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

Infections caused by Chlamydia pneumoniae were first described in 1985. The infection can cause common cold, sore throat, hoarseness, cough, headache, fatigue and sometimes influenza-like illness. Examination can indicate serous otitis media, sinusitis, laryngitis, bronchitis and pneumonia. The course can be long and relapsing. The recommended drugs for treatment are tetracycline or erythromycin for at least two weeks. Five verified cases are described in the article, four of them with symptoms from the upper respiratory tract only. It is concluded that Chlamydia pneumoniae is a not unusual cause of upper airway diseases. Up to now the diagnosis can best be verified by micro immunofluorescence. The authors call for a rapid and reliable test for use in physician's office. It is proposed that infections caused by Chlamydia pneumoniae be termed TWAR.
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PMID:[TWAR infection is a common diagnosis in outpatient clinics]. 157 35

A number of practical office and bedside clues to cardiac disease in infants and children have been passed on through the years. They relate to the history, to the inspection and palpation components of the physical examination, and to knowledge of the specific cardiac defects that are likely to be associated with certain clinical syndromes. With the possible exception of coarctation of the aorta, the clues are not diagnostically specific. In many instances, however, they serve to narrow a broad array of diagnostic possibilities to 2 or 3 and, with the aid of other clues and auscultation, they can often be distinguished from one another. When a primary care physician is confronted with a child who has an incidental murmur that is "probably" innocent but could be organic, useful clues favoring an organic murmur are a history of congenital heart disease in a first-degree relative; a history of maternal rubella syndrome, alcohol use, or teratogenic drug use during pregnancy; a history of inappropriate sweating; a history of syncope, chest pain, or squatting; maternal diabetes mellitus; premature birth; birth at a high altitude; cyanosis; abnormal pulsations; recurrent bronchiolitis or pneumonia; chronic unexplained hoarseness; asymmetric facies with crying; and a physical appearance suggestive of a clinical syndrome.
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PMID:Clues in diagnosing congenital heart disease. 157 99

Bacterial tracheitis (BT) was found in 10 of 748 children (1.3%) admitted with croup during 1983-1990. 9.9% of all the 748 croup cases seen (74) were admitted to the pediatric intensive care unit (PICU) and 16 of the 74 required intubation. 10 of those intubated (62.5%) were found to have BT and had typical features of croup, including inspiratory stridor, hoarseness and cough. Airway obstruction resulted mainly from accumulated tracheal pus. After endotracheal intubation all required frequent suctioning of thick purulent secretions. In 2 children causative microorganisms were cultured from the blood, and in all 10 from the tracheal pus. All children were given antibiotic therapy but a 7 month-old girl died of secondary complications (respiratory syncytial virus infection, pneumonia and adult respiratory distress syndrome). The others recovered and were discharged from the PICU within 3-14 days. BT should be suspected when tracheal intubation is required in croup. In such cases close monitoring in a PICU and frequent tracheal suctioning after intubation is necessary; antibiotic therapy should be considered.
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PMID:[Bacterial tracheitis in children]. 178 11

Chlamydia pneumoniae has recently been recognized as an important cause of respiratory tract disease, including atypical pneumonia. Serosurveys suggest that C. pneumoniae is endemic in most countries and is capable of causing outbreaks and epidemics of pneumonia, especially in countries where the antibody prevalence is relatively low. The population incidence of infection appears to be cyclical, with approximately 4-year cycles in the US (Seattle) and 6-year cycles in Denmark having been demonstrated. Pneumonia caused by the organism is unusual in young children in developed countries but may be an important cause of lower respiratory infections among children in developing and tropical countries. In otherwise healthy adults, C. pneumoniae pneumonia usually can be treated effectively on an outpatient basis. Patients with C. pneumoniae pneumonia often have a gradual onset of symptoms: a sore throat and hoarseness followed by a cough. Auscultatory and radiographic findings usually are prominent, even in patients with mild disease, and a cough and malaise may persist for several weeks or more after appropriate therapy. Microimmunofluorescence serologic testing is available in only a few laboratories. However, the new HL cell line holds promise of making culture and isolation of C. pneumoniae more widely available. Questions remain about the routes of transmission of C. pneumoniae, its incubation period, its role in lower respiratory disease in children in developing countries, the optimal antibiotic therapy, the existence and importance of chronic and latent C. pneumoniae infections, and the organism's association with nonrespiratory tract disease.
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PMID:Infections with Chlamydia pneumoniae strain TWAR. 185 69

Between 1980 and 1988, 98 patients with adenocarcinoma of the esophagogastric junction were seen at the University of Western Ontario. Eighty-two patients underwent resection of the celiac lymph nodes, lesser curve and cardia of the stomach, and thoracic esophagus through abdominal and neck incisions avoiding thoracotomy. The esophagus was replaced by a stomach tube in 80 patients or by a colon tube in two patients. Two of 82 patients died while hospitalized. Early postoperative morbidity included anastomotic leaks that closed spontaneously (13), transient hoarseness (10), myocardial infarction (2), pulmonary embolus (6), and atelectasis or pneumonia (13). Late postoperative complications included delayed gastric emptying (4), symptomatic reflux (4), diarrhea (10), and anastomotic strictures (17). The 2-year survival of 30% was significantly affected by the stage of disease (p = 0.003), depth of tumor penetration (p = 0.02), lymph node metastasis (p = 0.001), tumor differentiation (p = 0.008), and tumor DNA ploidy (p = 0.02). Local recurrences appeared initially in 20 patients: anastomotic (3), peritoneal (14), mediastinal (3); distant metastasis occurred in 27 patients: bone (15), liver (5), brain (2), and multiple organs (5). Swallowing was restored and maintained in 75 patients. Esophagogastrectomy without thoracotomy provides a safe, effective method of restoring swallowing in patients with adenocarcinoma of the esophagogastric junction. This technique provides acceptable survival and local recurrence rates.
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PMID:The results of esophagogastrectomy without thoracotomy for adenocarcinoma of the esophagogastric junction. 247 86

Tracheopathia osteoplastica is an unusual disease characterized by cartilaginous or bony projections into the tracheobronchial lumen, with sparing of the posterior membranous portion of the tracheobronchial tree. The cause of this disorder is unknown. The diagnosis is seldom made because of the chronic and asymptomatic nature of the condition. More than 90% of the cases are diagnosed at postmortem examination. Symptoms may include dyspnea, coughing, hemoptysis, hoarseness, and wheezing. Tomography of the trachea may reveal beaded calcification of the tracheobronchial cartilages. Bronchoscopy is diagnostic. Histologically, the abnormal growths show heterotopic bone formation. No known treatment is available. We describe two female patients, one with hemoptysis and another with asthmalike symptoms, in both of whom bronchoscopy established the diagnosis of tracheopathia osteoplastica. The first patient had recurrent episodes of pneumonia attributable to bronchial obstruction by bony projections. In the second patient, removal of large lesions that obstructed the upper part of the trachea relieved the dyspnea. Of interest is the fact that the first patient was the biologic mother of the second. To our knowledge, this constitutes the first report of familial occurrence of tracheopathia osteoplastica.
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PMID:Tracheopathia osteoplastica: familial occurrence. 250 29

A 34 year-old female was admitted because of anemia and leukopenia. Her bone marrow contained abundant blastic cells, which were histochemically positive for peroxidase and alpha-naphthyl butyrate esterase, but negative for ASD chloroacetate esterase. She was diagnosed as acute monocytic leukemia (FAB, M5a). Complete remission was achieved after the administration of BHAC, daunorubicin, 6MP and prednisolone, and she was discharged after consolidation therapies. But shortly later, she noticed hoarseness and erythematous nodules on her breast and abdomen. Though the examinations of peripheral blood and bone marrow did not show any abnormality, hoarseness rapidly worsened and she complained of dyspnea. X-ray and CT scan demonstrated narrowing of the trachea under the cricoid cartilage, and trans-tracheal biopsy revealed leukemic involvement. In addition, erythematous skin lesion showed the infiltration of leukemic cells by biopsy. Although radiation and chemotherapy was initiated, she died of pneumonia. We tried to discuss the laryngo-tracheal and skin involvement of acute monocytic leukemia as early symptoms of relapse.
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PMID:[Relapse of acute monocytic leukemia present with skin and tracheal involvement]. 262 95

Vocal cord paralysis may follow intracranial operation if the vagus nerve is damaged intraoperatively. If the resulting laryngeal incompetence is severe, hoarseness, dysphagia, and aspiration may develop. This is often followed by a pneumonitis requiring chronic gastric tube feeding. Teflon vocal cord injection has been shown to restore the sphincteric action of the larynx and enable patients to phonate and swallow properly again. Nine patients underwent this procedure for chronic aspiration and hoarseness. All had vagus injury attributable to antecedent intracranial operation, and all experienced relief of their symptoms with only minor complications. Teflon vocal cord injection is advocated as a safe, effective means of managing patients with aspiration and dysphagia secondary to vagus nerve injury.
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PMID:Teflon injection for vocal cord paralysis after intracranial operation. 341 77

During the course of 872 thyroidectomies performed at the University of Michigan Medical Center between 1972 and 1982, 50 patients (5.7%) were found to have substernal goiters, 42 of which were benign and eight malignant (16%). Symptoms included airway compression (22 patients), dysphagia (13 patients), hoarseness (four patients), weight loss (three patients), and thyrotoxicosis (10 patients). Five patients with compression symptoms, four of whom had benign disease, had superior vena cava syndrome. Most patients were elderly (mean age 66 years), were women (3.2 women:1 man), and had long-standing goiters (mean duration 16 years). All but one operation was performed through a cervical incision. There were no intraoperative deaths. Complications were: pneumonia (one patient), wound hematoma (one patient), transient hypocalcemia (two patients), and atrial fibrillation (two patients). This series illustrates five reasons to support operative management. (1) There is no other treatment for long-standing large multinodular goiters. (2) Iodine 131, the alternative to operation for patients with large thyrotoxic goiters, can precipitate acute reactions in the elderly that can result in respiratory distress. (3) A long history of having a large multinodular goiter precluded neither malignancy, hyperfunction, nor complications such as tracheal or esophageal compression. (4) Malignancy occurs in a significant number of these lesions, which are inaccessible to needle biopsy. (5) Nearly all substernal goiters can be removed through a cervical incision. Presence of a substernal goiter is in itself an indication for operation.
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PMID:Rationale for the operative management of substernal goiters. 664 12

A case of Wegener's granuloma in which the lesion was localized in the larynx and the neighboring structures was reported. The patient was a 52-year-old male. The initial symptom was hoarseness. He died of severe laryngeal involvement and accompanying pneumonia after an entire course of 4 years and 8 months. Autopsy revealed no involvement of the nose, lung and kidney.
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PMID:Wegener's granuloma localized in the larynx. Report of a case. 665 59


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