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

Information from the Danish National Patient Register revealed that 817 patients had been hospitalized with verified whooping cough during the period 1980-1986. The letters of discharge or the case records were obtained for all patients under one year for the entire period and for all patients over one year for the period 1984-1986, a total of 627 persons. These were supplemented by information from forms with information about positive cultures for whooping cough in nasopharyngeal swabs and from individual notifications about children under one year. 65% of the hospitalized patients were under one year and only 2% over 15 years. The severity of the disease measured by the duration of hospitalization and the presence of serious complications and symptoms decreased with age. The average duration of hospitalization was 15 days for children under one year and seven days for children over one year. Five children died. One child developed epilepsy, nine of the remainder required assisted respiration and recovered apparently without permanent damage. Out of the 627 patients who were hospitalized, pneumonia developed in 12%, seizures in 2% under one year and 5% over one year, apnoea occurred in 10% under one year and 2% over one year and cyanosis occurred in 61% under one year and 30% over one year. None of the vaccinated children developed seizures, required assisted ventilation or died and only 2% had apnoea as compared with 7% in the unvaccinated children. Children under two months and children in whom vaccination was contraindicated were responsible for 56% of the hospitalizations among children under one year and for 79% of the most severe cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Whooping cough necessitating hospitalization in Denmark, 1980-1986]. 205 95

Viral pneumonias are both a diagnostic and a therapeutic challenge for primary care physicians. The illness should be suspected when an upper respiratory tract infection progresses to include dyspnea and cyanosis. Rapid diagnostic tests are now available to detect most of the viruses that cause pneumonias. Fortunately, viral pneumonias usually resolve without specific antiviral therapy; however, ribavirin is indicated for respiratory syncytial virus pneumonia in children and ganciclovir sodium (Cytovene) for cytomegalovirus pneumonia in immunocompromised patients. Acyclovir (Zovirax) is indicated for pneumonias due to herpes simplex virus and varicella-zoster virus infections. A high index of suspicion for bacterial superinfections is essential to reduce the risk of death from this complication.
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PMID:Viral pneumonias. A diagnostic and therapeutic challenge. 223 93

To identify predictors of mortality, the records of 133 elderly patients with pneumonia admitted to a small rural midwestern hospital were examined using a retrospective cohort design. All recorded clinical information available to the patient's physician within the first hours of admission was reviewed. Twenty-one (15.8%) patients died during the hospitalization. Patients with preexisting coronary heart disease, dementia, urinary incontinence, and impaired mobility were more likely to die. Impaired mental status, absence of fever, rapid respiratory rate, hypotension, cyanosis, and diffuse abnormalities on chest examination were also associated with mortality. Logistic regression analysis revealed five predictive indicators of mortality: impaired level of consciousness (odds ratio [OR] = 11.3), tachypnea (OR = 10.8), temperature lower than normal (OR = 14.2), white cell count higher than 20 X 10(9)/L (20,000 mm-3) (OR = 12.2), and cyanosis (OR = 8.6). A risk score based on this regression model demonstrated that 1 of 95 patients with a score lower than 3 (1%), 7 of 22 with a score of 3 (32%), and 13 of 15 patients with a score higher than 3 (87%) died during their hospitalization. The validity of this risk-scoring system was confirmed in another sample of 40 patients. Studies such as this may be useful in identifying information of important prognostic value that enables physicians, patients, and family members to make more effective decisions.
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PMID:Factors predicting mortality in rural elderly hospitalized for pneumonia. 229 10

This study examined the clinical signs and symptoms in 897 children aged under 5 years presenting with pneumonia to Goroka Hospital in the highlands of Papua New Guinea between June 1982 and July 1985. The usefulness of the signs in predicting severity of disease was determined and risk factors for severe disease were identified. While cyanosis and poor feeding were the strongest predictors of death, bronchial breathing, grunting, and nasal flaring also significantly increased the risk of dying. First-born children, children under 1 year of age, females, malnourished children, and children with symptoms for more than 7 days were at increased risk of severe disease and of dying. Fever alone did not increase the risk of dying unless it was present for more than 7 days. These clinical signs of severity and risk factors may be used to improve the efficiency of health education programmes, for both health workers and mothers, aimed at reducing childhood mortality from pneumonia.
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PMID:Clinical signs and risk factors associated with pneumonia in children admitted to Goroka Hospital, Papua New Guinea. 260 82

In summary, HAPE is a potentially fatal form of noncardiogenic PE seen in a small number of individuals visiting above 9,000 ft in elevation. The pathophysiology is uncertain but is probably due, at least in part, to hydrostatic and capillary permeability abnormalities of the pulmonary vascular bed in response to hypobaric hypoxia. A subclinical form above 14,000 ft is common (15% to 23% incidence), but the incidence of HAPE itself is unclear. Possible risk factors include rapid ascent, strenuous activity on arrival, reascent to altitude by highlanders after a short stay lower, previous HAPE, cold, respiratory tract infections, sedation, youth, and the peripheral edema of AMS. Clinical presentation is similar to that of pneumonia: tachypnea, tachycardia, cyanosis, cough, fever, and chest discomfort. Symptoms often worsen with sleep. WBC count is usually elevated, and arterial blood gases reveal a respiratory alkalosis and an alarmingly low hemoglobin saturation. Chest radiographs reveal bilateral patchy infiltrates. Radiographic findings are dissimilar to those from cardiogenic PE. Differential diagnosis includes pneumonia, PE and HAB. Treatment modalities include early descent, bed rest, oxygen therapy, and EPAP. Mortalities range from 4% to 27% depending on the rapidity of descent and evacuation.
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PMID:High-altitude pulmonary edema: a collective review. 266 Aug 18

It is important to define clinical signs that can be used to identify children who have a high risk of dying from pneumonia so that these children can be given more intensive therapy. We prospectively studied 748 children in Papua New Guinea who had severe pneumonia, as defined by the World Health Organization. There was a very high mortality in children with a prolonged illness, severe roentgenogram changes, cyanosis, leukocytosis, hepatomegaly or inability to feed, and there was a trend toward a higher mortality in children with grunting or severe chest indrawing. Afebrile malnourished children had a particularly high mortality, but afebrile children had an increased mortality only if they were malnourished, and malnourished children had an increased mortality only if they were afebrile. Mortality was not increased in very young children or in children with tachypnea or tachycardia. The World Health Organization has suggested that most children with pneumonia in developing countries can be treated with penicillin but has recommended that children who are cyanotic or too sick to feed be treated with chloramphenicol because of their high risk of dying; our findings confirm that children who are cyanotic or too sick to feed have a very high risk of dying from pneumonia.
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PMID:Clinical signs that predict death in children with severe pneumonia. 269 26

Sixteen patients with extralobar sequestration of the lung are reported on. The age at time of diagnosis varied from 21 days to 12 years (mean 3.6 years). Most of the patients presented with respiratory symptoms, such as dyspnoea, pneumonia, coughing attacks, cyanosis and asthmatic symptoms, but diagnosis was made incidentally in 4. Diagnosis was established by chest X-ray in every case. Preoperative angiography and bronchography was carried out in six cases. All 16 patients underwent thoracotomy for removal of the sequestration. Rudimentary bronchial remnants were found in 6 cases. Extralobar sequestration was associated with 12 additional malformations in 10 of the 16 patients. The clinical picture varies considerably and many of the "typical" features, such as systemic arterial blood supply, left lower lobe localization and diaphragmatic defect, are often absent. Diagnosis and treatment are easy.
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PMID:Extralobar sequestration of the lung in children. 310 80

Congenital tracheoesophageal fistula presents with clinical features of variable types and severity, including choking, coughing, and cyanosis with feeds, pneumonia, and abdominal distension. The rarity of the condition, its nonspecific symptomatology, and limitations in its demonstration by contrast radiology and endoscopy contribute to delays between first presentation and confirmation of the diagnosis. Recognition of symptom complexes and a high index of clinical suspicion should assist early diagnosis. In our experience with 30 infants with "H" fistula, an initial barium swallow demonstrated the fistula in 73%, and in all patients by the third attempt. Refinements in technique have shown contrast radiology to be satisfactory and safe in the initial investigation of infants with suspected congenital tracheoesophageal fistula and enables differentiation from other causes of aspiration.
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PMID:The diagnosis of congenital tracheoesophageal fistula. 337 46

The incidence of nosocomial infections (NI) and the related risk factors in a Department of Pediatric Cardiovascular Surgery were studied, during a 6 months period. 155 successive admissions were considered. Nosocomial infections were 17 (11%), nosocomial colonizations 18 (11.6%). The most important risk factors for nosocomial infections were: age, cyanosis, duration of hospitalization, hospitalization in Intensive Care Unit and central venous catheter only as a risk factor for sepsis. The most important risk factors for nosocomial colonizations were: tracheal intubation and central venous catheter. In 4 cases the NI was related to nosocomial colonization (2 sepsis, 1 pneumonia, 1 wound infection). The most frequently isolated microorganisms were Pseudomonas aeruginosa and Staphylococcus spp. The Authors found that a longer than 5 days period of antibiotic prophylaxis did not reduce the incidence of nosocomial infections.
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PMID:[Occurrence of hospital infections in a department of pediatric heart surgery]. 360 1

In the nursery of an Austrian hospital, five newborns accidentally received 10% natrium chloride solution by infusion or oral feeding. Because of wrong labelling by the hospital pharmacy the solution was taken for 10% glucose. In all five newborns, bradycardia, edemas, cyanosis and cramps occurred. In all cases, autopsy revealed a fatal haemorrhagic encephalopathy and more or less extended haemorrhages of the lungs, the kidneys and the liver. There was no suppurative pneumonia and no arteritis. The intracerebral bleedings, thromboses and necroses may be provoked by tissue shrinking caused by hypernatraemic dehydration. The cerebral lesions again cause hyperosmolarity leading to death in most cases. Peritoneal dialysis which may be life-saving in some cases, unfortunately has not been performed in the present cases.
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PMID:[Accidental saline poisoning in newborn infants. Morphologic findings and pathogenetic discussion]. 365 35


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