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Query: UMLS:C0034063 (pulmonary edema)
 10,665 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The volume and composition of fluid on the surface of the alveoli can affect alveolar ventilation, gas diffusion, and macrophage function. The passive permeability and active processes of the alveolar epithelial lining play a role in regulating surface fluid and are a potential site of damage by airborne chemicals. Like other epithelial barriers, the alveolar lining is permeable to lipophilic substances but restricts the transmural flow of small ions and hydrophilic nonelectrolytes (equivalent pore radius ca. 0.5-1.5 nm). The mammalian fetal lung and alveolar sacs of the adult bullfrog secrete Cl- and K+ into the airspace. Secretion by the fetal lung ceases at birth. Many environmental agents increase the permeability of the capillary endothelium and/or respiratory epithelium and induce pulmonary edema. Studies with bullfrog alveolar sacs have demonstrated that selective effects may or may not be followed by general derangement of the epithelial barrier. Exposure of the luminal surface to HgCl2 (10(-6) to 10(-4) M) induces a selective increase in Cl- secretion that is followed by a fall in transport and a general increase in ion permeation. CdCl2 (10(-5) to 10(-3) M) depresses ciliomotion on cells on the trabecula of the alveolus but does not affect Cl- secretion or transepithelial conductance. HNO3, like other mineral acids, increases conductance and the radii or pores in the barrier, whereas NaNO3 selectively inhibits Cl- secretion. Amphotericin B(10(7) to 10(-5) MJ) induces K+ secretion into the lumen of both bullfrog and rat lung. We conclude that environmental agents induce changes in epithelial function that may compromise the lung's ability to regulate respiratory fluid without destroying the characteristic permeability of the epithelial lining.
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PMID:Chemical modulation of alveolar epithelial permeability. 625 Aug 8

Nitric acid (HNO3) is a strong acid and oxidizing agent used for various applications including production of ammonium nitrate in the fertilizer industry. Nitrogen oxides formed when nitric acid interacts with the environment have been implicated in inhalation injuries. This describes a case of a 49-year-old male who presented to the emergency department complaining of an acute onset of shortness of breath approximately 12 hours after being exposed to nitric acid fumes. He presented with a room air oxygen saturation of 80 percent with moderate to severe respiratory distress. His plain film chest radiograph showed bilateral pulmonary infiltrates and pulmonary edema. Over a seven-day hospital course, he had an improvement in his clinical status and chest X-ray with normal pulmonary function tests one month after discharge. Although exposure to the fumes of nitric acid is known to cause delayed pulmonary edema, it is rarely reported in the medical literature. This case serves as a reminder to consider exposure to fumes of nitric acid in a patient presenting with pulmonary edema and highlights the importance of obtaining a work history.
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PMID:Pulmonary Edema Occurring after Nitric Acid Exposure. 3077 39

Nitrate toxicosis associated with consumption of cabbages (Brassica oleracea var. capitata L.) (Brassicaceae) was diagnosed in a small herd comprising of ten goats in Matinyani ward, Kitui West sub-County of Kitui County in Kenya. The clinical signs were ataxia, ruminal tympany, bluish-brown mucous membranes, rapid and difficult breathing, incoordination, head pressing, aggressive movements, jugular distension, increased heart rates, tremors, and coma. Six goats died of intoxication. Dark brown/chocolate-colored and poorly clotted blood was the prominent necropsy finding. There was limited froth in the trachea and bronchi consistent with mild pulmonary oedema. There were liver congestion, pericarditis, and enlarged and congested kidneys with pinpoint haemorrhages. Four other affected goats were treated with intramuscular antihistamines and oral administration of ivermectin. No further mortality was observed after the treatment. Cabbages fed to goats had 6.6% nitrate on dry matter (DM) basis , while ruminal contents had 5.55% nitrate on dry matter basis (DM). Dark brown blood collected at postmortem had a methemoglobin fraction of 78%. Forage nitrate levels of 0.5% and above are potentially dangerous, with acute poisoning likely to occur if the nitrate level exceeds 1%. Death can occur when blood methemoglobin levels rise up to 67-90%. Findings from the current study are indicative of nitrate-nitrite toxidrome associated with ingestion of cabbages.
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PMID:Nitrate Poisoning due to Ingestion of Cabbages (Brassica oleracea var. capitata L.) (Brassicaceae) in Kitui County, Kenya. 3168 1