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Biomedical subjects

T M Roy

Publications and source records attributed to T M Roy.

At least 19 recordsLinked to original sources
PubMed1997

Rheumatoid arthritis and the pulmonary nodule.

The potential difficulties offered by the presence of a solitary pulmonary nodule in a patient with rheumatoid arthritis are illustrated by a male non-smoker with clinical, serologic and radiographic rheumatoid arthritis, active and fibrosing alveolitis and a new lung nodule. This nodule proved to be squamous cell carcinoma without the typical risk factors. The findings of a solitary pulmonary density or nodule in a patient with rheumatoid arthritis provides no assurance that the lesion is benign. Both necrobiotic nodules and lung cancer may present as solitary pulmonary nodules in patients with this autoimmune disease.

Arthritis, Rheumatoid↗
PubMed1996

Exercise-induced asthma. Is gastroesophageal reflux a factor?

An acid-induced cholinergic esophagobronchial reflex has been described whereby acid refluxing into the esophagus causes bronchospasm. Reports of exertional gastroesophageal acid reflux prompted us to study the possibility that exercise-induced asthma (EIA) could be related to gastroesophageal reflux (GER). Following an overnight fast, 10 athletes with a history of EIA (nine men, one woman; mean age 31) were studied. Continuous monitoring of intraesophageal pH and motility, ECG, and arterial oxygen saturation was done. After baseline monitoring at rest for 15 min, subjects underwent treadmill exercise for 10 min followed by continuous monitoring for 30 min after exercise. Spirometry was done at baseline prior to exercise, then repeated every 5 min after exercise for 30 min. Two subjects were retested at a later date following a standard test meal. All 10 subjects demonstrated a decrease in FEV1 in response to exercise, but only half met criteria for EIA. Although 60% (6/10) showed some evidence GER, only three subjects demonstrated a pathologic degree of GER. In the two subjects retested postprandially, change in FEV1 was no different in one and improved in the other despite worsening of GER in both. There was no significant correlations between GER and EIA (P = 0.2). EIA correlated inversely with amplitude of esophageal contractions (P = 0.029) and was directly related to the percentage of multipeaked contractions and the duration of peristaltic contractions (P = 0.08). EIA is not associated with exertional GER.

Adolescent↗
PubMed1996

Improvement in oxygenation after large volume paracentesis.

Seventeen patients with biopsy-confirmed hepatic cirrhosis and tense ascites performed reproducible pulmonary functions and had arterial blood gas analysis before and after having a therapeutic large volume paracentesis. Each patient showed significant improvement in the static lung volumes as determined by helium dilution techniques. Dynamic airflow also improved as expressed by the FVC and the FEV1. The FEV1/FVC ratio remained unchanged. Each patient showed a significant improvement in oxygenation 120 minutes after LVP. Alveolar ventilation as expressed by PaCO2 did not change. The pathophysiology that explains the improvement in oxygenation remains speculative. Large volume paracentesis appears to have a salutary effect on oxygenation, as well as on pulmonary function.

Ascites↗
PubMed1996

Plasmacytoma as a cause of obstructive sleep apnea.

Solitary extramedullary plasmacytomas are uncommon neoplasms. They occur most frequently in the upper aerodigestive tract and account for 4% of the nonepithelial tumors in this site. The evolution of a plasmacytoma is unsteady and symptoms at presentation have included dystonia, dysphagia, oral pain, cough, and dyspnea on exertion. Plasmacytoma of the upper aerodigestive tract has not been previously reported as a cause of obstructive sleep apnea.

Humans↗
PubMed1996

Extrapulmonary tuberculosis in Tennessee: lessons from the last decade.

In conclusion, extrapulmonary TB remains a significant fraction of the total TB cases in Tennessee. During the last few years, the percentage of extrapulmonary TB in Tennessee has been on the increase. Understanding these changes in the epidemiology of extrapulmonary TB will help the clinician in making a prompt diagnosis, leading to appropriate therapy. Understanding the changing trends at the national level may aid state health departments in reorganizing disease control programs, thus, facilitating the eradication of TB and other communicable diseases in Tennessee.

AIDS-Related Opportunistic Infections↗
PubMed1996

Progressive massive fibrosis in a zinc miner.

The diagnosis of progressive massive fibrosis (PMF) is traditionally associated with exposure to coal dust. Since the legislation of better control of mine dust, the incidence of PMF has declined significantly. Clinicians who are not regularly involved in the medical care of coal workers may have limited knowledge of this incapacitating problem. Physicians are reminded that PMF is a complex process that can occur after exposure to mixed respirable particles other than coal dust.

Aged↗
PubMed1996

Diaphragmatic paralysis following scalenotomy for thoracic outlet syndrome.

Potential phrenic nerve injury that results in diaphragmatic dysfunction and respiratory insufficiency has important implications for the anesthesiologist who must insure adequate ventilation and gas exchange. A variety of traumatic injuries as well as some surgical manipulations have been identified with an increased frequency of diaphragmatic paralysis. We have observed the occurrence of this sequelae after scalenotomy for thoracic outlet obstruction, a previously unreported association.

Diagnosis, Differential↗
PubMed1996

The posttraumatic pulmonary mass.

Each year approximately 2 million people are seriously injured in traffic accidents. Injuries to the chest play a major role in the mortality and morbidity of these patients. One-third to one-half of motor vehicle crash victims suffer blunt thoracic trauma. The spectrum of injuries is broad but posttraumatic pulmonary masses are rarely noted. The proper use of radiographic imaging procedures allows documentation of pulmonary hematoma and exclusion of more ominous lesions.

Accidents, Traffic↗
PubMed1996

Cardiac tamponade as the initial presentation of bronchioloalveolar cell carcinoma.

Bronchioloalveolar cell carcinoma (BCC) is a relatively uncommon form of bronchogenic cancer with an insidious onset and a variety of radiographic appearances. Although the World Health Organization currently classifies it as a subtype of adenocarcinoma, many investigators view BCC as a distinct tumor with characteristic clinical features. There are still uncertainties regarding its origin, as well as the significance of associated clinical findings such as cardiac tamponade.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1996

"Ovarian asthma"-- act or fancy?

Hormonal interactions have been suspected of worsening airways dysfunction in a subgroup of female asthmatics. Despite reports of fatal and near-fatal asthma attacks associated with menstruation, there is little consensus about the impact of this biologic function on the clinical expression of asthma. The authors present a young asthmatic female whose episodic and potentially fatal worsening of asthma typically occurred within the days prior to her menses in the absence of other trigger factors.

Adult↗
PubMed1996

Treatment of pneumothorax in the patient with AIDS.

With the diagnosis of the adult immunodeficiency syndrome (AIDS), a patient's risk of sustaining a nontraumatic pneumothorax increases to 450 times that of the general population. The approach to pneumothorax that occurs in the patient with AIDS differs from the strategy that is used for spontaneous pneumothorax in immunocompetent young adults. The modifications in treatment are predicated on understanding the etiology of spontaneous lung collapse in the patient with AIDS.

AIDS-Related Opportunistic Infections↗
PubMed1996

Pulmonary abscess due to Corynebacterium striatum.

Non-diphtheria corynebacteria are normal commensals of the skin and mucous membranes of humans. Increasingly, however, these saprophytic organisms are being recognized as pathogens. Patients infected with these bacteria typically have an underlying immunosuppressive process and/or an indwelling venous catheter. Pleuropulmonary infection with Corynebacterium striatum is rare. We present a patient with diabetes mellitus who developed an intrapulmonary abscess due to C. striatum.

Aged↗
PubMed1996

Nutritional status and mortality in respiratory failure caused by tuberculosis.

A retrospective analysis of the records of all patients admitted to the intensive care unit with respiratory failure and nonmiliary tuberculosis was conducted to determine variables that might be predictive of survival. Nutritional status, as reflected by the patient's serum albumin and hemoglobin, were the best predictors of survival and were more helpful than the widely accepted APACHE II scoring system. This observation suggests that early and aggressive attention to improving the patient's nutritional status may be as important as effective antitubercular therapy and mechanical ventilation in salvaging these individuals.

Adult↗
PubMed1995

Phrenic nerve injury following scalenectomy in a patient with thoracic outlet obstruction.

We present a case in which a patient with normal pulmonary reserve experienced orthopnea and hypoxia secondary to unilateral diaphragmatic paralysis following right scalenectomy. This operation was performed in an attempt to relieve neurovascular compromise at the thoracic outlet. To our knowledge, this association has not been previously described in the literature.

Dyspnea↗