Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0034067 (emphysema)
 11,506 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Serum levels of alpha 1-antitrypsin were studied in 80 patients with chronic bronchitis. As a manifestation of the inflammatory response, nonsignificant increase was recorded compared to the group of healthy subjects. In discordance with literary data, no significant differences were found between bronchitics smokers and non-smokers. In 5 patients (6.2%), alpha 1-antitrypsin serum levels were below the lower limit of the reference range. The patients complained of cough, expectoration, and dyspnea. As a preventive measure, it is recommended to determine serum alpha 1-antitrypsin levels in smokers before they take up a job in a dusty environment and in bronchitics before inhalation treatment with proteolytic enzymes is administered. In alpha 1-antitrypsin deficit the value of substitution therapy in patients with emphysema is being emphasized.
 ...
PMID:[Levels of alpha 1-antitrypsin in the blood of patients with chronic bronchitis]. 278 79

The chemistry, pharmacology, pharmacokinetics, clinical efficacy, adverse effects, and dosage of ipratropium bromide are reviewed. Ipratropium bromide, a synthetic quaternary isopropyl derivative of atropine, interrupts vagally mediated bronchoconstriction by inhibiting the cyclic guanosine 3',5'-monophosphate system at parasympathetic nerve endings. Ipratropium bromide is poorly absorbed after oral and inhaled administration but diffuses rapidly into tissue after i.v. or i.m. administration. The elimination half-life is 3.2-3.8 hours. After inhalation, the drug is eliminated in the urine and feces. The bronchodilatory effect of ipratropium bromide in stable chronic obstructive pulmonary disease appears to be comparable, and may be superior, to that of the beta-sympathomimetic agents. In acute exacerbations, ipratropium bromide is useful but may not be the preferred agent because of a delayed onset of action (within 15 minutes; mean dose-dependent duration of effect, three to five hours). Combination therapy with other bronchodilating drugs has proved useful. Ipratropium bromide may be a useful adjunctive agent in the treatment of asthma. Since the onset of action is delayed, ipratropium bromide should not be used as single-drug therapy in an acute asthmatic exacerbation. Reported adverse effects, including cough, nausea, palpitations, dry mouth, nervousness, gastrointestinal distress, and dizziness, have been mild. The usual dosage is two inhalations (36 micrograms) four times daily, and the maximum number of doses per day should not exceed 12. Although ipratropium bromide is currently indicated only for maintenance therapy in stable chronic bronchitis and emphysema, it may be useful as adjunctive therapy in asthma and in the management of acute exacerbations of chronic bronchitis and asthma. Additional experience in a variety of chronic obstructive pulmonary disorders will help to clarify the role of ipratropium bromide in the treatment of obstructive pulmonary disease.
 ...
PMID:Use of ipratropium bromide in obstructive lung disease. 297 9

Chronic obstructive pulmonary disease (COPD) is equated with chronic bronchitis and emphysema as one disease entity. In COPD airflow limitation is relatively persistent--unlike asthma. Tests for "small-airways disease" form no part of routine practice, for their accuracy in detecting pathological change is debatable. The proteolytic theory of the pathogenesis of emphysema highlights the role of neutrophil elastase, antielastases, oxidants, antioxidants, and thus of potential new treatments. Clinical features of COPD include breathlessness, cough, and sputum, with airflow obstruction and lung hyperinflation. The differential diagnosis includes bronchiectasis, cystic fibrosis, and pulmonary hypertension, but pulmonary fibrosis, etc., is distinguished by radiological infiltrates. Plain chest radiography cannot reliably diagnose emphysema in life, but a new method measuring lung density from the computed tomographic (CT) scan allows location, quantitation, and diagnosis of emphysema (defined by enlargement of distal air spaces) in humans in life. "Pink puffers" with breathlessness, hyperinflation, mild hypoxemia, and a low PCO2 are contrasted with "blue bloaters" with hypoxemia, secondary polycythemia, CO2 retention, and pulmonary hypertension and cor pulmonale. Antismoking measures are a major aim in management. A bronchodilator regimen combining a slow-release oral theophylline with an inhaled beta 2-agonist, ipratropium, and high-dose inhaled steroids is proposed because even modest improvement in obstruction can help these patients. In acute exacerbations with purulent sputum, antimicrobials against Streptococcus pneumoniae and Hemophilus influenzae are used with controlled oxygen therapy aiming to keep the arterial PO2 over 50 mm Hg without the pH falling below 7.25. Influenza prophylaxis is recommended, but pneumococcal vaccination remains debatable. Chronic under-nutrition in "emphysema" implies controlled trials of feeding regimens--but these remain to be assessed. Long-term oxygen therapy is the only treatment known to prolong life in blue bloaters, and oxygen concentrators and transtracheal oxygen delivery are discussed. Pulmonary vasodilators (e.g., beta 2-agonists, hydralazine, nifedipine, angiotensin-converting enzyme [ACE] inhibitors, etc.) have not yet been proved to provide long-term reduction in pulmonary arterial pressure. Blue bloaters have severe nocturnal hypoxemia in rapid eye movement (REM) sleep that is corrected by oxygen or the investigational drug almitrine.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Chronic obstructive pulmonary disease. 304 40

A 50 percent or greater savings in oxygen usage and aesthetic benefits leading to increased compliance are reasons for increasing use of the transtracheal catheter for administration of home supplemental oxygen. Minor complications of the procedure are common and include catheter dislodgement, bronchospasm, subcutaneous emphysema, bleeding at the catheter site, as well as hemoptysis and wound infections. Rare complications include retroflexion of the catheter into the upper trachea from coughing, and fracture of the catheter with loss in the trachea. New, improved catheters and detailed descriptions for operator use may reduce the frequency of these complications. This report describes a potentially serious complication of a transtracheal catheter system which resulted despite appropriate use and care of the catheter.
 ...
PMID:Endotracheal mass resulting from a transtracheal oxygen catheter. 333 22

We studied 149 children aged seven months to 13 years (mean age 2.9 +/- 0.2 years) who had aspirated foreign bodies for age, sex, and type of foreign body. Symptoms, physical findings, chest x-ray, and fluoroscopy were compared with different sites of enlodgement. Positive history was obtained in 135 (91%). In 133 children, the diagnosis was made on admission. Frequent symptoms were cough (80%) and cyanosis (27%) following aspiration, while prevalent emergency department symptoms were cough (33%) and dyspnea (30%). Common physical findings on admission were decreased breath sounds (65%), tachypnea (43%), and fever (36%). Admission chest radiographs revealed emphysema (43%) and infiltrates or atelectasis (29%). Forty-one children (27%) were asymptomatic, and 43 children had normal chest x-ray. Fluoroscopy showed inspiratory mediastinal shift in 57%. Bronchoscopy performed within 48 hours of admission was successful in removing the foreign material in 88% of the children. Food particles were the most common type of foreign body. Hoarseness and stridor were significantly more common in upper airway enlodgement (P less than 0.01). Decreased breath sounds were significantly more common among children with lower airway enlodgement (P less than 0.001). A delay in diagnosis of longer than three weeks was associated with equivocal history of aspiration (P less than 0.05), and with significantly more wheezing (P less than 0.02) and atelectasis (P less than 0.01). Our study reemphasizes the importance of integrating various diagnostic tools in order to accurately evaluate and manage these children.
 ...
PMID:Foreign body aspiration in childhood. 338 Jul 39

Bronchoalveolar lavage (BAL) has not been associated with the complication of pneumothorax. Candidates for this procedure are predisposed to develop pneumothorax due to underlying infectious interstitial emphysema. This risk factor is increased by the hyperbaric consequences of lavage and also by the cough induced by bronchoscopic examination. While BAL remains a useful diagnostic procedure, patients should be monitored for occurrence of pneumothorax.
 ...
PMID:Bronchoalveolar lavage-induced pneumothorax. 339 30

Airway responsiveness to inhaled histamine was examined in two groups of carefully selected patients with nonasthmatic chronic obstructive airways disease (COAD). Twelve patients with chronic bronchitis and airflow obstruction but little emphysema and 13 with predominantly emphysema and airflow obstruction but little bronchitis were selected based on history, chest roentgenogram, and diffusing capacity for carbon monoxide (Dsb). Emphysema patients had less cough, less sputum, less chronic bronchitis, lower Dsb, and more radiographic evidence of vascular deficiency. There was no difference in anthropometric features, smoking history, atopic skin sensitivity, hemoglobin, blood eosinophilia, PaO2, PaCO2, ECG, lung volumes, or expiratory flow rates. The two groups had similar airway responsiveness to inhaled histamine; the geometric mean provocation concentrations producing a 20 percent FEV1 fall (PC20) was 0.56 mg/ml for the bronchitis patients and 0.28 mg/ml for the emphysema patients (p greater than 0.20). Regression of log histamine PC20 vs percent predicted FEV1 showed a high correlation in both groups (r = 0.73, p less than 0.01 in bronchitis and r = 0.79, p less than 0.001 in emphysema). The regression lines were almost identical. These data suggest that in COAD bronchial responsiveness to inhaled histamine is mainly due to the altered airway geometry, and that there is no difference in histamine responsiveness between patients with emphysematous COAD and nonemphysematous COAD with chronic bronchitis.
 ...
PMID:Airway responsiveness to inhaled histamine in chronic obstructive airways disease. Chronic bronchitis vs emphysema. 340 23

Respiratory infections of 19 subjects of advanced age and/or with underlying respiratory disease were treated with cefoperazone (CPZ) and its clinical effects were studied. Sixteen subjects suffered from respiratory tract infection and 3 subjects had pneumonia. The age of the subjects ranged from 39 to 77 years with the mean of 63.8, 7 of them being more than 70 years of age. The underlying respiratory diseases included chronic pulmonary emphysema in 6 subjects, diffuse panbronchiolitis in 3, bronchiectasis in 3, silicosis in 2 and one each of chronic bronchitis, pulmonary fibrosis, lung cancer and old pulmonary tuberculosis. One case, 75 years of age, had renal insufficiency. The daily dose of CPZ was 4 grams in 18 of the 19 subjects and the duration of administration ranged 5 to 22 days. The remaining 1 subject received 2 g of CPZ daily for 6 days. Clinical effects were judged from the changes in fever, cough, amount of sputum, dyspnea, rales, cyanosis, chest X-ray, white blood cell counts, CRP, erythrocyte sedimentation rates and results of sputum culture. Clinical effects were good in 16 subjects, fair in 1, and poor in 2. Bacteriological follow-up was carried out in 13 subjects. Infecting bacteria were eliminated from 5 subjects, reduced in 2 and, in 4 subjects, they were replaced by other bacteria. In 1 subject, P. aeruginosa was isolated from sputum even after the treatment with CPZ, and in another subject H. influenzae relapsed immediately after the cessation of the CPZ treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Effects of cefoperazone on respiratory infections of patients of advanced age and/or with underlying respiratory diseases]. 373 62

With the recent development of new potential antibiotics, it has become easier to treat patients with common bacterial infections. However, we find it difficult to handle severe infections due to opportunistic pathogens, developed in the so-called immunocompromised patients. SM-4300 is a newly developed intravenous human gamma-globulin, which is said to be intact without conventional enzyme-treatment and sulfonization. SM-4300 is also free from large molecules of aggregated gamma-globulin. SM-4300 was administered in combination with antibiotics to 2 patients of severe respiratory infections, having refractory underlying diseases. Case No. 1 was a 65-year-old female with bronchopneumonia, who had been suffering from pulmonary fibrosis, chronic bronchitis, chronic congestive heart failure and tricuspid insufficiency for several years. During her hospitalization because of these diseases, she developed cough with slight sputum and exertional dyspnea accompanied by high body temperature of 38 degrees C on January 1983. Chest X-ray revealed infiltration in the right lung field which was compatible with bronchopneumonia. SM-4300 of 5 g was added intravenously on 5th day after 4 day-cefotiam treatment with no improvement. High body temperature subsided and laboratory data became normal around 3 days after single SM-4300 injection. Case No. 2 was a 68-year-old male patient of chronic bronchitis with chronic pulmonary emphysema and bronchial asthma. Around the end of May 1983, he complained of dyspnea on exertion and had mucopurulent sputum, more than 100 ml daily, from which Pseudomonas aeruginosa was cultured in large number. He was afebrile.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Clinical studies on SM-4300, a new intravenous human gamma-globulin]. 393 26

The Industrial Injuries Advisory Council has reaffirmed the view that simple pneumoconiosis does not produce disability or shorten life. This is often true but, without overlooking the importance of chronic bronchitis, such conclusions are wrong in many instances.Chronic bronchitis is probably commoner in miners without pneumoconiosis than in those with it, and an uneven distribution of bronchitis may mask the effects of pneumoconiosis. Cough and sputum in a miner with pneumoconiosis are not always due to chronic bronchitis. Disability is usually judged on measurement of vital capacity and forced expiratory volume, factors which cannot be expected to be significantly altered by simple pneumoconiosis alone. Other tests may show abnormalities which lead to ventilation and perfusion inequalities and to an increase in the ventilatory cost of exercise. Focal emphysema, often a consequence of simple pneumoconiosis, develops slowly and its influence on disability is delayed.Disagreements arise because epidemiologists expect all lungs with simple pneumoconiosis react in the same way, and they want a quantitative relation between simple pneumoconiosis and emphysema before attributing one to the other.There are major difficulties in assessing disability but there is little justification for the regular application of the rule that if the results of ventilatory tests are normal disability is not present and if they are abnormal this is due to something other than simple pneumoconiosis.
 ...
PMID:Disability and coal workers' pneumoconiosis. 427 9


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>