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)

A patient with gamma heavy chain disease (Franklin's disease) was discovered during evaluation for pancytopenia and splenomegaly. Lymphadenopathy, palatal edema, and infiltration of the bone marrow palatal edema, and infiltration of the bone marrow with abnormal cells were all absent. Serum and urine protein electrophoresis demonstrated a monoclonal protein migrating in the beta region. Immunoelectrophoresis showed that it reacted with antibodies against the Fc fragment of IgG heavy chains (gamma chains) but not with antibodies against kappa and lambda but not with antibodies against kappa and lambda light chains of Fab fragments. In the first year after detection of the disease, the patient had acute cholecystitis and disseminated herpes zoster. Sixteen months after diagnosis he died of overwhelming pneumonia caused by Pseudomonas aeruginosa and lebsiella neumoniae. A striking feature of his illness was his asymptomatic presentation, with pancytophenia and splenomegaly the only indication of this disease.
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PMID:Gamma heavy chain disease--presenting as pancytopenia and splenomegaly. 40 13

The treatment of patients with sickle cell disease and cholelithiasis is controversial. This retrospective study assesses the outcome of preoperative transfusion and timely cholecystectomy in symptomatic sickle cell disease patients. Fourteen patients who had undergone cholecystectomy were determined to have sickle cell disease. The patients' mean age was 17.9 years. Eleven patients were female. Thirteen patients had complained of abdominal pain. Ultrasound confirmed the diagnosis of cholelithiasis in 12 of 13 patients tested. Hemoglobin before treatment averaged 7.7 g/dL. Transfusion or exchange transfusion was given to 12 patients, raising the average hemoglobin to 10.3 g/dL. Postoperative morbidity was 14%: one patient had a urinary tract infection and another a left-lower-lobe pneumonia. No sickle cell crises or deaths occurred. Postoperative hospital stay averaged 4.4 days. With judicious use of preoperative transfusion, early cholecystectomy for symptomatic gallstones was well tolerated by sickle cell disease patients and is advisable to avoid the morbid sequelae of acute cholecystitis and peroperative sickle cell crisis.
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PMID:Cholecystectomy in patients with sickle cell disease: experience at a regional hospital in southeast Georgia. 150 60

Retrospective review of the first 210 patients treated by laparoscopic cholecystectomy revealed 55 patients (26%) with acute cholecystitis diagnosed preoperatively or intraoperatively. Average age was 52 years amongst 38 women and 17 men. Cardiac history was present in 4%, pulmonary disease was noted in 9%, and other significant medical history was found in 10%. Abnormal preoperative laboratory values (white blood cell count, liver function) were seen in 80%. Operations averaged 104 minutes. Dissection was performed with the potassium titanyl phosphate (KTP) laser in 9%, neodymium-doped yttrium aluminum garnet (Nd Yag) laser in 20%, and electrocautery alone in 71%. Average body habitus was 5 ft 9 in, 178 lb for men and 5 ft 5 in, 155 lb for women. Average length of stay was 2.6 days. Thirty-eight patients (69%) left the hospital in < 2 days. Postoperative complications included one case each of urinary retention, pneumonia, myocardial infarction, and three cases of postoperative fever. Drains were placed in 10 patients (18%). There was no mortality. Suggestions are made for technical considerations that make laparoscopic cholecystectomy a safe and efficient approach to acute cholecystitis.
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PMID:Laparoscopic treatment of acute cholecystitis. 166 69

We reviewed the charts of the cancer patients admitted in a medical oncology ICU during an 11-month period. Among 330 admissions (55% for a medical complication, 45% for monitoring during administration of an intensive or potentially toxic treatment), 49 patients died and 34 autopsies were performed. Every autopsied case was reviewed by a group of oncologists and pathologists. The direct cause of death was neoplasia itself in only four patients. Six deaths remained unexplained after post mortem examination. In 23.5% of cases, the direct cause of death was a major infection (four aspergillosis, two candidemia, one CMV pneumonia, one acute cholecystitis). Overall, the clinical diagnosis of the immediate cause of death was correct in only 41% of the cases. Lesions of pulmonary edema (PE) were found at autopsy in 68% of the cases. No predictive factors for PE were determined.
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PMID:Causes of deaths in an oncologic intensive care unit: a clinical and pathological study of 34 autopsies. 214 96

The diagnosis of hepatic abscesses in outpatients is accurate in hardly half of the cases. The rest of them are commonly taken for: acute cholecystitis, cholecystopancreatitis, pancreatitis, peritonitis, phlebitis of the splenic veins, intestinal obstruction, chronic enterocolitis, pneumonia, pleurisy. Misdiagnosis is usually attributed to the absence of pathognomonic symptoms and atypical course of a hepatic abscess. With right chest and hypochondrium pains of unknown origin and elevation of body temperature, diagnostic efforts should be directed to recognition of a hepatic abscess.
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PMID:[Diagnosis of liver abscess]. 233 34

Acute symptomatic biliary tract disease in the elderly is usually associated with a tenfold increase in operative morbidity and mortality when compared to the disease in non-elderly patients. Over a 10-year period 118 elderly patients with a mean age of 77.2 years (range 65 to 98 years) were operated on for benign biliary tract disease. Acute cholecystitis was found at operation in 33 patients (28%), empyema in nine (7.6%), gangrene of the gallbladder in three (2.5%), and 24 patients (20.3%) were found to have common bile duct stones. Seventy-three patients had chronic cholecystitis. Complications occurred in 29 patients (24.6%), with pneumonia and wound infection as the two most common. Fifteen patients died, making the overall mortality rate 12.7 per cent. The mean age of the patients who died was 81.5 years. Two patients died following elective operations (mortality rate 1.7%), while the remainder died after emergent or urgent operations (11%). Elective biliary tract surgery in the elderly for symptomatic disease is safe and will reduce postoperative morbidity and mortality.
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PMID:Symptomatic biliary tract disease in the elderly patient. 372 84

Acute cholecystitis is a non-rare disease, the incidence of which was increasing in the last years parallel to biliary lithiasis, which in 90% of cases is the first cause of such pathology. From the anatomopathological standpoint, we distinguish three types of acute cholecystitis: catarrhal, suppurative and gangrenous. The most frequently remarked symptom is ache at right hypochondrium. Only in 30% of cases cholecyst can be palpated, in form of ovoid mass; typical is the positiveness of Murphy's manoeuvre; constant is fever, but not subicterus. The introduction of new methods of ascertainment, exempt from any risks, simple to be performed and remarkably careful, made the diagnostics of acute cholecystites easier: parietal cholecystotomography, hepato-biliary scintigraphy, echotomography (first approach investigation), computerized axial tomography and laparoscopy almost always succeed in dispelling doubts. By using more than one of these investigations, a diagnostic accuracy, touching on 100%, can be reached. The differential diagnosis should be placed with: peptic ulcer, acute pancreatitis, acute appendicitis, gonococcus perihepatitis, virus hepatitis, acute pyelonephritis, right basal pneumonia. The complications an acute cholecystitis can occur are: perforation (localized, in free peritoneum or in a hollow organ), choleperitonaeum, necrosis of hepatic parenchyma, acute pancreatitis. Due to the possible arising of such complications, the mortality unfortunately is not indifferent (5%), especially in patients already weakened by other chronic diseases. Still discussed is the question as to when performing operation. In fact, there are three trends: intervention in immediate emergency, in postponed emergency, or in remote time (preceded by a medical treatment). The Authors prefer the intervention in postponed emergency, as, in their experience, they remarked the poor effectiveness of the delay medical treatment, also involving a greater difficulty in the technical execution of the intervention and a longer stay in hospital. From 1973 up to 1983, 241 cases of acute cholecystitis (158 women and 83 men) were hospitalized at the First Aid Surgical Centre of the Catania University. Eight patients refused the surgical intervention. The remaining 233 underwent, depending upon the seriousness of the affection, the associated diseases and the different reactiveness to the medical treatment, operation: in immediate emergency (26.1%); in postponed emergency (67.8%; in remote time (6.1%). The mortality was 2.2%, with the lowest percentage in the second group.
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PMID:[Acute cholecystitis]. 640 77

An open-label, nonrandomized, multicenter study was designed to evaluate the efficacy and safety of intravenous (i.v.) ciprofloxacin, followed by oral ciprofloxacin and/or some other antimicrobial, as presumptive (empiric) therapy in hospitalized patients with clinical and bacteriologic evidence of infection. Out of a total of 149 patients recruited by 31 physician investigators, 148 were assessable for the determination of clinical efficacy and 102 patients were assessable for bacteriologic efficacy. All 149 patients were included in the evaluation of the safety of i.v. ciprofloxacin. The mean duration of IV ciprofloxacin therapy was 6 days, and 111 patients were subsequently switched to oral treatment with ciprofloxacin and/or some other antimicrobial. A clinically favorable response was achieved using i.v. ciprofloxacin in 48 (75%) of 64 patients with pneumonia; 4 (80%) of 5 patients with other lower respiratory tract infection (LRTI); 21 (88%) of 24 patients with pyelonephritis; all 7 (100%) patients with complicated cystitis; 16 (94%) of 17 patients with other complicated urinary tract infection (UTI); all 8 (100%) patients with cellulitis; both (100%) patients with infected ulcer; 4 (80%) of 5 patients with other skin or skin structure infection; 5 (83%) of 6 patients with bone infections; all 8 (100%) patients with septicemia; the 1 (100%) patient with acute cholecystitis; and the 1 (100%) patient with liver abscess. Of the 88 patients from these infection categories who were switched to oral ciprofloxacin, only 2 patients (2.3%) were classified as a clinical failure at the end of all therapy. Eradication of the causative pathogen was demonstrated with i.v. ciprofloxacin in 18 (55%) of 33 assessable patients with pneumonia; 1 (25%) of 4 patients with other LRTI; 17 (81%) of 21 patients with pyelonephritis; 3 (43%) of 7 patients with complicated cystitis; 9 (69%) of 13 patients with other complicated UTI; 3 (60%) of 5 patients with cellulitis; neither (0%) of the 2 patients with infected ulcer; 3 (50%) of 6 patients with other skin or skin structure infection; 2 (33%) of 6 patients with bone infections; and 4 (80%) of 5 patients with septicemia. A causative pathogen was not isolated in the 1 patient with liver abscess; initial bacteriologic culture was not available for the patient with acute cholecystitis. Of the 56 bacteriologically assessable patients from these infection categories who were switched to oral ciprofloxacin, there were only 3 patients (5.4%) in whom the causative bacterial pathogens were not successfully eradicated at the end of all therapy. There were no unexpected adverse events with the use of i.v. ciprofloxacin.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Sequential intravenous/oral ciprofloxacin as an empiric antimicrobial therapy: results of a Canadian multicenter study. The Canadian Collaborative Investigational Group. 792 17

Transient electrocardiographic changes in patients with acute cholecystitis, pancreatitis, and pneumonia have been reported in the past. These changes usually are in the form of T-wave inversion, ST-segment depression, and rarely ST-segment elevation in the absence of coronary artery disease. To the authors' knowledge, this is the first report documenting both left ventricular segmental wall motion abnormality and electrocardiographic changes of myocardial injury in the presence of acute pancreatitis.
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PMID:Electrocardiographic and segmental wall motion abnormalities in pancreatitis mimicking myocardial infarction. 772 Feb 88

Ascariasis is a helminthic infection of global distribution with more than 1.4 billion persons infected throughout the world. The majority of infections occur in the developing countries of Asia and Latin America. Of 4 million people infected in the United States, a large percentage are immigrants from developing countries. Ascaris-related clinical disease is restricted to subjects with heavy worm load, and an estimated 1.2 to 2 million such cases, with 20,000 deaths, occur in endemic areas per year. More often, recurring moderate infections cause stunting of linear growth, cause reduced cognitive function, and contribute to existing malnutrition in children in endemic areas. Ascaris infection is acquired by the ingestion of the embryonated eggs. The larvae, while passing through the pulmonary migration phase for maturation, cause ascaris pneumonia. Intestinal ascaris is usually detected as an incidental finding. Ascaris-induced intestinal obstruction is a frequent complication in children with heavy worm loads. It can be complicated by intussusception, perforation, and gangrene of the bowel. Acute appendicitis and appendicular perforation can occur as a result of worms entering the appendix. HPA is a frequent cause of biliary and pancreatic disease in endemic areas. It occurs in adult women and can cause biliary colic, acute cholecystitis, acute cholangitis, acute pancreatitis, and hepatic abscess. RPC causing hepatic duct calculi is possibly an aftermath of recurrent biliary invasion in such areas. Ultrasonography can detect worms in the biliary tract and pancreas and is a useful noninvasive technique for diagnosis and follow-up of such patients. ERCP can help diagnose biliary and pancreatic ascariasis, including ascaris in the duodenum. Also, ERCP can be used to extract worms from the biliary and pancreatic ducts when indicated. Pyrantel pomoate, mebendazole, albendazole, and levamisole are effective drugs and can be used for mass therapy to control ascariasis in endemic areas.
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PMID:Ascariasis. 886 40


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