Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027947 (neutropenia)
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A comparison of the clinical features, predisposing factors, side effects by antitubercular drugs and diagnostic procedures in pulmonary tuberculosis in 37 younger and 35 elderly men was carried out. Elderly patients had a higher number of underlying diseases including cardiovascular diseases and hypertension than younger patients. The classic symptoms and signs of tuberculosis, such as productive cough, fever and general fatigue, were observed in relatively high proportions of both patients, whereas weight loss (43% vs. 16%) and crackles in the lung fields (49% vs. 16%) were significantly higher in the elderly patients than the younger ones. As for roentgenographic abnormalities, a higher involvement of middle and lower lung fields was seen in the elderly patients than in the younger. Although leukocytosis was noted in a significantly lower proportion of the elderly patients, neutropenia due to drug treatment was significantly higher (23%) than in younger patients (5%). In a mass survey, the detection of pulmonary tuberculosis in elderly men was significantly lower (23%) than that in younger men (54%). Although improved living conditions, better sanitation and the development of new chemotherapeutic agents have contributed to the decline of pulmonary tuberculosis in general populations, better procedures for early detection or diagnosis of pulmonary tuberculosis in the elderly people should be achieved as soon as possible.
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PMID:Clinical features of pulmonary tuberculosis in young and elderly men. 273 43

A comparison of the clinical features, predisposing factors, drug-induced adverse effects and diagnostic approach in pulmonary tuberculosis in 37 younger and 35 elderly men was carried out. Elderly patients had a higher number of underlying diseases, including cardiovascular diseases and hypertension, than younger patients. The classic symptoms and signs of tuberculosis, such as productive cough, fever and general fatigue, were observed in relatively high proportions of both patients, whereas weight loss (43 vs. 16%) and crackles in the lung fields (49 vs. 16%) were significantly higher in the elderly patients than the younger ones. As for roentgenographic abnormalities, a higher involvement of middle and lower lung fields was seen in the elderly patients than in the younger. Although leukocytosis was noted in a significantly lower proportion of the elderly patients, neutropenia due to drug treatment was significantly higher (23%) than in younger patients (5%). In a mass survey, the detection of pulmonary tuberculosis in elderly men was significantly lower (23%) than that in younger men (54%), suggesting that an extensive mass survey for pulmonary tuberculosis in elderly men should be done.
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PMID:Comparison of younger and elderly patients with pulmonary tuberculosis. 278 9

To discuss diagnosis, risk factors, clinical and radiologic manifestations of invasive pulmonary aspergillosis (IPA) that is accepted as an important mortality factor in organ transplant recipients. We retrospectively evaluated seven IPA cases who were diagnosed among 207 patients that had undergone organ transplantation surgery in our center between 1998-2001. Of seven patients, four was renal and three was liver recipients. Diagnosis was made histopathologically (three post-mortem, one transbronchial lung biopsy) in four patients while culture positivity (sputum and tracheal aspiration material) with clinical and radiological evaluation was the diagnostic criteria for three patients. The most common respiratory symptoms were fever, productive cough and dyspnea. The most common fiberoptic bronchoscopic findings were mucosal fragility, hemorrhage. In one patient plaque formation was found. One liver recipients had been on hemodialysis because of renal insufficiency (serum creatine was 2.6 mg/dL). All liver and kidney recipients had allograft failure. One liver and two kidney recipients had neutropenia, two liver and one kidney recipients had thrombocytopenia. Six patients had received amphotericin-B and/or itraconazole therapy. Four of the five exitus were receiving antifungal treatment. Three of them were lost in a short time while only one non-survivor had received itraconazole for three weeks. The most frequent CT findings were patchy infiltrations and nodule formation with or without cavitation. Five patients were lost in two months (mortality, 71.4 %), two survivors are under follow up. These findings showed, IPA should be thought in the differential diagnosis of pulmonary infections after organ transplantation.
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PMID:[Invasive pulmonary aspergillosis in solid organ transplant recipients]. 1514 25

A 67-year-old man was admitted to our hospital, complaining of productive cough and chest pain. Chest radiograph and computed tomography revealed a huge mass invading the mediastinum, enlargement of right hilar and cardiophrenic lymph nodes and nodules in right lower lobe and left upper lobe. Multiple space occupying regions in the liver were also observed. Cytology for exfoliated sputum revealed adenocarcinoma, so he was diagnosed with advanced lung cancer (clinical stage T 4 N 2 M 1, stage IV). He was enrolled in a clinical phase II study, and received combination chemotherapy with TS-1 and cisplatin. TS-1 was administered on days 1-21. Cisplatin was administered on day 8. Every cycle was repeated every 5 weeks. The patient then received 6 cycles of chemotherapy,and yielded a partial response (87% decrease in size determined by RECIST criteria version 2. 0). Grade 2 leukopenia and neutropenia were observed, and non-hematologic toxicities were also mild. The disease progressed after the end of chemotherapy, and he was given 5 regimens of chemotherapy, including gefitinib. He died of brain metastases. Time to progression of his disease for combination chemotherapy using TS-1 and cisplatin chemotherapy was 240 days. Survival time was 709 days. This combination chemotherapy was effective in the present case, and might prolong survival. We think it is valuable to confirm the efficacy of TS-1 and cisplatin combination chemotherapy.
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PMID:[A case of adenocarcinoma of the lung significantly responding to TS-1 plus cisplatin combination chemotherapy]. 1661 61

A 63-year-old man was admitted for pneumonia with neutropenia. After the pneumonia resolved with administration of antibiotics and granulocyte colony-stimulating factor, he was diagnosed with autoimmune neutropenia (AIN) on the basis of bone marrow findings and positive antineutrophil antibodies. He had recurring high fever once or twice a month with productive cough and an elevated serum C-reactive protein level. However, after the initiation of treatment with oral trimethoprim-sulfamethoxazole (TMP/SMX), the respiratory tract infection no longer recurred. The standard management for adults with AIN has not been established. In our case, the recurrent infection was resolved with TMP/SMX prophylaxis. Thus, TMP/SMX prophylaxis may be beneficial for managing adults with AIN.
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PMID:Efficacy of using trimethoprim-sulfamethoxazole prophylaxis in an adult patient with autoimmune neutropenia. 3151 7