Thoracic disorders in the immunocompromised patient:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
1999
|
| Schriftenreihe: | Chest surgery clinics of North America
9,1 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | X, 266 S. Ill. |
Internformat
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| 245 | 1 | 0 | |a Thoracic disorders in the immunocompromised patient |c Lary A. Robinson, guest ed. |
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THORACIC DISORDERS IN THE IMMUNOCOMPROMISED PATIENT
CONTENTS
Preface xiii
Lary A. Robinson
Recognition of the Immunocompromised Patient 1
Maria G. Gutierrez and Charles H. Kirkpatrick
Immunocompromised patients are at greater risk for malignan¬
cies, autoimmunity, and opportunistic infections that may compli¬
cate the recovery and prolong the hospitalizations of surgical
patients. This article reviews clinical conditions that are accompa¬
nied by abnormalities of host defense systems. Guidelines for
recognition of at risk patients are given, and, when possible,
strategies for control of risk are presented.
The Initial Pulmonary Evaluation of the
Immunocompromised Patient 19
Frank W. Walsh, Mark W. Rolfe, and Mark J. Rumbak
The number of patients who have undergone solid organ trans¬
plantation, bone marrow transplantation, or who are HIV infected
is increasing yearly. Infectious and noninfectious pulmonary com¬
plications are common in the immunocompromised patient. This
article discusses the initial evaluation of pulmonary disorders in
these patients and outlines a diagnostic approach.
New Directions in Antimicrobial Therapy 39
John N. Greene, S. J. Poblete, and Dina Krieff
The virulent microorganisms that we try to contain with new
antimicrobial agents quickly find the gap in our defenses and
exploit it. Resistance to all available antibiotics at the same time,
CHEST SURGERY CLINICS OF NORTH AMERICA
VOLUME 9 • NUMBER 1 • FEBRUARY 1999 vii
however, rarely occurs. The authors report the most current anti¬
microbials used as monotherapy or in combination to successfully
treat the more resistant pathogens. The higher mortality and
subsequent cost to treat these infections are reviewed.
Malignancies Associated with the Immunocompromised
State 63
Kushagra Katariya and Richard J. Thurer
Neoplastic disease occurs more frequently in immunocompro¬
mised patients than in the general population. These tumors
occur at an earlier age and behave more aggressively. Their origin
is linked to viral infection and other causes of immunodeficiency,
such as antirejection drugs. Despite aggressive therapy, these
patients have a poor prognosis when compared with immuno
competent individuals with similar tumors.
Complications from Induction Regimens for Thoracic
Malignancies: Perioperative Considerations 79
Michael J. Liptay and Willard A. Fry
The treatment of locoregionally advanced non small cell lung
cancer is evolving rapidly. Surgeons must continue to take a
prominent role in treatment, from the pretreatment evaluation
phase, through reassessment after induction therapy and intraop
erative decision making, to vigilant postoperative care. Non
small cell carcinoma patients are by far the most challenging
thoracic oncologic patients to care for. The multidisciplinary team
formula required for optimal results mandates that surgeons, as
experts familiar with all facets of patient care, provide the neces¬
sary leadership.
The Thoracic Surgeon's Role in the Management of
Patients with HIV Infections and AIDS 97
J. Michael DiMaio and Michael A. Wait
The advent of improved medical care has prolonged life expec¬
tancy of patients with HIV infection. These advances increase the
probability that the surgeon's role will be significantly greater in
the future to take care of patients with HIV related illnesses. The
morbidity and mortality of thoracic surgical procedures per¬
formed on HIV patients seems to be no different than patients
without HIV. The authors recommend taking an aggressive surgi¬
cal posture in patients with AIDS and HIV infections. Video
assisted thoracic surgery, especially in the treatment of pneumo
thoraces and empyemas, should be used and has been shown to
be safe and effective.
Viii CONTENTS
Noninfectious Immunologic Disorders in Adults 113
Gregory Bensch and John M. Routes
This article covers a variety of immunologic defects and discusses
their potential side effects, with an emphasis on immunodefi¬
ciencies with survival into adulthood. To organize the approach
to immunodeficiencies, the immune system is broken down
broadly into four major components: the complement cascade,
antibody (B cell) mediated immunity, cellular (T cell) mediated
immunity, and phagocytosis.
Thoracic Complications in Solid Organ Transplantation 125
K. Eric Sommers and Mark B. Anderson
Thoracic complications of solid organ transplantation are com¬
mon and can arise from the implantation surgical procedure or
can be secondary to the need for lifelong immunosuppression.
Problems that arise can be general to cardiothoracic surgery or
unique to transplant patients. This article provides an overview
of these complications and some approaches to their avoidance
and management.
Thoracic Complications Related to Bone Marrow
Transplantation 139
Anthony A. Floreani, Joseph H. Sisson, Jud Gurney,
Debra J. Romberger, Linda C. Anderson,
and James O. Armitage
Although progress has been made in the diagnosis and manage¬
ment of respiratory complications after bone marrow transplanta¬
tion, such complications are still frequent and are a major cause
of morbidity and mortality. The use of cytomegalovirus (CMV)
negative marrow and blood products, surveillance bronchosco
pies, and prophylactic use of antivirals have significantly reduced
the incidence of CMV pneumonia. DNA amplification techniques
have allowed earlier detection of viral respiratory infections and
early detection of localized invasive aspergillosis can improve
survival with lung resection and antifungal therapy. Consider¬
ation for open lung biopsy should include the patient's degree of
preoperative respiratory impairment, because this may relate to
early postoperative survival.
Opportunistic Thoracic Infections: Bacteria, Viruses,
and Protozoa 167
Elizabeth A. Talbot and Charles B. Hicks
The range of potential bacterial, viral, and protozoan pathogens
that can cause pulmonary infections in immunocompromised pa¬
tients is extensive. An aggressive diagnostic approach is essential
CONTENTS ix
to maximizing chances for a successful outcome. This article
discusses the general diagnostic approach and provides a discus¬
sion of the most important bacterial, viral, and protozoan chest
infections occurring in this setting.
Aspergillus and Other Fungi 193
Lary A. Robinson
Opportunistic infections that arise in the immunocompromised
host are a major cause of morbidity and mortality. Although
bacterial infections are more frequent, invasive fungal infections
occur commonly and carry higher risks in these immunocom¬
promised patients. Newer antifungal agents, along with an occa¬
sional pulmonary resection, have improved the treatment options
and the survival from invasive fungal infections in immunocom¬
promised patients.
Mycobacterium tuberculosis and Other Mycobacteria 227
James R. Mault and Marvin Pomerantz
The immunocompromised post transplant HIV positive patient is
at increased risk for mycobacterial infection. Early diagnosis and
aggressive therapy is critical to successful outcome. Surgical ther¬
apy may be required in patients who have complex mycobacterial
lung disease, drug resistant tuberculosis, or mycobacterial infec¬
tions other than tuberculosis.
Congenital Immunodeficiency Syndromes 239
Larry W. Williams
Since the description of agammaglobulinemia in 1952, a number
of other genetically determined immunodeficiency syndromes
have been identified. Defects of innate immune function most
commonly involve abnormalities of granulocytes, respiratory
cilia, or complement proteins. Defects of acquired immunity may
involve T cells, B cells, or both, and may be accompanied by
distinctive abnormalities in other systems that have a major im¬
pact on patient care. This discussion focuses on the disorders in
which there have been recent advances in our knowledge.
Index 259
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| spelling | Thoracic disorders in the immunocompromised patient Lary A. Robinson, guest ed. Philadelphia [u.a.] Saunders 1999 X, 266 S. Ill. txt rdacontent n rdamedia nc rdacarrier Chest surgery clinics of North America 9,1 Déficits immunitaires - complications Sujet immunodéprimé Immunocompromised Host Immunologic Deficiency Syndromes complications Thoracic Diseases Krankheit (DE-588)4032844-2 gnd rswk-swf Brustorgan (DE-588)4194536-0 gnd rswk-swf Immundefekt (DE-588)4026622-9 gnd rswk-swf Atemwegsinfektion (DE-588)4250190-8 gnd rswk-swf Immunsuppression (DE-588)4026641-2 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Immunsuppression (DE-588)4026641-2 s Atemwegsinfektion (DE-588)4250190-8 s DE-604 Immundefekt (DE-588)4026622-9 s Brustorgan (DE-588)4194536-0 s Krankheit (DE-588)4032844-2 s Robinson, Lary A. Sonstige oth Chest surgery clinics of North America 9,1 (DE-604)BV005455558 9,1 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008479604&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Thoracic disorders in the immunocompromised patient Chest surgery clinics of North America Déficits immunitaires - complications Sujet immunodéprimé Immunocompromised Host Immunologic Deficiency Syndromes complications Thoracic Diseases Krankheit (DE-588)4032844-2 gnd Brustorgan (DE-588)4194536-0 gnd Immundefekt (DE-588)4026622-9 gnd Atemwegsinfektion (DE-588)4250190-8 gnd Immunsuppression (DE-588)4026641-2 gnd |
| subject_GND | (DE-588)4032844-2 (DE-588)4194536-0 (DE-588)4026622-9 (DE-588)4250190-8 (DE-588)4026641-2 (DE-588)4143413-4 |
| title | Thoracic disorders in the immunocompromised patient |
| title_auth | Thoracic disorders in the immunocompromised patient |
| title_exact_search | Thoracic disorders in the immunocompromised patient |
| title_full | Thoracic disorders in the immunocompromised patient Lary A. Robinson, guest ed. |
| title_fullStr | Thoracic disorders in the immunocompromised patient Lary A. Robinson, guest ed. |
| title_full_unstemmed | Thoracic disorders in the immunocompromised patient Lary A. Robinson, guest ed. |
| title_short | Thoracic disorders in the immunocompromised patient |
| title_sort | thoracic disorders in the immunocompromised patient |
| topic | Déficits immunitaires - complications Sujet immunodéprimé Immunocompromised Host Immunologic Deficiency Syndromes complications Thoracic Diseases Krankheit (DE-588)4032844-2 gnd Brustorgan (DE-588)4194536-0 gnd Immundefekt (DE-588)4026622-9 gnd Atemwegsinfektion (DE-588)4250190-8 gnd Immunsuppression (DE-588)4026641-2 gnd |
| topic_facet | Déficits immunitaires - complications Sujet immunodéprimé Immunocompromised Host Immunologic Deficiency Syndromes complications Thoracic Diseases Krankheit Brustorgan Immundefekt Atemwegsinfektion Immunsuppression Aufsatzsammlung |
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