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

The capacity of IL-2 production of peripheral blood lymphocyte (PBL) were determined in 54 patients with pneumonia in acute stage (23 cases of 20-57 years old and 31 cases over 60 years old) and 33 cases in convalescent stage. 20 elderly COPD in remission patients and 59 healthy control (32 aged 20-55 and 27 over 60) were determined also. It was shown that the capacity of IL-2 production of the patients with pneumonia in acute stage were markedly lower than healthy control (P less than 0.01), and that of the elderly patients' were markedly lower than elderly COPD patients also (P less than 0.01). The IL-2 level were also lower in the patients with pneumonia in convalescence than in the healthy control (P less than 0.01). The capacity of IL-2 production of elderly COPD patients and healthy elderly donors were at the same level (P greater than 0.05), both of the two groups' IL-2 level were significantly lower than that of the healthy young-middle age donors. It was suggested that the lowered immune function may be one of the important factors causing the COPD patients and the elderly people susceptible to infection, and it may be one of the important causes of the more severe condition and protracted course in elderly patients.
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PMID:[The capacity of IL-2 production of peripheral blood lymphocyte in patients with pneumonia]. 139 76

The oral cavity is responsible for two essential functions: the production of speech and the initiation of alimentation. All of the specialized oral tissues and sensory systems that allow for the execution of these functions are susceptible to age-, disease-, and treatment-related changes, and alterations in any one or more function may result in deleterious consequences to the host and impact on the quality of life. Oral physiology is generally believed to be age-stable in healthy individuals; however, in the presence of single or multiple medical diseases and their treatment, these functions deteriorate. This article focuses on the influence of common geriatric diseases, disorders, and impairments on oral health and function. Data are presented to suggest that oral health is altered in the presence of heart, cerebrovascular, liver, and renal diseases, cancer, COPD, diabetes, pneumonia, and influenza. Arthritic, hearing, visual, orthopedic, and speech impairments multiple medical problems. Finally, adjustments in treatment and management strategies may be necessary for older patients with these diseases and impairments.
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PMID:Oral sequelae of common geriatric diseases, disorders, and impairments. 150 40

Cigarette smoking has significant detrimental effects on both the structure and function of the lung; it is the single most important risk factor for the development of COPD. Uncertainty remains concerning the mechanisms by which smokers develop obstructive lung disease. It is speculated, however, that an imbalance between proteolytic and antiproteolytic forces in the lung or an increase in heightened airways responsiveness is responsible. Population-based studies have documented lower levels of FEV1, accelerated loss of ventilatory function, and increased respiratory symptoms and infections among smokers compared with nonsmokers. Data from both prospective and retrospective studies have consistently shown increased mortality from COPD, pneumonia, and influenza among cigarette smokers compared with nonsmokers.
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PMID:The health consequences of cigarette smoking. Pulmonary diseases. 154 66

APACHE II system, is a simple and inexpensive method to evaluate severity of Intensive Care Patients. In a 2 years period (between 1988 and 1990), grading severity using APACHE II system, was performed on 498 consecutive mechanical Ventilated Patients in a Respiratory Intensive Care Unit. APACHE II was higher in COPD patients, but patients with Pneumonia and Organophosphate Poisoning had higher mortality. Correlating the different components of APACHE II with the results, we verified that Prognosis was not influenced by the Previous Health Status. Mortality was higher with increasing age, in patients with COPD and Organophosphate Poisoning. APS was the most important index for prognosis. Patients with Pneumonia and Organophosphate Poisoning had the highest APS. The Authors conclude that APACHE II is an objective and not time consuming method to evaluate severity in ICU Patients. However indexes measured on the first 24 hours of ICU staying are a result of severity of illness, treatment performed and time elapsed before ICU admission, and, this may be a possible source of bias when comparing different Unit results.
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PMID:[Severity evaluation of ventilated patients at a respiratory intensive care unit with the APACHE II system]. 159 71

The incidence of mediastinal emphysema (ME) and pneumothorax (PTX) was analyzed to determine the roentgenographic patterns and risk factors for the development of barotrauma in a population of mechanically ventilated patients. The roentgenograms of 139 intubated patients admitted to our medical intensive care unit over a ten-month period were evaluated for the presence of ME and PTX. Barotrauma was diagnosed in 34 of these patients, and ME was the initial manifestation in 24 patients. Of these patients with initial ME, ten subsequently developed PTX, a positive predictive value of 42 percent. The adult respiratory distress syndrome (ARDS) patient population was at highest risk for barotrauma, with an intermediate risk seen in those admitted with COPD or pneumonia. Values of peak inspiratory pressure, positive end-expiratory pressure level, respiratory rate, tidal volume, and minute ventilation were significantly elevated in patients who developed barotrauma as compared with patients who did not develop barotrauma. However, these elevations in part reflect the high incidence of barotrauma in the ARDS population, a patient group in which all of the above parameters were elevated.
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PMID:Pulmonary barotrauma in mechanical ventilation. Patterns and risk factors. 836 43

We reviewed the records of all patients in the intensive care unit (ICU) who had Pseudomonas aeruginosa pneumonia over a 2.5-year period. Of patients with P aeruginosa pneumonia, 20 of 34 survived the initial episode of pneumonia. Ten of these 20 developed recurrence. In the nonrecurrent group, nine of ten survived hospitalization, compared to only four of ten in the recurrent group. Comparing the recurrent to the nonrecurrent group, factors associated with recurrence were the APACHE 2 score (12.3 +/- 2.7 vs 8.6 +/- 4.2 [p less than 0.03]), APS score (7.0 +/- 3.5 vs 2.7 +/- 2.1 [p less than 0.01]), and chronic pulmonary disease (8/10 vs 2/10 [p less than 0.05]). The recurrent P aeruginosa group was younger (63 +/- 10 vs 74 +/- 11 years old [p less than 0.03]) and spent more time receiving mechanical ventilation (95 +/- 64 vs 26 +/- 36 days [p less than 0.01]), in the ICU (101 +/- 61 vs 33 +/- 35 days [p less than 0.01]), and in the hospital (144 +/- 77 vs 84 +/- 32 days [p less than 0.03]). Although not statistically significant, in the recurrent group, eight of ten patients had tracheostomy and seven of ten had COPD, vs three of ten and two of ten, respectively, in the nonrecurrent group. Recurrent P aeruginosa pneumonia in the ICU is associated with increased morbidity and mortality and does not appear to be related to the adequacy of antibiotic treatment. Chronic lung disease appears to predispose patients to recurrent P aeruginosa pneumonia.
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PMID:Recurrent Pseudomonas aeruginosa pneumonia in an intensive care unit. 172 69

Four hundred episodes of COPD among patients admitted to Chulalongkorn Hospital between 1982 and 1986 were analyzed. There were 193 males and 45 females with 325 and 75 episodes of admission, respectively; the average age on admission was 68.4 +/- 0.5 years. The most significant associated underlying factor was cigarette smoking in 94 per cent of the cases, with the patients smoking an average of 1.15 packs of cigarettes per day for 43 years. In our study, 26.8 per cent of the patients had a cough, with the average age at onset being 47.4 +/- 2.1 years. The most common clinical manifestation was dyspnea with 58.5, 35.2 and 0.5 per cent having dyspnea functional class II, III, IV and with the average age at onset being 61.1 +/- 0.7, 66.6 +/- 0.7 and 71.0 +/- 1.0 years, respectively. An important manifestation on admission was dyspnea functional class III and IV, which were present in of 89 per cent of the cases. The main precipitating factors which led to the patients' admission were upper respiratory tract infection, pneumonia, bronchospasms and congestive heart failure, which accounted for 48.0, 10.0, 8.5, 31.8 and 18.3 per cent of the cases, respectively. With regard to these complications, there were 16.5, 48.3, 31.1 and 12.5 per cent of the patients who suffered respiratory failure requiring assisted ventilation, corpulmonale, polycythemia and peptic ulcer, respectively. Arterial blood gas on admission revealed a pH level of 7.36 +/- 0.1, pCO2 of 53.3 +/- 23.7 torr, and PO2 of 54.2 +/- 19.9 torr.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Chronic obstructive pulmonary disease at Chulalongkorn Hospital: an analysis of 400 episodes. 181 89

Adjusted admission rates for respiratory distress (COPD, asthma, bronchitis, and pneumonia) varied up to 3.09-fold between the highest and lowest hospital market areas in 1986 for the state of Ohio. Reasons for the variability can be determined through small area analysis techniques with the help of area physicians. Substantial improvements in the availability, delivery, and cost of respiratory care would reasonably be anticipated as a result of such analysis and feedback.
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PMID:Small area analysis shows differences in utilization. 182 50

Respiratory syncytial virus is the major cause of lower respiratory tract infection in children. Adults who are immunocompromised, aged, institutionalized, and/or have underlying medical diseases may be at risk for severe RSV infection. Intubated adults in an MICU were evaluated for evidence of RSV infection. Respiratory secretions were analyzed by cell culture and RSV EIA. Serologic testing was obtained. Respiratory secretions from MICU personnel with acute respiratory symptoms and patients admitted for pneumonia, asthma, or COPD also were screened. Five of 11 intubated patients had evidence of RSV infection. One of seven MICU employees and four of 48 ward patients had RSV-positive respiratory secretions. During community outbreaks of RSV infection, adults admitted to an MICU already may be infected with RSV; those admitted for other reasons are at risk for nosocomial infection. Patients occupying other hospital units and personnel may be instrumental in the nosocomial dissemination of RSV.
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PMID:Respiratory syncytial virus infection among intubated adults in a university medical intensive care unit. 193 97

The literature dealing with the magnitude, mechanism and effects of reduced FRC in the perioperative period is reviewed. During general anaesthesia FRC is reduced by approximately 20%. The reduction is greater in the obese and in patients with COPD. The most likely mechanism is the loss of inspiratory muscle tone of the muscles acting on the rib cage. Gas trapping is an additional mechanism. Lung compliance decreases and airways resistance increases, in large part, due to decreased FRC. The larynx is displaced anteriorly and elongated, making laryngoscopy and intubation more difficult. The change in FRC creates or increases intrapulmonary shunt and areas of low ventilation to perfusion. This is due to the occurrence of compression atelectasis, and to regional changes in mechanics and airway closure which tend to reduce ventilation to dependent lung zones which are still well perfused. Abdominal and thoracic operations tend to increase shunting further. Large tidal volume but not PEEP will improve oxygenation, although both increase FRC. Both FRC and vital capacity are reduced following abdominal and thoracic surgery in a predictable pattern. The mechanism is the combined effect of incisional pain and reflex dysfunction of the diaphragm. Additional effects of thoracic surgery include pleural effusion, cooling of the phrenic nerve and mediastinal widening. Postoperative hypoxaemia is a function of reduced FRC and airway closure. There is no real difference among the various methods of active lung expansion in terms of the speed of restoration of lung function, or in preventing postoperative atelectasis/pneumonia. Epidural analgesia does not influence the rate of recovery of lung function, nor does it prevent atelectasis/pneumonia.
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PMID:Perioperative functional residual capacity. 180 4


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