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

Congenital lobar emphysema is mainly seen in new-born and young babies. In the first hours or days, symptoms appear such as dyspnea, cyanosis, tachypnea, wheezing, thoracic and epigastric retractions. Later symptoms are faintness, psychomotoric retardation and malformation of the thorax. Etiology and pathogenesis of this emphysema of individual parts of the lung are unclear. The course is paroxysmatic, persistent or chronic. Preferred therapy of choice is the resection of the parts concerned. After operation the prognosis is good.
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PMID:[Congenital lobar emphysema]. 722 6

The role of genetic or familial factors in the development of bronchopulmonary dysplasia (BPD) has not been evaluated. Detailed histories concerning asthma, allergy, and other lung diseases were obtained on first and second degree relatives of 17 infants with BPD, and 21 infants who had hyaline membrane disease but who did not develop BPD (HMD group). All infants in the BPD and HMD groups had hyaline membrane disease requiring assisted ventilation and greater than 50% inspired oxygen in the first five days of life. The diagnosis of HMD and BPD were made on radiographic and clinical criteria. Of the 17 infants with BPD, 13 had first or second degree relatives with physician-diagnosed asthma, compared to seven of 21 in the HMD group (P less than .01). In addition, a significantly greater number of relatives of BPD infants (P less than .005) had been hospitalized for their asthma as compared to HMD relatives. There were no differences between the groups for allergic rhinitis, eczema, bronchitis, emphysema, chronic cough, smoking, or wheezing with respiratory illnesses. These results suggest the possibility that airways with a genetic predisposition for reactivity may become highly reactive following neonatal lung disorders and their treatment. These irritable airways may then contribute to the development, or progression, or both of BPD.
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PMID:Family history of asthma in infants with bronchopulmonary dysplasia. 737 38

Emphysema, chronic bronchitis, asthma, and cystic fibrosis are often cited as examples of chronic airways obstruction, while sarcoidosis is typically restrictive. Approximately 15 percent of sarcoidosis patients, however, have airways obstruction clinically characterized by wheezing with granulomatous involvement of airways. Since the majority have Stage IV disease by chest radiograph, their lungs usually have honey-combining with pulmonary fibrosis, adhesions, cavities, and mediastinal distortion.Patients had a mixed ventilatory defect, but obstruction of large airways was present as shown by decreased specific airways conductances. Small airways obstruction was also present as shown by low instantaneous flows at the terminal portion of the maximum expiratory flow-volume curve and diminished helium response of this curve. The closing volume, however, was not very sensitive. Radioactive xenon washout from ventilation lung scans and N2 washout from the lungs were prolonged in patients with worse disease.The authors conclude that the obstructive type of physiologic pattern is more frequent than recognized in sarcoidosis, which like that of cystic fibrosis has some restrictive element and is characterized by poor reversibility to bronchodilators. A trial period of beclomethasone dipropionate aerosol was not helpful in two patients. Relief of this distressing airways obstruction continues to pose a challenging problem in management.
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PMID:Chronic airways obstruction in pulmonary sarcoidosis: its poor response to bronchodilators. 742 Apr 39

Of the twenty-three employees at a pharmaceutical plant manufacturing a new product containing papain, twelve had respiratory symptoms of cough, wheezing, dyspnoea, or chest paint. Most were studied with in-depth interviews by a doctor, extensive pulmonary function tests, and immunoserological tests for IgE and precipitating antibodies specific for papain, as well as total IgE antibodies to common natural allergens. There were significant correlates (all P values < 0.05) between the presence of specific IgE antibodies to papain and decreases of FEV1, FEF75--85, TLC, RV, and response to bronchodilators as percentage change from baseline for all spirographic flow rates. Atopic workers developed pulmonary symptoms and antipapain antibodies significantly sooner after papain exposure than did the others. Duration of exposure had no effect on symptomatology, pulmonary function, or immunological response. However, those judged to have the greatest amount of dust exposure per work-day had significantly more pulmonary symptoms (P < 0.005). Papain produced lung diseases by acting as an inhalant allergen rather than a proteolytic enzyme. Papain is a potent sensitizer in humans for the production of respiratory disease. The pulmonary reactions, based on physiological data, seem to involve small airways, alveolar, and interstitial lung tissue in an inflammatory rather than destructive manner, and thus resemble bronchitis and interstitial lung disease rather than pulmonary emphysema or typical bronchial asthma.
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PMID:Pulmonary disease in workers exposed to papain: clinico-physiological and immunological studies. 746 Feb 65

In 1985, 864 patternmakers participated in a voluntary union-sponsored health screening program that included an evaluation of respiratory symtomatology and dysfunction. Pulmonary function test (PFT) measurements included a minimum of three readings of forced expiratory volume at 1 second (FEV1). A "reliable" test was one where the two best volumes were within 5%. Medical history and respiratory symptoms were assessed on a standardized questionnaire. Fifty-nine of the 864 tested were unable to reproduce their best FEV1 result. Although these 59 case subjects had significantly lower PFT results than the other 805 tested (P < .01), the mean values for FEV1 and forced vital capacity for the case subjects were greater than 90% of predicted values. The case subjects were more likely to experience wheezing and dyspnea and have a history of emphysema than the rest of the group screened (n = 805). They also had a higher mean age and more years in the trade. Twenty-one of the 59 case subjects were among the 602 who participated in a similar health screening program offered 3 years later. To minimize the effects of age and smoking status on PFT performance, these 21 case subjects were each matched on age and smoking with two comparison subjects who had reliable tests. At follow-up, the 21 case subjects and 41 comparison subjects both had a decline in ventilatory capacity that was significantly greater than would be expected by advancing age alone. A number of methodological issues that impact the interpretation of these data are discussed.
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PMID:Significance of the inability to reproduce pulmonary function test results. 807 30

Spirometry was performed by 5,201 elderly participants of the Cardiovascular Health Study during their baseline examination and a subset of the ATS/DLD-78 respiratory questionnaire was administered by trained interviewers. In never smokers (46 percent of the cohort), the overall prevalence of chronic cough was 9 percent, chronic phlegm was 13 percent, attacks of wheezing with dyspnea were 8 percent, and grade 3 dyspnea on exertion was 10 percent. The prevalence of lung disease in current smokers (12 percent of the cohort) was 8/7 percent (men/women) with chronic bronchitis and 14/5 percent with emphysema. Overall, 6 percent reported asthma (a physician-confirmed history) and 12 percent reported hay fever. Using a logistic regression model, attacks of wheezing with dyspnea were strongly associated with a lower FEV1, coronary heart disease, heart failure, and a large waist size (in participants without a diagnosis of asthma, chronic bronchitis, or emphysema). Undiagnosed airways obstruction was twice as likely in women and those with lower income, and was associated with current and former smoking, pack-years of smoking, and chronic cough. Dyspnea on exertion (DOE) was three times or more likely if a participant reported heart failure, coronary heart disease, or emphysema; and much more likely if their FEV1 or FVC was substantially reduced. Dyspnea on exertion was also positively associated with older age, chronic bronchitis or asthma, a larger waist or hip size, pack-years of smoking, and less education. We conclude that DOE and attacks of wheezing with dyspnea are commonly associated with cardiovascular disease and a low FEV1 in those over 65 years and that airways obstruction frequently remains undiagnosed in the elderly.
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PMID:Prevalence and correlates of respiratory symptoms and disease in the elderly. Cardiovascular Health Study. 808 66

Cardiovascular disease (CVD) is more prevalent in elderly than in middle-aged patients. Symptoms such as intermittent wheezing with dyspnea may then be due to either CVD or asthma. The objective of this study was to determine the prevalence and correlates of asthma in the elderly and their associations with CVD and CVD risk factors. A community sample of 5201 elderly persons from the Cardiovascular Health Study was asked if they had a physician diagnosis of asthma, and multiple cardiovascular risk and disease variables were measured. Six percent of the participants (309) recalled a history of asthma, and half of these were never smokers. Thirty percent of those with asthma were currently taking a bronchodilator, 14% inhaled steroids, and 10% oral prednisone. Men and women with asthma who were cigarette smokers were more likely to report a concurrent diagnosis of congestive heart failure than smokers without asthma (p = .04). However, when we determined the independent CVD correlates of asthma in this cohort, controlling for smoking status, age, gender, and diagnoses of chronic bronchitis and emphysema, only higher levels of high-density lipoprotein cholesterol (HDL-C) and higher plasma fibrinogen levels were significantly associated with asthma. It was concluded that asthma is as prevalent in the elderly as in middle-aged persons and is associated with higher HDL-C and higher fibrinogen levels, but not with prevalent cardiovascular disease.
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PMID:Asthma and its association with cardiovascular disease in the elderly. The Cardiovascular Health Study Research Group. 862 70

The performance of the self-organizing map (SOM), an artificial neural network, was evaluated in the classification of lung sounds. Patients with asthma (n = 8), emphysema (n = 8) and fibrosing alveolitis (n = 8), and patients with healthy lungs (n = 8) were selected for the study. Fast Fourier transform (FFT) spectra from midinspiratory breath sounds recorded at the right lower lobe area were used to construct feature vectors in the learning and classification process of SOM. The sound segments did not contain wheezing sounds. The lung sounds of 25/32 (78%) patients were classified correctly, with an overall kappa (kappa) value of 0.71. The agreement between the clinical and proposed diagnoses based on classification of lung sounds was good among patients with emphysema (kappa = 0.92) and those with healthy lungs (kappa = 0.83), but only moderate among patients with asthma (kappa = 0.52) and fibrosing alveolitis (kappa = 0.54). This is due to the limitations in distinguishing breath sounds of asthmatics without wheezing sounds from those with crackles in fibrosing alveolitis by the spectral pattern alone. The results indicate that SOM based on FFT spectra is potentially useful in the classification of lung sounds, e.g. in health screening or in differential diagnosis of pulmonary disorders. To enhance the performance of SOM, other features of lung sounds should be combined with FFT spectra.
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PMID:Classification of lung sounds in patients with asthma, emphysema, fibrosing alveolitis and healthy lungs by using self-organizing maps. 896 30

Anticholinergic drugs have been reported to be effective in pulmonary emphysema. We studied the effects of the anticholinergic drug oxitropium bromide on exercise capacity and lung function in patients with this disease. We studied 11 men and 1 women, aged 69.3 +/- 4.5 yrs, in whom chest radiography showed pulmonary emphysema. Before and after the subjects inhaled two puffs of oxitropium bromide, they walked in a corridor for 12 minutes, and the distance they walked and spirometric data were recorded. FVC and FEV1 were significantly higher after inhalation of the drug. FEV1% did not change, and the distance walked increased slightly. We also studied symptoms and peak expiratory flow rate in 37 patients with pulmonary emphysema before and after the start of therapy with inhaled oxitropium bromide. Symptom scores of wheezing and sleep improved, and peak expiratory flows increased significantly. We conclude that inhaled oxitropium bromide can improve lung function and slightly increase exercise capacity in patients with pulmonary emphysema. These effects may be caused by bronchodilation-induced increases in FEV1 and FVC. Monitoring of peak expiratory flow in patients with pulmonary emphysema may be useful for evaluating the clinical effectiveness of oxitropium bromide.
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PMID:[Effects of oxitropium bromide on exercise and lung function in patients with pulmonary emphysema]. 907 Nov 54

In the present work 92 patients were studied all of whom had inhaled a foreign body (FB) into one of the tracheobronchial branch. The following factors were evaluated: sex, age, nature of the FB, localization in the respiratory tree, clinical symptoms, radiological findings, time lapse between diagnosis and removal. The peak incidence (61.9%) was in children under 3 years of age with a male-female ratio of 2:1. The most frequently inhaled FBs were of organic nature (31.5%); of these 58.6% were peanuts. The time lapse between inhalation and removal of the FB was as follows: in 20.5% the object was removed within 24 hours; in 66.4% within one week; in 12% in more than a week; and in 1.1% it took more than 8 weeks. In 53.2% of the cases the right bronchial branches were involved while in 28.2% the left side was affected. The most frequent symptoms were coughing (73.9%), wheezing (69.5%), dyspnea (51%) and fever (17.3%). Radiography detected the FB in only 7 cases (8.7%); in the remaining cases only indirect signs of the FB could be found: atelectasia (11.9%), emphysema (19.5%), cardio-mediastinic shift controlateral to the FB (10.8%). As regards complications, only 6 patients showed signs of slight endobronchial bleeding, 2 cases showed a pneumothorax and one other patient required a tracheotomy because of the particular shape of the FB which proved unable to pass backward through the glottis. In all cases the FB was removed using stiff bronchoscopy under either local or general anesthesia. The authors feel that, even if no clinical signs are found and radiography proves negative, one must always consider the possibility of a FB in the tracheal-bronchial branches, particularly in patients within the age range most at risk (under 3 years) and in those having a highly suspicious clinical history. In addition, the authors assert that the use of corticosteroids before and after the bronchoscopy markedly decreases the incidence of post-operative subglottic edema which would require an emergency tracheotomy.
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PMID:[Inhalation of foreign bodies: epidemiological data and clinical considerations in the light of a statistical review of 92 cases]. 941 54


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