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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Bronchoalveolar washout was performed in 130 patients with pneumonia during a period of 28 months. Microbiological investigation involved common bacteria, Legionella, fungi, viruses (Cytomegalovirus, herpes, RSV), Mycobacterium, and Pneumocystis carinii. Infection HIV was present in 75% of patients. The remaining patients had malignant diseases or severe pneumonia. The overall sensitivity of the technique was 65.4% and the positive predictive value was 92%. The technique was less sensitive in cases of bacterial pneumonia (sensitivity = 34.4%). This was attributed to the fact that 82.8% of these cases received antibiotic therapy. Pneumocystis carinii and Mycobacterium tuberculosis were the most common agents (44.8% and 34.5%, respectively). In seven instances the clinical picture was related to cytomegalovirus, although this diagnosis can not be easily done.
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PMID:[Evaluation of bronchoalveolar lavage in the microbiological diagnosis of pneumonia in patients at risk]. 186 7

Two types of postoperative complications should be distinguished, i.e. early complications including a lethality within 30 days and delayed complications which may occur after several years. In the period between 8/1985 and 12/1987 216 operations were carried out on patients with bronchial carcinoma. The operative lethality rate was 2.3%. The most frequently performed operation was lobectomy with 59% followed by pneumonectomy including extended pneumonectomy with 17.5%. 57.7% of patients with bronchial carcinomata were resected in the early stage I and II, and 26.4% of patients in stage IIIa. Squamous cell carcinomata occurred most frequently, with an incidence of 41%. Of the common postoperative complications cardiac arrhythmia was to be found most often (27%). Pulmonary embolism developed in 5% of all cases, cerebral complications in 3.7%, wound infections in 2.3% and post-operative haemorrhages in 1.3%. Bronchus stump insufficiency and dehiscence of suture were found in 2.2%, and pleural empyema in 4.2% of the complications directly resulting from the operation. Only 6 of 9 patients had suffered an persistent bronchopleural fistula lasting 7 days. Infections of the respiratory tree were identified in 18.3% and pneumonia in only 8.3% of cases. Delayed empyemas and bronchus fistulas belong in the category of delayed complications. The risk of deformation of the vertebral column caused by processes of involution in the cavity of pneumonectomy should be kept in mind following pneumonectomy. A distinction shall be made between the postthoracotomy syndrome an classical intercostal neuralgia, which has a sharply defined clinical picture and may be treated by operative neurolysis or resection of the nerve.
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PMID:[Early and late postoperative complications in thoracic surgery interventions]. 187 91

Antibiotic usage for initial empirical treatment of infections in hospitalized patients was assessed by means of a questionnaire sent to physicians in charge of surgical and medical intensive care units, departments of neurosurgery, neurology, general surgery, thoracic surgery, internal medicine and pediatrics. Analysis of a total of 82 questionnaires filled in by the various departments revealed that the most frequently used regimens for initial empirical therapy were combinations of a broad spectrum penicillin with an amino-glycoside or of a second generation cephalosporin with an aminoglycoside in intensive care. Third generation cephalosporins ranked third among combination partners with aminoglycosides. Imipenem and fluoroquinolones were used only rarely for first line treatment. Second line treatment was most frequently with third generation cephalosporins or imipenem/cilastatin for internal wards and intensive care with an extension for staphylococcal infections with vancomycin or teicoplanin as the most frequent additional antibiotics. Patterns of antibiotic usage changed with regard to infection sites with a predominance of third generation cephalosporins or broad spectrum penicillins in combination with an aminoglycoside and metronidazole in abdominal sepsis and peritonitis. In case of pneumonia a differentiation between community acquired and hospital acquired pneumonias was made. Treatment was predominantly carried out with penicillin G, ampicillin or a second generation cephalosporin with or without the addition of an aminoglycoside in case of community acquired pneumonia. The addition of clindamycin or metronidazole was considered for suspected staphylococcal infection or aspiration pneumonia. Third generation cephalosporins were preferred for pneumonia treatment in surgical patients.
Infection
PMID:Antibiotic usage for initial empirical treatment of infections in hospitalized patients in West Germany. 188 63

Incidence and fatality of neonatal sepsis in intensive care units have been relatively high despite progress in the management of very ill neonates and combined treatment of sepsis with antibiotics. Between 1985 and 1989 944 children (632 premature babies and 312 term babies) were treated in the intensive care unit of the University Children's Hospital of Kiel. The incidence of sepsis was 5% (congenital sepsis 4%, sepsis acquired after birth 1%). Pneumonia occurred in 4% (congenital pneumonia in 2%, postnatal pneumonia in 2%). Early diagnosis and treatment with piperacillin plus cefotaxime reduced the mortality rate of sepsis to 2%. Sepsis never developed under treatment with piperacillin plus cefotaxime. Early recognition of neonatal sepsis by a good blood culture technique and beginning of treatment on first suspicion of sepsis with cefotaxime and piperacillin can improve the results especially in intensive care patients.
Infection
PMID:Neonatal sepsis in an intensive care unit and results of treatment. 188 66

Twenty-five pediatric orthotopic liver transplantations (OLTs) performed in 22 patients at Sainte-Justine Hospital were reviewed for infections complications. One patient died within 12 hours posttransplantation and is excluded. The patients had an average age of 6.1 years (range, 1.25 to 19 years) and an average weight of 20.4 kg (range, 11 to 55 kg). Two patients (9%) were cytomegalovirus (CMV) seropositive and 9 of 19 patients (48%) were Epstein-Barr virus (EBV) seropositive preoperatively. Five of the donors (20%) were CMV seropositive. The most common indications for OLT were biliary atresia (8) and tyrosinemia (7). There were 4 deaths, for an overall mortality rate of 19%. In 3 patients, deaths were related to infection (CMV hepatitis and duodenitis with aortoduodenal fistula, adult respiratory distress syndrome [ARDS] with Streptococcus viridans pneumonia, Escherichia coli cholangitis with progressive hepatic failure). Fifteen patients (72%) had 41 major infections, most of them bacterial, during the first month posttransplantation. These include pneumonia (25%), line sepsis (17%), cholangitis (14%), and tracheitis (14%). There was only one major viral infection, a CMV hepatitis that occurred in the first month posttransplantation. Three patients had fungal infections (8%) associated with hepatic artery thrombosis and recurrent cholangitis. All three patients required retransplantation. There was only one protozoal infection (Pneumocystis carinii pneumonia) causing life-threatening respiratory failure, from which patient recovered without sequelae. Infection still remains a serious complication of OLT. Bacterial infection is common and is usually associated with technical complications. The low rate of CMV infection is related to low incidence of CMV in the donor pool and the minimal use of strong immunosuppressants.
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PMID:Infectious complications of pediatric liver transplantation. 191 82

A woman in the first trimester of pregnancy presented with pneumonia and hilar lymphadenopathy after exposure to lambing ewes. She subsequently aborted. Infection with Chlamydia psittaci of ovine origin was confirmed. Pregnant women are susceptible to this infection, which may cause life threatening disease. The patient also had features of sarcoidosis, and the two conditions ran a similar time course. There is a possibility that ovine psittacosis caused an illness indistinguishable from sarcoidosis.
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PMID:Ovine psittacosis and sarcoidosis in a pregnant woman. 192 35

We analyzed 101,479 nosocomial infections in 75,398 adult patients (greater than 15 years) that were reported to the National Nosocomial Infections Surveillance (NNIS) system between 1986 and 1990 by 89 hospitals using the NNIS hospital-wide surveillance component. Overall, 54% of the infections occurred in elderly patients (greater than or equal to 65 years). In the elderly, 44% of the infections were urinary tract infections (UTIs), 18% were pneumonias, 11% were surgical wound infections (SWIs), 8% were bloodstream infections (BSIs), and the remainder were infections at other sites. When we compared the infections in elderly patients with those in younger adult patients, ages 15 to 64 years, a far greater percentage of the infections in elderly patients were UTIs, and there were more pneumonias than SWIs. Elderly and younger patients with ventilator-associated pneumonia were about 1.5 times more likely to develop a secondary BSI than those with pneumonia not associated with ventilator use. When the pathogens isolated from the infections were compared to those reported to the NNIS system in 1984, the percentage that were coagulase-negative staphylococci had increased in both elderly and younger patients. The patient died in 12% of all of the infections. Surveillance personnel reported that 54% of the infections in elderly infected patients who died were related to death compared with 59% in younger infected patients who died. When the infection was related to the patient's death, it was most often pneumonia or a BSI. The risk of an infection-related death was significantly higher when the infected patient developed a secondary BSI. Infection prevention efforts should target infections that occur frequently, are amenable to intervention, and have an adverse outcome.
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PMID:Nosocomial infections in elderly patients in the United States, 1986-1990. National Nosocomial Infections Surveillance System. 192 80

Ultrastructural changes occurred in alveolar epithelium in the acute and repair stages of induced respiratory syncytial virus pneumonia induced in eight calves (calf Nos. 1-7, 3 to 6 days old and calf No. 8, 2 weeks old), using a bovine strain of respiratory syncytial virus. Five of the calves were Friesians, three were Hereford x Friesians, and all were male. Tissues from three mock-infected control calves (two Friesian, one Hereford x Friesian) were also examined. Evidence of respiratory syncytial virus infection was observed in both type I and type II pneumocytes from day 4 to day 8 after infection. Infection of type I pneumocytes frequently resulted in necrosis. The response of type II pneumocytes to respiratory syncytial virus infection varied and included hypertrophy, hyperplasia, and syncytial formation. In some infected type II pneumocytes, there were numerous irregular projections of the cell surface, associated with viral budding. Hypertrophy and hyperplasia of type II pneumocytes, epithelial syncytium formation, and irregular cytoplasmic projections from epithelial cells caused considerable thickening of respiratory membrane and occlusion of alveolar lumina. Neutrophils were frequently observed in close association with virus-infected epithelial cells, but evidence of respiratory syncytial virus infection and replication was not observed in alveolar macrophages or neutrophils. Proliferation of type II pneumocytes appeared to play a major role in maintaining the integrity of the alveolar epithelium during the acute stage of the experimental pneumonia. Increased numbers of type II pneumocytes were present on alveolar walls, particularly from 4 to 8 days after infection, and some alveoli were lined entirely by this cell type. In some areas, however, squamous epithelial cells were also involved in covering exposed alveolar basement membrane.
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PMID:Ultrastructural features of alveolar lesions in induced respiratory syncytial virus pneumonia of calves. 194 7

This paper presents the epidemiological study of respiratory viral infections in Croatia from 1 September 1986 till 31 August 1987. A total of 527 patients with acute respiratory diseases were examined. Their nasopharyngeal secretion and/or throat swab were taken and the viruses were demonstrated by the method of direct viral diagnosis (isolation and rapid immunofluorescent detection). This 12-month study on acute respiratory infections in Croatia in 1986/1987 shows that viruses were the agents in 47.2% of these infections. Out of a total of 527 patients with acute respiratory disease, 177 patients had RSV (prevalence 33.6%), 40 adenovirus (prevalence 7.6%), 18 enterovirus (prevalence 3.4%), 12 parainfluenza (prevalence 2.3%), 8 herpes simplex virus (prevalence 1.3%) and 3 influenza virus (prevalence 0.6%) infection; (9 patients had mixed infections with two viruses). Viral etiology was proved in 44.0% of upper respiratory tract infections, 86.5% of bronchiolitis, 63.3% of pneumonia, 57.5% of bronchitis, and 33.3% of croup. The epidemical wave of RSV infections started in October 1986 and lasted for the next 7 and a half months with a peak in December 1986. Infections with parainfluenza occurred in November 1986 and subsided in March 1987 with a peak in December 1986. An epidemic of adenovirus occurred in two waves and lasted throughout 9 months. Enteroviruses caused infections during the fall and at the beginning of the winter 1986 but also again in the spring 1987.
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PMID:Epidemiological picture of respiratory viral infections in Croatia. 195 Jun 39

Cancer of the head and neck is a common cancer worldwide. The majority of patients present with locally advanced disease. Recently a great deal of improvement has been made in multimodality therapy of this disease, warranting more careful consideration of factors affecting quality of life, disease course, and treatment. Infection is clearly a factor. Analysis of 662 hospital admissions of 169 head and neck cancer patients was performed. A definite infection was documented in 86 febrile episodes, pneumonia contributed to 40%, bacteremia to 13%, skin and soft tissue infection to 12%, and tracheobronchitis to 10%. Among the evaluated risk factors, foreign bodies, specifically intravenous (IV) cannulae and gastrostomy tubes, race, performance status, alcohol intake, and nutritional status were statistically significant variables that predicted for or were associated with infection. Infection contributed to 44% of the deaths.
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PMID:The role of infection in the morbidity and mortality of patients with head and neck cancer undergoing multimodality therapy. 198 64


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