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

The clinical course of 16 patients with polycythemia vera (PV), treated in the period 1982 to 1993, was shown. Splenomegaly occurred in three fourths of these patients (75%), and hypertension was a major symptom. Thrombosis such as myocardial infarction and cerebral infarction was noted. Eight patients was treated with myelosuppressive agents and the 8 other patients were treated with phlebotomy. A 70-year-old male who was treated with mitobronitol (DBM) developed acute myeloblastic leukemia (AML) 11 years later. He was treated with multi-combination chemotherapy (BHAC-DMP), and entered complete remission, followed by early relapse. He became refractory to chemotherapy and died of acute pneumonia 6 months later. Median survival of 16 cases of PV was more than 10 years, and long-term treatment and care are necessary.
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PMID:[A clinical study of sixteen polycythemia vera cases--acute myeloblastic leukemia in patients with polycythemia vera]. 799 24

In order to investigate the change of glutathione concentration in BAL from the patients with diffuse interstitial lung disease. We measured the levels of glutathione in BAL from the patients with interstitial lung disease, including idiopathic interstitial pneumonitis (IIP), hypersensitivity pneumonitis (HP), collagen disease with pneumonitis, and sarcoidosis. The result showed that the glutathione concentration in BAL of the patients with IIP, HP, collage disease with pneumonitis, were significantly lower than that of the control group, but compared with the control group, the glutathione concentration of the patients with sarcoidosis did not show significant difference. The results may provide further insight into the pathogenesis of oxidant-induced interstitial lung disease and its therapy.
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PMID:[Measurement of total glutathione concentration in bronchoalveolar lavage recovered from the patients with diffuse interstitial lung disease]. 808 13

The number and types of mononuclear cells obtained by bronchoalveolar lavage from 105 marrow transplant patients with and without cytomegalovirus pneumonia were studied to determine whether: (1) CMV pneumonia was associated with local recruitment of lymphocytes and lymphocytes of particular subtypes to the lung, and (2) whether local recruitment was affected by the known risk factors for the development of CMV pneumonia, namely acute graft-versus-host disease and total body irradiation. Results showed a significant increase in the number of lymphocytes (P = 0.014) and in the number of lymphocytes marking for CD8 (P = 0.0045) and CD16 (P = 0.052) in BAL from all patients compared with BAL from normal subjects. However, no significant differences were observed in BAL cellular characteristics between patients with and without pneumonia nor between patients with CMV or other etiologies of pneumonia. There were also no significant differences in BAL characteristics when patients were analyzed for the presence of acute GVHD, the use of TBI, or the type of transplant. These results do not provide evidence for local recruitment of lymphocytes to the lung unique of patients with CMV pneumonia nor to patients with GVHD and CMV pneumonia, in contrast to what is observed in murine CMV pneumonia.
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PMID:Mononuclear cell reconstitution in the lung after marrow transplantation. Lack of influence of cytomegalovirus pneumonia, irradiation, and graft-versus-host disease. 809 99

To assess the usefulness of BAL in diagnosing bacterial pneumonia in mechanically ventilated patients, 80 BAL fluid samples obtained from 72 patients with lung infiltrates were studied using the following parameters: infected cell count (polymorphonuclear leukocytes or macrophages with intracellular organisms), microscopic examination of stained smears, and quantitative culture with the determination of the simplified bacterial index (SBI) and the predominant species index (PSI). Of the 80 BAL samples studied, 56 were performed under antibiotic therapy. Bacterial pneumonia was the final diagnosis in 28 cases. The SBI is the sum of the whole numbers of each bacterial concentration expressed as a common logarithm. The PSI is the whole number of the predominant microorganism's concentration expressed as a common logarithm. The discriminative value of each test was assessed using a receiver operating characteristic (ROC) curve, whereby the possibility of establishing a cutoff value used to discriminate between the presence or absence of pneumonia is evaluated. The percentage of infected cells was higher in the pneumonia group (8.8 +/- 18.1 versus 0.4 +/- 1.1%, p < 10(-3), but no cutoff value could be proposed. Under microscopic examination, the presence of bacteria was noted with a significantly greater frequency in the pneumonia group (sensitivity 67.8% and specificity 82.7%). A total of 58 BAL samples were positive when cultured. The SBI was significantly higher in the pneumonia group (6.5 +/- 2.9 versus 1.6 +/- 1.7, p < 10(-4).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Bronchoalveolar lavage for diagnosing bacterial pneumonia in mechanically ventilated patients. 814 47

The authors discuss the etiology, pathomechanisms, radiological features of lipid pneumonia. The role of bronchoalveolar lavage is stressed in determining this diagnosis. A case is presented of a patient receiving paraffin oil for chronic constipation. The diagnosis was made after identifying the lipid droplets (Sudan III stain) in alveolar macrophages sampled by BAL.
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PMID:[A case of lipid pneumonia]. 814 66

A review is presented of the microbiological data, and the methods for obtaining these data, which are relevant for the diagnosis of lower respiratory tract infection. The necessity for adequate information exchange between the microbiology laboratory and the clinic is stressed. Once the specimen (usually sputum) has reached the laboratory, it is screened macroscopically and microscopically for adequacy, and cultures are set up. Many patients with acute community-acquired pneumonia (CAP) have no sputum, and some produce purulent sputum containing no obvious infecting micro-organisms. Despite modern microbiological techniques, only 110 out of 250 acute CAP patients had positive bacteriological cultures and 41 more yielded only positive serological results, so that an aetiological diagnosis was reached in 60%. Invasive methods of specimen collection (bronchoscopy, BAL, protected brush, etc) have also been studied, together with quantitative bacterial counting, but the results have not yielded so much useful information that these procedures can be unreservedly recommended. Molecular biological methods (DNA probes, PCR, etc) are only now becoming available. The bacteriological findings in patients with acute CAP have been compared with those in acute exacerbations of chronic bronchitis (CB), and several differences have emerged in the order of frequency of occurence. H. influenzae is in first place with exacerbations of CB, but is second to S. pneumoniae in acute CAP. The latter occupies third position in CB, with Moraxella catarrhalis second. The role of Chlamydia pneumoniae in acute CAP is not yet clear, but the serological results suggest an association in 42 out of 147 patients tested (29%), 15 of whom also had positive bacteriological cultures.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Critical review of microbiological data and methods in diagnosis of lower respiratory tract infections. 819 20

We describe the cases of two individuals with advanced AIDS who sought treatment for rapidly progressive respiratory failure due to T gondii pneumonia. The first patient responded to specific therapy after an early diagnosis but died 2 months later of bacterial sepsis. In the second case, the diagnosis was made at autopsy. This led to a meticulous retrospective review of the original slides of material obtained from BAL. T gondii tachyzoites not previously identified during the initial analysis of the slides were seen on both GIE and PAP stains. Neither of our severely immunocompromised patients had evidence of central nervous system involvement. Even though we cannot exclude dissemination to other organs, a progressive pneumonitis mimicking a classic P carinii infection was the primary presentation. Trophozoites were identified by BAL in both cases, underscoring the diagnostic potential of this minimally invasive procedure.
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PMID:Toxoplasma gondii pneumonia in patients with the acquired immunodeficiency syndrome: diagnosis by bronchoalveolar lavage. 820 79

In general, lung involvement in connective tissue disorders has not been as well defined as has isolated interstitial lung disease; this applies particularly to bronchiolitis, which occurs infrequently. The low prevalence of bronchiolitis may reflect difficulties in making the diagnosis in mild to moderate disease; at present, most reported disease is severe. This is likely to account for the lack of therapeutic success in obliterative bronchiolitis and in many patients with follicular bronchiolitis. There is a need for earlier intervention if treatment is to be effective, and thus there is a need to refine the noninvasive diagnosis of bronchiolitis. This goal is unlikely to be achieved without the systematic noninvasive evaluation and surveillance of large groups of patients with connective tissue diseases. The role of the pulmonary function laboratory in identifying early bronchiolitis remains entirely uncertain; whether silent "small airways disease," defined physiologically, predicts the eventual development of bronchiolitis is unclear. The reversibility of this asymptomatic lesion with inhaled steroid therapy and the role of inhaled treatment in bronchiolitis, in general, have not been evaluated. More work needs to be done to determine the predictive value of CT appearances and BAL findings, to try to identify a subgroup of patients at greater risk of developing severe bronchiolitis. Further histocompatibility studies may serve as a basis for the selection of patients with an increased likelihood of developing airways disease. The role of open lung biopsy requires further clarification. Better noninvasive evaluation should reduce the need for this invasive procedure; in some patients, however, including those with concomitant interstitial lung disease, histologic assessment will remain an essential component of management. In recent years, in contrast to early reports, it has become apparent that organizing pneumonia has a better prognosis than fibrosing alveolitis in the connective tissue diseases; overall, stability or regression of disease, usually with corticosteroid therapy, was documented in 28 of 39 reported cases. In these patients, a tissue diagnosis serves to identify the need for aggressive therapeutic intervention. Finally, the compilation of larger clinical series would improve our understanding of severe bronchiolitis. This is likely to require multicenter collaboration, which often is impracticable; without this approach, however, the description of bronchiolitis will remain anecdotal.
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PMID:Bronchiolitis in association with connective tissue disorders. 831 70

The opsonic activity of plasma fibronectin (FN) by rat alveolar macrophage (AM) was examined, and the in vivo effect of FN in Staphylococcus aureus (S. aureus) experimental rat pneumonia was evaluated. The chemiluminescence response of AM was enhanced by the presence of FN (300 micrograms/ml) in S. aureus and Streptococcus pneumoniae, but was not enhanced in gram-negative rods (Haemophilus influenzae, Branhamella catarrhalis, Pseudomonas aeruginosa). FN (300 micrograms/ml) promoted the phagocytosis of S. aureus by AM, but did not promote the bactericidal activity of that by AM. In the experimental rat pneumonia with S. aureus inoculation, plasma FN concentration decreased with time, but increased by the administration of FN (1 mg). The number of bacteria in the lung, peripheral white blood cell and BAL fluid cell also decreased by the administration of FN. Furthermore, FN was significantly improved on inflammatory findings of rat lung tissue 24 hours after inoculation with S. aureus. These results suggest that FN plays an important role as an opsonic by alveolar macrophage, and that FN has utility for clinical trials in patients with pneumonia.
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PMID:[Efficacy of fibronectin on opsonic activity by alveolar macrophage and experimental rat pneumonia]. 833 12

The purpose of this prospective postmortem study was to assess the diagnostic accuracy of bronchoscopic techniques (bronchoalveolar lavage [BAL] and protected specimen brush [PSB]) and nonbronchoscopic techniques (blind bronchial sampling [BBS] and mini-BAL) in the diagnosis of ventilator-associated pneumonia (VAP). The results of each technique were compared with histology and culture of lung tissue specimens obtained by surgical pneumonectomies in 38 patients who died after at least 72 h of mechanical ventilation. Histology was positive for VAP in 18 patients and negative in 20 patients. There were 12 definite VAP (positive histology and positive lung cultures) and 6 histologic VAP (positive histology and negative cultures). Clinical pulmonary infection score (CPIS) at a threshold of 6 achieved a sensitivity of 72% and a specificity of 85%. When the CPIS was combined with the logarithmic concentration of the predominant microorganism obtained from the BBS sample culture, specificity was increased to 95%, for a threshold of 10. Using 10(3) cfu/ml as the threshold of positivity for cultures obtained with PSB and mini-BAL samples and 10(4) cfu/ml for cultures obtained with BBS and BAL, the respective sensitivities of these techniques for definite VAP were 42, 67, 83, and 58%. The sensitivity of BBS was significantly higher than that of PSB (p < 0.05). The area under the receiver operator characteristic curve was significantly greater for BBS than PSB (p < 0.05). Given that it is more sensitive and noninvasive, BBS is preferable to PSB for the diagnosis of VAP.
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PMID:Bronchoscopic or blind sampling techniques for the diagnosis of ventilator-associated pneumonia. 852 Jul 66


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