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

To determine whether there was a significant difference in morbidity rates from cesarean section between urban and rural hospitals, we reviewed 742 maternal records from three urban hospitals and 435 records from 11 rural hospitals, along with the corresponding infant charts. When a comparison was made of advance in diet, day of discharge, elevations of temperature, number of positive cultures, use of two or more antibiotics, use of blood transfusions, and incidence of major complications, significant differences were found only in the number of positive cultures and use of antibiotics, which occurred more frequently in rural hospitals. Pediatric morbidity was evaluated by comparing Apgar scores, temperatures less than 36 degrees C, use of oxygen for longer than 15 minutes, number of infants intubated, use of intravenous fluids and antibiotics, incidence of respiratory distress syndrome and transient tachypnea, number of neonatal transfers, and major complications. Urban hospitals had significantly more Apgar scores of 4 to 6 at 5 minutes (p less than 0.01). Temperatures less than 36 degrees C were found more frequently in rural hospitals (p less than 0.001). No statistical difference was found in any other category. The results show little difference in maternal or pediatric morbidity rates between urban and rural hospitals and between obstetricians and family practitioners.
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PMID:A comparison of cesarean section morbidity in urban and rural hospitals. A three-year retrospective review of 1,177 charts. 712 41

The radiologic changes of the chest X-ray of 270 newborns with respiratory distress were analyzed. In cases of Hyaline Membranes the chest X-ray showed finely granular evenly disseminated structures combined with signs of hypoventilation. Localized, patchy, streaky, homogenous and reticulonodular shadows were found in cases of pneumonia and hemorrhage. Hyperinflation were an additional sign for an inflammatory disease. This symptom was also demonstrated in pulmonary bleeding, but was less common. The bilateral interstitial augmentation of the pulmonary structure in combination with cardiomegaly was mainly a symptom for cardial insufficiency and transient tachypnea. The differentiation between fine granular and reticulo-nodular structures should create no problem if the chest X-ray if of good quality. Extrapulmonary air collections were found in a high percentage in the course of artificial ventilation as a consequence of the "baro-trauma." The radiologic diagnosis of BPD was no problem. The value of the chest X-ray lies in the demonstration of a pulmonary cause for the respiratory distress, in the demonstration of complications and in the radiological observation of the disease.
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PMID:[Most frequent causes, complications and differential diagnosis of neonatal respiratory distress in chest x-ray]. 715 18

An acute pneumonia developed in 28 calves which had been housed together from one to two weeks of age. The clinical signs included pyrexia, tachypnoea, respiratory distress and coughing. Some of the calves died. The pneumonia was characterised by an alveolitis with multinucleated syncytia, alveolar epithelial hyperplasia and bronchiolitis. Interstitial emphysema was also present. Fifteen of 19 calves examined serologically had rising neutralising antibody titres to respiratory syncytial virus; in nine calves the rise was fourfold or greater. Respiratory syncytial virus was not isolated from the calves. There was no evidence of parainfluenza type 3 virus involvement. The adult cows being sucked by the calves remained clinically normal throughout the incident. Six calves examined six weeks after the outbreak started had a chronic cuffing pneumonia characterised by lymphocytic bronchiolitis; some of the calves also had bronchiolitis obliterans. Mycoplasma dispar was found in two of them.
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PMID:Acute fatal pneumonia in calves due to respiratory syncytial virus. 725 27

A total of 506 amniotic fluid samples from 337 pregnancies was analysed for lecithin/sphingomyelin (L/S) ratio and phosphatidylglycerol. Two-dimensional chromatography on either laboratory-made or commercial thin-layer silica gel plates was required for proper resolution of the phospholipids. The predictive accuracy of the L/S ratio and the phosphatidylglycerol analysis was assessed in 225 patients, 187 of whom had an L/S ratio of 2 or more. In addition to predicting respiratory distress syndrome of the newborn, the phospholipid results predicted the risk of transient tachypnoea, symptomatic pneumothorax and the persistence of fetal circulation. The phosphatidylglycerol results improved the predictive value of both the mature L/S ratio (2 or more) and the non-mature L/S ratio (below 2).
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PMID:Measurement of the lecithin/sphingomyelin ratio and phosphatidylglycerol in aminotic fluid: an accurate method for the assessment of fetal lung maturity. 726 1

One hundred and forty-five elective repeat cesarean sections performed in one large medical community during a two-year period were studied. Ninety-nine of the patients had no prenatal test for determination of pulmonary or fetal maturity; 18 patients had an amniocentesis for L/S ratio. Only two infants were thought to be delivered prematurely, at 37 weeks gestational age. One of these infants had no respiratory distress. The other infant was delivered before the EDC by menstrual dates because a single ultrasound measurement performed one week before delivery suggested a "term fetus", and this infant had severe hyaline membrane disease. Six other infants had mild respiratory distress compatible with transient tachypnea or aspiration. In this medical community, one must question whether the risk of routine amniocentesis for L/S ratio before every elective repeat cesarean section might outweigh the potential benefits of the procedure.
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PMID:Respiratory distress associated with elective repeat cesarean section. A two-year experience in one medical community. 727 94

Phorbol myristate acetate is a potent aggregator of platelets. It was found that it was similarly potent in aggregating neutrophils and in producing striking thrombocytopenia and neutropenia when infused intravenously into rabbits. Aggregation and cytopenia were further correlated in that both types of responses developed abruptly and persisted for more than 90 minutes. Animals infused with 40 microgram/kg of the phorbol ester exhibited moderately severe respiratory distress. Their respiratory rate doubled shortly after the infusion, and this tachypnea persisted for more than 2 hours. At necroscopic examination, the lungs of these rabbits contained two outstanding abnormalities: numerous foci of alveolar hemorrhage and extensive intravascular accumulations of platelets and neutrophils. Thus, these animals had evidence of increased permeability and potential occlusion of the pulmonary microvasculature. Increased permeability, occlusion of lung blood vessels, or the occurrence of both processes was further indicated in studies on animals pre-infused with the plasma protein marker 125I-albumin: animals infused with the phorbol ester had a significantly increased amount of this label in their lungs in spite of thorough postmortem perfusion of their pulmonary vasculature with saline and fixative. We conclude that phorbol myristate acetate has actions in vivo that resemble those of a variety of other platelet (eg, arachidonic acid) and neutrophil (eg, chemotactic factors) aggregating agents that cause cytopenia and lung dysfunction. However, compared with these other agents, the phorbol ester produces respiratory distress of intermediate severity and greater duration. The drug, therefore, induces a syndrome that more closely resembles that seen in a variety of clinical and experimental conditions that associate shocklike states with cytopenia and lung dysfunction. It may serve as a useful tool in the study of the pathophysiology of these states as well as in those produced by other aggregating agents.
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PMID:Phorbol myristate acetate: in vivo effects upon neutrophils, platelets, and lung. 744 4

A progressive pulmonary disease resulting in severe respiratory failure and death in an average of 3 weeks was diagnosed in 11 young Dalmatian dogs. The dogs were from 4 litters, all genetically related by a common ancestor. The initial clinical signs were tachypnea and noisy respiration. Respiratory distress developed shortly before death and was characterized by strenuous and rapid respirations, along with cyanosis and vomiting. On blood gas analysis, there were severe arterial hypoxemia, hypercapnia, and marked alveolar-arterial oxygen difference. Radiographically, a diffuse pattern of alveolar, interstitial, and peribronchial densities was observed in the lungs. Most dogs developed pneumomediastinum and gastroesophageal intussusception in the terminal phase of the disease. There was no response to treatment with antibiotics, corticosteroids, diuretics, or oxygen. At necropsy, the lungs were wet, heavy, and relatively airless. Absence of 1 kidney in 2 dogs and severe internal hydrocephalus in 2 dogs were additional necropsy findings. Pulmonary histopathology included metaplasia and atypia of the alveolar and bronchiolar epithelium, a nonpurulent inflammatory reaction characterized mainly by mononuclear cells and macrophages, eosinophilic hyaline membrane formation, and focal pulmonary fibrosis. The histological manifestations were typical of acute lung injury. Clinically, the findings were consistent with adult respiratory distress syndrome (ARDS), except for the relatively long course. No known risk factors for ARDS, such as trauma, toxin exposure, infection, or endotoxemia could be identified. The relationship of the other abnormalities (ie, renal aplasia, hydrocephalus) to the pulmonary disease also remains obscure. An inherited defect is suspected, because segregation analysis of the 4 litters suggests autosomal recessive inheritance.
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PMID:Lung injury leading to respiratory distress syndrome in young Dalmatian dogs. 767 17

Appropriate and early treatment with exogenous surfactant has clinical and economic benefits for neonates with pulmonary surfactant deficiency. In order to rapidly and reliably identify such neonates, we have evaluated the shake and click tests, biophysical tests of surfactant function, using 0.2 mL samples of tracheal (TA) and gastric aspirates (GA). Samples from 181 neonates with a gestational age range of 24-40 weeks were shaken with 95% ethanol. If bubbles formed (positive shake test) they were examined in air-free water under a microscope. In a positive shake or click test, the bubbles rhythmically increase and then decrease in size, denoting the presence of active surfactant. The probability of the tests to predict clinical surfactant deficiency was analyzed. The latter was defined as respiratory distress syndrome or transient tachypnea of the newborn diagnosed by chest radiography and clinical criteria. The click test on TA from preterm infants was most accurate, with a 100% positive predictive value and specificity, and a 93% and 94% negative predictive value and sensitivity respectively. These values for GA were 73%, 84%, 97%, and 95%, respectively. The test is quick, simple, inexpensive, reproducible, and unaffected by contamination with blood. The accuracy of this test on TA in diagnosing surfactant deficiency in neonates would permit early and optimal treatment with exogenous surfactant. When performed on GA, the test could aid decisions regarding transfer of neonates to tertiary level care.
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PMID:"Click test": rapid diagnosis of the respiratory distress syndrome. 809 Jun 9

Chest x-rays provide information that can help the clinician evaluate the newborn with respiratory distress. This article reviews the etiology, signs and symptoms, and common radiologic findings of the following lung disorders: (1) transient tachypnea of the newborn, (2) meconium aspiration syndrome, (3) respiratory distress syndrome, (4) chronic lung disease, and (5) air leaks. Each disorder is presented singly. Because some disorders have overlapping clinical and radiological features, clinical correlations and review of the infant's previous films are important in implementation of care.
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PMID:Understanding neonatal chest x-rays Part II: Clinical and radiological manifestations of selected lung disorders. 812 64

The term adult respiratory distress syndrome (ARDS) was first introduced by Ashbaugh and Petty more than two decades ago. Since then, our understanding of this clinicopathologic entity has increased significantly. However, little therapeutic progress has been achieved, and the mortality remains high. ARDS is characterized by diffuse pulmonary microvascular injury resulting in increased permeability and, thus, noncardiogenic pulmonary edema. Ventilation-perfusion lung studies have demonstrated that the predominant pathogenesis of hypoxemia in ARDS is related to intrapulmonary shunts. Common symptoms include dyspnea, tachypnea, dry cough, retrosternal discomfort, and moderate to severe respiratory distress. In most cases the diagnosis of ARDS is that of exclusion. The mainstay of therapy for this syndrome is the management of the underlying disorder causing it. To date, there are no specific pharmacologic interventions of proven value for the treatment of ARDS. Once the potentially treatable sources have been found and their therapy started, the main treatment for ARDS is supportive.
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PMID:Adult respiratory distress syndrome (ARDS): the basics. 816 9


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