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

Pneumothorax, pneumomediastinum and subcutaneous emphysema are potential complications of a variety of pediatric illnesses. A review by the authors confirms the reports of others that asthma is the primary medical cause of pneumothorax and subcutaneous emphysema and that a variety of inflammatory and obstructive lesions can be associated with extra-vasation of pulmonary air. Pneumothorax infrequently complicates asthma. Asthma-associated pneumomediastinum rarely requires vigorous therapeutic intervention and massive subcutaneous emphysema may necessitate tracheostomy. Pressurized delivery of sympathomimetic aerosols have been condemned by some as an unnecessary cause of iatrogenic air leak. The data of the authors indicate that this form of therapy rarely causes air leak syndromes. The pathophysiology of extravasation of pulmonary air is reviewed.
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PMID:Air leak syndromes as complications of respiratory disease in infancy and childhood. 59 76

A prevalence survey on the island of Karkar had previously shown that chronic lung disease was common in both sexes after the age of 35 years and that, in part, this was related to the smoking of home-grown air-cured tobacco. To investigate the nature of this chronic lung disease, 37 nontuberculous subjects with reduced ventilatory capacity (forced expiratory volume in one second less than 75% predicted) underwent clinical and lung function investigations. Ninety-two per cent had adventitiae, 62% had chronic productive cough and 54% had dyspnoea on exertion. Lung function tests showed an irreversible obstructive defect with a variable, but on average, only moderately reduced transfer factor. The chest radiography showed evidence of hyperinflation in 38% of cases but non had narrowing or loss of pulmonary vessels suggestive of emphysema. "Inflammatory changes" occurred in 35% and were associated with a mild but significant element of restriction. The results suggest that chronic bronchitis and chronic bronchiolitis were the main underlying abnormalities and that emphysema was comparatively unimportant. Asthma appeared to be relatively uncommon, especially in children. The clinical and lung function findings in 16 asthmatics were essentially similar to those observed in asthmatics elsewhere and the atopic status of asthmatics and controls was similar to that observed in developed societies. In common with Highland asthmatics however, the age at onset was in early adult life rather than in childhood.
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PMID:A clinical and lung function study of chronic lung disease and asthma in coastal Papua New Guinea. 105 71

This study has been compiled from the hospital records of 926 patients with chronic non-specific respiratory disease, i.e. asthma, chronic bronchitis and emphysema. The aims of the study were to ascertain the role of age, allergy, family history, cigarette smoking, social class and occupation in the genesis of these diseases, and to investigate aggravating factors and the morbidity associated with these diseases. Asthma was found to occur in the younger age groups, allergy and family history being the outstanding aetiological factors in this disease. In chronic bronchitis the age factor is not decisive, and the influence of allergy, family history and the smoking of cigarettes is evenly distributed. Emphysema occurs mainly in later life, although 2 cases of younger onset with alpha1-antitrypsin deficiency were noted. In this disease, allergy and family history appear to be of lesser aetiological importance than the smoking of cigarettes. The majority of patients in all diagnostic categories fell into social group III (skilled workers) and most did work not associated with dust. In each diagnostic category, a certain number of patients were found in whom the factors of allergy, family history, cigarette smoking and general atmospheric pollution did not play a part. In these patients the possible role of the microclimate at the place of work is emphasised and warrants further study. The high prevalence, especially of asthma and chronic bronchitis, among housewives is stressed. Aggravating factors, i.e. humidity, irritating substances, temperature variations, dust, and type and locality of work, are shown to influence the symptomatology of asthma, bronchitis and emphysema. These diseases have a high associated morbidity, resulting in the loss of working days and in early retirement for the sufferers.
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PMID:[Chronic non-specific respiratory disease with reference to 926 cases]. 114 76

Asthma and chronic obstructive pulmonary disease (COPD) are complex conditions with imprecise definitions which make definitive morphological comparisons difficult. Broadly, the airways in asthma are occluded by tenacious plugs of exudate and mucus, there is fragility of airway surface epithelium, thickening of the reticular layer beneath the epithelial basal lamina and bronchial vessel congestion and oedema. There is increased inflammatory infiltrate comprising 'activated' lymphocytes and eosinophils with release of granular content in the latter, and there is enlargement of bronchial smooth muscle particularly in medium sized bronchi. Three conditions contribute to COPD. In chronic bronchitis there is mucous hypersecretion with enlargement of tracheo-bronchial submucosal glands and a disproportionate increase of mucous acini. In small (peripheral) airways disease, there is inflammation of bronchioli, mucous metaplasia and hyperplasia, with increased intralumenal mucus, increased wall muscle, fibrosis and airway stenoses. Respiratory bronchiolitis is a critically important early lesion which may predispose to the development of centrilobular emphysema. The severity of destruction of alveolar wall in emphysema appears to be the most important determinant of chronic deterioration of airflow.
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PMID:Histological features of the airways in asthma and COPD. 157 25

Asthma and chronic obstructive pulmonary disease (COPD) are complex conditions with imprecise definitions, which make definitive morphologic comparisons difficult. Broadly, the airways in asthma are occluded by tenacious plugs of exudate and mucus, and there is fragility of airway surface epithelium, thickening of the reticular layer beneath the epithelial basal lamina, and bronchial vessel congestion and edema. There is increased inflammatory infiltrate comprising "activated" lymphocytes and eosinophils with release of granular content in the latter, and there is enlargement of bronchial smooth muscle, particularly in medium-sized bronchi. Three conditions contribute to COPD. In chronic bronchitis there is mucous hypersecretion with enlargement of tracheobronchial submucosal glands and a disproportionate increase of mucous acini. In small or peripheral airways disease, there is inflammation of bronchioli and mucous metaplasia and hyperplasia, with increased intraluminal mucus, increased wall muscle, fibrosis, and airway stenoses. Respiratory bronchiolitis is a critically important early lesion that may predispose to the development of centrilobular emphysema. The severity of emphysema, rather than type, appears to be the most important determinant of chronic deterioration of airflow, and in this there may be significant loss of elastic recoil prior to the observed morphologic destruction of the acinus.
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PMID:Morphology of the airway wall in asthma and in chronic obstructive pulmonary disease. 202 27

Asthma and chronic obstructive pulmonary disease (COPD), i.e. chronic bronchitis and emphysema are common. The pathological and clinical features of these diseases are described. Ventilatory function, lung volumes and 6-min walking tests are used to assess respiratory function while blood gas estimations are essential when managing respiratory failure. The causal mechanisms of respiratory failure are described. In COPD careful assessment with maximization of respiratory function is essential preoperatively. Continued smoking increases postoperative complications sixfold. Bronchial irritability, common in asthma and COPD, increases the anaesthetic risks while many anaesthetic agents adversely affect respiratory function. Postoperative pulmonary complications remain common particularly in COPD. The hypoxia occurring in the first 2 hours post-surgery is usually more pronounced in COPD. Careful postoperative monitoring with aggressive treatment of any complications is essential in these patients. Surgical treatment may significantly improve respiratory function in some patients with bullous emphysema.
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PMID:Obstructive airways disease in surgical practice. 268 19

The National Mortality Database of Statistics Canada was used to study chronic obstructive pulmonary disease (COPD) mortality trends between 1950 and 1984 by age, sex, birth cohort, and province. Provincial hospital statistics were combined for the period 1971 to 1984 to determine age-specific hospital separation rates for COPD. Utilization of physician services for COPD was determined for one province using physicians' claims for payment. Results of these analyses indicate that mortality from COPD has leveled off for men and is increasing for women; the trend is different for combined chronic bronchitis-emphysema and for asthma. Mortality from COPD varies by age, sex, birth cohort, and province. Mortality from COPD stopped increasing with the 1910 to 1914 birth cohort in men and the 1920 to 1924 in women. Male and female birth cohorts born after 1920 to 1924 have decreased mortality. It is speculated that the age-standardized mortality will decrease in the near future. Surveys of smoking habits over time support the hypothesis that a proportion of sex, birth cohort, regional, and socio-economic variation of COPD mortality is due to smoking. Hospital morbidity is higher for men than for women particularly for those more than 65 yr of age. Between 1971 and 1983, mortality/morbidity ratios were relatively stable. Asthma mortality and morbidity are increasing; changing concepts about the disease may be one reason for this observation.
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PMID:Morbidity and mortality from chronic obstructive pulmonary disease. 278 56

This report is an analysis of cases of obstructive lung disease diagnosed during the first 8 yr of a community study. Of 351 subjects who received a new diagnosis of asthma, emphysema, or chronic bronchitis from community physicians, 152 (44.5%) had a prior or concomitant diagnosis of another obstructive disease. Asthma developed most often in young subjects, emphysema in older subjects, and chronic bronchitis occurred in all age groups. Among older subjects, disease groups were surprisingly similar, with wheeze, dyspnea, and attacks of shortness of breath with wheeze all occurring frequently in diagnosed subjects, including those with emphysema. The majority of subjects who developed emphysema were males. In contrast, 72.8% of the asthma and chronic bronchitis subjects were females. These results suggest that physician bias may result in labeling male patients as emphysematous and female patients as asthmatic or bronchitic.
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PMID:Comparisons of asthma, emphysema, and chronic bronchitis diagnoses in a general population sample. 371 70

The diagnosis of chronic obstructive pulmonary disease covers a wide range of lung problems that have as their base the partial blockage of the smooth movement of air from the lungs during expiration. Asthma, simple bronchitis, chronic obstructive bronchitis, and emphysema are the diseases usually considered as chronic obstructive disease. Many of their multiple presentations are quite common in clinical medicine but are sometimes difficult to recognize. Once the inciting event is identified, it is often reversible.
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PMID:Clinical presentations of chronic obstructive pulmonary disease. 384 19

Expectoration of large, branching, bronchial casts, termed plastic bronchitis, is an uncommon condition in children. Asthma or allergy often is the cause of cast production, but in some instances no etiology is found. Five children produced large, obstructing bronchial casts that either were expectorated or were extracted at bronchoscopy. Four of the children had asthma or allergies and the fifth had congenital tricuspid atresia and chronic pericardial and pleural effusions. In two patients, expectorated casts initially were thought to be aspirated food material. Radiographic findings during periods of cast formation included atelectasis, obstructive emphysema, bronchiectasis, pleural effusion, and pneumomediastinum. Cast formation may be self-limited but generally ceases with appropriate treatment of the causative disorder. Bronchoscopic extraction of casts may benefit some patients.
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PMID:Plastic bronchitis: large, branching, mucoid bronchial casts in children. 387 Dec 86


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