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)

The diagnostic value of 73 bronchoalveolar lavages was assessed in 67 immunocompromised children (aged 3 months to 16 years) with pulmonary infiltrates. Thirty one children had primary and 19 secondary immune deficiency, 14 acquired immunodeficiency syndrome (AIDS), and three AIDS related complex. Bronchoalveolar lavage was performed during fibreoptic bronchoscopy, under local anaesthesia in all but two. One or more infective agents was found in eight of 11 patients with severe acute pneumonia and in 26 of 62 patients with interstitial pneumonitis. In interstitial pneumonitis, the most frequently encountered agents were Pneumocystis carinii (12), cytomegalovirus (8), and Aspergillus fumigatus (3). The yield was related to the severity of interstitial pneumonitis. The mean cellular count and cytological profile in lavage returns from patients with varying infective agents or underlying pathological conditions showed no significant difference, except in those children with AIDS and AIDS related complex who had appreciable lymphocytosis (mean percentage of lymphocytes 28 (SD 17]. In children with AIDS and chronic interstitial pneumonitis lymphocytosis without pneumocystis infection was observed in eight of nine bronchoalveolar lavage returns and was suggestive of pulmonary lymphoid hyperplasia. Finally, bronchoalveolar lavage produced a specific diagnosis from the microbiological or cytological findings in 44 instances (60%). Transient exacerbation of tachypnoea was observed in the most severely ill children but there was no case of respiratory decompensation attributable to the bronchoscopy. Bronchoalveolar lavage is a safe and rapid examination for the investigation of pulmonary infiltrates in immunocompromised children. It should be performed as a first line investigation and should reduce the use of open lung biopsy techniques.
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PMID:Value of bronchoalveolar lavage in the management of severe acute pneumonia and interstitial pneumonitis in the immunocompromised child. 282 34

Gastroesophageal reflux may predispose patients to pulmonary complications such as bronchospasm and aspiration pneumonitis. This is especially true in patients who are critically ill, those with reflux-induced asthma and those undergoing general anesthesia. Decreasing the amount of acid reflux reduces the potential for respiratory complications. In patients at risk, administration of H2-receptor antagonists minimizes the risk of acid aspiration and resolves asthma symptoms.
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PMID:Respiratory complications of gastroesophageal reflux. 289 46

Hurler-Scheie syndrome is an intermediate form of mucopolysaccharidosis. Affected patients characteristically present in infancy with serious abnormalities including the upper airways and the lungs. We present two patients with Hurler-Scheie syndrome and describe their anaesthetic management. One case was complicated by difficult endotracheal intubation and postoperative pneumonia. The second case was successfully managed using spinal anaesthesia and mild sedation.
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PMID:Anaesthetic problems in Hurler-Scheie syndrome. Report of two cases. 309 67

Eighty-one insulin-dependent diabetic (19.7%) and 330 non-diabetic patients (80.3%) underwent renal transplantation between September 1977 and September 1981. Preoperatively, the diabetics had a higher incidence of ST-T-changes in ECG (62.2 vs. 39.8%) (p less than 0.001) as well as pulmonary congestion (14.5 vs. 5.2%) (p less than 0.05) and pleural effusion (10.1 vs. 4.5%) in chest X-rays than non-diabetic patients. The incidences of marked blood pressure changes and cardiac arrhythmias during anaesthesia did not differ between the groups, nor did the incidences of ischaemic heart attacks, pneumonia and pulmonary atelectasis in the chest X-rays during the first postoperative week. Diabetic patients had higher mortality during the first postoperative month (6/81; 7.4% vs. 4/330; 1.2%) (p less than 0.01) than non-diabetic patients.
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PMID:Operative and postoperative non-surgical complications in diabetic patients undergoing renal transplantation. 329 Oct 91

The effect of interstitial pulmonary fibrosis on pregnancy is unclear. We present the findings in a 31-year-old woman with severe pulmonary fibrosis (vital capacity, 37 percent of predicted) secondary to hard metal disease who went through a successful term pregnancy. The patient was a grinder of tungsten-carbide drill bits who developed pneumonitis and subsequent fibrosis. Her therapy required steroids and cyclophosphamide for stabilization of her pulmonary function prior to her pregnancy. At six months' gestation, right heart catheterization showed normal cardiac output and pulmonary arterial and wedge pressures. Stage 2 exercise study demonstrated a maximum oxygen consumption of 1.17 L/min (53 percent of predicted). The patient was able to exercise to a maximum workload of 300 kpm/min (32 percent of predicted). She became hypoxemic (arterial oxygen pressure, 54 mm Hg) at 150 kpm/min. Her pregnancy concluded with an uncomplicated normal vaginal delivery requiring only supplemental oxygen and spinal anesthesia. Review of the few similar cases suggests that a woman can have a successful pregnancy despite severe pulmonary dysfunction.
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PMID:Pregnancy in a woman with severe pulmonary fibrosis secondary to hard metal disease. 334 80

Early and late delayed effects of up to 20 fractions of pions and X rays were investigated in the mouse lung. The whole thorax of female CD-1 mice was irradiated under Ethrane/O2 anesthesia. Respiration rate was measured by whole body plethysmography at biweekly to monthly intervals. With signs of irreversible respiratory distress, animals were sacrificed and their lungs evaluated histologically. In addition to the effect of fractionation, the influence of dose-rate and anesthesia was studied as well. The degree of injury for the most predominant lesions (macrophage accumulation, fibrosis, vascular congestion) was scored, and the correlation with the relative change in respiratory rate and survival was analyzed. This analysis showed the primary lesion to be radiation pneumonitis at a median survival time of approximately 100 days. Focal fibrosis was observed to occur soon thereafter, and no evidence was obtained for an independent second wave of fibrotic injury. Fibrosis seemed primarily the result of pathological organization in areas with heavy concentration of macrophages. It was observed that the mice were unusually sensitive, with a single dose X ray ED50/180 of 8.8 Gy. A similar value was found for unanesthetized mice. This might have been the result of performing these studies at an altitude of 2100 m. The fractionation effect also seemed more pronounced, with alpha/beta values of 0.6 Gy for X rays and 4 Gy for pions, which is significantly lower compared to reported values. At the pion dose-rate of 0.25 Gy.min-1, RBE values for single doses were 0.9 when compared to high dose-rate X rays, and 1.36 at equivalent dose rates. This clearly shows that significant repair occurs during the relatively low dose-rate pion irradiations. With smaller doses per fraction, the dose-rate effect became less dominant, and for 20 fractions of pions the RBE was 1.4 compared to fractionated high dose-rate X rays. These RBE's are similar to values reported for acute effects in skin.
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PMID:Late effects of fractionated pi-mesons compared to X rays on mouse lung. 338 20

Pulmonary complications remain the most important cause of postoperative morbidity and mortality. The many advances of modern surgical care over the last 30 years have not appreciably altered the incidence of these complications. Many risk factors have been shown to contribute to this problem, but no studies have examined the impact of preoperative protein depletion on respiratory function and related this to the development of postoperative pulmonary complications. 80 patients (42 men, 38 women, median age of 64 years, with a range of 15-91 years) awaiting major elective gastrointestinal (G.I.) surgery were divided into two categories on the basis of a direct measurement of protein depletion: nonprotein-depleted patients (n = 41, mean protein loss, 2% +/- 1.7 SEM) and protein-depleted patients (n = 39, mean protein loss, 36% +/- 3.5 SEM). There was no significant difference between these two categories in regard to age, height, sex, surgical diagnosis, the presence of chronic lung disease, smoking, proportion of upper abdominal incisions, degree of obesity, the duration of anesthesia, and the use of prophylactic antibiotics and physiotherapy. There was a significant difference between these two categories of patients in regard to respiratory muscle strength (p less than .025), vital capacity (p less than .05), and peak expiratory flow rate (p less than .005). Pneumonia developed in a significantly higher proportion of protein-depleted patients with atelectasis (p less than .05), and their stay in the hospital after surgery was longer (p less than .05). These data show that protein depletion is associated with an impairment of respiratory function, and is in itself a significant risk factor in the development of postoperative pneumonia.
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PMID:Risk factors for postoperative pneumonia. The importance of protein depletion. 340 Oct 64

A hundred patients scheduled for cholecystectomy were randomized to either thoracic epidural anaesthesia and analgesia for 24 h with bupivacaine intraoperatively about 100 mg and 15 mg/h thereafter (TEA) for postoperative analgesia, TEA combined with general anaesthesia (low dose fentanyl) (TEA + GA) and general anaesthesia (GA) (low dose fentanyl). During TEA and TEA + GA the arterial pressure was significantly decreased as compared with GA. TEA was associated by an intense haemodilution in comparison with GA. Blood glucose and plasma cortisol responses were significantly suppressed by TEA. The decreases in peripheral blood lymphocyte and eosinophilic counts observed after operation under GA was significantly reduced by TEA. The increase in the neutrophil count was inhibited by TEA but the increase in non-filamented neutrophils was significantly augmented by TEA. The postoperative alleviation of the alteration of the above mentioned parameters by TEA was slightly diminished in the TEA + GA group. However, we found no significant reduction in cardiac dysrhythmias (TEA 7%, TEA + GA 7% and GA 10%), ST-segment depression (TEA 17%), TEA + GA 3.3% and GA 12.5%), wound complication (TEA 3%, TEA + GA 0%, GA 0%), pneumonia (TEA 3%, TEA + GA 3% and GA 0%), subphrenic abscess (TEA 6%, TEA + GA 0%, GA 3%), mortality (TEA 0%, TEA + GA 3%, GA 0%), and urinary tract infect (TEA 17%, TEA + GA 7% and GA 2.5%). Since an equal number of patients in each group, about 30%, suffered one or more of the postoperative complications this epidural analgesia was not effective in reducing postoperative morbidity albeit the significant alleviation of the postoperative stress response.
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PMID:The effect of thoracic epidural analgesia on postoperative stress and morbidity. 343 97

Experimental and clinical data suggest that the valva ileocaecalis under neurogenic and hormonal influences, modulates antegrade and retrograde flow of succus entericus. A priori reasoning suggests that this function may influence nutrient absorption by and intraluminal endogenous microbial flora within the ileum. The hypothesis to be tested was, can anatomical and functional integrity of the valva ileocaecalis be preserved during the performance of a right hemicolectomy with reestablishment of intestinal continuity via a cecocolostomy? The methodology involved utilization of Lewis male rats weighing approximately 500 gm. General anesthesia was induced for all procedures. The animals were randomly assigned to three groups (10 animals/group): (A) sham operation; (B) pericecal dissection (preservation of the arteria et vena ileocolica); and (C) periileal dissection (ligation of the aforementioned vessels). Celiotomy was performed employing standard clean techniques, and was accompanied by a right hemicolectomy and an end-to-end or end-to-side cecocolostomy. Function of the heterotopic valva ileocaecalis was assessed 6-12 weeks post-operatively employing radiographic criteria (fluoroscopic analysis after intraluminal instillation of barium sulfate). Light microscopic analysis was performed subsequent to the radiographic studies. Periileal dissection associated with ligation of the arteria et vena ileocolica uniformly resulted in anastomotic disruption. Pericecal dissection associated with preservation of those vessels resulted in uniform anastomotic integrity, although two animals succumbed secondary to pneumonitis within 5 post-operative days. Radiographic analysis of the heterotopic valva ileocaecalis revealed intermittent antegrade and no retrograde flow of contrast material, which suggested functional integrity. Qualitative light microscopic analysis revealed architectural integrity.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Valva ileocaecalis: preservation during ileocolonic surgery employing a rodent experimental model. 348 15

Clinical analysis of incidence and degree of postoperative infectious complications was made in 140 patients subjected to operations on the lungs for cancer. The analysis has shown that in the group of patients operated upon under conditions of combined halothane anesthesia, the incidence and degree of postoperative infectious complications (suppuration of wounds, pneumonia in the other lung, empyema of the pleura) were considerably higher than in the group of patients operated on under conditions of neuroleptoanesthesia. The incidence of infectious complications was also higher in patients operated upon after preoperative irradiation. Mechanisms of immunosuppressive effects of general halothane anesthesia are discussed.
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PMID:[Role of anesthesia in the development of postoperative infectious complications in thoracic oncological surgery]. 348 12


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