scholarly journals Severe bradyarrhythmia requiring temporary pacemaker in a COVID-19 patient receiving lopinavir/ritonavir treatment: a case report

2020 ◽  
Vol 4 (Issue 2) ◽  
pp. 79 ◽  
Author(s):  
Zhenisgul Tlegenova ◽  
Bekbolat Zholdin ◽  
Meirambek Kurmangazin ◽  
Bulat Khamidulla ◽  
Zhambul Zhailybaev
Keyword(s):  
Normal Sinus Rhythm ◽  
Stable Condition ◽  
Chronic Obstructive ◽  
Nasopharyngeal Swab ◽  
Sinus Arrest ◽  
Treatment Benefit ◽  
Obstructive Pulmonary Disease ◽  
Normal Sinus ◽  
Escape Rhythm ◽  
Temporary Pacemaker

A 74-year-old Asian female with a history of hypertension and chronic obstructive pulmonary disease was admitted to hospital for coughing, shortness of breath and fatigue; her nasopharyngeal swab was positive for COVID-19. Lopinavir/ritonavir 800mg/200 mg, daily was started. On the third day of antiviral therapy, the patient complained of dizziness, nausea, she was disorientated, and electrocardiogram showed sinus arrest, junctional escape rhythm 36 beats per min. Patient was successfully treated by temporary pacemaker, normal sinus rhythm was reverted on a 3rd  day after stopping the lopinavir/ritonavir treatment. She was discharged home in stable condition. Bradyarrhythmia in form of sinus arrest can develop during treatment with lopinavir/ritonavir. The temporal nature of the observed changes and the ECG finding suggests the use of L/R contributed to the changes. This case highlights off-label prescribing lopinavir/ritonavir outside of a clinical trial setting should be avoided until the data have proven that treatment benefit over placebo.

scholarly journals COVID-19 in CKD Patients: Lessons from 553 CKD Patients with Biopsy-Proven Kidney Disease

2021 ◽  
pp. 1-8
Author(s):  
Juan León Román ◽  
Clara García-Carro ◽  
Irene Agraz ◽  
Nestor Toapanta ◽  
Ander Vergara ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Kidney Disease ◽  
Kidney Biopsy ◽  
Cox Regression ◽  
Gastrointestinal Symptoms ◽  
Bivariate Analysis ◽  
Chronic Obstructive ◽  
Nasopharyngeal Swab ◽  
Obstructive Pulmonary Disease ◽  
Immunosuppressed Patients

<b><i>Introduction:</i></b> Chronic kidney disease (CKD) patients infected with COVID-19 are at risk of serious complications such as hospitalization and death. The prognosis and lethality of COVID-19 infection in patients with established kidney disease has not been widely studied. <b><i>Methods:</i></b> Data included patients who underwent kidney biopsy at the Vall d’Hebron Hospital between January 2013 and February 2020 with COVID-19 diagnosis during the period from March 1 to May 15, 2020. <b><i>Results:</i></b> Thirty-nine (7%) patients were diagnosed with COVID-19 infection. Mean age was 63 ± 15 years and 48.7% were male. Hypertension was present in 79.5%, CKD without renal replacement therapy in 76.9%, and cardiovascular disease in 64.1%. Nasopharyngeal swab was performed in 26 patients; older (<i>p</i> = 0.01), hypertensive (<i>p</i> = 0.005), and immunosuppressed (<i>p</i> = 0.01) patients, those using RAS-blocking drugs (<i>p</i> = 0.04), and those with gastrointestinal symptoms (<i>p</i> = 0.02) were more likely to be tested for CO­VID-19. Twenty-two patients required hospitalization and 15.4% died. In bivariate analysis, mortality was associated with older age (<i>p</i> = 0.03), cardiovascular disease (<i>p</i> = 0.05), chronic obstructive pulmonary disease (<i>p</i> = 0.05), and low hemoglobin levels (<i>p</i> = 0.006). Adjusted Cox regression showed that low hemoglobin levels at admission had 1.81 greater risk of mortality. <b><i>Conclusions:</i></b> Patients with CO­VID-19 infection and kidney disease confirmed by kidney biopsy presented a mortality of 15.4%. Swab test for COVID-19 was more likely to be performed in older, hypertensive, and immunosuppressed patients, those using RAS-blocking drugs, and those with gastrointestinal symptoms. Low hemoglobin is a risk factor for mortality.

scholarly journals Experience of treatment with Berodual-N in industrial workers with COPD

2005 ◽  
pp. 103-106
Author(s):  
L. A. Stepanishcheva ◽  
G. L. Ignatova ◽  
E. V. Nikolaeva
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Outpatient Treatment ◽  
Clinical Signs ◽  
Stable Condition ◽  
Chronic Obstructive ◽  
Symptomatic Therapy ◽  
Industrial Workers ◽  
Obstructive Pulmonary Disease ◽  
Stage 1 ◽  
Progressive Course

Chronic obstructive pulmonary disease (COPD) is an actual healthcare problem due to its widespread, progressive course and mortality. A great deal of the patients’ treatment takes a symptomatic therapy. Results of outpatient treatment with Berodual-N of patients with COPD stage 1 to 2 in stable condition are shown in the article. A significant improvement in clinical signs, lung function parameters (FEV1) and physical tolerance were noted.

scholarly journals Inflammatory marker levels and peripheral blood circulation in skin microvessels in patients with chronic obstructive pulmonary disease

2008 ◽  
pp. 57-61 ◽  
Author(s):  
I. V. Tikhonova ◽  
A. V. Tankanag ◽  
N. I. Kosyakova ◽  
N. K. Chemeris
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Proinflammatory Cytokine ◽  
Inflammatory Marker ◽  
Respiratory Rhythm ◽  
Stable Condition ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Myogenic Activity ◽  
Peripheral Blood Circulation

Levels of inflammatory markers and skin microcirculation were studied in patients with chronic obstructive pulmonary disease. Proinflammatory cytokine concentrations and number of desquamated endothelial cells in blood flow were significant increased during exacerbation compared with controls. The increase in proinflammatory cytokine concentrations in exacerbation was accompanied by increased skin perfusion, increased oscil lation amplitudes in the frequency ranges of respiratory rhythm and higher endothelial activity compared with controls. In stable condition, the lev els of proinflammatory cytokines decreased compared with those in exacerbation. Myogenic activity was decreased twice in patients with stable con dition compared with healthy persons. The endothelialdependent vasodilation did not change and the endothelialindependent vasodilation increased in all patients compared with controls.

Management of patients with chronic obstructive pulmonary disease in COVID-19 pandemic

2020 ◽  
Vol 1 (19) ◽  
pp. 77-80
Author(s):  
S. I. Krayushkin ◽  
I. V. Ivakhnenko ◽  
E. A. Sushchuk ◽  
A. V. Zaporoshchenko
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Maintenance Therapy ◽  
Pulmonary Disease ◽  
Stable Condition ◽  
Adverse Outcomes ◽  
Chronic Obstructive ◽  
Significant Morbidity ◽  
Obstructive Pulmonary Disease ◽  
Increased Risk ◽  
Coronavirus Infection

The pandemic of COVID-19, a disease caused by a novel coronavirus SARS-CoV-2, is associated with significant morbidity and mortality. Recent data showed that patients with chronic obstructive pulmonary disease (COPD) have an increased risk for severity and complicated COVID-19 infection. In coronavirus pandemic, patients with COPD should continue standard maintenance therapy, including bronchodilators and their combination with inhaled glucocorticosteroids, in order to maintain a stable condition and prevent the development of exacerbations that can be provoked by COVID-19. It is important for this group of patients to carefully monitor the condition and follow measures aimed at preventing infection with coronavirus infection due to the increased risk of adverse outcomes.

scholarly journals Transient cardiac arrhythmias related to lopinavir/ritonavir in two patients with HIV infection

Sexual Health ◽  
2009 ◽  
Vol 6 (3) ◽  
pp. 254 ◽  
Author(s):  
Santosh K. Chaubey ◽  
Ashim K. Sinha ◽  
Elizabeth Phillips ◽  
Darren B. Russell ◽  
Henrik Falhammar
Keyword(s):  
Normal Sinus Rhythm ◽  
Hiv Positive ◽  
Type Ii ◽  
Normal Sinus ◽  
Triple Vessel Disease ◽  
Escape Rhythm ◽  
Combination Drugs ◽  
Permanent Pace ◽  
Pace Maker ◽  
Mobitz Type

A 42-year-old Thai man was administered the combination drugs liponavir/ritonavir and abacavir/lamivudine. On day 3 he was admitted and his electrocardiogram demonstrated sinus arrest with junctional escape rhythm with a rate of 42 min−1. Three days after stopping the medication he reverted to normal sinus rhythm. A 55-year-old Caucasian man was admitted to hospital with triple vessel disease. He had a permanent pace maker inserted 4 years previously for Mobitz type II AV block detected on stress electrocardiogram, which developed 1 month after initiation of lopinavir/ritonavir. These two cases highlight the importance of considering lopinavir/ritonavir induced arrhythmias when dealing with HIV-positive individuals.

scholarly journals Identification of novel pheno-groups in heart failure with preserved ejection fraction using machine learning

Heart ◽  
2020 ◽  
Vol 106 (5) ◽  
pp. 342-349 ◽  
Author(s):  
Åsa K Hedman ◽  
Camilla Hage ◽  
Anil Sharma ◽  
Mary Julia Brosnan ◽  
Leonard Buckbinder ◽  
...  
Keyword(s):  
Machine Learning ◽  
Heart Failure ◽  
Ejection Fraction ◽  
Stable Condition ◽  
Chronic Obstructive ◽  
Preserved Ejection Fraction ◽  
Obstructive Pulmonary Disease ◽  
Model Based Clustering ◽  
Applied Model ◽  
End Point

ObjectiveHeart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome. We aimed to derive HFpEF phenotype-based groups ('phenogroups') based on clinical and echocardiogram data using machine learning, and to compare clinical characteristics, proteomics and outcomes across the phenogroups.MethodsWe applied model-based clustering to 32 echocardiogram and 11 clinical and laboratory variables collected in stable condition from 320 HFpEF outpatients in the Karolinska-Rennes cohort study (56% female, median 78 years (IQR: 71–83)). Baseline proteomics and the composite end point of all-cause mortality or heart failure (HF) hospitalisation were used in secondary analyses.ResultsWe identified six phenogroups, for which significant differences in the prevalence of concomitant atrial fibrillation (AF), anaemia and kidney disease were observed (p<0.05). Fifteen out of 86 plasma proteins differed between phenogroups (false discovery rate, FDR<0.05), including biomarkers of HF, AF and kidney function. The composite end point was significantly different between phenogroups (log-rank p<0.001), at short-term (100 days), mid-term (18 months) and longer-term follow-up (1000 days). Phenogroup 2 was older, with poorer diastolic and right ventricular function and higher burden of risk factors as AF (85%), hypertension (83%) and chronic obstructive pulmonary disease (30%). In this group a third experienced the primary outcome to 100 days, and two-thirds to 18 months (HR (95% CI) versus phenogroups 1, 3, 4, 5, 6: 1.5 (0.8–2.9); 5.7 (2.6–12.8); 2.9 (1.5–5.6); 2.7 (1.6–4.6); 2.1 (1.2–3.9)).ConclusionsUsing machine learning we identified distinct HFpEF phenogroups with differential characteristics and outcomes, as well as differential levels of inflammatory and cardiovascular proteins.

Some effects of breath holding and apneic underwater diving on cardiac rhythm in man

1962 ◽  
Vol 17 (3) ◽  
pp. 461-466 ◽  
Author(s):  
C. Robert Olsen ◽  
Darrell D. Fanestil ◽  
Per F. Scholander
Keyword(s):  
Cardiac Arrhythmias ◽  
Cardiac Rhythm ◽  
Sinus Tachycardia ◽  
Normal Sinus Rhythm ◽  
Sinus Bradycardia ◽  
Breath Holding ◽  
Sinus Arrest ◽  
Sinus Arrhythmia ◽  
Normal Sinus ◽  
Idioventricular Rhythm

Man's bradycardic response to simple breath holding was augmented by submersion in water of 27 C and was not prevented by muscular exercise. Cardiac arrhythmias occurred with 45 of 64 periods of apnea in 16 subjects and were more frequent during the dives than during breath holding. These arrhythmias, with the exception of atrial, nodal, and ventricular premature contractions, were inhibitory in type and included sinus bradycardia and arrhythmia, sinus arrest followed by either nodal escape or ventricular escape, A-V block, A-V nodal rhythm, and idioventricular rhythm. T waves frequently became tall and peaked during both breath holding and dives. Prompt return to normal sinus rhythm was the rule with the first breath after surfacing. Sinus tachycardia, sinus arrhythmia, and atrial, nodal, or ventricular premature contractions were seen during recovery. Submitted on October 9, 1961

scholarly journals COPD

2018 ◽  
Vol 25 (06) ◽  
pp. 847-853
Author(s):  
Saba Ajaz Baloch ◽  
Farya Zafar ◽  
Huma Ali ◽  
Ali Akbar Sial ◽  
Ashok Kumar ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Stable Condition ◽  
Medical Community ◽  
Health Concern ◽  
Chronic Obstructive ◽  
Type I ◽  
Obstructive Pulmonary Disease ◽  
Bode Index ◽  
I 11 ◽  
Male Patients

Introduction: Chronic obstructive pulmonary disease (COPD) is considered asa major public health concern to the medical community. COPD is associated with episodicexacerbations which are evident as enhanced dyspnea, worsening of lung function, coughand production of sputum. Objectives: To assess 126 COPD exacerbated patients in a tertiarycare hospital of Karachi, Pakistan. Study Design: Descriptive study. Setting: Various wardsof tertiary care Ziauddin Hospitals. Period: November 2016 to April 2017. Methods: Patientswere classified into Type I, II and III exacerbation. Consent was taken from patients’ caregivers,while hospital permission was also obtained. At the time of study all the patients were receivingappropriate therapy and patients were clinically in stable condition. Data collection wasperformed by thorough reviewing and recording the data from patients’ medical records. Also,the questionnaire was filled by the principal investigator to collect three evaluation parametersincluding MMRC Dyspnea Scale Score, Bode Index and Dose Index Scoring System. Datawas expressed in terms of percentages.Direct medical costs were also determined in Rupees(Rs.) of these patients. Results: Results indicated that most of the male patients were foundto have exacerbation. It was found that patients having smoking habits were found to havehigher frequency of COPD exacerbation (Type I, 11 (8.730 %); Type II, 36 (28.571 %); TypeIII, 40 (31.746 %)) as compared to non smokers. Major complaints which were found in 126patients were shortness of breath, fever, cough and increased sputum. It was found that mostcommon comorbid diseases found in 126 patients were hypertension, diabetes mellitus andtuberculosis. In this study, the direct cost analysis of 126 COPD exacerbated patients were alsocarried out. Conclusion: Present study indicated multiple indicators for repeated exacerbationsin COPD. Which in terns increase the treatment costs for the patients.

scholarly journals ACUPOINT TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION IN HOSPITALIZED COPD PATIENTS WITH SEVERE DYSPNOEA: STUDY PROTOCOL FOR A RANDOMIZED CONTROLED TRIAL

2019 ◽  
Author(s):  
Carles Fernández ◽  
Jordi Vilaró
Keyword(s):  
Nerve Stimulation ◽  
Hospital Admissions ◽  
Stable Condition ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Electrical Nerve Stimulation ◽  
Non Invasive ◽  
Copd Patients ◽  
Transcutaneous Nerve Stimulation ◽  
To Receive

Abstract Background Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a major cause of hospital admissions and dyspnoea is its main symptom. Some studies have concluded that a new modality of acupuncture called Acupuncture transcutaneous nerve stimulation (acuTENS) could reduce dyspnoea in COPD patients by increasing beta-endorphin levels, however those trials have mainly been conducted on patients with stable condition. This study aims to determinate if the administration of acuTENS can reduce dyspnoea in patients hospitalized for AECOPD. Methods A multicentric randomized control trial with patient- and assessor-blinded will be conducted. A sample of 60 patients will be randomised to receive 45 minutes of either real acuTENS or sham acuTENS treatment once a day during 5 consecutive days. The trial will be conducted at the “Hospital del Mar” of Barcelona (Spain) and the “Hospital Sant Joan de Déu de Manresa” in Manresa (Spain). The Borg scale at baseline, and day 1 to 5 will be the primary outcome. Secondary outcomes will be the duration of the hospitalization, quantity of drugs administrated, expiratory peck flow adverse effects and mortality and readmissions at 3 months. Discussion AcuTENS is non-pharmacological, non-invasive and cheap intervention. This trial will help to understand acuTENS potential role in the treatment of AECOPD.

scholarly journals COVID-19, Chronic Obstructive Pulmonary Disease and Pneumothorax: A Frightening Triad

2020 ◽  
Author(s):  
Erika Poggiali ◽  
Andrea Vercelli ◽  
Teresa Iannicelli ◽  
Valentina Tinelli ◽  
Laura Celoni ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Chest Ct ◽  
Chronic Obstructive ◽  
Nasopharyngeal Swab ◽  
Obstructive Pulmonary Disease ◽  
Diffuse Emphysema ◽  
Chest Ct Scan

We describe the case of a male patient admitted to our emergency department during the Italian COVID-19 epidemic, for progressive worsening dyspnoea. A diagnosis of pneumothorax and diffuse interstitial lung involvement was promptly made by lung ultrasound and confirmed by an HRCT scan. A chest CT scan also showed diffuse emphysema, as observed in chronic obstructive pulmonary disease (COPD), and small consolidations in the lower lobes, suggestive for COVID-19 pneumonia. A chest tube was immediately inserted in the emergency room with complete resolution of the dyspnoea. A nasopharyngeal swab for 2019-nCoV was positive. Unfortunately, the patient died from COVID-19-related acute respiratory distress syndrome after 48 days of hospitalization.

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