scholarly journals Diagnosis of disappearing lung syndrome as a complication of non-hospital pneumonia of viral etiology (COVID-19)

2021 ◽  
pp. 5-11
Author(s):  
Y.I. Feshchenko ◽  
М.І. Lynnyk ◽  
М.І. Gumeniuk ◽  
I.A. Kalabukha ◽  
V.І. Іgnatieva ◽  
...  
Keyword(s):  
General Condition ◽  
Postpartum Period ◽  
Inpatient Treatment ◽  
Community Acquired Pneumonia ◽  
Third Wave ◽  
Viral Etiology ◽  
Acute Period ◽  
Difficulty Breathing ◽  
Ct Analysis ◽  
History Of

BACKGROUND. Particularly dangerous coronavirus disease (COVID-19) continues to be one of the urgent problems of mankind. Researchers around the world have noted that in the third wave of the COVID-19 pandemic, the disease became more aggressive. Physicians more often began to pay attention to the occurrence of progressive lung degradation, in particular bullous-emphysematous changes in the lungs, and in those patients who did not have a history of chronic lung disease. Due to the fact that in the acute phase of coronavirus infectious computed tomography (CT) of the chest according to the national protocol is not required, the timing of this complication remains unknown. OBJECTIVE. To study the timing of the onset of disappearing lung syndrome as one of the complications of communityacquired pneumonia of viral etiology (COVID-19) and to demonstrate on clinical observations according to CT. MATERIALS AND METHODS. A group of patients referred for treatment to the SI “National institute of phthisiology and pulmonology named after F.G. Yanovsky of the NAMS of Ukraine”. Among the examined according to CT of the chest identified 21 patients (15 men and 6 women aged 24 to 67 years) with radiological signs of disappearing lung syndrome. Nine of them (7 men and 2 women aged 24 to 54 years) were treated at the institute during the acute period of the disease. Another 12 (8 men and 4 women aged 27 to 67 years) were referred to the institute from other medical institutions, where they were treated for community-acquired pneumonia of viral etiology (COVID-19) 3-4 months ago. RESULTS AND DISCUSSION. CT analysis of the chest in 21 patients with disappearing lung syndrome showed that 9 (42,9 %) of them were diagnosed with bullous-emphysematous changes in the acute period of the disease – from 1 to 2 months, and in 12 (57,1 %) – in the postpartum period, in the period from 3 to 4 months. At the same time, patients had difficulty breathing, coughing, no significant improvement in general condition after previous inpatient treatment. Three of 12 patients noted deterioration of the general condition. CONCLUSIONS. In severe patients with community-acquired pneumonia of viral etiology (COVID-19), a progressive pulmonary degradation syndrome with the formation of bullous-emphysematous changes can occur both in the acute period of the disease and develop or progress in the postpartum period (after 3-4 months after inpatient treatment). CT of the chest should be performed in all patients after inpatient treatment and elimination of acute respiratory distress syndrome, which will allow timely diagnosis of changes in lung architecture and complications of the disease.

scholarly journals Evaluation of the treatment efficacy in the patients with viral etiology community acquired pneumonia (COVID-19) with the use of syndrome-pathogenetic small volume infusion therapy according to computer tomography data

2021 ◽  
pp. 31-38
Author(s):  
М.І. Lynnyk ◽  
V.І. Іgnatieva ◽  
G.L. Gumeniuk ◽  
O.R. Tarasenko ◽  
S.H. Opimakh ◽  
...  
Keyword(s):  
Treatment Efficacy ◽  
Intravenous Infusion ◽  
Small Volume ◽  
Community Acquired Pneumonia ◽  
Chest Ct ◽  
Infusion Therapy ◽  
Complete Regression ◽  
Pathological Changes ◽  
Viral Etiology ◽  
Acute Period

BACKGROUND. In a pandemic, when the etiotropic therapy of SARS-CoV-2 has not yet been developed, a comprehensive individual syndrome-pathogenetic approach to the treatment of patients with community-acquired pneumonia of viral etiology (COVID-19) is extremely important. The search for new commonly available drugs that can affect the inhibition of the cytokine storm, eliminate endothelial dysfunction and accelerate reparative processes in the lungs is relevant. At the same time the parenteral way of administration of the drugs provides the maximum bioavailability. OBJECT. To evaluate the treatment efficacy in the patients with viral etiology community-acquired pneumonia (COVID-19) with the use of syndrome-pathogenetic small volume infusion therapy according to computed tomography (CT) data. MATERIALS AND METHODS. We examined 12 patients (9 men and 3 women aged 18 to 62 years) with viral etiology community-acquired pneumonia (COVID-19), who were appointed for the treatment to the SI “National institute of phthisiology and pulmonology named after F.G. Yanovsky of the NAMS of Ukraine” in the acute period of the disease. 10 patients (8 men and 2 women aged 21 to 57 years) were referred to the institute from other medical institutions, where they were treated for viral etiology community-acquired pneumonia (COVID-19) 2-3 months ago. In addition to standard therapy all patients were additionally prescribed small volume infusion therapy 1-2 times a day for 10 days: Reosorbilact intravenous infusion 200 ml per day; Xavron (edaravon) 30 mg, which was diluted in 100 ml of saline, was administered intravenously; Tivorel (L-arginine and L-carnitine) intravenous infusion 100 ml per day. CT of the chest was performed on a scanner Aquilion TSX-101A (Toshiba, Japan) followed by comparative analysis. RESULTS AND DISCUSSION. Prior to treatment, patients with the viral etiology community-acquired pneumonia (COVID-19) had a systemic inflammatory process in both the acute and post-COVID-19 periods, which according to chest CT showed the same radiological symptoms: the presence of “ground-glass” and consolidation. Lesions of the lung parenchyma ranged from 30 to 60 %. After the course of treatment, all patients had a positive clinical effect, which was confirmed by positive radiological dynamics. At the same time, complete regression of pathological changes in the lungs was observed in 50 % of the patients with acute COVID-19 and in 40 % of the patients with post-COVID-19 syndrome. CONCLUSIONS. In the acute period of coronavirus infection when the patient is admitted to the hospital, it is advisable to additional use of the syndrome-pathogenetic treatment with such drugs: edaravon, a fixed combination of L-arginine and L-carnitine, hyperosmolar crystalloid solution in the regimen of small volume infusion therapy. This therapy can be used for patients in the post-COVID-19 period, when clinical symptoms, laboratory parameters of systemic inflammation, as well as characteristic pathological changes on chest CT present.

Interaction between methadone and clarithromycin as the suspected cause of an opioid toxidrome

2021 ◽  
Vol 14 (5) ◽  
pp. e240647
Author(s):  
Blair Wallace ◽  
Daniel Edwardes ◽  
Christian Subbe ◽  
Muhammed Murtaza
Keyword(s):  
Respiratory Failure ◽  
Community Acquired Pneumonia ◽  
Opiate Dependence ◽  
Pleuritic Chest Pain ◽  
Once Daily ◽  
High Importance ◽  
Level Of Consciousness ◽  
The World ◽  
History Of

A 40-year-old patient was admitted through the acute medical take with pleuritic chest pain and rigours. He had a medical history of opiate dependence and was receiving 60 mg of methadone once daily. He was diagnosed with a community-acquired pneumonia and treated with amoxicillin and clarithromycin. After administration of only two concomitant doses of methadone and oral clarithromycin, he developed an opioid toxidrome with type-2 respiratory failure, a decreased level of consciousness and pinpoint pupils. The patient was treated with naloxone and his symptoms improved. Retrospectively, it was suspected that an interaction between clarithromycin and methadone might have contributed to the toxidrome. Respiratory failure has not been previously prescribed for this combination of medication and is of high importance for physicians and pharmacists around the world.

Head Trauma in a Community-Based Sample of Victims of Intimate Partner Violence: Prevalence, Mechanisms of Injury and Symptom Presentation

2021 ◽  
pp. 088626052110163
Author(s):  
Jessica E. Meyer ◽  
Varna Jammula ◽  
Peter A. Arnett
Keyword(s):  
Intimate Partner Violence ◽  
Brain Injury ◽  
Head Trauma ◽  
Partner Violence ◽  
Physical Violence ◽  
Structured Interview ◽  
Intimate Partner ◽  
Difficulty Breathing ◽  
History Of ◽  
Subconcussive Head Trauma

Objective. The present study aimed to explore the prevalence of subconcussive head trauma, traumatic brain injury (TBI), potential hypoxic events, and hypoxic brain injury (HBI) in victims of physical intimate partner violence (IPV). The study also aimed to characterize the injury presentation and mechanisms of injury in this population. Method. A group of 47 female participants with a history of at least one relationship that included physical violence completed a structured interview assessing for subconcussive hits, TBI, and HBI. Participants ranged in age from 19 to 55, and had an average of 15.3 years of education. Forty-four participants completed the structured interview in person and three participants completed the interview over the phone. Results. The majority of participants reported sustaining at least one impact to the head and approximately half of the participants sustained at least one impact that resulted in a mild TBI. Approximately half of the participants experienced at least one incident of having difficulty breathing due to a violent act from their partner, and approximately one-third of participants reported symptoms consistent with mild HBI. The most common mechanisms of injury were being hit with a closed fist and being strangled. Conclusions. The high levels of head trauma observed in this study highlight the need for clinical and community providers to screen victims of physical IPV for head trauma. The unique characteristics of this population (female sex, high frequency of injuries, and presence of HBIs) indicate that research evaluating the cognitive effects of injuries in this population is needed.

Acceptance and Commitment Therapy (ACT): A Third Wave Behaviour Therapy

2008 ◽  
Vol 36 (6) ◽  
pp. 667-673 ◽  
Author(s):  
Chris Cullen
Keyword(s):  
Acceptance And Commitment Therapy ◽  
Relational Frame Theory ◽  
Third Wave ◽  
Behaviour Therapy ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Relational Frame ◽  
Important Relationship ◽  
History Of ◽  
Clinical Conditions

AbstractThis paper introduces Acceptance and commitment Therapy (ACT) as one of the newer contextualist behaviour therapies. A brief history of the development of ACT is outlined. The concepts of equivalence and laterality and the important relationship between Relational Frame Theory and ACT are then described. The “hexagram” summary of the six core linked processes in ACT is presented and, finally, the research evidence to support the effectiveness of ACT applied to a range of clinical conditions and client groups is summarized.

scholarly journals Miliary tuberculosis in a paediatric patient with psoriasis

2021 ◽  
Vol 14 (3) ◽  
pp. e237580
Author(s):  
Jacob Kilgore ◽  
Jonathon Pelletier ◽  
Bradford Becken ◽  
Stephen Kenny ◽  
Samrat Das ◽  
...  
Keyword(s):  
Brain Mri ◽  
Miliary Tuberculosis ◽  
Pulmonary Nodules ◽  
Chronically Ill ◽  
Community Acquired Pneumonia ◽  
Oral Antibiotic ◽  
Cavitary Lesion ◽  
Oral Antibiotic Therapy ◽  
History Of ◽  
Chest X Ray

We present a 16-year-old girl with a history of well-controlled psoriasis, on immunosuppression, who sought evaluation in the emergency department for 4 months of fever, cough and unintentional weight loss. The patient had seen multiple providers who had diagnosed her with community-acquired pneumonia, but she was unimproved after oral antibiotic therapy. On presentation, she was noted to be febrile, tachycardic and chronically ill-appearing. Her chest X-ray showed diffuse opacities and a right upper lobe cavitary lesion concerning for tuberculosis. A subsequent chest CT revealed miliary pulmonary nodules in addition to the cavitary lesion. The patient underwent subsequent brain MRI, which revealed multifocal ring-enhancing nodules consistent with parenchymal involvement. The patient was diagnosed with miliary tuberculosis and improved on quadruple therapy. Though rates of tuberculosis are increasing, rates remain low in children, though special consideration should be given to children who are immunosuppressed.

Rhabdomyolysis: An evidence-based approach

2021 ◽  
pp. 175114372110507
Author(s):  
Sarah Burgess
Keyword(s):  
Fluid Overload ◽  
Kidney Injury ◽  
Community Acquired Pneumonia ◽  
Evidence Based ◽  
Shortness Of Breath ◽  
Past Medical History ◽  
Urine Dipstick ◽  
The Past ◽  
Acting Insulin ◽  
History Of

A 76-year-old lady was found on the floor following a fall at home. She was uninjured, but unable to get up, and had been lying on the floor for roughly 18 hours before her son arrived. She had been unwell for the past 3 days with a cough and shortness of breath. She had a past medical history of diabetes, hypertension, hypercholesterolaemia and atrial fibrillation (AF). On examination, she was alert but distressed, clinically dehydrated, febrile and tachycardic. She was treated for community acquired pneumonia with co-amoxiclav and was fluid resuscitated with Hartmann’s solution. Her hyperkalaemia was treated with 50 mL of 50% glucose containing 10 units of rapid-acting insulin. Her creatinine kinase (CK) on admission was 200,000, and she had an acute kidney injury (AKI). Urine dipstick was positive for blood. However, her renal function continued to deteriorate over the succeeding 48 h, when she required renal replacement therapy (RRT) due to fluid overload and anuria.

Pragmatism, Practice and the Politics of Critique

2017 ◽  
Vol 14 (2) ◽  
pp. 212-220 ◽  
Author(s):  
Alexander Livingston
Keyword(s):  
William James ◽  
American Exceptionalism ◽  
James Baldwin ◽  
The Political ◽  
Cultural Critique ◽  
Third Wave ◽  
American Pragmatism ◽  
Political Implications ◽  
History Of ◽  
Historical Practices

Colin Koopman’s Pragmatism as Transition offers an argumentative retelling of the history of American pragmatism in terms of the tradition’s preoccupation with time. Taking time seriously offers a venue for reorienting pragmatism today as a practice of cultural critique. This article examines the political implications third wave pragmatism’s conceptualization of time, practice, and critique. I argue that Koopman’s book opens up possible lines of inquiry into historical practices of critique from William James to James Baldwin that, when followed through to their conclusion, trouble some of the book’s political conclusions. Taking time and practice seriously, as transitionalism invites pragmatists to do, demands pluralizing critique in a way that puts pressure on familiar pragmatist convictions concerning liberalism, progress, and American exceptionalism.

scholarly journals Extra-pontine myelinolysis secondary to hypernatremia induced by postpartum water restriction

2017 ◽  
Vol 30 (1) ◽  
pp. 84-87 ◽  
Author(s):  
A Chhabra ◽  
R Kaushik ◽  
RM Kaushik ◽  
D Goel
Keyword(s):  
Postpartum Period ◽  
Resonance Imaging ◽  
Water Restriction ◽  
Delta Waves ◽  
Steady Improvement ◽  
Pontine Myelinolysis ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Electroencephalogram Eeg ◽  
Progressive Weakness

A young adult female with restricted water intake during the postpartum period presented with history of progressive weakness, dizziness and tendency to fall with generalized slowing of movement. On examination, patient was anaemic, febrile and stuporous. Investigations revealed hypernatremia, delta waves in electroencephalogram (EEG) and features suggestive of extra-pontine myelinolysis on magnetic resonance imaging (MRI) of brain. After correcting hypernatremia and instituting anti-cholinergic therapy, there was a gradual but steady improvement in neurological symptoms of the patient over a period of one week and the patient was discharged in a conscious, oriented and ambulant state. As such, neuroimaging findings can be crucial in diagnosing hypernatremic encephalopathy in the postpartum period.

scholarly journals Peculiarities of pregnansy and childbirth in patients with a burdened gynecological anamnesis

2020 ◽  
Vol 5 ◽  
pp. 5-10
Author(s):  
T. P. Andriichuk ◽  
A. Ya. Senchuk ◽  
V. I. Chermak
Keyword(s):  
Retrospective Study ◽  
High Risk ◽  
Pregnant Women ◽  
Postpartum Period ◽  
Control Group ◽  
Careful Monitoring ◽  
Pregnancy And Childbirth ◽  
History Of ◽  
High Level ◽  
Adaptive Reactions

The objective: to study the features of pregnancy, childbirth, postpartum period, fetal status and newborns in patients with a history of chronic salpingo-оophoritis.Materials and methods. Conducted a retrospective study of 150 birth histories and neonatal development maps. All patients were divided into two groups. The main group includes 100 patients with chronic salpingo-оophoritis, for which they received anti-inflammatory treatment from 1 to 3 times before pregnancy. The control group included 50 pregnant women who did not suffer from chronic salpingo-оophoritis.Results. Our analysis of pregnancy, childbirth, fetal and neonatal status in women with chronic salpingo-оophoritis indicates that such patients have a complicated obstetric and gynecological and somatic history, which forms an unfavorable basic condition of organs and systems, imperfect adaptation to pregnancy, high risk of failure of adaptive reactions. The result is a violation of the formation and development of the mother-placenta-fetus system and, as a consequence, a high level of complications during pregnancy, childbirth and perinatal pathology.Conclusion. Patients suffering from chronic salpingo-oophoritis should be considered at high risk of possible complications during pregnancy and childbirth. This category of women needs quality preconception training and careful monitoring during pregnancy.

scholarly journals Challenges to Democracy in the Middle East

2002 ◽  
Vol 19 (1) ◽  
pp. 124-128
Author(s):  
Kamran Asghar Bokhari
Keyword(s):  
Middle East ◽  
Political Development ◽  
Third Wave ◽  
Cultural Dynamics ◽  
Senior Lecturer ◽  
Arab Nationalism ◽  
French Mandate ◽  
History Of ◽  
The One ◽  
The University

Many scholars have attempted to tackle the question of why democracy has seemingly failed to take root in the Islamic milieu, in general, and the pre dominantlyArab Middle East, in particular, while the rest of the world has witnessed the fall of"pax-authoritaria" especially in the wake of the demercratic revolution triggered by the failure of communism. Some view this resistance to the Third Wave, as being rooted in the Islamic cultural dynamics of the region, whereas others will ascribe it to the level of political development (or the lack thereof). An anthology of essays, Challenges to Democracy in the Middle East furnishes the reader with five historical casestudies that seek to explain the arrested socio politico-economic development of Syria, Lebanon, Iraq, Iran, and Turkey, and the resulting undemercratic political culture that domjnates the overall political landscape of the Middle East. The first composition in this omnibus is "The Crisis of Democracy in Twentieth Century Syria and Lebanon," authored by Bill Harris, senior lecturer of political studies at the University of Otago in Dunedin, New Zealand. Haris compares and contrasts the political development of Syria and Lebanon during the French mandate period and under the various regimes since then. He examines how the two competing forms of national­ism, i.e., Lebanonism and Arabism, along with sectarianism, are the main factors that have contributed to the consolidation of one-party rule in Syria, and the I 6-year internecine conflict in Lebanon. After a brief overview of the early history of both countries, the author spends a great deal oftime dis­cussing the relatively more recent political developments: Syria from 1970 onwards, and Lebanon from I 975 to the I 990s. Harris expresses deep pes­simism regarding the future of democratic politics in both countries, which in his opinion is largely due to the deep sectarian cleavages in both states. The next treatise is "Re-inventing Nationalism in B􀀥thi Iraq 1968- 1994: SupraTerritorial Identities and What Lies Below," by Amatzia Baram, professor of Middle East History at the University of Haifa. Baram surveys the Ba·th's second stint in power (1968-present) in lraq. Baram's opinion is that a shift has occurred in B􀀥thist ideology from an integrative Pan-Arab program to an Iraqi-centered Arab nationalism. She attributes this to Saddam's romance with the past, on the one hand, which is the reason for the incorporation of themes from both the ancient Mesopotamian civiliza­tion and the medieval Abbasid caliphal era, and, on the other hand, to Islam and tribalism, that inform the pragmatic concerns of the Ba'thist ideological configuration ...

Sign in / Sign up

Export Citation Format

Share Document