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 40-year-old homosexual man with the acquired immunodeficiency syndrome (AIDS) presented with dyspnea and renal insufficiency. A chest radiograph showed cardiomegaly and prominent pulmonary arteries, without alveolar infiltrates. Swan-Ganz catheterization revealed pulmonary hypertension and no evidence of left-to-right shunt. Liver function tests were normal. He was treated empirically for Pneumocystis carinii pneumonia, but he died 3 days after admission. At autopsy, membranoproliferative glomerulonephritis type III, P. carinii pneumonia, and plexogenic pulmonary arteriopathy were found. The kidney and lung were studied by electron microscopy and immunohistochemistry. Electron-dense immunoglobulin deposits were identified in glomerular capillaries and were confirmed by immunohistochemistry, but the pulmonary plexogenic lesions were negative. The combination of membranoproliferative glomerulonephritis and plexogenic pulmonary arteriopathy has not been described in AIDS to date.
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PMID:Membranoproliferative glomerulonephritis and plexogenic pulmonary arteriopathy in a homosexual man with acquired immunodeficiency syndrome. 367 2

Respiratory infections of 19 subjects of advanced age and/or with underlying respiratory disease were treated with cefoperazone (CPZ) and its clinical effects were studied. Sixteen subjects suffered from respiratory tract infection and 3 subjects had pneumonia. The age of the subjects ranged from 39 to 77 years with the mean of 63.8, 7 of them being more than 70 years of age. The underlying respiratory diseases included chronic pulmonary emphysema in 6 subjects, diffuse panbronchiolitis in 3, bronchiectasis in 3, silicosis in 2 and one each of chronic bronchitis, pulmonary fibrosis, lung cancer and old pulmonary tuberculosis. One case, 75 years of age, had renal insufficiency. The daily dose of CPZ was 4 grams in 18 of the 19 subjects and the duration of administration ranged 5 to 22 days. The remaining 1 subject received 2 g of CPZ daily for 6 days. Clinical effects were judged from the changes in fever, cough, amount of sputum, dyspnea, rales, cyanosis, chest X-ray, white blood cell counts, CRP, erythrocyte sedimentation rates and results of sputum culture. Clinical effects were good in 16 subjects, fair in 1, and poor in 2. Bacteriological follow-up was carried out in 13 subjects. Infecting bacteria were eliminated from 5 subjects, reduced in 2 and, in 4 subjects, they were replaced by other bacteria. In 1 subject, P. aeruginosa was isolated from sputum even after the treatment with CPZ, and in another subject H. influenzae relapsed immediately after the cessation of the CPZ treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Effects of cefoperazone on respiratory infections of patients of advanced age and/or with underlying respiratory diseases]. 373 62

9 consecutive cases of Legionnaires' disease are presented, all of which involved either a pathological urinary sediment or acute renal insufficiency. Diabetic glomerular sclerosis and terminal septic shock in one patient accounted per se for the urinary findings and terminal oliguric renal failure. In the remaining 8 patients the renal abnormalities are interpreted as manifestations of Legionnaires' disease: these were acute renal insufficiency in 6, requiring dialysis treatment in 4, proteinuria in 7, hematuria in 5, leukocyturia in 5 and cylindruria in 3 patients. One patient died of pneumonia and one patient, without Legionella-related renal involvement, of septic shock. Renal histology of 5 patients showed acute interstitial nephritis in one and diffuse sclerosing interstitial nephritis in a second patient, whose biopsy was obtained after 3 months' hemodialysis treatment. In 3 patients renal biopsy findings were explained by preexisting renal pathology, i.e. diabetic nephropathy, chronic transplant rejection and shock kidney respectively. Renal failure requiring hemodialysis and urinary abnormalities were largely reversible.
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PMID:[Renal involvement in Legionnaires' disease]. 381 99

The frequency and the various etiologies of community acquired pneumonia are not well established. In adults, it is believed that half of the cases are caused by viruses and Mycoplasma pneumoniae. The pneumonia in these patients is limited and treated on an ambulatory basis. In patients who need to be hospitalized, the main etiology of pneumonia is S. pneumoniae. Despite effective antibiotic treatment, pneumococcal pneumonia still remains a life-threatening infection, especially in bacteremic patients presenting with underlying predisposing factors such as renal insufficiency, liver cirrhosis, and age over 70. In order to prevent the morbidity and mortality due to pneumococcal pneumonia, vaccination of the high-risk population on a larger scale than at present should be considered.
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PMID:[Community-acquired pneumonias: importance of pneumococcal pathology]. 387 65

Ninety patients with serious infections, including 61 with septicaemia, pneumonia, peritonitis or meningitis, were treated with ceftazidime. Of these patients, 85.6% were clinically cured (73.3%) or improved (12.2%) by the antibiotic. In this study, 57.7% had infections due to Escherichia coli (24.7%), Klebsiella sp. (14.5%) and Pseudomonas sp. (18.5%). Two children with cystic fibrosis and Pseudomonas pneumonia and an adult with Legionella pneumonia responded well to ceftazidime treatment. Seventy patients had fever before treatment and most of them became apyrexial in less than 2 to 3 days. Ceftazidime was given either intramuscularly (42 patients) or intravenously (48 patients), in a dose of 1 g tds in 71 patients or 2 g tds in severe infections in 11 patients, or reduced to suit the renal function (7 patients) or in paediatric doses (2 children). Blood ceftazidime levels were measured in eight patients with normal renal function. The average level one hour post dosing was 45.2 mg/l and the average trough level was 8.1 mg/l. Six patients were suffering from variable degrees of renal insufficiency (serum creatinine 149 to 668 mmol/l). Their average blood level 1 h post-dosing was 68.8 mg/l. In a patient with meningitis, the CSF level was 2.4 mg/l 2 h after a 1 g dose. These levels are several times the ceftazidime MIC values for most clinical bacterial isolates. Ceftazidime is a valuable and safe alternative to aminoglycoside therapy.
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PMID:Ceftazidime: a new approach in the treatment of moderate and severe infections. 635 15

The hemolytic-uremic syndrome (HUS) following dysentery caused by S. dysenteriae Type 1, characterized by microangiopathic hemolytic anemia and acute renal insufficiency, is clinically similar but not identical to the idiopathic HUS. We studied renal necropsy specimens of nine children who died of HUS following shigellosis by light and immunofluorescent microscopy and compared them to 12 controls: six cases with severe shigellosis without HUS, and six with pneumonia or sepsis. Eight of nine HUS cases showed cortical necrosis, extensive glomerular thrombosis or arterial thrombosis. Cases without HUS showed only scattered glomerular fibrin thrombin and widening of the mesangium. Among seven HUS cases studied by immunofluorescent microscopy, three demonstrated deposition of glomerular IgM and complement (C3) and one of the three had IgG and IgA as well; four cases had neither immunoglobulin or complement deposits. Among nine controls, two demonstrated IgM and three IgG, but none had C3. Both HUS and non-HUS cases had fibrin deposition. In the three HUS cases studied by electron microscopy intracapillary material (fibrin and platelets) was seen in all three, and sparse electron-dense deposits in mesangial matrix in one. The data indicate that the renal histopathology in the HUS following shigellosis consistently presents as a severe thrombotic microangiopathy, but lacks the characteristic endothelial and mesangial lesions of idiopathic HUS. The infrequent demonstration of glomerular immunoglobulin deposition fails to support an immunoglobulin-mediated pathogenesis.
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PMID:Renal histopathology in the hemolytic-uremic syndrome following shigellosis. 637 79

In 71 adult acute myelogenous leukaemia (AML) cases, the relationship between well-known prognostic features and complete remission (CR) rate and survival was studied. These features were: (i) bone marrow karyotype classified NN, AN, AA according to Sakurai & Sandberg (5); (ii) patients' age; (iii) clinical 'negative prognostic features' (NPF): previous history of preleukaemia, septicaemia or pneumonia, hyperleucocytosis, associated pathology (diabetes, obesity, renal insufficiency etc.). 59 years of age was found to be a frontier between 2 homogeneous groups having quite different prognosis. The NN/AN/AA classification had good prognostic value (CR rate and survival) in patients under 59 years, but not in older patients. In those patients over 59, a significant difference in CR rate and survival appeared between cases with NPF and those without. For each feature having an established relationship to survival, a panel of prognostic points was determined as follows: age over 59 (1 point), AA karyotype in patients under 59 (2 points), NPF in patients over 59 (1 point). Using this stage classification, it was possible to classify every case into 1 of 3 groups (i.e.: 0 points, 1 point, 2 points). The life-table analysis of these 3 groups showed very significant differences. The median survival times were 18.5 months, 5.2 months and 1.3 month, for the 0-point group (26 cases), the 1-point group (19 cases) and the 2-point group (26 cases), respectively.
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PMID:A stage classification for prognosis in adult acute myelogenous leukaemia based upon patients' age, bone marrow karyotype and clinical features. 658 30

During the period from 1976 to 1981, 364 patients with bladder carcinoma were seen at the Keio University Hospital. Extensive preoperative investigation of pulmonary, cardiovascular, and renal function was obtained in all patients. Of the 12 patients studied, 9 underwent a one-stage total cystectomy and ileal loop diversion and the remaining 3 a two-stage procedure. Of the 9 patients, decreased FEV 1.0 per cent by spirometry was noted in 5, ECG abnormality such as bundle branch blocks in 8, and diminished creatinine clearance ranging from 28 to 68 ml/min were observed in all 9. Major postoperative complications included pyelonephritis in 2 patients, pneumonia in 1, pelvic abscess in 2, renal insufficiency in 3, and paralytic ileus in 2. There was no immediate postoperative death. In these elderly patients, functional reserve of the lung, heart, and kidney is less than optimal and is further decreased by major surgical procedures. Therefore, total cystectomy in the elderly patients is justifiable only in a selected group of patients, when functional status of the vital organ is thoroughly worked up and prophylactic and therapeutic measures are instituted promptly if indicated.
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PMID:One-stage total cystectomy and ileal loop diversion in patients over eighty years' old with bladder carcinoma. Pre- and postoperative functional reserve of various organs. 664 6

In a prospective study (from April, 1980 to April, 1981) of 110 patients with moderately severe to severe pneumonia 11 were found to have 12 manifestations of Legionnaires' disease. Diagnosis was proven by indirect immunofluorescence tests, either a quadruple titre rise to 1 : 128 or a single titre of at least 1 : 256. The clinical picture in all 11 patients was the typical one of severe pneumonia, usually involving the lower lobes, high fever between 39 and 40.4 degrees C, as well as WBC counts between 6.8 and 28.9 X 10(9)/l. In nine cases artificial ventilation was required, in four there was acute renal failure requiring dialysis, in four other definite renal insufficiency. All patients had underlying disease, in some severe, such as chronic obstructive lung disease, diabetes mellitus, heart failure, liver cirrhosis, renal transplantation or extensive operations. Eight patients died, four of them of Legionnaires; disease. The relatively high infection rate (10%) indicates that in patients with risk factors, as well as those with a pneumonia unresponsive to the standard treatment within five to seven days, Legionnaires' disease should be considered in the differential diagnosis.
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PMID:[Legionnaires' disease: prospective study of its incidence, clinical features and prognosis. (author's transl)]. 706 Apr 96

A patient undergoing examination for moderately severe renal insufficiency had fulminant five-lobed pneumonia caused by Legionella pneumophila. Her clinical course was complicated by granulocytopenia. Bone marrow aspiration showed notable inhibition of myelopoiesis, involving all stages of maturation. The presence of a serum inhibitor of granulopoiesis was demonstrated by in vitro bone marrow culture. Normal bone marrow cultured in the presence of serum from two normal control subjects yielded 69 +/- 5.2 (mean +/- SE) and 61 +/- 5 granulocyte colonies. When the patient's serum was substituted for normal human serum only 14.3 +/- 2.3 colonies were formed. Each of the drugs to which she had been exposed was tested in the in vitro system, using therapeutic concentrations, and none showed significant suppression of granulocyte colony formation. These observations indicate that legionnaires' disease was associated with a serum factor that notably inhibited the growth of granulocyte colonies in this patient.
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PMID:Myelosuppression in Legionnaires' disease. 709 51


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