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

Shortness of breath is a common symptom in thyrotoxicosis and it may have a number of causes. We have studied dyspnoea, skeletal muscle power and respiratory muscle power in eleven patients who had thyrotoxicosis with no evidence of heart failure. Four patients (36.4%) had a marked improvement with treatment in the maximal inspiratory pressure developed at the mouth. All four were breathless and had a proximal myopathy before treatment. This confirms the existence of a group of thyrotoxic patients with a reversible respiratory muscle myopathy which may explain the frequent finding of breathlessness on exertion in such patients.
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PMID:Thyrotoxicosis and dyspnoea. 707 72

The incidence, clinical findings, location, etiology, clinical diagnosis, and surgical treatment of chondrosarcoma of the larynx are discussed. Important features in the diagnosis and treatment of a chondrosarcomatous tumor of the larynx are demonstrated in a case report. The patient's chief complaint was episodic shortness of breath occurring with increasing frequency over a period of 12 months. Her dyspnea progressed in severity until an emergency tracheotomy was required for airway control. CT scan documented the attachment of the tumor to the right posterior lateral wall of the cricoid cartilage. Direct laryngoscopy and biopsy were done to obtain tissue for diagnosis. The histopathological examination revealed low-grade chondrosarcoma. The tumor was removed totally with a wide-margin mucous membrane incision and careful curettement. A definite difference in the consistency of the tumor compared to normal cartilage allowed complete excision of the tumor with minimal sacrifice of healthy cricoid cartilage. This presentation emphasizes the conservative surgical removal of these tumors and notes how a curette can be used for this removal.
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PMID:Diagnosis and conservative surgical management of chondrosarcoma of the larynx. 711 19

A 13-year-old boy suffering from celiac disease (CD) developed shortness of breath at exercise and episodes of malaise, fever and acute dyspnea following contact with pigeons. Lung function testing and chest X-ray suggested interstitial lung disease. Serum precipitins and a combined systemic and pulmonary reaction 4 h after challenge with an extract of pigeon droppings confirmed bird-fancier's lung. This case exhibits two points of interest. Extrinsic allergic alveolitis was found in childhood in combination with CD and it may be considered that both these diseases are based on one common immunologic disorder; HLA-typing of the boy's family showed that he carried HLA-DR 3 in a double dose and was therefore homozygous for HLA-DR 3. This is of some interest because extrinsic allergic alveolitis and CD are both associated with HLA-DR 3.
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PMID:Extrinsic allergic alveolitis combined with celiac disease in childhood. 717 73

A case of timolol-associated heart failure in a 73-year old white man is reported. The patient, with a history of cardiovascular disease and glaucoma, was admitted to the hospital because of complaints of shortness of breath, orthopnea, and reduced exercise tolerance. Chest roentgenogram showed interstitial congestive failure, and an EKG demonstrated sinus bradycardia. The patient's medications before admission included quinidine, isosorbide dinitrate, dipyridamole, aspirin, pilocarpine eyedrops 4%, timolol eyedrops 0.5%, and nitroglycerin ointment and sublingual tablets. On the second day of hospitalization, it was noted that the patient's dyspnea and sinus bradycardia could be related to a recent increase in his timolol dosage. The timolol was discontinued, and the patient's heart rate increased. As the patient's pulse rate increased, the symptoms of congestive heart failure disappeared. This case demonstrated the importance of obtaining complete drug histories from patients. The potential for adverse system reactions resulting from topical medications should be considered.
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PMID:Bradycardia and congestive heart failure associated with ocular timolol maleate. 728 2

The clinical features of 68 Japanese patients (53 men and 15 women; mean age 44 years) with primary pulmonary alveolar proteinosis were reviewed. Pulmonary alveolar proteinosis was diagnosed from histologic findings after open lung biopsy (n = 7) or transbronchial lung biopsy (n = 61). Major symptoms were a dry cough (24.2%) and dyspnea or shortness of breath on exertion (51.5%), but one third of the patients were asymptomatic. Crackles were audible in 30% of the patients, but clubbing (6%) and cyanosis (4%) were rare. Ten patients had been occupationally exposed to dust. Slightly less than half (46%) of the patients first presented with symptoms, and the remainder (54%) first presented with abnormal pulmonary infiltrates seen on chest roentgenograms taken during general health examinations. Many patients had abnormally high levels of LDH and CEA in serum (62% and 63%, respectively). Restrictive pulmonary dysfunction (%VC < 80%) was seen in 31% of the patients, an abnormally low DLco (%DLco < 70%) was seen in 62%,m and hypoxemia (PaO2 < 80 mmHg) was seen in 67%. Arterial blood gas tension was closely correlated with the severity of disease in these patients. Chest roentgenograms usually showed bilateral symmetric alveolar infiltrates, mainly distributed from hilar areas toward the pleura, but on CT scans many of the shadows were mixed with alveolar and interstitial infiltrates of various extent along the pulmonary arteries and bronchi. There was no apparent relation between chest roentgenographic findings and chest CT findings in these patients. Neither the extension nor other characteristics of shadows in the chest roentgenograms and chest CT scans were closely related to symptoms, laboratory data, or pulmonary function in these patients. Symptoms were alleviated and chest roentgenographic findings improved in 82% of the 51 patients who underwent therapeutic bronchoalveolar lavage, and in 94% of the 17 patients who did not undergo that procedure. In patients who underwent therapeutic bronchoalveolar lavage and also in those who recovered spontaneously, both diffusing capacity and blood gas values improved significantly. When compared to the patients who did not undergo therapeutic bronchoalveolar lavage, significantly more of those who did undergo that procedure has initial PaO2 values below 60 mmHg, and fewer of them had values greater than 80 mmHg. Thus, a PaO2 below 60 mmHg may be an indication for therapeutic bronchoalveolar lavage in patients with this disease. During the follow-up period (mean 5 years, range 2 months to 23 years), four patients had pneumothorax and none died of pulmonary alveolar proteinosis.
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PMID:[Primary pulmonary alveolar proteinosis--clinical observation of 68 patients in Japan]. 747 63

The aim of the study was to evaluate the relationship between several lung function indices and perceived dyspnoea during bronchoconstriction. Acute changes in lung function were induced by inhaled histamine followed by terbutaline, in 12 asthmatics and 12 subjects with chronic obstructive pulmonary disease (COPD). A bipolar visual analogue scale (VAS), allowing subjects to report either improvement or worsening when moving off from a 'nochange' midpoint, was used to rate shortness of breath. Large swings in ratings were seen in all asthmatics and in seven out of 12 COPD subjects (high perceivers). Using linear regression of VAS rating against parallel change in lung function, on a within-subject basis, the highest degree of correlation between dyspnoea and objective response was found to involve the change in specific inspiratory resistance (sRin) in the asthmatics. In the five low perceivers, the ability to discriminate an increase in airway obstruction, estimated as the VAS/change in lung function slope, was very poor. Using a stepwise multiple regression analysis, the sensation of dyspnoea was found to be significantly related to the FEV1 and the sRin in the asthmatics, to the inspiratory vital capacity and the maximal inspiratory flow at 50% FVC (MIF50) in the COPD subjects with high perception, and to the MIF50 in the COPD subjects with low perception.
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PMID:Perception of dyspnoea during acute changes in lung function in patients with either asthma or COPD. 748 Sep 77

The prevalence of respiratory symptoms and functional abnormalities has been evaluated in a sample of 350 workers (186 males and 164 females, mean age: 35.1 and 36.6 years respectively) employed in 24 factories of the shoes industry in the area of Pisa, exposed to airway irritants (solvent vapours, leather dusts and fumes). Each subject performed C.N.R. questionnaire of respiratory symptoms and diseases, and measurement of Forced Vital Capacity and derived indices. A mild prevalence of respiratory symptoms (chronic cough: 9.3% and 8.5% in males and females respectively; chronic phlegm: 14.6% and 6.8%; persistent wheeze: 2.1% and 1.7%; dyspnea of 1st degree: 23.3% and 39.0%) was reported, more frequently in smokers than in non smokers. Subjects with longer job duration in the shoe industry showed a trend to have a higher prevalence of chronic phlegm than subjects with shorter job duration; on the contrary, the last ones had a higher prevalence of rhino-conjunctivitis. A higher prevalence of attacks of shortness of breath and dyspnea of 2nd degree in males, and dyspnea of 1st degree in females was observed in workers to high risk job (to shear, to use adhesive, etc.) with respect to workers employed in low risk job (to assembly, to store etc). Mean spirometric values where in the normal range. Subdividing the subjects in groups with different smoking habit and job duration, a mild effect of the occupational exposure in groups with the same smoking habit could be observed for FEV1 and MEF50 particularly.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A cross-sectional epidemiological study of symptoms and respiratory physiology in a sample of workers in shoe manufacture]. 772 Sep 56

The pathogenesis of the limiting symptoms in patients with chronic heart failure, shortness of breath and fatigue on exercise, are poorly understood. We analysed data from 222 incremental symptom limited exercise tests to determine whether there were differences between patients stopped by breathlessness or fatigue. One hundred and sixty patients were stopped by breathlessness and 62 by fatigue. There was no differences between the two groups in underlying diagnosis or in exercise performance (peak oxygen consumption 15.66 (+/- 5.62) ml.kg-1.min-1 in the fatigue group, 15.13 (+/- 4.64) in the breathless group). The ventilatory response as assessed by ventilatory response to carbon dioxide production (VE/VCO2 slope) was not different between the two groups (2.61 (+/- 0.96) in the fatigue group, 3.03 (+/- 1.23) in the breathless group: P = ns). There were no differences between the two groups in left ventricular dimensions, left ventricular ejection fraction or left ventricular end-diastolic pressure. The limiting symptoms of breathlessness and fatigue in chronic heart failure are two sides of the same coin. Any pathophysiological explanation of exercise limitation in chronic heart failure must unify these two symptoms.
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PMID:Muscle fatigue and dyspnoea in chronic heart failure: two sides of the same coin? 773 21

We report the incidence, clinical features, and course of acute dyspnea following combination chemotherapy using mitomycin and vindesine or vinblastine. The courses of 387 patients with advanced non-small cell lung cancer receiving combined mitomycin and vinca alkaloid chemotherapy were analyzed. Of these patients, 25 experienced acute respiratory distress. Factors contributing to the dyspnea are reported. The syndrome is characterized by the sudden onset of dyspnea without other respiratory symptoms. Acute shortness of breath always occurred on a day when a vinca alkaloid was administered. The median number of previous doses of vinca alkaloid at the time of the event was 10 and the median number of prior mitomycin doses was 3. Rechallenge with the drug in two cases led to recurrence. The incidence was 4% in a group of 378 patients on four protocols for non-small cell lung cancer. Radiographs of 87% of patients showed new focal or diffuse interstitial infiltrates. Arterial blood gases demonstrated low PO2 and increase in A-a gradient. Pulmonary function tests revealed severely impaired diffusing capacity. Substantial improvement occurred over 24 hours. Approximately 60% of the patients experienced chronic respiratory impairment that only partially responded to corticosteroid therapy. No other causes for this syndrome were identified. A syndrome of acute dyspnea occurred in 4% of patients treated with mitomycin and vinca alkaloid therapy. The syndrome has a distinctive presentation, which can lead to chronic pulmonary insufficiency. Clinicians caring for patients receiving combined therapy with mitomycin and a vinca alkaloid should be aware of this type of acute pulmonary toxicity. Further studies are necessary to clarify its etiology.
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PMID:Syndrome of acute dyspnea related to combined mitomycin plus vinca alkaloid chemotherapy. 774 13

We conducted a randomized clinical trial to evaluate a limited pulmonary rehabilitation program focused on coping strategies for shortness of breath but without exercise training. Eighty-nine patients with COPD were randomly assigned to either 6-week treatment or general health education control groups. Treatment consisted of instruction and practice in techniques of progressive muscle relaxation, breathing retraining, pacing, self-talk, and panic control. Tests of 6-min walk distance, quality of well-being, and psychological function as well as six dyspnea measures were administered at baseline, posttreatment, and 6 months after the intervention. Baseline pulmonary function tests also were obtained. At the end of the 6-week treatment, there were no significant differences between the treatment and control groups on any outcome measure. At the 6-month follow-up, a significant group difference was seen on only one variable, Mahler's transition dyspnea index. The results of this evaluation suggest that a treatment program of dyspnea management strategies, without structured exercise training or other components of a comprehensive pulmonary rehabilitation program, is not sufficient to produce significant improvement in dyspnea, exercise tolerance, health-related quality of well-being, anxiety, or depression.
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PMID:Treatment of dyspnea in COPD. A controlled clinical trial of dyspnea management strategies. 749 13


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