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PubMed1982

Percutaneous interventional catheter therapy for lesions of the chest and lungs.

Percutaneous, nonsurgical interventions using angiographic catheter techniques and radiologic guidance were used in the management of seven cases of various lesions of the chest and lungs. Successful catheter therapy included the embolization of a large, acquired, postinflammatory vascular malformation causing massive hemoptysis and a cavernous hemangioma of the chest wall. Sixteen pulmonary arteriovenous fistulas (one patient), an iatrogenic internal mammary artery-to-innominate vein fistula, and a persistent, postbiopsy bronchopleural fistula were successfully closed. Percutaneous drainage of a pyogenic lung abscess and the nonoperative retrieval of an intravascular foreign body that had embolized to the left pulmonary artery were also successfully achieved. Performed under local anesthesia with minimal morbidity, stress, and risk, interventional catheter therapy is remarkably cost-effective. Primary chest physicians are encouraged to consider this mode of therapy whenever applicable.

Adult↗
PubMed1986

Pulmonary complications of benign esophageal disease.

Three patients with esophageal reflux and associated pulmonary complications are presented: one with a lung abscess, another with recurring pneumonitis that required hospitalization, and the third with bronchospasm or asthma secondary to reflux and chronic aspiration. Two were treated surgically by the repair of esophageal and pulmonary lesions. The third patient was treated medically, with resolution of pulmonary symptoms and improvement of pulmonary function. A review is presented of the association between esophageal and pulmonary problems and of the insidious complications that may result.

Adult↗
PubMed2001

[Etiology of hemoptysis: Prospective analysis of 752 cases].

OBJECTIVES: To know the etiology of hemoptysis and its distribution in our area compared with other current and historic series. METHODS: Prospective, descriptive study of 752 cases of hemoptysis. The etiology of these cases was determined by evaluating the clinical record, chest X-ray, functional respiratory tests and sputum smear for acid-fast bacilli, together with other examinations such as bronchoscopy and computerized tomography (CT) according to previously established criteria. RESULTS: The mean age of patients was 60 years (SD: 15 years), 79% were males and 75% smokers. Diagnoses included neoplasms (28%), chronic bronchitis (19.8%), bronchiectasis (14.5%), pneumonia or lung abscess (11.5%), idiopathic forms (8%), and miscellaneous causes with lower percentages such as tuberculosis (1.7%) and its sequelae (4%), cardiac diseases (1.5%) and pulmonary embolism (2.3%). Bronchoscopy was performed in 694 (92.2%) and detected the bleeding site or provided a specific diagnosis in 39% (81% if only neoplasms are considered) and non-specific but abnormal in 57%. The amount of bleeding was small in most cases and kept no relationship with causes. CONCLUSIONS: Neoplasms, chronic bronchitis and bronchiectasis are the most common causes of hemoptisis in our area. Bronchiectasis and tuberculosis have decreased compared with previous series used as reference. In contrast, there has been an increase in the number of neoplasms and chronic bronchitis and a plateau in those attributed to cardiac diseases, pneumonia or lung abscess and cryptogenetic forms. To obtain the origin, bronchoscopy complemented by CT remains essential.

Adolescent↗
PubMed1983

[Clinical study on dosage schedule of tobramycin: controlled comparison between 180 mg b.i.d. and t.i.d].

The efficacy and safety of tobramycin (TOB) administration at 90 mg twice a day (90 mg group) to patients with respiratory tract infections (RTI) were objectively investigated by means of a well-controlled comparative study. The results in this 90 mg group were compared with the case of administering 3 times a day of 60 mg each (60 mg group) as the control. In both of these patient groups, TOB was administered by intramuscular injection for 10 consecutive days. This study included 85 patients (90 mg group: 43 patients; 60 mg group: 42 patients). The Committee, however, excluded 19 patients consisting of 13 cases of infection other than RTI and 6 cases of out of protocol drug administration. Thus, 66 patients (90 mg group: 32 patients; 60 mg group: 34 patients) were used for the efficacy analysis. All 85 patients were used, however, for the evaluation of the safety of TOB and for the usefulness of TOB as judged by the physicians in charge. A brief summary of the results is presented below. The cases employed by the Committee consisted of 8 and 17 cases in the 90 mg and 60 mg groups, respectively, with bacterial pneumonia and lung abscess, and 24 and 17 cases in the 90 mg and 60 mg groups, respectively, with chronic RTI. There was a tendency for the distribution of disease cases in the 2 drug groups to be significant. Within the chronic RTI disease classification, the number of patients with chronic bronchitis was almost equal in the 2 drug groups; 16 cases in the 90 mg group and 15 cases in the 60 mg group. However, secondary infections were diagnosed in 8 cases in the 90 mg group and 2 cases in the 60 mg group. The clinical efficacy judged for all cases investigated by the Committee showed efficacy ratios of 56.3% for the 90 mg group and 70.6% for the 60 mg group. The difference between the 2 drug groups was not statistically significant. In the treatment of bacterial pneumonia and lung abscess, the efficacy rate in the 90 mg group was 87.5%, while it was 88.2% in the 60 mg group; these high values were practically identical. Against chronic RTI, the efficacy rates were 45.8% in the 90 mg group and 52.9% in the 60 mg group; within that disease classification, the efficacy rates against the chronic bronchitis cases were nearly the same at 43.8% and 46.7%, respectively. These data showed no statistically significant differences between the 2 drug administration groups. (ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1984

A comparison of cefotaxime and cefoperazone in respiratory tract infections.

The clinical efficacy and safety of cefotaxime and cefoperazone were evaluated in a comparative study. There were 18 adult males and 11 females. Their underlying disease was pneumonia (10), pleural empyema (2), bronchiectasis (6), bacterial bronchitis (9), lung abscess (2). Bacterial material included sputum, bronchial secretion gained by bronchoscopy or tracheal aspiration, and pleural punctures obtained up to 24 h before treatment. Most patients had Streptococcus pneumoniae or Haemophilus influenzae infections, although two patients in the cefoperazone group had infections caused by Pseudomonas aeruginosa, and another two anaerobic flora. Standard disc diffusion, and agar dilution susceptibilities were performed on all isolates. Patients received either cefoperazone (14) intravenously or intramuscularly in a dose range from 2 to 8 g/day or cefotaxime (15) 1 to 2 g intravenous or intramusculary at dosing intervals of 6 to 8 h (total 3 to 8 g/day), depending on the severity of the disease. Clinical improvement occurred in 14/15 (93%) of patients in the cefotaxime group, and 12/14 (86%) of patients treated with cefoperazone. Two failures in the cefoperazone group were secondary to superinfection (Acinetobacter and Ps. aeruginosa). Bacteriological and symptomatic failure, occurred in one patient with anaerobic lung abscess treated with cefotaxime. The results of this study indicate that cefotaxime is safe and effective in the therapy of acute bacterial lower respiratory tract infections.

Adult↗
PubMed1976

Diagnostic problems in suppurative lung disease.

Eleven of 48 (23%) patients diagnosed as having lung abscess or empyema presented diagnostic problems in the localization of infected material. All 11 patients were found eventually to have empyemas, all but one of which was complicated by bronchopleural fistulas. Difficulty in distinguishing abscess from empyema on a chest roentgenogram delayed diagnostic and therapeutic thoracentesis from 1 to 12 days. Pleural effusions were noted in all but one of the patients who did not initially have a bronchopleural fistula. In addition, once the bronchopleural fistula became established, the extension of the air-fluid level to the chest wall, the tapered borders of the air-fluid pocket, and the extension of the lesion across fissure lines were noted, in retrospect, to be suggestive of pleural localization. Delay in the evacuation of empyema fluid can lead to chronic complications and increased morbidity. Early identification and treatment of pleural effusions may avoid these diagnostic and therapeutic problems.

Adolescent↗
PubMed1989

[Clinical efficacy and pathogenetic validation of the intrapulmonary and intrabronchial administration of proteinase inhibitors and antibiotics in the treatment of patients with nonspecific lung diseases].

Eighty patients (34 with lung abscess, 39 with lingering pneumonia associated with chronic bronchitis) were examined for the activity of the proteinase inhibitory system in bronchial washing off as well as for the level of alpha 1-proteinase inhibitor in blood serum. The system of proteinases inhibitors was found to be unbalanced with the predominance of proteinases. The proteinase inhibitor contrycal was included into the multimodality treatment of patients. The patients of the main group were administered contrycal and antibiotics intrapulmonarily with the aid of a needle jet injector (NJI-1) and endobronchially, whereas the control group patients were given intravenous injections in the identical daily and total dose. The local (intrapulmonary and endobronchial) administration of proteinase inhibitors and antibiotics turned out to compare very favourably with intravenous injection of the same remedies.

Adolescent↗
PubMed1990

Quantitative C-reactive protein in pulmonary infections.

A total of 207 cases were selected to evaluate the diagnostic value of C-reactive protein (CRP) in pulmonary infections. The mean +/- SD of CRP values in various pulmonary infections were as follows: 18.62 +/- 11.34 micrograms/ml for 32 cases of exudative-fibrotic tuberculosis; 15.98 +/- 16.66 micrograms/ml for 15 cases of tuberculous pneumonia; 25.61 +/- 18.96 micrograms/ml for 29 cases of tuberculous effusion; 16.66 +/- 10.18 micrograms/ml for 11 cases of tuberculous cavity; 81.1 +/- 24.9 micrograms/ml for 10 cases of miliary tuberculosis; 36.4 +/- 22.1 micrograms/ml for 19 cases of mycoplasmal pneumonia; 241 +/- 72 micrograms/ml for 38 cases of bacterial pneumonia; 225 +/- 65 micrograms/ml for 30 cases of bacterial pneumonia with effusion; 169 +/- 50 micrograms/ml for 16 cases of lung abscess. The CRP values of other pulmonary infections were as follows: 20.6, 20.8 micrograms/ml for two cases of Strongyloides stercoralis pneumonia; 7.4, 1.6 micrograms/ml for two cases of aspergilloma; 11.2, 12.4, 7.6 micrograms/ml for three cases of Pneumocystis carinii pneumonia. Serial changes in CRP values in 13 cases of well-treated bacterial pneumonia showed that values of CRP decreased to below half of the initial value on the 3rd to 4th day, and returned to about normal value on the 10th to 13th day. The study suggested that: a) various types of infections had different levels of CRP values, b) level of CRP values was determined both by the pathogen and the severity of inflammation, c) serial CRP values in bacterial infection could be used as a guide in treatment.

Adolescent↗
PubMed1963

BRAIN ABSCESS.

Explore the source record for details and available documents.

Brain Abscess↗
PubMed2001

Surgery for bronchiectasis.

OBJECTIVE: The incidence of bronchiectasis has declined markedly in developed countries. However, a reasonable number of patients still need surgery, despite aggressive physiotherapy and antibiotic therapy. We have reviewed our patients to clarify the benefits from surgery and to analyse the complications. MATERIAL AND METHODS: Between 1988 and 1999, we have operated on 119 patients with bronchiectasis, 71 female and 48 male, with a mean age of 42.2 years (range 11--77 years). Surgery was indicated because of unsuccessful medical therapy in 66 patients (55%), 31 (26%) had haemoptysis, 11 (9.2%) had lung abscess, 10 (8.4%) had lung masses, and three (2.5%) had pneumothorax. The most common manifestations were cough with sputum in 90 patients (76%), haemoptysis in 45 (38%) and recurrent infections in 57 (48%). The mean duration of the symptoms was 4 years (range 1--40 years). The lower lobes were diseased in 61 patients and bilateral disease was found in ten. The mean number of involved pulmonary segments was five (range 1-15). A lobectomy was performed in 75 patients (62%), a segmentectomy in 12 (10%), a pneumonectomy in nine (7.4%) and a bilobectomy in four (3.3%). Complete resection of the disease was achieved in 108 cases (91%). RESULTS: There was no operative mortality and perioperative morbidity occurred in 15 patients (15%), including temporary broncho-pleural fistulae in 7 (5.8%), and post-operative haemorrhage and atrial arrhythmias in four (3.3%) each. After a mean follow-up was 4.5 years, 73 patients (68%) of this group were asymptomatic, and 31 (29%) had meaningful clinical improvement, while only four (3.7%) maintained or worsened prior symptoms. The best clinical improvement occurred in patients with complete resection of the disease (P=0.008). There were no differences in the respiratory function, comparing pre- and post-operative data, with a 2-year of minimum interval. The VC was 91 and 89% and the FEV1 was 83% and 81% of expected, respectively before and after surgery, (P=NS). CONCLUSION: Surgery of pulmonary bronchiectasis has few complications and markedly improves symptoms in the great majority of patients, especially when complete resection of the disease is achieved. Pulmonary resection of bronchiectasis does not alter respiratory function.

Adult↗
PubMedDate not supplied

Thoracic ultrasonography technique in newborn calves and description of normal and pathological findings.

The aim of this study was to establish whether thoracic ultrasonography is a viable screening method for detecting respiratory disorders in newborn calves. Thoracic ultrasonography was performed on 66 newborn calves. There were 10 normal control animals with healthy lungs and 56 newborn calves suffering from respiratory disorders such as lung atelectasis, aspiration of amniotic fluid, pulmonary edema, pneumonia, and lung abscesses. Ultrasonography of the lung enabled rapid classification of the severity, extent and type of pulmonary lesion found, thus supplementing the clinical examination. Processes deep to the pleura were not amenable to thoracic diagnosis by ultrasonography. This is due to the inability of sound waves to penetrate normally ventilated lung. Despite this problem, ultrasonography of the lung is suitable for assessment of clinically unclear respiratory disorders in calves.

Animals↗
PubMed1992

Aerobic and anaerobic bacterial interactions in the development of anaerobic bacterial pneumonia.

The interactions between aerobic and anaerobic bacteria in the development of anaerobic bacterial pneumonia were studied by introducing Bacteroides fragilis and Escherichia coli alone or in combination into guinea pigs by tracheal infusion. The lung lesions induced by B. fragilis were mainly located near the pleura, unlike those induced by E. coli, and were accompanied by pneumonia, lung abscess, and pleuritis. The lung lesions produced by mixed infection with B. fragilis (10(9) cfu) and E. coli (10(7) cfu) were significantly more severe than those induced by either microbe alone, and the redox potentials at the foci of inflammation were markedly reduced (max: -330 mV). Analysis of lung lesions after treatment with aztreonam and clindamycin and neutrophil phagocytic activity suggested that E. coli was primarily responsible for the lung lesions and that B. fragilis promoted the accompanying inflammation, resulting in increased pathogenicity of the mixed infections.

Animals↗