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

The postoperative courses of 224 patients who left the operating room alive after coronary bypass surgery were followed to determine the time of onset of complications to determine when discharge is safe. A total of 155 complications occurred in 103 patients including 59 with supraventricular tachycardia, 17 with fever, and 9 to 11 with ventricular arrhythmias, cerebrovascular accidents, wound infection, or deep vein thrombosis. Pneumonia occurred in seven patients, and other complications occurred in five or fewer patients. Most initial complications (77.6%) occurred by day 5, and 89.3% of the patients with complications had their initial event before day 8. Hence it appears that it is safe to discharge patients on day 8 after coronary artery bypass graft surgery if they have not had a postoperative complication.
 ...
PMID:Temporal relationship of complications after coronary artery bypass graft surgery: scheduling for safe discharge. 829 94

Patients who develop locally recurrent uterine corpus or uterine cervix cancer after primary surgery are usually treated with radiotherapy. The optimal radiotherapeutic approach, however, has not been defined. We report the use of exploratory laparotomy, omental pedicle grafting, and intraoperative transperineal interstitial brachytherapy in the treatment of 28 such patients (10 with recurrent corpus and 18 with recurrent cervix cancer). In addition, 22 patients also received perioperative whole pelvic teletherapy while 21 also received a second closed interstitial application. Local control was achieved in 20 patients (71%), but only 10 (36%) continue to be alive without disease after a median of 44 months. Eighteen patients have died (17 of disease) a median of 13 months after open implant. Patients treated with a single implant (n = 7), with side wall involvement (n = 5), with tumors greater than 6 cm in size (n = 4), with a history of previous pelvic irradiation (n = 8), or with persistent disease after open interstitial therapy (n = 8), were not salvaged. Ten patients suffered acute morbidity which included deep venous thrombosis (n = 1), wound separation (n = 1), urinary infection (n = 2), wound infection (n = 2), pneumonia (n = 1), and fever (n = 3). Two other patients experienced chronic non-tumor-related comorbidities. These included a vesicovaginal fistula with a rectovaginal fistula in 1 patient and a small bowel obstruction with a ureteral stricture in another. A single individual suffered from both acute and chronic complications (fever, ureterointestinal fistula).(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Open interstitial brachytherapy for the treatment of local-regional recurrences of uterine corpus and cervix cancer after primary surgery. 831 43

Prior studies have suggested that pre-irradiation methotrexate (MTX)-based chemotherapy improves duration of response and survival in primary central nervous system lymphoma (PCNSL). To circumvent the potential emergence of drug resistance, we combined high-dose MTX with agents highly active against systemic lymphoma. Patients received three week cycles of CHOD (cyclophosphamide 750 mg/m2, doxorubicin 50 mg/m2, and vincristine 1.4 mg/m2 [2 mg maximum] on day 1; dexamethasone 10 mg/m2 days 1-5), and MTX (3.5 gm/m2) with leucovorin rescue on day 8 (or on recovery from the CHOD nadir). Whole brain irradiation (WBRT) was planned after at least three cycles. Eighteen patients were treated. Complete responses were seen in eleven patients, and partial responses in three. Four progressed during therapy, three succumbing to progressive disease and one subsequently responding to WBRT. Response duration was 37.5 months in those responding to therapy. The time to progression for all eighteen patients was 19.5 months. Medial survival was 25.5 months. Disease-free survival was 50% at 38 months in MCHOD responders. Grade 3 or 4 myelotoxicity was seen in 19 of 50 cycles. There were three instances of neutropenic fever, three of azotemia, two of deep vein thrombosis, and one each of community-acquired pneumonia, intracranial hemorrhage, superior vena cava syndrome, and hepatotoxicity. Late radiation-related toxicities were seen in two patients. Pre-irradiation MCHOD has activity against PCNSL, but appears to be no better than MTX monotherapy and has greater toxicity.
 ...
PMID:Therapy of primary central nervous system lymphoma with pre-irradiation methotrexate, cyclophosphamide, doxorubicin, vincristine, and dexamethasone (MCHOD). 894 1

The prevalence of DVT in the general community has been estimated from large descriptive studies of symptomatic patients; the annual incidence of proximal DVT has been reported to be 48 cases for 100,000. When associated to known risk factors, the incidence of DVT is strongly elevated; postoperative DVT occurs, for instance, in 5% to 40% of patients undergoing surgical procedures. Estimated of the incidence and prevalence of PE are less reliable than for DVT because the ante-morten diagnosis of PE is difficult and the post-mortem diagnosis highly selective. An analysis conducted on 11,000 autopsies showed that 316 of these had macroscopic pulmonary emboli; nevertheless, 11% of cases only had the diagnosis before death, while 32% of the patients were diagnosed as died of myocardial infarction, 15% of cerebrovascular disease and 14% of pneumonia. Update results, indicate that mortality due to PE is the first cause of death in hospitalized patients. Venous thromboembolism is a common disease often misdiagnosed because of low accuracy of clinical diagnosis; correct approaches for prophylaxis, therapy and to diagnosis are necessary to manage high-risk patients for DVT and/or PE and to reduce costs and social impact.
 ...
PMID:[Venous thromboembolism: epidemiology and risk factors]. 901 39

With trauma being common in this country and over 110,000 recent organ transplants performed, transplant recipients may become trauma victims. At present, only a few older small series of traumatized transplant patients exist. At the University of Arkansas, over the past 40 months, 12 patients with significant trauma were retrospectively identified (seven with kidney and five with combined kidney and pancreas transplants). The most common causes of trauma were car accidents and falls. All patients suffered closed skeletal fractures, and no transplanted organs were directly injured or lost. Complications included death, deep vein thrombosis, renal failure, sepsis, and pneumonia. In spite of immunosuppression and preexisting renal osteodystrophy, fractures in the surviving patients healed, with a mean follow-up of 15 months. A large series of traumatized transplant patients is presented with a review of the management of traumatic injuries for each type of organ transplant. A trauma transplant registry is needed to formulate appropriate management and follow-up.
 ...
PMID:Trauma management in solid organ transplant recipients. 914 57

Laparoscopic splenectomy has been reported to be the procedure of choice in selected patients with hematologic disorders. The purpose of this study is to review our experience with laparoscopic splenectomy in this patient population. The charts of all patients with hematologic disorders who presented for laparoscopic splenectomy over a 17-month period were reviewed. Fifteen patients, nine males and six females, aged 12 to 80 years (mean, 49 years) presented for laparoscopic splenectomy. Surgical indications included 13 cases of idiopathic thrombocytopenic purpura and one each of hemolytic anemia and Hodgkin's disease. Splenectomy was performed utilizing a four- or five-puncture laparoscopic technique. For completed laparoscopic splenectomies, the mean operative time was 129 minutes, and the mean estimated blood loss was 232 cc. Mean splenic weight was 210 g. There were no operative deaths. There was a single intraoperative complication, a 1700-cc hemorrhage, and two postoperative complications: pneumonitis and deep venous thrombosis. Overall morbidity was 20 per cent. A single patient (7%) required conversion to laparotomy for completion due to hemorrhage. For patients completed laparoscopically, the mean hospitalization was 1.5 days, and none required parenteral narcotics for pain control after the first 36 hours. Laparoscopic splenectomy for patients with hematologic disorders is a safe and technically feasible procedure. Decreased hospitalization and discomfort are the primary benefits. This technique should be added to the repertoire of surgeons treating patients with hematologic disorders.
 ...
PMID:Elective laparoscopic splenectomy for hematologic disorders. 924 37

We report the case of a 72 year-old man with advanced, stage IV, prostate cancer who underwent osteosynthesis of the cervical spine for nerve root decompression due to metastasis which was causing severe pain in his right upper limb. After three months in the hospital, he developed occlusive thrombosis of the right axillosubclavian vein as a complication of prolonged catheterization of the right subclavian vein for treatment of septicemia secondary to a hospital acquired pneumonia. The patient received thrombolytic therapy with IV streptokinase in the contralateral arm in the following dosage: 250,000 units in 15 minutes followed by 100,000 units per hour during five days. This led to total recanalization of the thrombus, with significant reduction of the arm edema. Twenty-four hours after the end of the thrombolytic therapy, the patient started to complain of dysfagia to solids and liquids and a contrasted esophagogram revealed extensive extrinsic compression of the esophagus due to a probable retroesophageal hematoma. The patient required enteral nutrition via nasoenteral tube during three months after which swallowing returned to normal and a repeat upper GI series confirmed that the hematoma had been reabsorbed, with normal passage of contrast through the esophagus. On late follow-up, the patient did not show evidence of any sequelae of deep venous thrombosis nor any residual dysfagia and is currently in use of elastic stockings and low molecular weight heparin.
 ...
PMID:[Retroesophageal hematoma with severe dysfagia after streptokinase for the treatment of the axillosubclavian vein thrombosis]. 956 35

Azathioprine is a drug commonly used for the treatment of inflammatory bowel disease, organ transplantation and various autoimmune diseases. Hepatotoxicity is a rare, but important complication of this drug. The cases reported to date can be grouped into three syndromes: hypersensitivity; idiosyncratic cholestatic reaction; and presumed endothelial cell injury with resultant raised portal pressures, venoocclusive disease or peliosis hepatis. The components of azathioprine, 6-mercaptopurine and the imidazole group, may play different roles in the pathogenesis of hepatotoxicity. The strong association with male sex, and perhaps with human leukocyte antigen type, suggests a genetic predisposition of unknown type. Many of the symptoms of hepatotoxicity, such as nausea, abdominal pain and diarrhea, can be nonspecific and can be confused with a flare-up of inflammatory bowel disease. As well, the subtype resulting in portal hypertension can occur without biochemical abnormalities. A 63-year-old man with Crohn's disease who is presented developed the rare idiosyncratic form of azathioprine hepatotoxicity, but also had a severe disabling steroid myopathy, peripheral neuropathy, resultant deep venous thrombosis and pulmonary embolism related to immobility, and a nosocomial pneumonia. His jaundice and liver enzyme levels improved markedly on withdrawal of the drug, returning to almost normal in five weeks. Treating inflammatory bowel disease effectively while trying to limit iatrogenic disease is a continuous struggle. Understanding the risks of treatment is the first important step. There must be a low threshold for obtaining liver function tests, especially in men, and alertness to the need to discontinue the drug or perform a liver biopsy should patients on azathioprine develop liver biochemical abnormalities, unexplained hepatomegaly or signs of portal hypertension.
 ...
PMID:Cholestatic hepatocellular injury with azathioprine: a case report and review of the mechanisms of hepatotoxicity. 981 67

In recent years, organized basic care and the use of thrombolysis have been significantly effective in improving the acute stroke therapy especially for the ischemic stroke subtype. Combining the efforts for the basic care of stroke patients in the setting of the so-called stroke-units is the goal for a qualified therapy. Main parts in the basic care algorhythm are: optimization of the cerebral perfusion, maintenance of an initial high blood pressure, best oxygen supply, reduction of an increased body temperature and antiinfectious treatment, reduction in the rate of complications (like deep vein thrombosis, pneumonia, falls etc.) and the early physiotherapeutic therapy. Thrombolysis is restricted to selected patients with infarctions of the middle cerebral artery with symptoms starting not longer than three hours before treatment, without hemorrhage in CCT and fulfilling the strict in- and exclusion criteriae established by the recent multicenter trials. The use of rt-PA (0.9 mg/kg body weight) is recommended. Local fibrinolysis is used in patients suffering from basilar artery thrombosis. The use of other recanalizing techniques like PTA or stenting is yet still experimental in acute stroke patients. Neuroprotective agents which were proven in clinical trials are still not available. In recent years therapy with hemodilution was widely used, nowadays the intravenous application of fluids with hemodilutive properties is restricted to patients with reduced cardiac output and macroangiopathy to maintain or to improve cerebral perfusion. Early intravenous anticoagulation with heparin is defined as secondary prevention and not as therapeutical intervention.
 ...
PMID:[Acute therapy of stroke]. 1041 99

Pulmonary diseases play a particular role during pregnancy. First, the adaptive hyperventilation of the mother implies sufficient pulmonary reserves, and second, and increasing oxygen consumption of the fetus during pregnancy might be compromised by maternal hypoxemia and could be followed by fetal growth retardation and fetal hypoxemia. Asthma bronchiale is the leading pulmonary disease in pregnancy and is not associated with higher risk for pregnancy and fetus when sufficiently threatened. First line medicaments are beta-2-agonists and steroids. Pneumonia however is a serious menace to the pregnant women, especially when not early diagnosed and correctly treated. Respecting the leading germs, macrolids or wide-spectrum penicillins are used. Tuberculosis has no deleterious effect on pregnancy with early diagnosis and treatment, which follows the usual guidelines during pregnancy with isoniacid, rifampicin and ethambutol. Cystic Fibrosis is not a strict contraindication for a pregnancy, especially for mild clinical forms. However, preconceptional counseling and regular clinical controls before and during pregnancy are indispensible. Deep vein thrombosis and pulmonary embolism are more frequent during pregnancy; the search for risk factors, prophylaxis and treatment are essential to avoid these complications. Heparin is the ideal prophylaxis and treatment in pregnancy, while oral anticoagulants should be avoided because of their effect on the fetus.
 ...
PMID:[Lung diseases in pregnancy]. 1054 31


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>