scholarly journals Just the facts: What drugs are safe and effective for COVID-19?

CJEM ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. 591-594
Author(s):  
Brit Long ◽  
Stephen Y. Liang ◽  
Hans Rosenberg ◽  
Christopher Hicks ◽  
Michael Gottlieb
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Oxygen Saturation ◽  
Medical History ◽  
Face Mask ◽  
Therapeutic Agents ◽  
Past Medical History ◽  
Oxygen Supplementation ◽  
X Ray ◽  
Chest X Ray

A 53-year-old male presents with cough, fever, and myalgias for 7 days. Vitals include temperature, 38.0°C; heart rate, 110; blood pressure, 118/70 mm Hg; respiration rate, 28; and oxygen saturation 83% on room air. His only past medical history is hypertension. Your community is in the midst of the coronavirus disease 2019 (COVID-19) pandemic. The patient is hypoxic but responds to oxygen supplementation with nasal cannula and a face mask. His chest x-ray demonstrates multifocal infiltrates. Are there any therapeutic agents currently available for COVID-19?

scholarly journals Mediastinal eggshell calcifications

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Lisa N Glass ◽  
◽  
Joseph Delio ◽  
Jalil E Ahari ◽  
◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Deep Vein Thrombosis ◽  
Chest Pain ◽  
Lower Extremity ◽  
Medical History ◽  
Past Medical History ◽  
Vein Thrombosis ◽  
Progressive Dyspnea ◽  
Deep Vein

A 71-year-old man, who is non-smoker with past medical history notable for hypertension and right lower extremity deep vein thrombosis three years prior, presented with progressive dyspnea on exertion of two weeks duration. He did not have any chest pain; heart rate and blood pressure were normal. His DVT had occurred in the setting of trauma, where he was injured by a falling tree. He was treated with anticoagulation for six months and recovered.

scholarly journals The use of a new semi-quantitative rapid test for procalcitonin in the diagnosis of multisegmental community-acquired pneumonia

2021 ◽  
Vol 93 (3) ◽  
pp. 279-282
Author(s):  
Sabina S. Bayramova ◽  
Konstantin Yu. Nikolayev ◽  
Oksana V. Tsygankova
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Respiratory Failure ◽  
Rapid Test ◽  
Community Acquired Pneumonia ◽  
Procalcitonin Level ◽  
X Ray ◽  
Erythrocyte Sedimentation ◽  
Chest X Ray ◽  
The Mean

Aim. Evaluation of the possibilities of a new semi-quantitative rapid test for procalcitonin in the diagnosis of multisegmental community-acquired pneumonia. Materials and methods. A one-stage comparative study involved 123 patients hospitalized in a hospital with a confirmed diagnosis of community-acquired pneumonia. The mean age of the patients was 49.521.0 (MSD) years. On the first day of hospitalization, all patients underwent a general clinical examination, chest x-ray, and a plasma procalcitonin level was determined using a semi-quantitative rapid test. Results. Indicators of a new semi-quantitative rapid test for procalcitonin of at least 2 ng/ml are directly related to laboratory and instrumental indicators reflecting the severity of community-acquired pneumonia, namely, the severity of respiratory failure (p=0.001), respiratory rate (p=0.001), and heart rate contractions (p=0.001), systolic blood pressure (p=0.025), oxygen saturation (p=0,001), erythrocyte sedimentation rate (p=0.021), fibrinogen (p=0.003) and high CRB-65 scores (p=0.001). They are also associated with multisegmental community-acquired pneumonia (2=4.7; p=0.030) and complications of this disease, such as hydrothorax (p=0.029) and death (2=22.1; p=0.001). Conclusion. Using a new semi-quantitative rapid test for procalcitonin allows you to optimize the diagnosis of complications of community-acquired pneumonia and determine the high risk of multisegmental pneumonia.

Midazolam for Conscious Sedation During Pediatric Oncology Procedures: Safety and Recovery Parameters

PEDIATRICS ◽  
1991 ◽  
Vol 88 (6) ◽  
pp. 1172-1179
Author(s):  
Theresa D. Sievers ◽  
John D. Yee ◽  
Mary E. Foley ◽  
Peter J. Blanding ◽  
Charles B. Berde
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Bone Marrow ◽  
Oxygen Saturation ◽  
Cancer Patients ◽  
Pediatric Cancer ◽  
Conscious Sedation ◽  
Face Mask ◽  
Pediatric Cancer Patients ◽  
Verbal Stimulation

Multiple bone marrow aspirations or biopsies and lumbar punctures are a necessary part of the diagnosis and treatment of many pediatric cancer patients. Pharmacologic sedation may decrease the distress associated with these procedures. Midazolam (MDZ, Versed) is a water-soluble, rapid-onset, short-duration benzodiazepine that has not been studied widely in children. We prospectively evaluated safety and recovery parameters for intravenous MDZ used for conscious sedation by oncologists (without an anesthesiologist in attendance) for 70 procedures (bone marrow aspirations, lumbar punctures, or bone marrow aspirations plus lumbar punctures) in 24 ambulatory pediatric cancer patients, aged 1.5 to 15.5 years. MDZ was used alone or in combination with morphine or fentanyl. Respiratory rate, oxygen saturation, blood pressure, and heart rate were monitored. Sedation, anxiolysis, and recovery were assessed with a behavior score and a modified recovery room discharge score. Restraint was not required in 45% of the procedures. In no case was a respiratory rate < 12 observed. In nine procedures (13%), an oxygen saturation ≤ 90 occurred, all within 10 minutes after the last dose of MDZ. Ten procedures (14%) required verbal stimulation to take deeper breaths. Two patients did not respond immediately to verbal stimulation and received face-mask oxygen. Hypoxemia was not correlated with opioid use. Hypoxemia appears to be related to total MDZ dose and may occur with normal respiratory rates; all cases resolved with verbal stimulation or face-mask oxygen without specific airway maneuvers or assisted ventilation. Heart rate and blood pressure remained stable in all 70 procedures. In all 70 procedures a satisfactory discharge score was achieved by 60 minutes after the last dose of MDZ. Full or partial amnesia was reported in 90% of the procedures. No long-term adverse effects were reported on follow-up. Midazolam appeared to offer effective sedation and amnesia in children undergoing bone marrow aspirations or lumbar punctures. Safe administration requires constant observation, use of pulse oximetry, and availability of supplemental oxygen and resuscitation equipment because significant hypoxemia can occur in patients breathing room air. A recovery period of 60 minutes appeared to be adequate.

The Effects of Passive and Active Smoking on Brachial and radial Blood Pressure and Some Other Physical Factors in Healthy Young Adults

2017 ◽  
Vol 5 (3) ◽  
pp. 259
Author(s):  
Shireen H. Ramadhan ◽  
Shamil K. Talal ◽  
Wasfiya A. Moner
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Oxygen Saturation ◽  
Oxygen Concentration ◽  
Tobacco Smoke ◽  
Blood Pressure Measurement ◽  
Reference Level ◽  
Physical Factors ◽  
New Device ◽  
Active Smoker

Tobacco smoke is enormously harmful to human health, there’s no safe way to smoke. The primary objective of this study is to analyze the role of tobacco smoke compounds and their ability to damage the cardiovascular system and, in particular, to interfere with blood pressure (Brachial and radial pressure), heart rate and partly on the percentage blood Oxygen saturation. A new device has been manufactured which is unique for measuring the level of smoke, to obtained privies readings, the device had fixed to the first reference level آ and starting up from it. The effect of smoking has been studied on (26) male passive (26) active smoker volunteer, (14) female passive and (14) female active smoker participants. The results has been showed that the blood pressure and heart rate has been increased with increasing the number of cigarettes in both genders for passive and active smokers. However, this effect for male was more pronounced comparing with females for passive and active smokers. In the case of oxygen saturation concentration percentage, for males the change of oxygen concentration percentage was not stable. In other words, it was fluctuated with the number of cigarettes. But for females the oxygen concentration was decreased but not too much. This means that this effect was not pronounced. this study found آ that the most pronounced effect has been shown by male’s comparison to females for both passive and active smokers. As well as in nonsmoker’s males, the relation between heart rate and smoke level is inversely proportional. While in male and female smokers and female nonsmokers the relation is proportional. In all cases the relation between the smoke level and time of smoking is inversely proportional. Finally males& females are affected differently by tobacco use; the sensitivities to smoke for males are higher than in females for passive and active smokers in both brachial and radial blood pressure measurement.

One hour effects of salbutamol and formoterol on blood pressure, heart rate and oxygen saturation in asthmatics

2008 ◽  
Vol 14 (3) ◽  
pp. 353-361
Author(s):  
Geraldo Andrade Capuchinho-Júnior ◽  
Ricardo Marques Dias ◽  
Sônia Regina da Silva de Carvalho
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Oxygen Saturation

scholarly journals Osteopetrosis - A Case Series Exploring Complications and Multidisciplinary Management

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A209-A209
Author(s):  
Catherine Stewart ◽  
Paul Benjamin Loughrey ◽  
John R Lindsay
Keyword(s):  
Back Pain ◽  
Lumbar Spine ◽  
Medical History ◽  
Scaphoid Fracture ◽  
Past Medical History ◽  
Dxa Scan ◽  
X Ray ◽  
Management Of Complications ◽  
History Of ◽  
Spine Mri

Abstract Background: Osteopetrosis is a group of rare inherited skeletal dysplasias, with each variant sharing the hallmark of increased bone mineral density (BMD). Abnormal osteoclast activity produces overly dense bone predisposing to fracture and skeletal deformities. Whilst no cure for these disorders exists, endocrinologists play an important role in surveillance and management of complications. Clinical Cases: A 43-year-old female had findings suggestive of increased BMD on radiographic imaging performed to investigate shoulder and back pain. X-ray of lumbar spine demonstrated a ‘rugger jersey’ spine appearance, while shoulder X-ray revealed mixed lucency and sclerosis of the humeral head. DXA scan showed T-scores of +11 at the hip and +12.5 at the lumbar spine. MRI of head displayed bilateral narrowing and elongation of the internal acoustic meatus and narrowing of the orbital foramina. Genetic assessment confirmed autosomal dominant osteopetrosis with a CLCN7 variant. Oral colecalciferol supplementation was commenced and multi-disciplinary management instigated with referral to ophthalmology and ENT teams. A 25-year-old male presented with a seven-year history of low back pain and prominent bony swelling around the tibial tuberosities and nape of neck. Past medical history included repeated left scaphoid fracture in 2008 and 2018. Recovery from his scaphoid fracture was complicated by non-union requiring bone grafting with open reduction and fixation. Plain X-rays of the spine again demonstrated ‘rugger jersey’ spine. DXA scan was notable for elevated T scores; +2.9 at hip and +5.8 lumbar spine. MRI spine showed vertebral endplate cortical thickening and sclerosis at multiple levels. The patient declined genetic testing and is under clinical review. A 62-year-old male was referred to the bone metabolism service following a DXA scan showing T scores of +11. 7 at the hip and +13 at the lumbar spine. His primary complaint was of neck pain and on MRI there was multi-level nerve root impingement secondary to facet joint hypertrophy. Past medical history was significant for a long history of widespread joint pains; previous X-ray reports described generalized bony sclerosis up to 11 years previously. Clinical and radiological monitoring continues. Conclusion: Individuals with osteopetrosis require a multidisciplinary approach to management. There is no curative treatment and mainstay of therapy is supportive with active surveillance for complications.

scholarly journals Autonomic modulation at rest and in response to postural change in adolescents with Duchenne muscular dystrophy: a cross-sectional study

2021 ◽  
Vol 79 (9) ◽  
pp. 766-773
Author(s):  
Mariana Viana Rodrigues ◽  
Mileide Cristina Stoco-Oliveira ◽  
Talita Dias da Silva ◽  
Celso Ferreira ◽  
Heloisa Balotari Valente ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Duchenne Muscular Dystrophy ◽  
Muscular Dystrophy ◽  
Oxygen Saturation ◽  
Cross Sectional Study ◽  
Control Group ◽  
Autonomic Modulation ◽  
Postural Change ◽  
Cross Sectional

ABSTRACT Background: Analysis of autonomic modulation after postural change may inform the prognosis and guide treatment in different populations. However, this has been insufficiently explored among adolescents with Duchenne muscular dystrophy (DMD). Objective: To investigate autonomic modulation at rest and in response to an active sitting test (AST) among adolescents with DMD. Methods: Fifty-nine adolescents were included in the study and divided into two groups: 1) DMD group: adolescents diagnosed with DMD; 2) control group (CG): healthy adolescents. Participants’ weight and height were assessed. Lower limb function, motor limitations and functional abilities of the participants in the DMD group were classified using the Vignos scale, Egen classification and motor function measurement, respectively. The following variables were assessed before, during and after AST: systolic blood pressure (SBP), diastolic blood pressure (DBP), respiratory rate (f), oxygen saturation and heart rate (HR). To analyze the autonomic modulation, the HR was recorded beat-by-beat. Heart rate variability (HRV) indices were calculated in the time and frequency domains. Results: Differences in relation to groups were observed for all HRV indices, except LF/HF, oxygen saturation, HR and f (p < 0.05). Differences in relation to time and the interaction effect between group and time were observed for RMSSD, SD1, SD2, SD1/SD2, LFms2 and LFnu, HFun, SBP and DBP (p < 0.05). Differences in relation to time were also observed for the indice SDNN, FC and f (p < 0.05). Conclusions: Performing the AST promoted reduced autonomic modulation and increased SBP, DBP and HR in adolescents with DMD.

scholarly journals Effect of a Taped Filter Mask on Perceived Breathlessness, Heart Rate, Lactate and Oxygen Saturation During a Graded Exercise Test

2021 ◽  
Author(s):  
Hoi Lam Ng ◽  
Johannes Trefz ◽  
Martin Schönfelder ◽  
Henning Wackerhage
Keyword(s):  
Heart Rate ◽  
Oxygen Saturation ◽  
Exercise Test ◽  
Repeated Measures ◽  
Face Mask ◽  
Cycle Ergometer ◽  
Peripheral Oxygen Saturation ◽  
Graded Exercise Test ◽  
Graded Exercise ◽  
The Face

Abstract Background: Face masks are an effective, non-pharmacological strategy to reduce the transmission of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and other pathogens. However, it is a challenge to keep masks sealed during exercise, as ventilation can increase from 5-10 L/min at rest to up to 200 L/min so that masks may be blown away from the face. To reduce leakage e.g. during exercise, a face mask was developed that is taped onto the face. The aim of this study was to investigate during a graded cycle ergometry test the effect of a taped mask on the perception of breathlessness, heart rate, lactate, and oxygen saturation when compared to a surgical mask and no mask.Methods: Four trained and healthy males and females each (n=8 in total) performed incremental cycle ergometer tests until voluntary exhaustion under three conditions: (1) No mask/control, (2) surgical mask or (3) taped mask. During these tests, we measured perception of breathlessness, heart rate, the concentration of blood lactate and peripheral oxygen saturation and analysed the resultant data with one or two-way repeated measures ANOVAs. We also used a questionnaire to evaluate mask comfort and analysed the data with paired t-tests. Results: When compared to wearing no mask, a taped face mask significantly reduces the maximal workload in a graded exercise test by 12±6% (p=0.001). Moreover, with a taped face mask, subjects perceive severe breathlessness at 12±9% lower workload (p=0.012) and oxygen saturation at 65% of the maximal workload is 1.5% lower (p=0.018) when compared to wearing no mask. Heart rate and the concentration of lactate were not significantly different at any workload. When compared to wearing a surgical mask, wearing a taped face mask has a significantly better wearing comfort (p=0.038), feels better on the skin (p=0.004), there is a lower sensation of moisture (p=0.026) and wearers perceive that less heat is generated (p=0.021). We found no sex/gender differences for any parameters. Conclusions: A taped mask is well tolerated during light and moderate exercise intensity but reduces maximal exercise capacity.

Abstract WP189: Prediction of Apnea Hypopnea Index among Stroke and TIA Patients

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Jason Sico ◽  
Susan Ofner ◽  
H. Klar Yaggi ◽  
Dawn Bravata
Keyword(s):  
Blood Pressure ◽  
Sleep Apnea ◽  
Prediction Model ◽  
Cerebrovascular Disease ◽  
Medical History ◽  
Neck Circumference ◽  
Apnea Hypopnea Index ◽  
Berlin Questionnaire ◽  
Past Medical History ◽  
Obstructive Sleep

INTRODUCTION: Obstructive sleep apnea (OSA) is common among patients with stroke and TIA. Previously validated OSA screening instruments used in the general population are largely based on reported symptoms; when applied to those with cerebrovascular disease, they have shown poor correlation with the presence of OSA diagnosed via polysomnography (PSG). We sought to develop a cerebrovascular disease specific prediction model for OSA that is less reliant on symptomatology. Methods: We used data from a multi-site randomized, controlled strategy trial that included ischemic stroke and TIA patients at two VA hospitals. Data on patient demographics, vital signs, anthropomorphic measurements, past medical history, medications, stroke severity, and sleep questionnaires were obtained. All patients received PSG. Sleep apnea was defined as present if the apnea-hypopnea index (AHI) was ≥5. Because approximately half of subjects had OSA, discrimination was difficult; thus, AHI was used as the outcome for our prediction model. Epworth Sleepiness Scale (ESS)≥10, the Berlin Questionnaire>10, and Sleep Apnea Clinical Score (SACS)≥15 were considered ‘high risk’ for OSA. Bivariate regression models were used to assess the strength of the association between predictors and the outcome (log AHI+1); those statistically significant at the 0.1 level were entered into a multi-variable regression model. Backward elimination was used until all remaining variables were significant at the 0.05 level. Results: Among 194 Veterans, 119 (61.3%) had an AHI≥5. Neck circumference > 16 inches, systolic blood pressure less than 132 mmHg, peripheral vascular disease, and recent hospitalization for congestive heart failure were associated with increase in log AHI; history of chronic obstructive pulmonary disease/asthma was associated with a decrease in log AHI (R2=0.13). ESS≥10 (p=0.86) and Berlin Questionnaire >10 (p=0.80) were not associated with log AHI. The SACS≥15 was associated with AHI (p=0.01); however, it did not remain significant in the final model. Conclusions: A model using blood pressure, neck circumference and past medical history data was predictive of AHI. Further work is required to validate the use of this model in a larger cerebrovascular disease cohort.

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