Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a prospective study of 44 neonates (33 outborn and 11 inborn) with pneumonia, the bacteriology of pneumonia was determined by blood culture and serum counterimmunoelectrophoresis (CIEP). Twenty-nine babies also underwent lung aspiration. The lung aspirate was subjected to bacterial culture and CIEP. CIEP was done to detect the bacterial antigens of Streptococcus pneumoniae and Haemophilus influenzae. Absence of tachypnoea, found more commonly in low birth weight babies, was a poor prognostic sign. Low birth weight babies had a significantly higher mortality than babies with normal birth weight. Altogether, a bacterial etiology of neonatal pneumonia could be established in 25 cases (56.7%). In 10 babies, Strep. pneumoniae antigen was detected in serum and/or lung aspirate. Micro-organisms were cultured from blood and/or lung aspirate from 17 babies. Eleven babies (25%) grew Gram negative bacteria. The common bacteria identified in decreasing order of frequency were Strep. pneumoniae, Klebsiella pneumoniae, Staphylococcus epidermidis, Acinatobacter lowfii, Staph. aureus, Pseudoamonas aeruginosa etc. All the Gram negative bacteria as well as staphylococci were sensitive to amikacin while only 23.5 per cent was sensitive to gentamicin. All staphylococci isolated were sensitive to methicillin.
 ...
PMID:Clinical & bacteriological profile of neonatal pneumonia. 179 46

The authors sought to explain regional differences in physicians' accuracies in diagnosing pneumonia by prospectively studying emergency department patients at three sites and analyzing differences in physicians' diagnostic strategies and patient characteristics. They enrolled 1,119 Illinois patients, 150 Nebraska patients, and 142 Virginia patients presenting with fever or respiratory symptoms for whom physicians ordered a chest radiograph because of suspicion of pneumonia. Emergency department physicians recorded patients' clinical findings and estimated the probability that a chest radiograph would show pneumonia. A measure of accuracy, the correlation between physicians' probability estimates and actual outcomes, was 0.41 (95% CI 0.36-0.46) at Illinois, 0.66 (95% CI 0.54-0.75) at Nebraska, and 0.55 (95% CI 0.42-0.65) at Virginia. Physicians' strategies at the three sites differed markedly in their weightings of asthma, signs of consolidation, cough, tachypnea, age, and gender. These differences in weighting paralleled differences in the optimal clinical strategies derived from patient data at the three sites. Differences in diagnostic accuracy were best explained by differences in the difficulties of diagnosing pneumonia in the populations. Physicians at each site used clinical findings in a way that was close to optimal for their location. This type of analysis provides a new tool for understanding the sources of regional variations in clinical practice.
 ...
PMID:Use of clinical judgment analysis to explain regional variations in physicians' accuracies in diagnosing pneumonia. 188 Dec 75

To determine the effect of respiratory infections on oxyhemoglobin saturation in a high-altitude population, we recorded clinical signs, oxyhemoglobin saturation determined by pulse oximetry, and findings on radiographs of the chest of 423 children with acute respiratory infections; the children were living at an altitude of 3750 m in the Peruvian Andes. We defined hypoxemia as an oxyhemoglobin saturation value greater than 2 SD below the mean value for 153 well children in this population. Eighty-three percent of children with clinical bronchopneumonia, but only 10% of children with upper respiratory tract infection, had hypoxemia (p less than 0.001). Compared with previous studies of children living at lower altitudes, the presence of tachypnea was relatively nonspecific as a predictor of radiographically determined pneumonia or of hypoxemia, especially in infants. A history of rapid breathing was 74% sensitive and 64% specific in the prediction of hypoxemia, and performed as well as a standard World Health Organization case management algorithm in the prediction of radiographic pneumonia or hypoxemia. Radiographic pneumonia was not a sensitive predictor of hypoxemia or clinically severe illness. In contrast, the presence of hypoxemia was a useful predictor of radiographic pneumonia, with both sensitivity and specificity of 75% in infants. We conclude that acute lower respiratory tract infection in children living at high altitude is frequently associated with hypoxemia, and that oxygen should be administered to children with a diagnosis of pneumonia in these regions. Case management algorithms developed in low-altitude regions may have to be modified for high-altitude settings. In this setting, pulse oximetry is a good predictor of pneumonia. Because pulse oximetry is more objective and cheaper than radiography, its role as a clinical and investigative tool merits further exploration.
 ...
PMID:Prevalence and prediction of hypoxemia in children with respiratory infections in the Peruvian Andes. 196 Jun 4

A 8 day-old full-term newborn showed severe cardiac disturbances after intravenous injection of erythromycin. The neonate, suspected of having Chlamydia pneumonitis because of tachypnea and rhinitis, had been given 5 injections of erythromycin without clinical effect. Pallor, vomiting and bradycardia developed a few minutes after the 6th injection, and ECG showed ventricular arrhythmia, prolonged QT interval and an atrioventricular block. The infant died in intensive care unit. This case and the analysis of other published cases of cardiac disturbances following the parenteral use of erythromycin, indicate the potential arrhythmogenic risk of this drug. It is suggested that newborns treated with erythromycin should be monitored by ECG.
 ...
PMID:[QT prolongation and circulatory arrest after an injection of erythromycin in a newborn infant]. 201 21

Between October, 1985, and February, 1987, 28 (8.7%) cases of scrub and murine typhus were diagnosed among 320 children with greater than or equal to 1 week history of obscure fever. Scrub typhus is a rural disease and characterized by fever, tachypnea and hepatosplenomegaly. Skin rash was rare and eschar was absent. Four patients had pneumonia and two had meningitis. Murine typhus, more an urban disease, was milder and half the patients presented exclusively because of night fever. Slightly enlarged liver and skin rash were the only significant physical signs. Lacking the classical textbook presentations, both rickettsioses often were missed or diagnosed as enteric fever. Recognition is important because patients with either disease respond well to treatment with chloramphenicol or doxycycline.
 ...
PMID:Scrub and murine typhus in children with obscure fever in the tropics. 204 66

Concomitant pneumonia and influenza constitute the leading infectious cause of death in the elderly and the fourth most common cause of death overall. The presence of concomitant illness and delays in diagnosis contribute to significant mortality from this disease in the elderly; senescence of the immune system seems less important in predisposition to pneumonia than the presence of concomitant illness. Delay in diagnosis is frequently secondary to the atypical presentations of pneumonia in the elderly. The usual symptoms of fever, chills, rigors, and sputum production that are present in young adults all may be absent; confusion may be the only presenting symptom. Tachypnea is frequent, but the physical examination, in addition to often being technically difficult, is not sufficiently sensitive in making a diagnosis. Leukocytosis is common, but by no means specific. Chest roentgenograms frequently show incomplete consolidation and findings are difficult to distinguish from other diseases of the elderly, such as congestive heart failure, atelectasis, pulmonary embolism, and malignancy. Therefore, clinical diagnosis requires a high index of suspicion despite atypical clinical manifestations.
 ...
PMID:Clinical features of pneumonia in the elderly. 209 72

The purpose of this study was to investigate the prevalence of respiratory distress syndrome attributable to surfactant deficiency in infants of diabetic mothers tested for fetal lung maturation. Three tests were assessed: (1) lecithin/sphingomyelin ratio, (2) phosphatidylglycerol concentration, and (3) optical density at 650 nm. From January 1987 through June 1989, 526 diabetic gestations were delivered within 5 days of fetal lung maturation testing. Surfactant-deficient respiratory distress syndrome was present in five infants (0.95%); all were less than 34 weeks' gestational age. Other causes of respiratory distress were transient tachypnea of the newborn (n = 5), hypertrophic cardiomyopathy (n = 4), pneumonia (n = 2), polycythemia (n = 1), and meconium aspiration syndrome (n = 1). The use of standard maturity values of lecithin/sphingomyelin ratio greater than or equal to 2.0, phosphatidylglycerol greater than 2% to 5%, and optical density at 650 nm greater than or equal to 0.150 were evaluated. Each test had a 100% sensitivity in identifying surfactant-deficient respiratory distress syndrome and a 100% negative predictive value in identifying the absence of disease. All three tests had a low positive predictive value: 15% for lecithin/sphingomyelin ratio, 9% for phosphatidylglycerol, and 3% for optical density at 650 nm. We concluded that most cases of respiratory distress in the infants of diabetic mothers were unrelated to surfactant deficiency. The standard maturity values used in fetal lung maturation tests were valid in the diabetic gestation. The optical density at 650 nm was useful as a first-line test to predict the absence of surfactant-deficient respiratory distress syndrome.
 ...
PMID:Prevalence and etiology of respiratory distress in infants of diabetic mothers: predictive value of fetal lung maturation tests. 214 51

In the aged, pneumonia is associated with considerable morbidity and mortality. As a consequence of ageing, decreased mobility, underlying illnesses and medication, especially the host defense mechanisms in the respiratory tract may become deficient. The kind of micro-organism that causes the infection depends on whether the patient lives at home or whether he is institutionalised (nursing home, skilled nursing facility, hospital). Pneumonia in patients at home is mainly caused by pneumococci, whereas in institutionalised patients also other micro-organisms, especially Gram-negative bacteria are the cause. The diagnosis is often difficult due to the lack of symptoms and signs in the aged patient. An important sign is tachypnea. For the choice of anti-microbial therapy the question whether the patient acquired the infection at home or in an institution is crucial, as is the question, whether the patient has recently used anti-microbial drugs. Finally, therapy differs in patients that produce sputum and in those who do not.
 ...
PMID:[Pneumonia in the elderly]. 221 39

The effect of early acyclovir therapy on the course of varicella pneumonia in previously healthy adults was assessed. Medical records from five university-affiliated medical centers were retrospectively reviewed; included were all immunocompetent adults with a clinical diagnosis of primary varicella, a chest radiograph consistent with varicella pneumonia, and an arterial blood gas measurement indicating significant hypoxia. Of the 38 patients who met the study criteria, 11 had had a course of intravenous acyclovir initiated within the first 36 hours of hospitalization; the mean time from admission to initiation of therapy in this early-treatment group was 9.6 hours. The group that received early acyclovir treatment had a lower mean temperature beginning on the fifth day of hospitalization (37.0 degrees C vs. 37.7 degrees C; P = .011) and a lower mean respiratory rate beginning on the sixth day of hospitalization (21 vs. 28 respirations per minute; P = .004). Early acyclovir therapy also resulted in a significant improvement in oxygenation beginning on the sixth day of hospitalization in patients with follow-up arterial blood gas measurements (P = .035). Thus, early institution of acyclovir therapy is associated with reduction in fever and tachypnea and improvement in oxygenation in otherwise healthy adults with varicella pneumonia.
 ...
PMID:Early treatment with acyclovir for varicella pneumonia in otherwise healthy adults: retrospective controlled study and review. 223 18

An infant infected with HIV presented with fever, tachypnoea, hypoxia, and radiological evidence of bilateral pneumonitis. Fluorescent antibody technique identified Pneumocystis carinii within 24 hours from secretions obtained by nasopharyngeal aspiration. This rapid, non-invasive method should be the first line investigation of suspected P carinii pneumonia in immunocompromised patients.
 ...
PMID:Diagnosis of Pneumocystis carinii pneumonia from non-invasive sampling of respiratory secretions. 227 Sep 45


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>