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

Eight cases of chronic eosinophilic pneumonia (CEP) diagnosed between January 1977 and December 1979 are described. Clinical manifestations included toxic syndrome, cough and fever, lasting from 1 to 15 months. Chest x-ray revealed peripheric bilateral infiltrates, with the exception of one case. In two patients there was no peripheral eosinophilia and five received antituberculous drugs at some point during the illness. In all cases tests for fungi and parasites were negative. In only two patients was an increase in IgE found. Hystological study confirmed CEP in 7 patients through either trans-bronchial biopsy or minimal thoracotomy. Treatment with corticosteroids was dramatically effective in all patients; both clinically and radiologically. In two cases which were asymptomatic, decreased carbon monoxide diffusing capacity persisted six months later. One hundred fifteen cases of CEP published since Carrington et al. first described CEP as a separate entity of the pulmonary infiltrates with eosinophilia syndrome are reviewed.
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PMID:[Chronic eosinophilic pneumonia: report of eight cases (author's transl)]. 725 63

Respiratory dysfunction is a major consequence of smoke inhalation and significant surface burns. Carbon monoxide intoxication, asphyxia, and upper airway obstruction occur early, whereas pulmonary edema and bacterial pneumonia may be delayed for days or weeks. The noxious constituents of smoke are believed to stimulate irritant receptors producing bronchoconstriction and to cause chemical injury to the airway mucosa and the alveolar-capillary membrane producing pulmonary edema. Pneumonia occurs in most patients who survive the initial injury. Thorough history and physical and laboratory examinations may forecast the severity of injury. Treatment includes administration of oxygen, use of bronchodilators, and when necessary, mechanical ventilation. The long-term sequelae of smoke inhalation are unknown.
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PMID:Pathophysiology and management of the complications resulting from fire and the inhaled products of combustion: review of the literature. 735 93

A respiratory tract illness was detected in a 1-year-old male Syrian hamster; after it failed to respond to antibiotic therapy, the hamster was euthanized by CO2 administration. Postmortem examination revealed acute edematous pneumonia, and Corynebacterium paulometabulum was isolated from the lungs.
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PMID:Acute pneumonia in a Syrian hamster: isolation of a Corynebacterium species. 747 73

Denutrition is a common finding in patients with chronic respiratory failure (CRF). Preoperative denutrition increases the risk of nosocomial pneumonia and difficulties in weaning from mechanical ventilation. A preoperative nutritional support may have beneficial effects on respiratory muscles performance. However, prospective studies need to be carried out in patients with CRF to substantiate this hypothesis. Postoperative nutritional support is indicated if weaning from the ventilator is expected to require more than several days, in order to preserve the diaphragmatic function. Lipid-enriched nutrition may have a beneficial effect, when energy supply is high, as the resulting decrease in CO2 production may facilitate the weaning from the ventilator. A beneficial effect of branched-chain amino acid-enriched solutions has not been demonstrated in patients with CRF.
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PMID:[Artificial nutrition in patients with chronic respiratory insufficiency undergoing surgery]. 748 27

Conditioning with busulphan (BU) and cyclophosphamide (CY) prior to allogeneic bone marrow transplantation (BMT) is an alternative to regimens that include total body irradiation (TBI). The aim of the study was to assess the occurrence and degree of lung function impairment after this treatment. Prospectively, 43 consecutive patients, aged 17-51 (median 31) yrs, were examined by lung function measurements and clinical and radiographic evaluation, prior to BMT and at 3 month intervals up to 1 yr after BMT. All patients had normal chest radiographs before BMT and at the 12 month follow-up. Mean baseline values were above 100% of predicted normal for lung volumes and above 90% for gas transfer. Excluded from the lung function follow-up analyses were nine patients who had suffered infectious pneumonia and/or developed obliterative bronchiolitis. For the remaining patients (n = 34), mean alveolar volume (VA), forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) had dropped by nearly 10% compared with baseline 3 months after BMT, but were restored within 1 yr. FEV1/FVC x 100 (FEV1%) was increased, reflecting the restrictive pattern. Hb-adjusted transfer factor of the lungs for carbon monoxide (TL,CO) had dropped by 20% after 3 months, and remained reduced by 15% after 1 year. Prior to BMT the smokers had significantly lower TL,CO than the nonsmokers, and after BMT the difference was accentuated. Reductions in lung function were independent of sex, age and type of haematological disorder. We conclude that BMT with BU/CY is associated with transient declines in lung volumes and a persistent reduction in gas transfer 1 yr after therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Decreased lung function in one year survivors of allogeneic bone marrow transplantation conditioned with high-dose busulphan and cyclophosphamide. 748 89

Pentoxifylline has been reported previously in an unblinded study to improve oxygen saturation, treadmill walk time, and resting diffusion of carbon monoxide (Dco) in patients with COPD. We recruited 12 patients with moderate to severe COPD whose exercise capacity was limited by ventilation or who developed hypoxemia with exercise. Patients were randomized to receive pentoxifylline or placebo, each for a 12-week period in a prospective, double-blind, crossover design study, to assess the effects of pentoxifylline on oxygenation, resting Dco, and exercise tolerance using arterial blood gas analysis. Eleven patients with a mean FEV1 of 0.94 L and a mean Dco of 9.85 mL/min/mm Hg completed the study. One patient withdrew from the study after developing pneumonia. There were no significant differences in resting oxygenation, resting Dco, or spirometry after 12 weeks of pentoxifylline relative to placebo. The 12-min walk test and dyspnea index for activities of daily living were also not significantly different while taking pentoxifylline. Finally, at maximal exercise, there were no differences in workload attained, exercise duration, oxygen consumption, carbon dioxide production, minute ventilation, oxygen saturation, PO2, alveolar-arterial oxygen pressure difference, or Borg score while taking pentoxifylline relative to placebo. We conclude that pentoxifylline does not improve oxygenation, resting Dco, exercise tolerance, or dyspnea in patients with moderate to severe COPD.
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PMID:The effects of pentoxifylline on oxygenation, diffusion of carbon monoxide, and exercise tolerance in patients with COPD. 749 61

We investigated pulmonary function and bronchoalveolar lavage fluid (BALF) before and after COP-BLAM III therapy in elderly patients with non-Hodgkin's lymphoma (NHL). The patients consisted of 8 men and 5 women, over 60 years of age, with previously untreated NHL. The PaO2 averaged 86.5 +/- 7.6 mmHg before treatment, and 69.3 +/- 9.2 mmHg after treatment. Six Patients showed a decrease in PaO2 to less than 20 mmHg. Percent (%) carbon monoxide diffusion capacity was 91.4 +/- 7.1% before treatment and 69.6 +/- 11.5% after-treatment, and 8 patients showed a decrease of at least 20%, whereas there were no definite changes in percent vital capacity or the percent of forced expiratory volume in one second. After BALF collection, the total cell count was slightly increased and the lymphocyte count was also increased after treatment, whereas there were no significant changes in neutrophil or eosinophil counts. There were no significant changes in T-cell or B-cell counts after treatment. The CD4/CD8 was 0.51 before treatment and 1.65 after treatment in patients without pulmonary complications, showing a tendency to increase, while the low ratio before treatment, 0.24, was nearly unchanged after treatment in those who developed pneumonia during their course. Considerable attention should be paid to pulmonary complications. As a result of chemotherapy, lymphocytic infiltration was observed subclinically in the lung, suggesting that changes in the local pulmonary immune system may be involved in the occurrence of pulmonary complications.
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PMID:[Evaluation of pulmonary function and bronchoalveolar lavage fluid in elderly non-Hodgkin's lymphoma before and after COP-BLAM III therapy]. 752 44

The complex pathophysiology of adult respiratory distress syndrome (ARDS) makes preventive and therapeutic concepts difficult. Ample experimental evidence indicates that ARDS can be prevented by blocking systemic inflammatory agents. Clinically, only heparin, for inhibition of coagulation phenomena, is presently used among this array of approaches. Corticosteroids have not proven to be beneficial in ARDS. Alternative antiinflammatory agents are being proposed and are under current clinical investigation (e.g. indomethacin, acetylcysteine, alpha 1-proteinase inhibitor, antitumor necrosis factor, interleukin 1 receptor antagonist, platelet-activating factor antagonists). Symptomatic therapeutic strategies in early ARDS include selective pulmonary vasodilation (preferably by inhaled vasorelaxant agents) and optimal fluid balance. Transbronchial surfactant application, presently tested in pilot studies, may be available for ARDS patients in the near future and may have acute beneficial effects on gas exchange, pulmonary mechanics, and lung hemodynamics; its impact on survival cannot be predicted at the present time. Strong efforts should be taken to reduce secondary nosocomial pneumonia in ARDS patients and thus avoid the vicious circle of pneumonia, sepsis from lung infection, and perpetuation of multiple organ dysfunction syndrome. Optimal respirator therapy should be directed to ameliorate gas-exchange conditions acutely but at the same time should aim at minimizing potentially aggravating side effects of artificial ventilation (barotrauma, O2 toxicity). Several new techniques of mechanical ventilation and the concept of permissive hypercapnia address these aspects. Approaches with extracorporeal CO2 removal and oxygenation are being used in specialized centers.
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PMID:Prevention and therapy of the adult respiratory distress syndrome. 761 57

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)
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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

Smoke inhalation injury is a complex of disease processes best understood and treated when defined in terms of the time period after injury. The early phase (0 to 36 hrs) is characterized by diagnosis and treatment of carbon monoxide and cyanide toxicity and by management of early airways edema, bronchorrhea, and bronchoconstriction with aggressive pulmonary toilet. Between 1 and 5 days, the major characteristic is airways mucosal slough, tracheobronchitis, and increasing lung water and impaired gas exchange. Pulmonary toilet and infection control, as well as close management of fluid shifts, is the major treatment. With onset of the inflammation-infection phase, the risk of nosocomial pneumonia increases markedly, as does the impairment in lung function as a result of marked increase in oxygen consumption and CO2 production. Nutrition, stress modification, avoidance of muscle fatigue, and control of infection are the key treatment modalities.
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PMID:Smoke inhalation injury. 792 21


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