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

In sixteen patients with upper airway obstruction, breathlessness was a symptom in all with maximum mid vital capacity flow rates in inspiration or expiration of 1-7 litres per second or less. With one exception, all these patients had stridor. The stridor was inspiratory in nine, expiratory in one and both inspiratory and expiratory in two. There was no diagnostic difficulty in the twelve patients with extrathoracic airway obstruction and in this group tests of inspiratory flow (forced inspired volume in one second, peak inspiratory flow or maximum mid inspiratory flow) were of most value in following the progression of the disease and the response to treatment. Flow volume loops were particularly useful where extrathoracic obstruction and diffuse intrapulmonary airway obstruction co-existed. The two patients with intrathoracic upper airway obstruction caused considerable difficulty with diagnosis and both were initially thought to have, and treated unsuccessfully for, asthma. In each patient flow volume loops showed a low flow expiratory plateau, diagnostic of severe intrathoracic airway obstruction but recorded in the absence of any clinical or radiographic features of emphysema. An obstructing lesion of the intrathoracic trachea was therefore suspected and this was confirmed by tracheal tomography. In one patient serial expiratory flow volume curves demonstrated the combination of intrathoracic upper and lower airway obstruction. Two patients had tracheal stenosis in the region of the suprasternal notch. Each showed a characteristic twin humped expiratory flow volume curve and in one patient the stenosis was demonstrated both physiologically and radiologically to move in and out of the thorax. The importance of a standard posture during serial measurements is emphasized. The ratio of forced expired volume in one second measured in millilitres, to the peak expiratory flow measured in litres per minute, was of limited value if differentiating upper from lower airway obstruction in these patients. It is concluded that upper airway obstruction is likely to become more common and that respiratory function tests, in particular the flow volume loop, play an essential part in the recognition and management of this problem.
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PMID:Upper airway obstruction--a report on sixteen patients. 100 57

A 65-year-old man was admitted to our hospital complaining of productive cough, dyspnea and stridor. Chest X-ray disclosed overinflation with micronodular infiltrates. Blood examination showed mild eosinophilia and IgE elevation. Pulmonary function test disclosed severe airway obstruction and diffusion capacity impairment. Although clinical improvement was achieved after bronchodilator therapy, laboratory abnormalities continued. Open lung biopsy demonstrated mononuclear cellular and eosinophilic infiltration at alveolar lumen and vessel walls without prominent fibrosis, which was compatible for prolonged eosinophilic pneumonia. From above findings, this case was thought as a prolonged eosinophilic pneumonia combined with pulmonary emphysema and bronchial asthma.
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PMID:[A case of prolonged eosinophilic pneumonia with pulmonary emphysema and bronchial asthma diagnosed by open lung biopsy]. 175 22

Thirty seven flexible bronchoscopies were performed in 33 infants in a neonatal intensive care unit, using a 2.2 mm flexible ultrathin bronchoscope. Twenty eight procedures were performed via an endotracheal tube or tracheostomy and nine in spontaneously breathing infants. Indications for endoscopy included persistent atelectasis and/or emphysema (n = 21), unexplained acute respiratory distress (n = 10), stridor (n = 3), assessment of congenital abnormalities of the tracheobronchial tree (n = 2), and follow up of an endobronchial granuloma during the course of corticosteroid treatment (n = 1). Abnormal airway dynamics and/or abnormal structure were seen in 23 of 37 cases. In 54% of the procedures, the results of bronchoscopy had a direct effect on further management. The procedure was well tolerated and completed in less than two minutes. Our results suggest that the ultrathin flexible bronchoscope improves airway exploration and the understanding of respiratory disorders during the first months of life, particularly in ventilated infants.
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PMID:Ultrathin flexible bronchoscopy in neonatal intensive care units. 177 81

Injury to the thoracic trachea is a potentially lethal condition in a patient with multiple injuries. Several clinical signs are commonly associated with this process: subcutaneous emphysema, aphonia, stridor, pneumothorax refractory to thoracostomy tube drainage, pneumomediastinum, and hemoptysis. The clinical appearance of tracheobronchial rupture may be delayed for hours or even weeks following injury. Standard treatment for disruption of the thoracic trachea is primary repair via a right thoracotomy. We describe a patient with a complex carinal injury following blunt thoracoabdominal trauma who was successfully managed with prompt surgical intervention.
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PMID:Carinal injury: diagnosis and treatment--case report. 194 57

Thirty consecutive patients undergoing lung resections were randomized into two groups: Group A (n = 15) received minitracheotomy postoperatively and group B (n = 15) were control patients. Postoperative respiratory course was monitored by serial clinical assessments, chest x-ray examination, arterial blood gases, sputa bacterial cultures, and the patient's requirement and response to chest physiotherpy. The two groups were similarly matched in age (mean 58.5 years), smoking habits, pulmonary functions, and surgical procedures. Postoperative pulmonary complications of collapse/consolidation developed in 11 patients (two in group A and nine in group B) (p less than 0.03). Four patients (all in group B) required nimitracheotomy in addition to antibiotics and chest physiotherapy to treat their pneumonia. Chest physiotherapy requirement was less in group A than in group B, with a mean number of sessions of seven in group A and eight in group B and a mean total time of 92 minutes in group A and 112 minutes in group B. The mean duration of minitracheotomy was 4.13 days. Minor temporary symptoms resulted from the minitracheotomy in eight patients (42%) and included discomfort, voice changes, subcutaneous emphysema, and stridor. There was one case of long-term morbidity (5%)-skin scarring from wound infection at the site of the minitracheotomy. No postoperative deaths resulted. We conclude that the prophylactic use of minitracheotomy is safe and effective in decreasing postoperative respiratory complications in patients undergoing lung resections.
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PMID:Prophylactic minitracheotomy in lung resections. A randomized controlled study. 202 47

Unilateral obstructive emphysema seen on chest X-ray in a pediatric patient is usually associated with a foreign body in a bronchus. We present a 31-month-old female who presented with a 2-week history of increasing expiratory stridor. Endoscopic examination revealed a polypoid mass in the right main bronchus. Biopsies and cultures were consistent with endobronchial tuberculosis. We review the presentation and treatment of tuberculosis in children. Endobronchial tuberculosis is a rare complication of pulmonary tuberculosis which may result in stenosis of the bronchus.
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PMID:Endobronchial tuberculosis in children. A case report and review. 208 21

The incidence rate and the clinical significance of inborn abnormalities of respiratory organs frequently are still underrated. In the clinic for paediatrics of the Medical Academy of Dresden malformations of respiratory organs, situated below the larynx, were demonstrated in 18 per cent of patients who had been referred hither in the course of 20 years for bronchopulmonary diagnostics. The clinical symptoms are very different and often uncharacteristic. Not seldom malformations of that kind first of all remain silent till a superinfection or a striking roentgenogram will arise the suspicion on a malformation. Following symptoms may refer to: permanent or intermitting stridor in the stenoses of the large respiratory tract (trachea and main bronchi), that is diagnosed as the most frequent anomaly. In nearly 80 per cent of the patients suffering from stenoses of a main bronchus symptoms of a recurrent or chronically obstructive bronchitis stood in the foreground. Mostly a tachy- and a dyspnoe are the leading symptoms in case of a connatal lobar emphysema, the most frequent anmaly of the pulmonary parenchyma followed by the pulmonary hypolasia and -agenesis. Chronic or relapsing pneumonias respectively a persisting cough may appear as symptoms in pulmonary sequestrations and in isolated anomalies of the bronchial aborization that otherwise in the majority of the cases will rest clinically mute. The long-term prognosis for children suffering from stenoses in the main bronchis is compared with those of tracheal stenoses relatively satisfactory.
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PMID:[Clinical significance of the most important abnormalities of respiratory organs]. 221 21

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.
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PMID:[Tracheobronchopathia osteochondroplastica]. 236 84

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.
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PMID:Foreign body aspiration in childhood. 338 Jul 39

This case describes the development of subcutaneous emphysema following restorative dentistry performed under general anesthesia. Initial treatment consisted of intravenous epinephrine and dexamethasone due to difficulty in breathing and laryngeal stridor. Dexamethasone and other adjunctive drugs were administered over the 4 days following surgery while the symptoms subsided. The author emphasizes the importance of early recognition and prompt management in managing this unusual complication.
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PMID:Subcutaneous emphysema. 386 64


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