Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0392680 (shortness of breath)
 5,217 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Lower respiratory disease is a major source of morbidity in military recruits, with hospitalization rates for pneumonia more than 30 times that of the non-recruit population. The etiologic agent remains unknown in over 75% of cases. This study prospectively examined the etiology of pneumonia among recruits at Naval Training Center, San Diego, California. Recruits presenting with cough, fever, or shortness of breath and pulmonary infiltrates on chest X-ray were eligible for enrollment. A standardized scoring form and focused physical exam were completed on each subject. Sputum specimens were obtained for Gram's stain and culture, DNA probing for Legionella and Mycoplasma species, and direct fluorescent antibody staining for Legionella. Acute and convalescent serologies were performed for adenovirus, influenza A and B, Mycoplasma pneumoniae, Chlamydia group, and respiratory syncytial virus. Of 110 eligible patients, 100 consented to enrollment and 75 patients completed the study. Etiologic diagnoses were obtained in 40 of the patients (53%). M. pneumoniae, Haemophilus influenzae, and viruses accounted for the majority of infections. Mixed infections were seen in six patients. Forty-seven percent of patients had no diagnosis established. Pneumonia in this series of military recruits was frequently caused by M. pneumoniae and H. influenzae. Fifty percent of cases were undiagnosed with routinely available laboratory methods. Further studies are warranted to more clearly define the etiologic agents of recruit pneumonia and the utility of prophylactic measures.
Mil Med 1994 Oct
PMID:Pneumonia in military recruits. 787 Mar 17

Seven cases of Pneumocystis carinii pneumonia with granulomatous reaction in patients infected with the human immunodeficiency virus are described. The patients were all adult men between the ages of 32 and 45 years, with different high-risk factors. Clinically, all the patients presented with a history of non-productive cough and shortness of breath. Two of the patients had a past history of pulmonary pneumocystosis. Radiologically, six patients had diffuse pulmonary infiltrates and one nodular pulmonary infiltrate. Transbronchial lung biopsies were obtained in four patients and open lung biopsies in three. All presented a predominant granulomatous reaction composed of epithelioid and multinucleated giant cells. Several other special stains to detect the presence of other microorganisms to account for the granulomatous reaction were negative.
Mil Med 1993 Sep
PMID:Granulomatous Pneumocystis carinii in AIDS patients. 823 7

o-Chlorobenzylidenemalonitrile, more commonly called CS, is grouped with several other irritant agents referred to as "tear gas." It is a riot-control agent used frequently in military settings to test the ability and speed of personnel in donning their military gas masks. When personnel are exposed to CS without proper personal protective equipment, it has potent irritant effects. We report a unique cluster of hospitalizations of nine U.S. Marines who developed a transient pulmonary syndrome. All nine patients had symptoms of cough and shortness of breath. Five of the nine presented with hemoptysis, and four presented with hypoxia. Symptoms were associated with strenuous physical exercise from 36 to 84 hours after heavy exposure of CS in a field training setting. Four of the nine Marines required intensive care observation as a result of profound hypoxia. All signs and symptoms resolved within 72 hours of hospital admission. One week after CS exposure, all nine Marines demonstrated normal lung function during spirometry before and after exercise challenge using cycle ergometry.
Mil Med 2002 Feb
PMID:Acute pulmonary effects from o-chlorobenzylidenemalonitrile "tear gas": a unique exposure outcome unmasked by strenuous exercise after a military training event. 1244 9

Takayasu arteritis is a rare autoimmune disease affecting large and moderate sized arteries, often involving the aorta or coronary vasculature. We report a case of an adolescent male with a history of recurrent respiratory tract infections who presented with fever, cough, and shortness of breath and who was diagnosed with acute aortic valve failure and coronary ischemia. Ultimately, the patient's condition was attributed to Takayasa arteritis. This typical presentation of an atypical disease provides valuable teaching points, including the use of bedside echocardiography for the diagnosis of acute aortic insufficiency and the differential diagnosis of increased erythrocyte sedimentation rate. It also serves to remind clinicians to maintain a high index of suspicion for unusual disease processes in patients who fail to respond to empiric therapy for recurrent subacute illnesses.
Mil Med 2002 Feb
PMID:Takayasu arteritis presenting as a recurrent respiratory tract infection: a diagnosis facilitated by bedside echocardiography and increased erythrocyte sedimentation rate. 1187 45

First-term attrition, defined as failing to complete the contracted first enlistment term, is one of the most serious and costly problems faced by the U.S. Navy. This study was an investigation of 1-year Navy attrition in relation to demographic factors and variables assessed by the Sailors' Health Inventory Program (SHIP) questionnaire, a medical and psychosocial history questionnaire completed by all Navy recruits. Overall attrition, as well as specific categories of attrition (e.g., medical, behavioral, and administrative), were studied. The sample consisted of 66,690 Navy recruits whose status (retention vs. attrition) could be tracked to the 1-year mark. The strongest predictors of overall attrition were educational level, self-reported history of shortness of breath, ever being suspended or expelled from school, history of depression/excessive worry, fainting or dizziness, and recurrent back pain. Many other medical and psychosocial items from SHIP were also predictive of attrition. Similar factors were associated with different categories of attrition (e.g., medical, behavioral). The implications of these findings for attrition reduction strategies are discussed.
Mil Med 2002 Sep
PMID:Predictors of Navy attrition. I. Analysis of 1-year attrition. 1236 69

A 75-year-old man referred to the outpatient vascular surgery clinic of Taleghani Hospital (Shaheed Beheshti University of Medicine, Tehran, Iran) due to a local nontender mass in his groin. In his history, it was discovered that the mass had appeared a few months after a gunshot injury. He had a history of shortness of breath with a New York Heart Association functional class fluctuating between II and III, but no history of smoking or addiction. In the physical examination, a 5-cm by 5-cm nonpulsatile mass with engorged vessels was found in the anterior portion of the left groin, which was not tender. An elective arterial angiography revealed an arteriovenous fistula joining the femoral artery to the femoral vein at the left groin. The cardiac assessments revealed cor pulmonale (with a restrictive pattern and diastolic dysfunction) and pulmonary hypertension due to primary pulmonary dysfunction. The patient was anesthetized with a balanced general anesthesia method, considering all relevant cardiac and respiratory monitoring methods and specially withholding drugs increasing pulmonary vascular bed pressure, suppressing the myocardium, or increasing the regurgitant flow across the mitral and, especially, the tricuspid valve. The moment the fistula was closed, a rapid fall in the patient's heart rate was noted, from approximately 60 beats per minute to above 40 beats per minute; this decreased heart rate continued up to a few hours after the surgery and did not accompany any significant hemodynamic derangement including the patient's blood pressure. The patient received his postoperative care in the ordinary surgical ward and was discharged a few days later.
Mil Med 2007 Oct
PMID:Traumatic arteriovenous fistula due to an old gunshot injury: a victim from the Afghanistan War. 1798 81

The objectives of this study were to determine the prevalence of smoking, identify the effects of deployment on smoking behavior and risk factors for smoking, and determine the short-term health outcomes associated with smoking in Australian Defence Force (ADF) personnel. Participants were randomly sampled from ADF members who deployed to the Solomon Islands between 2003 and 2005 and from a nondeployed comparison group. In total, 435 of 995 (44%) eligible individuals completed the study questionnaires. The prevalence of current smoking was highest in those who had completed less formal education and those who served in the Navy. Nearly two-thirds (63%) of current or former smokers smoked more while on overseas deployment. Current smokers were more likely to report current wheeze, shortness of breath, and persistent cough compared with nonsmokers. The ADF should continue to address cigarette smoking through its health promotion and health review programs and implement activities to reduce cigarette smoking on deployment.
Mil Med 2010 Apr
PMID:Smoking prevalence, its determinants and short-term health implications in the Australian Defence Force. 2044 2

A previously healthy 20-year-old male trainee developed chest pain, shortness of breath, and neck pain after repeatedly shouting "Hooah!" during a motivational squad competition. He was found to have developed a pneumomediastinum with soft tissue crepitus of the neck. He had an uneventful recovery. Unique to the military training environment, vigorous shouting, including "Hooah!" as a motivational stimulus, can have barotraumatic consequences. The term "spontaneous" as applied to a pneumomediastinum diagnosis is examined and the auscultatory finding of "Hamman's sign" is reviewed.
Mil Med 2011 Mar
PMID:"HOOAH!" A case of pneumomediastinum in the military training environment; Hamman's sign 71 years later. 2145 67

After an 18-hour bus ride, a 29-year-old soldier complained of leg pain. Ten days later, he collapsed. After cardiopulmonary resuscitation (CPR), he revived but complained of chest pain and shortness of breath. Computed tomography revealed massive thrombus in the right pulmonary artery, emboli in the left pulmonary artery, and right ventricle ballooning. Adequate anticoagulation required repeated boluses and continuous infusion (1,600 units/hour) of heparin. Vena caval filter was not available, and possible additional clot in the legs could not be completely assessed. After no improvement in 24 hours, alteplase was given (10 mg IV bolus and 90 mg over 2 hours). At 12 hours, tachycardia, tachypnea, and dyspnea resolved and computed tomography revealed marked resolution. This case illustrates both the value of CPR and aggressive fibrinolytic therapy in patients who suddenly collapse from massive pulmonary embolism. The collapse was likely due to a saddle embolus. Chest compressions probably fractured the large clot. Although not completely reestablished, enough flow occurred for successful resuscitation. Even though delayed, fibrinolytic therapy was effective and should be considered even in patients where vena caval filter placement is not feasible and/or complete evaluation of the extremity deep venous system is not possible.
Mil Med 2011 Dec
PMID:Treatment of massive pulmonary embolism in a soldier in Kosovo: the potential value of cardiopulmonary resuscitation and fibrinolytic therapy. 2233 66

Paradoxical vocal fold movement is important to consider in the differential for dyspnea on exertion or shortness of breath. It is often confused with asthma and remains undiagnosed because of a paucity of pathognomonic examination and imaging findings. This case serves as a reminder of the specific clinical picture, diagnosis, and treatment of paradoxical vocal fold movement. It also highlights the broader importance of continuity of care and the clinician's ability to revisit the differential diagnosis if an initial workup is unrevealing or the patient is not responding to treatment.
Mil Med 2015 Oct
PMID:What to Do When the Inhaler Fails: Revisiting the Diagnosis. 2644 82


1 2 Next >>