scholarly journals The “contagious” clinician

2021 ◽  
Vol 76 (3) ◽  
pp. 147-152
Author(s):  
Leanne Sykes ◽  
George P Babiolakis ◽  
Bernice Boers
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Quality Care ◽  
Limited Attention ◽  
Healthy Environment ◽  
Aerosol Spray ◽  
Novel Variant ◽  
Life Threatening ◽  
The Many

The many new airborne viral pathogens such as coronavirus (Covid-19), the novel variant (SARS-CoV-2), acute respiratory distress syndrome (ARDS), severe acute respiratory syndrome (SARS), and Middle East respiratory distress syndrome (MERS), have brought about a whole new avalanche of problems. These airborne pathogens are all highly contagious and transmissible, especially in the dental setting where the procedures and machinery used may generate enormous amounts of aerosol spray. This is an ideal vector for air/ droplet spread. Most dentists have implemented screening procedures to determine if their patients are well enough to be treated, and have begun wearing a full gamut of personal protective clothing (PPE). Nonetheless, a concern that has received limited attention in the literature is the “contagious clinician” who continues to work and who may pose a risk of infecting their patients. This paper explores both the patient’s rights to quality care in a safe and healthy environment, as well as the clinician’s rights to determine for themselves if they are mentally and physically competent to practice. It also poses questions about whether health care practitioners can be mandated to be inoculated against potentially life-threatening and highly infectious agents.

Mediastinal teratoma presenting with respiratory distress and cardiogenic shock in a neonate

2020 ◽  
Vol 30 (5) ◽  
pp. 788-789
Author(s):  
Mila Stajevic ◽  
Ivan Dizdarevic ◽  
Igor Krunic ◽  
Vesna Topic
Keyword(s):  
Respiratory Failure ◽  
Cardiogenic Shock ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Emergency Operation ◽  
Fast Growing ◽  
Mediastinal Teratoma ◽  
Venous Compression ◽  
Life Threatening

Abstract Mediastinal teratomas are uncommon, fast-growing thoracic tumours, which are usually diagnosed in childhood or adolescence. Neonatal forms are the rarest and often present with life-threatening respiratory distress syndrome. In our case, respiratory failure in a neonate was aggravated by severe cardiogenic shock due to aortic and systemic venous compression, extreme heart displacement and rotation, necessitating an emergency operation on the first day of life.

scholarly journals Acute respiratory distress syndrome in a case of diabetic ketoacidosis requiring ECMO support

2021 ◽  
Vol 2021 ◽  
Author(s):  
Milad Darrat ◽  
Brian Gilmartin ◽  
Carmel Kennedy ◽  
Diarmuid Smith
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Diabetic Ketoacidosis ◽  
Distress Syndrome ◽  
Early Recognition ◽  
Ecmo Support ◽  
List Type ◽  
Life Threatening ◽  
Life Threatening Complication

Summary Acute respiratory distress syndrome (ARDS) is a rare but life-threatening complication of diabetic ketoacidosis (DKA). We present the case of a young female, with no previous diagnosis of diabetes, presenting in DKA complicated by ARDS requiring extra corporeal membrane oxygenation (ECMO) ventilator support. This case report highlights the importance of early recognition of respiratory complications of severe DKA and their appropriate management. Learning points ARDS is a very rare but life-threatening complication in DKA. The incidence of ARDS remains unknown but less frequent than cerebral oedema in DKA. The mechanism of ARDS in DKA has multifactorial aetiology, including genetic predisposition. Early recognition and consideration of rare pulmonary complication of DKA can increase survival rate and provide very satisfactory outcomes. DKA patients who present with refractory ARDS can be successfully rescued by ECMO support.

Control of Life-threatening Air Leak after Gastrostomy in an Infant with Respiratory Distress Syndrome and Tracheoesophageal Fistula

1985 ◽  
Vol 62 (5) ◽  
pp. 670-672 ◽  
Author(s):  
HELEN W. KARL ◽  
ALVIS PAGE ◽  
LUCILLE WILLIAMS ◽  
FRED J. SPIELMAN ◽  
CHARLES B. WATSON
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Tracheoesophageal Fistula ◽  
Distress Syndrome ◽  
Air Leak ◽  
Life Threatening

scholarly journals Rationale for the Use of Radiation-Activated Mesenchymal Stromal/Stem Cells in Acute Respiratory Distress Syndrome

Cells ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. 2015 ◽  
Author(s):  
Isabel Tovar ◽  
Rosa Guerrero ◽  
Jesús J. López-Peñalver ◽  
José Expósito ◽  
José Mariano Ruiz de Almodóvar
Keyword(s):  
Stem Cells ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Human Umbilical Cord ◽  
Annexin A1 ◽  
Significant Difference ◽  
Life Threatening ◽  
Stromal Stem Cells

We have previously shown that the combination of radiotherapy with human umbilical-cord-derived mesenchymal stromal/stem cells (MSCs) cell therapy significantly reduces the size of the xenotumors in mice, both in the directly irradiated tumor and in the distant nonirradiated tumor or its metastasis. We have also shown that exosomes secreted from MSCs preirradiated with 2 Gy are quantitatively, functionally and qualitatively different from the exosomes secreted from nonirradiated mesenchymal cells, and also that proteins, exosomes and microvesicles secreted by MSCs suffer a significant change when the cells are activated or nonactivated, with the amount of protein present in the exosomes of the preirradiated cells being 1.5 times greater compared to those from nonirradiated cells. This finding correlates with a dramatic increase in the antitumor activity of the radiotherapy when is combined with MSCs or with preirradiated mesenchymal stromal/stem cells (MSCs*). After the proteomic analysis of the load of the exosomes released from both irradiated and nonirradiated cells, we conclude that annexin A1 is the most important and significant difference between the exosomes released by the cells in either status. Knowing the role of annexin A1 in the control of hypoxia and inflammation that is characteristic of acute respiratory-distress syndrome (ARDS), we designed a hypothetical therapeutic strategy, based on the transplantation of mesenchymal stromal/stem cells stimulated with radiation, to alleviate the symptoms of patients who, due to pneumonia caused by SARS-CoV-2, require to be admitted to an intensive care unit for patients with life-threatening conditions. With this hypothesis, we seek to improve the patients’ respiratory capacity and increase the expectations of their cure.

scholarly journals Rituximab Twice Weekly for Refractory Thrombotic Thrombocytopenic Purpura in a Critically Ill Patient with Acute Respiratory Distress Syndrome

2020 ◽  
Vol 13 (1) ◽  
pp. 153-157
Author(s):  
Bahjat Azrieh ◽  
Arwa Alsaud ◽  
Khaldun Obeidat ◽  
Amr Ashour ◽  
Seham Elebbi ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Distress Syndrome ◽  
Standard Of Care ◽  
Critically Ill Patient ◽  
Microangiopathic Hemolytic Anemia ◽  
Thrombocytopenic Purpura ◽  
Life Threatening

Thrombotic thrombocytopenic purpura (TTP) is a rare, serious, life-threatening disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, and hypercoagulability. The etiology is a deficiency of ADAMTS13 which is usually caused by acquired antibodies. Plasma exchange and steroids is the standard of care in the treatment of TTP. However, there are refractory cases of TTP which require further management. Rituximab appears to be a safe and effective therapy for refractory and relapsing TTP. Here we report a challenging case of TTP that responded to treatment with rituximab twice weekly. According to our knowledge, rituximab twice weekly has never been used for TTP before.

scholarly journals Pneumopericardium

2014 ◽  
Vol 34 (2) ◽  
pp. 163-165 ◽  
Author(s):  
Meen Raj Pathak ◽  
Disuja Shakya
Keyword(s):  
Chest Pain ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Subcutaneous Emphysema ◽  
Distress Syndrome ◽  
Paediatric Population ◽  
Male Child ◽  
Pericardial Cavity ◽  
Life Threatening ◽  
Tension Pneumopericardium

Pneumopericardium may be defined as the presence of air within pericardial cavity which results due to spontaneous or iatrogenic cause. It is rare but life threatening entity, commonly caused by respiratory distress syndrome and vigorous resuscitation, in the paediatric population. Although, pneumopericardium is often asymptomatic, it may cause chest pain, dyspnoea and subcutaneous emphysema. The course of pneumopericardium is usually benign and self-limited. Treatment is crucial in tension pneumopericardium, a complication of pneumopericardium. Here, we report a case of pneumopericardium in a nine month old male child after vigorous resuscitation and intubation for respiratory distress syndrome. DOI: http://dx.doi.org/10.3126/jnps.v34i2.11152 J Nepal Paediatr Soc 2014;34(2):163-165

Ketorolac may control more than pain

2003 ◽  
Vol 105 (5) ◽  
pp. 549-550 ◽  
Author(s):  
Frank ISIK
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Inhalation Injury ◽  
Clinical Science ◽  
Inflammatory Cascade ◽  
Life Threatening

Life-threatening acute respiratory distress syndrome (ARDS) complicates the recovery of patients with burn and inhalation injury. The study by Enkhbaatar and co-workers in this issue of Clinical Science suggests that reducing the early and robust inflammatory cascade may provide patients with protection from developing cardiopulmonary compromise seen early after burn and inhalation injury.

scholarly journals Rapid-Onset Acute Respiratory Distress Syndrome (ARDS) in a Patient Undergoing Metastatic Liver Resection: A Case Report and Review of the Literature

2010 ◽  
Vol 2010 ◽  
pp. 1-9 ◽  
Author(s):  
Thorsten Brenner ◽  
Johann Motsch ◽  
Jens Werner ◽  
Lars Grenacher ◽  
Eike Martin ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Liver Resection ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Surgical Procedure ◽  
Distress Syndrome ◽  
Rapid Onset ◽  
Pulmonary Complications ◽  
Life Threatening ◽  
Metastatic Liver

Metastatic liver resection following cytoreductive chemotherapy is an accepted treatment for oligometastatic tumor diseases. Although pulmonary complications are frequently reported in patients undergoing liver surgery including liver transplantation, life-threatening acute respiratory failures in the absence of aspiration, embolism, transfusion-related acute lung injury (TRALI), pulmonary infection, or an obvious source of systemic sepsis are rare. We performed an extensive clinical review of a patient undergoing metastatic liver resection who had a clinical course compatible to an acute respiratory distress syndrome (ARDS) without an obvious cause except for the surgical procedure and multiple preoperative chemotherapies. We hypothesize that either the surgical procedure mediated by cytokines and tumor necrosis factor or possible toxic effects of oxygen applied during general anesthesia were associated with life-threatening respiratory failure in the patient. Discrete and subclinical inflammated alveoli (probably due to multiple preoperative chemotherapies with substances at potential risk for interstitial pneumonitis as well as chest radiation) might therefore be considered as risk factors.

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