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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between 1974 and 1987, 14 patients (10 male and 4 female) underwent thoracotomy for treatment of pulmonary mycosis. They were studied on their clinical findings and surgical treatment. The median age was 48 years (range 19 to 71 years). Fourteen cases consisted of 9 aspergillosis and 5 cryptococcosis. None of them was either debilitated or immunosuppressed before falling ill. Five of the 14 patients had other pulmonary disease and 11 had symptoms; i.e. hemoptysis or bloody sputum in 4 cases, chest pain in 3, fever in 3, cough and sputum in 2. Nine aspergillosis consisted of 4 aspergilloma, 3 aspergillus pneumonia and 2 aspergillus empyema. Three cases of aspergillosis occurred in preexisting cavity. Five cryptococcosis consisted of 3 pseudotumorous, 1 disseminated small nodular, and 1 infiltrative types. Preoperative diagnosis was as follows; pulmonary mycosis 5, pulmonary tuberculosis 4, lung cancer 3, empyema 1 and hydropneumothorax 1. Four patients underwent partial resection, 8 lobectomy, 1 pneumonectomy, 1 muscle prombage and thoracoplasty. The prognosis is satisfactory. All patients are alive and has no recurrence. On histopathological examination, in aspergilloma cases, invasion of aspergillus to surrounding lung tissue was not seen. In addition to well-known fact that blood-borne dissemination hardly occurred in aspergilloma in contrast to cryptococcosis. These findings suggest that aspergilloma and solitary lesion of cryptococcosis should be resected, and adjuvant chemotherapy should be accompanied for cryptococcosis.
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PMID:[A study on clinical findings and surgical treatment of pulmonary mycosis]. 260 Apr 62

Fracture of the neck of the femur (FNF) is a common disorder in the elderly. A total of 618 cases consisting of 117 males and 501 females, whose age was 65 years or more, were enrolled in a prospective study. A total of 45 cases among them revealed pulmonary complications. These were divided into the following three groups: Group 1 (4.7%) who had respiratory disease(s) or symptoms prior to the fracture; Group 2 (1.9%), diagnosed as having pulmonary thromboembolism (PTE). In Group 3 (0.6%), PTE was a possible diagnosis but it was not distinguished from pneumonia in precise. In the patients of group 2 and 3, respectively, the following respiratory symptoms were observed: dyspnea (31.3%), productive cough (25%), syncope (12.6%), chest pain (6.3%), tachycardia (46.7%), and tachypnea (50%). An abnormal chest roentgenogram was found 56.4% in both group 2 and 3. Seven patients in group 2 showed remarkable reduction of PaO2 on admission, however these all recovered within 7 days without any thrombolytic treatment. The prevalence of PTE caused by FNF in the elderly was close to that in younger cases, but the clinical symptoms were less in the former.
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PMID:[Pulmonary complications subsequent to fractured neck of the femur in the elderly]. 279 69

A 42-year-old man with an atypical pneumonia. He had chest pain and a dry cough for 3 weeks, was dull at the left base clinically, and had left lower zone consolidation on chest radiography. The pneumonia spread despite oral ampicillin and cloxacillin. Blood culture grew Listeria monocytogenes and white cell count showed a monocytosis. He responded to intravenous penicillin and gentamicin with complete X-ray clearance.
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PMID:Listeria pneumonia. A case report. 291 43

A group of 12 internists, members of a university-affiliated hospital, designed and implemented protocols for the general inpatient management of four medical problems (chest pain, stroke, pneumonia, and upper gastrointestinal hemorrhage). Hospital charges for the 63 cases were compared with charges generated by 64 controls who had been patients admitted to the same physicians with the same diagnoses during the same period of the preceding year, before the project was begun. A group of nonparticipating internists was similarly evaluated during the two time periods to control for changes in practice patterns extraneous to the intervention. Adjustment was made for inflation (6%) and differences in case mix. The program resulted in a 15% reduction in total average charge generated by the cases. Sizeable reductions were achieved in utilization of EKGs (34.8%), x-rays (15.4%), laboratory testing (20.4%), and drugs (11.4%). Given the prevailing attitude that health care costs are too high and that many services are unnecessary, the benefit of altering physician behavior by using standards established by them for themselves could be substantial, especially with the threat of more restrictive and less sympathetic modes of controlling costs.
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PMID:Inpatient management protocols to reduce health care costs. 308 2

Four hundred and fifty-three adults in 25 British hospitals entered a prospective study of community-acquired pneumonia. A microbiological diagnosis was established in 67 per cent; Streptococcus pneumoniae (34 per cent). Mycoplasma pneumoniae (18 per cent) and Influenza A virus (7 per cent) were the commonest microorganisms. Our observations support the view that most of those in the microbiologically negative group (33 per cent) had S. pneumoniae infection. In addition to cultures of blood and sputum the most useful initial tests were for sputum pneumococcal antigen and serum mycoplasma specific IgM. Twenty-six patients (5.7 per cent) died, seven within 48 h of admission. Multivariate analyses showed age, absence of chest pain, absence of vomiting, previous treatment with digoxin, tachypnoea, diastolic hypotension, confusion, leucopenia, leucocytosis, and raised blood urea levels were significantly correlated with death. Patients had a 21-fold increased risk of death if they had two of the following: admission respiratory rate greater than or equal to 30/min, admission diastolic BP less than or equal to 60 mmHg, urea greater than 7 mmol/l during admission. Mortality was not related to aetiology except that all three patients with combined Influenza A virus and Staphylococcus aureus infection died. Nine patients had legionella pneumonia; none died. No patients who died from pneumococcal pneumonia, mycoplasma pneumonia or staphylococcal pneumonia had received an appropriate antibiotic before admission. Such deaths are possibly preventable. Assisted ventilation was used in 22 patients of whom 14 survived. Hospital stay in survivors averaged 10.8 days; after six weeks 79 per cent were fit for normal activities, and 55 per cent showed resolution of radiographic signs of pneumonia. We recommend that antibiotics should be given as early as possible and chosen always to cover S. pneumoniae, and in addition M. pneumoniae during outbreaks, and S. aureus during influenza epidemics.
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PMID:Community-acquired pneumonia in adults in British hospitals in 1982-1983: a survey of aetiology, mortality, prognostic factors and outcome. The British Thoracic Society and the Public Health Laboratory Service. 311 95

A 54-year-old black man presented with a soft-tissue sarcoma of the left anterior thigh. Surgical staging studies and initial biopsy results identified the lesion as a grade IIB pleomorphic liposarcoma. After radical hip disarticulation, follow up pathologic studies of the disarticulated limb showed the tumor to be confined to the anterior compartment of the left thigh without extracompartmental extension. The post-excisional surgical pathology report identified at least four different malignant mesenchymal elements: liposarcoma, myosarcoma, chondrosarcoma, and extraosseous osteogenic sarcoma. The sarcoma was therefore reclassified as a malignant mesenchymoma. The fact that the tumor was found to be intracompartmental at the time of surgery changed the staging of the tumor to stage IIA. A radical surgical margin, as recommended by Enneking, remained the treatment of choice. Three months postoperatively, the patient had chest pain and dyspnea. Chest films revealed multiple pulmonary nodules and the patient died of pneumonia 3 months later.
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PMID:A case report of malignant mesenchymoma with discussion of musculoskeletal tumor staging: the Enneking system. 317 99

Persons with Q fever usually present with severe retrobulbar headache, a fever to 104 degrees F or higher with shaking chills, general malaise, myalgia, chest pain, and sometimes pneumonia and hepatitis. Cattle, sheep, goats, and ticks are the primary reservoirs of the etiologic agent, Coxiella burnetii. Humans are usually infected by inhaling infectious aerosols. Because C. burnetii can survive for long periods in the environment, it poses a continuing health hazard once it is disseminated. Q fever usually occurs sporadically, but large outbreaks are frequently observed throughout the world, particularly among abattoir workers and personnel working in research centers. Q fever endocarditis follows a chronic course and is frequently fatal. Tests for antibodies to C. burnetii are required for confirmation of the diagnosis. Tetracyclines remain the mainstay of treatment for acute Q fever, and tetracyclines in combination with other antibiotics have been advocated for patients with Q fever endocarditis. Vaccines for Q fever have been proven effective in clinical trials.
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PMID:Q fever: current concepts. 331 37

Exogenous lipid pneumonia (ELP) is caused by the aspiration of animal, vegetal or, more often, mineral oils. Even though it may also be acute, ELP is most frequently a chronic disease, affecting people with predisposing factors, such as neuromuscular disorders, structural abnormalities and so on; very often exogenous lipid pneumonia is found in tracheotomized patients. The pathology of lipid pneumonia is a chronic inflammatory process evolving in foreign-body-like reaction, and eventually in "end-stage lung" condition. Clinically, most patients are asymptomatic; few cases only present with cough, dyspnea and chest pain. Eight cases of ELP, studied over the past 3 years, are described in this paper. All the patients were examined by chest radiographs and standard tomograms; 3 patients underwent CT. X-ray features were mono/bilateral consolidation of the lower zones, with air bronchogram and variable reduction in volume. CT density was not specific for fat tissue. In all cases the diagnosis was confirmed at biopsy. In 5 patients, followed for at least one year, clinical-radiological features showed no change. Thus, complications of ELP (especially malignant evolution) could be excluded. The authors conclude that lipid pneumonia must be considered in differential diagnosis of patients with history of usage of oils and compatible X-ray findings. The usefulness of an accurate follow-up is stressed.
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PMID:[Exogenous lipid pneumonia. Clinico-radiologic characteristics]. 338 10

Clinical characteristics and course of disease of 19 pneumococcal, 11 adenoviral, 15 mycoplasmal and 10 mixed pneumonias, diagnosed in 55 military conscripts, were compared. Controls consisted of 104 conscripts with upper respiratory infections (URI). The triad: productive cough, blood stained sputum, and chest pain aggravated by breathing (pneumococcal score) distinguished pneumococcal and mixed pneumonias but not adenoviral and mycoplasmal pneumonias from URI. Higher C-reactive protein (CRP) and white blood cell (WBC) count distinguished the pneumococcal pneumonias, but not the other pneumonias, from URI. The pneumococcal scores and simple laboratory tests on admission were compared. The score effectively separated pneumococcal from adenoviral and mycoplasmal pneumonias, and patients with mixed infections from mycoplasmal infections. Higher CRP values and WBC counts distinguished pneumococcal pneumonia from other pneumonias. Auscultation revealed crackles in 27% of adenoviral and in 60-70% of mycoplasmal, pneumococcal and mixed pneumonias. Maxillary sinusitis was more common in pneumococcal (56%) than in mycoplasmal (7%) or mixed pneumonia (10%) or URI (14%). Pneumococcal pneumonias differed in most respects from the other groups. It is difficult to distinguish between adenoviral, mycoplasmal and mixed pneumonia and also URI.
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PMID:Clinical diagnosis of pneumococcal, adenoviral, mycoplasmal and mixed pneumonias in young men. 339 72

Postpericardiotomy syndrome, a frequent complication of open-heart surgery, is characterized by fever, chest pain, and pericardial and pleural effusions. These signs may develop 1 to 12 weeks after intracardiac surgery in approximately 30 percent of patients. Although the etiology of the syndrome is unknown, evidence points to a viral and/or autoimmune cause. Postpericardiotomy syndrome is diagnosed after excluding other conditions such as endocarditis and pneumonia. In many cases, the syndrome is self-limiting and occurs only once, but in other cases the symptoms have recurred as many as eight times. When the symptoms recur, management is more difficult because optimal pharmacologic treatment is not known. Antiinflammatory agents, such as salicylates and steroids, represent the drugs most commonly used. Although analgesics with codeine or oxycodone are important for the patients' symptomatic relief, early recognition of the syndrome is the key to limiting the discomfort and possible complications associated with this condition.
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PMID:Postpericardiotomy syndrome. 351 Aug 43


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