Deep Neck Infections: decisional algorithm for patients with multiple spaces involvement

2021 ◽  
Vol 16 ◽  
Author(s):  
Filippo Ricciardiello ◽  
Salvatore Mazzone ◽  
Pasquale Viola ◽  
Gianluca Guggino ◽  
Giuseppe Longo ◽  
...  
Keyword(s):  
Diagnostic Delay ◽  
Deficiency Anemia ◽  
Chronic Obstructive ◽  
Exclusion Criteria ◽  
Obstructive Pulmonary Disease ◽  
Therapeutic Algorithm ◽  
Duration Of Hospitalization ◽  
Life Threatening ◽  
Deep Neck Infections ◽  
Decisional Algorithm

Background: Deep Neck Infections (DNIs) spread along fascial planes and involve neck spaces. Recently, their incidence has decreased due to the introduction of antibiotics; nevertheless, complications related to DNIs are often life-threatening. Objective: The purpose of this article is focused on the identification of predisposing factors of these complications, as well as on the development of a reliable therapeutic algorithm. Method: Sixty patients with DNIs were enrolled from 2006 to 2019 for a retrospective study. The exclusion criteria for the present study was cellulitis, small abscesses responding to empiric or specific antibiotic therapy or with involvement of only one deep neck space. During the analysis the following parameters of interest have been evaluated: gender, age, site of origin, pathways of spread, comorbidities, clinical features, bacteriology data, type of surgical approach required, complications, duration of hospitalization and mortality rate. On admission, microbial swab analysis was performed. Results: Diabetes Mellitus (DM), Chronic Obstructive Pulmonary Disease (COPD), iron deficiency anemia and the involvement of multiple spaces have been associated with a significantly higher risk of developing complications. Most of our patients had polymicrobial infections. All patients underwent surgical drainage. The complication rate had occurred in 56.6% of patients, while death in 18.3%. Conclusion: DNIs represent a medical and surgical emergency with potential serious complications, thus avoiding diagnostic delay is mandatory.

scholarly journals Study of Serum B-Type Natriuretic Peptide (BNP) Levels as a Prognostic Marker in Acute Exacerbation of COPD in HSK Hospital, Bagalkot, Karnataka

2021 ◽  
Vol 8 (19) ◽  
pp. 1332-1335
Author(s):  
Sunil Baragi ◽  
Kadappa Jaligidad ◽  
Joachim Piedade Souza
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Hypertension ◽  
Partial Pressure ◽  
Acute Exacerbation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Acute Exacerbation Of Copd ◽  
Duration Of Hospital Stay ◽  
Life Threatening ◽  
Exacerbation Of Copd

BACKGROUND Pulmonary hypertension (PH) and heart failure are common comorbidities in 20 – 30 % of chronic obstructive pulmonary disease (COPD) patients with acute exacerbation. Similarities in signs and symptoms and lack of objective measures to stratify them at emergency department makes the management difficult. Echocardiography though useful requires specialised training. Hence, B-Type Natriuretic Peptide (BNP) is a simple test that can prognosticate the severity and can influence management in such patients. The purpose of the study was to estimate the significance of BNP during acute exacerbation of chronic obstructive pulmonary disease (AECOPD) as an important marker of severity and to study its correlation with duration of hospital stay, place and mode of management in patients with severe and life-threatening exacerbation of COPD. METHODS This is a prospective longitudinal observational study conducted on 50 patients of severe and life-threatening COPD exacerbation admitted to General Medicine department of HSK hospital, Bagalkot and their outcomes were noted based on the BNP levels. RESULTS The study showed higher levels of BNP in patients admitted to ICU as compared to emergency ward (P = 0.001). Greater values among those on invasive mechanical ventilation vs. non-invasive ventilation (NIV). There was a positive correlation and statistical significance of BNP values with arterial blood gases (ABG) parameters like pulmonary hypertension (PH), partial pressure of carbondi-oxide (PaCO2), partial pressure of oxygen (PaO2), echo parameters like right ventricle (RV) diameter and pulmonary artery systolic pressure (PASP) and duration of hospital stay. CONCLUSIONS BNP is a simple, low cost and easily available blood test that can prognosticate oxygen requirement, mode of ventilation, place of management and can grade and reflect the severity in acute exacerbation of COPD. KEYWORDS AECOPD, BNP, Prognostic Marker, Outcome

scholarly journals 3D-bioprinted tracheal reconstruction: an overview

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Lidia Frejo ◽  
Daniel A. Grande
Keyword(s):  
In Vivo Studies ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Tracheal Reconstruction ◽  
Airway Reconstruction ◽  
Life Threatening ◽  
Scaffold Materials ◽  
Cellular Types

Abstract Congenital tracheomalacia and tracheal stenosis are commonly seen in premature infants. In adulthood, are typically related with chronic obstructive pulmonary disease, and can occur secondarily from tracheostomy, prolong intubation, trauma, infection and tumors. Both conditions are life-threatening when not managed properly. There are still some surgical limitations for certain pathologies, however tissue engineering is a promising approach to treat massive airway dysfunctions. 3D-bioprinting have contributed to current preclinical and clinical efforts in airway reconstruction. Several strategies have been used to overcome the difficulty of airway reconstruction such as scaffold materials, construct designs, cellular types, biologic components, hydrogels and animal models used in tracheal reconstruction. Nevertheless, additional long-term in vivo studies need to be performed to assess the efficacy and safety of tissue-engineered tracheal grafts in terms of mechanical properties, behavior and, the possibility of further stenosis development.

scholarly journals Neuromorphic on-chip recognition of saliva samples of COPD and healthy controls using memristive devices

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Pouya Soltani Zarrin ◽  
Finn Zahari ◽  
Mamathamba K. Mahadevaiah ◽  
Eduardo Perez ◽  
Hermann Kohlstedt ◽  
...  
Keyword(s):  
Medical Devices ◽  
Energy Efficient ◽  
Performance Evaluations ◽  
Chronic Obstructive ◽  
Healthy Controls ◽  
Effective Management ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Life Threatening ◽  
On Chip

AbstractChronic Obstructive Pulmonary Disease (COPD) is a life-threatening lung disease, affecting millions of people worldwide. Implementation of Machine Learning (ML) techniques is crucial for the effective management of COPD in home-care environments. However, shortcomings of cloud-based ML tools in terms of data safety and energy efficiency limit their integration with low-power medical devices. To address this, energy efficient neuromorphic platforms can be used for the hardware-based implementation of ML methods. Therefore, a memristive neuromorphic platform is presented in this paper for the on-chip recognition of saliva samples of COPD patients and healthy controls. Results of its performance evaluations showed that the digital neuromorphic chip is capable of recognizing unseen COPD samples with accuracy and sensitivity values of 89% and 86%, respectively. Integration of this technology into personalized healthcare devices will enable the better management of chronic diseases such as COPD.

scholarly journals Perbedaan Latihan High Intensity Ground Walking Dan Latihan Static Bicycle Terhadap Kapasitas Latihan Pada Penderita PPOM

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Setiawan Setiawan ◽  
Nur Basuki
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Exercise Capacity ◽  
High Intensity ◽  
Chronic Obstructive ◽  
Bicycle Exercise ◽  
Exclusion Criteria ◽  
Obstructive Pulmonary Disease ◽  
Walking Exercise ◽  
Improve Exercise Capacity

Abstract: High Intensity Ground Walking, Static Bicycle exercise, exercise capacity, the 6-minutes walking test, chronic obstructive pulmonary disease (COPD). This study aimed to compare the benefits between High Intensity Ground Walking exercise and Static Bicycle exercise on exercise capacity in patients with chronic obstructive pulmonary disease (COPD). This research is a quasi-experimental study design with two groups pre and post test design. The subjects were all patients COPD with moderate and severe degree in The Special hospital of Pulmonary dr. Ario Wirawan Salatiga, that meet the inclusion and exclusion criteria. Inclusion criteria: (1) the degree of moderate and severe COPD (2) Age 25 to 70 years, (3) Value of FEV1 less than 60% (4) There is a decrease in exercise tolerance with the results of the 6-minute test less than 300 meter (5) Willing to follow this research. Exclusion criteria: (1) Having a concomitant diseases such as heart, kidney failure, uncontrolled diabetes, severe hypertension (2) need an ambulation aid (3) Having musculoskeletal and neuromuscular disorders of the lower extremities. Do not follow the exercises more than 3 times. The data was collected directly by assessing the results of the six-minute walk test before and after the treatments. Data collected were analyzed using SPSS 11.5. The different test within groups measured with Wilcoxon test, and for between groups measured wirh Mann Whitney test. The significance level was set on 0.05. Results and Conclusion:(1)High Intensity Ground Walking exercises improve exercise capacity in patients with COPD (p = 0.005), (2) Static Bicycle training program improve exercise capacity of patients with COPD (p = 0.005), (3) There is no difference between High Intensity Ground Walking Exercise and Static Bicycle training in improving exercise capacity in patients with COPD (p = 0.970).

Physiologic Airflow Disruption

2017 ◽  
Author(s):  
Kinza Sentissi ◽  
Stephanie Yacoubian
Keyword(s):  
Lung Disease ◽  
Obstructive Lung Disease ◽  
Status Asthmaticus ◽  
Perioperative Complications ◽  
Airway Hyperreactivity ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Airway Lumen ◽  
Life Threatening ◽  
Airway Walls

Airflow disruption can be triggered through multiple mechanisms. The obstruction can stem from within the airway lumen, airway walls, or the tissues surrounding it. This section focuses on airflow disruption initiated by bronchospasm, obstructive lung disease, asthma and status asthmaticus. Bronchospasm presents with increased airway resistance secondary to airway hyperreactivity or anaphylaxis. Asthma and chronic obstructive pulmonary disease (COPD) are obstructive and inflammatory lung pathologies. Airflow disruption in asthma is reversible between exacerbations. The airway obstruction in COPD is not fully reversible. Status asthmaticus is the most severe presentation of asthma and can be life threatening. Poorly controlled obstructive lung disease can result in perioperative complications. Patients should therefore be medically optimized before undergoing operative procedures.

Pathophysiology and causes of airflow limitation

2016 ◽  
Author(s):  
David V. Tuxen
Keyword(s):  
Mechanical Ventilation ◽  
Tension Pneumothorax ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Dynamic Hyperinflation ◽  
Obstructive Pulmonary Disease ◽  
Increased Risk ◽  
Ventilation Technique ◽  
Nebulized Salbutamol ◽  
Life Threatening

Exacerbations of asthma or chronic obstructive pulmonary disease (COPD) can be life-threatening emergencies, and require careful management to minimize the risks of morbidity and mortality. Prompt, full bronchodilator therapy, careful observation and appropriate mechanical ventilation technique is required. Dynamic hyperinflation of the lungs occurs in all patients, and must be careful assessed and regulated. Excessive dynamic hyperinflation can result in respiratory tamponade, hypotension, circulatory failure, pneumothoraces and, in severe cases, cardiac arrest. Intravenous or continuous nebulized salbutamol commonly causes lactic acidosis that should be detected and managed. Prolonged paralysis during difficult mechanical ventilation can result in severe necrotizing myopathy. Pneumothoraces in ventilated patients with asthma are usually under tension, redistribute ventilation to the contralateral lung, and risk a second tension pneumothorax. Patients surviving mechanical ventilation for asthma and COPD have an increased risk of recurrence and death. All these problems require awareness, avoidance or detection and management

A neural network approach for understanding patient experiences of chronic obstructive pulmonary disease (COPD) through a social media listening study (Preprint)

2020 ◽  
Author(s):  
Tobe Freeman ◽  
Raul Rodriguez-Esteban ◽  
Juergen Gottowik ◽  
Xing Yang ◽  
Veit J. Erpenbeck ◽  
...  
Keyword(s):  
Neural Network ◽  
Lived Experience ◽  
Respiratory Illness ◽  
Chronic Obstructive ◽  
Acute Respiratory Illness ◽  
Network Approach ◽  
Online Content ◽  
Neural Network Approach ◽  
Obstructive Pulmonary Disease ◽  
Life Threatening

UNSTRUCTURED The abundance of online content contributed by patients is a rich source of insights about the lived experience of disease. We present a novel neural network approach to identify and explore a lexicon of community words and phrases used by patients to describe their symptoms, and show its utility for the life-threatening chronic lung disease COPD. Our findings demonstrate the potential of neural networks to gain a quantitative patient-focused understanding about how each distinct COPD symptom contributes to the burden of chronic and acute respiratory illness. This approach can be readily applied to other disease areas in which there exists sufficient online content contributed by patients and caregivers.

scholarly journals STEROIDS IN THE TREATMENT OF CHRONIC DISEASES

2019 ◽  
pp. 91-97
Author(s):  
SHARMA P ◽  
IMAM S ◽  
MEHTA DK
Keyword(s):  
Skin Diseases ◽  
Tertiary Care ◽  
Educational Interventions ◽  
The Body ◽  
Teaching Hospitals ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Disease States ◽  
Rational Drug ◽  
Life Threatening

Since their identification, which was almost 80 years ago, steroids have played a prominent role in the treatment of many disease states such as chronic obstructive pulmonary disease, asthma, rheumatoid arthritis, and inflammatory bowel disease. Many of the clinical roles of steroids are related to their potent anti-inflammatory and immune-modulating properties. Numerous skin diseases are successfully treated with systemic steroids. Corticosteroids, though they are lifesaving drugs, produce adverse reactions which may be mild or life threatening. Steroids have diverse effects on various systems of the body. Therefore, educational interventions among physician, patients, as well as students should be carried out to further enhance rational drug use. The purpose of this review was to identify the most commonly prescribed steroids and their side effects, basic pharmacology, complications, as well as the assessment of patient knowledge about the use of steroids in tertiary care teaching hospitals.

On-Scene and Final Assessments and Their Interrelationship Among Patients Who Use the EMS on Multiple Occasions

2017 ◽  
Vol 32 (5) ◽  
pp. 528-535 ◽  
Author(s):  
Julia Tärnqvist ◽  
Erik Dahlén ◽  
Gabriella Norberg ◽  
Carl Magnusson ◽  
Johan Herlitz ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Abdominal Pain ◽  
Chest Pain ◽  
Pulmonary Disease ◽  
Final Diagnosis ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Threatening Condition ◽  
Life Threatening ◽  
Age Range

AbstractIntroductionThe use of Emergency Medical Services (EMS) is increasing. A number of patients call repeatedly for EMS. Early studies of frequent callers show that they form a heterogenous group.ProblemThere is a lack of research on frequent EMS callers. There is furthermore a lack of knowledge about characteristics and the prehospital assessment of the patients who call for EMS on several occasions. Finally, there is a general lack of knowledge with regard to the association between the prehospital assessment by health care providers and the final diagnosis.MethodPatients in Skaraborg in Western Sweden, who used the EMS at least four times in 2014, were included, excluding transport between hospitals. Information on the prehospital assessment on-scene and the final diagnosis was collected from the EMS and hospital case records.ResultsIn all, 339 individual patients who used the EMS on 1,855 occasions were included, accounting for five percent of all missions. Fifty percent were women. The age range was 10-98 years, but more than 50.0% were in the age range of 70-89 years.The most common emergency signs and symptoms (ESS) codes on the scene were dyspnea, chest pain, and abdominal pain. The most common final diagnosis was chronic obstructive pulmonary disease (eight percent).Thirteen percent of all cases had a final diagnosis defined as a potentially life-threatening condition. Among these, 22.0% of prehospital assessments were retrospectively judged as potentially inappropriate.Forty-nine percent had a defined final diagnosis not fulfilling the criteria for a potentially life-threatening condition. Among these cases, 30.0% of prehospital assessments were retrospectively judged as potentially inappropriate.Conclusion:Among patients who used EMS on multiple occasions, the most common symptoms on-scene were dyspnea, chest pain, and abdominal pain. The most common final diagnosis was chronic obstructive pulmonary disease. In 13.0%, the final diagnosis of a potentially life-threatening condition was indicated. In a minority of these cases, the assessment on-scene was judged as potentially inappropriate.TärnqvistJ, DahlénE, NorbergG, MagnussonC, HerlitzJ, StrömsöeA, AxelssonC, Andersson HagiwaraM. On-scene and final assessments and their interrelationship among patients who use the EMS on multiple occasions. Prehosp Disaster Med. 2017;32(5):528–535.

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