpansion on this injury. After 7 days of at least 80% right pneumothorax, rabbits received intravenous infusions of either SOD (n = 7), heat-inactivated SOD (n = 1), or vehicle (n = 7) immediately before lung reexpansion. Lung injury was assessed by measuring the systemic white cell counts, pulmonary blood volumes, extravascular albumin, extravascular lung water, wet/dry weight ratios, and histology 2 h after reexpansion. The reexpanded lung showed increased extravascular albumin, extravascular lung water and wet/dry weight ratios with decreased blood volumes compared to the uninjured lung. SOD delayed the onset of leukopenia and neutropenia at 3 and 7 min after reexpansion, but the white cell counts had decreased to the same level in both groups by 30 min. SOD had no effect on the degree of injury after 2 h. While a single bolus of SOD given immediately before reexpansion delayed the onset of this injury, it did not affect the injury that subsequently developed in the lung.
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PMID:Evaluation of reexpansion pulmonary edema following unilateral pneumothorax in rabbits and the effect of superoxide dismutase. 239 1

To assess the previously reported association of intraventricular hemorrhage (IVH) with neutropenia, we prospectively followed during a 38-month study period infants with birth weight less than or equal to 1500 gm who survived greater than 72 hours and underwent serial cranial sonography and neutrophil counts for the first 14 days of life. Neutrophil counts were interpreted according to a widely employed reference range. Infants with conditions other than IVH reported to be associated with neutropenia (sepsis, maternal hypertension, 5-minute Apgar score less than or equal to 5) were excluded. Final study groups included 38 infants with IVH and 114 without IVH. No significant differences were found for birth weight, gestational age, respiratory distress syndrome, mechanical ventilation, prolonged rupture of membranes, patent ductus arteriosus, route of delivery, pneumothorax, or sex. The occurrence of neutropenia before 14 days of age was not significantly different between the groups (50% with IVH, 56% without IVH), nor were differences found at individual postnatal ages. Comparison of immature neutrophil count and immature/total neutrophil ratio also revealed no differences. The high incidence of neutropenia in our non-IVH group raises questions about application of these widely accepted reference ranges to very low birth weight infants.
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PMID:Neutropenia and intraventricular hemorrhage among very low birth weight (less than 1500 grams) premature infants. 265 58

Suramin sodium is a reverse transcriptase inhibitor with in vitro activity against the human immunodeficiency virus (HIV), the causative agent of acquired immunodeficiency syndrome (AIDS). Ninety-eight patients with AIDS manifest as opportunistic infections (n = 38), AIDS with Kaposi's sarcoma (n = 38), AIDS-related complex (n = 20), or AIDS-associated non-Hodgkin's lymphoma (NHL) (n = 2) were treated with suramin sodium at 0.5, 1.0, or 1.5 g/wk for six weeks followed by maintenance therapy with 0.5 or 1.0 g/wk. Of 72 patients who were HIV culture positive before therapy and were assessable for subsequent HIV culture 40% became culture negative during treatment, with no apparent correlation between virus recovery and serum suramin concentration. No immunologic improvement was noted. One complete clinical remission was noted in a patient with Kaposi's sarcoma and stage IV NHL. Seven minor clinical responses were also noted. Toxic reactions were generally reversible, and included fever (78%), rash (48%), malaise (43%), nausea (34%), neurologic symptoms (33%), and vomiting (20%). Suramin-induced neutropenia was noted in 26%, thrombocytopenia in 12%, a serum creatinine level of 180 mumol/L or higher (greater than or equal to 2.1 mg/dL) in 12%, liver dysfunction in 14%, and clinical and/or laboratory evidence of adrenal insufficiency in 23%. Sixteen patients died while receiving suramin or within three weeks of discontinuation of drug therapy due to infection (n = 6), hepatic failure (n = 3), pulmonary Kaposi's sarcoma (n = 2), AIDS encephalitis (n = 2), AIDS-associated NHL (n = 1), iatrogenic hemo-pneumothorax (n = 1), or pulmonary disease of uncertain etiology. Suramin as currently administered cannot be recommended as effective therapy for AIDS.
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PMID:Suramin therapy in AIDS and related disorders. Report of the US Suramin Working Group. 365 Mar 39

Neutropenia with abnormal mobility of neutrophils is described in 3 related patients. All presented generalized phlebectasias; 2 had also persistent fetal circulation. One patient died at the age of 2 days from severe pulmonary hypoplasia and bilateral pneumothorax. It is speculated that the defective neutrophil mobility and the vascular abnormalities could be due to a common, genetically inherited, basic defect.
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PMID:Congenital neutropenia associated with phlebectasias and persistent fetal circulation. 716 Nov 18

Fifty-six fibreoptic bronchoscopies were performed on 42 patents with Hodgkin's disease, lymphoma, or leukaemia and pulmonary complications which did not respond to conventional antibiotics. All these patients had received chemotherapy, radiotherapy, or both for the treatment of their underlying conditions. Twenty-two bronchoscopic procedures were complicated by thrombocytopenia and neutropenia, requiring platelet transfusion before bronchoscopy, and many patients were hypoxaemic. Visual examination of the tracheobronchial tree, alveolar lavage, bronchial brushing, and transbronchial biopsy were carried out as approximate. Three patients had minor pulmonary haemorrhage, and three developed a pneumothorax after transbronchial biopsy. A specific diagnosis was obtained in 14 of 18 patients (78%) with diffuse chest radiographic abnormalities, in seven of 11 patients (64%) with lobar or segmental (focal) abnormalities, in two of eight patients with small (local) lesions, and in three of five patients with hilar abnormalities. In only three patients were infections diagnosed. It is concluded that fibreoptic bronchoscopy is a useful and safe diagnostic procedure in this situation but its value depends upon the type of radiological abnormality.
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PMID:Fibreoptic bronchoscopy and diagnosis of pulmonary lesions in lymphoma and leukaemia. 736 Dec 80

One hundred ten women with gynecologic malignancies underwent 116 subclavian vein Groshong catheter insertions at the bedside under local anesthesia and intravenous sedation. Three (2.6%) additional patients had unsuccessful insertions because of an inability to access the subclavian vein or thread the guidewire. Fluoroscopy was not used. There was one delayed pneumothorax and no insertion-related infections. The 111 single-lumen catheters used primarily for the administration of chemotherapy are the subject of this report. The mean age of patients was 60 (range 13 to 89) years and their average Gynecologic Oncology Group performance score was 1.1 (range, 0 to 3). Diagnoses include 74 ovarian, 19 cervical, 13 uterine, and 5 other gynecologic malignancies. Hyperalimentation was administered in 16 (14%) patients. Grade IV neutropenia occurred in 57 (51%) patients and 44 (40%) received granulocyte colony-stimulating factor during therapy. The average lifespan of catheters was 247 (range, 37 to 703) days, and 39 (35%) women died from disease with their catheter in situ at a mean time of 288 days. Thirty-seven (33%) catheters were removed after completion of chemotherapy at an average time of 239 (range, 78 to 448) days. As of 1/1/94, 22 patients continued to use their catheters at a mean of 313 (range, 182 to 509) days. The remaining 13 (11.7%) catheters were removed due to complications (7 episodes of bacteremia, 3 tunnel infections, 2 catheter migration/thromboses, and 1 catheter laceration). Twenty episodes of fever in 17 (15.3%) patients were evaluated with blood cultures in the absence of a tunnel infection. None of the 10 culture negative cases resulted in catheter removal, whereas 7 of 10 patients with bacteremia had catheters removed. Exit site infections occurred in 23 (21%) patients and were resolved with local measures and oral antibiotics. The risk of exit site cellulitis was 3.3% per month. When compared to placement of permanent central venous access devices at our institution in the operating room or radiology suite, bedside placement of Groshong catheters resulted in a savings of $1448 and $231 per case, respectively.
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PMID:An evaluation of Groshong central venous catheters on a gynecologic oncology service. 789 88

Invasive aspergillosis is an emerging cause of death in hematologic patients. Several patterns of lung involvement are described: acute tracheobronchitis, bronchopneumonia, pleural aspergillosis and angioinvasive aspergillosis. The latter pattern is the most common one; it is characterized by different signs, some of which, supported by clinical data, are quite suggestive for fungal etiology. Particularly, nodules and/or wedge-shaped lesions with a ground-glass halo are a useful early feature, best detected by HRCT. Early therapy with amphotericin B may improve survival chances. Therefore, in neutropenia patients we decided, when possible, to perform high-resolution computed tomography (HRCT) as soon as fever appears. This was feasible in 8 of 32 patients with invasive aspergillosis examined with HRCT. Immediate treatment with amphotericin B in one such patient showing a nodule with the halo sign allowed the lesion to completely disappear. The authors describe the frequency of different radiologic signs in 32 patients, as observed in 54 HRCT exams; the results are compared with those obtained with conventional CT and chest X-ray. Compared to chest X-ray, CT detects more lesions and is more sensitive to small pneumothorax and minimal pleural effusion or thickening. HRCT is more suitable to detect initial cavitation and thin ground-glass haloes.
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PMID:[Invasive aspergillosis in the hematologic patient: the usefulness of computed tomographic and high-resolution computed tomographic studies]. 864 47

Sixty-eight patients suffering from breast cancer, ovarian cancer, lymphoma or multiple myeloma were treated with high-dose chemotherapy and autologous stem cell transplantation. They underwent placement of a central venous port via the subclavian vein for delivery of chemotherapy and reinfusion of stem cells. All patients were followed prospectively for device-related and overall complications, comprising a total of 18,213 days in situ (median: 267 days, range: 90-480). One patient experienced a pneumothorax (1.4%) spontaneously resolved, as an acute toxicity. Two patients (2.8%, 0.1 episodes/1000 days of use) were forced to have the port removed due to infection, caused by Streptococcus mitis in one case, while the causative agent was not identified by laboratory tests in the second. The other 66 patients completed the therapeutic programme, including peripheral stem cell reinfusions and supportive care, such as i.v. antibiotics, antiemetics or fluid administration and blood sample collection, without additional complications. In conclusion, the use of totally implantable central venous access ports has resulted in good long-term access to central veins, in spite of the severe neutropenia and increased septic risk of this category of oncology patients.
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PMID:Totally implantable central venous access ports for high-dose chemotherapy administration and autologous stem cell transplantation: analysis of overall and septic complications in 68 cases using a single type of device. 1043 41

The aim of this study was to evaluate the efficacy of percutaneous treatment of pulmonary lesions from invasive aspergillosis in immunocompromised patients. From 1992 to 1998, ten patients (seven men and three women; mean age 56 years) affected by hematological neoplasms (8 acute myeloid leukemias, 2 non-Hodgkin's lymphomas) and post-chemotherapy prolonged neutropenia developed pulmonary lesions from invasive aspergillosis. A total of 13 lesions (diameter 2-7 cm, median 5 cm) were treated percutaneously due to insufficiency of the high-dose i.v. therapy; under CT guidance, a median of 10 cm3 per session of a 1 mg/cm3 diluted solution of amphotericin B was injected through a fine needle (21-22 G); 45 sessions overall were performed (one to five per lesion, median four), according to the volume of the nodules, tolerance, and complications. The results were retrospectively evaluated either radiologically or clinically. Complications were cough, mild hemoptysis, and small pneumothorax and/or pleural effusion. No major complications occurred. One month after the beginning of treatment, 8 lesions completely resolved, 4 greatly improved, and 1 was not significantly reduced. In all ten patients symptoms improved (eight of ten could restart chemotherapy as scheduled). After antiblastic retreatment, 1 patient had mycotic recurrence. In our experience transthoracic topical treatment with amphotericin B of single or few lung lesions from invasive aspergillosis was effective, affording a rapid improvement of the lesions and symptoms, and allowing continuation of chemotherapy as scheduled, thereby reducing the risk of recurrences.
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PMID:Percutaneous treatment with amphotericin B of mycotic lung lesions from invasive aspergillosis: results in 10 immunocompromised patients. 1130 75

Nineteen dogs were identified that had mastocytemia (mast cells in venous blood samples) not associated with mast cell neoplasia. The first 10 dogs were identified by examination of blood films from dogs with suspected parvovirus enteritis (8), fibrinous pericarditis and pleuritis secondary to thoracic lacerations (1), and renal insufficiency of unknown cause (1). Because of the apparent association with acute enteritis, blood films from 52 suspected canine parvovirus cases were examined retrospectively and 8 mastocytemic dogs were found. An additional 52 canine blood films were randomly selected from the same retrospective time period and 1 mastocytemic dog was found that had pneumothorax, pelvic fractures, and hemorrhagic septic abdominal effusion secondary to renal hemorrhage and traumatized intestines. All mastocytemic dogs had acute inflammatory leukograms the day that mast cells were first detected: neutropenia with toxic neutrophils (4), neutropenia with a left shift (8), total neutrophil count within reference interval but with a left shift (5), or neutrophilia with a left shift (2). All dogs except the renal insufficiency case had circulating toxic neutrophils. Five dogs were mastocytemic on more than 1 day. The pathogenesis of the mastocytemia associated with the acute inflammatory disease was not determined.
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PMID:Mastocytemia in dogs with acute inflammatory diseases. 1533 38


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