scholarly journals Respiratory failure, clinical course and community management of COVID‐19 patients in a large Australian cohort

2021 ◽  
Vol 51 (3) ◽  
pp. 334-340
Author(s):  
Teresa Louie ◽  
Ben Kwan ◽  
Clarissa Susanto ◽  
Andrew Ng
Keyword(s):  
Respiratory Failure ◽  
Clinical Course ◽  
Community Management ◽  
Australian Cohort

scholarly journals Generalized tetanus in an 11-year-old boy: A case report

2021 ◽  
Vol 11 (1) ◽  
pp. 69-75
Author(s):  
Artem A. Kozlov ◽  
Irina V. Shevchuk ◽  
Aleksei E. Zavialov ◽  
Anatoly N. Emelyanov
Keyword(s):  
Case Report ◽  
Respiratory Failure ◽  
Gastrointestinal Tract ◽  
Pain Relief ◽  
Antibiotic Therapy ◽  
Clinical Course ◽  
Treatment Strategies ◽  
Adequate Pain Relief ◽  
Choice Of Treatment ◽  
Severe Tetanus

The study presents a case report of a generalized form of severe tetanus in an unvaccinated 11-year-old child. Pain and convulsive syndromes, respiratory failure, and damage to the gastrointestinal tract prevailed in the acute period. Antibiotic therapy, anti-tetanus serum, adequate pain relief, and anticonvulsant therapy were the leading treatments of the child. Moreover, the paper discusses literature data on the options for the clinical course and choice of treatment strategies. The lack of planned vaccination in children is unsafe.

scholarly journals Vaping-associated lung injury: a case report and literature review

2021 ◽  
Vol 5 (2) ◽  
pp. 1-4
Author(s):  
Dewansh Goel ◽  
Kenneth Iyamu
Keyword(s):  
Case Report ◽  
Respiratory Failure ◽  
Lung Injury ◽  
Clinical Presentation ◽  
Clinical Course ◽  
Electronic Cigarettes ◽  
Invasive Mechanical Ventilation ◽  
Young Male ◽  
Acute Onset ◽  
Current Evidence

Usage of vaping and electronic cigarettes products is a growing trend among young adults, with rising rates worldwide. Such products are gaining popularity for many reasons including an alternative to smoking cigarettes, trying something new, or as a means to relax. While users may feel that these products are less harmful or a safer substitute to smoking traditional products, the side effect profile of vape inhalation has the potential for profound injury to the lung tissue and significant respiratory failure. We would like to present a case in which a young male who was evaluated at our Emergency department for acute onset respiratory failure subsequently requiring invasive mechanical ventilation in the setting of vaping associated lung injury (VALI). In the case report, we will highlight the patient’s clinical course as well as a summary of the current evidence surrounding evaluation, diagnosis and management of this emerging pathology. We want to emphasize the importance of a detailed history which should include the use of vaping products when a young patient presents with acute respiratory failure, allowing VALI to be in the differential diagnosis. Additionally, we want to compare the clinical presentation of VALI to that of COVID-19 pneumonia as they both have many similar attributes including symptoms and findings on lung imaging studies.

scholarly journals Clinical and intestinal histopathological findings in SARS-CoV-2/COVID-19 patients with hematochezia

2020 ◽  
Author(s):  
Margaret Cho ◽  
Weiguo Liu ◽  
Sophie Balzora ◽  
Yvelisse Suarez ◽  
Deepthi Hoskoppal ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Clinical Course ◽  
Laboratory Data ◽  
Ischemic Injury ◽  
Medication History ◽  
Elderly Male ◽  
Acute Phase Reactants ◽  
Mortality And Morbidity ◽  
Histopathological Findings ◽  
Gi Symptoms

Gastrointestinal (GI) symptoms of SARS-CoV2/COVID-19 in the form of anorexia,nausea, vomiting, abdominal pain and diarrhea are usually preceeded by respiratory manifestations and are associated with a poor prognosis. Hematochezia is an uncommon clinical presentation of COVID-19 disease and we hypothesize that older patients with significant comorbidites (obesity and cardiovascular) and prolonged hospitalization are suspectible to ischemic injury to the bowel. We reviewed the clinical course, key laboratory data including acute phase reactants, drug/medication history in two elderly male patients admitted for COVID-19 respiratory failure. Both patients had a complicated clinical course and suffered from hematochezia and acute blood loss anemia requiring blood transfusion around day 40 of their hospitalization. Colonoscopic impressions were correlated with the histopathological findings in the colonic biopies and changes compatible with ischemia to nonspecific acute inflammation, edema and increased eosinophils in the lamina propria were noted.Both patients were on anticoagulants, multiple antibiotics and antifungal agents due to respiratory infections at the time of lower GI bleeding. Hematochezia resolved spontaneously with supportive care. Both patients eventually recovered and were discharged. Elderly patients with significant comorbid conditions are uniquely at risk for ischemic injury to the bowel. Hypoxic conditions due to COVID-19 pneumonia and respiratory failure, compounded by preexisting cardiovascular complications, and/or cytokine storm orchestrated by the viral infection leading to alteration in coagulation profile and/or drug/medication injury can be difficult to distinguish in these critically ill patients. Presentation of hematochezia may further increase the mortality and morbidity of COVID-19 patients, and prompt consultation and management by gastroenterology is therefore warranted.

scholarly journals CLINICAL COURSE, RISK FACTORS FOR TRANSFER TO ICU AND MORTALITY IN PATIENTS WITH COVID-19 AFFECTED BY ACUTE RESPIRATORY FAILURE REFERRED TO A RESPIRATORY INTERMEDIATATE CARE UNIT.

2020 ◽  
Author(s):  
Enrico Buonamico ◽  
Vitaliano Nicola Quaranta ◽  
Esterina Boniello ◽  
Michela Dimitri ◽  
Marco Majorano ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Clinical Course ◽  
Laboratory Data ◽  
Icu Patients ◽  
Female Patients ◽  
Female Sex ◽  
Inflammatory Status

Introduction There are no clear guidelines as yet for the selection of patients affected by COVID-19 who can be treated in intermediate RICU, neither shared criteria for their intubation and transfer in ICU. In the present study we described the clinical course and risk factors for transfer to ICU and mortality of SARS-Cov-2 positive patients affected by acute respiratory failure, hospitalized in a Respiratory Intermediate Care Unit in the south of Italy. Methods In this retrospective, observational single centre study we evaluated 96 laboratory confirmed COVID-19 patients affected by acute respiratory failure (ARF). We compared demographic data, laboratory data and clinical outcomes between deceased and survived patients, aiming to identify risk factors for transfer to ICU and mortality, and possible gender-related differences. Results Of 96 patients, 51 (53.1%) survived and 45 (46.9 %) died. Among those who died, 23 (51.1%) deceased in RICU. Twenty-nine (30.2%) were transferred to ICU, of whom 22 (75.9%) died in ICU. Patients affected by COPD have a higher mortality compared to patients without this comorbidity (p=0.002). Lower baseline P/F ratio (p=0,014) and neurologic comorbidities (p=0,008) emerged as risk factors for death. Male were younger than female patients (66 vs 80 y.o.; p=0.042). In female patients, lower peripheral blood lymphocyte count (p=0.007) is a risk factor for death, characteristic gender-related in our sample. Female sex was a protective parameter against transfer to ICU (p=0,036) and P/F ratio was not a significant predictor of transfer to ICU (p=0,227). Only higher baseline CRP (p=0,034) has shown a predictive role for transfer to ICU in our sample. Patients deceased after a transfer to ICU had younger age (p=0,000), lower median comorbidity number (p=0,000), lower D-dimer (p=0,029) and lower prevalence of female sex (p=0,029). Discussion Mortality in our study was similar to that found in other studies involving patients in non-invasive ventilation. In our study older age and comorbidities play as predictors of death in COVID-19 patients. COPD, despite presenting low prevalence, is a risk factor for death, both in men and women. In female patients chronic ischemic heart disease and congestive heart failure are death predictors. High CRP and lymphopenia, linked to inflammatory status, are predictors of transfer to ICU. Patients transferred to ICU higher mortality than the others, and patients who die in ICU are mostly men, younger and have less comorbidities. Baseline P/F ratio is not a good predictor of transfer to ICU, while in our sample is a sensible predictor of death. More studies need to be performed on COVID-19 patients, in the urgency of COVID-19 pandemic persistence.

scholarly journals Risk of unsuccessful noninvasive ventilation for acute respiratory failure in heterogeneous neuromuscular diseases: a retrospective study

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Hiroshi Kataoka ◽  
Hitoki Nanaura ◽  
Kaoru Kinugawa ◽  
Yuto Uchihara ◽  
Hiroya Ohara ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Amyotrophic Lateral Sclerosis ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Clinical Course ◽  
Neuromuscular Diseases ◽  
Invasive Ventilation ◽  
Noninvasive Mechanical Ventilation ◽  
To Receive ◽  
Lateral Sclerosis

If invasive ventilation can be avoided by performing noninvasive mechanical ventilation (NIV) in patients with acute respiratory failure (ARF), the disease can be effectively managed. It is important to clarify the characteristics of patients with neuromuscular diseases in whom initial NIV is likely to be unsuccessful. We studied 27 patients in stable neuromuscular condition who initially received NIV to manage fatal ARF to identify differences in factors immediately before the onset of ARF among patients who receive continuous NIV support, patients who are switched from NIV to invasive ventilation, and patients in whom NIV is discontinued. Endpoints were evaluated 24 and 72 hours after the initiation of NIV. After 24 hours, all but 1 patient with amyotrophic lateral sclerosis (ALS) received continuous NIV support. 72 hours later, 5 patients were switched from NIV to invasive ventilation, and 5 patients continued to receive NIV support. 72 hours after the initiation of NIV, the proportion of patients with a diagnosis of ALS differed significantly among the three groups (P=0.039). NIV may be attempted to manage acute fatal respiratory failure associated with neuromuscular diseases, but clinicians should carefully manage the clinical course in patients with ALS.

scholarly journals SRP-positive necrotising myopathy: takes more than just the muscles

2021 ◽  
Vol 14 (2) ◽  
pp. e237647
Author(s):  
Samantha Below ◽  
Maaman Bashir
Keyword(s):  
Pulmonary Hypertension ◽  
Respiratory Failure ◽  
Autoimmune Disease ◽  
Clinical Course ◽  
Signal Recognition Particle ◽  
Muscle Pathology ◽  
Signal Recognition ◽  
Shortness Of Breath ◽  
Time Of Admission ◽  
Underlying Pathology

Necrotising myopathy is an autoimmune disease that commonly affects muscles. Here we examine a case of a middle-aged women presenting with a chief report of shortness of breath, who subsequently developed muscle weakness. Her clinical course was complicated by respiratory failure and pulmonary hypertension likely due to the underlying pathology of signal recognition particle-positive necrotising myopathy. After further evaluation, her shortness of breath was thought to be secondary to muscle pathology rather than cardiopulmonary pathology. She was transferred to our institution for workup by rheumatology. At the time of admission, 6 months after initial presentation, her weakness progressed, so that she was unable to lift her arms and legs against gravity. Furthermore, neurological examination revealed mild facial and nuchal weakness, severe proximal weakness, more moderate distal weakness and global areflexia.

scholarly journals Clinical and functional features of bronchial asthma in pregnancy

2005 ◽  
pp. 73-76
Author(s):  
O. B. Prikhodko ◽  
Yu. S. Landyshev ◽  
E. B. Romantsova
Keyword(s):  
Respiratory Failure ◽  
Lung Function ◽  
Bronchial Asthma ◽  
High Frequency ◽  
Clinical Course ◽  
Perinatal Complications ◽  
Functional Features ◽  
Complicated Pregnancy ◽  
In Pregnancy

Clinical course of bronchial asthma (BA) was followed-up during pregnancy (in I, II, and III trimesters). We observed 62.3 % of patients with mild BA, 29.8 % with moderate and 7.9 % with severe BA. Acute bronchial asthma was diagnosed in 68.4 % of the patients, of them 40.5 % were in the I trimester, 55.7 % were in the II trimester and 54.4 % were in the III trimester. During the follow-up period BA was stable in 43 % of the cases, improved in 14 % and worsened in 43 %. Complicated pregnancy course was diagnosed in 94.7 % of the patients. High frequency of perinatal complications was found. A complex assessment of lung function using spirography and zonal reography of the lungs allows early detection of the respiratory failure and timely diagnosis of BA impairment.

Diffuse Lung Disease

2012 ◽  
Author(s):  
Timothy R. Aksamit
Keyword(s):  
Differential Diagnosis ◽  
Respiratory Failure ◽  
Lung Disease ◽  
Lung Diseases ◽  
Clinical Course ◽  
Diffuse Lung Disease ◽  
Wide Range ◽  
Life Threatening ◽  
Diffuse Lung ◽  
Parenchymal Lung

Diffuse lung disease includes a wide range of parenchymal lung diseases that have infectious, inflammatory, malignant, drug, occupational or environmental, and other causes. Although many identifiable causes are recognized, the cause of most cases of diffuse lung disease in many published series is idiopathic. The clinical course may be acute or prolonged and may progress rapidly to life-threatening respiratory failure with death, or it may be indolent over many years. In most instances, a differential diagnosis can readily be formulated by obtaining the medical history, with emphasis on the nature of the symptoms, duration, and pertinent environmental, occupational, drug, and travel exposures.

scholarly journals An unexplained death after routine cardiac surgery: how long have we dealt with coronavirus disease 2019?

2020 ◽  
Vol 31 (6) ◽  
pp. 904-905
Author(s):  
Laura Varela Barca ◽  
Isabel Torralba Cloquell ◽  
Jaime Herrero Cereceda ◽  
Jose Ignacio Sáez de Ibarra
Keyword(s):  
Cardiac Surgery ◽  
Case Report ◽  
Respiratory Failure ◽  
Severe Acute Respiratory Syndrome ◽  
Clinical Course ◽  
Epidemiological Data ◽  
Spike Protein ◽  
Post Mortem ◽  
Immunohistochemical Detection ◽  
Unexplained Death

Abstract We present a case report of fatal respiratory failure after cardiac surgery in the early stages of the coronavirus disease 2019 outbreak. Although not supported by epidemiological data nor clinical course, coronavirus disease 2019 infection was revealed post-mortem by immunohistochemical detection of the severe acute respiratory syndrome coronavirus 2 spike protein in lung tissue.

Sign in / Sign up

Export Citation Format

Share Document