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

Chlamydia are intracellular bacteria which infect many vertebrates, including humans. They cause a myriad of severe diseases, ranging from asymptomatic infection to pneumonia, blindness or infertility. IFN-gamma plays an important role in defense against acute infection and in the establishment of persistence. Chlamydia have evolved mechanisms to escape IFN-gamma functions. IFN-gamma-mediated effector mechanisms may involve effects on the metabolism of tryptophan or iron, on the inducible NO synthase (iNOS), on the secretion of chemokines and adhesion molecules or on the regulation of T-cell activities. IFN-gamma is secreted by the innate and the adaptive arms of the immune system. Within the former, Chlamydia-infected macrophages express IFN-gamma that in turn mediates resistance to infection. IFN-alpha/beta are pivotal for both IFN-gamma- and iNOS-mediated resistance to chlamydial infection in macrophages.
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PMID:The role of IFN-gamma in the outcome of chlamydial infection. 1208 78

Malnutrition, one of the world's greatest health problems, is a factor in the death of millions of children each year. Infection is the cause of death in over half these cases. Dietary deficiency, especially of protein, causes serious disturbances in the immune system. The mucus and cutaneous surfaces are the first affected. Studies of the respiratory mucus demonstrate frequent breaches which allow germs to penetrate. Antibodies are synthesized in reduced quantities, lymphocyte counts are often diminished, and reaction with infectious agents is poor. The phagocyte function of polynucleated cells is poor. Malnutrition is often associated with war, ignorance, poverty, and poor hygiene. Deficiencies of iron, vitamin A, and zinc may aggravate immune deficits. Ingestion of contaminated water is the main cause of diarrhea, which is very frequent among the malnourished and may be more serious than among adequately nourished individuals. Colibacillus and salmonella are most frequently isolated. Germs such as shigella, campylobacter, and rotavirus have the same incidence as in well nourished children. Pneumonia is responsible for 4 million deaths in children under 5 annually and is more common in the malnourished. The pathogenic agents may be pneumococci, Hemophilus, or staphylococci. Tuberculosis is also frequent, especially in zones with a prevalence of AIDS. Diagnosis of tuberculosis with cutaneous tests is difficult in the malnourished. Regardless of the pathogenic agent, pneumonia is more serious in the malnourished, and the need for treatment is more urgent. Urinary infections may occur in 10-25% of malnourished children vs. 2% of healthy children. The colibacillus is the most frequent cause. Specticemias, the most severe of infections, are not rare in the malnourished and are usually caused by Salmonella or the colibacillus. 20% of malnourished children are affected by infections acquired in the hospital. Among viral infections affecting them are measles and herpes. The fatality rate from measles may reach 25% in malnourished children. Parasitoses are frequent, but they do not seem to be more serious in malnourished children than in the general population. It is imperative in treating malnourished children to observe rigorous hygiene, use clean water, treat infections early, avoid hospital infections, and apply all available vaccines.
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PMID:[Infections in malnourished infants and children]. 1228 6

Certain socioeconomic factors weakened families and socioeconomic development in the Philippines. 34% of pregnant mothers in 1982 had anemia and by 1987 it increased to 45%. 70.4% of children 6-12 months old and 38.7% of those 12 months were also deficient in iron. Moreover, 12.4% of pregnant women in 1987 had a goiter for a total of 223,200 pregnancies of which likely resulted in spontaneous abortions, fetal death, or cretinism. 20% of newborns weighed 2.5 kg in 1990 so 324,000 newborns began their lives malnourished. Breast feeding fell from 87% in 1983 to 80% in 1984. 17.7% of children 6 years old were malnourished and 67% of them had stunted growth. 23% of elementary school students also were malnourished. Family daily energy intake decreased from the already inadequate level of 1808 calories in 1982 to 1753 in 1987. Similar falls in dietary intakes included protein, carbohydrates, calcium, ascorbic acid, and riboflavin. In 1989, 50% of families were poor thereby limiting their access to health, education, and food. Even though fertility fell from 6.3 in 1970 to 4.5 in 1984, it still was too high. Infant mortality in 1990 stood at 652 which meant that 250 babies died each day. In addition, 70 1-4 year old children died each day. Yet most of these deaths could have been prevented. Pneumonia was responsible for 40% of these child deaths. Other leading causes of death included diarrhea, measles, nutritional deficiencies, and bronchitis. The government has chosen primary health care (PHC) as the means to better the health status of the population, but is had no official policy and PHC committees largely are inactive. The government must seriously implement PHC throughout the Philippines and place health at the top of its list. Cooperation and coordination among all levels of government and nongovernmental organizations must begin.
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PMID:Health and nutrition and the role of the family. 1234 61

A 28-year-old female presented for evaluation of left flank pain and polyuria after having been exposed to cadmium in the jewelry manufacturing industry for approximately 3 years. This patient possessed both elevated 24-hr urinary ss2-microglobulin and elevated blood cadmium levels. Approximately 6 months after initial presentation, the patient resigned from her job due to shortness of breath, chest pain, and anxiety. Exposure to cadmium in the jewelry industry is a significant source of occupational cadmium exposure. Other occupational sources include the manufacture of nickel-cadmium batteries, metal plating, zinc and lead refining, smelting of cadmium and lead, and production of plastics. Cadmium is also an environmental pollutant that accumulates in leafy vegetables and plants, including tobacco. Major toxicities anticipated from cadmium exposure involve the renal, pulmonary, and, to a lesser extent, gastrointestinal systems. These include the development of renal proximal tubular dysfunction, glomerular damage with progressive renal disease, and respiratory symptoms including pneumonitis and emphysema. Low-level cadmium exposure has also been associated with increased urinary calcium excretion and direct bone toxicity, effects that recent research suggests may result in the development of osteoporosis. The body burden of cadmium, over half of which may reside in the kidneys, is most often measured through the use of urinary cadmium levels. Blood cadmium measurements generally reflect current or recent exposure and are especially useful in cases with a short exposure period and only minimal accumulation of cadmium in the kidneys. Both ss2-microglobulin and alpha1-microglobulin serve as organ-specific, early-effect biomarkers of tubular proteinuria and thus play a role in identifying early signs of cadmium-induced renal damage in those with potential exposures. In addition to ensuring workplace compliance with Occupational Safety and Health Administration-mandated monitoring and screening measures, it is prudent for those with cadmium exposure to maintain adequate intake of both iron and calcium, appropriate measures even in the absence of exposure.
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PMID:Cadmium exposure and nephropathy in a 28-year-old female metals worker. 1246 Aug 7

It has been proposed that the presence of siderophages in the lungs of infants who die unexpectedly should be considered a marker of a previous hypoxic event, which may preclude a diagnosis of sudden infant death syndrome. The authors retrospectively reviewed all infant deaths (<1 year old) going to autopsy at the Denver Office of the Medical Examiner from January 1999 to January 2001. Lung sections were stained with Prussian blue, and siderophages were counted in 20 high-power fields per lobe sampled. Cell counts were performed by two independent pathologists who were blinded to history and cause of death, with good reproducibility. Iron stain results were then categorized by average number of siderophages per 20 high-power field (category 1 = <5, category 2 = 5-100, category 3A = 100-500, category 3B = >100 in a single lobe, category 4 = >500). The results were subsequently correlated to case history, autopsy findings, and cause/manner of death. Forty-three cases were reviewed. The causes of death included sudden infant death syndrome (16), asphyxia (5), undetermined (6), and other (16). Those deaths were categorized by the above criteria as follows: category 1. (32), category 2. (6), category 3. (4), and category 4. (1). All sudden infant death syndrome deaths were in category 1. Categories 1 and 2 also included deaths in which hypoxia might have been present before death because of such factors as pneumonia and congenital heart disease. Categories 3 and 4 included a known homicidal asphyxia in which repeated episodes of intentional smothering were documented, 2 probable asphyxias, 1 nonaccidental trauma, and 1 undetermined. All 5 cases had questionable circumstances surrounding the death of the infant. Pulmonary siderophages were described in only 1 of the 43 autopsy reports. It was concluded that pulmonary siderophages can be markedly increased in cases of repeated asphyxia. Siderophages may also be increased in cases where hypoxia may have been present for another reason, but not to the same degree. Siderophages are not increased in sudden infant death syndrome. Because iron-laden macrophages often are not recognized on routine examination with hematoxylin and eosin staining, iron stains may be helpful in the evaluation of infant deaths. If siderophages are present in increased amounts without an obvious explanation, further investigation is warranted.
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PMID:Pulmonary siderophages and unexpected infant death. 1246 13

Iron plays a crucial role in the energy metabolism of microorganisms. Humans have developed iron-withholding mechanisms as a form of non-specific immunity. We describe a patient with iron overload and severe Legionella pneumophila pneumonia. This report emphasizes the importance of early consideration of and appropriate therapy against Legionella for patients with iron overload who present with community-acquired pneumonia.
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PMID:Severe Legionella pneumophila pneumonia in a patient with iron overload. 1247 34

Health facility ledgers of 11 rural health facilities in western Kenya were reviewed to evaluate diagnostic and prescribing practices. Clinics lacked laboratory facilities. Of 14,267 sick child visits (SCVs), 76% were diagnosed with malaria and/or upper respiratory infections. Other diagnoses were recorded in less than 5% of SCVs. Although two-thirds of malaria cases were diagnosed with co-infections, less than 3% were concomitantly diagnosed with anemia. Chloroquine and penicillin constituted 94% of prescriptions. Half of children given a sole diagnosis of measles or pneumonia were prescribed chloroquine, and 22% of children with a sole diagnosis of malaria were given penicillin. Antimalarials other than chloroquine were rarely prescribed. Only 12% of children diagnosed with anemia were prescribed iron supplementation, while 53% received folic acid. This study highlights limited diagnostic and prescribing practices and a lack of adherence to national treatment guidelines in rural western Kenya.
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PMID:Diagnostic and prescribing practices in peripheral health facilities in rural western Kenya. 1274 85

We investigated the opinions of medical doctors and nursing staff about desirable medical treatment for terminally ill geriatric patients. The purpose of the present study is: 1) to examine the recent opinion of doctors and nurses, 2) to examine discrepancies of opinions between doctors and nurses on treatment for terminal geriatric patients. Doctors and nurses working in long-term care wards in four hospitals were enrolled. They were asked to fill in a questionnaire which asked about desirable medical treatments for a typical bedridden terminally ill geriatric patient. The difference of answers between doctors and nurses were analyzed. The most common opinion of the 18 doctors and 84 nurses were as follows: 1) for the treatment of relapsing pneumonia, they would perform oxygenation, antibiotic injections, and continuous intravenous infusion during the period of discontinuation of enteral nutrition, 2) for the treatment of relapsing urinary tract infection, they would catheterize patients for a brief period and would irrigate the bladder, and would perform antibiotics injection, 3) for chronic anemia, they would perform iron replacement, 4) for decubitus ulcer, they would treat conventionally, and 5) at the final stage just before death, they would avoid special therapy for shock after obtaining informed consent from patient's family. To most questions, the proportion of each answer was almost identical between doctors and nurses; however, there were discrepancies concerning "way of nutrition in patients with relapsing pneumonia" and "irrigation of the urinary bladder" (p = 0.0544 and 0.0531, respectively). We expect that the present study will activate a discussion of what constitutes appropriate medical treatment for terminally ill geriatric patients.
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PMID:[Opinions of doctors and nurses about appropriate medical treatment for terminally ill geriatric patients]. 1457 22

Even in the twenty-first century, welding is still a common and a highly skilled occupation. The hazardous agents associated with welding processes are acetylene, carbon monoxide, oxides of nitrogen, ozone, phosgene, tungsten, arsenic, beryllium, cadmium, chromium, cobalt, copper, iron, lead, manganese, nickel, silver, tin, and zinc. All welding processes involve the potential hazards for inhalation exposures that may lead to acute or chronic respiratory diseases. According to literature described earlier it has been suggested that welding fumes cause the lung function impairment, obstructive and restrictive lung disease, cough, dyspnea, rhinitis, asthma, pneumonitis, pneumoconiosis, carcinoma of the lungs. In addition, welding workers suffer from eye irritation, photokeratitis, cataract, skin irritation, erythema, pterygium, non-melanocytic skin cancer, malignant melanoma, reduced sperm count, motility and infertility. Most of the studies have been attempted previously to evaluate the effects of welding fumes. However, no collectively effort illuminating the general effects of welding fumes on different organs or systems or both in human has not been published. Therefore, the aim of this review is to gather the potential toxic effects of welding fumes documented by individual efforts and provide informations to community on hazards of welding.
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PMID:Health hazards of welding fumes. 1464 49

Iron overload is a common acute and long-term event associated with autologous and allogeneic hematopoietic stem cell transplantation (HSCT). In a state of iron excess, free iron becomes available to catalyze the conversion of reactive oxygen species (ROS) intermediates such as superoxide anion (O2*-) and hydrogen peroxide (H2O2) to highly toxic free radicals such as hydroxyl radical (OH*). ROS may help to promote chronic liver disease, sinusoidal obstruction syndrome, idiopathic pneumonia syndrome and bacterial, fungal and other opportunistic infections. Phlebotomy has been effectively and safely used to deplete excess iron stores post-HSCT in thalassemic and other iron-overloaded patients. Intracellular iron levels may also be decreased through pharmacologic chelating agents, while antioxidants such as N-acetylcysteine, glutamine (glutathione precursor) and captopril have been shown to replenish glutathione redox potential and scavenge free radicals. A better understanding of the mechanisms involved in the iron-generated pro-oxidant state associated with HSCT will likely lead to reduced toxicity and improved patient outcomes.
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PMID:Rust and corrosion in hematopoietic stem cell transplantation: the problem of iron and oxidative stress. 1528 99


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