Showing papers in "Clinics in Chest Medicine in 1990"

TL;DR: Morbidity and mortality rates for chronic obstructive pulmonary disease (COPD) have been increasing over time and epidemiologic investigators have been exploring the reasons for these increases through prevalence surveys and longitudinal studies.

TL;DR: It is suggested that there is a spectrum in the extent of lung involvement and disease severity in patients at risk for ARDS, and the factors that govern which patients will develop the fulminant syndrome are poorly understood.

TL;DR: The clinical setting and presentation, radiographic manifestations, pathologic findings, and the prognosis of bleomycin-induced interstitial fibrosis are described and the role of pulmonary function tests in monitoring patients for toxicity is discussed.

TL;DR: Despite the formidable barrier that infection of the lung allograft poses, the procedure of pulmonary transplantation clearly holds sufficient promise that all efforts possible should be made to hurdle this barrier and ensure a place formonary transplantation in the armamentarium of treatment for irreversible pulmonary disease.

TL;DR: The various complications are classified based on their timing after the transplant procedure, and a diagnostic and therapeutic approach is outlined and the prognosis is discussed.

TL;DR: Clinical features, more than serum markers, have been the best predictors of whether lung injury will follow sepsis, indicating that the mere presence of mediators alone cannot cause ARDS and that there are individual susceptibility factors in the effects of these mediators.

TL;DR: The age of the "mediator" of ARDS, and of the corresponding therapeutic "magic bullet," is over, and the complexity of the redundant networks by which inflammation is regulated seems bewildering in relation to ARDS.

TL;DR: Although many factors have been shown to relate to survival in patients with COPD, the patient's age and baseline postbronchodilator FEV1 are the best predictors of mortality as discussed by the authors.

TL;DR: Bleomycin-induced fibrosis is probably the composition of several mechanisms working in sequence and simultaneously, and the role(s) and interaction of the cellular, biochemical, and molecular elements are examined.

TL;DR: With a greater understanding of how these agents damage lung tissue, physicians may be able to more safely administer these drugs to patients, and all physicians using cytotoxic drugs must be aware of the potential for lung injury with these agents.

TL;DR: Six groups of drugs used as anti-inflammatory/antirheumatic agents have been discussed in association with pulmonary damage penicillamine, gold, methotrexate, salicylates, NSAIDs, and colchicine.

TL;DR: Several forms of emphysema can be recognized morphologically and may have specific clinical associations, however, in the usual patient with severe CAO, it is the severity, rather than the type, of empysema, that is most significant.

TL;DR: The psychosocial assessment of applicants to the Toronto Lung Transplant Program provides the team with a variety of information including coping style; adjustment to illness; presence and management of psychiatric disorders; ability to adhere to medical recommendations; and available social support.

TL;DR: Much of the known information regarding the pathogenesis of dyspnea in the COPD patient is summarized and a great many of the therapeutic options that have been investigated are reviewed.

TL;DR: The ARDS-specific derangements of lung mechanisms are reviewed, measurement techniques applicable to the clinical setting are described, and ways in which such information can be used in patient management are suggested.

TL;DR: The use of radiation therapy is limited by the occurrence of the potentially fatal clinical syndromes of radiation pneumonitis and fibrosis.

TL;DR: The outcome of single and double lung transplants performed by the Toronto Lung Transplant Group is described, including mortality, cause of death, pulmonary physiology, arterial blood gases, and exercise performance.

TL;DR: It is likely that new data derived from molecular and cellular studies of O2 toxicity will continue to enrich the clinical atmosphere and allow more directed approaches to therapy of acute lung injuries, including ARDS.

TL;DR: This article illustrates and describes several interstitial reactions to injury that have few histologic features in common and has enormous potential in this field for the laboratory investigation of drug injury.

TL;DR: Information gathered from the continued study of this population of stable outpatients with COPD will have wide application to the entire COPD patient population, including those patients with respiratory failure on mechanical ventilation, where numerous complicating factors makes the study of nutritional intervention and respiratory muscle function difficult.

TL;DR: The diagnosis is made by the careful exclusion of other causes for the observed illness and the finding of clinical, radiographic, physiologic, and pathologic abnormalities compatible with amiodarone toxicity.

TL;DR: The pharmacologic treatment of chronic obstructive pulmonary disease (COPD) differs from that of asthma in several respects, and oral therapy should be the keystone, using a long-acting theophylline or a beta 2-sympathomimetic agent.

TL;DR: A better understanding of the mechanism of amiodarone pulmonary toxicity will not only improve diagnostic approaches to patients with this serious lung disorder, but will also provide the opportunity to develop unique therapeutic strategies that control the toxicity and potentially not interfere with the intended therapeutic efficacy of the drug.

TL;DR: The indications for single lung, double lung, or heart-lung transplantation at major North American transplant centers are presented, the selection criteria are discussed, and the standard preoperative evaluation is outlined.

TL;DR: This article review available strategies for mechanically ventilating patients with the adult respiratory distress syndrome, including inverse ratio ventilation, extracorporeal techniques, high-frequency ventilation, prone position, and fluctuating PEEP.

TL;DR: Until more useful diagnostic categories are available, the choice of diagnostic tests should be guided more by their clinical usefulness than by their sensitivity and specificity for identifying classic diagnostic categories of obstructive lung disease.

TL;DR: The value of using this definition for establishing prognosis is described by discussing the basis for the acute lung injury scoring system, the various clinical disorders that may be associated with acute lungs injury and how they affect outcome, and the influence of nonpulmonary organ failure on the outcome of patients with acute lung injuries.

TL;DR: The cumulative weight of investigative evidence currently supports the premise that concepts of acute respiratory failure must encompass the abnormal gas exchange in the systemic as well as the pulmonary microvasculature, and needs not dispense with the term ARDS.

TL;DR: The Pittsburgh experience with the pulmonary donor is discussed and guidelines for the maintenance and selection of appropriate donor lungs are provided, including autoperfusion and the use of blood-based pulmoplegia and University of Wisconsin storage solution.

TL;DR: This article has reviewed what is known about the effects of drugs on respiratory myoneural function and what can be inferred from studies on other striated muscles to suggest continued clinical caution is justified.