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)

Two patients with closed rupture of the cervical trachea secondary to blunt trauma, one secondary to neck injury and the other secondary to thoracic injury, were analysed with those reported else where (58). Signs and symptoms included subcutaneous emphysema, respiratory distress, hoarseness/dysphonia, dysphagia, hemoptysis and so on. We conclude that: (1) the diagnosis of blunt trauma of the cervical trachea requires a high index of suspicion, since this injury can easily be overlooked; (2) tracheostomy is the best means of airway control; (3) good long-term airway quality is best obtained by immediate repair of injuries.
 ...
PMID:[Closed rupture of the cervical trachea]. 130 96

A retrospective review of 400 Chinese children who had inhaled foreign bodies was undertaken. There has been a yearly increase in the total number of cases of airway foreign bodies removed in our hospital. Fifty-eight percent of the children presenting were from the countryside; 42% were townspeople. Approximately 90% of the patients were under 3 years of age, with the peak incidence of foreign body inhalation occurring between 1 and 2 years of age (57.8%). The male-female ratio was about 1.2:1. About 95% of the removed foreign bodies were organic in origin. The majority of the foreign bodies were found most often in the right bronchial tree (46%). A positive history of foreign body inhalation was obtained in 98% of the cases. Twenty-eight percent of the children presented at the hospital within 24 hours, 71% within 1 week, and 29% more than 1 week after inhaling the foreign body. The most common presenting symptoms of laryngotracheal foreign bodies were cough, wheezing, dyspnea, and hoarseness; those of bronchial foreign bodies were cough, wheezing, decreased air entry, and rhonchi. More than two-thirds of the children with larygotracheal foreign bodies had normal x-ray findings. The most common fluoroscopic findings in those children with bronchial foreign bodies were mediastinal shift (36.8%), obstructive emphysema (35.7%), and normal findings (35%). A total of 348 (87%) bronchial foreign bodies were removed by rigid bronchoscopy (81%), rod-lens bronchoscopy (5%), and spontaneous expulsion (1%); 52 (13%) laryngeal and tracheal foreign bodies were removed by direct laryngoscopy (12%) and tracheotomy (1%). A single endoscopic procedure successfully removed 92.5% of 400 foreign bodies detected in the airways. One child died during bronchoscopy, for a mortality rate of 0.25%.
 ...
PMID:Inhalation of foreign bodies in Chinese children: a review of 400 cases. 204 47

A 70-year-old woman developed increasing dyspnoea and hoarseness without stridor. Bronchoscopy revealed the characteristic picture of a "rock-garden" with multiple whitish irregularly shaped nodules in the distal two third of the trachea, except the pars membranacea, involving the right-sided bronchial system to the origin of the lower-lobe bronchus, and the left main bronchus. The diagnosis of tracheobronchopathia osteochondroplastica was confirmed histologically: primary tracheobronchial amyloidosis was excluded. Tomography of the tracheobronchial tree demonstrated the findings, but a plain chest X-ray did not. The symptoms in this patient were not, however, caused by tracheobronchopathia osteochondroplastica but by concomitant pulmonary emphysema and acute laryngitis and were improved after symptomatic treatment of the laryngitis.
 ...
PMID:[Tracheobronchopathia osteochondroplastica]. 236 84

Minitracheostomy is a technique to assist in the removal of airway secretions while maintaining glottic function. A flanged, reclosable cannula 4.0 mm in internal diameter is inserted through the cricothyroid membrane into the trachea. Sixty procedures were performed in 56 patients from July 1988 to June 1989. Indications for placement included excessive postoperative secretions (46/60), difficulty with endotracheal suctioning (4/60), preoperative secretions (4/60), postpneumonic secretions (5/60), and acute airway obstruction (1/60). Successful intratracheal placement was possible in all instances, and the device was well tolerated. Major intratracheal bleeding necessitating endotracheal intubation occurred in 2 patients. Minor complications included local hematoma (5 patients), subcutaneous emphysema (2 patients), and hoarseness (1 patient). No deaths occurred. Cannulas remained in place for one day to 35 days. Removal resulted in closure within 48 hours. No adverse laryngeal effects were seen. A successful result, not requiring other invasive methods to remove secretions, was obtained in 43 (72%) of the 60 procedures. Minitracheostomy is a useful adjunct for secretion removal in the hospitalized patient.
 ...
PMID:Clinical experience with minitracheostomy. 236 85

A case of mediastinitis and left pyopneumothorax complicating a laryngeal phlegmon caused by Candida albicans is described. A 64-year-old woman was admitted complaining of pharyngeal pain, hoarseness, dysphagia, and pain behind the left angle of the mandible. In that hospital, she was diagnosed as having a laryngeal phlegmon. She was known to be diabetic and hypertensive since 54 years of age. After admission, she became dyspneic, and chest X-rays revealed left atelectasis, left pleural effusion and left pneumothorax. After a drain was inserted into the left thoracic cavity, she was transferred to our hospital. Chest X-rays showed widening of the mediastinum, an enlarged cardiac shadow, mediastinal emphysema, left pneumothorax and bilateral pleural effusion. A thoracic CT also showed extensive mediastinal emphysema. On March 19, 1988 we incised the abscess behind the left angle of the mandible and inserted drains into both the mediastinum and left thoracic cavity under general anesthesia. Candidiasis was diagnosed based on culture of pus obtained from the abscess behind the left angle of the mandible. She was treated with antibiotics intravenously and through both drainage tubes for about 1 month. She was cured and discharged after 5 months of hospitalization.
 ...
PMID:[Mediastinitis and left pyopneumothorax complicating a laryngeal phlegmon]. 262 14

The low incidence of blunt trauma to the cervical portion of the trachea limits management experience in most centers. Hence, we combined our patients with those in published reports containing essential information on injury, treatment, and results. Among 51 patients (93% male), ages ranged from 3 to 65 years. There were 32 complete transections, 15 partial transections, and four tears. There were associated injuries of the recurrent laryngeal nerve (49%), esophagus (21%), larynx (14%), and cervical spine (9%). Presenting signs and symptoms included subcutaneous emphysema in 84%, respiratory distress in 76%, hoarseness/dysphonia in 46%, and hemoptysis in 21%. Tracheostomy was the best means of airway control; 13 of 17 (76%) attempted oral/nasotracheal intubations failed, necessitating emergency tracheostomy. Five patients with no respiratory distress and minimal tissue injury were successfully managed without tracheal repair. Ten patients had tracheal repair without tracheostomy. The only poor result occurred in a patient with a treatment delay of several days. Tracheal repair with tracheostomy was used in 27 patients, with good results in 19. Two patients died of other injuries, and six patients (four with delayed repair) required subsequent tracheal reconstruction. Repair over a stent was used in seven patients, four of whom had satisfactory results. From this review we conclude that (1) the diagnosis of blunt trauma to the cervical trachea requires a high index of suspicion, since this injury can easily be overlooked; (2) tracheostomy (vs intubation or cricothyroidotomy) is the preferred means of airway control; (3) preoperative laryngoscopy/bronchoscopy should be done to assess vocal cord function, possible laryngeal damage, and level of tracheal injury; (4) good long-term results, measured by voice and airway quality, are best obtained by immediate repair of significant injuries.
 ...
PMID:Blunt injuries of the cervical trachea: review of 51 patients. 305 18

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

Forty-five newborn infants in respiratory failure with respiratory distress syndrome were treated with intermittent negative pressure ventilation (INPV). There was a survival rate of 38% (17/45).All infants were initially treated without nasotracheal intubation. However, 24 of these developed a Paco(2) greater than 70 mm. Hg and were subsequently intubated. Intubation was followed by a decrease in the degree of hypercarbia in each instance and simultaneous increase in Pao(2).COMPLICATIONS ENCOUNTERED DURING VENTILATION WERE: emphysema (one patient), aspiration pneumonia (two patients), septicemia (two patients), misplaced nasotracheal tube (one patient).Follow-up of the 17 surviving patients for periods of four to 36 months disclosed two patients with post-intubation hoarseness. One infant initially had spastic quadriplegia with EEG abnormalities, both of which cleared by 5 months of age. In the remaining 14 infants, the results of physical, neurological and psychological examinations have remained within normal limits.
 ...
PMID:Negative pressure artificial respiration: use in treatment of respiratory distress syndrome of the newborn. 526 98

Blunt and penetrating neck injuries are an infrequent cause of morbidity and mortality in the pediatric population. Although less common than penetrating injuries, blunt pediatric neck injuries are more often life-threatening because of associated laryngotracheal disruption. The authors reviewed their experience with pediatric neck injuries over the past 5 years. There were nine blunt and 14 penetrating injuries, representing 0.5% of the trauma admissions. There was no significant difference in age or gender distribution between the two groups. Blunt pediatric neck injuries were more often associated with frank respiratory distress at the time of presentation. Massive subcutaneous emphysema and hoarseness were the most common symptoms encountered. All patients with blunt injury underwent direct laryngoscopy and bronchoscopy (DL & B) and esophagoscopy. DL & B results were positive for eight patients; seven patients underwent neck exploration and successful repair of the laryngotracheal injuries. There were two deaths; one of these patients had laryngeal transection, which was not recognized at the time of DL & B. The other death resulted from associated tracheobronchial disruption secondary to massive blunt chest trauma. The patients with penetrating neck injuries were more likely to be treated nonoperatively, to have a shorter stay in the hospital and intensive care unit, and to have a lower injury severity score. There were no deaths in this group. The authors conclude that all patients with blunt neck trauma should undergo emergent and meticulous DL & B. Visualization of laryngotracheal disruption mandates immediate neck exploration and primary repair.
 ...
PMID:Laryngotracheal disruption from blunt pediatric neck injuries: impact of early recognition and intervention on outcome. 773 60

Thirty patients with external laryngeal trauma were analysed retrospectively. Injuries were mostly caused by motor vehicle accidents (car = 36.7 per cent; motorcycle = 23.3 per cent). The main presenting symptoms and signs were hoarseness, neck tenderness, dysphagia, and neck emphysema. Sites of laryngeal injury included arytenoid swelling, vocal fold injury, soft tissue contusion or superficial mucosal laceration, cricoarytenoid dislocation, thyroid fracture, epiglottic fracture and mixed injuries. Treatment was varied depending on the severity of the injuries. Sixteen cases were managed conservatively by medical treatment; two cases received intubation; four cases were treated initially by tracheostomy; eight cases received surgical repair and/or reconstruction; cases made a full recovery of the voice and 18 cases fair voice recovery due to either sustained vocal fold swelling or limitation of vocal fold movement. One case was graded as poor. Twenty-eight cases had good airway patency and two cases fair airway patency. A delay in the early detection of laryngeal trauma may precipitate into life-threatening airway problems, therefore prompt and accurate diagnosis should be followed immediately by skillful airway management.
 ...
PMID:Clinical analysis of external laryngeal trauma. 816 3


1 2 3 4 Next >>