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Query: UMLS:C0392680 (shortness of breath)
 5,217 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report two children who presented with cough and shortness of breath 7-8 months after a matched sibling stem cell transplant (SCT) for chronic myelogenous leukemia and myelodysplastic syndrome, respectively. Pulmonary function tests (PFTs) revealed severe airways obstruction (AO). However, radiographic investigations showed no serious abnormalities in the early phase and open lung biopsy revealed only mild lymphocytic bronchiolitis and bronchiolitis obliterans consistent with pulmonary graft-versus-host disease (GVHD). Despite administration of bronchodilators and various immunosuppressive agents obstructive lung disease progressed to pulmonary failure in patient 1, whereas stabilization of the clinical course was observed in patient 2. Serial PFTs were the best predictor of the clinical course in contrast to radiographic and histologic findings. It is concluded that PFTs should be performed repeatedly in pediatric patients after allogeneic SCT with the aim of diagnosing GVHD-associated AO in the subclinical phase. Progressive post-transplant AO necessitates prompt initiation of intensive immunosuppressive therapy in order to stop the underlying immunopathologic process even in the absence of severe radiographic and histologic findings.
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PMID:Discrepancy of clinical, radiographic and histopathologic findings in two children with chronic pulmonary graft-versus-host disease after HLA-identical sibling stem cell transplantation. 982 80

To succeed, startup enterprises need both passion and good management. But entrepreneurs can be famous for their visionary ardor and still be lousy managers. Traditionally, the key to long-term growth is getting the company founder to step aside so professional management can take over. Sometimes, however, this means abandoning a company's greatest asset in order to improve its procedures. A better solution is for the entrepreneur to learn to manage. Kye Anderson had motivation to spare. When she was 13, her 47-year-old father suffered recurrent shortness of breath followed by a massive heart attack. For her, the result was a single-minded career in medical technology and the development of innovative systems for diagnosing heart-and-lung disease. She had the zeal and determination it took to sell her ideas to investors and doctors, found a company, and grow it. But then, on the grounds that she lacked the financial and managerial expertise to carry her business from exuberant adolescence to profitable maturity, she stepped aside. A year and a half later, Anderson came back. She picked new board members who could act as entrepreneurial mentors. She reasserted certain original core values such as the importance of R&D and the emphasis on the patient as the ultimate customer. She discarded business lines that had strayed too far afield, and she learned how and what to delegate. Most important of all, Anderson realized that a leader's greatest obligation is to preach, and she began to spend much of her time communicating with her own employees about the purpose, mission, values, and strategy that could carry the company into a billion-dollar primary-care market.
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PMID:The purpose at the heart of management. 1011 3

Spontaneous pneumomediastinum (SPM) is defined as pneumomediastinum in the absence of an underlying lung disease. It is the second most common cause of chest pain in young, healthy individuals (< 30 years) necessitating hospital visits. It is surpassed in frequency in this setting only by spontaneous pneumothorax. These two conditions may coexist in 18% of patients. The incidence of spontaneous pneumomediastinum varies in different communities and generally is relatively uncommon. Inhalational drug use (cocaine and cannabis) have been associated with a significant number of cases, although cases with no apparent etiologic or incriminating factors are well recognized. Also its recurrence, though uncommon, is worthy of note. It is a benign clinical condition with diverse clinical presentations. Physicians' knowledge of the presentation, treatment, and prognosis of SPM will guard against the need for expensive radiologic and laboratory tests. The differential diagnosis of chest pain, shortness of breath, and dysphagia include cardiac, pulmonary, and esophageal diseases. The tendency to pursue these entities may lead to laboratory investigations such as electrocardiograms, arterial blood gases, ventilation/perfusion scans, and contrast radiographic studies of the esophagus.
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PMID:Spontaneous pneumomediastinum in an 18-year-old black Sudanese high school student. 1038 62

Diffuse panbronchiolitis (DPB) is an important cause of progressive obstructive lung or chronic suppurative lung disease in the Far East (Japan, China and Korea). It is a distinctive sinobronchial syndrome with typical radiological and histologic features. We have identified three patients who have typical clinical manifestation and pathological confirmation. DPB should be suspected in patients who have clinical manifestations of chronic cough, productive sputum and shortness of breath. The chest radiograph often shows diffuse nodular shadows on a background of hyperinflated lungs. High resolution computed tomographic (HRCT) can guide the diagnosis and differentiate from other diseases. Finally, the most important issue of DPB is the treatment. Chronic treatment with low-dose erythromycin can improve the survival of patients.
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PMID:Diffuse panbronchiolitis, the first case reports in Thailand. 1051 94

After spinal cord injury (SCI), breathlessness during daily activities is common. In 308 individuals with SCI, the authors measured pulmonary function and administered a survey regarding health status, participation in wheelchair athletics, and breathlessness during different activities. The following questions were included: A. Are you troubled by shortness of breath when hurrying on the level or going up a slight hill?; B. Do you have to go slower than people of your own age on the level because of breathlessness?; C. Do you ever have to stop for breath when going at your own pace on the level?; and D. Do you ever have to stop for breath after going about 100 yards on the level? The analysis was restricted to 183 subjects with neurologically motor complete or incomplete SCI who, to get around, used hand-propelled wheelchairs more than 50% of the time. Of these, 56 (31%) reported breathlessness during some types of activities. Subjects with neurologically motor complete cervical or high thoracic SCI (T-6 and above) were more likely to report breathlessness than others (39% compared with 25%, p = .039). Among wheelchair athletes, the prevalence of breathlessness was 8/49 (16%) versus 48/134 (36%) for non-athletes (p = .011). Adjusting for smoking, neurological level, and history of obstructive lung disease, non-athletes were 2.3 times more likely to report breathlessness than athletes were (p = .049 to .075, depending on regression model). This relationship persisted when adjusted for percent predicted forced expiratory volume (FEV1) and maximal expiratory and inspiratory pressures. Therefore in SCI, wheelchair athletes are less likely to report breathlessness than non-athletes, but the mechanism does not appear to be improvement in respiratory muscle performance or pulmonary function.
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PMID:Breathlessness and exercise in spinal cord injury. 1075 Nov 34

Air pollution produces adverse health effects. The consequences of lifelong daily exposures to atmospheric pollutants upon the respiratory apparatus of healthy children are of considerable clinical importance. We investigated the association between exposure to a highly polluted urban environment with a complex mixture of air pollutants-ozone and particulate matter the predominant ones-and chest x-ray abnormalities in 59 healthy Mexican children who are lifelong residents of Southwest Metropolitan Mexico City (SWMMC), with a negative history of tobacco exposure and respiratory illnesses. Their clinical results and x-ray findings were compared to those of 19 Mexican control children, residents of a low-pollution area, with a similar negative history of tobacco exposure and respiratory illnesses. Ozone concentrations in SWMMC exceeded the U.S. Environmental Protection Agency (U.S. EPA) National Ambient Air Quality Standard (NAAQS) for O(3): 0.08 ppm as 1-h maximal concentration, not to be exceeded more than 4 times a year, on 71% of days in 1986 and 95% in 1997, with values as high as 0.48 ppm. Ozone maximal peaks are usually recorded between 2 and 5 pm coinciding with children's outdoor physical activities. Children in the control group reported no upper or lower respiratory symptomatology. Every SWMMC child complained of upper and/or lower respiratory symptoms, including epistaxis, nasal dryness and crusting, cough, shortness of breath, and chest discomfort. Children aged 7-13 yr had the most symptomatology, while 5- to 6-year olds and adolescents with the lowest number of statistically significant outdoor exposure hours had less respiratory symptoms. Bilateral symmetric mild lung hyperinflation was significantly associated with exposure to the SWMMC atmosphere (p = .0004). Chronic and sustained inhalation of a complex mixture of air pollutants, including ozone and particulate matter (PM), is associated with lung hyperinflation, suggestive of small airway disease, in a population of clinically healthy children and adolescents. Small airways are a target of air pollutants in SWMMC children, with ozone and PM being most likely responsible, based on experimental animal, controlled-chamber, and epidemiological data available. Our main concern is the potential likelihood for the development of chronic lung disease in this highly exposed population.
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PMID:Exposure to air pollution is associated with lung hyperinflation in healthy children and adolescents in Southwest Mexico City: a pilot study. 1088 Jan 43

Dyspnea (shortness of breath, breathlessness) is a major and disabling symptom of heart and lung disease. The representation of dyspnea in the cerebral cortex is unknown. In the first study designed to explore the central neural structures underlying perception of dyspnea, we evoked the perception of severe 'air hunger' in healthy subjects by restraining ventilation below spontaneous levels while holding arterial oxygen and carbon dioxide levels constant. PET revealed that air hunger activated the insular cortex. The insula is a limbic structure also activated by visceral stimuli, temperature, taste, nausea and pain. Like dyspnea, such perceptions underlie behaviors essential to homeostasis and survival.
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PMID:Breathlessness in humans activates insular cortex. 1092 55

Cold causes cardiopulmonary stress often perceived as shortness of breath or chest pain, and causes exacerbation of these symptoms in persons suffering heart or lung disease. We investigated the prevalence of these symptoms and their association with sex, age and cold exposure in a population-based sample of 1,785 persons who lived in three areas of Finland. The exposure to cold was measured by the annual number cold days (mean daily temperature below 0 degree C) in the resident locality and weekly hours spent in the cold in winter. Shortness of breath was 25% and chest pain 52% more common in females than in males, and their prevalence increased by 24% and 77%, respectively, for every 10 years of age. The prevalence of shortness of breath increased by 5% and chest pain by 6% for every 10 cold days in the resident locality, and by 6% and 7% for every 10 hours spent in the cold, respectively. We suggest that environmental cold, measured by the number of cold days throughout the year and weekly hours spent in the cold, may provoke cardiopulmonary symptoms independent of sex and age.
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PMID:Dependence of cold-related coronary and respiratory symptoms on age and exposure to cold. 1120 70

Screening for lung disease in workers with a low prevalence of chronic obstructive pulmonary disease (COPD) is subject to debate. Examining all workers would lead to unacceptable costs. Surveillance of high-risk groups may be a useful alternative. Data from 314 workers exposed to dust were used to develop a prediction model. Data from a study comprising 96 rubber workers were used to validate the model's performance. COPD was defined as a ratio of forced expiratory volume in 1 second to forced vital capacity outside the 5th percentile. The accuracy of the model was evaluated by receiver operating characteristic curve analysis and by comparison of the observed versus predicted probabilities. Shortness of breath, wheeze, heavy smoking, and work-related lower respiratory symptoms were identified as independent determinants of having COPD. Workers with COPD can be distinguished from those without COPD on the basis of a medical/work-related questionnaire. Occupational physicians can develop a low-cost strategy for detecting workers at risk for COPD.
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PMID:Health surveillance for occupational chronic obstructive pulmonary disease. 1138 79

In a 37-year-old patient HIV infection was diagnosed in June 1986. Eight years later the patient complained of increasing shortness of breath and occasional syncopes on exertion. He developed peripheral oedema and ascites. Echocardiography revealed severe pulmonary hypertension. Right ventricular systolic pressure (RVSP) was 77 mm Hg. There was no evidence of left ventricular dysfunction, valvular heart disease, thromboembolic disease or obstructive or restrictive lung disease, nor were there other known causes or risk factors of pulmonary hypertension. HIV-associated pulmonary arterial hypertension was diagnosed. Oral anticoagulation and zidovudine were begun, but RVSP rose to 96 mm Hg. After the introduction of lamivudine, and later stavudine and nelfinavir, HIV-RNA copies decreased from 133 400 to below 50 copies per mL. Six years after the diagnosis of HIV-associated pulmonary arterial hypertension RVSP had continually fallen to 49 mm Hg and the grossly enlarged right heart dimensions had nearly normalised without vasodilator treatment. The patient remains in excellent health and his sole complaint is of mild dyspnoea on exertion.
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PMID:Regression of HIV-associated pulmonary arterial hypertension and long-term survival during antiretroviral therapy. 1197 Dec 5


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