Cases reported "Asthma"

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11/22. Normal airway responsiveness to methacholine in cardiac asthma.

    Cardiac asthma has been used as a synonym for episodes of cough, dyspnea, and wheezing caused by left ventricular dysfunction. The similarity of the terms bronchial asthma and cardiac asthma, and the observed symptoms of each disease implies a common pathophysiology. Bronchial asthma is characterized pathologically by airway narrowing, inflammation, edema, and obstruction by mucus. Bronchial asthma is defined as increased responsiveness of the tracheobronchial tree, which is manifested clinically as reversible expiratory airflow obstruction. The classic symptoms of bronchial asthma are cough, dyspnea, and wheezing. Cardiac asthma produces the same symptoms, but the pathophysiology producing these symptoms is not well described. We describe two patients with cardiac asthma who failed to demonstrate airway hyperresponsiveness to nonspecific bronchoprovocation testing and we postulate that these patients' symptoms were produced exclusively by left ventricular failure.
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12/22. Treatment of asthma-related respiratory arrest with endotracheal albuterol (salbutamol).

    An albuterol (salbutamol) sulphate solution was successfully administered endotracheally to a 67-year-old woman suffering severe bronchospasm and impending ventilatory arrest secondary to asthma. Following two doses of endotracheal albuterol her clinical status and arterial blood gases improved dramatically. She was extubated shortly after and had an uneventful recovery. The endotracheal route for albuterol administration appears to provide an effective method of delivery to the bronchial tree when the asthmatic patient has been intubated.
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13/22. Treatment of a patient with chronic bronchial asthma with many bronchoscopies and lavages using acetylcysteine: a case report.

    This Case Report is that of a young woman followed for 21 years, whose life was saved repeatedly by bronchoscopy and lavage to remove mucous plugs and casts from the tracheobronchial tree. In 1982, after again having a respiratory crisis and not having a bronchoscopy and lavage, she died. The pathology revealed a thickened hyalinized basement membrane and numerous mucous plugs filling the larger bronchi and bronchioles.
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14/22. Dual asthmatic responses to prosopis juliflora.

    Case histories of two asthmatic patients who are allergic to the pollen allergen of prosopis juliflora, a perennial tree abundantly seen in Delhi and northern india, are presented. Both developed immediate (Type I) as well as late (Type III) responses to intradermal, as well as inhalation, provocation tests. Prior inhalation of disodium cromoglycate inhibited the dual asthma response to inhalation tests but did not inhibit the response to intradermal tests.
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15/22. Asthma and other symptoms in cinnamon workers.

    Cinnamon, which is the bark of the cinnamomum zeylanicum tree, contains cinnamic aldehyde, which is an irritant. Workers processing cinnamon before export are exposed to much cinnamon dust. Forty such workers with an average of four years' service in the industry were examined. Thirty five workers (87.5%) had symptoms, nine having had asthma (22.5%). Other symptoms, probably related to the irritant nature of cinnamon dust, were irritation of skin (50%), loss of hair (37.5%), and smarting of eyes while at work (22.5%). Loss of weight (65%) was the commonest finding. Contact dermatitis which has previously been described was not found in any of the workers.
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16/22. Respiratory diseases and food allergy.

    Both upper and lower respiratory tracts can be affected by food allergy. Manifestations in either may be exclusively due to food allergy (common in infants) or may result from the combined effects of food allergy plus another defect such as gastroesophageal reflux, a congenital defect of the heart or tracheo-bronchial tree, an immunodeficiency syndrome such as isolated IgA or IgG4 deficiency, or a concomitant inhalant allergy. Chronic rhinitis is the most common respiratory tract manifestation of food allergy. When it occurs in conjunction with lung disease, it may be a helpful indicator of activity of the allergic lung disease and of the patient's compliance in following a specific diet. Recurrent serous otitis media may be solely or partially due to food allergy. Large tonsillar and adenoid tissues, sometimes with upper airway obstruction, may be caused, or aggravated by, food allergies. Lower respiratory tract disease manifested by chronic coughing, wheezing, pulmonary infiltrates, or alveolar bleeding may also occur. Lower respiratory tract involvement is generally associated with a greater delay in onset of symptoms and with a larger quantity of allergen ingestion than chronic rhinitis. food allergy should be considered when there is a history of prior intolerance to a food in childhood or of symptoms beginning soon after a particular food was introduced into the diet. It is an important consideration in patients who have chronic respiratory tract disease which does not respond adequately to the usual therapeutic measures and is otherwise unexplained.(ABSTRACT TRUNCATED AT 250 WORDS)
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17/22. status asthmaticus: use of acetylcysteine during bronchoscopy and lavage to remove mucous plugs.

    Three patients suffering from severe, chronic, bronchial asthma underwent bronchoscopy and lavage, using in the irrigant fluid acetylcysteine, isoetharine and Solu-Medrol. All patients had a large amount of thick mucus in the tracheobronchial tree which was removed during the lavage. Following the lavage, all three patients were easily treated with conventional allergic measures and were able to lead normal lives, which they could not do before. A discussion of the precautions to be taken by the medical-surgical team in charge of a patient undergoing bronchoscopy and lavage is made. These conclusions were based on the results of two previous reports by the authors in addition to the present communication.
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18/22. Tracheobronchopathia osteochondroplastica. Report of a young man with severe disease and retrospective review of 18 cases.

    Tracheobronchopathia osteochondroplastica (TPO) is a rare condition of unclear cause. Sporadic cases have been published from all over the world, but some geographical differences in the occurrence may exist. The condition is characterized by cartilaginous or bony outgrowths into the lumen of the tracheobronchial tree. Clinicians should include this disease in the list of differential diagnoses when confronted with symptoms like persistent and often productive cough, haemoptysis, dyspnoea and wheeze. If the condition is extensive, there may occur unexpected and acute clinical problems. We describe the case of a young man in whom we diagnosed a severe form of TPO while examining him for asthma. This patient suffered also from ozaena and the combination of these two conditions is rather common. We also retrospectively reviewed our material of 18 cases with this condition.
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19/22. Occupational rhinoconjunctivitis and bronchial asthma due to Phoenix canariensis pollen allergy.

    We report a case of occupational bronchial asthma and rhinoconjunctivitis caused by Phoenix canariensis (PC) pollen. The canary palm is a type of palm tree, belonging to the arecaceae family, which is widely distributed in frost-free regions as an ornamental tree. Our patient was referred because he suffered symptoms of bronchial asthma, rhinoconjunctivitis, and contact urticaria when pruning dried leaves from PC during the pollination months. The skin prick test (SPT) with a PC pollen extract was positive, as was the specific IgE to PC pollen determined by Phadezym RAST, indicating an IgE-mediated sensitization. The nonspecific bronchial provocation test (BPT) performed with methacholine disclosed a mild bronchial hyperreactivity, and specific BPT with PC pollen elicited an immediate fall of 25% in FEV1 with respect to baseline. On RAST inhibition studies, a significant cross-reactivity was found between PC pollen and date palm (P. dactylifera) pollen. These results suggest that PC pollen could be a potential allergen in PC-growing areas.
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20/22. Asthma deaths in children--a continuing problem.

    The clinical and pathological features of five children who died of asthma over a recent 12-month period are reported. All had severe, chronic asthma requiring maintenance corticosteroid therapy. Three had been receiving beclomethasone dipropionate by inhalation and these had acute inflammation of the tracheobronchial tree at necropsy. Adrenal atrophy was found in all four cases examined histologically, despite normal short tetracosactrin tests in three of these shortly before they died. The need for high-dose corticosteroid by mouth for exacerbations of asthma in those weaned from oral steroids is emphasized by these deaths. The introduction of beclomethasone dipropionate by inhalation has led to an increase in the number of children in this high-risk group.
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