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

The advances in modern neoplastic therapie are benefitting more and more even older aged patients. The equality of chances for these patients is reached by general rehabilitation. The special problem of the therapy for older aged patients is their multi-morbidity. Besides the cancer exist for instant: malcirculation, emphysema, neurologic diseases and psychical defects. For all those diseases one has to take care within the rehabilitation. Beside consequently treated immuno-chemotherapy, modern surgical treatment, extinction of pain and mobilisation of the patients, the therapy of the patients psychical conditions is very important. For this the modern knowledge of group-therapy has it's special orientated engagement.
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PMID:[The rehabilitation therapy for older aged neoplastic patient (author's transl)]. 3 11

A 66-year-old patient developed a retropneumoperitoneum and pneumomediastinum after a proctoscopy. Following the examination, which was done as an out patient, he had some pain but was able to reach home without difficulty. Radiography of the abdomen on the next day showed definite gas collection round the right kidney and below the middle of the diaphragm. The mediastinum showed some translucencies consistent with cranial spread of air from the retropneumoperitoneum; it was particularly marked round the aorta. The film also showed supraclavicular emphysema. After being placed supine the patient's symptoms rapidly disappeared. There were no complications and no treatment was necessary. The case is discussed in relation to the relevant literature.
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PMID:[Retropneumoperitoneum and pneumomediastinum following proctoscopy (author's transl)]. 15 32

Spontaneous pneumomediastinum is a relatively rare disease, the clinical signs of which may be misleading, and the physiopathology is still unknown. The authors report 7 cases collected over a period of 3 years and note the etiology, the clinical findings and the X-ray findings. The disease often affectsyoung sybjects, without any sex predominance. The initial symptom is thoracic pain and is often accompanied by dispnea. Subcutaneous emphysema only appears secondarily and may be mild. The association with pneumothorax is not rare. Among the etiological circumstances, pneumomediastinum often occurs after an effort or a respiratory infection with dyspnea. The diagnosis depends on the discovery of subcutaneous emphysema and on radiological signs in A.P. and lateral chest views. Treatment should be as conservative as possible in the usual benign forms. It should be limited to bed rest, analgesics and sedatives. In severe cases, supra-sternal drainage permits decompression of the mediastinum. The physiopathological mechanisms are discussed, but the usually accepted theory is rupture of an alveolus into the pulmonary interstitial tissue. The pressure gradient necessary for this rupture may be due to variations in alveolar or vascular pressure.
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PMID:[Spontaneous pneumomediastinum]. 17 Jun 84

Perforation of the esophagus is a very serious condition which is nearly always fatal, unless it can be diagnosed and treated at the earliest possible moment. Ten thousand case histories in a Department of Internal Medicine and a Department of Surgery were reviewed, among which 12 cases of esophageal perforation were found. The overall mortality in this series was 59 percent; the mortality of the surgically treated group was 39 percent. Four of the five patients operated on within the first 24 hours survived. The prognosis was poor when the lower third of the esophagus was ruptured. Esophageal perforations are becoming increasingly more frequent because of the widespread practice of endoscopy. The clinical symptoms of the condition include subcutaneous emphysema, retrosternal pain and dispnea. X-rays often show air or fluid in the mediastinum, air and fluid in the pleural space, and evidence of rupture when opaque contrast material is employed. These signs should usually by sufficient for an early diagnosis. Surgery is the treatment of choice.
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PMID:[Perforation of the esophagus. A review of 12 cases (author's transl)]. 54 26

Since it is relatively rare, spontaneous pneumomediastinum is often little known to clinicians. Making the diagnosis, however, presents no problem if the three essential signs are present, that is to say: -subcutaneous emphysema of the base of the neck (7 cases), -Hamman's sign, (6 cases), -a paramediastinal air shadow on chest roentgenograms, (8 cases). The condition is brought about by rupture of perivascular alveoli resulting in the migration of air along the pulmonary vessels. The principal advantage of making the diagnosis is that it enables one to eliminate other pain-causing thoracic syndromes, especially myocardial infarction, pulmonary embolus and acute pericarditis. The clinical course is usually benign necessitating no treatment.
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PMID:[Spontaneous pneumomediastinum in adults. 10 cases (author's transl)]. 67 52

The healthy or previously damaged pulp responds to most of the drugs currently applied to the dentin with an inflammatory reaction. By means of a standardized biological screening test, the modes of action of hydrogen peroxide and of Falikain preparations are demonstrated on the pulp of the rat incisor. Hydrogen peroxide produces an emphysema of the pulp tissue associated with a slowing of the circulation and partly irreversible capillary stases, whereas Falicain compound preparations (Falicid, Myrex) cause, by way of haemolysis, injuries involving entire areas of the pulp. For this reason, hydrogen peroxide should not be used for cleaning cavities. Myrex is well suited for symptomatic treatment to relieve pain, if removal of the inflamed pulp ensues.
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PMID:[Reactions of the pulp-dentin system to drugs]. 106 48

Laparoscopic cholecystectomy (LSC) was attempted in 30 patients and was accomplished in 29 during the nine months between March and November 1991. Twenty eight patients had cholelithiasis with or without adenomyosis, and two had adenomyosis of the gall-bladder. Mean operative time was 219 min and postoperative pain was slight. Two complications (6.9%), including necrosis of the common hepatic duct and subcutaneous emphysema, were encountered. Patients with subacute and severe chronic cholecystitis were included in the cases. Thus this technique is recommended for almost all patients who require the removal of the gall-bladder for benign diseases.
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PMID:Laparoscopic cholecystectomy report of 30 cases. 128 75

Fifty-six patients presenting with infertility (17); bleeding, pain, and pressure symptoms (32); and pelvic mass (seven) associated with leiomyomas were managed with laparoscopic myomectomy. Twenty-four second-look procedures were performed to evaluate healing and adhesion formation. Operative time ranged between 45-443 minutes (mean 157), estimated blood loss varied from 10-400 mL (mean 75), and the mean length of hospital stay was 1 day. Traditional morcellation was used initially but was abandoned because of long operating time; vaginal or abdominal removal (depending on size) proved more satisfactory. Three patients developed subcutaneous emphysema and one had febrile morbidity due to upper respiratory tract infection. There were no other complications. In 24 second-look procedures, adhesions were present in 16 subjects (66%). Twelve of 17 in the infertility group conceived (71%); all 39 patients with other complaints experienced satisfactory relief. There were no reoperations. When myomectomy is indicated, the laparoscopic approach appears to offer an alternative to abdominal surgery in selected patients.
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PMID:Laparoscopic myomectomy. 140 34

Pneumomediastinum is a rare pathological condition with air in the mediastinum outside the trachea and oesophagus. The etiology may be spontaneous/resulting from exertion, traumatic, iatrogenic or it may be due to inflammation, neoplasm or perforation of a hollow abdominal organ. In pneumomediastinum resulting from exertion, a pressure gradient occurs and this causes rupture of marginally situated pulmonary alveoli. Air escapes from the alveoli into the perivascular adventitia and dissects its way along the vessels to the mediastinum. The commonest symptoms are pain in the thorax in 80-90% of the patients, followed by sensation of oppression and dysphagia. Stethoscopic examination reveals crepitation synchronous with pulse and respiration in half of the cases. The diagnosis is verified by radiographic examination of the thorax where air can be seen as vertical radio-translucent regions in the mediastinum and along the borders of the heart. Patients with pneumomediastinum should be admitted to hospital for investigation as treatment of a possible basic condition, e.g. rupture of the oesophagus or bronchus, is important. In uncomplicated cases, the mediastinal emphysema disappears in the course of a week. Mediastinotomy with incisions for relief of pressure may prove necessary.
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PMID:[Pneumomediastinum]. 150 65

Between 50 to 60% of all polytraumatized patients have a thoracic injury with a mortality of 30 to 60%. The first diagnostic steps involving symptoms such as in- or expiratory pain, emphysema of the skin, flail chest or sipping noise lead via clinical examination to first and often definitive therapeutic procedures, i.e. intubation, artificial respiration and insertion of chest tube. X-ray of the chest, computed tomography as well as ultrasonic screening and monitoring of arterial blood gases are important in in-door technical diagnosis. The decision for emergency room thoracotomy or a regular or delayed operation has to be made at times. Complications (20%) to consider are pneumo- and haematothorax, pleural rind, pneumonia, broncho-pleural fistula and most of all pleural empyema.
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PMID:[Lung injuries: diagnosis and surgical strategy]. 198 16


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