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

The most universally employed measurement of the impact of epidemics and pandemics is the excess of mortality due to influenza and pneumonia. Other criteria are absenteeism from school and work, and all three will show positive indications when epidemics are of substantial size. During the 1974-1975 influenza season in Houston, school and industrial absenteeism and the increase in influenza and pneumonia deaths, despite a newly devised statistical procedure, did not signal an epidemic. However, a system of community surveillance of febrile respiratory illness with cultures for influenza virus during late January and early February 1975 gave unmistakable evidence of an influenza epidemic, with more than 600 virus isolations and an estimated occurrence of 50,000 cases of the disease. It is believed that this type of study can explore facets of the epidemiology of the disease not hitherto adequately examined. From this surveillance, which will continue through the summer months, it is hoped to gain further knowledge of the occurrence of antigenic drift and shift, and of the details of the early origin and progress of epidemics. Current speculation is that there will be another world pandemic before 1980 caused by a derivative of A strains presently circulating; in 1985-1991, a pandemic is predicted to be caused by a virus antigenically related to the swine agent of 1918. The purity of vaccines has been increased in recent years through ultracentrifugation and high-efficiency filtration, so that dosages can be increased while severity of reactions is reduced. The current level of dosage of vaccine for adults is 1200 chick cell agglutinating units, almost double what it was a dozen years ago. Recently, vaccines have been prepared more rapidly by the use of viral recombinants that incorporate the surface antigens of newly emerged epidemic strains into the core of older strains that grow well in embryonated eggs. This practical device greatly reduces the lead time in the preparation of new vaccines. The main problem in immunization against influenza is the need to reimmunize every 1-3 years. This creates an enormous requirement for vaccine and therefore a problem of selection of recipients. Currently, it is recommended that aged persons and those with cardiovascular, pulmonary and other chronic illnesses should receive the vaccine. Pregnant women are not more susceptible than others to the disease, and they should receive vaccine only if they have some other indications for immunization. Schoolchildren probably are important in transmission of the disease, but at present there is no special recommendation to immunize them. Young children occasionally have severe febrile convulsions when immunized against influenza, and those with this history probably should not be immunized. Amantadine is useful as a prophylactic agent in A(H3N2) influenza infections, and several reports suggest therapeutic benefits as well. Its benefits probably have not been fully utilized...
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PMID:Influenza. 104 31

Cell-mediated immunity (CMI) was assessed during infection and after convalescence in 12 patients with influenza pneumonia and 10 patients with bacterial pneumonia. The patients with influenza pneumonia had a marked impairment of skin test reactivity, and their lymphocytes showed a diminished response to phytohemagglutinin and streptokinase-streptodornase stimulation in vitro. Suppression of CMI was related to the severity of the pneumonia. Patients with bacterial pneumonia showed as great a suppression of the response to phytohemagglutinin and streptokinase-streptodornase as the patients with viral pneumonia. All parameters of CMI returned to normal in both groups after convalescence. The depression of CMI could not be related to a decrease in the number of thymus-derived lymphocytes or to serum-suppressive factors in these patients.
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PMID:Effect of viral and bacterial pneumonias on cell-mediated immunity in humans. 108 45

An important consideration in evaluating vaccines is the duration of immunity. The only really important measure of this immunity is the protection against infections and/or illness at various time intervals, following natural or artificial challenge. There are few data of this sort, more commonly immunity is estimated by measuring serum antibody, in many instances an erroneous measure. Serum antibody levels to respiratory viruses fall only slightly 6 months following infection or immunization. It is difficult to assess the duration of antibody for much longer than this, because of problems with intercurrent infection. With respiratory bacterial infections, e.g. pneumococcal pneumonia, parenterally-induced immunity probably lasts for only several months. Secretory antibody induced by inactivated viral vaccines, seems to persist for about a year, after having reached a peak level at about 4-6 weeks following immunization. Work with the live attenuated polio virus vaccine indicates longer lasting immunity, with detectable antibody persisting for up to 34 months. Restimulation with the inactivated polio virus vaccine produced no evidence of a secondary response (memory). Following booster immunization with influenza very little evidence of memory is seen. Cell-mediated immunity (CMI): in guinea pigs BCG sensitization can be demonstrated for at least 2-9 months. In humans, intracutaneous BCG immunization leads to positive tuberculin reaction in 6-10 weeks, and skin sensitivity lasts an average of about 4 years. There is contradicting data as to the duration of protection against infection following BCG immunization. Local and systemic CMI have been shown to exist independently of each other in experimental animals and man.
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PMID:Duration of circulating and secretory antibody and cell-mediated immunity following immunization. 112 72

Individual cases of influenza are not reported nationally to the Center for Disease Control (CDC). Other methods of surveillance, therefore, must be used to estimate the extent and impact of influenza in the country. In the past, CDC has performed telephone surveys during the respiratory season and tabulated mortality due to pneumonia and influenza from 121 cities. The telephone data vary considerably from state to state and are only a general assessment of influenza activity. Tabulation of influenza-pneumonia deaths reflects more accurately the extent and impact of influenza but suffers from a 3-4 week-lag behind the actual clinical events. To improve influenza surveillance over the past 2 years, CDC obtained weekly numbers of emergency room visits to large community hospitals, school and industrial absenteeism, numbers of specimens submitted and numbers positive for influenza isolation from laboratories throughout the United States. Surveillance was most effective in large urban areas of the US where community hospital emergency rooms function as private physicians. Where people are more likely to consult a private physician than utilize a hospital emergency room, the correlation between private physician visits and influenza was good. Furthermore, school and industrial absenteeism are not very sensitive indicators of influenza-A activity; however, school absenteeism was a good index of influenza-B activity.
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PMID:Influenza surveillance in the United States 1972-1974. 116 28

Primary influenza pneumonia is a disease of high mortality. Differentiation between a bacterial and viral etiology for the pulmonary infiltrates frequently presents a diagnostic dilemma. Rapid diagnosis is essential; and once established, the patient requires careful supportive therapy. This report describes two patients with primary influenza pneumonia complicated by severe respiratory failure. Early diagnosis of the pulmonary infiltrates was accomplished by obtaining bronchial secretions with fiberoptic bronchoscopy and staining them with influenza-A fluorescent conjugate. One patient died of the complications of this illness, despite maximal supportive therapy. The other patient survived the illness and at the time of hospital discharge was showing marked improvement in his exercise tolerance. There was subsequent gradual return of ventilation and gas transport function to normal values.
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PMID:Rapid diagnosis of primary influenza pneumonia. 117 10

Sixteen patients with pericarditis caused by Histoplasma capsulatum were studied. Fourteen were less than 30 years old, and no patient had an underlying illness or was receiving immunosuppressive therapy. All patients experienced a flu-like prodromal illness lasting from 2 weeks to 4 months. Pneumonitis or hilar adenopathy, or both, was found in 12; pleural effusion, uncommon in primary pulmonary histoplasmosis, was found in seven patients. Pericardial fluid, pleural fluid and bone marrow cultures yielded no growth. All patients demonstrated a fourfold or greater change in complement-fixing antibody titers. No patient had disseminated disease, and only one required treatment with ampholericin B. The illness ran a protracted course, and in six patients symptomatic pericarditis recurred. Ultimately all recovered. Ten patients were restudied 6 months to 12 years after recover. Only one patient had pericardial calcification, and none had constrictive pericarditis. This form of granulomatous pericarditis, unlike that caused by Mycobacterium tuberculosis, appears to carry a good prognosis.
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PMID:Pericarditis caused by Histoplasma capsulatum. 124 38

One hundred eighty children hospitalized for acute respiratory disease were studied in Cali, Colombia. In the majority of patients, pneumonia was the reason for hospitalization and remained the final diagnosis. Fifty-one cases of pneumonia of indeterminate etiology comprised the largest single diagnostic category, followed by 38 cases of pneumonia associated with measles, and 22 cases assocaited with serologic evidence of infection with other viral agents or Mycoplasma pneumoniae. Etiologic diagnosis could be assigned with a reasonable degree of confidence in 116 of the 180 patients (64%). The laboratory procedure found most likely to provide the etiologic diagnosis in this series was paired sera specimens for demonstration of rise in antibody titer against the common viral respiratory pathogens. Those most frequently implicated serologically as etiologic agents in the cases studied were, in order of decreasing frequency, measles, influenza, parainfluenza, and adenoviruses.
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PMID:Etiology of respiratory tract infections in children in Cali, Colombia. 124 87

Surfactant replacement therapy may be a promising approach for treatment of respiratory failure caused by viral pneumonia. This study in mice demonstrates that during the development of lethal influenza A pneumonia, thorax-lung compliance (Ctl/kg) and lung volume at 5 cm H2O PEEP (V5/kg) significantly decrease (28 and 54%, respectively), whereas lung water content significantly increases (25%). Surfactant replacement therapy during the end stage of pneumonia significantly increases Ctl/kg (31%) and V5/kg (21%). Instillation of the vehicle for surfactant in control animals does not significantly affect Ctl/kg (5% decrease), but it significantly decreases V5/kg (25% decrease). Further, a new method for postmortem measurement of lung volumes in small laboratory animals based on Archimedes' principle is presented.
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PMID:Surfactant replacement therapy improves pulmonary mechanics in end-stage influenza A pneumonia in mice. 131 14

A 69-year-old male with bronchial asthma was admitted to a hospital with fever, dyspnea, and productive cough. Arterial blood gas analysis revealed sever hypoxemia (PaO2 54.8 torr, PaCO2 28.8 torr). Chest roentgenogram showed diffuse reticulonodular shadows predominantly in the upper filed and a small amount of bilateral pleural effusion. CT image of the lung showed nodular opacities at the peripheral branches of the pulmonary arteries and bronchi, some of which had become confluent. The bronchoarterial bundle had become thicker compared with a CT taken 18 months before this admission. Three days treatment with antibiotics and gamma globulin did not change the symptoms or radiologic findings. After commencing methylprednisolone therapy, the pneumonia showed rapid improvement. Based upon the significant elevation of serum influenza B (B/Singapore/79) virus antibody titer, the patient was diagnosed as having influenza B viral bronchopneumonia. Twenty-three days after initiation of steroid therapy, slight nodular opacities were observed on CT. This finding suggests that bronchiolitis has a relatively prolonged course in influenza viral bronchopneumonia.
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PMID:[A case of influenza B viral bronchopneumonia followed by CT]. 132 5

We investigated a broad spectrum of immunoactive mediators in a mouse model of influenza. ICR mice (4-5 wk old) that were infected with a 10 LD50 dose of influenza A/PR8/34 virus died after 6 days without evidence of bacterial superinfection. Maximal virus titers were reached by day 2 postinfection, whereas the multifocal pneumonia with mononuclear cell infiltration reached its maximum at the end of infection. We measured the cytokines IL-1 alpha, IL-1 beta, IL-2, IL-3, IL-4, IL-6, IFN-gamma, TNF-alpha, granulocyte (G)/macrophage (M)-CSF, G-CSF, M-CSF, and the lipid mediators leukotriene B4 and platelet-activating factor in the cellfree bronchoalveolar lavage fluid of mice during infection. We found an early increase of IL-1 alpha, IL-1 beta, IL-6, TNF-alpha, GM-CSF, IFN-gamma, and leukotriene B4. Levels of these factors peaked between 36 h and day 3 postinfection, with the exception of IL-6 that remained at elevated levels throughout infection. G-CSF and M-CSF increased slowly and reached a maximum by day 5 postinfection. We were unable to detect IL-2, IL-3, or IL-4. PAF remained at the same level throughout infection. Our results suggest that lung-resident cells, and possibly the alveolar macrophages, participate actively in the onset of the inflammatory response against the invading virus. The inability to detect the T cell products IL-2, IL-3, and IL-4 was unexpected considering the role of T cells in the elimination of the virus in infected mice. Our observation confirms thus earlier findings about the inability of specific T cell clones to elicit an unspecific antiviral effect.
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PMID:A kinetic study of immune mediators in the lungs of mice infected with influenza A virus. 132 55


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