Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients with acute liver failure (ALF) have increased susceptibility to infections, principally as a result of impaired phagocytic function, reduced complement levels, and the need for invasive procedures. Bacteriologically proven infection is recorded in up to 80% of these patients and fungal infection (predominantly candidiasis) in 32%. Clinical signs such as high temperature and high WBC are absent in 30% of the cases. Pneumonia accounts for 50% of infective episodes, and bacteremia and urinary tract infection a further 20 to 25% each, at a median 5, 3, and 2 days, respectively, after the onset of ALF. Selective parenteral and enteral antisepsis regimens (SPEAR) were evaluated in prospective controlled studies, but early systemic antibiotics alone are as effective as SPEAR. With early antibiotics, the incidence of infective episodes is reduced to 20% and the overall mortality to 44%, with a reduction in progression to encephalopathy and an increased opportunity for transplantation.
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PMID:Bacterial and fungal infection in acute liver failure. 902 52

A retrospective review of cases seen in the Diarrhea Treatment and Training Unit (DTU) of Bangalore (India) Medical College's Vani Vilas Children's Hospital during 1992-1994 confirmed the efficacy of the standard case management approach. This strategy entails oral rehydration therapy (ORT), continued feeding, and selective use of intravenous fluids and antibiotics. Of the 7966 children (4374 males and 3592 females) reporting to the DTU during the 2-year study period, only 2412 (30.5%) had received oral rehydration solution (ORS) or home-available fluids before admission. Acute watery diarrhea was present in 7316 cases (91.84%). Death occurred in 59 acute watery diarrhea cases, 6 dysentery cases, and 7 persistent diarrhea cases. The average time for cases managed in the ORT area was 2 hours and 45 minutes, while the hospital stay for admitted cases averaged 3 days. In 6957 cases (87.33%), ORS was sufficient treatment. Of the 1009 children (12.67%) who required intravenous fluids, 254 had dehydration attributable to conditions such as persistent vomiting and inability to drink due to oral thrush. Only the 512 children (6.2%) with cholera and dysentery received antibiotics. Of the 72 children who died (case fatality rate, 0.9%), 43 had associated severe malnutrition with pneumonia and anemia, 14 had a central nervous system infection, and 13 had septicemia; in only 2 cases could death be directly ascribed to diarrheal disease. One of these cases was due to shigella encephalopathy and the other to severe dehydration with acidosis. The average cost of treatment per patient was Rs 2.91 when only ORS was used compared with Rs 24.28 when intravenous rehydration was required. The finding that less than one-third of children had received ORS before admission suggests a need for the establishment of more DTUs in large hospitals that can train community-based health personnel in diarrhea case management.
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PMID:Management of diarrhea in a DTU. 905 85

We describe a case of exogenous lipoid pneumonia in a child with anoxic encephalopathy who was taking mineral oil for constipation. Computed tomography produced images suggesting this condition, and the diagnosis was confirmed by demonstrating the presence of lipid-laden alveolar macrophages in the bronchoalveolar lavage fluid. Despite discontinuing the offending agent, the pulmonary infiltrates did not improve; however, successful resolution was obtained by whole lung lavage.
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PMID:Mineral oil lipoid pneumonia in a child with anoxic encephalopathy: treatment by whole lung lavage. 909 34

In order to explore the allelic polymorphism of HLA-DR and TNF B loci and susceptibility to systemic lupus erythematosus (SLE) in the Han nationality of northern China with the aid of methods of polymerase chain reaction/sequence specific primers (PCR/SSP) and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) respectively. The findings from a case-control study on 151 blood samples (45 from the cases and 106 from the controls) indicated that there were significantly higher frequency of DR2 (P < 0.05, RR = 1.56) and DR3 (P < 0.01, RR = 2.69), which represent candidate susceptible genes or useful markers for SLE. The DR5 allele in the samples (P < 0.05, RR = 0.43) might be an antagonistic or protective allele, or a marker for such allele. The frequency of TNF B * 1 and TNF B * 2 alleles was investigated in 45 SLE patients and 80 healthy controls and it was found that the frequency of TNF B * 2 allele was significantly higher in the patient group (P < 0.05, RR = 1.84). It might also be a suspicious susceptible allele or a marker for such allele. The frequency of HLA polymorphisms in various clinical/immunological subsets of our patient population was also determined. Clinical findings used include plasma SC5b-9 level, SSA, SSB, Sm, RNP, ANA antibodies, and SLE complications (SLE nephritis, pneumonia & encephalopathy). It turned out that there was a positive association between HLA-DR2 allele and SLE nephritis (P < 0.05, RR = 1.32).
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PMID:[Study on some susceptible genes of systemic lupus erythematosus in Han nationality of China]. 927 40

Less than half of the paediatric HIV infections recorded in Australia have resulted from perinatal transmission, but in recent years this has been the predominant mode of infection. There are 136 infants who are known to have been exposed perinatally to HIV in Australia: 49 of these are infected. Caesarean section is thought now not to reduce the risk of perinatal transmission (PNT); rather, the risk increases with duration of membrane rupture and rises rapidly after 4 h of membrane rupture. However, no data exist to show that interventions to expediate delivery after membrane rupture reduce the risk of PNT. Data such as these suggest that the majority of perinatal infections (probably about 60%) occur close to the time of delivery. While the overall risk of PNT for non-breast fed infants is approximately 20-25%, the risk of infection for the infant is considerably increased when there is evidence of increased maternal viral burden. Advanced maternal disease predicts that if the infant is infected there is more likely to be early progression of HIV than is the case for the less frequently infected infants of mothers who are asymptomatic. Bottle feeding may prevent infection of 10% of children exposed perinatally. Use of zidovudine by the mother in the third trimester and i.v. zidovudine during labour, followed by oral zidovudine for the infant for 6 weeks can reduce the PNT rate by two thirds, to about 8%. Approximately 3% of uninfected infants with perinatal HIV exposure may be found to be transiently virus positive but eventually become antibody negative and thus appear to have eliminated the virus. The risk of Pneumocystis carinii pneumonitis (PCP) cannot be predicted on the basis of CD4 count and it is recommended that all children of infected mothers commence PCP prophylaxis around the age of 6 weeks-2 months and continue that therapy until the age of 12 months or until it becomes clear that the infant is uninfected. The cumulative risk of AIDS increases rapidly during the first year of life to about 20%, then more slowly at a rate of about 2 or 3% a year. The shape of this curve reveals the bimodal progression of HIV disease in children. About 15-20% of children rapidly develop a severe immune deficiency, opportunistic infections and, in most cases, encephalopathy. There is a very high morbidity rate in this group of children, most of whom die before the age of 3 or 4 years. In contrast, 80-85% of children only become immunodeficient after a relatively long period, which is similar to or perhaps even longer than that in adults. Recent studies indicate that zidovudine antiviral monotherapy is no longer appropriate. While no clear alternative to monotherapy has emerged most would, wherever possible, commence antiretroviral therapy with a combination of two or three drugs including zidovudine plus didanosine or lamivudine. If a third drug is used it would probably be a protease inhibitor.
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PMID:Paediatric HIV update. 940 77

We report on a 32-year old HIV-infected male patient who was admitted to the hospital in a comatose state. A cryptococcus neoformans septicemia with meningoencephalitis was diagnosed. Intravenous treatment with amphotericin B was initiated and replaced three weeks later by fluconazole per os. With this therapy the patient recovered quite well. However, following two grand mal epileptic seizures he suddenly fell into a deep coma 22 days after admission to the hospital. The cause of the encephalopathy remained unclear, and the patient died 2 days later. Autopsy revealed a severe meningoencephalitis and a pneumonia due to cryptococcus neoformans. Departing from this case we discuss diagnosis, clinical presentation and treatment of cryptococcus meningoencephalitis.
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PMID:Cryptococcosis, epileptic seizures and encephalopathy in a HIV-infected patient. 948 May 18

Between 1 November 1993 and 31 October 1996, admissions to paediatric departments for Bordetella pertussis complications were reported to a nationwide, hospital-based active surveillance system. The case definition included pertussis complicated by pneumonia, apnoea requiring assisted ventilation, seizures, encephalopathy or a combination of these. Two hundred sixteen cases of pertussis complications were registered. 57.4% of them were in infants, 50.9% of them less than 6 months old. There were five deaths, three previously healthy children died. At the time of hospital admission, 106 cases would have been eligible for at least three doses of pertussis vaccine, only four (3.8%) had received the recommended number of immunisations. From the second quarter of 1995, the reported number of cases declined. The decrease coincides with an improvement of pertussis vaccination coverage between 1992 and 1995 due to an increased use of acellular vaccines. The reduction of complicated pertussis was observed even in age-groups too young for the recommended vaccinations. The observed decrease could be due to the increase in vaccination coverage with interruption of the chain of transmission to the younger age-groups, to a cyclic decrease in pertussis cases, or to a combination of both. Continued surveillance will provide information on the epidemiological trend of hospitalisations for pertussis complications in the first European country to have introduced vaccination with acellular vaccines on a large scale.
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PMID:Pertussis complications in Germany--3 years of hospital-based surveillance during the introduction of acellular vaccines. 971 80

The data obtained in experiments on shoal using plastic charges of 100-50-25 g of equivalent power of antipersonnel mines showed that injuring action on shoal was four times greater than that on land and resulted in considerably graver skeletal traumas and distant injuries. Of special significance in pathogenesis of mine-explosive wounds on shoal is pneumonia followed by arterial air embolism and encephalopathy. Although the undermining on land and on shoal have many common etiopathogenetic features, there are substantial differences first of all due to different mechanisms of their appearance. It must be taken into account while performing evacuatory, diagnostic and medical measures in such patients.
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PMID:[The characteristics of mine-blast wounds in shoals]. 991 63

To assess the morbidity associated with the continued high levels of pertussis, we studied all children <2 years of age who were admitted to the 11 Immunization Monitoring Program--Active (IMPACT) centers, which constitute 85% of Canada's tertiary care pediatric beds. In the 7 years preceding implementation of acellular pertussis vaccine, a total of 1,082 pertussis cases were reported, of which 49.1% were culture-confirmed. The median age of the patients was 12.4 weeks; 78.9% of cases were in children <6 months of age. Complications of pertussis were common: pneumonia was reported in 9.4% of cases, new seizures in 2.3%, and encephalopathy in 0.5%. There were 10 deaths (0.9%), all in children < or =6 months of age. Duration of hospitalization was longer (9.3 days vs. 4.9 days; P = .001) and intensive care was required more frequently (19.2% vs. 4.9%; P = .001) in infants under <6 months of age than in those > or =6 months. Pertussis continues to cause significant morbidity and occasional mortality in Canada, particularly in young infants.
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PMID:Epidemiological features of pertussis in hospitalized patients in Canada, 1991-1997: report of the Immunization Monitoring Program--Active (IMPACT). 1045 Nov 59

The factors that can influence the outcome of orthotopic liver transplantation (OLT) are numerous. The purpose of this study was to determine the effects of recipient preoperative factors on patient mortality. Between April 1986 and April 1998 a total of 600 OLTs were performed in our institution. We retrospectively reviewed our first 203 consecutive primary adult OLTs with at least 4 years of follow-up. A case-control comparison was performed between survivors and nonsurvivors, and differences in recipient variables were studied for their correlation with patient mortality. A logistic regression analysis was also performed. Mortality was significantly increased among those with fulminant hepatic failure (FHF) (66.6%, p = 0.003), primary cancer (63.1%, p = 0.018), females (46.1%, p = 0. 043), encephalopathy grade IV (72.7%, p = 0.012), recipients under respiratory support (69.2%, p = 0.031), and ABO-incompatible transplants (80%, p = 0.05). FHF, primary cancer, and female gender were the only variables that had a significant association with mortality in the logistic regression analysis. A higher incidence of prolonged respiratory support, bacterial and fungal infections, pneumonia, and chronic rejection contributed to the lower outcome observed in females. These results stress the need for continuous evaluation of the selection criteria of candidates for OLT suffering from primary cancer and FHF. The impact of recipient gender on mortality warrants further analysis but suggests that in the future more attention must be paid to the influence of this factor on the final outcome of OLT.
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PMID:Recipient factors as determinants of mortality after adult liver transplantation. 1055 22


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