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Query: UMLS:C0034067 (emphysema)
 11,506 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 36 patients with bronchial asthma a new inhalable corticosteroid (Fluocortin-butyl-ester) was administered to reduce systemic steroids and especially to study the recovery of pituitary-adrenal function. On the basis of the present results, it can be said that patients with the least degree of emphysema and obstruction and with good coughing dynamics and productive expectoration are most suitable for therapy with inhalable corticosteroids. If the systemic steroid reduction is adequate, the recovery phase of the pituitary-adrenocortical system begins after about 5 months and the response to ACTH appraoches normal values after about 8-9 months. About 4 mg prednisolone-equivalent per day can be assumed to be the systemically effective limiting dose. The reducibility as a percentage of the initial dose-regardless of its absolute value- and the maintenance dose achieved also appear to be of equal importance for the recovery of the functional reserve of the pituitary-adrenocortical system. No relationship to the duration of the disease and the initial steroid dose could be demonstrated. The clinical picture of the corticosteroid withdrawal syndrome is dependent on endogenous cortisol synthesis. The symptoms disappear spontaneously with increasing synthesis.
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PMID:Recovery of pituitary-adrenal axis after withdrawal or reduction of systemic corticosteroids in patients with bronchial asthma. 23 Jul 36

For many years there has been much argument whether workers in the dusty trades are prone to chronic bronchitis. In 1966 the Medical Research Council issued a report of a Select Committee which concluded that occupationally induced bronchitis did not play a significant part in the aetiology of airways obstruction in dust-exposed men. Since then epidemiological studies have demonstrated that the prolonged inhalation of dust leads to an increase in prevalence of cough and sputum. Furthermore, new physiological techniques have demonstrated a slight decrement in ventilatory capacity as a result of industrial bronchitis, and which is related to lifetime dust exposure. Unlike bronchitis induced by cigarette smoke, the predominant effect of industrial bronchitis is on large rather than small airways and the condition is not accompanied by emphysema.
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PMID:Industrial bronchitis. 36 24

The characteristics of 11 patients (age range, 13 to 31 yr) with asthma complicated by pneumomediastinum are presented. Nine of 11 patients were male. Cough and chest pain were prominent symptoms in the affected individuals. Subcutaneous emphysema was noted in all but 1 patient who presented with an unusual radiographic finding: a radiolucent rim surrounding the pulmonary artery. Hamman's sign was detected in 7 patients. None of the patients required specific therapy for pneumomediastinum. The pathophysiology of pneumomediastinum was reviewed.
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PMID:Pneumomediastinum as a complication of asthma in teenage and young adult patients. 44 43

A four-year experience with transtracheal aspiration was reviewed in order to determine those patients at risk for developing life-threatening complications. One hundred procedures were performed by at least 20 different physicians trained according to an established protocol. Complications were limited to minimal subcutaneous emphysema in 19 percent (10/52), pneumomediastinum in 3 percent (3/93), and gross but self-limited hemoptysis in 1 percent (one patient); occasional unifocal premature ventricular contractions were noted in one patient. We conclude that patients not at risk of developing life-threatening complications from transtracheal aspiration can be identified. They (1) are able to cooperate and have a clearly identifiable and normal cricothyroid membrane, (2) have the procedure performed only by well-trained or supervised physicians, (3) have an arterial oxygen pressure of at least 70 mm Hg with administration of supplemental oxygen, and (4) have a prothrombin activity of at least 65 percent of the control value or a normal bleeding time or a platelet count of at least 100,000/cu mm. To minimize subcutaneous emphysema or pneumomediastinum, no patient should have therapy with intermittent positive-pressure breathing or any other procedure that might induce coughing for the subsequent 24 hours.
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PMID:Transtracheal aspiration. Guidelines for safety. 49 22

In an intensive care unit an important role is assigned to respiratory physiotherapy. Its principal task is efficacious toilet of the bronchi by fluidifying the secretions, promoting their ungluing from the respiratory tree and facilitating their evacuation by cough or by aspiration with a catheter or bronchoscope. The technique comprises the inhalation of a secretolytic (e.g. Bisolvon, NaCl 9%) and, in the case of asthma, bronchospasmolytic (e.g. Ventoline) aerosol followed by breathing exercises. The other objectives of physiotherapy are to ensure a better distribution of inspired air, increase failing ventilation, ameliorate disturbed gas exchange, relax the contracted respiratory muscles and prevent bronchiolar collapse in emphysema during expiration. The field of application of respiratory physiotherapy is large; its purpose is prophylactic and therapeutic. The method is prophylactic in all patients confined to bed, where there is a risk of bronchial obstruction or ventilatory failure, especially in those with severe operation, traumatism or consciousness disorder. Physiotherapy has a therapeutic role in several, principally broncho-pulmonary diseases, such as asthma, obstructive emphysema, pneumonia, bronchiectasis, pulmonary abscess, atelectasis, and pulmonary and pleural fibrosis. Myocardial infarction and pulmonary embolism in the acute state, acute pulmonary edema, pneumothorax and pulmonary hemorrhage are contraindications for physiotherapy. If the method is to be effective the intensive care unit should have a specialized physiotherapist attached to it working there on a daily basis.
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PMID:[The role of respiratory physiotherapy in an intensive care unit]. 52 99

Symptoms, clinical findings and pulmonary function in 47 patients with tracheobronchomalacia were compared with the bronchoscopic finding. The main symptoms were phlegm, cough, and dyspnoea. Recurrent respiratory infections and haemoptysis were features of the recent medical history. Only 30% had emphysema, and cor pulmonale in the ECG was uncommon. A notch in FEV1 was seen in 25 patients (54%), against 3 (6%) in the controls. FVC, FEV1/FIV1 and notch in FEV1 were directly proportionate to the severity of the malacia. A low FEV1/FIV1 and notch in FEV1 are suggestive of tracheobronchomalacia and an indication for bronchoscopy.
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PMID:Acquired tracheobronchomalacia. A clinical study with bronchological correlations. 61 23

73 welders were examined, who weld in an assembly room of a machine factory, mainly by an electric arc. In anamneses 60% of persons under examination notified of coughing, expectorating, dyspnoea during work, and frequent acute rhinitis. Clinical symptoms of respiratory tract disease, resulting from welding, were found in 10% of welders. Simple bronchitis, resistant bronchitis with pulmonary emphysema, pleural adhesions were diagnosed. In one case fibronodular tuberculosis was found (1%). In 8% of workers, aged 40--50, a dynamic arterial hypertension and radiological symptoms of aortosclerosis were found. 5% welders had granulocytopenia. Disturbances of the examined systems occurred in factory welders with duration of employment above 10 years.
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PMID:[Health conditions of a group of factory arc welders]. 68 52

A 47 year old man with asthma, allergic rhinitis, and chronic maxillary and ethmoid sinusitis and polyposis, in whom for 2 years intraorbital pressure symptoms are experienced on nose-blowing, sneezing and coughing, is presented. Paranasal sinus X-rays demonstrated an intraorbital pneumocoele that increased in size with Valsalva manoeuvre. The diagnosis, pathology and treatment of intraorbital emphysema and pneumoceles are discussed.
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PMID:[Spontaneous ethmoid pneumocele in chronic maxillary and ethmoid sinusitis and polyposis (author's transl)]. 71 19

Expiratory stenosis of the trachea and the main bronchi is caused first of all by slackening of the pars membranacea in rarer cases by tracheomalacia or tracheomegalia. Often it is associated with other respiratory diseases above all tracheobronchitis, emphysema and pneumosclerosis. Predominant clinical symptoms are dyspnoea, barking cough and attacks of suffocation. X-ray-pictures in several diameters and levels and bronchological examinations are crucial for securiting the diagnosis. Among 95 patients of all age groups 14 were operated on predominantly according to the method of NISSEN. Operation is contradicted in stages of severe emphysema with respiratory insufficiency of bilateral pulmonary tuberculosis or of chronic bronchitis. In 10 patients a good result was achieved by the operation.
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PMID:[Surgery of expiratory stenosis of the thoracic part of the trachea and main bronchi (author's transl)]. 79 6

Major fracture of the intrathoracic airway following closed chest trauma is a potentially lethal injury which can be repaired successfully if the diagnosis is made early, Cough, dyspnea cyanosis, hemoptysis, mediastinal emphysema, or pneumothorax not responding to drainage via intercostal tube and a deterioration of the patient's clinical condition out of proportion to the apparent closed chest injury, should alert the clinician to the possiblity of this entity. This report describes the findings in a patient with a longitudinal disruption of the entire intrathoracic trachea and the findings in a second patient with complete transection of the right main bronchus. Each was repaired primarily, with eventual recovery, The principles of management of this difficult group of injuries are reviewed.
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PMID:Major airway injury in closed chest trauma. 87 56


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