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

Two cases of congenital bronchopulmonary foregut malformation are reported and another 27 cases reviewed and the findings analyzed. The left lower lobe and the entire right lung are the most common locations of pulmonary involvement. The distal portion of the esophagus or cardioesophageal junction was the most common site of communication (83%). The majority of the patients (60%) presented in the first eight months of life, and the incidence in females was nearly twice that in males. Chronic cough, recurrent pneumonias and respiratory distress were the most common clinical findings, whereas two patients were totally asymptomatic. The esophagogram was the single most useful diagnostic procedure (82%). The microscopic structure of the congenital fistula resembled esophagus, bronchus or both. Surgical treatment was curative in most instances. Sime deaths occurred prior to corrective surgery, whereas the postoperative deaths in most instances were related to severe associated congenital anomalies. We believe a common embryologic pathogenesis leads to the formation of a variety of bronchopulmonary foregut malformations. These bronchopulmonary foregut malformations include intralobar and extralobar sequestrations, pulmonary sequestration with patent, or involuted--partial or complete--gastroesophageal communication, esophageal or gastric diverticula, and esophageal or bronchogenic duplication cysts.
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PMID:Bronchopulmonary foregut malformations. A unifying etiological concept. 17 83

A mediastinal squamous cell carcinoma and thyroid carcinoma were found in an aged horse. Clinical signs consisted of bilateral thyroid gland enlargement, chronic cough, and mild respiratory distress. The neoplasms were not treated. Squamous cell carcinoma is a common neoplasm in horses, but not in the cranial portion of the mediastinum. Thyroid carcinomas in horses are uncommon. This combination of neoplasms is rare and may have been associated with a defect in the immune system.
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PMID:Mediastinal squamous cell carcinoma and thyroid carcinoma in an aged horse. 225 49

Chronic bronchial disease constitutes a significant, yet underdiagnosed, cause of both chronic cough and episodic and acute-onset respiratory distress in mature dogs and cats. Untreated chronic bronchial disease is a debilitating, progressive respiratory syndrome that results in decreased exercise tolerance, inactivity, paroxysmal respiratory distress, airway collapse and even death. With proper medical treatment, however, the prognosis for the effective long term management of chronic bronchial disease, even in severe cases, can be good.
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PMID:Chronic lung disease in old dogs and cats. 236 63

Three Laotian refugee children with chronic pulmonary complaints and findings were found to have pulmonary paragonimiasis during a one-year period in Chicago. These patients ranged from 8 to 11 years of age and the diagnosis was delayed five to six months in two children because of the unfamiliarity of American physicians with signs and symptoms of this disorder. Clinical manifestations included chronic cough for up to two years, apparent hemoptysis in two patients, lack of fever or sweats, and family history negative for tuberculosis. Physical findings included rales and dullness to percussion, clubbing (one patient), and lack of fever or respiratory distress. All three patients showed interstitial infiltrates on chest roentgenogram whereas two had multiple small cystic areas. Moderate eosinophilia was present. Paragonimus westermani ova were found in stools of two patients, in sputum of two patients, and in bronchoscopic specimens in one patient. All patients demonstrated striking clinical and radiologic improvement following treatment with bithionol (50 mg/kg every other day for 15 doses), which was well tolerated. Lung fluke infestation must be considered in Indochinese refugee children with apparent hemoptysis or chronic pulmonary symptoms, and sputum and stool should be examined for P westermani ova.
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PMID:Pulmonary paragonimiasis in Laotian refugee children. 709 90

Advances in the understanding of human respiratory disease can come from careful clinical studies of the diseases as they occur in man, but such studies are naturally limited in terms of experimental manipulation. In the last 2 decades, an increasingly complex plethora of experimental respiratory disease models has been developed and utilized by investigators, but relatively less attention has been paid to the naturally occurring pulmonary diseases of animals as potential models. This paper is aimed at presenting selected examples of spontaneous pulmonary disease in animals that may serve as exploitable models for human chronic bronchitis, bronchiectasis, emphysema, interstitial lung disease, hypersensitivity pneumonitis, hyaline membrane disease, and bronchial asthma. Chronic bronchitis in dogs is characterized by chronic cough, excessive mucus production, and chronic inflammatory changes in bronchial walls. The disease affects mainly smaller-breed dogs of middle age or older. Equine chronic bronchitis tends to be a small airway disease with marked goblet cell proliferation and excessive mucus production, which may be accompanied by alveolar emphysema. Many animals develop bronchiectasis or bronchiolitis obliterans secondary to chronic suppurative bronchopneumonia, but chronic respiratory disease (CRD) of rats may be the most useful model of bronchiectasis. Models for emphysema must include actual alveolar destruction and ideally should be accompanied by appropriate pathophysiologic decrements. Many animals occasionally develop emphysema, but the disease has not been well documented, except possibly in horses. The interstitial lung diseases of man represent a complicated and poorly understood group of entities and near-entities. The same is true for animals, although interstitial lung disease in animals is much less common than bronchopneumonia. Cattle seem prone to develop interstitial lesions. Proliferative interstitial pneumonia of cattle includes many morphologic similarities to the spectrum of human interstitial pneumonitides. Fibrosing alveolitis of cattle is a morphologic end point that may have its origins in different forms of interstitial injury. Hypersensitivity pneumonitis has been best detailed in cattle and in horses and is clinically, etiologically, immunologically, and morphologically similar to the disease in man. Hyaline membrane disease has been poorly documented in animals, with the possible exception of the neonatal respiratory distress syndromes of foals and piglets. Bronchial asthma is similarly not well established as a spontaneous disease in animals, although experimental models exist. Eosinophilic bronchiolitis of cattle may represent a useful asthma model but has been poorly detailed. In order to make them useful as models, more attention should be paid to detailing the clinical, morphologic, and etiologic aspects of these naturally occurring animal pulmonary diseases.
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PMID:Criteria for development of animal models of diseases of the respiratory system: the comparative approach in respiratory disease model development. 745 67

A cross-sectional echocardiographic study of 50 black Zimbabwean children with clinical human immunodeficiency virus (HIV) infection was carried out. The median age was 9 months. Seventy per cent had chronic cough, 60% respiratory distress and 40% cyanosis. Sixty per cent had pericardial effusion and 48% right ventricular hypertrophy (RVH) and dilation. However, the clinical diagnosis of heart failure was difficult as most of these children (80%) had hepatomegaly. These findings suggest that respiratory disease plays a role in the causation of RVH in these children. As cardiac causes of RVH were absent, this was presumed to be due to cor pulmonale. HIV-infected children presenting with respiratory distress may have clinically unapparent cor pulmonale. Early and appropriate management may by beneficial.
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PMID:Cor pulmonale in children with human immunodeficiency virus infection. 767 13

We review a single surgeon and surgical centre's experience with congenital cystic adenomatoid malformation of the lung (CCAML) in relation to clinical spectrum, operative experience, and postoperative course. A retrospective hospital record review was done on surgically treated cases of CCAML over a 10-year period, focusing on number with antenatal diagnosis, spectrum of postnatal presentation, type of surgery performed, and outcome. Forty-seven patients from birth to 14 years of age underwent surgery for CCAML. Antenatal diagnosis (ante) was made in 30 cases. Of these, 10 became symptomatic before surgery. Six of the 17 postnatally-diagnosed (pnd) cases were an asymptomatic incidental finding. Overall, 16 were symptomatic in the 1st year of life, and five were symptomatic beyond 1 year of age. Symptoms varied from respiratory distress (seven ante, six pnd) to chronic cough (three, and recurrent chest infection (three ante, two pnd). All preoperative diagnoses were confirmed with chest CT. Most patients (25) were operated on before 3 months of age. Eleven were operated on in the first 2 weeks of life as emergency surgery for respiratory distress. The most common lobe involved was the right upper lobe (16), and lobectomy was performed in 42 cases, segmentectomy in four, and pneumonectomy in one. Seventeen cases were extubated immediately postoperatively; 29 required postoperative ventilation overnight, and nine needed more prolonged ventilation. Early postoperative complications included pneumothorax (two), pleural effusion (one), and chylous effusion (one). Late complications included recurrence in three cases (all segmentectomy), who then subsequently underwent lobectomy. There was one death from respiratory failure. Because there is an increasing trend in the detection of asymptomatic antenatally-diagnosed CCAML, consideration of early surgical excision to prevent complications is suggested by our series. CT scanning is mandatory for postnatal evaluation because chest x-ray could be normal. Safe elective excision after 3 months is supported by our low morbidity and less need for postoperative ventilation. Lobectomy is the procedure of choice to prevent recurrence.
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PMID:Congenital cystic adenomatoid malformation of the lung: indications and timing of surgery. 1518 10

Patients with congenital diaphragmatic hernia usually present in the immediate neonatal period with respiratory distress. However, presentation beyond the neonatal period has sporadically been reported. We report a case of a 4-year-old girl who presented with a 1 month history of chronic cough and low-grade fever, with no response to multiple antibiotics. Initially, both clinical and radiological findings suggested inflammatory chest disease. Fortunately, after performing ultrasound, suspicion was raised and she was later diagnosed to have left congenital diaphragmatic hernia of Bochdalek type. Although rare, this entity should form one of the differential diagnoses of unresolving pneumonia in children.
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PMID:Congenital diaphragmatic hernia masquerading as pneumonia. 1523 34

Pulmonary blastomycosis is an uncommon pathologic condition that is endemic to Canada and the upper Midwest of the United States. Blastomycosis has a variety of radiologic manifestations, including airspace consolidation, focal masses, intermediate-sized nodules, interstitial disease, miliary disease, and cavitary lesions. Affected patients may be asymptomatic or may present with clinical manifestations ranging from mild chronic cough to acute respiratory distress syndrome-like symptoms. Patients with acute symptoms are more likely to have airspace consolidation, whereas chronic manifestations may be associated with masslike lesions. Intermediate-sized nodules with accompanying airspace consolidation, particularly in the upper lobes, should raise suspicion for fungal disease. Lymphadenopathy and pleural effusions are quite uncommon, and calcification is not often seen. Blastomycosis may be aggressive and require treatment. Dissemination from the lung is not unusual and can involve any organ. Diagnosis is often delayed because blastomycosis can mimic many other disease processes, including bacterial pneumonia, malignancy, and tuberculosis. Radiologists can best contribute to the care of patients who live or travel in endemic areas by maintaining a high degree of suspicion for blastomycosis and being familiar with its myriad manifestations.
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PMID:Imaging manifestations of blastomycosis: a pulmonary infection with potential dissemination. 1749 83

Recurrent respiratory papillomatosis (RRP), which is caused by human papillomavirus types 6 and 11, is the most common benign neoplasm of the larynx among children and the second most frequent cause of childhood hoarseness. After changes in voice, stridor is the second most common symptom, first inspiratory and then biphasic. Less common presenting symptoms include chronic cough, recurrent pneumonia, failure to thrive, dyspnea, dysphagia, or acute respiratory distress, especially in infants with an upper respiratory tract infection. Differential diagnoses include asthma, croup, allergies, vocal nodules, or bronchitis. Reports estimate the incidence of RRP in the United States at 4.3 per 100,000 children and 1.8 per 100,000 adults. Infection in children has been associated with vertical transmission during vaginal delivery from an infected mother. Younger age at diagnosis is associated with more aggressive disease and the need for more frequent surgical procedures to decrease the airway burden. When surgical therapy is needed more frequently than four times in 12 months or there is evidence of RRP outside the larynx, adjuvant medical therapy should be considered. Adjuvant therapies that have been investigated include dietary supplements, control of extra-esophageal reflux disease, potent antiviral and chemotherapeutic agents, and photodynamic therapies; although several have shown promise, none to date has "cured" RRP, and some may have serious side effects. Because RRP, although histologically benign, is so difficult to control and can cause severe morbidity and death, better therapies are needed. The potential for a quadrivalent human papilloma vaccine is being explored to reduce the incidence of this disease.
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PMID:Recurrent respiratory papillomatosis: a review. 1849 62


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