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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 investigated the possible adverse health effects to sheet-metal workers who had past exposure to asbestos. A cross-sectional medical examination of 1,330 workers was conducted during 1986 and 1987 in seven cities in the United States and Canada. A total of 1,016 workers had been employed for at least 35 y in the industry, and the mean duration from onset of asbestos exposure was 39.5 y (SD = 7.41 y). Chest x-ray abnormalities were found in more than half of the group. Pleural fibrosis, the most frequently found abnormality, was present in 47.0% of the cases and was the only abnormality found in 27.8% of cases; parenchymal interstitial fibrosis, found in 33.1% of cases, was the only abnormality found in 16.2% of cases. Radiologic abnormalities increased as duration of exposure increased. A positive smoking history was associated with a higher prevalence of radiologically detectable parenchymal abnormalities, a finding confirmed by us and others. Dyspnea on exertion was graded by a Medical Research Council questionnaire, the examinee's self-assessment, and a more detailed 12-point scale questionnaire. Few persons had marked shortness of breath, and approximately one-third had slight dyspnea. Individuals who had radiologic abnormalities experienced more shortness of breath than did those who had no radiologic abnormalities. Cigarette smoking also resulted in a higher prevalence of dyspnea. The results indicate that during the past, construction sheet-metal workers have been significantly exposed to asbestos on the job. Every effort should be made to minimize the anticipated serious health consequences, and further asbestos exposure for those who continue in this trade should be avoided.
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PMID:Radiological abnormalities among sheet-metal workers in the construction industry in the United States and Canada: relationship to asbestos exposure. 199 30

The tolerance of totally curarized subjects for prolonged breath hold is viewed by many as evidence that respiratory muscle contraction is essential to generate the sensation of breathlessness. Although conflicting evidence exists, none of it was obtained during total neuromuscular block. We completely paralyzed four normal, unsedated subjects with vecuronium (a non-depolarizing neuromuscular blocker). Subjects were mechanically ventilated with hyperoxic gas mixtures at fixed rate and tidal volume. End-expiratory PCO2 (PETCO2) was varied surreptitiously by changing inspired PCO2. Subjects rated their respiratory discomfort or 'air hunger' every 45 sec. At low PETCO2 (median 35 Torr) they felt little or no air hunger. When PETCO2 was raised (median 44 Torr) all subjects reported severe air hunger. They had reported the same degree of air hunger at essentially the same PETCO2 before paralysis. When questioned afterwards all subjects said the sensation could be described by the terms 'air hunger', 'urge to breathe', and 'shortness of breath', and that is was like breath holding. They reported no fundamental difference in the sensation before and after paralysis. We conclude that respiratory muscle contraction is not important in the genesis of air hunger evoked by hypercapnia.
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PMID:'Air hunger' from increased PCO2 persists after complete neuromuscular block in humans. 212 Jul 57

The validity and utility of physical examination maneuvers were determined in diagnosing congestive heart failure (CHF) in patients with acute dyspnea. Fifty one patients presented to the emergency room with the chief complaint of shortness of breath. History and physical examination were obtained independently, and the physical examination included hepatojugular reflux and the Valsalva maneuver. The diagnosis of CHF was made by predetermined criteria, and was compared with the diagnosis of the emergency room (ER) physician and with the response to bedside maneuvers. The hepatojugular reflux and Valsalva maneuvers were valid in the diagnosis of congestive heart failure in acutely dyspneic patients. Although these maneuvers rarely added to the routine assessment of patients in this study, they may provide a useful, noninvasive adjunct to clinical diagnosis in problematic cases.
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PMID:Clinical diagnosis of congestive heart failure in patients with acute dyspnea. 232 44

Two male patients aged 12 and 31 years suffered from Crohn's disease for more than six years and were treated with Cortison for more than four years. Surgical excision of parts of the terminal ileum was performed in both patients. They suffered from pulmonary symptoms as dyspnoea, shortness of breath and ventilation disturbances two years after operation. Wedge biopsies of the lungs revealed the following histomorphological findings: 1. Granulomatous interstitial lymphocyte infiltrates 2. Acute alveolitis with severe dysplasia of pneumocytes 3. Moderate interstitial fibrosis. Immunohistology performed in one case showed predominantly lambda chains expressed by lymphocytes associated with IgA and IgM. IgG was missing, furthermore kappa chains could not be detected. Macrophages contained endogenous lectins (sugar receptors) for fucose, maltose, and N-acetyl-D-glucosamine (glcNAc). No receptors specific for mannose, lactose, and heparin could be found. Pneumocytes did not bind the neoglycoproteins but were found to express HLA-DR receptors detectable by the monoclonal antibody LN 3 in dysplastic pneumocytes only. The histomorphological and immunohistochemical findings suggest that the analyzed alterations of lung tissue are related to the underlying disease of enteritis regionalis.
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PMID:Are there characteristic alterations in lung tissue associated with Crohn's disease? 224 78

With use of a qualitative research approach, a study was conducted to explore the phenomenon of dyspnea from the point of view of patients with chronic obstructive pulmonary disease. During a nonacute phase of their illness, 96 adults with chronic bronchitis or emphysema were asked in semistructured interviews to recall their feelings associated with sensations of shortness of breath during hospitalizations for the acute phase. Through content analysis, accounts of different subjects were compared, and several themes were isolated that dominated the dyspneic experience. The themes were fear, helplessness, loss of vitality, preoccupation, and legitimacy. Each theme was expanded by integrating accounts of dyspnea previously reported in the literature with the field study data. Substantiated descriptions of the five themes are presented to sensitize nurses to patients' perceptions of dyspnea and nursing behaviors during hospitalization for the acute phase of chronic obstructive pulmonary disease.
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PMID:Dyspnea during hospitalizations for acute phase of illness as recalled by patients with chronic obstructive pulmonary disease. 231 59

The delay between the onset of symptoms and the call for help is the longest single component of the time taken for patients with acute myocardial infarction to come under coronary care and receive thrombolytic therapy. In order to investigate factors influencing patient delay, visual analogue scores for pain, shortness of breath, and anxiety were obtained retrospectively from 250 patients with acute myocardial infarction, for the time of onset of symptoms, and for the time of the call for help. The predominant symptom was chest pain, followed by anxiety and breathlessness. Although all symptoms increased in severity after their onset, the initiation of a call was largely unexplained in terms of worsening symptoms. Patient delay had a skewed distribution with modal, median and mean values of up to 1 h, 1.5 h, and 11 h respectively. Patient delay was negatively correlated with the pain score at the time of calling, but most of the variance of patient delay could not be explained in terms of symptom scores. However, patient delay was independently and negatively related to maximum serum aspartate aminotransferase. During acute myocardial infarction, patients with higher cardiac enzyme levels experience more pain and delay less. This tendency for patients with more severe infarction and a greater risk of death to call for help sooner is an added reason for administering thrombolytic treatment at the first opportunity: those patients who call early have most to gain from prompt therapy.
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PMID:Association of patient delay with symptoms, cardiac enzymes, and outcome in acute myocardial infarction. 237 99

Three cases of high altitude pulmonary edema (Hurtado's disease) are described. The onset of the symptoms occurred within 72 hours after arrival from the sea level. Their main clinical features were dry cough, shortness of breath, tachycardia, progressive dyspnea and weakness. Rales and obstructive bronchial signs were detected on chest auscultation. Treatment included oxygen administration, diuretics and bed rest, with satisfactory clinical evolution within four days. Hurtado's disease is a form of noncardiogenic pulmonary edema, increased pulmonary vascular pressure and permeability are, probably, the main factors in its development. It has been suggested that both factors could a be consequence of hypobaric hypoxia.
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PMID:[Pulmonary edema in high altitude]. 248 89

A 35-year-old primigravida was admitted to the Department of obstetrics complaining of dyspnea and left back pain at 21 weeks' gestation. Chest roentgenogram revealed diffuse reticulonodular shadows predominantly in both lower lung fields and arterial hypoxemia was present. Pulmonary function tests showed restrictive impairment and decreased carbon monoxide diffuse capacity. From these results, interstitial pneumonia was suspected and she was first treated with prednisolone. However during her pregnancy, spontaneous pneumothorax occurred. Following spontaneous delivery of healthy infant at 37 weeks, left chylothorax occurred, and pleurodesis was performed with OK432. Thereafter the histological diagnosis of pulmonary lymphangiomyomatosis was made by transbronchial lung biopsy and treatment of prednisolone was stopped. She was treated with tamoxifen. In addition, progesterone-receptor was detected in the pulmonary tissue obtained at open lung biopsy. She was treated with cyclophosphamide in addition to tamoxifen. At present, shortness of breath has decreased slightly in comparison with one year previously, but no improvement has been seen in lung function tests or chest roentgenogram.
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PMID:[A case of pulmonary lymphangiomyomatosis induced by pregnancy]. 258 8

A 61-year-old man was admitted to our hospital because of persisting cough, sputum and shortness of breath for four months. Brushing specimens and BALF bronchoscopically obtained revealed acid-fast bacilli and TBLB showed pathological findings consistent with interstitial pneumonia. Based on these results, clinical symptoms, chest roentgenograms on admission and identification of M. kansasii, a diagnosis of M. kansasii lung infection occurred in idiopathic pulmonary fibrosis was made. The patient's symptoms consistent with M. kansasii lung infection and his sputum became negative 6 weeks after antituberculosis chemotherapy with INH, SM and RFP. Because of an increasing dyspnea due to pulmonary fibrosis, however, the patient received oxygen therapy. This case suggested an increasing tendency of compromised hosts associated with M. kansasii lung infection.
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PMID:[M. kansasii lung infection occurring in a compromised host with idiopathic pulmonary fibrosis]. 258 49

A 25-year old man with 5-year history of bronchiectasis was admitted to the ICU complaining of severe shortness of breath. He had a respiratory rate of 40 to 50 breath/min. On 0.5 l/min of oxygen with nasal cannula, arterial blood pH was 7.39, Paco2 52.3 mmHg, Pao2 45.0 mmHg. Then, on 1 l/min of oxygen, Pao2 was unchanged, but Paco2 increased to 58 mmHg. As his consciousness was so clear, we applied to him the negative extra-thoracic pressure ventilator which was designed by the authors. Negative extra-thoracic pressure ventilation (NETPV) was maintained at a IMV rate of 30 breath/min, peak negative extra-thoracic pressure of -20 to -30 cmH2O, and an inspiratory/expiratory ratio of 1:2. During NETPV, his respiratory rate and oxygen consumption were decreased and Pao2 was increased compared with his spontaneous breathing. He made a recovery from dyspnea, especially, he was able to take a deep breath. When NETPV was applied to him, pulmonary artery and arterial catheterizations revealed that central venous pressure was slightly decreased, cardiac index unchanged or slightly decreased, heart rate, systemic blood pressure, and pulmonary arterial pressure unchanged compared with spontaneous breathing. The patient was able to read books and maintained communication in his voice with his family and the medical staff. After 3 days of the treatment with NETPV, a marked improvement was noted and the patient was discharged from the ICU. NETPV has the benefits as follows. First, it is very easy for both a patient and a doctor to assist his breathing because an endotracheal intubation is not necessary.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Bronchiectasis treated with negative extra-thoracic pressure ventilation]. 274 17


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