Biomedical subjects

T M Roy

Publications and source records attributed to T M Roy.

At least 109 records · Page 6Linked to original sources

PubMed1992

DaCosta's syndrome: chronic symptomatic hyperventilation.

In 1871, DaCosta published his observation of somatic symptoms preceded by significant hyperventilation. More than a century later, the hyperventilation syndrome remains a poorly defined but common clinical condition. Although familiar to most practitioners of medicine when it presents as an acute phenomenon, the diagnosis may go unrecognized in its chronic form. The ability of a chronic hyperventilatory state to mimic a life-threatening cardiopulmonary disease is not always appreciated.

Adult↗

PubMed1992

Recognition of upper airway obstruction misdiagnosed as asthma.

Distinguishing new onset asthma from an insidious upper airway obstruction can prove difficult and is more frequently being addressed in the medical literature. We examine our experience in a teaching hospital and analyze the problems relating to establishing the correct diagnosis.

Adult↗

PubMed1992

Impact of arterial blood gas analysis in disability evaluation of the bituminous coal miner with simple pneumoconiosis.

The Department of Labor has set guidelines for the use of resting arterial blood gas analysis in determination of total and permanent disability for coal workers' pneumoconiosis. To determine the prevalence with which bituminous coal miners fall below the arterial tensions of both oxygen and carbon dioxide published in the Federal Register, we studied 1012 miners who had both reproducible spirometry and arterial blood gas analysis as part of their disability evaluation. Eighty-seven percent of impaired miners could be identified by the spirometric criteria. Thirteen percent of impaired bituminous coal miners had acceptable pulmonary function but were eligible for black lung benefits by the blood gas guidelines. This population would have been missed if blood gas analysis were excluded from the evaluation process. On the other hand, approximately 25% of the blood gas analyses that were performed could be eliminated if a policy was adopted to do this test only on miners with spirometry that exceed the federal guidelines.

Carbon Dioxide↗

PubMed1992

Respiratory failure and death from HIV-associated myopathy.

As increasing numbers of patients with HIV infection enter the medical system, the neuromuscular problems caused by this retrovirus are better defined. Recent attention has focused on the development of myopathy and/or polyneuropathy in patients with the acquired immune deficiency syndrome. We report a patient whose initial presentation was that of progressive weakness. A diffuse HIV-induced myopathy was diagnosed that eventually resulted in ventilatory failure and death. The limited medical literature on this subject is summarized for practitioners who may encounter AIDS patients with muscle weakness.

Acquired Immunodeficiency Syndrome↗

PubMed1992

Platypnea, orthodeoxia and cirrhosis.

It is estimated that 15% to 45% of patients with cirrhosis of the liver are hypoxemic without apparent lung or heart disease. This report reviews the association of orthostatic hypoxemia with hepatic dysfunction.

Aged↗

PubMed1991

Tuberculosis in the intensive care unit: a chemotherapeutic controversy.

A survey of 150 practicing pulmonary physicians was conducted to determine chemotherapy preferences for the treatment of the patient suffering respiratory insufficiency secondary to active nonmiliary tuberculosis. An equal sample was selected from both the private sector and academic medicine in order to determine if antituberculous agent selection differed between these two groups. The majority of the 109 physicians who responded to the questionnaire (64.2%) indicated that they would use isoniazid, rifampin, and a third agent. There was no statistical difference in the choice of ethambutol, pyrazinamide, or streptomycin as the third drug. There was no difference between university and community based physicians in the use of three drug combinations or in the selection of the specific third agent. This study suggests that, although the majority of pulmonologists responding would treat the patient with respiratory insufficiency from tuberculosis with an aggressive three drug approach, there is no consensus as to which agent should be the third drug.

Antitubercular Agents↗

PubMed1991

Thoracic empyema due to Streptococcus intermedius.

With improved laboratory identification procedures, Streptococcus milleri (intermedius) is becoming recognized as an important human pathogen with the potential to form abscesses in a wide range of organs. The occurrence of a rapidly progressive and toxic empyema due to this organism in an otherwise healthy young adult without a predisposing lower respiratory tract infection allows us to examine the possibility that this microbe may be a significant but frequently unrecognized cause of adult empyema.

Adult↗

PubMed1991

Yellow nail syndrome: a perspective.

The Yellow Nail syndrome is an unusual lymphangitic disorder classically characterized by the presence of nail discoloration, lymphedema and pleural effusion. Since the recognition of the significance of these associated physical findings, four cases have been diagnosed at our institution in the last six years. This suggests that the syndrome may not be as rare as previously reported in medical literature. More often it may remain unrecognized in the absence of the classic triad of physical findings. To heighten awareness of this disorder, we describe our most recent patient diagnosed with YNS and provide a review of the current medical literature.

Female↗

PubMed1991

The respiratory complications of leptospirosis.

Leptospirosis is an uncommon disease. Respiratory failure attributable to this infection is unusual, but remains a major cause of mortality. Mechanical ventilation has been required for patients with significant alveolar hemorrhage and the adult respiratory distress syndrome. We report a patient with ventilatory failure due to the severe muscle weakness associated with leptospirosis and review the pulmonary consequences of this infection.

Humans↗

PubMed1991

Wegener's granulomatosis complicated by pregnancy. A case report.

A 23-year-old woman who presented in the 17th week of her third intrauterine pregnancy was diagnosed as having active Wegener's granulomatosis. Therapy, consisting of corticosteroids, cyclophosphamide and hemodialysis, was instituted and maintained until delivery. Although Wegener's granulomatosis complicated by pregnancy has been reported previously, this is the first reported patient to be treated successfully with the above agents during the second and third trimesters without apparent harm to her or her infant.

Adult↗

PubMed1991

Bronchogenic carcinoma and the acquired immunodeficiency syndrome.

The majority of patients with the acquired immunodeficiency syndrome will develop clinical and radiographic pulmonary involvement during the course of their disease. Although opportunistic pathogens account for the majority of these intrathoracic abnormalities, pulmonary neoplasms are being encountered more often than would be expected for the age group under consideration. Clinicians need to be vigilant for the possibility of the early appearance of bronchogenic carcinoma in this subset of patients.

Acquired Immunodeficiency Syndrome↗

PubMed1991

Pneumothorax: an unusual presentation of primary bronchogenic neoplasm.

We report the occurrence of spontaneous pneumothorax as the initial pulmonary event in a patient subsequently found to have a primary adenocarcinoma of the ipsilateral lung. A review of the literature regarding this rare presenting feature of bronchogenic neoplasm is provided.

Adenocarcinoma↗

PubMed1991

Hyperbaric oxygen treatment for carbon monoxide poisoning: observations based on 8 years experience.

Patients may develop significant carbon monoxide intoxication under a variety of circumstances. We propose that the frequency of symptoms, the patient's presentation, and ultimately the outcome are significantly related to the type of exposure. This association may help the practicing physician maintain the proper index of suspicion for recognizing carbon monoxide poisoning and providing the proper treatment for severe cases.

Adolescent↗

PubMed1991

Drug-induced pleural effusions.

Systematic analysis of pleural fluid, in conjunction with the patient's clinical presentation, should allow the clinician to arrive at the correct diagnosis in approximately 90% of cases. An awareness that some commonly used pharmaceutical agents can cause pleural effusion may help the clinician recognize the pathogenesis of some effusions whose cause is less obvious.

Humans↗

PubMed1991

Respiratory failure associated with myasthenia gravis.

Dysphagia and respiratory muscle weakness are the two most potentially dangerous findings in patients with neuromuscular disease because they predispose to aspiration pneumonia and respiratory failure. Myasthenia gravis is unique among the neuromuscular disorders for the variety of exacerbating factors that may lead to such clinical deterioration. While the major cause of ventilatory failure remains intensification of the underlying autoimmune process, well intentioned therapy may also lead to situations that necessitate ventilatory support. This report describes a patient with myasthenia gravis and respiratory failure and reviews the various etiologies of pulmonary dysfunction that are associated with the natural course of this disease and its treatment.

Adult↗

PubMed1990

Thallium-201 scintigraphy in the diagnosis and management of myocardial sarcoidosis.

We have described three patients with clinical evidence of myocardial sarcoidosis to illustrate the utility of thallium-201 scintigraphy in demonstrating the myocardial lesions. Both the symptomatic and asymptomatic individuals studied showed the characteristic "reverse redistribution" phenomenon. No abnormalities were seen during the exercise phase of the thallium study, but myocardial defects were detected in each patient when repeat studies were obtained at rest six hours later. Steroid therapy resolved the defects in each case. We propose thallium-201 scintigraphy of the heart as a safe and useful tool for documenting myocardial involvement in sarcoidosis and following the effects of therapy.

Adrenal Cortex Hormones↗

PubMed1990

Intracranial tuberculoma.

In North America, central nervous system involvement by tuberculosis is uncommon. This patient review describes the clinical and radiological features of this unusual neurologic lesion. Special emphasis is given to the methods of arriving at the correct diagnosis, to the efficacy of combination antituberculous therapy, and to the possibility of paradoxical expansion of these lesions during the course of successful treatment.

Aged↗

PubMed1990

Wegener's granulomatosis presenting as subglottic stenosis.

One of the rarest diseases associated with upper airway obstruction in adults is subglottic stenosis from the necrotizing vasculitis of Wegener's granulomatosis. Early recognition and treatment of this potentially fatal syndrome is necessary to insure long-term survival.

Adolescent↗