scholarly journals Immersion Pulmonary Edema in Female Triathletes

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Eric A. Carter ◽  
Michael S. Koehle
Keyword(s):  
Pulmonary Edema ◽  
Water Immersion ◽  
Water Environment ◽  
Previous History ◽  
Signs And Symptoms ◽  
Contributing Factors ◽  
Long Distance ◽  
Oxygen Administration ◽  
Capillary Stress ◽  
Life Threatening

Pulmonary edema has been reported in SCUBA divers, apnea divers, and long-distance swimmers however, no instances of pulmonary edema in triathletes exist in the scientific literature. Pulmonary edema may cause seizures and loss of consciousness which in a water environment may become life threatening. This paper describes pulmonary edema in three female triathletes. Signs and symptoms including cough, fatigue, dyspnea, haemoptysis, and rales may occur within minutes of immersion. Contributing factors include hemodynamic changes due to water immersion, cold exposure, and exertion which elevate cardiac output, causing pulmonary capillary stress failure, resulting in extravasation of fluid into the airspace of the lung. Previous history is a major risk factor. Treatment involves immediate removal from immersion and in more serious cases, hospitalization, and oxygen administration. Immersion pulmonary edema is a critical environmental illness of which triathletes, race organizers, and medical staff, should be made aware.

scholarly journals Acute respiratory distress secondary to a huge chronic left ventricular pseudo-aneurysm

2019 ◽  
Vol 6 (4) ◽  
pp. K19-K22
Author(s):  
Jonathan Hinton ◽  
George Hunter ◽  
Madhava Dissanayake ◽  
Rob Hatrick
Keyword(s):  
Myocardial Infarction ◽  
Pulmonary Edema ◽  
Previous History ◽  
Late Presentation ◽  
Left Ventricular ◽  
Inferior Wall ◽  
Life Threatening ◽  
History Of ◽  
Pseudo Aneurysm ◽  
Chest X Ray

Summary Pseudo-aneurysms are a rare, potentially life-threatening complication of a myocardial infarction. We present the case of a 45-year-old male who was brought to the emergency department in extremis and had a previous history of a late presentation inferior ST-elevation myocardial infarction treated percutaneously. Clinical examination revealed evidence of cardiogenic shock, pulmonary edema and a pulsatile epigastric mass. Chest X-ray demonstrated marked cardiomegaly and pulmonary edema. Urgent echocardiography confirmed the presence of a huge basal inferior wall pseudo-aneurysm with bi-directional flow. This was also associated with severe mitral regurgitation, due to posterior mitral annular involvement. The patient was transferred to the local cardiothoracic surgical unit where he underwent emergency repair of the pseudo-aneurysm and mitral valve replacement. Despite the surgery being complex he made a full recovery.

Diving Accident Evacuations by Helicopter and Immersion Pulmonary Edema

2020 ◽  
Vol 91 (10) ◽  
pp. 806-811
Author(s):  
Laëtitia Corgie ◽  
Nicolas Huiban ◽  
Jean-Michel Pontier ◽  
François-Xavier Brocq ◽  
Jean-François Boulard ◽  
...  
Keyword(s):  
Pulmonary Edema ◽  
Decompression Sickness ◽  
Mediterranean Coast ◽  
Military Hospital ◽  
Emergency Unit ◽  
Diving Accident ◽  
Landing Zone ◽  
Diving Accidents ◽  
Non Invasive Ventilation ◽  
Life Threatening

BACKGROUND: Scuba diving activities expose divers to serious accidents, which can require early hospitalization. Helicopters are used for early evacuation. On the French Mediterranean coast, rescue is made offshore mainly by a French Navy Dauphin or at a landing zone by an emergency unit EC 135 helicopter.METHODS: We retrospectively analyzed diving accidents evacuated by helicopter on the French Mediterranean coast from 1 September 2014 to 31 August 2016. We gathered data at the Center for Hyperbaric Medicine and Diving Expertise (SMHEP) of the Sainte-Anne Military Hospital (Toulon, France), the 35 F squadron at Hyres (France) Naval Air Station, and the SAMU 83 emergency unit (Toulon, France).RESULTS: A total of 23 diving accidents were evacuated offshore by Dauphin helicopter and 23 at a landing zone on the coast by EC 135 helicopter without hoist. Immersion pulmonary edema (IPE) accounted for one-third of the total diving accidents evacuated by helicopter with identified causes. It was responsible for at least half of the deaths at the dive place. A quarter of the rescued IPE victims died because of early cardiac arrest.DISCUSSION: Helicopter evacuation is indicated when vital prognosis (IPE and pulmonary overpressure in particular) or neurological functional prognosis (decompression sickness) is of concern. IPE is the primary etiology in patients with serious dive injuries that are life-threatening and who will benefit from helicopter evacuation. A non-invasive ventilation device with inspiratory support and positive expiratory pressure must be used, in particular for IPE.Corgie L, Huiban N, Pontier J-M, Brocq F-X, Boulard J-F, Monteil M. Diving accident evacuations by helicopter and immersion pulmonary edema. Aerosp Med Hum Perform. 2020; 91(10):806811.

Ultrasound diagnosis of dissecting thoracic aortic aneurysms: procedure with a handheld device and a video-illustrated case

2021 ◽  
Vol 51 (1) ◽  
pp. 10-15
Author(s):  
Kenneth V Iserson ◽  
Sri Devi Jagjit ◽  
Balram Doodnauth
Keyword(s):  
Aortic Dissection ◽  
Correct Diagnosis ◽  
Signs And Symptoms ◽  
Aortic Aneurysms ◽  
Thoracic Aortic Aneurysms ◽  
Handheld Device ◽  
Thoracic Aortic Dissection ◽  
Threatening Condition ◽  
Life Threatening ◽  
Handheld Ultrasound

Acute thoracic aortic dissection is an uncommon, although not rare, life-threatening condition. With protean signs and symptoms that often suggest more common cardiac or pulmonary conditions, it can be difficult to diagnose. Ultrasound has proven useful in making the correct diagnosis. This case demonstrates that training gained using standard ultrasound machines can be easily and successfully adapted to newer handheld ultrasound devices. The examination technique using the handheld device is illustrated with photos and a video.

Electric Vehicle Charger Placement Optimization in Michigan Considering Monthly Traffic Demand and Battery Performance Variations

2021 ◽  
pp. 036119812098195
Author(s):  
Fatemeh Fakhrmoosavi ◽  
MohammadReza Kavianipour ◽  
MohammadHossein (Sam) Shojaei ◽  
Ali Zockaie ◽  
Mehrnaz Ghamami ◽  
...  
Keyword(s):  
Optimal Allocation ◽  
Critical Factor ◽  
Cold Weather ◽  
Contributing Factors ◽  
Modeling Framework ◽  
Long Distance ◽  
Charging Infrastructure ◽  
Traffic Demand ◽  
Adverse Weather ◽  
Performance Variations

Limited charging infrastructure for electric vehicles (EVs) is one of the main barriers to adoption of these vehicles. In conjunction with limited battery range, the lack of charging infrastructure leads to range-anxiety, which may discourage many potential users. This problem is especially important for long-distance or intercity trips. Monthly traffic patterns and battery performance variations are two main contributing factors in defining the infrastructure needs of EV users, particularly in states with adverse weather conditions. Knowing this, the current study focuses on Michigan and its future needs to support the intercity trips of EVs across the state in two target years of 2020 and 2030, considering monthly traffic demand and battery performance variations. This study incorporates a recently developed modeling framework to suggest the optimal locations of fast EV chargers to be implemented in Michigan. Considering demand and battery performance variations is the major contribution of the current study to the proposed modeling framework by the same authors in the literature. Furthermore, many stakeholders in Michigan are engaged to estimate the input parameters. Therefore, the research study can be used by authorities as an applied model for optimal allocation of resources to place EV fast chargers. The results show that for charger placement, the reduced battery performance in cold weather is a more critical factor than the increased demand in warm seasons. To support foreseeable annual EV trips in Michigan in 2030, this study suggests 36 charging stations with 490 chargers and an investment cost of $23 million.

scholarly journals A rare case of fat embolism syndrome secondary to abdominal liposuction and gluteal fat infiltration

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Salvador Recinos ◽  
Sabrina Barillas ◽  
Alejandra Rodas ◽  
Javier Ardebol
Keyword(s):  
Right Ventricular Dysfunction ◽  
Signs And Symptoms ◽  
Fat Embolism ◽  
Fat Infiltration ◽  
Fat Embolism Syndrome ◽  
Embolism Syndrome ◽  
Threatening Condition ◽  
Life Threatening ◽  
Bone Marrow Harvesting ◽  
Dermatologic Manifestations

Abstract Fat embolism syndrome (FES) is a rare, life-threatening condition habitually associated with traumatic events such as fractures and, less commonly, burns, liposuction and bone marrow harvesting and transplant [ 1]. The biochemical theory for this condition suggests that fat droplets embolize and convert into fatty acids, eventually leading to toxic injury and inflammation, which results in increased vascular permeability, edema and hemorrhage [ 2]. FES may have an asymptomatic interval lasting 12–72 hours after the insult; however, in some cases, signs have also been seen intraoperatively. Pulmonary signs and symptoms are customarily the earliest and manifest in 75% of patients. Nevertheless, neurologic and dermatologic manifestations are also characteristic, and most severe cases could perhaps present with disseminated intravascular coagulation, right ventricular dysfunction, shock or death. The following case consists of a 37-year-old patient that presented with fat embolism syndrome during liposuction and gluteal fat infiltration.

scholarly journals An unusual presentation of acute myocardial infarction in physiotherapy direct access: findings from a case report

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lorenzo Storari ◽  
Valerio Barbari ◽  
Fabrizio Brindisino ◽  
Marco Testa ◽  
Maselli Filippo
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Case Report ◽  
Visceral Pain ◽  
Signs And Symptoms ◽  
Final Diagnosis ◽  
Outpatient Setting ◽  
Direct Access ◽  
Life Threatening ◽  
Medical Referral

Abstract Background Shoulder pain (SP) may originate from both musculoskeletal and visceral conditions. Physiotherapists (PT) may encounter patients with life-threatening pathologies that mimic musculoskeletal pain such as Acute Myocardial Infarction (AMI). A trained PT should be able to distinguish between signs and symptoms of musculoskeletal or visceral origin aimed at performing proper medical referral. Case presentation A 46-y-old male with acute SP lasting from a week was diagnosed with right painful musculoskeletal shoulder syndrome, in two successive examinations by the emergency department physicians. However, after having experienced a shift of the pain on the left side, the patient presented to a PT. The PT recognized the signs and symptoms of visceral pain and referred him to the general practitioner, which identified a cardiac disease. The final diagnosis was acute myocardial infarction. Conclusion This case report highlights the importance of a thorough patient screening examination, especially for patients treated in an outpatient setting, which allow distinguishing between signs and symptoms of musculoskeletal from visceral diseases.

scholarly journals Unusual dyspnea in a hemodialysis patient: A case report

10.3823/2607 ◽  
2019 ◽  
Vol 12 ◽  
Author(s):  
Ching-Hsiang Wang ◽  
Jenq-Shyong Chan ◽  
Chung-Chi Yang ◽  
Po-Jen Hsiao
Keyword(s):  
Hemodialysis Patient ◽  
Pleural Cavity ◽  
Middle Age ◽  
Clinical Symptoms ◽  
Rapid Development ◽  
Previous History ◽  
Final Diagnosis ◽  
Spontaneous Hemothorax ◽  
Life Threatening ◽  
History Of

The typical clinical symptoms of hemothorax include a rapid development of chest pain or dyspnea, which may be life-threatening without immediate management. As we know, spontaneous hemothorax, a collection of blood within the pleural cavity without previous history of trauma or other cause, which usually onsets suddenly. The early and accurate diagnosis of spontaneous hemothorax is imperative in clinical practice. We reported a middle-age male undergoing regular hemodialysis was referred to our emergency department due to unknown cause of dyspnea and acute respiratory failure. Chest radiography revealed bilateral patchy infiltration of lung. Pleural tap analysis showed exudative pleural effusion with numerous red blood cells. Video-assisted thoracic surgery (VATS) were performed and confirmed the final diagnosis of spontaneous hemothorax. He was then successfully treated with the surgery of VATS combined chest tube thoracostomy.

scholarly journals Research and Design of Distributed IoT Water Environment Monitoring System Based on LoRa

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Wei Chen ◽  
Xiao Hao ◽  
JianRong Lu ◽  
Kui Yan ◽  
Jin Liu ◽  
...  
Keyword(s):  
Water Quality ◽  
Water Temperature ◽  
Real Time ◽  
Monitoring System ◽  
Water Environment ◽  
Quality Parameters ◽  
Water Quality Parameters ◽  
Environment Monitoring ◽  
Long Distance ◽  
Internet Of Things Technology

In order to solve the problems of high labor cost, long detection period, and low degree of information in current water environment monitoring, this paper proposes a lake water environment monitoring system based on LoRa and Internet of Things technology. The system realizes remote collection, data storage, dynamic monitoring, and pollution alarm for the distributed deployment of multisensor node information (water temperature, pH, turbidity, conductivity, and other water quality parameters). Moreover, the system uses STM32L151C8T6 microprocessor and multiple types of water quality sensors to collect water quality parameters in real time, and the data is packaged and sent to the LoRa gateway remotely by LoRa technology. Then, the gateway completes the bridging of LoRa link to IP link and forwards the water quality information to the Alibaba Cloud server. Finally, end users can realize the water quality control of monitored water area by monitoring management platform. The experimental results show that the system has a good performance in terms of real-time data acquisition accuracy, data transmission reliability, and pollution alarm success rate. The average relative errors of water temperature, pH, turbidity, and conductivity are 0.31%, 0.28%, 3.96%, and 0.71%, respectively. In addition, the signal reception strength of the system within 2 km is better than -81 dBm, and the average packet loss rate is only 94%. In short, the system’s high accuracy, high reliability, and long distance characteristics meet the needs of large area water quality monitoring.

scholarly journals Anal Extrusion of Ventriculoperitoneal Shunt: A Case Report and Review of Literature

2021 ◽  
Vol 31 (4) ◽  
pp. 13
Author(s):  
Farhad Bal'afif ◽  
Donny Wisny Wardhana ◽  
Tommy Alfandy Nazwar ◽  
Novia Ayuning Nastiti
Keyword(s):  
Physical Examination ◽  
Ventriculoperitoneal Shunt ◽  
Surgical Procedure ◽  
Rare Complication ◽  
Female Child ◽  
Contributing Factors ◽  
Peritoneal Catheter ◽  
Factors Affecting ◽  
Vp Shunt ◽  
Life Threatening

<p>Ventriculoperitoneal (VP) Shunt is a commonly performed surgical procedure and offers a good result in the treatment of hydrocephalus. In general, 25% of the complication rate of this surgical procedure is abdominal complications. Anal extrusion of a peritoneal catheter is a rare complication ranging from 0.1 to 0.7% of all shunt surgeries. This study presents a rare case of anal extrusion of ventriculoperitoneal shunt in a 1-year-old female child who was asymptomatic. The physical examination revealed swelling and redness along the shunt tract on the retro auricular region, soft abdomen, and no catheter was observed in the anal. This study found several contributing factors affecting the complications in the anal extrusion of a peritoneal catheter, that are thin bowel wall in children and sharp tip and stiff end of VP shunt. The shunt should be disconnected from the abdominal wall, and the lower end should be removed through the rectum by colonoscopy or sigmoidoscopy/proctoscopy or by applying gentle traction on the protruding tube. This study concludes that due to potentially life-threatening consequences and case rarity, thorough anamnesis, physical examination, and objective investigation are needed to determine the appropriate management for anal extrusion of ventriculoperitoneal shunt. </p>

scholarly journals Occurrence of high altitude cerebral edema (hace) and high altitude pulmonary edema (HAPO) simultaneously at 12000 ft: a rare phenomen

2018 ◽  
Vol 5 (4) ◽  
pp. 1075
Author(s):  
Dharmendra Kumar ◽  
T. K. Rath ◽  
L. C. Verma
Keyword(s):  
Pulmonary Edema ◽  
High Altitude ◽  
Cerebral Edema ◽  
Standard Protocol ◽  
Contributing Factors ◽  
Lower Altitude ◽  
High Altitude Pulmonary Edema ◽  
High Altitude Cerebral Edema ◽  
Rapid Ascent ◽  
Male Sex

High altitude cerebral edema (HACE) and High altitude pulmonary edema (HAPO) are the most dreaded complications related to high altitude. Authors managed a case of HACE and HAPO simultaneously set at unusually low height (1200 ft) in a patient. The altitude was not too much to develop these comorbidities as studied earlier. Relationship with altitude was immaterial in our case. However, rapid ascent without proper acclimatisation, young and tender age, male sex and smoking were associated contributing factors. He was managed with standard protocol and descent to lower altitude.

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