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7 results

  • In vitro measurement of ciliary beat frequency in 92 children with recurrent respiratory tract problems

  • A Drake-Lee, A Green, A-L McDermott
  • Journal:
    The Journal of Laryngology & Otology / Volume 136 / Issue 12 / December 2022
    Published online by Cambridge University Press:
    10 October 2022, pp. 1183-1188
    Print publication:
    December 2022
    • Article
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  • Background

    Chronic or recurrent mucoid respiratory tract symptoms may be difficult to diagnose.

    Method

    Ninety-two children with chronic respiratory symptoms were divided into 4 groups: 18 children with refractory asthma, 10 with bronchiectasis without dextrocardia, 18 with dextrocardia and 46 with recurrent respiratory tract infections. Except for five neonates, cytology samples were taken under general anaesthesia. Ciliary beat frequency was measured photometrically and analysed by in-house computer software.

    Results

    Nasal polyps were found in one child with normal ciliary beat frequency. Twenty-six children had no beating cilia (male to female ratio, 15:11). The effect of increasing temperature on the ciliary beat frequency of the remaining 66 patients was evaluated (42 patients, more than 30°C, median, 8.3 Hz; 24 patients, 30–37°C, median, 11.8 Hz; p = 0.0003).

    Conclusion

    The measurement of ciliary beat frequency is part of the diagnostic work up of patients with persistent or recurrent respiratory tract infections.

  • Chapter 22 - Pulmonary Issues

  • from Section III - Care of the Elderly by Organ System
  • Edited by Jan Busby-Whitehead, University of North Carolina, Chapel Hill, Samuel C. Durso, The Johns Hopkins University, Maryland, Christine Arenson, Thomas Jefferson University, Philadelphia, Rebecca Elon, The Johns Hopkins University School of Medicine, Mary H. Palmer, University of North Carolina, Chapel Hill, William Reichel
  • Book:
    Reichel's Care of the Elderly
    Published online:
    30 June 2022
    Print publication:
    21 July 2022, pp 270-285

  • Summary

    Older adults are disproportionately affected by many chronic lung diseases. Numerous normal physiologic changes occur in the lungs with age, from reduced parenchymal elastic recoil to thoracic cage distortion. These changes impact pulmonary pathophysiology and disease diagnosis. Clinicians should be cognizant of geriatric issues that can impact diagnosis, treatment, and the occurrence of adverse events secondary to treatment. For example, multimorbidity, the co-occurrence of multiple comorbidities, is more common with increasing age. Additionally, people with chronic lung diseases have a higher burden of geriatric syndromes, such as frailty, functional impairment, falls, and social isolation. Older adults are at increased risk of severe morbidity from acute lung conditions such as pneumonia and pulmonary embolism. Treatment of older patients in the intensive care unit requires special attention to geriatric issues (called “age-friendly care”) that will improve the quality of their care. This chapter reviews the natural history of pulmonary system aging, discusses the most commonly encountered chronic lung diseases with aging, and briefly examines special issues with caring for older adults in a critical care setting.

  • 47 - Rhabdomyolysis

  • from Section 7 - Renal emergencies
  • Edited by Kaushal Shah, Jarone Lee, Kamal Medlej, American University of Beirut, Scott D. Weingart
  • Book:
    Practical Emergency Resuscitation and Critical Care
    Published online:
    05 November 2013
    Print publication:
    24 October 2013, pp 320-324

  • Summary

    This chapter discusses the diagnosis, evaluation and management of massive hemoptysis. Worldwide, tuberculosis (TB) is the most common cause of massive hemoptysis. In the United States, patients frequently have a history of pulmonary disease and/or smoking, cancer, prior hemoptysis, immunosuppression, cardiac disease, or coagulopathy/anticoagulant use. Patients may present with a sentinel bleed, with only a small amount of initial hemoptysis. The clinical course of these patients is difficult to predict, as small amounts of hemoptysis may suddenly become massive. Patients may present to the ED in extremis with active hemorrhage and respiratory failure. If the patient does not have active bleeding and is stable enough to go to radiology, chest CT may assist finding the etiology of hemoptysis. Bronchiectasis, lung abscess, pulmonary artery aneurysm, pulmonary embolism, and mass lesions are all abnormalities that can be identified by chest CT.

  • Chapter 12 - Anesthesia for lung resection

  • from Section 2 - Anesthesia for operative procedures
  • Edited by Cait P. Searl, Sameena T. Ahmed
  • Book:
    Core Topics in Thoracic Anesthesia
    Published online:
    10 December 2009
    Print publication:
    02 April 2009, pp 81-85

  • Summary

    This chapter reviews common respiratory disease processes. It provides an overview of the disorders that may be met by the thoracic anesthetist, and considers their anesthetic implications. Infective disorder described in the chapter includes pneumonia, tuberculosis, aspergillus, bronchiectasis, and cystic fibrosis. Patients with pneumonia may present with a history of cough, production of purulent sputum and fever, together with pleuritic chest pain and shortness of breath. Hematogenous spread causes generalization of the disease and can cause miliary tuberculosis (TB) and/or TB meningitis. The chapter discusses airway obstructive disorders such as asthma and chronic obstructive pulmonary disease (COPD), along with interstitial lung disease and the disease involving the pulmonary circulation. Pulmonary embolism usually occurs as a complication and consequence of deep vein thrombosis. Lung cancer remains the commonest cause of cancer death worldwide.

  • Does Young's syndrome exist?

  • A K Arya, H L Beer, J Benton, I Lewis-Jones, A C Swift
  • Journal:
    The Journal of Laryngology & Otology / Volume 123 / Issue 5 / May 2009
    Published online by Cambridge University Press:
    08 January 2009, pp. 477-481
    Print publication:
    May 2009
  • Background and methods:

    Young's syndrome describes a combination of male infertility, azoospermia, bronchiectasis and sinusitis. Although Young's syndrome is a well accepted disorder within the realms of infertility medicine, it is also accepted as being a potential cause of sino-nasal disease which is rarely seen by otolaryngologists. However, the significance of the sinus component within this triad is not fully understood. To gain further insight into the relationship of sinusitis with Young's syndrome, we reviewed all of the currently available published literature.

    Results:

    Within the reviewed literature, the diagnosis of sinusitis in Young's syndrome was crude and poorly defined; there was little emphasis on sinus disease in most publications.

    Conclusions:

    The prevalence of Young's syndrome is reported to be declining, and the level of evidence regarding sinus disease within this syndrome is limited to case series only. There is, in fact, little evidence to support Young's syndrome being a significant aetiological factor for sinus disease, nor indeed to support the existence of Young's syndrome as an entity in its own right. The only documented aetiological factor is mercury exposure in childhood, an event that is seldom currently encountered; this would support our theory of the extinction of the condition. As an incidental finding, we found that the term Young's syndrome refers to two different medical conditions.

  • Bronchiectasis and sino-nasal disease: a review

  • C M Philpott, D C McKiernan
  • Journal:
    The Journal of Laryngology & Otology / Volume 122 / Issue 1 / January 2008
    Published online by Cambridge University Press:
    25 June 2007, pp. 11-15
    Print publication:
    January 2008

  • The ‘one airway’ model for upper and lower respiratory tract disease is a concept gaining increasing momentum in both respiratory medicine and otorhinolaryngology. The specific common aetiology and pathophysiology of concomitant bronchiectasis and sino-nasal disease, such as chronic rhinosinusitis, are discussed here, as well as the clinical manifestations, along with a review of all the relevant literature in the field.