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

The most common prescriptions for antibiotics in France are those used in the treatment of respiratory infections, both in hospital and in general practice. They represent 10% of the total drug bill and about 1.5 to 2% of the total expenses of medical care. Antibiotics are often presented excessively or irrationally either because the proper indications were not firmly established or because unnecessarily powerful preparations were used. This is illustrated by two examples (among others), namely uncomplicated pneumococcal pneumonia and chronic bronchitis. More economic solutions are not easy and the current lack approach should not be replaced by a dogmatic one. Two immediate measures would hold the attention of respiratory physicians: the publication of a guide to antibiotic therapy in respiratory disease and periodic audits of antibiotic usage.
Rev Fr Mal Respir 1981
PMID:[The cost of antibiotics in respiratory disease (author's transl)]. 733 Apr 31

The authors study the diagnosis and the prognosis in 25 children with systemic lupus erythematosus and in 22 children with dermatomyositis. The most frequent signs when the diagnosis is established are articular involvements, erythema of the face, renal disorders and the presence of LE cells. The symptoms are often misleading, which explains the long delay between the first sign of the disease and the time of diagnosis, which can vary between one month to nine years. The prognosis of this disease has improved because of modern treatments : only four patients died, three of them because of renal failure and one because of cerebral embolism, after six months, one year, three years and ten months, In dermatomyositis the most frequent signs at the time of diagnosis are skin involvements and muscular and articular symptoms. The period of time between the onset of the disease and the diagnosis is shorter : one month to four years, 19 times equal to or less than one year, because the clinical picture is quite clear. Ten times the clinical evolution lead to a complete cure, 9 times a clear improvement with sequelae was observed : retractile myelosclerosis, calcinosis and medullary compression. One patient died of intestinal ulceration and two of pneumonia aggravated by involvement of the respiratory muscles.
Rev Rhum Mal Osteoartic 1980 Feb
PMID:[Systemic lupus erythematosus and dermatomyositis in children]. 736 Oct 65

A hypersensitivity pneumonia is rare during gold therapy. The underlying mechanism is immunological in origin, of Gell and Coombs Type IV. As there are numerous possible pulmonary disorders during the course of inflammatory rheumatism treated with gold, the early detection is vital, in order to prevent progress to fibrosis. In parallel with broncho-alveolar lavage to look for a T8 lymphocytic alveolitis, which is very suggestive, high resolution computed tomography has a place in the early diagnosis, to characterise the lesions, to aid in an aetiological diagnosis, and also to assess progress on treatment. The authors present a case of pneumonitis induced by gold with visible interstitial lesions on computed tomography, accompanied by significant bronchial distortion and bronchiectasis suggestive of fixed lesions. These lesions partially regressed following steroid therapy; the diagnostic and prognostic role for high resolution computer tomography was discussed.
Rev Mal Respir 1995
PMID:[The use of high resolution x-ray computed tomography in the diagnosis of hypersensitivity pneumopathy to gold salts. Apropos of a case]. 763 31

Between may 1988 and march 1993, twenty five double lung transplants were performed and five heart/lung transplants. Lung function tests (EFR) were performed on these patients for a period of 19.2 +/- 3.4 months. The aim of this study was two-fold. First, to report our overall results and to estimate the role of the single breath nitrogen washout test (N2 slope) in the early detection of chronic rejection (RC). Secondly, to assess the diagnostic value of EFR in the discrimination of acute rejection (RA) and of cytomegalovirus pneumonitis (PCMV). There were 41 episodes of RA and 21 episodes of PCMV and they were analysed as a function of the presence or absence of RC. In the absence of RC, RA produced no change in EFR and PCMV was accompanied by a pure restrictive ventilatory defect. On the otherhand, RA and PCMV lead to a worsening of obstruction and an hypoxaemia which characterises RC. The diagnosis of RC was made, on average, 14.4 +/- 2.9 months after surgery. However, from the sixth month the nitrogen slope was significantly increased and other parameters of EFR (particular maximal flows at low lung volume) remained normal. Thus, our results suggest that the N2 slope, measured in the absence of any evidence of acute rejection, constitutes an early test for chronic rejection. When its pathological rise is compared to the results of histology (presence or absence of RC), it shows a sensitivity of 0.94 and a specificity of 0.93.
Rev Mal Respir 1995
PMID:[Lung transplantation and respiratory function tests. Functional outcome in the presence and absence of chronic rejection]. 774 37

In order to better understand the immunopathology of acute complications of lung transplantation we have analysed the different parameters of cytotoxic cell and macrophage activation during the course of pulmonary allograft rejection and cytomegalovirus pneumonia. In transplanted patients presenting with an acute pulmonary allograft rejection, a cytomegalovirus pneumonia or no complication (control group), we have studied, first serum markers of immune activation: interleukin-2 soluble receptor (IL-2sR), neopterin, IL-6, TNF soluble receptors (TNF-sR55 and TNF-sR75). Secondly the intrapulmonary compartmentalisation of allogenic and antiviral responses were evaluated by studying bronchoalveolar lavage fluid (BAL). The level of IL-6 was measured in BAL supernatants and the gene expression of two cytokines (IL-1 beta and IL-6) and two markers of activated cytotoxic cells (granzyme B and perforin) were studied by in situ hybridisation on the alveolar cells. Acute pulmonary allograft rejection was characterised by the paucity of systemic stigmata of immune activation and by the intrapulmonary compartmentalisation of the inflammatory response principally expressed by an increase in alveolar concentration of IL-6, TNF-sR55 and TNF-sR75, and an increased expression of the IL-1 beta gene. Cytomegalovirus pneumonia is accompanied by an intense local and systemic inflammatory activity as evidenced by the serum level of IL-2sR, neopterin, TNF-sR55 and TNF-sR75, the alveolar concentration of IL-6, TNF-sR55 and TNF-sR75, and the expression of monokine (IL-1 beta, IL-6) and of cytotoxic mediator (granzyme b, perforin) genes by BAL cells. These mediators could participate in the elaboration of an acute or chronic inflammatory response which would be potentially deleterious for the graft.
Rev Mal Respir 1994
PMID:[Immunopathology of cytomegalovirus pneumonia and allograft rejection in lung transplantation. Group of Pulmonary Transplantation of the University Paris-Sud]. 783 5

Toxocariasis is a frequent disease in children, but the severe clinical manifestations are rare in the literature (diffuse interstitial pneumonia with hypoxaemia and acute severe asthma). The diagnosis is made thanks to the reliability of serological techniques (the ELISA test and using antigen excretion-secretion tests of the larvae of Toxocara canis). The authors report a case of acute severe eosinophilic pneumonia whose outcome was rapidly favourable following steroid therapy; the existence of positive Toxocara canis serology with a contamination risk of the patient in the domestic environment leads us to integrate the clinical picture into the larva migrans syndrome.
Rev Mal Respir 1994
PMID:[Acute eosinophilic pneumonia and the larva migrans syndrome: apropos of a case in an adult]. 783 10

The authors report a new case of bronchio-alveolar carcinoma which developed on a background of iatrogenic exogenous lipid pneumonia; this association is extremely rare (less than 20 cases in the literature) and poses the problem of possible cancer developing in the centre of the lipid pneumonia.
Rev Mal Respir 1994
PMID:[Associated lipid pneumonia and bronchiolo-alveolar carcinoma]. 783 11

The authors report a case of acute idiopathic eosinophilic pneumonia, a recently described entity of unknown etiology. The patients develop a rapidly progressive respiratory failure which is reversible following steroid therapy. The key to the diagnosis is an eosinophilia in the broncho-alveolar lavage or in the lung biopsy. Our observation of a favourable outcome in this case without steroid therapy is evidence perhaps of a less aggressive form of the disease.
Rev Mal Respir 1995
PMID:[Subacute idiopathic eosinophilic pneumopathy with favorable outcome without corticotherapy]. 789 63

The aim of this prospective study was to analyse the contribution of the measurement of alveolar arterial gradients of CO2 during forced expiration in the diagnosis of pulmonary emboli occurring in chronic airflow obstruction (COPD) as a result of smoking. The study was carried out on 178 patients: Group 1: 54 subjects without emboli (14 controls, 33 COPD and 7 patients with chest pain); Group 2: 72 patients with proved emboli (49 non COPD, 23 COPD); Group 3: 52 patients COPD presenting with varied non-embolic broncho-pulmonary pathology (pneumonia, bronchospasm, pulmonary oedema, bronchial neoplasm). The diagnosis of pulmonary emboli was confirmed by scintigraphy in patients with non COPD or angiography (in patients with COPD). The maximal fraction of CO2 was measured using a capnologue during a forced expiration which was long and prolonged until residual volume was achieved. The PaCO2 was measured simultaneously by an analysis of arterial blood gases. The D index was calculated according to the formula [(PaCO2-PEM CO2)/PaCO2] x 100. The D index was significantly lower in Group 1 (3.42 +/- 3.8% p < 0.0001) than in Group 2 (20.8 +/- 10%) and Group 3 (17.6 +/- 11.7%) (not significant between Groups 2 and 3). In patients with COPD the specificity and sensitivity and the predicted positive and negative value were 100% for a D limit of 7%. In COPD patients these values were respectively 82, 95, 75 and 96% for a D limit of 7%; on the other hand for a D below 5% the values were 60, 100, 64 and 100% respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
Rev Mal Respir 1995
PMID:[The significance of maximal expiratory concentrations of CO2 (MEC CO2) in the negative diagnosis of acute pulmonary embolism in chronic obstructive bronchopneumopathies]. 789 65

The consensus conference of the French Language Society of Infectious Disease convened at Lille in 1991 stressed the fact that "in the management of pneumonia, neither the clinical features nor the bacteriological information would enable a prediction of the responsible and effective agent with sufficient accuracy" and that antibiotic therapy should be empirical, based on the probabilities linked to the epidemiology and locality. The object of this study was to ascertain the diagnosis and therapeutic attitude of the general practitioner (GP) dealing with an acute infectious pneumonia in a 40 year old adult, previously well without any critical signs, which was the model taken for the consensus conference. One hundred GPs were selected at random from the general medical list in the city of Bordeaux and registered with the local medical council in Gironde. They were invited to answer a questionnaire containing 69 questions. The results were analysed for the two phases of the enquiry. The strategy of first intention and the method of re-evaluating for treatment instituted. Secondly the strategy used when faced with a patient who did not improve with the initial treatment. Eighty eight GPs answered the questionnaire and thus we are able to give the following information: the differential diagnosis was not clearly made between bronchial and pulmonary pathology when faced with a lower respiratory tract infection; two thirds of the GPs had a diagnostic and therapeutic approach which was in agreement with the recommendations of the consensus.(ABSTRACT TRUNCATED AT 250 WORDS)
Rev Mal Respir 1994
PMID:[Diagnostic and therapeutic strategies in acute pneumopathies in urban practice]. 797 39


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