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At least 91 records · Page 5Linked to original sources

PubMed1999

Atypical Wegener's granulomatosis with positive cytoplasmic antineutrophil cytoplasmic antibodies, ophthalmologic manifestations, and slowly progressive renal failure without respiratory tract involvement.

A 68-year-old woman had microscopic hematuria and proteinuria since the age of 50. She also had hearing impairment, arthralgia, retinal embolism, peripheral arterial occlusion of the right foot and chronic renal failure during the course. At the age of 68, she had progressive renal failure and nephrotic syndrome with high titers of serum cytoplasmic antineutrophil cytoplasmic antibodies (c-ANCA). No evidence of respiratory tract involvement was found. Methylprednisolone pulse therapy and low dose cyclophosphamide therapy ameliorated the renal failure and reduced the serum c-ANCA level. She, however, died on July 19, 1998 due to pulmonary fungal and pneumocystis carinii infection.

Aged↗

PubMed1989

Critique of available studies on the toxicology of kretek smoke and its constituents by routes of entry involving the respiratory tract.

Kreteks are tobacco cigarettes containing clove, imported into North America from Indonesia. Health effects, including severe pulmonary toxicity, are suspected to be associated with kretek use among adolescents and young adults. The most likely candidate for a specific toxic effect among the chemical constituents of kreteks is eugenol. Eugenol is a natural compound found in high concentrations in clove buds and is the active ingredient that distinguishes kreteks from conventional cigarettes. It is a potent and valuable topical anesthetic, as well as a pungent spice constituent. Until kretek use became a fad in North America in the early 1980s, the toxicity of eugenol by routes of exposure involving the respiratory tract had not been considered because human exposure had been predominantly oral and topical. Concern over the possible pulmonary toxicity of kretek smoke has stimulated studies on the smoke, eugenol itself, and other chemical constituents of kreteks. Two sets of studies are now available for review, one series conducted by La Voie et al. of the American Health Foundation and another conducted by Clark et al. of the Huntingdon Research Centre in the United Kingdom. Their methods and findings are very different. Common problems include low statistical power, methods of exposure that do not duplicate human exposure, and failure of the models to replicate the circumstances of the extant clinical reports, which suggest that aspiration, idiosyncratic or allergic reactions, or impaired host defense mechanisms may be involved. The available toxicologic studies must be considered preliminary.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗

PubMed1987

Modulation of rabbit airway smooth muscle responsiveness by respiratory epithelium. Involvement of an inhibitory metabolite of arachidonic acid.

The integrity of the respiratory epithelium may be important in development of bronchial hyperreactivity; however, the mechanisms involved remain unknown. This study was undertaken to determine if epithelium of rabbit intrapulmonary bronchi is capable of modulating the responsiveness of airway smooth muscle to a pharmacologic stimulus, and whether epithelial-derived prostaglandins play a role in this modulatory function. Mechanical removal of the epithelium from bronchial segments, or incubation of intact bronchi with indomethacin (an inhibitor of prostaglandin synthesis) increased the sensitivity of bronchial smooth muscle to bethanechol. Cyclooxygenase was localized within mucosal epithelial cells of intact airways by avidin-biotin immunoperoxidase staining using a monoclonal antibody to the enzyme. Removal of the epithelium significantly reduced the levels of PGE2 and 6-keto-PGF1 alpha accumulated in the media surrounding bronchial explants. In epithelium-intact bronchi precontracted with bethanechol, arachidonic acid evoked an indomethacin-sensitive relaxation response comparable to relaxation induced by exogenous addition of PGE2. Although PGE2 evoked similar responses in epithelium-denuded bronchi, arachidonic acid-induced relaxation responses were negligible. The results suggest epithelial cells of rabbit bronchi modulate the responsiveness to pharmacologic stimuli by production and release of an inhibitory cyclooxygenase metabolite of arachidonic acid.

Animals↗

PubMed1989

Guillain-Barré syndrome and related conditions in Victorian teaching hospitals 1980-84.

Cases of Guillain-Barré syndrome, its variants, and chronic inflammatory demyelinating neuropathy presenting during the period 1980-84 were identified through computer-based record systems. Case notes were examined, and cases that did not meet standard criteria for diagnosis were excluded. A hundred and ten patients were identified, giving an annual adult incidence rate of 0.9/100,000 and a male:female ratio of 1.3:1. The majority of cases developed severe tetraparesis, but unusual presentations included the Miller-Fisher variant, paraplegia, and bibrachial involvement. There was wide variation in peak disability, ranging from ambulant with weakness (32%), through bedfast but without significant respiratory involvement (29%), to respiratory involvement requiring admission to an intensive care unit (38%). Of those discharged directly home, the average hospital stay for those less than 50 years was 27 days, whilst that for those over 50 was 49 days. CSF protein was measured in 87 patients, and was greater than or equal to 0.6 g/L in 76% of these. Nerve conduction studies were performed in 52 patients, and were abnormal in 90% of these. Guillain-Barré syndrome and allied conditions represent a major drain on health resources, and the need to provide adequate plasmapheresis facilities for patients early in the course of severe disease is stressed.

Adolescent↗

PubMed1997

[Radiologic features of lung diseases in HIV infection in children].

OBJECTIVES: The purpose of this study was to assess the incidence of respiratory involvement in HIV-infected children, along with the radiological manifestations of the various HIV-related diseases. MATERIAL AND METHODS: A retrospective review of the medical records of 65 HIV-infected children (63 vertically-infected and 2 through blood transfusion) has been carried out. The mean time of follow-up since the diagnosis of HIV infection was 32 +/- 27 months, beginning January 1987. Patients have been classified into 5 categories: Pneumocystis carinii (PC) pneumonia, lymphoid interstitial pneumonitis (LIP), lobar pneumonia, acute respiratory distress and a miscellaneous group. Plain chest radiographies were performed according to clinical criteria and at least every 6 months in asymptomatic patients. Diagnosis into categories was based upon chest X-ray findings, along with several etiological diagnostic criteria depending on the category. RESULTS: Respiratory involvement occurred in 32 children (49%). The most common diseases were PC pneumonia in 7 patients, LIP in 8 children, and lobar pneumonia and acute respiratory distress in 6 and 7 cases, respectively. PC pneumonia in children younger than one year had a good clinical and radiological correlation. LIP diagnosis has been based only on radiological criteria with the typical pattern. We want to highlight the disappearance of the radiological findings in 3 cases over time. Interestingly, several patients had other etiologic diagnosis, such as S. pneumoniae pneumonia, miliary tuberculosis, and two patients had acute respiratory distress, one caused by adenovirus and the other by enterovirus. CONCLUSION: Respiratory involvement is common in HIV-infected children. Clinical and radiological manifestations are variable. Plain chest radiography plays a very important role in the management and follow-up of these patients.

Adolescent↗

PubMedDate not supplied

[Respiratory function involvement in intestinal chronic inflammatory disease: description of a case].

In the process of chronic intestinal inflammatory diseases the involvement of other organs and apparatuses is frequent. The respiratory apparatus, however, is not so frequently concerned as other organs, especially with regard to the paediatric age. The rarity of clinical evidences concerning the respiratory apparatus contrasts with the anomalies of the lung functionality tests described in literature. A fifteen year old boy is taken into consideration. He was first examined at the age of nine, when his symptomatology (slight fever and abdominal pain) was regarded as a chronic intestine inflammatory disease and it was treated with salazopyrina and cortisone. Compilations supervened later on, such as ilium arthritis, psoriasis-like dermatitis, perineal abscess. Five years after the beginning of the intestine disease the lungs were also involved and there was evidence of dyspnoea, especially when the patient was under stress. The clinical picture was confirmed by the reduction of the parameters of the respiratory functionality in the sense of an insufficiency of obstructive and restrictive kind. The pulmonary compilation was treated with disodium cromoglycate; such treatment was stopped, after the appearance of headache. After more than a year since the supervening of the lung complication the patient is being kept under periodic control to evaluate his pulmonary functionality. The indexes are constantly altered in the sense of a reduction of FEV 1, of FVC, of FEF 25-75 and of PEF, while the ventilatory and perfusional pulmonary scintigraphy has not shown relevant anomalies.

Child↗

PubMed1998

Occurrence of some viruses and bacteria involved in respiratory diseases of ruminants in Hungary.

Serological surveys, virological and bacteriological investigations were carried out on large populations of lambs and calves kept in intensive fattening units on Hungarian large-scale farms, in order to study the occurrence of viruses and bacteria involved in the respiratory disease complex. The investigations were carried out in stocks where 5-20% of the young animals succumbed to acute or chronic pneumonia every year. Serological surveys revealed that seropositivity to bovine adenovirus type 2 (BAV-2) and parainfluenza type 3 (PI-3) were the most widespread viral infections both in cattle and sheep (BAV-2: 56% and 88%, PI-3: 76% and 41%, respectively). Antibodies against infectious bovine rhinotracheitis virus (BHV-1) were also found in a high proportion (45%) of sera of 3-8 month old calves, while in 2-6 month old lambs ovine adenovirus 1 (OAV-1) was the third most frequent virus (22%). Bacteriological investigations demonstrated secondary infections caused by different Pasteurella haemolytica and Pasteurella multocida serotypes in most cases. In cattle herds P. multocida A proved to be the predominant bacterium: it was isolated in each herd examined, while P. haemolytica A1 strains were isolated in 7 and Haemophilus somnus in 2 out of 13 herds. In sheep flocks P. haemolytica was the most frequent species isolated, 10 serotypes were cultured from pneumonic sheep but serotypes A2, A1 and A8 were the dominant ones.

Animals↗

PubMed1993

Respiratory muscles and ventilatory failure: 1993 perspective.

Some conditions that predispose to ventilatory failure increase the work of breathing (chronic obstructive pulmonary disease [COPD], obesity, kyphoscoliosis), whereas others cause severe respiratory muscle weakness. Specific reasons for muscle weakness include critical illness (electrolyte imbalance, acidemia, shock, sepsis), chronic illness (poor nutrition, cachexia), and neuromuscular diseases. Inspiratory muscle weakness from mechanical disadvantage to the diaphragm is characteristic of asthma and COPD. The increased work of breathing combined with muscle weakness increases the pressure needed to inspire a breath and decreases maximal inspiratory pressure. When this pressure exceeds 0.4, dyspnea and inspiratory muscle fatigue ensue. One way to lower this pressure and avert fatigue is to lower the tidal volume. Ventilatory drive is high, not low, in ventilatory failure. Concomitant shortening of inspiration and breath duration cause the small tidal volume and increased respiratory rate. Gas exchange is compromised by ventilation/perfusion imbalance, and the ratio of dead space to tidal volume is also increased by rapid, shallow breathing. Reduction in tidal volume minimizes dyspnea, but the small tidal volume is inadequate for gas exchange. Acute treatment of respiratory muscle failure involves respiratory muscle rest through mechanical ventilation and removal of noxious influences (infection, metabolic disarray), whereas chronic treatment involves rebuilding the contractile apparatus by nutritional repletion and training.

Animals↗

PubMed2000

Priming of the neutrophil respiratory burst involves p38 mitogen-activated protein kinase-dependent exocytosis of flavocytochrome b558-containing granules.

The respiratory burst of human neutrophils is primed by a number of pro-inflammatory stimuli, including tumor necrosis factor-alpha (TNFalpha) and lipopolysaccharide (LPS); however, the mechanism of priming remains unknown. LPS has been shown previously to increase membrane expression of flavocytochrome b(558), a component of the NADPH oxidase. This study shows that TNFalpha also increases membrane expression of flavocytochrome b(558). Mitogen-activated protein kinase (MAPK) modules have been implicated in the action of priming agents. Pharmacologic inhibitors of MAPKs, SB203580 and PD098059, revealed that priming of the respiratory burst and up-regulation of flavocytochrome b(558) are dependent on p38 MAPK but not on extracellular-signal regulated kinase (ERK). TNFalpha and LPS primed respiratory burst activity and increased membrane expression of CD35 and CD66b, specific markers of secretory vesicles and specific granules that contain flavocytochrome b(558), with similar time courses and concentration dependences. These processes also required p38 MAPK but were independent of ERK. TNFalpha failed to prime respiratory burst activity or to increase membrane CD35 expression in enucleated neutrophil cytoplasts. These data suggest that one mechanism by which TNFalpha and LPS prime neutrophil respiratory burst activity is by increasing membrane expression of flavocytochrome b(558) through exocytosis of intracellular granules in a process regulated by p38 MAPK.

Antigens, CD↗

PubMed1994

Clinical and radiological features in three cases of pulmonary involvement from recurrent respiratory papillomatosis.

Clinical case reports of 3 children with recurrent respiratory papillomatosis who developed lung dissemination of the disease are presented. The radiological features of the primary pulmonary disease included papillomata in the distal airway and multiple, nodular lung lesions, both solid and cavitated. Changes secondary to pulmonary papillomatosis included atelectasis, infection and bronchiectasis. Respiratory papillomatosis involving pulmonary parenchyma is associated with a poor prognostic outcome. Early detection of such involvement and aggressive treatment of secondary infection are required to limit parenchymal damage.

Child, Preschool↗

PubMed1980

[Clinical aspects and therapy of tetanus].

The various clinical symptoms of the tetanus are included by the Authors in three different groups. In the first and the second ones are the localized forms or tetanus, which affects several skeletal muscle groups without involvement of the respiratory apparatus. In the third group, in addition to the tetanus of the new-born babies, are the most severe forms of tetanus, the dangerousness of which is due to a respiratory involvement or to the persistence of a severe hypertensive-hypotensive syndrome, associated with hyperpyrexia and an ingravescent uncontrollable circulatory failure, in the completely sedated patient. An encephalopathic coma may also occur. The highest mortality (55-70 per cent) is observed in the tetanuses of the third group. The therapy is based on the triad seroanatoxins, antibiotics and sedative drugs. Tracheotomy and assisted mechanical ventilation are essential in the patients of the third group in order to be allowed to administer curare-like drugs as choice remedy. But, in spite of all these heroic treatments, the mortality is still high.

Anti-Bacterial Agents↗

PubMed2002

A review of functional and structural components of the respiratory center involved in the arousal response.

State-dependent changes influencing both the central chemoreceptor and vagal inputs to respiratory neurons may provide useful markers to assess some intrinsic factors of the respiratory center. In this paper we discuss the following topics from our recent experiences, and their relevance to the assessment of sleep-related phenomena. (1) 'Post-sigh' apnea appears predominantly during non-REM sleep in control subjects, and is a potential marker of respiratory dysfunction during this stage of sleep. (2) The disarranged configuration of the arcuate nucleus in Fukuyama-type congenital muscular dystrophy may represent a disturbance in the tangential migration pathway in the brainstem, and may be related to the sudden death that is common in this disorder. The maldevelopment of the arcuate nucleus in the victims of sudden infant death syndrome (SIDS) may also be related to some abnormality in the differentiation and migration of this neuronal population. (3) The onset of hypoglossal nerve activity precedes inspiratory activity of the phrenic nerve, possibly representing a latent drive from the respiratory rhythm generator. These issues are not only related to respiratory rhythmogenesis itself, but are also important in understanding the pathological conditions of arousal responses.

Journal Article↗

PubMed1999

Autosomal dominant myopathy with proximal weakness and early respiratory muscle involvement maps to chromosome 2q.

Two Swedish families with autosomal dominant myopathy, who also had proximal weakness, early respiratory failure, and characteristic cytoplasmic bodies in the affected muscle biopsies, were screened for linkage by means of the human genome screening set (Cooperative Human Linkage Center Human Screening Set/Weber version 6). Most chromosome regions were completely excluded by linkage analysis (LOD score <-2). Linkage to the chromosomal region 2q24-q31 was established. A maximum combined two-point LOD score of 4.87 at a recombination fraction of 0 was obtained with marker D2S1245. Haplotype analysis indicated that the gene responsible for the disease is likely to be located in the 17-cM region between markers D2S2384 and D2S364. The affected individuals from these two families share an identical haplotype, which suggests a common origin.

Chromosomes, Human, Pair 2↗

PubMed1992

[Aggravation of hypoxemia in supine position in myotonic dystrophy].

Myotonic dystrophy (MyD) involves a variety of systems. Respiratory disorders are common, namely elevation of diaphragm, alveolar hypoventilation, aspiration pneumonia and sleep apnea. We evaluated respiratory involvement. The subjects were 11 patients with MyD. Also 6 patients with limb girdle muscular dystrophy (LG) were examined to be compared with MyD. Both groups had the similar activities of daily living. All of them never complained of dyspnea. Arterial blood gas studies were performed in supine position and standing position. A new evidence was found that hypoxemia was aggravated and alveolar-arterial oxygen pressure difference was increased in supine position in MyD. Next, pulmonary function tests were done in supine position and sitting position. Functional residual capacity (FRC) were more reduced in supine position in MyD compared with LG. The value to subtract closing capacity from FRC was negative in supine position in MyD, showing closing phenomenon. We propose the mechanism of the aggravation of hypoxemia may be the following. The reduction of FRC caused by respiratory muscle involvement brings out the closing phenomenon. Abnormal uneven distribution of ventilation-perfusion ratio happens and then hypoxemia is worsened in supine position in MyD.

Adult↗

PubMed2001

Maximal respiratory pressures in myasthenia gravis. Relation to single fiber electromyography.

OBJECTIVES: The respiratory muscle weakness was evaluated in mild forms of myasthenia gravis (MG) and was compared with single fiber electromyography results (SFEMG) in the extensor digitorum communis muscle. MATERIAL AND METHODS: We assessed 61 treated MG patients without clinical respiratory involvement (13 ocular forms, 28 form IIa and 20 form IIb patients) by maximal respiratory pressure (MRP) to ascertain whether they were consistent with SFEMG results. RESULTS: Maximal expiratory pressure (MEP) and maximal inspiratory pressure (MIP) were reduced below the lower limit for healthy subjects in 85% and 77% of ocular patients; in 93% and 89% of form IIa, respectively; and in 95% of form IIb. The highest percentage of MEP and MIP reduction showed a positive correlation with increased jitter (r=0.45, P<0.001; r=0.27; P<0.05 respectively) and impulse blocking (r=0.35, P<0.01; r=0.28, P<0.05 respectively). CONCLUSION: We consider MRP measure useful for assessing respiratory muscle weakness in MG patients with subclinical respiratory involvement.

Adult↗

PubMed1999

Dyspnoea, peripheral airway involvement and respiratory muscle effort in patients with type I diabetes mellitus under good metabolic control.

Dyspnoea and pulmonary dysfunction have recently been associated with Type I (insulin-dependent) diabetes mellitus. The putative role of altered pulmonary mechanics and of performance of inspiratory muscles in inducing dyspnoea has not been yet assessed in Type I diabetes. To better focus on this topic we evaluated nine patients with Type I diabetes mellitus, aged 19 to 48 years with good and stable metabolic control, without a history of smoking and microvascular complications, alongside a group of 14 healthy control subjects. In each subject, pulmonary volumes, static and dynamic compliance, pleural pressure swings (Pplsw), maximal inspiratory pressures (Pplsn), Pplsw(%Pplsn), a measure of respiratory muscle effort, and tension-time index [TTI=TI/TTOTxPplsw(%Pplsn)] were measured (TI=inspiratory time;TTOT=total time of the respiratory cycle). All subjects were studied at baseline and during hypoxic rebreathing. Patients had normal pulmonary volumes. During hypoxic rebreathing, a normal change in respiratory muscle effort [DeltaPplsw(%Pplsn)/DeltaSaO2] and DeltaTTI/DeltaSaO2, and a lower change in tidal volume versus change in oxygen saturation [DeltaVT(% vital capacity)/DeltaSaO2], resulted in a higher ratio of respiratory effort to tidal volume [Pplsw(%Pplsn)/VT(% vital capacity)], a measure of neuroventilatory dissociation of the respiratory pump. Hypoxic dyspnoea, assessed by a modified Borg scale, showed a greater rate of rise (DeltaBorg/DeltaSaO2) and a greater increase for a given level of respiratory effort in patients. Moreover, neuroventilatory dissociation related to the expression of peripheral airway involvement, as assessed in terms of low dynamic compliance, and to concurrent change in dyspnoea sensation. Patients with Type I diabetes mellitus under good metabolic control and with normal lung volumes may have abnormal peripheral airway function. The latter is thought to be responsible for the association between dyspnoea sensation and neuroventilatory dissociation.

Adult↗

PubMed2000

Xanthoma disseminatum with respiratory tract involvement and fatal outcome.

Xanthoma disseminatum (XD) is a rare mucocutaneous xanthomatosis classified as a benign form of non-Langerhans' cell histiocytosis. The case history is presented of a 61 year old woman with XD who developed dyspnoea and spirometric features of airflow obstruction. Bronchoscopy and computed tomography confirmed involvement of the large and medium sized bronchi and she subsequently died from acute respiratory failure. The post-mortem findings and the importance of respiratory tract disease in this unusual condition are discussed.

Airway Obstruction↗

PubMed1993

[Solid-phase immunoenzyme analysis in the differential diagnosis of pulmonary tuberculosis and other infectious diseases with respiratory organ involvement].

The authors studied the information efficiency of stable-phased immunofermental analysis (IFA) in differential diagnosis of infectious diseases of respiratory system and pulmonary tuberculosis. IFA method was used on 60 infectious patients with non-tuberculous pathology, 64 patients with pulmonary tuberculosis and 200 donors. It was found out that the minimal diagnostical IFA titer in pulmonary tuberculosis was 1:320 (antibody revealing frequency--up to 89.2%; specificity--95%). IFA method with phosphatide antigen has a great practical significance in differential diagnosis of influenza, acute respiratory viral infections and pneumonias with pulmonary tuberculosis.

Antibodies, Bacterial↗