Respiratory Poliomyelitis Research Articles

James Ronald Harries

James Ronald Harries, or “Jimmy” as he was known to his many friends throughout the world, was one of the leading tropical physicians of his day. He is credited with...

A new factor in urolithiasis: long-term effects of severe respiratory poliomyelitis.

Summary 25 (41%) patients, in a review of 61 patients with severe respiratory poliomyelitis, developed urolithiasis. There was a significantly increased incidence of stone formation in the urinary tract amongst those using the tank respirator when compared with those on intermittent positive pressure ventilation (I.P.P.V.). It is suggested that overventilation of patients on I.P.P.V. protects against urolithiasis by a direct action on calcium metabolism. No correlation existed between the occurrence of urolithiasis and either urinary tract infection or the degree of immobility.

Cartilage calcification and rib erosion in chronic respiratory poliomyelitis

Radiographs of 32 patients treated for severe poliomyelitis for variable periods in tank respirators have been studied. Two groups of lesions have been encountered. Rib erosions, forming the first group, are considered to be caused by pressure of the scapula. Calcification of intervertebral discs, narrowing of sacro-iliac joints, calcification of the acetabular labrum and sclerosis of lumbar apophyseal joints form the second group; these findings have not been reported before as a complication of poliomyelitis. The causation is discussed but the precise mechanism remains undetermined.

Evaluation of Lung Volumes and Intrapulmonary Gas Mixing in Diseased and Normal Children

The evaluation of pulmonary function is particularly helpful in the clinical management of long-term respiratory diseases of childhood such as cystic fibrosis of the pancreas with pulmonary complications, asthma, and respiratory poliomyelitis. Clinical studies coupled with physiological measurements of pulmonary function help to determine: (1) the evolution of pulmonary disease processes; (2) the progress of therapy programs; and (3) the programming of energy demands. Furthermore, important serial changes can be appreciated in lung compartition and functional evaluation. A renewed interest in the physiology of the child’s pulmonary function has developed in the last decade. This has been stimulated by the clinician’s desire to use physiological measurements in evaluating disease states. Several studies of total lung volume and its subdivisions in healthy children have been published in an effort to establish useful comparative values for ill children (Table 1). It appears that significant variations are imposed by choice of techniques, by body positioning, and by other factors. Comparisons in health and disease are therefore best made by use of identical methods among individuals as much alike in body size and age as possible. Attempts also have been made to extend functional evaluation to include intrapulmonary gas mixing and thereby develop standards for judging impairment in lung gas distribution. Several methods of quantitating intrapu]monary gas mixing have appeared in the literature.’� Several variations greatly influence distribution indices that are dependent upon time and volume of ventilation, and that must be determined during very steady or basal states. The clearance equivalent as used by Becklake,’ Lundin,6 and Luft7 appears to offer one means of correcting for these variations in lung volume and for naturally large differences in depth and rate of qulet breathing found among healthy subjects in a steady state. The determination of the total lung capacity and its subdivisions and the efficiency of intrapulmonary gas mixing in 50 healthy children and 21 children with various types of chronic pulmonary diseases are reported and contrasted.

Emotional reactions of patients and medical personnel to respiratory poliomyelitis

Emotional reactions of patients and medical personnel to respiratory poliomyelitis

The total lung capacity and its subdivisions in respiratory poliomyelitis

The supine total lung capacity and its subdivisions has been determined in 62 patients with respiratory muscle paralysis due to poliomyelitis. The results were contrasted with those obtained using the same methods in 50 healthy subjects matched according to age, sex, and physical characteristics. A significant reduction of the total lung capacity was found in the patients. This was accounted for by reductions or alterations in the functional residual capacity and the maximum lung volume above the resting expiratory level. The frequent reduction of functional residual capacity was more marked in the patients studied after 2 years from onset of their illness. Respiratory muscle paralysis, duration of illness, thoracic deformities, and prolonged artificial respiration were considered to be contributory to these lung compartition changes.

The anaesthetists role in the care of respiratory poliomyelitis

An effort has been made to show that the anaesthetist is particularly qualified to assist with the assessment and management of respirai ory poliomyelitis, and can contribute materially towards the scientific treatment of this disease. Time has not permitted a detailed discussion of the many facets of this interesting subject, but some of the physiological problems have been outlined and some practical suggestions given. An active poliomyelitis ward is recommended as a first-class laboratory for the study of respiratory physiology and electrolyte balance.

POLIOMYELITIS

THROUGHOUT the literature there are numerous references to the involvement of the cerebellum in poliomyelitis; still clinical evidence of disturbances of this region of the nervous system is generally lacking. This may be due to the fact that it is somewhat difficult and unsatisfactory to examine cerebellar function in patients severely paralyzed with spinal poliomyelitis or critically ill with bulbar or respiratory poliomyelitis. Certainly, in most studies evidence of residual cerebellar disturbances in patients that have recovered from this illness is generally lacking. Because of the volume of our material it was felt that a detailed study of the cerebellum might be of value in indicating the actual nature and extent of the cerebellar lesions in this disease. As early as 1898 Medin1reported cases of poliomyelitis in which the chief finding was incoordination. He referred to these cases as the ataxic, or cerebellar, form of the disease. He

Chest sequel˦ of infectious diseases

1. Lobular, segmental or lobar collapse is a frequent accompaniment of the late form of bronchopneumonia in whooping cough. Small areas of collapse are also frequently found in ambulant cases not clearing up satisfactorily from the fourth week onwards. These are potential sources of bronchiectasis. 2. An attack of whooping cough concurrent with an unhealed tuberculous primary complex may cause the latter to flare up and become progressive. 3. The complications of measles are more easily controlled by antibiotics than those of whooping cough, and recent epidemics of measles are milder than formerly. Pulmonary collapse and bronchiectasis as sequel˦ of measles are now accordingly comparatively rare. 4. A primary complex or any form of pulmonary tuberculosis concurrent with an attack of measles is very likely to be aggravated. In this respect measles is probably a greater potential danger than whooping cough. 5. Virus infections, such as measles, poliomyelitis, smallpox, mumps and rubella are often complicated by some degree of myocarditis, which may cause sequel˦. 6. Rheumatic heart disease is a frequent sequela, and pneumonitis and polyarteritis nodosa are rarer sequel˦ of h˦molytic streptococcal infections. 7. Chronic myocardial disorder is an uncommon sequela of diphtheritic myocarditis. 8. Chronic respiratory deficiency and attacks of severe gastric dilatation are not uncommon sequel˦ of respiratory poliomyelitis. 9. Diffuse calcified nodules in the lung fields may be residua of benign histoplasmosis contracted in certain parts of the world.

Hydrotherapy with respiratory poliomyelitis patients; a preliminary report.

Hydrotherapy with respiratory poliomyelitis patients; a preliminary report.

Eighteen years of dependence on a respirator.

ABSTRACT A case of respiratory poliomyelitis and peripheral paralysis was reported in The Journal (113:1806 [Nov. 11] 1939) in which the patient had depended on a respirator for eight years. This dependence continued 10 1/2 more years until the patient died, on April 17, 1950. During the 18 1/2 year period that he was ill, the patient stayed in Vassar Brothers Hospital, Poughkeepsie, N. Y. As the report covering the first eight years is presented here in the briefest outline, the original report should be referred to for details.REPORT OF A CASE B. S., then 13 years old, was admitted to the medical service of Vassar Brothers Hospital on the fifth day of an acute attack of poliomyelitis, with complete paralysis of all four extremities, with the exception of the toes and the fingers of the left hand. Twelve hours later, dyspnea and cyanosis necessitated the continuous use of