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At least 19 recordsLinked to original sources
PubMed1977

[Early respiratory involvement in burns. Mechanism and prognostic significance].

A retrospective study, on 87 flame burn patients, of arterial Pa02, chest X-ray and lactic dehydrogenase isoenzyme III revealed the very early onset (before the 24th hour) of severe respiratory problems. This involvement, with a severe prognostic significance, appears to be much more closely related to the extent of the cutaneous burn than to the inhalation of fumes or vapours, and seems to fall into the more general category of "post-aggression lung".

Adult↗
PubMedDate not supplied

[Resistance to antibiotics of bacteria involved in respiratory infections (author's transl)].

The present status of resistance to antibiotics of bacteria involved in respiratory infections is reviewed. Schematically it can outlined as follows. Streptococcus B-haemolyticus as well as Pneumococcus did not change their sensitivity to penicillin, but some strains are now resistant to tetracycline. Streptococcus viridans, Enterococcus and H. influenzae did not change substantially their sensitivity to antibiotics. Staphylococcus aureus is the bacterial species that always poses some problems with regard to antibiotic resistance. Due to the selection of strains penicillinase-producing because of the large use of penicillin, the most part of clinical isolates of staphylococci is now resistant to penicillin. In addition an increased number of strains resistant to the other antibiotics has been registered as soon as they has been introduced in therapy. The resistant strains spread in a particularly rapid way in hospital. The introduction in therapy of penicillinase-resistant penicillins constituted a remarkable advance in therapy of staphylococcal infection. However, there is now a growing number of indications about the emergence of methicillin resistant strains of staphylococci. On the other hand it must be recalled that since 1960 a marked reduction of incidence and mortality in severe staphylococcal infections has been noted. Incidence and mortality of respiratory infections due to Gram-negative bacilli is augmented particularly in connection with a larger use of immunosuppressive and antineoplastic therapies, of particular surgical or reanimation procedures, of intensive courses of antibiotic therapy etc. Emergence of Pseudomonas, Proteus, Serratia, Providencia, etc. infections poses many difficult problems of chemotherapy since these species are scarcely sensitive to antibiotics. Carbenicillin, cephalosporins, sisomicin, tobramycin, amikacin are the more recent drugs that alone or in combination may offer some chances of success in this field.

Anti-Bacterial Agents↗
PubMed2026

Respiratory manifestations as clues to inherited metabolic disorders in children: a phenotype-driven diagnostic approach.

UNLABELLED: Inherited metabolic disorders (IMDs) are uncommon but clinically important causes of respiratory morbidity in children. Respiratory involvement may be the first or dominant manifestation, although it may precede, accompany, or follow systemic involvement. Because cough, dyspnea, hypoxemia, recurrent infection, abnormal chest imaging, and ventilatory failure are non-specific, affected children may initially be managed for common respiratory conditions, such as infection, asthma, aspiration, immunodeficiency, or non-metabolic diffuse lung disease, before the underlying IMD is recognized. This narrative mini-review presents a phenotype-driven approach to recognizing IMDs in pediatric respiratory practice. Rather than cataloguing rare disorders by metabolic pathway, it organizes respiratory involvement into practical clinical entry points: diffuse lung disease, pulmonary alveolar proteinosis-like disease, pulmonary vascular disease, recurrent infection or bronchiectasis, upper-airway or thoracic restriction, and neuromuscular respiratory failure and aspiration. For each pattern, we highlight extrapulmonary red flags and first-line biochemical, enzymatic, and genetic tests that may guide early etiological diagnosis. CONCLUSION: Careful recognition of respiratory phenotypes, combined with targeted metabolic and genomic evaluation, may shorten diagnostic delay and allow disease-specific treatment before irreversible pulmonary or neurological injury occurs. WHAT IS KNOWN: • IMDs can involve the respiratory system and may mimic common pediatric respiratory disorders or non-metabolic forms of childhood diffuse lung disease. • Respiratory manifestations may precede, accompany, or follow classical systemic features, and their temporal pattern varies among individual IMDs. WHAT IS NEW: • This mini-review organizes IMD-related respiratory involvement by presenting respiratory phenotype rather than by metabolic pathway. • It links respiratory entry points with extrapulmonary red flags and targeted biochemical, enzymatic, and genetic testing to support earlier diagnosis.

Humans↗
PubMedDate not supplied

Legionnaires' disease pneumonia: histopathologic features and comparison with microbial and chemical pneumonias.

The histopathologic findings in lung tissue are reported from five cases of Philadelphia Legionnaire's Disease and the results are compared to pneumonias caused by other microbial and chemical agents. Histopathology of lung tissue was similar in all cases, despite the fact that death occurred between the fourth and 14th day of clinical illness. The inflammatory response was almost totally limited to the lower respiratory tract and primarily involved respiratory bronchioles, alveolar ducts and alveoli. Major bronchial branches and pulmonary interstices showed little or no involvement. There was considerable variation in the extent and nature of the consolidation, but the overall reaction pattern was highly characteristic of diffuse alveolar damage. Most involved areas showed intra-alveolar, fibrinocellular mononuclear cell predominant exudates, associated with pneumonocytic hyperplasia and slough. These findings plus the presence of erythroleucophagocytosis by macrophages and paucity of polymorphonuclear leucocytes are commonly associated with psittacine pneumonia, and much less so with classic patterns of bacterial, viral, fungal or rickettsial pneumonias. Of the toxic inhalants, nickel carbonyl, phosgene, nitrous oxide, cadmium oxide and some halogenated hydrocarbons have been associated with this tissue reaction pattern. Bacteria were notably absent in lung tissue stained by methods used to demonstrate the Legionnaires' Disease agent.

Adult↗
PubMed1977

[Respiratory function disorders during hepatopathies with immunity involvement].

A respiratory functional test was done systematically on 24 patients with chronic hepatitis and was found normal in only 2 cases. It showed an alteration of the transfer in 14 patients and a syndrom of hyperinflation in 8 others. Despite the histopathological proof it seems that the transfer alteration could be attributed to diffuse interstitial pulmonary lesions. They have already been noted in chronic hepatitis by several authors. The pathogeny of this interstitial involvement probably implied immunity phenomenons including the participation of the antigen Australia or others. As for the hyperinflation syndrome observed in 4 patients in the absence of any bronchopulmonary history, it could reveal an emphysema, which, so far, had not been seen associated to chronic hepatitis.

Adult↗
PubMed2026

Clinical Variability and Genotype-Driven Outcomes in CHRND-Related Congenital Myasthenic Syndrome.

BACKGROUND: Congenital myasthenic syndromes (CMS) caused by pathogenic variants in CHRND, encoding the δ-subunit of the nicotinic acetylcholine receptor (AChR), are rare, and data on genotype-phenotype correlations and long-term outcomes are limited. METHODS: We performed a retrospective, multicenter study of nine patients with genetically confirmed CHRND-related CMS from specialized neuromuscular centers. Clinical, electrophysiological, genetic, and therapeutic data were systematically collected. All diagnoses were established by exome sequencing during routine clinical work-up. RESULTS: Eight patients were compound heterozygous and one was homozygous for pathogenic CHRND variants, including nonsense, missense, splice-site variants, and one microdeletion. Disease onset ranged from the neonatal period (n = 7) to adolescence (n = 2). Three patients were followed longitudinally for 22-43 years. Ocular involvement, particularly ptosis and ophthalmoparesis, was present in all patients. Generalized fatigable weakness was common, whereas bulbar and respiratory involvement occurred in a subset and reflected overall disease severity. Genotypes including a null allele or a homozygous missense variant tended to be associated with more severe phenotypes, while compound heterozygous missense variants were linked to a broader and generally milder spectrum, sometimes limited to ocular symptoms. Long-term outcomes ranged from minimal symptoms under therapy to severe motor impairment with respiratory insufficiency, highlighting substantial interindividual variability. CONCLUSIONS: This study expands the phenotypic and genotypic spectrum of CHRND-related CMS and underscores the critical role of genotype in determining disease severity. Comprehensive genetic testing, longitudinal phenotyping, and genotype-informed management are essential for optimal diagnosis and care in this rare disorder.

Humans↗
PubMed1977

Disseminated toxoplasmosis with brain involvement in a renal allograft recipient.

A 47-year-old male with renal failure received a renal transplant which subsequently was rejected. After removal of the transplant the patient went into a catabolic state, and developed fever and hematochezia. The patient became septic, developed respiratory involvement. This is the eighth recorded case of central nervous system toxoplasmosis following renal transplantation.

Brain↗
PubMed1979

Extensive sarcoidosis involving the upper respiratory tract.

Sarcoidosis is a multisystem granulomatous disease without pathognomonic symptomatology or pathology. It may involve the upper respiratory tract, but this manifestation is rarely threatening. A case is reported here, in which extensive destruction of the larynx due to involvement by sarcoidosis necessitated tracheostomy. A review of the literature and a discussion of the therapeutic considerations are presented.

Adult↗
PubMed2026

Nipah virus in the era of global connectivity: molecular evolution, transmission risk, and preparedness strategies.

Nipah virus (NiV) is a highly pathogenic zoonotic RNA virus belonging to the genus Henipavirus within the family Paramyxoviridae, representing a continuing global health concern due to its high case fatality rate and potential for epidemic expansion in the era of increasing international connectivity. The virus demonstrates strong evolutionary adaptability driven by the absence of proofreading mechanisms during RNA replication, enabling genetic diversification that may influence host range, virulence, and transmission dynamics. Molecular pathogenesis of NiV is primarily mediated through interaction of viral glycoproteins with ephrin-B2 and ephrin-B3 receptors, facilitating host cell entry, endothelial damage, and neuroinvasion. Immune evasion facilitated by the action of accessory proteins encoded by the P gene (P, V, W, and C) acts to suppress innate antiviral immunity through the inhibition of interferon induction and JAK/STAT signaling. Human-to-human transmission of Nipah virus remains limited, with epidemiological evidence indicating basic reproduction numbers generally below unity; however, respiratory involvement and healthcare-associated exposure may enhance cluster outbreaks. Global travel, ecological disruption, and fragmented surveillance systems contribute to spillover risk, particularly in South and Southeast Asia where fruit bats of the genus Pteropus serve as natural reservoirs. Despite advances in vaccine technology, including subunit, viral vector, mRNA-based platforms, and monoclonal antibody therapies, no licensed prophylactic or therapeutic agent is currently available for human use. Global preparedness remains challenged by the scarcity of high-containment biosafety facilities, limited research funding, and absence of integrated One Health surveillance networks. Ethical considerations surrounding wildlife population control further complicate disease mitigation strategies. Emerging genomic surveillance, artificial intelligence-assisted predictive modeling, and regional data-sharing frameworks are essential for early detection and response. Strengthening molecular research on viral-host interactions and transmission determinants will be critical for preventing future Nipah virus outbreaks in an increasingly interconnected world.

Genomic surveillance↗
PubMed1975

Translocation of the umbilical artery to the lower abdomen: an adjunct to the postoperative monitoring of arterial blood gases in major abdominal wall defects.

A technique is presented for preserving the umbilical arteries for postoperative monitoring of arterial blood gases after repair of giant omphaloceles and gastroschisis. Translocation of the arteries to the lower abdominal wall removes them from the operative field and allows cannulation and long-term blood sampling. Complications have been minimal and the improved application of modern pulmonary support mechanisms has materially contributed to better patient management. The technique is a simple one and may prove applicable to other major newborn medical and surgical diseases involving respiratory insufficiency.

Abdomen↗
PubMed1979

Legionnaires' disease: one person's perspective.

Since July 1976 when an outbreak of severe, acute respiratory disease of unknown origin occurred among attendees at the 58th Annual Convention of the American Legion in Philadelphia, great progress has been made, including identification of the causative organism, Legionella pneumophila. Clinical features include not only respiratory involvement but often abdominal complaints, encephalopathy, renal disease, and rhabdomyolysis. Erythromycin appears to be an effective antimicrobial agent. Epidemiologic studies have defined epidemics as well as sporadic cases. Legionella pneumophila has appeared as an opportunistic pathogen. Organisms have been isolated from air-handling equipment and evaporative condensers in four instances. At present diagnosis usually is based on the demonstration of a fourfold rise in antibody titer between serum specimens obtained 3 to 6 weeks apart. Recent data suggest that organisms may be shown in tracheal secretions using a direct flluorescent antibody procedure and that antigen may be shown in urine using the microenzyme-linked immunosorbent assay (ELISA) technique.

Bacteria↗
PubMed1979

[Hematin treatment of acute intermittent porphyria. A case report (author's transl)].

A young woman with acute intermittent porphyria in profound relapse and severe nervous and respiratory involvement was treated by intravenous infusions of hematin, followed by improvement of symptoms. The diet with high carbohydrate and protein content and a B-adrenergic blocking agent, not showed any beneficial effect on acute attack. The infusion of hematin was followed by a lowering effect on urine porphybilinogen and delta-aminolevulinic acid and clinical improvement. The return to normal of porphyrin precursors in the urine was accompanied by almost complete clinical remission. The relationship of remission and repression of delta-aminolevulinic acid, decrease of urinary levels of porphyrin precursors, pulmonaries tests and electromyograms, were discussed.

Adolescent↗
PubMed1976

Immunologic mechanisms in systemic vasculitis.

Thirty-four patients with systemic vasculitis were studied to determine the possible type and frequency of associated immunologic abnormalities. The patients were divided into three clinical groups--those with systemic vasculitis without respiratory tract involvement, those with systemic vasculitis with respiratory tract involvement (particularly Churg-Strauss vasculitis and Wegener's granulomatosis), and those with limited vasculitis without visceral involvement. A diminished level of serum complement was found in half the patients with systemic vasculitis without respiratory tract involvement. These patients usually had diffuse skin disease that often was associated with the presence of rheumatoid factor and cryoglobulinemia and most likely represented an immune-complex induced disease. The serum IgE often was elevated in patients who had systemic vasculitis with respiratory tract involvement, particularly those with Churg-Strauss vasculitis and Wegener's granulomatosis, and may be a clue to the pathogenesis in this group of patients.

Adult↗
PubMed1975

Adenoviruses of man and animals.

Adenoviruses are capable of causing natural infections in a wide variety of vertebrates, including amphibia, birds and mammals. Although frequently causing inapparent infections, they may be associated with diseases of varying severity and localizations. The clinico-pathological manifestations most commonly associated with adenovirus infections involve the respiratory tract and the ocular conjunctiva. Involvement of the digestive, renal and nervous systems may also be observed. A state of latency with persistence of infection for prolonged periods has been described in many hosts. Many adenovirus types are oncogemic under experimental conditions but none have been associated with naturally occurring tumours. Although the diseases caused by adenoviruses tend to be mild, this is not invariably the case and these viruses may give rise to serious epidemiological situations and represent a threat to life under certain circumstances in which the use of prophylactic vaccination may be indicated.

Adenoviridae↗
PubMed1979

Clinical features of diphtheria in the respiratory tract.

Clinical features of 44 culture-confirmed cases of diphtheria involving the respiratory tract treated at the University of Washington and affiliated hospitals in Seattle over a five-year period were studied. Of 42 patients treated primarily in Seattle, five (11.9%) died; nonfatal, toxin-induced complications occurred in seven (16.7%). Airway obstruction was the most common cause of death in this series. Diphtheritic membrane (especially in the larynx), dyspnea, and leukocytosis were dire prognostic signs. We urge indirect laryngoscopyin all cases showing membrane formation; tracheotomy should be considered when laryngeal membrane is present. Diphtheria should be suspected in any patient with pharyngitis who has been in contact with endemic areas, especially when pharyngeal membrane is present.

Adult↗