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Query: UMLS:C0476273 (respiratory distress)
 19,632 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We reviewed 55 cases of streptococcal bacteremia in adult patients who received cytotoxic chemotherapy for treatment of acute leukemia. Viridans group streptococci were the most frequent species isolated (45 isolates). Hemolytic streptococci (four isolates), pneumococci (three isolates), and enterococci (three isolates) were infrequent. Clinical features of streptococcal bacteremia included fever, upper and lower respiratory infection, respiratory distress syndrome, soft tissue infection, and septic shock. Forty patients who had only streptococci, but no other organisms isolated from their blood, were compared with 36 cases of gram-negative bacillary bacteremia that occurred during the same study period within the same population at risk. The comparison showed that patients with streptococcal bacteremia had more often received high dose cytosine arabinoside as part of their chemotherapy (17 vs. five), had a longer mean duration of fever (11 vs. seven days, p less than 0.01) needed slightly more days of antibacterial therapy (15 vs. 12 days, p = 0.07, not significant), and were more likely to have been treated with newer quinolones for infection prevention (30 vs. eight). No differences between both groups were found for age, underlying disease, remission status, duration of severe granulocytopenia, and number of superinfections. The overall mortality was 18% in streptococcal bacteremia and 17% in gram-negative bacillary bacteremia. Streptococci, especially viridans group streptococci, should now be regarded as frequent causes of serious life-threatening infections following aggressive chemotherapy in patients with hematologic malignancies.
Infection
PMID:Streptococcal bacteremia in adult patients with leukemia undergoing aggressive chemotherapy. A review of 55 cases. 236 65

There were 920 live-births over the period of one year in urban slums (covering 40 anganwadi centres) of Gorakhpur city. Incidence of low birth weight (LBW) babies weighing 2.5 kg or less and those weighing 2 kg or less were 40.7% (19.8% preterm LBW and 80.2% term LBW) and 24% (25.3% preterm LBW and 74.7% term LBW) respectively. Incidence of preterm babies was 8.5%. Infections and respiratory distress were found to be the major killers of LBW babies. The neonatal mortality rate was observed to be significantly high in LBW and preterm babies. Again, babies weighing 2 kg or less and preterm were at greater risk and should be referred to specialised neonatal centres while those weighing 2.001-2.5 kg could be looked after at home by trained personnel in domiciliary newborn care.
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PMID:Mortality patterns in low birth weight babies in ICDS urban slum area. 260 Apr 32

Infections by Cryptosporidium were detected in association with clinical disease in 11 humans (Homo sapiens), 19 calves (Bos taurus), nine common quail (Coturnix coturnix), six mallard ducks (Anas platyrhynchos), five ring-necked pheasant (Phasianus colchicus) and a single budgerigar (Melopsittacus undulatus). Infections in mammals were accompanied by transient diarrhoea and anorexia, whereas infected birds exhibited clinical signs of respiratory distress. Repeated cross-transmission studies revealed apparent strain differences or differences in the host specificity of several mammalian and avian isolates for homologous vertebrate classes only. Oocysts from humans and calves were infective to mice, pigs or lambs, but not to chickens, whereas oocysts from quail and pheasant were infective to chickens, but not to mice.
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PMID:Cryptosporidium infections in birds and mammals and attempted cross-transmission studies. 296 17

The causative agent of acquired immunodeficiency syndrome is a retrovirus, human T lymphotropic virus type III/lymphadenopathy-associated virus, now known as human immunodeficiency virus (HIV). Infection of children with HIV results in a wide spectrum of clinical manifestations, ranging from asymptomatic to symptomatic, with the severest disease forms including neurologic deterioration, opportunistic infections and malignancy. This virus infects preferentially T cells bearing the CD4 receptors and also seems to exhibit preference for the central nervous system. The predominant route of infection in children is transplacental, and most affected children are infected at the time of birth. For women who give birth to infants with congenital infection with HIV, the main risk factor is intravenous drug abuse; a smaller percentage of these women acquire the infection via sexual contact and a few are infected via blood transfusions. Estimates for the incidence of transmission of the virus from an infected mother to her offspring vary from about 20 to 70%. Infection in most children and adults is documented by serologic testing, inasmuch as almost all infected people are HIV antibody-positive. Mothers of congenitally affected children are always HIV antibody-positive and also frequently have immune abnormalities. Women who give birth to infected children may, however, be asymptomatic in 50% of instances or more. Because antibodies to HIV are predominantly of the IgG class, they cross the placenta. All infants born to infected women therefore acquire passively transferred antibodies to HIV irrespective of whether or not the infants are infected with the virus itself. These passively transferred antibodies may sometimes persist for as long as 15 months. Thus in infants and children under 15 months of age in the absence of symptoms, the only definitive way to establish diagnosis is by viral isolation or viral antigen detection. Clinically the HIV-infected children can be divided into two groups, symptomatic and asymptomatic. Among the symptomatic group the main diagnostic specific features are: (1) opportunistic infection, e.g. with Pneumocystis carinii pneumonia; (2) interstitial pneumonitis with respiratory distress resulting from lymphocytic interstitial pneumonitis; (3) microcephaly and other neurologic abnormalities; (4) recurrent bacterial infections.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Human immunodeficiency virus infection in children: nature of immunodeficiency, clinical spectrum and management. 304 60

The aim of this multiinstitutional study was to evaluate a new cervical indwelling catheter in 84 patients with premature rupture of the membranes at less than 33 weeks' gestation. The average time of insertion of the catheter was 29.1 weeks' gestation, at an average of 2.0 days after rupture, and was left in place for an average of 6.5 days. The mean birth weight was 1417 gm. The mortality rate and the incidence of respiratory distress syndrome were 5.7% and 11.9%, respectively. Amniotic fluid culture was positive in 39.1% of patients before catheter insertion and only 4.3% at the time of delivery. Infection was noted in only four of 84 infants. The incidence of infection was very low in those treated for 3 days or more after catheter insertion.
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PMID:Clinical effectiveness of a new cervical indwelling catheter in the management of premature rupture of the membranes: a Japanese collaborative study. 340 90

An analysis of the causes of death in the neonatal nursery of the Port Moresby General Hospital in Papua New Guinea from 1982-1985 is presented, and conclusions were enumerated. The nursery has beds for 24 babies, subdivided into intensive care, infection and growing areas. Dormitory space for 12 mothers is available, and breast feeding is encouraged, whether by sucking, cup or tube: no bottle feeding is done. Up to 9 sisters staff the unit. A total of 2948 infants were admitted, including 831 cesarean births. 343 deaths occurred. 80 deaths were previable babies less than 1000 g. The neonatal mortality was 10/1000. The most common causes of death were septicemia or meningitis (24%), perinatal asphyxia (20%), respiratory distress syndrome (15%), congenital abnormalities (12%), meconium aspiration 7%, apnea of prematurity (7%). Other causes included pneumonia, hypothermia, intrauterine infection syndrome, cerebral hemorrhage and kernicterus. Note that hypothermia can occur in tiny babies, even in the tropics. Both respiratory distress and jaundice appear to be rare in melanesians compared to caucasians. Infections were due to tetanus, E. coli, S. aureus a Strep. faecalis, rather than the Group B hemolytic Strep. more often seen in the West. It was concluded that several inexpensive measures can be put in place to markedly enhance survival: train birth attendants to prevent perinatal asphyxia; maintain body temperature by available means; feed adequately, using expressed breast milk if necessary; maintain oxygenation properly using simple equipment such as a nasal catheter or perspex head box; prevent infection by scrupulous hand washing, cord care and overall cleanliness; manage neonatal jaundice.
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PMID:Neonatal care in perspective: results of neonatal care at Port Moresby. 347 16

In an open prospective study the efficacy and tolerance of imipenem/cilastatin was investigated in 24 critically ill patients on mechanical ventilation with nosocomial respiratory tract infection. Nine patients had previously received antibiotic therapy, eight of them with various other beta-lactam antibiotics which had failed. Imipenem was given in a dose of 1-3 g/24 h over 5-37 (mean 11) days. Seven patients were additionally treated with aminoglycosides, one patient with erythromycin. Pseudomonas aeruginosa (n = 14), Staphylococcus aureus (n = 4), Haemophilus influenzae (n = 4) and Escherichia coli (n = 3) were the potential pathogens most frequently isolated from tracheo-bronchial secretions. All of the isolates were susceptible to imipenem. 91% of the infections without and 77% with involvement of P. aeruginosa were successfully treated. Two patients who had not responded to previous treatment succumbed to the consequences of progressive respiratory distress syndrome. All of the gram-positive and 85% of the gram-negative pathogens (Pseudomonas not included) were eliminated in the course of therapy. By contrast, 64% of the isolates of P. aeruginosa persisted; half of these became imipenem-resistant. Nine patients showed adverse reactions including one case of pseudomembranous colitis or laboratory abnormalities which were all reversible. Imipenem/cilastatin proved highly effective and was relatively well tolerated; it is suitable as a single agent for the initial treatment of nosocomial respiratory tract infections in ventilated patients, although only with limitations in cases of infection due to P. aeruginosa.
Infection 1986
PMID:[Treatment of respiratory tract infections with imipenem/cilastatin in critical patients with respiratory insufficiency]. 375 53

The aim of this study was to find ways to reduce perinatal mortality. At St Helens Hospital there were 9876 births in the four year period 1978-81 and 93 perinatal deaths occurred, a perinatal mortality rate of 9.42 per 1000, stillbirths 6.58 and early neonatal deaths 2.84. Since 1971 the perinatal rate has been reduced by 29%. Perinatal anoxia was the major cause of death affecting 56 (5.67 per 1000). Only one infant each died of obstetric trauma, and respiratory distress syndrome, 0.1 per 1000. Infection affected four (0.4 per 1000) and lethal congenital abnormalities 24 (2.43 per 1000). Potentially medical avoidable factors were found to have occurred in 31% of the mothers and patient avoidable factors in 6% of mainly late or unbooked mothers. Unsure or incorrect dates in many mothers increased the difficulties in the recognition of infants with intrauterine growth retardation who are at high risk of hypoxia.
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PMID:Perinatal mortality at a level 2 obstetric hospital: problems after 32 weeks gestation. 659 70

The reconstruction of extensive defects of the trachea ist best accomplished by the use of the patient's own tissue. Unfortunately, this is not always feasible and several prosthetic devices for replacement of the trachea have been described. In an experimental study staged tracheal replacements were performed in five dogs using a ringed polyethylene terephthalate (PET) tubular prosthesis previously cultured in the major omentum of the subjects. A set of stainless-steel arches embodied in silicone compound was designed to prevent collapse of the prosthesis. One of the subjects died on the 10th post-operative day of an unidentified cause and the remaining four eventually developed signs of respiratory distress. The cause of the respiratory insufficiency was anastomotic stenosis in every case. Infection, erosion, collapse or displacement were not observed. The rings designed to avoid collapse of the prosthesis represent a suitable alternative for use as external reinforcement in the tracheal situation. The PET grafts implanted as tracheal prosthesis according to the guidelines of this protocol consistently developed anastomotic stenosis and failed to support a functional respiratory epithelium. A further conclusion is that the use of absorbable sutures encourages anastomotic dehiscence and thus must be avoided.
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PMID:Staged replacement of the canine trachea with ringed polyethylene terephthalate grafts. 786 94

Pneumonia is one of the major sites of infection in ventilated newborns. We investigated whether the cytokines IL-1 beta and TNF-alpha are detectable in tracheal aspirates of newborns with pneumonia as a diagnostic marker. All 12 infants with pneumonia had elevated levels of IL-1 beta (range 30-300 pg/ml) and TNF-alpha (range 60-680 pg/ml), whereas control infants (n = 21; respiratory distress syndrome, very low birth weight or infants intubated preoperatively) had no detectable levels of IL-1 beta or TNF-alpha. In vitro investigations with mononuclear cells of umbilical cord blood were performed to rule out that exogenously added surfactant influences IL-1 beta and TNF-alpha production. It is concluded that IL-1 beta and TNF-alpha are important and specific mediators of neonatal pneumonia which may be of diagnostic importance.
Infection
PMID:Increased levels of tumor necrosis factor alpha (TNF-alpha) and interleukin 1 beta (IL-1 beta) in tracheal aspirates of newborns with pneumonia. 800 82


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