Recurrent wheezing and massive atelectasis in an adolescent.
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Adenoma↗
Biomedical subjects
D C Stokes
Publications and source records attributed to D C Stokes.
Respiratory complications of achondroplasia.
Nine patients with achondroplasia who were seen over a three-year period developed significant respiratory complications. Eight had sleep-disordered breathing, including obstructive sleep apnea in five, for which two required tracheostomy. Of the seven patients with significant hypoxemia, five had clinical evidence of cor pulmonale and recurrent pulmonary infiltrates. Two patients died, one with autopsy findings of compression of the medulla at the level of the foramen magnum and one with respiratory and cardiac failure. Appropriate therapy for our patients depended on recognition of the mechanisms that led to the respiratory complications, including (1) chest deformity, (2) upper airway obstruction and sleep-disordered breathing, (3) neurologic complications, and (4) coincidental chronic pulmonary conditions such as asthma.
Achondroplasia↗
Sleep hypoxemia in young adults with cystic fibrosis.
Hypoxemia, obstructive apnea, and disordered breathing during sleep have been documented in adult patients with chronic obstructive pulmonary disease. We studied sleep, oxygen saturation, and breathing in nine patients (ages 17 to 26 years) with cystic fibrosis (CF) lung disease by means of all-night polygraphic tracings. Two had brief episodes of oxygen desaturation during rapid eye movement (REM) sleep, and one patient with severe disease had prolonged desaturation with episodic worsening associated with disordered breathing in REM sleep and with cough. No patient had apnea or any evidence of upper airway obstruction, in contrast with studies of older patients. In three patients, nocturnal coughing contributed to disruption of sleep cycles. Sleep oxygen desaturation may contribute to the development or progression of cor pulmonale in some patients with CF, but it seems to be most severe only in those with advanced disease.
Adult↗
Fetal alcohol syndrome: seven new cases.
In one year, the "fetal alcohol syndrome" (FAS) was recognized in seven newborn and older infants, bringing the total in the current literature to 26 cases. This recently rediscovered disorder consists of severe prenatal and postnatal growth failure, mental deficiency, and characteristic hypoplasia of the middle face and orbits with minor malformations of the heart and joints. The mothers have chronic alcoholism. By identifying and counseling such women, obstetricians and gynecologists may prevent the occurrence of the syndrome or diagnose it in the neonate.
Abnormalities, Drug-Induced↗
Differences between the N-acetyl hexosaminidase isozymes in serum and tissues.
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Blood Protein Electrophoresis↗
Pulmonary function following varicella-zoster pneumonia in children with leukemia.
Varicella-zoster virus (VZV) is a cause of serious pneumonias in immunosuppressed patients. Although there are reports of residual lung changes in adults following VZV pneumonia, no previous studies of lung function in children following this infection have been done. We studied 11 patients (median age 11 years) who had had VZV pneumonia 1 to 16 years previously. All patients had a primary diagnosis of acute lymphocytic leukemia. Pneumonia was mild in most of the patients: Three had only radiographic evidence of pneumonia and required no supplemental oxygen, and seven required an FiO2 less than or equal to 0.4 for intervals for up to 11 days. One patient had severe pneumonia and required major ventilatory support. Three patients (27%) had significant restrictive defects on follow-up, with total lung capacity 62-69% predicted; and a fourth was abnormal at 1 month follow-up but normal at 16 months. No obstructive defects were noted, although RV/TLC ratios were elevated in three patients and volume of isoflow increased in three. Single breath diffusing capacity was reduced in two patients, but gas exchange was normal in all. No residual radiographic changes were present except in the patient who had severe pneumonia and increased lung markings at 2 months follow-up. All three patients with restrictive changes had other infections before or following VZV, including Pneumocystis carinii pneumonia in two and recurrent, nonspecific pneumonias in the third. We conclude that VZV pneumonia had minimal residual effects on lung function in children with leukemia.
Chickenpox↗