Role of progestational agents in the treatment of undernourished patients with cystic fibrosis.
Explore the source record for details and available documents.
Adolescent↗
Biomedical subjects
D G Kissner
Publications and source records attributed to D G Kissner.
Idiopathic bronchiolitis obliterans with organizing pneumonia. An acute and life-threatening syndrome.
Idiopathic bronchiolitis obliterans with organizing pneumonia (BOOP) is a clinicopathologic syndrome characterized by an indolent course and favorable prognosis. This report describes five patients with a fulminating and life-threatening variant of this syndrome. Four patients presented with respiratory failure requiring respiratory assistance and positive pressure ventilation. Early recognition of the entity and prompt initiation of corticosteroid therapy in three patients was instrumental in preventing mortality. Our findings suggest that idiopathic BOOP may be the underlying pathology in a number of patients presenting with ARDS. Since corticosteroid therapy may improve survival in these patients, clinicians should heighten their index of suspicion for this entity. Early histologic diagnosis and initiation of corticosteroid therapy should be considered in patients with unexplained ARDS.
Adrenal Cortex Hormones↗
Use of an HeO2 mixture in the management of upper airway obstruction during labor and delivery. A case report.
A woman presented in the late third trimester of pregnancy with upper airway obstruction. Pulmonary functions improved with the inhalation of a low-density mixture of He and O2. That gas mixture was employed to augment the air flow and to decrease the respiratory effort during labor and delivery.
Adolescent↗
Tuberculosis. Missed opportunities.
The incidence of tuberculosis in the United States appears to be rising, most likely because of the introduction of the human immunodeficiency virus, and other factors such as outbreaks among the homeless and immigration of infected people from other countries. Because diagnosis and treatment of tuberculosis has shifted from specialized centers to the community, it is important that primary care physicians recognize and properly manage early forms of the disease. Several patients are described for whom an early diagnosis was not made, resulting in serious morbidity for the patients and risk of spread of disease to contacts.
Adult↗
Crack lung: pulmonary disease caused by cocaine abuse.
A patient developed 3 separate episodes of fever, transient pulmonary infiltrates, and bronchospasm after inhalation of cocaine. The illness was associated with eosinophilia, pruritus, and an elevated IgE level, indicating an immunologic pathogenetic mechanism. This is a complication of cocaine abuse not previously reported.
Cocaine↗
Anomalous pulmonary venous connection. Medical therapy.
Anomalous pulmonary venous connection is a congenital defect which may first be diagnosed in the adult who has developed lung disease or pulmonary vascular obstructive disease. Surgical repair may be inadvisable in such a case. To date, little attention has been paid in the literature to medical management. A case is presented in which medical palliation with nitrate therapy was successful.
Cardiac Catheterization↗
Cryptococcus laurentii lung abscess.
Pulmonary infection with Cryptococcus laurentii occurred in a patient with dermatomyositis receiving corticosteroid therapy. Infections with cryptococci other than C. neoformans are rare, and pulmonary involvement with C. laurentii has not been reported previously. The isolate was susceptible to amphotericin B but resistant to 5-fluorocytosine, and synergism could not be demonstrated with these 2 drugs. Amphotericin B without surgical resection, concurrent with reduction in the dosage of corticosteroids, resulted in clinical and roentgenogrphic resolution of the infection.
Adrenal Cortex Hormones↗
Management of sinusitis in adult cystic fibrosis.
Until recently, cystic fibrosis was frequently fatal during childhood. However, with current medical management, many patients are living into adulthood. This has created a new population of patients with chronic sinusitis and severe medical problems. In this report, experience with 22 patients, eight of whom have undergone sinus surgery, is presented, and recommendations for management are proposed. Presenting symptoms are typical of sinusitis, but in a few patients, severe debilitating headaches predominate. Oral antibiotics are often of little use due to the numerous courses of high dose intravenous antibiotics used for resistant pulmonary infections. Topical nasal steroids and mucolytics have been of some benefit. Fourteen operative procedures were performed on eight patients. These procedures included 12 endoscopic sphenoethmoidectomies, four Caldwell-Luc procedures, two frontal sinus obliterations, and one transseptal sphenoidotomy (many of these were in combination.) Results from this experience indicate 1) Failure of endoscopic surgery to control frontal and maxillary sinus disease; 2) Delayed healing of the ethmoid cavity with persistent crusting; and 3) Significant, albeit short term, symptomatic relief following surgical intervention. Based on this limited series, we conclude that surgery should be delayed until absolutely necessary and that an aggressive approach should be adopted when surgery is performed. In our hands this included initial endoscopic sphenoethmoidectomy with open surgical techniques used for removal of trapped inspissated secretions. We recommend long term intravenous antibiotics postoperatively and frequent cleaning of the ethmoid cavity after surgery, continuing indefinitely, to optimize the benefit of surgery.
Administration, Intranasal↗