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

Over the last seven years, we from the Dept. of Pediatrics at the University of Erlangen have recorded an increase in the rate of children admitted because of aspirated foreign bodies. Despite the most modern methods of bronchoscopy extraction available nowadays, an inhaled foreign body can become a serious matter if it results in acute respiratory distress or - and this occurs much more frequently - if it remains for a long period unrecognized in the bronchial system and, as a result of intense reactions of the mucous membrane, can then only be extracted with great difficulty. As a result, serious pneumonia and bronchiectasis may develop on the basis of this "stubborn bronchitis". In these 94 case studies we have reported case histories, examination findings as well as radiological diagnosis and stiff bronchoscopy for treatment. Finally, we have discussed suggestions for prevention of this accident.
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PMID:[Tracheobronchial foreign body aspiration in children. Report of over 94 patients]. 265 20

A term newborn with Candida albicans infection of the lungs and blood is described. Although no maternal risk factors were identified, this patient's rapid clinical deterioration and postmortem findings suggest congenital infection. Related cases in the literature are reviewed. This case suggests that a diagnosis of fungal pneumonia should be considered in any infant presenting with severe respiratory distress.
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PMID:Congenital candida pneumonia and sepsis: a case report and review of the literature. 266 61

A combined retrospective and prospective analysis of infants 60 days of age or less evaluated for fever (greater than or equal to 38.3 degrees C) or history of fever who received chest roentgenogram over a one-year period was performed to determine whether clinical characteristics were predictive of pneumonia. Of the 209 patients studied, 115 were reviewed prospectively and 94 retrospectively. Pneumonia was radiographically diagnosed in 16 patients. Individual clinical factors were not found to be highly predictive of pneumonia. However, infants with the following nine factors did not have pneumonia; illness in the summer months; absence of cough, dyspnea, and respiratory distress (grunting/flaring/retracting); respiratory rate less than 60; absence of rales and decreased breath sounds; presence of normal color; and white blood cell count less than 19,000/mm3. We recommend that these clinical characteristics be utilized to determine whether chest roentgenogram is warranted in the young infant evaluated for fever.
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PMID:Indications for chest roentgenogram in the febrile young infant. 232 Apr 91

A retrospective study analyzing the case notes of 49 hospitalized adults, either in intensive care (n = 26) or in thoracic medicine units (n = 23), for acute bacteriologically proven pneumococcal pneumonia based on samples obtained other than by sputum examination. The mortality was 54% in intensive care and 17% in the thoracic medicine unit. This significant difference may be explained in part by a respiratory distress syndrome in whom there were adequate criteria on admission for 7 patients in the intensive care group. Among these latter only one patient had had a splenectomy. The others did not have underlying disorders (three were chronic alcoholics); 7 patients were shocked on admission, four with a leukopenia less than 5,000/mm3 and six had a thrombocytopenia less than 100,000/mm3; finally 6 had a temperature of less than 38 degrees C. 7 patients died in less than four days (mean 2 days) in a clinical context of refractory hypoxemia. The significance of the respiratory distress syndrome is probably very different from the usual pneumonia; it seems rather to be an integration of the toxins induced by the pneumococcus. Its presentation can be particularly misleading as regards the diagnosis; the prescription of antibiotics once a diagnosis is obtained would seem insufficient by itself in this context to obtain a cure.
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PMID:[Adult respiratory distress syndrome, a manifestation of severe pneumococcal infection]. 274 May 92

2216 newborns and prematures with respiratory distress of different underlying diseases were treated with long term respiratory therapy from 1. Jan. 1975 to 31. Dec. 1985. One part of the patients were born in our hospital, the other part of them were transported from outside. The rate of prematures was 81.2%. The respiratory therapy was applied in 1813 cases because of pulmonary diseases (group 1.), while in 403 cases the respiratory troubles were extrapulmonary in origin (group 2.). The diseases in the first group were as follows: hyaline membrane disease in 482 cases (27.30%), intrauterine pneumonia in 634 cases (34.64%), postnatal pneumonia in 291 cases (15.90%), meconium aspiration syndrome in 110 cases (6.01%), severe RDS-II in 158 cases (8.63%), pulmonary immaturity in 116 cases (6.35%), persistent fetal circulation in 21 cases (1.15%) and pulmonary aplasia on the left in 1 case (0.021%). In the second group the greatest part of the cases were treated for neurological disturbances. We discuss the indications of different types of respiratory therapy and the complications as well. The survival rate was in the first group 59.3%, while in the second only 16.9%. Therefore the respiratory therapy seems to be more effective in the pulmonary diseases of the newborns. The mortality rate and the rate of severe complications were lower among inborn babies because of the early application of the respiratory therapy.
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PMID:[Continuous respiratory therapy of newborn and premature infants with respiratory disorders]. 277 89

A male patient with corticotropin-releasing factor (CRF) and adrenocorticotropin (ACTH)-producing syndrome is described. Soon after being referred to us the patient developed pneumonia, anaemia, oedema and respiratory distress, and died on the 24th day after admission. Autopsy and histology revealed that he had a rare type of multiple endocrine neoplasia (type 1 + paraganglioma) with a mediastinal paraganglioma, parathyroidal hyperplasia, pancreatic islet cell adenoma, duodenal multiple carcinoid tumours and adrenocortical nodular hyperplasia. It was not possible to examine the pituitary. The paraganglioma contained a large amount of immunoreactive (IR)-CRF (606 ng/g wet weight), IR-ACTH (59.4 ng/g wet weight), IR-human proopiomelanocortin n-terminal (1-76) peptide (hNT, 156.8 ng/g wet weight) and IR-beta-lipotropin (beta-LPH, 146.9 ng/g wet weight). The major IR-ACTH, beta-LPH and IR-hNT were eluted at ACTH-(1-39), beta-LPH and hNT marker positions, respectively. Big ACTH was not detected. IR-CRF eluted at the human CRF marker position on Sephadex G-75 chromatography and high performance liquid chromatography (HPLC). The IR-CRF fraction from the HPLC showed CRF bioactivity which paralleled that of synthetic human CRF in monolayer cultured rat anterior pituitary cells. Our results suggest that not only ACTH but CRF produced by the paraganglioma was responsible for the patient's Cushing's syndrome.
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PMID:Multiple endocrine neoplasia with Cushing's syndrome due to paraganglioma producing corticotropin-releasing factor and adrenocorticotropin. 287 33

A previously healthy young man presented with acute respiratory distress and diffuse bilateral infiltrates on chest radiograph. Eosinophilic pneumonia was diagnosed by bronchoalveolar lavage and confirmed by transbronchial lung biopsy. There was no evidence of an infectious etiology, and the patient rapidly improved with corticosteroid therapy. Most cases of eosinophilic pneumonia reported previously have followed a chronic course. The case presented here was acute in onset, suggesting a hypersensitivity reaction. High levels of bronchoalveolar lavage eosinophils indicate the diagnosis but not the etiology of eosinophilic pneumonia.
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PMID:Acute eosinophilic pneumonia: a hypersensitivity phenomenon? 291 47

3-methylindole (3-MI) dissolved in the lipophilic carrier Cremophore EL was administered intraperitoneally to male, twelve-week-old Sprague-Dawley rats. Gross and histopathologic changes in the lungs were studied using light microscopy at three time-periods following administration: 16, 24, and 46 hours. Both 3-MI and Cremophore caused changes in bronchiolar epithelium at 16 hours. By 46 hours, Cremophore-injected rats showed no effects of the carrier; whereas, 3-MI rats showed severe lung changes characterized by airway epithelial and pulmonary vascular endothelial necrosis and sloughing, cellular infiltration by lymphocytes and macrophages, perivascular edema, alveolar edema, and lymph stasis. Grossly, the controls showed no effect of the carrier and none died during the studies. In contrast, 3-MI injected rats quickly became lethargic and displayed tachypnea, anorexia, and progressive respiratory distress. Two of five 3-MI rats in the final group died just prior to 46 hours. All of this group had grossly congested lungs and marked pleural effusion. The lesions and time course showed similarities to those observed in ruminants and mice. We conclude that 3-MI in Cremophore causes an acute progressive pneumonitis in rats and suggest that the rats may be a suitable model for 3-MI-induced and similar toxic lung diseases in domestic animals and people.
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PMID:Pulmonary changes in rats following administration of 3-methylindole in cremophore EL. 298 Feb 17

Respiratory distress, from severe gastric aspiration pneumonitis and abdominal distention in the patient with tracheoesophageal fistula frequently requires mechanical ventilatory support. Bulk flow ventilation can lead to enlargement of the fistulous tract, elevation of gastric intraluminal pressures, raised airway pressures with hemodynamic instability, and retained secretions. We report a case of tracheoesophageal fistula, secondary to perforation of a squamous cell carcinoma of the esophagus, with temporary improvement in gas exchange on high frequency ventilation after failing on a conventional ventilator. The patient initially failed to improve on an Engstrom ventilator (Engstrom-Gambro, Inc., Barrington, IL) at 13 l/minute ventilation. Instituting high frequency jet ventilation with a VS 600 Jet Ventilator (Instrument Development Corporation, Pittsburgh, PA) at initial settings of 35 psi, rate 150, inspiratory time 40%, FiO2 0.8 and 12 cm H2O positive end expiratory pressure (PEEP), provided incremental improvement in gas exchange and oxygenation up to 26 cm H2O PEEP. However, in view of progressive multi-organ failure we terminated the jet ventilation after 48 h and returned the patient to conventional ventilation. We were unable to provide life-sustaining ventilation and oxygenation with either an Engstrom ventilator at 13 l/-minute ventilation or an MA-1 ventilator (Puritan-Bennett, Kansas City, MO) at a tidal volume of 800 cc and a ventilator rate of 30. Terminal respiratory failure occurred. Based on the period of improvement using high frequency jet ventilation, we believe this mode of ventilatory support is beneficial in the management of tracheoesophageal fistula.
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PMID:A double-crossover study comparing conventional ventilation with high frequency ventilation in a patient with tracheoesophageal fistula. 298 90

In order to better understand the bovine breathing pattern, tidal breathing flow-volume loops (TBFVL) were analyzed in 24 healthy cattle of different body weights (range: 37-660 kg) (Group A) and in 28 cattle suffering from the common respiratory diseases: verminous bronchitis (Group B); shipping fever (Group C); acute respiratory distress syndrome (Group D); respiratory syncytial virus pneumonia (Group E); organophosphate poisoning (Group F); and necrotic laryngitis (Group G). Respiratory airflow and tidal volume were measured with a breathing mask-Fleisch pneumotachograph assembly. TBFVL were traced from these values using a computerized method. All the loop indices proposed by Amis and Kurpershoek (1986a) were calculated from 5 representative breathing cycles for each of the 52 animals. The TBFVL shapes and indices were relatively constant in most healthy cattle and were not correlated with the body size. When compared to normal values, animals with moderate respiratory syndromes (Groups B and C) had a more flattened shape to their TBFVL. On the other hand, in most cattle with severe respiratory pathologies (Groups D, F and G expiration tended to be biphasic with the peak expiratory flow (PEF) occurring significantly later than in healthy animals. Both PEF and peak inspiratory flow were increased in all the pathological conditions. The TBFVL indices were more frequently and more severely changed during expiration than during inspiration.
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PMID:The effect of common bovine respiratory diseases on tidal breathing flow-volume loops. 306 8


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