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

For a total of 123 thoracolumbar traumatic lesions treated surgically in 101 patients over approximately 2 years (all monitored clinically and radiographically up to consolidation by follow-ups after from 6 to 26 months, mean 10 months) the technique used, complications and treatment are reported. The treatment procedure included: emergency surgery decompression, osteosynthesis, and fusion (posterior and possibly intersomatic); immediate recovery of function and loading; clinical and radiographic monitoring within 4-6 weeks, and possible anterior fusion in case of insufficient reconstruction of the anterior column. The complications observed out of 123 fractures were: collapse of the implant (4 cases), infection (5 cases), liquoral fistula (1 case), transitory paralysis of the abdominal muscles homolateral to the lombotomic incision (1 case), TVP (2 cases), bronchial pneumonia (2 cases), paralytic ileum (1 case). There was no sagittal deformity (secondary kyphosis) except for 5 cases of mechanical collapse that were resolved with a new operation. Neurologic deficit was caused by fracture in 49 patients (40% of the fractures or 48% of the patients). Six patients out of 30 affected with spinal cord lesion (20%) and 15 out of 19 affected with cone and/or cauda lesion (79%) improved. There was no progression of the neurologic findings after surgery. The authors conclude by proposing a protocol of posterior osteosynthesis for the use of a system in titanium made up of pedicle screws and hooks connected to a pair of cylindrical bars joined together.
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PMID:The treatment of thoracic and lumbar spine fractures: a study of 123 cases treated surgically in 101 patients. 1156 50

The purpose of this study was to determine the incidence of postoperative pulmonary complications (PPC) and the value of preoperative spirometry to predict PPC after laparoscopic cholecystectomy. Sixty-four of 1372 patients (8%) showed abnormal spirometry data. One out of 1372 patients developed aspiration pneumonia. The patient had high risk factors for serious PPC such as ASA physical status 4.84 y/o, longer anesthesia duration (230 min), multiple brain infarction and low albuminemia. Thirty to 39% of patients with abnormal spirometry showed less severe PPC such as atelectasis, lung collapse and pleural effusion, and incidence was the similar with normal lung function patients. Postoperative blood gas analysis showed a slight increase in arterial carbon dioxide tension during oxygen therapy. However, none of the patients with abnormal spirometry and less severe PPC developed manifest PPC (pneumonia, respiratory failure). Less severe PPC disappeared within second to third postoperative days. We conclude that laparoscopic intervention significantly reduced the incidence of severe PPC and the preoperative spirometry was not recommended in patients with no pulmonary symptoms.
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PMID:[Pulmonary complications following laparoscopic cholecystectomy in patients with abnormal spirometry]. 1179 60

Seventeen cases (i.e., 14 dogs and three cats) were identified as having Mycoplasma spp. as the sole bacterial isolate cultured from airway washings in 224 cases evaluated for lower respiratory disease that was present in each case. Primary diagnoses included pneumonia (35.3%), airway collapse (35.3%), and bronchitis (29.4%). Fourteen cases had follow-up information available. Of these cases, eight showed resolution or improvement with antimycoplasmal drugs. Mycoplasma spp. is recognized as a primary cause of respiratory disease in several species, including humans. The relationship between Mycoplasma spp. and respiratory disease detected in some of these cases suggests some Mycoplasma spp. may act as primary pathogens in dogs and cats.
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PMID:Mycoplasmal respiratory infections in small animals: 17 cases (1988-1999). 1190 28

Two patients who lived in Buenos Aires suburbs died from leptospirosis in July 2000 and March 2001. They developed a nonspecific febrile illness followed by hemorrhagic pneumonia and respiratory distress in absence of typical manifestations such as jaundice, nephropathy, thrombocitopenia or hemorrhages in other organs. In the house and surroundings of one patient rodents were captured and three strains of leptospira, serogroup Icterohaemorrhagiae were isolated. Laboratory guinea pigs were inoculated and they were sacrificed as soon as respiratory symptoms appeared. Necropsy showed primary lung injury, which was similar to the histopathological lesions found in one of the patients. Neither jaundice, nor renal damage was found. Pericardiac hemorrhages were considered as a possible cause of cardiopulmonary collapse. This clinical form has not been reported previously in this region, where conditions are indeed suitable for the human illness to appear.
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PMID:[Respiratory distress due to pulmonary hemorrhage in leptospirosis]. 1203 34

Streptococcus pneumoniae pneumonia frequently occurs in leukopenic hosts, and most patients subsequently develop lung injury and septicemia. However, few correlations have been made so far between microbial growth, inflammation, and histopathology of pneumonia in specific leukopenic states. In the present study, the pathogenesis of pneumococcal pneumonia was investigated in mice rendered leukopenic by the immunosuppressor antineoplastic drug cyclophosphamide. Compared to the immunocompetent state, cyclophosphamide-induced leukopenia did not hamper interleukin-1 (IL-1), IL-6, macrophage inflammatory protein-1 (MIP-1), MIP-2, and monocyte chemotactic protein-1 secretion in infected lungs. Leukopenia did not facilitate bacterial dissemination into the bloodstream despite enhanced bacterial proliferation into lung tissues. Pulmonary capillary permeability and edema as well as lung injury were enhanced in leukopenic mice despite the absence of neutrophilic and monocytic infiltration into their lungs, suggesting an important role for bacterial virulence factors and making obvious the fact that neutrophils are ultimately not required for lung injury in this model. Scanning and transmission electron microscopy revealed extensive disruption of alveolar epithelium and a defect in surfactant production, which were associated with alveolar collapse, hemorrhage, and fibrin deposits in alveoli. These results contrast with those observed in immunocompetent animals and indicate that leukopenic hosts suffering from pneumococcal pneumonia are at a higher risk of developing diffuse alveolar damage.
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PMID:Pathogenesis of pneumococcal pneumonia in cyclophosphamide-induced leukopenia in mice. 1211 31

The existence of tropical medical emergencies is a recurrent issue that joins the debate over the definition of tropical medicine. Is it medicine practiced in warmer climates, medicine practiced with poor diagnostic and therapeutic facilities or medicine involving only tropical diseases? Presentation of a few case reports provides a better response to this question than a long speech. The first case involves a 57-year-old man presenting a complicated attack of Plasmodium falciparum malaria and severe respiratory distress. The second case involves a pregnant AIDS patient presenting multifocal miliary tuberculosis associated with renal abscess and bacteremia. The third case involves a 34-year-old soldier hospitalized for right hilar pneumonia in whom work-up demonstrated co-infection by HIV 1 and 2, thick drop tests revealed uncomplicated Plasmodium falciparum malaria, and cytobacterial examination of sputum samples identified Salmonella enteritidis and acid-alcohol resistant germs. The fourth case involves a 60-year man hospitalized for febrile collapse in whom work-up revealed amebic pericarditis. These four case reports illustrate the main features of tropical medical emergencies: adult patients (frequently young), associated deficiencies or immunocompromise (HIV infection/AIDS), severe or complicated tropical disease, severe advanced stage disease because of inability to pay for care, multiple pathology, poor diagnostic/therapeutic facilities, and high mortality.
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PMID:[Does emergency tropical medicine exist? The physician's point of view]. 1224 20

Pertussis, also known as whooping cough, is a highly contagious disease, which is most dangerous to infants less than one year old. About half of the babies reported nationally to the Centers for Disease Control and Prevention (CDC) as having the disease are hospitalized. As many as 16/100 babies reported with pertussis get pneumonia, and about 2/100 have convulsions. For those babies reported to have pertussis, about 1/500 has brain problems, some of which can become permanent, and about 1/250 will die because of complications from the disease. Serious illness is less likely in older children and adults. Pertussis vaccine is generally administered in combination with diphtheria and tetanus vaccines, known as DTP vaccine. A primary series of DTP keeps 70-90/100 children from getting pertussis, usually through the elementary school years at least. About half of the children who receive DTP vaccine will not experience any discomfort at all. Some will have minor problems such as soreness, swelling and redness where the shot was given; fever; fussiness; drowsiness; and loss of appetite lasting 1-2 days. Once per 100 to 1000 shots, moderate problems can occur: crying non-stop for 3 hours or more, fever of 105 degrees (F) or higher. For 1 shot in 1750, a child may experience a seizure (convulsions, fits, spasms, twitching, jerking, or staring spells) usually caused by fever, or collapse or fainting (becoming blue, pale, limp, and non-responsive). Very rarely, DTP causes long seizures, decreased consciousness, or coma that usually does not last. Permanent brain damage can very infrequently follow such acute brain problems. There are no tests that can tell in advance if a child will be adversely affected by the DTP vaccine. Definitely the benefits from the DTP vaccine far outweigh the risks for almost all children.
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PMID:Facts about pertussis and DTP vaccine. 1234 38

Products of the p63 gene, a recently described member of the p53 family, are constitutively expressed in the basal cells of human bronchi and bronchioli. The truncated isoforms of the p63 gene (deltaN-p63 proteins) counteract the apoptotic and cell cycle inhibitory functions of p53 after DNA damage, and this property is likely to be central in the cell renewal strategy of stratified epithelial tissues. To investigate the dysfunctional repair processes that characterize idiopathic pulmonary fibrosis/usual interstitial pneumonia (IPF/UIP), we immunohistochemically analyzed the expression of the transactivating and dominant-negative isoforms of the p63 gene on 16 tissue samples obtained from patients suffering from this disorder. In most IPF cases herein investigated, epithelial cells expressing deltaN-p63 were observed at sites of abnormal proliferation at the bronchiolo-alveolar junctions, characterized by epithelial hyperplasia, squamous metaplasia, bronchiolization, and abnormal p53 nuclear accumulation. Similar features were not observed in normal lung and in samples taken from other pulmonary diseases used as controls, including acute interstitial pneumonia, idiopathic bronchiolitis obliterans organizing pneumonia, nonspecific interstitial pneumonia, and desquamative interstitial pneumonia. On the basis of these findings, we can hypothesize a new model for UIP pathogenesis, involving a deregulated development of mesenchymal-epithelial interactions and abnormal proliferation of epithelial cells at the bronchiolo-alveolar junction after cell injury. In our view, the progressive loss of alveolar tissue and lung remodeling after injury in IPF/UIP is concomitantly produced by pneumocyte loss and alveolar collapse on one hand and by progressive bronchiolar proliferation and architectural distortion on the other.
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PMID:Abnormal re-epithelialization and lung remodeling in idiopathic pulmonary fibrosis: the role of deltaN-p63. 1237 68

Allergic Bronchopulmonary Aspergillosis (ABPA) is characterized by recurrent pulmonary infiltrates that can result in central bronchiectasis and bronchiolitis obliterans especially if there is a lack of recognition and treatment. The incidence of ABPA is 1-2% in patients with persistent asthma and approximately 7% (range 2-15) in patients with cystic fibrosis. The diagnostic criteria are useful in that there is no single test (with the exception of central bronchiectasis in patients with asthma) that identifies ABPA. The differential diagnosis of ABPA includes many conditions including chronic eosinophilic pneumonia, Churg Strauss Syndrome, Hyper-IgE Syndrome, persistent asthma with lobar collapse, and cases of parasitism. The most useful laboratory assays in patients who have immediate cutaneous reactivity. to Aspergillus mixes or A. fumigatus are total serum IgE concentration, elevated serum IgE-A.fumigatus and serum IgG-A.fumigatus. Prednisone remains the drug of choice yet need not be administered indefinitely.
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PMID:Clinical aspects of allergic bronchopulmonary aspergillosis. 1245 38

Bronchoscopy is a highly versatile technique in the context of intensive care and has many potentially valuable indications. Safety is of paramount importance and the risks in critically unstable patients are correspondingly greater than in more stable children. The main contraindication to bronchoscopy is if it will provide no useful information. The procedure is obviously more risky in children with severe hypoxia, uncontrolled bleeding diathesis, cardiac failure or severe pulmonary hypertension. Monitoring should include at least oxygen saturation, blood pressure (ideally by continuous, invasive monitoring) and preferably capnography. Indications for bronchoscopy in paediatric intensive care include endobronchial toilet, sometimes instilling recombinant human DNAase even in children who do not have cystic fibrosis; checking tube patency and position; assisting in a difficult intubation or tube change; achieving the selective intubation of a main bronchus; the diagnosis and management of ventilator-associated pneumonia or the ventilated, immunocompromised host; the assessment of lobar collapse or focal hyperinflation; airway stent assessment; assessment of stridor on extubation and the diagnosis of any associated disease. New iatrogenic complications are also likely to be discovered. The procedure is very safe if performed by experienced operators with back-up from doctors skilled in airway management and the monitoring of sick children.
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PMID:Bronchoscopy in paediatric intensive care. 1261 34


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