scholarly journals Tetanus Complicated by Dysautonomia: A Case Report and Review of Management

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Nishant Sharma ◽  
Si Li ◽  
Metlapalli Venkata Sravanthi ◽  
Dan Kazmierski ◽  
Yichen Wang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Mechanical Ventilation ◽  
Wide Spread ◽  
Neck Stiffness ◽  
Vaccination Strategies ◽  
Life Threatening ◽  
Uncommon Case ◽  
Muscle Spasms ◽  
High Doses ◽  
Severe Tetanus

Tetanus is a life-threatening infectious neurological disorder that is now a rare disease due to the institution of wide-spread vaccination strategies. We present an uncommon case of generalized severe tetanus with consequent respiratory failure requiring mechanical ventilation, which was associated with dysautonomia. A 20-year-old unvaccinated female presented with neck stiffness and diffuse muscle spasms following a laceration sustained 3 weeks prior. She was admitted to the intensive care unit for mechanical ventilation and was treated with immunoglobulin, tetanus toxoid, metronidazole, and high doses of sedatives. She also developed dysautonomia, with alternating bradycardia and tachycardia, as well as fluctuating blood pressure. She was successfully extubated and discharged. We also review the epidemiology, pathophysiology, and management of tetanus and discuss dysautonomia in the setting of tetanus.

scholarly journals Successful Treatment of Streptococcal Toxic Shock Syndrome with Both Diffuse Peritonitis and Necrotizing Fasciitis

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Shuichi Sato ◽  
Masahiro Ito ◽  
Tsuyoshi Sakai ◽  
Anri Kaneta ◽  
Fumie Sato
Keyword(s):  
Mechanical Ventilation ◽  
Necrotizing Fasciitis ◽  
Toxic Shock Syndrome ◽  
Multiple Organ ◽  
Streptococcal Toxic Shock Syndrome ◽  
Diffuse Peritonitis ◽  
Multiple Organ Dysfunction ◽  
Toxic Shock ◽  
Life Threatening ◽  
Uncommon Case

Streptococcal toxic shock syndrome (STSS) is a life-threatening disease caused by infection of beta-hemolytic streptococci. Here, we report an uncommon case of STSS with both diffuse peritonitis and necrotizing fasciitis and summarize previous cases. The patient was diagnosed with STSS due to an infection of the soft tissue of the lower extremity after surgery for diffuse peritonitis. The general condition had rapidly deteriorated with multiple organ dysfunction. Immediate intensive care, including mechanical ventilation, hemodiafiltration, and repeated debridement, is indispensable for a favorable outcome.

PENGARUH PEMBERIAN BELIMBING DAN MENTIMUN TERHADAP PENDERITA HIPERTENSI DI DESA LAU KERSIK KECAMATAN GUNUNG SITEMBER KABUPATEN DAIRI

2019 ◽  
Vol 2 (1) ◽  
pp. 18-23
Author(s):  
Herri Novita Br Tarigan ◽  
Prista Hotmarina Purba
Keyword(s):  
Blood Pressure ◽  
Data Analysis ◽  
Fruit Juice ◽  
Blood Pressure Reduction ◽  
Reduce Blood Pressure ◽  
Pharmacological Therapy ◽  
Hypertensive Patients ◽  
Star Fruit ◽  
Equivalent Time ◽  
Life Threatening

Hypertension is a disease that is not uncommon in the community, including the Bukit Lau Kersik village. People with hypertension often do not show long-term symptoms and can be life-threatening. However, one of the management of hypertension that can be used as non-pharmacological therapy is consuming starfruit juice and cucumber which is quite easy to find in the Bukit Lau Kersik village. This combination of juices contains potassium which can reduce blood pressure in patients with hypertension. This study used Equivalent Time Sample Design with 14 subjects with hypertension in the Bukit Lau Kersik Village, Gunung Sitember Subdistrict, Dairi District. The technique of this research sample used Non-Probability Sampling with Saturated Sampling. The instrument used was a sphygmomanometer and a stethoscope. Bivariate data analysis in this study was the Wilcoxon statistical test. Based on the data analysis performed, the value of p = 0.011 (p= < 0.05) was obtained, meaning that there was a significant relationship between giving star fruit juice and cucumber to hypertensive patients. Then it can be concluded that there is an influence between giving star fruit and cucumber juice to blood pressure reduction in hypertensive patients in Bukit Lau Kersik Village Gunung Sitember Subdistrict, Dairi District in 2019. Suggestion: The factors that affect blood pressure in hypertensive patients and checking blood pressure before drinking star fruit juice and cucumber.

A Review of the Therapeutic Benefits of Moringa oleifera in Controlling High Blood Pressure (Hypertension)

2019 ◽  
Vol 5 (3) ◽  
pp. 232-245
Author(s):  
Chuku Okorie ◽  
Kola Ajibesin ◽  
Adekunle Sanyaolu ◽  
Adeena Islam ◽  
Selciya Lamech ◽  
...  
Keyword(s):  
Blood Pressure ◽  
High Blood Pressure ◽  
Moringa Oleifera ◽  
Kidney Diseases ◽  
Treatment Strategies ◽  
Secondary Hypertension ◽  
Therapeutic Benefits ◽  
Northern Regions ◽  
Long Time ◽  
Life Threatening

Moringa oleifera (M. oleifera) is an angiosperm plant that is a member of the Moringaceae family. It is a natural plant that is native to the sub-Himalayan northern regions of India, Bangladesh, Pakistan, and Afghanistan. The plant grows abundantly throughout tropical and subtropical areas of the world. For several centuries, many cultures have utilized various parts of the moringa plant as traditional medicine to treat common illnesses and control life-threatening conditions such as hypertension (HTN), diabetes, hyperlipidemia, inflammation, etc. This article reviewed the current literature on the therapeutic benefits of M. oleifera on hypertension, primarily focusing on identifying the plant’s key components and its roles in hindering the common pathophysiological pathways associated with hypertension. The number of people living with HTN has been predicted to increase to 1.56 billion worldwide by 2025 in spite of the myriads of preventive and treatment strategies available today. Therefore, it would be of great value to explore alternative complementary ways of controlling high blood pressure. HTN is commonly defined as blood pressure equal to or higher than 140/90 mm Hg. HTN itself is not a disease condition and does not elicit specific symptoms, however, if left untreated for a long time, it can lead to complicated cardiovascular diseases such as angina, congestive heart failure, myocardial infarction as well as stroke and chronic kidney diseases. Primary hypertension is diagnosed when there is no known identifiable underlying cause for the onset of the condition. Secondary hypertension is diagnosed when there is evidence of a disease or disorder triggering the onset of the condition. It is apparent that understanding the role of M. oleifera in the management of hypertension would expand the valuable strategies for the control of this condition.

scholarly journals Asymptomatic mediastinal extra-adrenal paraganglioma as a cause of sudden death: a case Report

2019 ◽  
Vol 14 (1) ◽  
pp. 564-567
Author(s):  
Qiancheng Xu ◽  
Yingya Cao ◽  
Hongzhen Yin ◽  
Rongrong Wu ◽  
Tao Yu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Case Report ◽  
Respiratory Failure ◽  
Pressure Drop ◽  
Thoracic Cavity ◽  
Severe Hypotension ◽  
Life Threatening ◽  
History Of ◽  
Posterior Mediastinal ◽  
Extra Adrenal Paraganglioma

AbstractA 23-year-old female patient was referred for treatment of a posterior mediastinal tumour. There was no history of hypertension or headache and no other complaints. The patient’s blood pressure increased to 210/125 mmHg after surgically manipulating the tumour, subsequently reversing to severe hypotension (25/15 mmHg) immediately after the tumour was removed. The life-threatening and irreversible blood pressure drop was difficult to treat with fluid and vasopressors, and the patient ultimately died of cardio-respiratory failure. Asymptomatic paraganglioma can be non-functional but can also be fatal. For any lump in the thoracic cavity, paraganglioma should be ruled out.

scholarly journals A fatal toxic shock-like syndrome post COVID-19 infection in a child

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Houda Ajmi ◽  
Wissem Besghaier ◽  
Wafa Kallala ◽  
Abdelhalim Trabelsi ◽  
Saoussan Abroug
Keyword(s):  
Ejection Fraction ◽  
Pediatric Intensive Care ◽  
Fresh Frozen Plasma ◽  
Multiple Organ ◽  
Clinical Feature ◽  
Fresh Frozen ◽  
Life Threatening ◽  
High Doses ◽  
Definition Of ◽  
High Level

Abstract Background Children affected by Coronavirus disease 2019 (COVID-19) showed various manifestations. Some of them were severe cases presenting with multi-system inflammatory syndrome (MIS-C) causing multiple organ dysfunction. Case presentation We report the case of a 12-year-old girl with recent COVID-19 infection who presented with persistent fever, abdominal pain and other symptoms that meet the definition of MIS-C. She had lymphopenia and a high level of inflammatory markers. She was admitted to pediatric intensive care unit since she rapidly developed refractory catecholamine-resistant shock with multiple organ failure. Echocardiography showed a small pericardial effusion with a normal ejection fraction (Ejection Fraction = 60%) and no valvular or coronary lesions. The child showed no signs of improvement even after receiving intravenous immunoglobulin, fresh frozen plasma, high doses of Vasopressors and corticosteroid. His outcome was fatal. Conclusion Pediatric patients affected by the new COVID-19 related syndrome may show severe life-threatening conditions similar to Kawasaki disease shock syndrome. Hypotension in these patients results from heart failure and the decreased cardiac output. We report a new severe clinical feature of SARS-CoV-2 infection in children in whom hypotension was the result of refractory vasoplegia.

High prevalence of ascending aortic dilation in adults with repaired coarctation of the aorta

2021 ◽  
pp. 1-6
Author(s):  
Daniel Rinnström ◽  
Mikael Dellborg ◽  
Ulf Thilén ◽  
Peder Sörensson ◽  
Niels-Erik Nielsen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Aortic Valve ◽  
Aortic Valve Disease ◽  
Congenital Heart ◽  
Coarctation Of The Aorta ◽  
Valve Disease ◽  
Aortic Dilation ◽  
Factors Associated ◽  
High Prevalence ◽  
Life Threatening

Abstract Background: Ascending aortic dilation is a feared complication in adults with repaired coarctation of the aorta, as the condition is associated with life-threatening complications such as aortic dissection and rupture. However, the data are currently limited regarding factors associated with ascending aortic dilation in these patients. Methods and results: From the national register of congenital heart disease, 165 adult patients (≥ 18 years old) with repaired coarctation of the aorta, and echocardiographic data on aortic dimensions, were identified (61.2% male, mean age 35.8 ± 14.5 years). Aortic dilation (aortic diameters > 2 SD above reference mean) was found in 55 (33.3%) of the 165 included patients, and was associated with manifest aortic valve disease in univariable logistic regression analysis (OR 2.44, 95% CI [1.23, 4.83]). Conclusions: Aortic dilation is common post-repair of coarctation of the aorta, and is associated with manifest aortic valve disease and thus indirectly with the presence of a bicuspid aortic valve. However, no association was found between aortic dilation and age or blood pressure.

Region-Specific Medial Fiber Micro-Architecture in the Longitudinal-Radial and Circumferential-Radial Planes of Ascending Thoracic Aortic Aneurysm Among Bicuspid and Tricuspid Aortic Valve Patients

2013 ◽  
Author(s):  
Alkiviadis Tsamis ◽  
Julie A. Phillippi ◽  
Ryan G. Koch ◽  
Jeffrey T. Krawiec ◽  
Antonio D’Amore ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Aortic Valve ◽  
Aortic Aneurysm ◽  
Thoracic Aortic Aneurysm ◽  
Aortic Wall ◽  
False Lumen ◽  
True Lumen ◽  
Life Threatening ◽  
The Media ◽  
Intimal Tear

Aortic dissection is a life-threatening cardiovascular emergency with a high potential for death. It usually begins with an intimal tear which permits blood to enter the wall, split the media and create a false lumen, which can reenter the true lumen or exit through the adventitia causing complete rupture. A possible mechanism for dissection of ascending thoracic aortic aneurysm (ATAA) can be the occurrence of blood pressure-induced wall stresses in excess to the adhesive strength between the degenerated aortic wall layers.

scholarly journals Risk factors for death among critically ill patients with acute renal failure

2006 ◽  
Vol 124 (5) ◽  
pp. 257-263 ◽  
Author(s):  
Geraldo Bezerra da Silva Júnior ◽  
Elizabeth De Francesco Daher ◽  
Rosa Maria Salani Mota ◽  
Francisco Albano Menezes
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Mechanical Ventilation ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Intensive Care ◽  
Liver Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Urine Volume

CONTEXT AND OBJECTIVE: Acute renal failure is a common medical problem, with a high mortality rate. The aim of this work was to investigate the risk factors for death among critically ill patients with acute renal failure. DESIGN AND SETTING: Retrospective cohort at the intensive care unit of Hospital Universitário Walter Cantídio, Fortaleza. METHODS: Survivors and non-survivors were compared. Univariate and multivariate analyses were performed to establish risk factors for death. RESULTS: Acute renal failure occurred in 128 patients (33.5%), with mean age of 49 ± 20 years (79 males; 62%). Death occurred in 80 (62.5%). The risk factors most frequently associated with death were hypotension, sepsis, nephrotoxic drug use, respiratory insufficiency, liver failure, hypovolemia, septic shock, multiple organ dysfunction, need for vasoactive drugs, need for mechanical ventilation, oliguria, hypoalbuminemia, metabolic acidosis and anemia. There were negative correlations between death and: prothrombin time, hematocrit, hemoglobin, systolic blood pressure, diastolic blood pressure, arterial pH, arterial bicarbonate and urine volume. From multivariate analysis, the independent risk factors for death were: need for mechanical ventilation (OR = 3.15; p = 0.03), hypotension (OR = 3.48; p = 0.02), liver failure (OR = 5.37; p = 0.02), low arterial bicarbonate (OR = 0.85; p = 0.005), oliguria (OR = 3.36; p = 0.009), vasopressor use (OR = 4.83; p = 0.004) and sepsis (OR = 6.14; p = 0.003). CONCLUSIONS: There are significant risk factors for death among patients with acute renal failure in intensive care units, which need to be identified at an early stage for early treatment.

scholarly journals BIOMARKER TERKINI DALAM USAHA MEMPREDIKSI PREEKLAMPSIA

2017 ◽  
Vol 13 (1) ◽  
pp. 119 ◽  
Author(s):  
Yosef Dwi Cahyadi Salan
Keyword(s):  
Blood Pressure ◽  
Pregnant Women ◽  
Gestational Age ◽  
Growth Pattern ◽  
Abnormal Placentation ◽  
Immunological Markers ◽  
Life Threatening ◽  
Early Biomarker ◽  
Main Factors ◽  
Angiogenic Markers

Abstract: Preeclampsia is a life-threatening disease and can occur in all pregnant women. Preeclampsia was defined as a disease in pregnant women that is characterized by an increase in blood pressure exceeds 140 mmHg for systolic and 90 mmHg for diastolic that occured in pregnant women with gestational age above 20 weeks. In recent decades the incidence of preeclampsia continues to rise and is caused by various factors. Factors to be considered as the most influential is the process of the growth of the placenta which is abnormal, but the main factors that trigger the growth of the placenta become abnormal is not yet certainly known, some studies tryingto find out the various factors that can trigger the growth of abnormal placentation of preeclampsia, especially the associationof the growth pattern blood vessels in the placenta are thought to have a major role in the occurrence of preeclampsia in pregnant women. From these studies are found several biomarkers that are believed to be an early marker in an attempt to prevent the occurrence of preeclampsia in pregnant women, such as angiogenic markers, immunological markers, markers of Metabolic and Endocrine marker. Keywords: Preeclampsia, Abnormal Placentation, and Early Biomarker. Abstrak: Preeklampsia merupakan salah satu penyakit yang mengancam jiwa dan dapat terjadi pada semua ibu hamil. Preeklampsia didefinisikan sebagai suatu penyakit pada ibu hamil yang ditandai dengan adanya peningkatan tekanan darah melebihi 140 mmHg untuk sistolik dan 90 mmHg untuk diastolik yang terjadi pada ibu hamil dengan usia kehamilan diatas 20 minggu. Dalam beberapa dekade terakhir angka kejadian preeklampsia terus meningkat dan disebabkan oleh berbagai macam faktor. Faktor yang dianggap paling berpengaruh yaitu adanya proses pertumbuhan plasenta yang tidak normal, akan tetapi faktor utama yang mencetuskan terjadinya pertumbuhan plasenta secara abnormal tersebut belum diketahui dengan pasti, beberapa penelitian mencoba mencari tau berbagai faktor yang dapat memicu terjadinya pertumbuhan plasenta abnormal pada preeklampsia, terutama yang berhubungan dengan pola pertumbuhan pembuluh darah pada plasenta yang diduga memiliki peranan besar dalam terjadinya preeklampsia pada ibu hamil. Dari penelitian-penelitian tersebut didapatkan beberapa biomarker yang dipercaya dapat menjadi penanda dini dalam usaha untuk mencegah terjadinya preeklampsia pada ibu hamil, seperti marker Angiogenik, marker Immunologis, marker Metabolik, dan marker Endokrin. Kata-kata Kunci: Preeklampsia, Pertumbuhan Plasenta Abnormal, dan Biomarker  Penanda Dini. 

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