Patients' understanding of and compliance with medications: the sixth vital sign?
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Adult↗
Biomedical subjects
Edward C Rosenow
Publications and source records attributed to Edward C Rosenow.
Studies in pneumonia and pneumococcus infection. 1904.
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Animals↗
Amiodarone pulmonary toxicity.
The amount of literature on amiodarone pulmonary toxicity (APT) peaked in 1983-1984 with several hundred cases reported cumulatively, and declined thereafter. Since the mid-1990s, publications have increased, which suggests that APT remains a current problem in clinical practice. Amiodarone remains difficult to diagnose noninvasively, and although the outcome is good in the majority of patients, not all cases of APT can be controlled satisfactorily.
Amiodarone↗
Chyloptysis in adults: presentation, recognition, and differential diagnosis.
Chyloptysis is a rare finding, and the accompanying respiratory symptoms are usually nonspecific. The recognition of the chylous nature of the sputum is requisite for proper diagnosis, especially if chyloptysis is not accompanied by chylous pleural effusion. The key to the differential diagnosis of chyloptysis is to consider illnesses that can induce reflux of chyle into the bronchial tree. There are two mechanisms postulated: the first requires the presence of an abnormal communication between the bronchial tree and the lymphatic channels, and the second requires a bronchopleural fistula in the context of a chylous pleural effusion. Chyloptysis in adults should prompt assessment for evidence of lymphatic obstruction from trauma, radiation, and malignancy, and to exclude diseases with known association with chyloptysis, ie, lymphangioleiomyomatosis, yellow nail syndrome, or thoracic lymphangiectasis. A lymphangiogram is recommended to define the abnormality. In the case of lymphangiectasis, patients respond to either dietary modification and/or ligation of the thoracic duct.
Adult↗
Mediastinal granuloma and mediastinal fibrosis.
Mediastinal granuloma/mediastinal fibrosis is a chronic inflammatory disease of the mediastinum. Mediastinal granuloma is the abnormal enlargment of mediastinal lymph nodes by granulomatous inflammation, is usually asyptomatic or minimally symptomatic, and is often detected on chest radiographs taken for other reasons. In contrast, mediastinal fibrosis is extensive fibrous tissue throughout the middle mediastinum causing compression, encasement, or invasion of the large bronchi, superior vena cava, pulmonary veins, or esophagus, often with serious clinical consequences. Some patients may exhibit a clinical entity characterized by enlarged fibrotic and/or calicified lymph nodes with a variable amount of fibrosis that may be asymptomatic, or may cause symptoms by compression or invasion of structures in the mediastinum. Clinical manifestations may be due to superior vena cava (SVC) obstruction, esophageal compression, large airway involvement, pulmonary artery or pulmonary vein narrowing, or laryngeal or phrenic nerve impingement. Definitive diagnosis is traditionally made on the basis of a surgical exploration and biopsy, either a mediastinoscopy or thoracotomy; however, characteristic findings on computed tomography (CT) of the chest may be sufficient for a diagnosis in a certain number of cases. The best therapy is unknown. Antifungal therapy and corticosteroids have been reported effective in some cases. Surgical resection of localized mediastinal granuloma or fibrosis causing symptoms is often effective. However, surgical resection of extensive mediastinal fibrosis usually is not feasible.
Journal Article↗