Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Five-thousand portable or posterior-anterior-lateral radiographs of acute care emergency department patients were interpreted. They revealed serious disease in 35% of patients with chest symptoms, in 27% of all patients examined, and in 18% of patients with noncardiorespiratory symptoms. The highest incidence of abnormal radiographs (42%-79%) occurred in patients with symptoms of congestive heart failure, dyspnea, hemoptysis, dysrhythmia, and hypertension. Asthma (14%) and trauma (5%) presented the lowest incidence of significant findings. Radiographs of patients suspected of having pneumonia were abnormal in 25% of cases, and in those patients with either cough or fever alone, the incidences of pneumonia were 13% and 18%. Whereas 24% of patients with dyspnea alone had radiographic findings of congestive heart failure, 52% of those with congestive heart failure diagnosed on clinical grounds had abnormal radiographs. The chest radiograph continues to be a significantly important examination in the diagnosis of disease, the prevention of overtreatment, and the redirection of clinical investigation in the acute care emergency department unit.
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PMID:Five thousand acute care/emergency department chest radiographs: comparison of requisitions with radiographic findings. 317 Nov 20

Phrenic nerve palsy (PNP) is seen in infants and young children usually resulting from operative trauma or birth injury. Spontaneous recovery usually occurs, but occasionally surgical plication is necessary. Twenty-three cases of PNP over a 10-year period were managed surgically. Patient ages ranged from 1 day to 30 months (median, 4 months), 18 were male and five female. Cause was operative trauma in 18 (17 cardiac surgery, one neuroblastoma), birth trauma in two, and idiopathic in three. The right side was involved in 14, the left in eight, and both in one. Indications for plication were inability to wean from the ventilator (group 1, 16 patients), recurrent pneumonia (group 2, four patients), and respiratory distress (group 3, three patients). The 16 patients in group 1 were intubated for a median of 18.5 days from onset of PNP to plication. Postoperatively, three had continuing congestive heart failure (one died at 16 days of age, one was still chronically ventilated at 22 months, one was extubated at nine days); the other 13 were extubated at a median of two days postoperatively. All the patients in groups 2 and 3 were extubated within two days of surgery. Twelve plications were transthoracic and 11 were transabdominal. Postoperative complications included pneumonia (2), wound infection (1), pneumothorax (2), and mucous plug with pulmonary collapse (1). One patient died of cardiac failure at 16 days. One patient in group 3 developed recurrent respiratory distress 4 months postoperatively; he had a recurrent elevated hemidiaphragm requiring a second plication.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Plication of the diaphragm for infants and young children with phrenic nerve palsy. 317 45

A 66-year-old white man with amiodarone pneumonitis is presented. The diagnosis was made with the aid of Ga-67 imaging, which is a sensitive method of detecting amiodarone pulmonary toxicity in patients with symptomatic pulmonary infiltrates on chest radiographs. Ga-67 imaging is especially useful in distinguishing amiodarone pneumonitis from congestive heart failure.
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PMID:Gallium-67 and pulmonary complications of amiodarone. 323 70

To exploit possible different non-cross-resistant mechanisms of cytotoxicity, 25 patients with advanced breast cancer were given combination chemotherapy consisting of iv mitoxantrone (7 mg/m2) and doxorubicin (30 mg/m2) every 3-4 weeks. The patients had predominantly visceral disease and received a median of six (range, one to 12) cycles of therapy. There were no complete responders, but 13 patients (52%) achieved partial remission lasting a median of 8 months (range, 4-21+). Three patients (12%) had disease stabilization and nine (36%) had disease progression. Hematologic toxicity was generally mild, with median wbc count and platelet count nadirs of 1900/mm3 (range, 700-3100) and 160,000/mm3 (range, 49,000-406,000), respectively. One patient may have died from treatment-related sepsis (pneumonia), but lymphangitic lung disease was not excluded. Hair loss progressing to severe alopecia over several treatment cycles was relatively common, affecting seven of 16 evaluable patients (44%). Vomiting was mild or absent in 17 (71%) of 24 evaluable patients. Three of 15 patients in whom serial measurements of left ventricular ejection fraction were performed developed significant reductions compatible with anthracycline-induced cardiotoxicity. Two of these patients also had pericardial effusions and one developed congestive heart failure. In conclusion, mitoxantrone and doxorubicin is an active, well-tolerated drug combination for the treatment of advanced breast cancer but may have appreciable cardiotoxicity.
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PMID:Phase II trial of a combination of doxorubicin and mitoxantrone in metastatic breast cancer. 330 79

In relation to antiasthmatic treatment of hospitalized patients with theophyllines, results concerning: a) a retrospective analysis of plasma levels observed over a 18-month period; b) a pharmacokinetic study and consequent determination of an efficient individual posology are reported. On the 194 serum drug tests (each comprehensive of the trough and peak concentrations) evaluated, 58 (30%) entered the retrospective study, after screening by predetermined criteria. 96 out of 194 (49%) tests were eliminated because of inappropriate sample collection or irrational dosage regimen. The theophylline blood levels, distinguished by drug formulation and posology, were spread over very large ranges (coefficient of variation up to 88%, mean of 55%), so that many concentrations were subtherapeutic or potentially toxic. The kinetic study, undergone by 22 patients, was carried out by administering and intravenous test-dose of aminophylline, followed by collection of blood samples at determined times. Elimination half-life, clearance and volume of distribution were then calculated by means of the plasma theophylline concentrations and subsequently an individual optimized dosage regimen (so as to keep the blood drug levels within the 8-16 mg.l-1 range) was determined. The considerable variability of elimination rate observed among patients (extreme values of half-life and clearance differ 10-fold) mainly account for the unforeseeability of plasma levels obtainable with a given posology. Even if the factors affecting the elimination rate of theophylline (i.e. cigarette smoking, obesity, congestive heart failure, chronic obstructive pulmonary disease, pneumonia) are taken into account, the blood concentrations are frequently unforeseeable. Therefore, the monitoring of plasma levels is necessary for every patient treated with theophyllines and a pharmacokinetic study is desirable in some cases.
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PMID:[Importance of the laboratory in optimizing anti-asthma therapy with theophylline]. 332 89

Autopsies are performed much less frequently in the elderly than in younger patients. Little information exists as to causes of death in the institutionalized elderly. The clinical diagnostic error rate documented by autopsy studies ranges from 6% to 68%. We analyzed the clinical and autopsy records of 234 patients who died during a 14 1/2-year period at our chronic care institution to determine the accuracy of clinical cause of death in addition to the pathologic cause of death. The most common causes of death included bronchopneumonia (33%), congestive heart failure (15%), metastatic carcinoma (14%), pulmonary embolism (8%), myocardial infarction (7%), cerebrovascular accident (6%), unknown cause of death (8%), and a miscellaneous group (9%). The highest diagnostic error rate was in the underdiagnosis of pulmonary embolism (39% antemortem accuracy rate). The most accurately diagnosed condition was cerebrovascular accident (92% antemortem accuracy rate). Pneumonia was correctly diagnosed antemortem in 73% of the patients studied. These data suggest that serious and potentially treatable illnesses are underdiagnosed in the elderly institutionalized patient and that there is valuable information to be learned by performing autopsies in the elderly population.
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PMID:Autopsy study of the elderly institutionalized patient. Review of 234 autopsies. 333 92

A case of Marfan's syndrome diagnosed in a newborn boy is described. Both parents were affected by the disease but none of them was aware of it. The boy had cardiac, skeletal and ocular manifestations from birth. He suffered early from severe congestive heart failure due to mitral insufficiency and died at four months of age of pneumonia. The family history is described in this report.
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PMID:Probable homozygotic form of the Marfan syndrome in a newborn child. 338 43

A prospective prognostic study of all admissions to a geriatric assessment and rehabilitation unit was carried out which analysed the medical profiles of 205 patients admitted for the first time during a four month period. All patients were followed up for at least six months after discharge. Particularly poor prognosis was noted among patients with renal failure, ischaemic heart disease, depression, pneumonia, congestive cardiac failure, trauma, mental disorder and dementia. Good prognosis was reported in patients with Parkinson's disease, faecal impaction, stroke and adverse drug reactions. Multiple diagnoses were common, and only nine patients had no active medical problems during their admission. The implications for adequate training of geriatricians in medicine are discussed.
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PMID:Medical profiles of patients admitted to a geriatric assessment and rehabilitation unit. 345 Nov 40

To determine if there are any unique features of nursing home-acquired pneumonia we carried out a case-control study wherein each patient admitted with nursing home-acquired pneumonia was age- and sex-matched with a patient with community-acquired pneumonia. There were 36 men and 38 women in the nursing home group. The mean age of both groups was 74 years. The mortality rate for nursing home-acquired pneumonia it was 40.5%, whereas for community-acquired pneumonia it was 28% (P = NS). Patients with nursing home-acquired pneumonia had a significantly higher incidence of dementia and cerebrovascular accidents, and patients with community-acquired pneumonia were more likely to be smokers and to have chronic obstructive pulmonary disease. Aspiration pneumonia was more common among patients with nursing home-acquired pneumonia (P less than .001), and Hemophilus influenza pneumonia more common among the patients with community-acquired infection (P less than .01). Sputum for culture could be obtained in only 31 and 39% of the patients--contributory to the high rates of pneumonia of unknown etiology 63.5 and 56.1% for the nursing home group and the control subjects, respectively. Patients with nursing home-acquired pneumonia received cloxacillin and aminoglycosides more frequently than patients with community-acquired pneumonia (P less than .05), and patients with community-acquired pneumonia received erythromycin more frequently than patients with nursing home-acquired pneumonia (P less than .05). Complications were common during the hospital stay of these patients--the most frequent being congestive heart failure, urinary tract infection, renal failure, and respiratory failure.
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PMID:Nursing home-acquired pneumonia. A case-control study. 348 49

This retrospective study consisted of 500 consecutive renal transplantations performed between September 1977 and September 1981. Preoperatively, congestive heart failure was registered in 262 cases (53.0%) and blood pressure disease in 352 cases (71.3%). The total number of patients with ischaemic heart disease was 22 (4.5%). General anaesthesia was given in 493 and regional anaesthesia in seven cases. In general anaesthesias, tubocurarine was the main relaxant and halothane the main inhalation agent used. Major complications during anaesthesia were blood pressure changes with a higher incidence of hypotension (49.6%) than hypertension (26.8%). Severe cardiac arrhythmias were rare and no intraoperative deaths occurred. One patient was successfully resuscitated in the ICU postoperatively, this being possibly related to hypoventilation caused by prolonged muscular relaxation. Other rare complications included one pneumothorax, one haemo- and hydrothorax, and two large haematomas all caused by preoperative central venous cannulation. In 69 cases (14.0%) additional neostigmine doses and in 34 cases (6.9%) naloxone was given at the end of anaesthesia. Pneumonia during the first postoperative week was recorded in 11 cases (2.2%), and occurred only in patients who received general anaesthesia. One of the three patients who died during the first week developed pneumonia postoperatively.
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PMID:Anaesthesiological complications in renal transplantation: a retrospective study of 500 transplantations. 354 45


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