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 75-year-old woman with acute respiratory failure due to pneumonia superimposed on bronchospastic chronic obstructive pulmonary disease and dilated cardiomyopathy developed multifocal and unifocal atrial tachycardia. Arrhythmia recurrence appeared to be dependent on reaching a critical but "nontoxic" serum theophylline concentration in the presence of high normal levels of digoxin. The arrhythmias responded to a decrease in serum theophylline concentration or to the administration of verapamil. The precipitation of the atrial arrhythmias by theophylline in the presence of digitalis, both of which may increase intracellular calcium and a dramatic response to verapamil, which inhibits calcium uptake and release, suggests that these arrhythmias may represent an example of "triggered activity" in man.
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PMID:Atrial arrhythmias exacerbated by theophylline. Response to verapamil and evidence for triggered activity in man. 406 86

Plasma fibronectin (FNp) concentrations were measured in 63 patients with acute respiratory failure and 28 patients with circulatory failure, using Laurell's electroimmunoassay method. Measurements were made in the acute phase and repeated in the course of the disease. The mean FNp concentration in 20 controls was 262 +/- 59 mg/l. FNp values were normal in the acute phase of chronic obstructive pulmonary disease and in cardiogenic pulmonary oedema. In contrast, they were significantly decreased in adult respiratory distress syndrome and in acute pneumonia, as well as in acute circulatory failure, notably from septic shock. FNp values were also considerably reduced in patients with severe disseminated intravascular coagulation syndrome. Clinical improvement was accompanied by a return to normal of FNp concentrations. The mortality rate was greater in patients with low FNp values than in those with normal values.
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PMID:[Acute respiratory and circulatory failure. Prognostic value of plasma fibronectin levels]. 622 Mar 70

The evolution of acute respiratory failure was studied in 27 patients with generalized peritonitis. The natural history of pulmonary failure indicates an incidence of 74% of atelectasis progressing to pneumonitis in the majority of patients. In 21 patients, similar aerobic microorganisms were recovered from the sputum and abdominal focus of infection. The emergence of gram negative pneumonia by the third day of onset of peritonitis appeared to add significantly to respiratory failure. In the management of respiratory failure, early use of positive and expiratory pressure with mechanical ventilation was associated with improvement or reversal of hypoxia. A high fatality (89%) was attributed to uncontrolled sepsis rather than to respiratory failure.
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PMID:Acute respiratory failure in patients with generalized peritonitis. 631 48

Acute respiratory failure is frequently fatal. Attempts to decrease mortality must include attention to pulmonary and extrapulmonary complications. Pulmonary complications include pulmonary emboli, barotrauma, fibrosis, and pneumonia. Swan-Ganz catheters, tracheal intubation, and mechanical ventilation can also result in pulmonary complications. Extra-pulmonary complications such as gastrointestinal hemorrhage, renal failure, infection, and thrombocytopenia may increase mortality. Early diagnosis, aggressive treatment, and prophylaxis of complications should increase survival.
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PMID:Complications of acute respiratory failure. 640 5

Nosocomial pneumonias, usually due to gram-negative bacilli, occurred in 13 consecutive baboons that underwent endotracheal intubation, prolonged deep sedation, and paralysis during studies of acute respiratory failure. Serial bacteriologic studies demonstrated colonization of the oropharynx by pathogenic bacteria within 24 to 48 h of instrumentation, followed by aspiration of colonizing organisms into the tracheobronchial tree. Specimens obtained from the lung periphery remained sterile for at least 24 h longer than the proximal airways. Despite the presence of multiple pathogenic species in oropharyngeal and tracheobronchial secretions, pneumonias were usually due to a single species selected from those colonizing more proximal regions. In an attempt to prevent pneumonias, we added 3 measures to the management of the next 19 animals: meticulous aspiration of oropharyngeal secretions, topical instillation of polymyxin B, and prophylactic administration of ampicillin beginning 3 days prior to study. These measures reduced the prevalence of colonization with Pseudomonas aeruginosa, Klebsiella pneumoniae, and Staphylococcus aureus, and only 3 of the 19 animals developed pneumonia. This dramatic reduction of pneumonias is explained in part by prevention of colonization by highly invasive organisms. These data indicate that manipulation of the bacterial flora of the upper respiratory tract may provide an effective approach to the prevention of nosocomial pneumonias.
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PMID:Pathogenesis and prevention of nosocomial pneumonia in a nonhuman primate model of acute respiratory failure. 647 98

Variations of functional residual capacity (FRC, estimated by the N2-washout technique) and oxygenation (PaO2/FIO2) were investigated in patients mechanically ventilated for acute respiratory failure (ARF, caused by pneumonia). The various ventilatory modes were compared. The results were as follows: 1. If FRC is reduced due to ARF, the reduction is diminished by PEEP. The quantitative amount of this effect cannot be predicted in the individual patients. 2. If CPPV is switched to IMV or CPAP with an equal PEEP value, FRC was not usually changed when the clinical course was favourable; however, FRC decreased if clinical signs of insufficient spontaneous respiration were present. The proportion of FRC reduction following such a change of respiratory mode was equal to the effect of removal of PEEP from 10 cm H2O to zero. 3. FRC and oxygenation do not undergo a parallel change in every situation. 4. Treatment and further research should focus not only on increasing reduced lung volume but mainly on diverting ventilation to perfused lung regions.
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PMID:[Behavior of functional residual capacity in acute respiratory insufficiency]. 662 35

Serious illness is accompanied by markedly increased susceptibility to colonization of the respiratory tract by gram-negative bacilli and an increase in the number of such organisms which adhere to regional epithelial cells during incubation in vitro. Trypsinization of cells from normal subjects causes a similar increase in bacillary adherence. We studied bacillary adherence to buccal cells in vitro, protease activity of upper respiratory secretions with a fibrin plate technique, and the amount of fibronectin on the surface of buccal cells with a direct radioimmunobinding assay. Among 10 patients seriously ill with acute respiratory failure bacillary adherence to buccal cells and protease activity in secretions were increased compared with controls and cell-surface fibronectin was decreased; all patients were colonized in vivo with gram-negative bacilli. These changes were persistent and 80% of the patients died. Serial determinations were made in eight patients undergoing coronary artery bypass surgery. Following surgery, protease activity and bacillary adherence increased and cell-surface fibronectin decreased; 38% of coronary artery bypass patients became colonized. In these uncomplicated patients the changes observed were transient, largely returning to normal by the third postoperative day. Increased protease activity of secretions and alterations in epithelial cell surfaces as reflected by loss of buccal cell-surface fibronectin occur swiftly after major illness and appear to underlie enhanced cell adherence of bacilli and colonization of the upper respiratory tract. These findings suggest new approaches to the prevention of nosocomial pneumonia.
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PMID:Role of salivary protease activity in adherence of gram-negative bacilli to mammalian buccal epithelial cells in vivo. 679 70

PEEP is widely accepted as a therapy for some forms of acute respiratory failure (ARF). PEEP increases functional residual capacity (FRC), decreases intrapulmonary shunt fraction, and improves arterial oxygenation. The time required for FRC and arterial oxygen tension (PaO2) to stabilize after an adjustment in the level of PEEP is not clearly established. Therefore, to determine the temporal relationship between PEEP, FRC, and PaO2 after adjusting the level of PEEP, aspiration pneumonitis was produced in swine. The FRC and the PaO2 decreased within seconds after intratracheal instillation of 0.1 N HCl; FRC of all animals was restored to its control value after the application of PEEP, 5 cm H2O, but PaO2 remained low. It was necessary to increase PEEP to 20 cm H2O and FRC to twice the control value to return arterial oxygenation to control levels. After PEEP was applied, an average of 15 sec was required to increase FRC; the less compliant the lung, the more rapid the change. After PEEP was removed, FRC stabilized within an average of 22 sec. When PEEP, 25 cm H2O, was removed, arterial oxygenation decreased suddenly and substantially which suggests that PEEP, especially at higher levels, should not be discontinued, even momentarily, for nonessential maneuvers.
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PMID:Temporal responses of functional residual capacity and oxygen tension to changes in positive end-expiratory pressure. 700 17

A patient with chronic bronchitis and acute respiratory failure due to mycoplasma pneumonia received excess parenteral fluid and developed hyponatremia associated with generalized seizures. The low serum osmolarity and elevated urine osmolarity were consistent with SIADH. Treatment with erythromycin and water restriction resulted in the complete recovery of her acute respiratory condition and return of the serum sodium and osmolarity values to normal.
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PMID:Inappropriate secretion of antidiuretic hormone and mycoplasma pneumonia infection. 703 12

Severe staphylococcal pneumonia developed secondary to pyomyositis of the buttock in an adult male Melanesian in East New Britain, Papua New Guinea. Penicillin-resistant Staphylococcus aureus was cultured from the abscess, and S. aureus, together with Gram-negative organisms, were cultured from sputum. Despite treatment with high dose cloxacillin together with supportive chemotherapy, progressive deterioration of lung function occurred and acute respiratory failure developed. As suitable ventilators were unavailable, tracheal intubation was performed, and manual assisted ventilation was carried out for 4 days. Progressive improvement in ventilation and general status resulted, and the patient recovered without sequelae.
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PMID:Severe staphylococcal pneumonia complicating pyomyositis. 710 17


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