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

There is evidence from pediatric tertiary care centers in the United States that childhood deaths from asthma in hospitalized patients are becoming increasingly rare, while asthma mortality outside the hospital appears to be on the rise. When a young outpatient with asthma dies, the event is apt to be sudden and unanticipated and the victim is likely to be a preadolescent or adolescent who has suffered from asthma most of his or her life and who, despite ongoing bronchodilator therapy, requires hospitalizations for treatment of status asthmaticus. Patients in this age cohort have a strong tendency to underuse, overuse, or neglect to use prescribed medications, possibly as a gesture of emerging independence or because of the depression engendered by a chronic illness. In some instances serious psychosocial pathology accounts for noncompliance. For a patient with chronic asthma with a high-risk profile, any departure from an ongoing treatment regimen may result in respiratory failure. Pathologic complications of asthma may also act to upset the precarious physiologic equilibrium these patients have established. Unsuspected chronic pneumonia may lead to further increases in a chronically high degree of oxygen desaturation. Hypoxic seizures during an asthma attack may precipitate pulmonary edema. Tension pneumothorax has an even greater fatality potential for high-risk patients with asthma than it has for other patients with asthma, and pulmonary hypertension with cor pulmonale may develop because of chronic hypoxia. Some sudden deaths in children with chronic, severe asthma are unassociated with any of the above, making it necessary to entertain still other hypotheses.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:An analysis of fifteen childhood asthma fatalities. 362

Haemophilus influenzae serotype d was isolated from three women with pneumonia and underlying cardiopulmonary disease. Two of the strains were isolated from blood, and the third strain was isolated from sputum. The biotypes of the isolates were I, IV, and VI.
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PMID:Pneumonia and bacteremia associated with Haemophilus influenzae serotype d. 660 62

Emphysema mortality is higher in Colorado than in the nation as a whole despite the younger age of Colorado's population Colorado death records from 1959 to 1976 were examined to determine if emphysema mortality increases with altitude within the state and if altitude adversely affects survival from chronic lung disease. Because the proportion of persons older than 65 yr of age in Colorado decreases with altitude (r = -0.6, p less than 0.01), emphysema mortality was age-standardized. The age-standardized rate increases with altitude among males (r = 0.9, p less than 0.01; y = 0.003(x) + 42.1). Emphysema deaths at higher altitudes in Colorado (greater than or equal to 7,000 ft) occur at a younger age (68.1 +/- 0.6 yr (mean +/- SEM) versus 70.1 +/- 0.6 yr at lower altitudes), after a shorter duration of illness, and more commonly from cor pulmonale than at lower altitudes (less than or equal to 4,500 ft) where pneumonia is more common as the immediate cause of death. The mechanism by which high altitude residence interacts unfavorably with survival is not known but may stem from augmented pulmonary hypertension caused by the hypoxia of lung disease added to the hypoxia of high altitude.
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PMID:Emphysema mortality is increased in Colorado residents at high altitude. 710 48

M. xenopi was definitely demonstrated 14 times in the sputum of a 70-year-old man with chronic obstructive lung disease. Sputum conversion was achieved by combined chemotherapy, but the patient died of cor pulmonale and associated terminal pneumonia. Autopsy revealed moderately advanced old fibrotic pulmonary lesions of tuberculous origin including a large "open healed" cavity, and recent involvement of lymphatic nodules with a bronchonodular fistula accompanied by dispersed lesions in the surrounding pulmonary tissue. Culture of the latter lesions yielded M. xenopi and were formed by central necrosis with numerous acid-fast rods surrounded by a hyaline capsule without any specific or nonspecific inflammation. No histological differences were detected between these lesions and lesions from a disease provoked by M. tuberculosis.
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PMID:Pulmonary mycobacteriosis caused by Mycobacterium xenopi. Report of a case. 711 26

A 7 year old boy developed in the newborn period a chronic suppurative process after routine BCG vaccination beginning at the site of the injection and spreading to the adjacent areas on neck and chin. A supraclavicular lymphadenopathy was also noted. Serial histological examinations revealed the typical histopathological pattern of tuberculosis and the boy received a tuberculostatic therapy for five years. During this time he suffered from multiple chronic bacterial infections which led to chronic granulomatous inflammations in different organs and to a fibrous pneumonitis with subsequent cor pulmonale. At the age of 6 years a negative NBT-test allowed the diagnosis of GCD. Consequently therapy with Sulfamethoxazol-Trimethoprim was started and the rate of infections diminished markedly.
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PMID:[BCG-infection in chronic granulomatous disease (author's transl)]. 718 85

In a 16-year mortality followup of some 293,000 insured U.S. veterans, specific causes of death were studied in relation to smoking status. The main results confirmed earlier findings.Mortality ratios for cigarette smokers as compared with nonsmokers were 1.73 for all causes of death, 1.58 for all cardiovascular diseases, 2.12 for all cancers, and 4.31 for all respiratory diseases. The highest ratios (those greater than 5.0) were observed for cor pulmonale, aortic aneurysm, emphysema and bronchitis, cancer of the pharynx, cancer of the esophagus, cancer of the larynx, and cancer of the lung and bronchus. The greatest excess in deaths in terms of observed numbers minus expected was found for the cardiovascular diseases, in particular for coronary heart disease.Mortality ratios for ex-cigarette smokers who had stopped smoking for reasons other than physicians' orders were much lower compared with nonsmokers than the mortality ratios for current cigarette smokers: 1.21 for all causes, 1.15 for all cardiovascular diseases, 1.39 for all cancers, and 2.08 for all respiratory diseases. For most causes of death, the mortality ratios for ex-cigarette smokers who had stopped smoking for reasons other than physicians' orders varied inversely with the number of years of cessation. For some diseases, the mortality risk for the ex-cigarette smoker returned to normal almost immediately after the cessation of smoking, whereas for others, the return to normal was more gradual. The first group included stroke and the combined category of influenza and pneumonia; the second group included cardiovascular diseases as a whole and coronary heart disease. For still other diseases, although the mortality ratio declined with the length of time smoking was discontinued, substantial excess risks remained even after 20 years of cessation. In this third group were aortic aneurysm, bronchitis and emphysema, and lung cancer-diseases with very high mortality ratios for current cigarette smokers. Parkinson's disease remained the one disease that clearly exhibited a negative association with cigarette smoking.
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PMID:Smoking and causes of death among U.S. veterans: 16 years of observation. 738 6

Acute pulmonary complications of sickle cell anemia are sickle cell lung disease and bacterial pneumonias. Chronic abnormalities in lung function include a restrictive ventilatory defect and perhaps increased venous admixture to the pulmonary circulation. Coexisting sarcoidosis may complicate sickle cell anemia and interact to potentiate sickling. Sickle cell lung disease, or acute "chest syndrome," occurs with greatest frequency in adults, is due primarily to pulmonary infarction, and may lead to cor pulmonale. On the other hand, bacterial pneumonia due to Streptococcus pneumoniae occurs with greater frequency in infancy and childhood. Mycoplasma and other organisms may also cause pneumonia with protracted illness and slow resolution. Bacteremia and meningitis may be further complications, particularly in children. Precise diagnosis of the acute febrile pulmonary episode is often difficult. In adults the illness is commonly self-limited. However, a vigorous diagnostic approach is warranted in all severely ill patients.
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PMID:The lung in sickle cell disease: a clinical overview of common vascular, infectious, and other problems. 746 92

Of 24 elderly patients with Streptococcus pneumoniae pneumonia confirmed by transtracheal aspiration, six had concomitant infection with gram-negative aerobic bacilli. All six patients were elderly men with underlying cardiopulmonary disease. Three had had recent prior episodes of gram-negative pneumonia and four had previously received antibiotics. The clinical, laboratory, and epidemiologic characteristics of these six patients with mixed bacterial pneumonia are reported.
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PMID:Mixed Streptococcus pneumoniae and gram-negative bacillary pneumonia in the elderly. 746 30

Hypersensitivity pneumonitis or extrinsic allergic alveolitis is an immunologically mediated lung disease caused by repeated inhalations of organic antigens. The basic histological lesion consists of a diffuse mononuclear cell infiltration of alveolar wall, alveoli, terminal bronchioles, and neighboring interstitium. The inflammation is often followed by granulomas, which then may progress to fibrosis. Unlike other infectious and noninfectious granulomatous disorders, hypersensitivity pneumonitis is limited to the lung. The disease occurs more frequently in men than in women and children. The acute form of hypersensitivity pneumonitis, characterized by fever, chills, myalgias, cough, and dyspnea, may be confused with acute pneumonitis. Although there is no single radiological, physiological, or immunologic test specific for hypersensitivity pneumonitis, the diagnosis can often be suspected on the basis of a compatible temporal relationship between pulmonary symptoms and a history of environmental or occupational exposure. Once the diagnosis is suspected, the presence of serum precipitating antibodies (immunoglobulin [lg] G), suppressor cytotoxic lymphocytosis in bronchoalveolar lavage (BAL) fluid, and granulomatous alveolitis in lung biopsy specimens is extremely helpful in confirming the diagnosis. For patients in whom the diagnosis is confirmed, avoidance of the causative antigen is the best therapy, although corticosteroids are used to suppress inflammation. Once the fibrosis has developed, the patient may gradually develop respiratory failure or cor pulmonale, possibly resulting in death.
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PMID:Hypersensitivity pneumonitis: a noninfectious granulomatosis. 756 4

To update the clinical profile of pediatric patients hospitalized with RSV infection, we retrospectively reviewed the records of 246 children (male:female ratio 1.44:1) admitted during one season to a tertiary-care hospital. The most common admitting diagnoses were bronchiolitis (37.4%), pneumonia (32.5%), and possible septicemia (13%). Median age was 3 months; median length of stay, three days. Twice as many minorities were admitted with RSV infection as all other admissions during the same year. Family history of asthma, while common (35%), did not affect length of stay or complications. Of the 38 (15%) patients requiring intensive care, 29 (76%) underwent ventilation. Patients with underlying cardiopulmonary disease had more complications, were more likely to require intensive care (about 50%), and had significantly longer hospital stays than others. All three patients (1.2%) who died had congenital heart disease. Common risk factors included young age, chronic cardiopulmonary disease, male sex, and possibly family history of asthma. Although the most typical clinical diagnoses remain bronchiolitis and pneumonia, a systemic illness resembling the sepsis syndrome has emerged at our institution as a significant clinical presentation.
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PMID:Clinical profile of pediatric patients hospitalized with respiratory syncytial virus infection. 840 43


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