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Biomedical subjects

R J Awe

Publications and source records attributed to R J Awe.

10 recordsLinked to original sources

Lung cancer in association with human immunodeficiency virus infection.

The association of lung cancer and infection by the human immunodeficiency virus (HIV) is uncommon. This report and critical review of the medical literature defines a clinical profile of 22 patients affected with this uncommon association. This clinical profile includes young age (median, 38 years), intravenous drug abuse (14 of 22 patients), preponderance of adenocarcinoma over other cell subtypes (11 of 22 patients), and advanced clinical stage at presentation (10 of 15 patients with staging data had Stage III or IV disease). This study also examines a possible increased risk for lung cancer in patients infected by HIV. Continued surveillance and reporting of lung tumors (other than lymphomas and Kaposi sarcomas) in patients infected by HIV should help to define the frequency of the association and the validity of the clinical profile.

Adenocarcinoma

Carcinomatous lung abscess. Diagnosis by bronchoscopy and cytopathology.

We compared the roentgenographic, bronchoscopic, and cytopathologic findings from 26 patients with carcinomatous lung abscesses (23 of which were within the tumor) with findings from 31 patients with simple lung abscesses. Despite well-described roentgenographic characteristics of the carcinomatous abscess, differentiation from a simple abscess was frequently not possible. Direct visual findings at the time of bronchoscopy were not helpful in the absence of an endobronchial lesion. Using sputums and cytological specimens from a single fiberoptic bronchoscopy, a diagnosis was made by cytopathology on initial hospitalization in 22 (88%) of 25 patients with carcinoma. No false-positive cytological studies were reported in the nonmalignant group despite the frequent presence of inflammation and infection.

Biopsy

Acute tuberculous pneumonia.

A case of acute tuberculous pneumonia diagnosed by transbronchial biopsy is presented. We postulate that the unusually rapid progression was due to an exudative hypersensitivity reaction to aspirated tuberculoprotein.

Acute Disease

Bacteremic Acinetobacter Herellea pneumonia with survival: case report.

A case of community-acquired pneumonia with Acinetobacter calcoacetium var. anitratus (Herellea vaginicola) is presented. Initial leukopenia and spare leukocytes in the sputum, followed by prolonged leukocytosis and fever, were unusual features of this case. The clinical significance and current antimicrobial drug therapy of acinetobacter infections are discussed.

Acinetobacter

The effect of bronchofiberscopic examination on oxygenation status.

Arterial blood gases were measured in 62 patients, none of whom was critically ill, to determine the effect of transnasal fiberoptic bronchoscopy on oxygenation status. Blood samples were obtained at regular intervals during the procedure. Thirty-four patients who were bronchoscoped while breathing room air had a significant drop in the arterial P02 following saline solution lavage. Twenty-eight patients who were given 28 percent oxygen via a Ventimask during the procedure were protected from this hypoxemia. Simultaneously measured arterial pH and Pco2 were unchanged during the procedure. Premedication alone resulted in a minimal but insignificant drop in PaO2 in 7 patients. These observations suggest that if the initial PaO2 is less than 70 mm Hg on room air, bronchoscopy by the transnasal approach is best performed with the administration of oxygen through an appropriate mask. If the patient is at risk of developing hypercapnia with supplemental oxygen, a 28 percent Ventimask should be utilized to prevent significant hypoxemia without causing hypercapnia.

Blood Gas Analysis

Left ventricular function during respiratory failure.

Indirect measures of left ventricular function were studied in seven patients with respiratory failure secondary to chronic obstructive pulmonary disease to determine if there were a relationship between left ventricular function and treatment of the pulmonary disease. All patients were studied during acute episodes while in respiratory failure having arterial Pco2 (Paco2) values greater than 49 torr with no clinical evidence of left ventricular failure. Indirect methods to evaluate left ventricular function included the use of the Swan-Ganz catheter for pulmonary capillary wedge pressure measurement, systolic time intervals, and cardiac output. There was improvement in left ventricular function with treatment of the respiratory failure manifested by decreases in the wedge pressure and pre-ejection period/left ventricular ejection time ratio, and an increase in the dp/dt/pulmonary capillary wedge pressure with treatment of the chronic obstructive pulmonary disease. The improvement in left ventricular function suggests that there is a depression of left ventricular function in respiratory failure. The depressed function improved with therapy of the lung disease without additional medication directed at cardiac function.

Adult