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

Fifty-one intravenous drug abusers were evaluated by a pulmonary consultative team over a 22-month period at a large inner city hospital. The most common pulmonary complication was septic pulmonary embolism, seen in 12 patients (23.5 percent). Community-acquired pneumonia was diagnosed in ten patients (19.6 percent). Mycobacterium tuberculosis occurred in five patients (9.8 percent). Although 25 of 40 patients (63 percent) tested for human immunodeficiency virus antibody were positive, acquired immunodeficiency syndrome (AIDS) was present in only five patients (9.8 percent). Bronchoscopy was used to evaluate pulmonary infiltrates in 15 of 51 cases (29 percent). Common bacterial infections and tuberculosis remain the most frequently encountered pulmonary problems in drug abusers, despite the onset of the AIDS epidemic.
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PMID:Pulmonary complications of intravenous drug abuse. Experience at an inner-city hospital. 339 99

High alcohol consumption is one of the major risk indicators for premature death in middle-aged men. An indicator of alcohol abuse--registration with the social authorities for alcoholic problems--was used to evaluate the role of alcohol in relation to general and cause-specific mortality in a general population sample. Altogether 1,116 men (11%) out of a total population of 10,004 men were registered for alcoholic problems. Total mortality during 11.8 years' follow-up was 10.4% among the non-registered men, compared to 20.5% among men with occasional convictions for drunkenness and 29.6% among heavy abusers. Fatal cancer as a whole was not independently associated with alcohol abuse, but oropharyngeal and oesophageal cancers together were seven times more common in the alcohol-registered groups. Total coronary heart disease (CHD) was significantly and independently associated with alcohol abuse, but nearly all the excess CHD mortality among the alcohol-registered men could be attributed to sudden coronary death. Cases with definite recent myocardial infarction were not more common in the alcoholic population. A combined effect of coronary arteriosclerosis and heart muscle damage secondary to alcohol abuse is suggested. Other causes of death strongly associated with registration for alcohol abuse include pulmonary embolism, pneumonia and peptic ulcer, as well as death from liver cirrhosis and alcoholism. Of the excess mortality among alcohol-registered subjects, 20.1% could be attributed to CHD, 18.1% to violent death, 13.6% to alcoholism without another diagnosis and 11.1% to liver cirrhosis.
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PMID:Alcoholic intemperance, coronary heart disease and mortality in middle-aged Swedish men. 342 75

A series of 105 Type III and IV comminuted intertrochanteric fractures were treated by the insertion of a Leinbach prosthesis and followed for an average of 8.1 months. Based upon the results, the insertion of a Leinbach prosthesis is recommended for the elderly patient with a comminuted intertrochanteric fracture. Function is restored within a short period of time and allows unrestricted weight-bearing almost immediately. The hospital stay is shortened. The incidence of secondary operations, thrombophlebitis, pulmonary embolism, decubiti, and pneumonia is relatively low.
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PMID:Comminuted intertrochanteric fractures treated with a Leinbach prosthesis. 356 99

Between 1972 and 1983 a total of 351 patients was operated suffering from mechanical occlusion of the small intestine (n = 256) and of the colon (n = 95). The surgical complication rate amounted to 28.1% in cases of small intestine ileus and to 24.3% in cases of colon ileus; the most frequent complications were anastomotic dehiscences following resections (small intestine 17.7%/colon 33.8%), enterotomies (5.8%/27.2%), abdominal wall ruptures (3.5%/4.2%) and re-ileus (5.5%/3.2%). The medical complication rate (postop. pneumonia, pulmonary embolism, cardial decompensation etc.) amounted to 17.7% resp. 22.1%. All these complications carried a mortality of 20.6% in small intestine ileus and of 30.4% in colon ileus. The consequences of this retrospective analysis resulted in: early intensive care treatment, general perioperative thrombosis-, pneumonia- and stress ulcer prophylaxis, exact preoperative radiological diagnosis, strict indications for enterotomies and resections, sole transversostomy in stage of ileus for the left-sided colon obstruction caused by carcinoma, discontinuity resection by Hartmann in cases of inflammatory or perforated large bowel stenoses and tube decompression of the small bowel in cases of peritonitis or wide-spread adhesions. Since 1984 we could prospectively decrease the complication resp. mortality rate of the small intestine ileus (n = 64) to 9.4% resp. 4.7% and of the colon ileus (n = 20) to 10% resp. 5%.
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PMID:[Surgically treated mechanical ileus]. 357 78

The potential risk implied in prophylactic operations is just as high as that elective interventions. Indications must be subject to stringent deliminating criteria. Required are thorough elucidation and documentation as well as comprehensive substantiation. Operations of that kind may be performed even without elaborate advance planning, if indications are urgent. Simultaneous operations are accompanied by higher risk in cases of major surgery or if one of the interventions is septic. High risk factors were recordable from combined stomach and bile duct surgery, when performed simultaneously. Morbidity amounted to 13 per cent (pulmonary embolism and pneumonia) and lethality to 15 per cent. Simultaneous operations should be performed by an experienced surgeon who should be a fast worker.
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PMID:[Indications and prognosis of preventive and simultaneous operations of the abdominal cavity]. 368 59

In acute myeloid leukemia (AML-46 patients) and various entities of chronic myeloproliferative diseases (CMPD-58 patients) an evaluation and comparison of clinical and postmortem findings has been performed. This study included also aspirates and core biopsies of the bone marrow which were initially taken on admission of those patients. Classification of CMPD was done following the concept of Georgii et al. (1984) into CGL -24-, CMGM-6-, E-MS-13- and MS/OMS-15 cases. There was a significant increase in blastic crisis in CGL compared with the other entities and in the latter a prolongation of the total course of disease due to a long period between symptoms--clinical diagnosis. As revealed by the autopsies causes of death were mostly infections (pneumonia, septicemia-50%) and lethal hemorrhages (gastrointestinal and cerebral--about 30%) in both AML and CMGM patients. Rare causes comprised fatal pulmonary embolism due to a peripheral thrombocytosis in CMPD, acute rupture of the spleen and extensive leukemic infiltrates of the myocard in AML. In addition to the well known giant enlargement of the spleen in MS/OMS, the relatively high frequency of a meningeal involvement (meningeosis leukemica) in AML (about 35%) and during an acute transformation in CMPD (up to 30%) was conspicuous. The examination of the bone marrow at various sites became feasible during the postmortem procedure and thus provided the opportunity to investigate the development and extent of a myelosclerosis evolving in CMPD. In contrast to the a- or hypoplasia and regeneration of the hematopoiesis following chemotherapy, the evolution of myelosclerotic lesions showed a very uniform pattern throughout the skeleton and obviously no reversal of a manifest MS/OMS after cytotoxic treatment.
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PMID:Autopsy and clinical findings in acute leukemia and chronic myeloproliferative diseases--an evaluation of 104 patients. 385 35

Correct identification of the subsets of pulmonary lupus has an unquestioned importance in planning the proper therapeutic regimen in this extremely variegated disease. Asymptomatic pulmonary lupus needs no treatment; however, pulmonary involvement in lupus may be life threatening, in which case prompt and aggressive treatment is mandatory. The different aspects of pulmonary lupus are demonstrated through the clinical histories of patients who suffered from pleuro-pulmonary lupus. The following entities are presented: lupus pneumonitis, lymphocytic interstitial pneumonia, pulmonary hypertension, pulmonary hemorrhage, pulmonary embolism associated with circulating lupus anticoagulant, lupus pleuritis and weakness of the diaphragm.
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PMID:Pleuro-pulmonary manifestations of systemic lupus erythematosus: clinical features of its subgroups. Prognostic and therapeutic implications. 392 88

Over a period of 12 1/2 years, 476 patients underwent thoracotomy for lung cancer at two affiliated hospitals. Hospital mortality for all patients was 5.25% and for those undergoing pulmonary resection, 5.67%. Hospital mortality is more indicative of true risk than is the 30 day mortality figure, which we regard as arbitrary and misleadingly low. Thirty-seven preoperative risk factors were analyzed for their effects on both morbidity and mortality, and 12 classes of postoperative complications were analyzed for their effect on mortality. All preoperative risk factors together accounted only for 12% of the risk of mortality (R2 by multiple regression analysis). Only three of these factors bore a significant association with mortality: patient age 60 years or over (p less than 0.05), need for pneumonectomy (p less than 0.005), and premature ventricular contractions on the admission electrocardiogram (p less than 0.05). All the listed postoperative complications together accounted for only 28% of the risk of mortality. Of these complications, four showed a significant association with postoperative death: infectious complications (pneumonia and empyema) and cardiovascular accidents (pulmonary embolism and myocardial infarction). In both analyses, the remainder of the risk of death must be attributed either to factors not considered or to purely random factors. It follows that much the greater part of the risk of death from surgical treatment of lung cancer could not be predicted from the preoperative status of the patients.
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PMID:Random versus predictable risks of mortality after thoracotomy for lung cancer. 395 74

To determine the relative importance of multiple interrelated factors that have been considered to contribute to pulmonary infarction, the authors performed a discriminant analysis on consecutively autopsied patients with pulmonary embolism. From the clinic records of 45 individuals, the authors tabulated the underlying illness, history of valvular or ischemic heart disease, right and left ventricular failure, sepsis, shock, malignancy, premortem functional status, and the clinician's suspicion of pulmonary embolism. At postmortem examination, the authors measured and recorded the extent of emphysema, pneumonia, neoplasia, pulmonary vascular atherosclerosis; thickness and dilatation of both cardiac ventricles; the presence of valvular heart disease; the number, diameter, and amount of occlusion of the pulmonary arteries that contained thromboemboli; the extension of the clot, the size of the infarct; the Reid-Index; and the thickness of pulmonary and bronchial arterial wall. The major determinants of infarction were as follows: poor premortem functional status, the number of lobes having emboli, left ventricular failure, and the presence of lung cancer. The authors then tested the equation generated from these patients on 21 additional patients. The discriminant function correctly classified 81% of first group and predicted the occurrence of infarction in new patients with 70% accuracy. The size of the infarct was most correlated with the use of vasodilators and the embolic burden.
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PMID:Factors associated with pulmonary infarction. A discriminant analysis study. 401 73

Between January 1979 and December 1982, 84 patients between the ages of 1 and 39 years presented to the emergency department in a state of cardiac arrest. There were 58 male patients (69%) and 26 female patients (31%) in the group. Presenting rhythms were ventricular fibrillation (37%), asystole (37%), idioventricular rhythm (14%), heart block (4%), bradycardia (4%), ventricular tachycardia (3%), and electromechanical dissociation (3%). Thirty-two percent had bystander CPR. Of 21 patients initially resuscitated (25%), only four (5%) survived to discharge from the hospital. All survivors were neurologically intact. Seventy-five of the 80 patients who died (90%) underwent autopsy. Cause of death in the five remaining patients was inferred from clinical history. Etiologies of the cardiac arrests were the following: toxic exposure or ingestion (26%), atherosclerotic heart disease (23%), undetermined (11%), pulmonary embolism (6%), hemorrhage (6%), epilepsy (2%), cardiomyopathy (7%), myocarditis (2%), pneumonia (4%), and one case each of airway obstruction, asthma, peptic disease, and septic shock. Diverse etiologies should lead to a diagnostic search for reversible conditions in young patients. The prognosis for hospital discharge is poorer in the young population than is reported in our overall cardiac arrest population; however, numbers of neurologically intact survivors are similar in the young and the overall cardiac arrest population.
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PMID:Cardiac arrest under age 40: etiology and prognosis. 648 35


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