Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0032290 (aspiration pneumonia)
 2,291 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The patient reported had a fulminant, refractory diarrhea of unknown etiology producing about 81 of diarrheal fluid daily which required continuously large volumes of intravenous fluid therapy. No protozoon other than Blastocystis hominis was present. Bacterial counts were very low in the fecal material because of continuous antibiotic therapy. Blastocystis hominis was present in large numbers, averaging for a 5-day period, 8.3 X 10(6)/ml of diarrheal fluid. Treatment with metronidazole for 12 days had no effect on either the diarrhea or the numbers of B. hominis present. The patient died from aspiration pneumonia without a firm diagnosis of his underlying disease. Identification of an unusual form of B. hominis seen only in diarrheal fluid was confirmed through cultivation, specific fluorescent antibody staining, as well as by transmission electron microscopy and light microscopy using hematoxylin staining and Nomarski interference contrast. The most significant result of this study is the description of ultrastructure of the in vivo trophozoite form of B. hominis. The persistence of certain morphologic features of the in vivo and in vitro forms of B. hominis is described. In vivo, B. hominis has a larger nucleus than in vitro, more prominent, well structured nucleoli, and hundreds of mitochondria with numerous delicate saccular cristae in a clear electron-lucent matrix and complex internal structure. Many cytoplasmic vesicles lined with ribosomes are present. The in vivo structure differs from the granular culture form of B. hominis, which has a smaller nucleus (nuclei), no distinct nucleoli, mitochondria characterized by a uniform structureless electron dense matrix, and few cytoplasmic, ribosome-lined vesicles. A feature retained in both in vivo and in vitro B. hominis is a distinct crescentic band of nuclear chromatin.
 ...
PMID:Ultrastructure and light microscope appearance of Blastocystis hominis in a patient with enteric disease. 99 21

The methods of continuous (C) and intermittent (I) nasogastric tube feedings in 60 patients, 54 men and 6 women, with a mean age of 72 +/- 9 years were compared in terms of number of complications, staff time used, and caloric intake. Patients were randomly assigned between these two methods and followed for 7 days. Diarrhea, aspiration pneumonia, clogged tubes, and self-extubation were observed in both groups. Diarrhea was significantly more frequent (96% of 30 patients) in the I group than the C group (66% of 30 patients) (p < .008). Furthermore, diarrhea was more prolonged (4 days or more) in 64% of 30 patients in the I group than the C group (4 days or more) in 58% of 30 patients (p < .02). However, clogged tubes occurred 3 times more often in the C group (p < .01). Self-extubation and aspiration pneumonia tend to be more frequent in the I group but the difference was not significant. The average time used by staff nurses in the maintenance of NGT feedings was not significantly longer in the I group (48.45 +/- 11 min/patient per day) than the C group (46.46 +/- 11 min/patient per day). In the C group the mean calories recommended were 2248 +/- 36 kcal/day but the actual caloric intake was only 1465 +/- 281 kcal/day, a deficiency of 783 +/- 291 kcal/day. The recommended calorie count for the I group was 2021 +/- 5 kcal/day but the amount delivered was only 1226 +/- 254 kcal/day, which resulted in a deficit of 795 +/- 259 kcal/day.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Continuous compared with intermittent tube feeding in the elderly. 149 8

Because critically ill surgical patients requiring nutritional support have altered metabolic pathways and are frequently hypermetabolic, catabolic, and hyperglycemic, nurses play an important role in monitoring their care. These metabolic changes place the patient at risk for rapid muscle wasting and nutritional depletion. Enteral and parenteral support provide specialized routes for the delivery of nutrients but have inherent risks and complications. Diarrhea and aspiration pneumonia are consistently reported complications of tube feeding on which nurses have a great impact. Further research is critical to improving nursing practice and patient care. CVC infection continues to plague the delivery of parenteral nutrition. Nurses must remain abreast of current research in this area and apply it in the clinical setting to improve patient care.
 ...
PMID:Perioperative nutrition problems. Nursing management. 212 7

The impact of oral rehydration therapy (ORT) on the estimated 5 million deaths of children yearly from acute dehydrating diarrhea is discussed in terms of worldwide adoption of ORT as primary therapy; establishment of national ORT programs; new scientific knowledge of intestinal absorption of ORT solutions; and implications of ORT for the next decade. ORT now encompasses 99% of the developing world, although it is implemented unevenly, as low as 12% in Africa. 75% of ORT formula is now produced locally. By 1988 60% of the world had ORT available, and 25% of affected children received ORT. More community health workers need training in ORT, since knowledge by mothers is key to treating children. Research is needed on the effect of ORT on aspiration pneumonia, the incidence of inadequate rehydration and death after ORT. Causes of death in children with diarrhea, and organisms associated with diarrhea resistant to ORT treatment. Current research focuses on maximal flow of nutrients and solvent drag across the intercellular tight junctions of the intestinal epithelium. Short chain fatty acids, butyrate, propionate and acetate, are also being studied as adjuncts to the carbohydrates and amino acids used in ORT solutions. In the future, ORT will be used with interventions such as breastfeeding, better weaning foods, sanitation, management of persistent diarrhea caused by specific organisms, targeted therapy and immunization.
 ...
PMID:Worldwide impact of oral rehydration therapy. 218 10

While single dose activated charcoal is effective in preventing drug absorption, repeated doses not only prevent absorption but also can increase systemic drug clearance. The mechanism for the latter effect may involve interruption of enterohepatic recycling and/or promotion of drug exsorption from the systemic circulation into the gut lumen. A comprehensive review of reported studies in volunteer subjects and overdose patients showed that repeated dose activated charcoal markedly decreased the half-life and/or increased the clearance of a wide range of drugs. Side-effects of the treatment were infrequent, but included aspiration pneumonia, diarrhoea and constipation. The addition of laxatives to repeated dose charcoal treatment did not offer any significant increase in drug clearance and is not recommended. It is suggested that the optimal regimen for the use of repeat dose activated charcoal in acute drug intoxications is an initial dose of 75-100 g, followed by 50 g every 4 hours until the risks of systemic drug toxicity are reduced to an acceptable level.
 ...
PMID:Role of repeated doses of oral activated charcoal in the treatment of acute intoxications. 222 32

Bacteroides melaninogenicus and Bacteroides oralis are predominant anaerobes in orofacial infections and aspiration pneumonia. Fusobacterium species are common pathogens in aspiration pneumonia, brain abscesses and orofacial infections. Clostridium perfringens can cause bacteremia and wound infections. Clostridium botulinum can produce a paralytic toxin that causes a paralytic syndrome in infants. Clostridium difficile can cause diarrhea or antibiotic-associated colitis.
 ...
PMID:Anaerobic infections in childhood. 287 20

Anaerobic bacteria are part of the normal flora of mucous membranes and outnumber aerobic bacteria in the oral cavity and gastrointestinal tract. Anaerobes can be isolated from pediatric patients with various infections when appropriate techniques for transportation and cultivation of samples are employed. Frequently anaerobes are isolated in combination with other facultative or aerobic bacteria. The genera or groups of anaerobes most frequently isolated from pyogenic infections in children are (in order of decreasing frequency) OFFteroides, Clostridium, gram-positive cocci, Fusobacterium, gram-positive rods (Eubacterium, Lactobacillus, Propionibacterium, Actinomyces, and Bifidobacterium), and gram-negative cocci (Veillonella and Acidaminococcus). Clostridium perfringens causes bacteremia and wound infections. Clostridium botulinum can produce a paralytic toxin that causes a lethal illness in adults and a paralytic syndrome in infants. Clostridium difficile can cause antibiotic-associated colitis or diarrhea. Bacteroides fragilis is most frequently involved in intraabdominal infections, infections of the female genital tract, subcutaneous abscesses, and bacteremia. Bacteroides melaninogenicus and Bacteroides oralis are the predominent anaerobes in orofacial infections and aspiration pneumonia. Fusobacterium species are pathogens in aspiration pneumonia, brain abscesses, and orofacial infections. Anaerobic gram-positive cocci can be recovered from all types of infections but predominate in respiratory tract and intra-abdominal infections. Recognition of the pathogenic qualities of the various anaerobic organisms can assist in their prompt identification and in the initiation of appropriate therapy.
 ...
PMID:Anaerobic infections in childhood. 637 28

Nasoenteral alimentation is less hazardous, cheaper and more physiological than parenteral nutrition. Serious complications of tube feeding such as bleeding from esophageal lesions or aspiration pneumonia have become rare since soft silicone-rubber or polyurethane tubes are used and the diets are delivered into the jejunum rather than into the stomach. The costs of full enteral alimentation are 25 to 50% of that caused by total parenteral nutrition. For intraduodenal or intrajejunal feeding continuous infusion of an elemental or oligopeptide diet is necessary. At the beginning of the feeding program infusion rate must be slowly increased over four to five days to avoid diarrhea, abdominal cramping and vomiting. The caloric requirements depend on the extent of protein energy malnutrition and hypercatabolism of the individual patient. Although follow-up of the patient's nutritional status and water- and electrolyte balance in the hospital must be extremely close at the beginning, tube feeding can be continued--if necessary--by home enteral nutrition later on.
 ...
PMID:[Enteral tube feeding--an alternative to parenteral infusion therapy]. 642 4

We report here our first experience with the use of a total artificial heart in a human being. The heart was developed at the University of Utah, and the patient was a 61-year-old man with chronic congestive heart failure due to primary cardiomyopathy, who also had chronic obstructive pulmonary disease. Except for dysfunction of the prosthetic mitral valve, which required replacement of the left-heart prosthesis on the 13th postoperative day, the artificial heart functioned well for the entire postoperative course of 112 days. The mean blood pressure was 84 +/- 8 mm Hg, and cardiac output was generally maintained at 6.7 +/- 0.8 liters per minute for the right heart and 7.5 +/- 0.8 for the left, resulting in postoperative diuresis and relief of congestive failure. The postoperative course was complicated by recurrent pulmonary insufficiency, several episodes of acute renal failure, episodes of fever of unidentified cause (necessitating multiple courses of antibiotics), hemorrhagic complications of anticoagulation, and one generalized seizure of uncertain cause. On the 92nd postoperative day, the patient had diarrhea and vomiting, leading to aspiration pneumonia and sepsis. Death occurred on the 112th day, preceded by progressive renal failure and refractory hypotension, despite maintenance of cardiac output. Autopsy revealed extensive pseudomembranous colitis, acute tubular necrosis, peritoneal and pleural effusion, centrilobular emphysema, and chronic bronchitis with fibrosis and bronchiectasis. The artificial heart system was intact and uninvolved by thrombosis or infectious processes. This experience should encourage further clinical trials with the artificial heart, but we emphasize that the procedure is still highly experimental. Further experience, development, and discussion will be required before more general application of the device can be recommended.
 ...
PMID:Clinical use of the total artificial heart. 1476 80

Lansoprazole is a proton pump inhibitor that reduces gastric acid secretion. It has proved effective in combination regimens for the eradication of Helicobacter pylori and as monotherapy to heal and relieve symptoms of gastric or duodenal ulcers and gastro-oesophageal reflux. After initial healing, it may be used to prevent recurrence of oesophageal erosions or peptic ulcers in patients in whom H. pylori is not the major cause of ulceration and to reduce basal acid output in patients with Zollinger-Ellison syndrome. Usual dosages are 15 to 60 mg/day, although dosages of < or = 180 mg/day have been used in patients with hypersecretory states. In patients with duodenal or gastric ulcer, short term lansoprazole monotherapy was similar to omeprazole and superior to histamine H2 receptor antagonists in achieving healing rates > 90%. Lansoprazole was as effective a component of H. pylori eradication regimens as omeprazole, tripotassium dicitrato bismuthate (colloidal bismuth subcitrate) or ranitidine. Lansoprazole was superior to ranitidine in symptom relief and healing of gastro-oesophageal reflux disease and tended to relieve symptoms more rapidly than omeprazole, although initial healing was similar. As maintenance treatment, lansoprazole was similar to omeprazole and superior to ranitidine in relieving symptoms and preventing relapse. Lansoprazole was also superior to ranitidine in healing and relieving symptoms of oesophageal erosions associated with Barrett's oesophagus; healing was maintained for a mean of 2.9 years in > or = 70% of patients. Lansoprazole was also superior to ranitidine in prophylaxis of redilatation of oesophageal strictures. After > or = 4 years of use in patients with Zollinger-Ellison syndrome, lansoprazole 60 to 180 mg/day effectively controlled basal acid output. Dosages may be reduced in some patients once healing and symptom relief has been achieved. Preliminary studies of lansoprazole in patients at risk of aspiration pneumonia or stress ulcers show promise. Although studies show lansoprazole is potentially effective in treating gastrointestinal bleeding, future studies should assess patients' H. pylori status. Lansoprazole has been well tolerated in clinical trials, with headache, diarrhoea, dizziness and nausea appearing to be the most common adverse effects. Tolerability of lansoprazole does not deteriorate with age and the drug is well tolerated in long term use (< or = 4 years) in patients with Zollinger-Ellison syndrome or reflux disease. Thus, lansoprazole is an important alternative to omeprazole and H2 receptor antagonists in acid-related disorders. In addition to its efficacy in healing or maintenance treatment, it may provide more effective symptom relief than other comparator agents.
 ...
PMID:Lansoprazole. An update of its pharmacological properties and clinical efficacy in the management of acid-related disorders. 927 7


1 2 3 4 Next >>