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

Light and electronmicroscopic changes in lung biopsies were studied in six patients with tropical pulmonary eosinophilia, aged 20 to 37 years, of varying duration, and with severe haematologic (blood eosinophil count of 3,600 to 18,200 per mm3), and respiratory changes. On light microscopy the main pathologic reaction consisted of large mononuclear cells and eosinophils in and around the alveoli and blood vessels, and proliferated reticulin. Fine structural changes probably being described for the first time, included the presence of many alveolar macrophages characterised by abundant cytoplasm, irregular or stunted microvilli, increased phagolysosomes with ingested debris, and depletion of other organelles. Eosinophils bearing typical old and young granules, were encountered in and around the alveoli and blood vessels in all case, and collagenosis around alveolar cells in a few. Subacute pneumonitis producing compression and disorganisation of alveoli and blood vessels, and lack of normal apposition of air and blood spaces, appear responsible for the respiratory disability. The detection of mycobacteria, cocci or chlamydia-like bodies in two specimens and of intranuclear virus-like particles in another, could either indicate secondary infection or have an immunogenic significance, in the absence of detection of filarial elements in any of the specimens. Lung biopsies from two additional patients (aged 13 & 32) who had mitral stenosis probably due to rheumatic heart disease, and secondary pulmonary hypertension, were studied as "control" specimens. Both at light and electronmicroscopy these specimens did not show any eosinophils or neutrophils, and fewer macrophages in the lung parenchyma. In contrast to tropical eosinophilia and, as expected, there was considerably more fibrosis of the lung parenchyma, especially in the alveolar subepithelial region and in the vessel walls. This, together with fibroblasts full of endoplasmic cisterns, noted particularly in the younger patient with shorter duration, probably represented an earlier change in this condition.
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PMID:The lung in tropical eosinophilia compared to that in pulmonary hypertension. Fine structural basis of respiratory disability. 161 Jul 62

The prognostic risk factors in 4323 patients with rheumatic heart disease, admitted from 1970 to 1990, were analysed. The overall mortality was 31.75% in this group of patients. Single factor analysis indicated that cardiac functional classification, time of death, month of death, cardiothoracic ratio, valvular lesions, cardiogenic shock, digitalis-induced arrhythmias, intercurrent pneumonia, pleurorrhea, and hypotension were related to the overall mortality and cardiac death. Multiple factor logistic analysis indicated that for the overall mortality, the independent prognostic factors included presence of cardiac functional classification, cardiothoracic ratio and cardiogenic shock; for cardiac death, the independent factors included cardiac functional classification, cardiothoracic ratio, cardiogenic shock, digitalis-induced arrhythmias and valvular lesions. The data analysis showed that these five factors were contributory to rheumatic heart disease with synergism.
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PMID:Nonconditional logistic regression analysis of risk factors in rheumatic heart disease. 844 96

This paper attempts to discuss the shape of inequalities in health in the Republic of Ireland by focusing on social class, gender and regional inequalities in health outcomes as shown in annual publications of vital statistics and in various research studies. The Republic of Ireland has a demographic profile of rapid population increase, unique in Europe. While the birth rate is the highest in Europe, the infant mortality rate is relatively low, yet the perinatal mortality rate is relatively high. Attempts are made to analyse social class variations in mortality and morbidity rates but, except for psychiatric care, Irish data on health by social class are scarce. There exist more data on gender inequalities which pinpoint the particular vulnerability of Irish women to ischaemic heart disease and certain types of cancer. Regional analysis of vital statistics reveals the vulnerability of people in urban areas (compared to rural areas) to cancer of the trachea, bronchus and lung, cirrhosis of the liver, tuberculosis of the respiratory system, pneumonia, and bronchitis, emphysema and asthma. In comparison to several European countries, Irish standardized mortality rates were the worst for urban women dying from lung cancer, and for urban men and women, Irish standardized mortality rates were the worst for non-rheumatic heart disease and respiratory tuberculosis. Various studies of morbidity of the elderly clearly reveal the hidden clinical iceberg of symptoms which are not presented to the health care system. Unfortunately, there is relatively little evidence of the health situation of disabled people, the travelling community or the long term unemployed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Health and social inequities in Ireland. 221 9

Blacks in the US experience increased mortality (1113 versus 745 per 100,000 males; 631 versus 411 per 100,000 females) and decreased life expectancy (63.7 years versus 70.7 years for males; 72.3 years versus 78.1 years for females); compared to Whites. In an effort to determine if the excess mortality among Black Americans might be explained by differences in access or quality of health care services, we performed a race-specific analysis of conditions for which mortality is largely avoidable given timely and appropriate medical care. Using methodology proposed by Rutstein and Charlton, mortality due to 12 causes was evaluated including tuberculosis, cervical cancer, Hodgkin's disease, rheumatic heart disease, hypertensive heart disease, acute respiratory disease, pneumonia and bronchitis, influenza, asthma, appendicitis, hernias and cholecystitis. In the US, during 1980 to 1986, an average of 17,366 deaths and 286,813 years of potential life (YPLL) before age 65 were lost each year due to all 12 sentinel causes combined. Of these causes, hypertensive heart disease, pneumonia and bronchitis, cervical cancer and asthma accounted for the greatest number of deaths. The mortality rate for all 12 causes combined among Blacks was 4.5 times that of Whites. The highest relative rates among Blacks compared to Whites were observed for tuberculosis, hypertensive heart disease and asthma. The overall mortality rate in the District of Columbia for the selected causes was 3.7 times the national rate. Compared to national rates, statistically significant elevated rates in the District were observed for tuberculosis, hypertensive heart disease and pneumonia and bronchitis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Black/white comparisons of deaths preventable by medical intervention: United States and the District of Columbia 1980-1986. 226 53

Acute rheumatic heart disease (RHD) with Aschoff nodules and biventricular dilation was diagnosed at autopsy in a patient with acquired immunodeficiency syndrome who died of pneumonia due to Pneumocystis carinii. The relationship of acute RHD and human immunodeficiency virus-associated immune deficiency is discussed.
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PMID:Rheumatic heart disease in a patient with acquired immunodeficiency syndrome. 278 74

A 14-year-old boy developed severe respiratory failure during the course of acute rheumatic fever. The results of all microbiological studies were normal. Rheumatic carditis or left ventricular failure was excluded by routine examinations, catheterization of the right side of the heart, and multiple-gated radionuclide ventriculography. The patient recovered completely after a course of high-dose prednisone. To our knowledge, this is the first well-documented case of rheumatic pneumonia in which the lung disease could be attributed to the rheumatic disease and not to a pathologic heart condition.
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PMID:An unusual case of rheumatic pneumonia. 400 40

With the object of studying the profile of infective endocarditis in Indian children younger than 16 years of age, a retrospective study of 37 patients with infective endocarditis admitted to this hospital between January 1984 and December 1990 was carried out. There were 26 boys and 11 girls (aged 2-16 years (mean (SD) 10.3 (3.8)). Eighteen (48.6%) patients had underlying congenital heart disease, 13 (35.1%) had associated rheumatic heart disease whilst the remaining six had no pre-existing heart disease. All six patients with a normal heart and infective endocarditis had preceding extra-cardiac bacterial illnesses (epididymitis and orchitis in one, pneumonia in five). Blood cultures were positive in only 16 (43.2%): Staphylococcus aureus was grown in nine, Streptococcus viridans in six and Candida albicans in one. Sixteen (43.2%) of the 37 patients died owing to worsening cardiovascular haemodynamics, uncontrolled septicaemia and our inability to offer emergency surgery. The profile of infective endocarditis in developing countries is different from that in Europe and the United States of America, and the disease carries a very high mortality.
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PMID:Infective endocarditis in children: profile in a developing country. 768 16

A 28-year-old man with a history of rheumatic heart disease, alcoholism and amphetamine abuse presented with severe left upper quadrant abdominal pain and persistent fever. He stayed at home for the previous two months due to intermittent dull lower abdominal pain, chills, fever and tarry stools without seeking medical help. A diagnosis of infective endocarditis with splenic infarcts and a renal infarct was made based on the echocardiographic and abdominal computer tomography scan findings. His clinical course was complicated by an acute inferior wall myocardial infarction and cerebral hemorrhage. Despite aggressive medical treatment, his condition deteriorated. One month later, his condition became more critical with pneumonia and intractable shock, and his family requested his discharge. He died soon after leaving the hospital.
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PMID:Widespread embolism in a patient with infective endocarditis--a case report. 776 62

Due to changes of humoral immunity, patients with rheumatic heart disease present, even before the operation, a high-risk group with regard to the development of infectious complications. Contamination of intraoperative material was revealed in 61.7% of cases during the operation. Extracorporeal circulation increases the cefotaxime half-life period which is in direct proportional dependence of the period of time between the beginning of the administration of the agent and the beginning of extracorporeal circulation. Immunocorrection by means of myelopid in the early postoperative period accelerates restoration of cellular and humoral immunity, and reduces the frequency of pneumonia occurrence and suppuration of the postoperative wound. Therefore, the prevention of infectious complications after operations on an open heart should be complex and should include broad-spectrum antibiotics and immunocorrective therapy.
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PMID:[Current approaches to the prevention of infectious complications in heart surgery]. 808 51

"Avoidable" mortality may be defined as causes of death whose occurrence is closely related to medical intervention. Areas with particular health care delivery problems can be identified through a geographical comparison of these "avoidable deaths." Mortality data for Valencia from 1982 to 1990 were examined to determine whether or not the availability of medical care resources in the area influenced the occurrence of avoidable deaths. We identified variations in mortality from avoidable causes, grouped according to the differences in levels of urbanization and health care resources, in the 537 municipalities of the Valencian community. (In Spain, the municipality is the lowest administrative division.) Linear regression analysis was performed to predict or estimate this relationship. Only in a small number of avoidable causes did the mortality trend for males differ significantly from 0 (p < 0.005) in relation to different levels of urbanization and health care resources. A direct association between these two variables was observed in males with regards to pneumonia, tuberculosis, chronic rheumatic heart disease, and bacterial infection. In females, a relationship between "avoidable" mortality rates and the differences in urbanization and health care resources was found in cervical cancer, pneumonia, abdominal hernias, and cholecystitis. Mortality from asthma and cardiovascular disease (in both males and females) declined faster in urbanized, high income areas than in rural areas. The results clearly demonstrate the considerable mortality risk associated with living in urban areas. On the contrary, we found very little correlation between health service access and mortality.
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PMID:Variations in avoidable mortality in relation to health care resources and urbanization level. 921 98


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