scholarly journals Dysbarism: An Overview of an Unusual Medical Emergency

Medicina ◽  
2022 ◽  
Vol 58 (1) ◽  
pp. 104
Author(s):  
Gabriele Savioli ◽  
Claudia Alfano ◽  
Christian Zanza ◽  
Gaia Bavestrello Piccini ◽  
Angelica Varesi ◽  
...  
Keyword(s):  
Atmospheric Pressure ◽  
Decompression Sickness ◽  
Clinical Manifestations ◽  
Oxygen Toxicity ◽  
Signs And Symptoms ◽  
General Term ◽  
The Body ◽  
Inert Gas ◽  
Medical Emergency ◽  
Clinical Pictures

Dysbarism is a general term which includes the signs and symptoms that can manifest when the body is subject to an increase or a decrease in the atmospheric pressure which occurs either at a rate or duration exceeding the capacity of the body to adapt safely. In the following review, we take dysbarisms into account for our analysis. Starting from the underlying physical laws, we will deal with the pathologies that can develop in the most frequently affected areas of the body, as the atmospheric pressure varies when acclimatization fails. Manifestations of dysbarism range from itching and minor pain to neurological symptoms, cardiac collapse, and death. Overall, four clinical pictures can occur: decompression illness, barotrauma, inert gas narcosis, and oxygen toxicity. We will then review the clinical manifestations and illustrate some hints of therapy. We will first introduce the two forms of decompression sickness. In the next part, we will review the barotrauma, compression, and decompression. The last three parts will be dedicated to gas embolism, inert gas narcosis, and oxygen toxicity. Such an approach is critical for the effective treatment of patients in a hostile environment, or treatment in the emergency room after exposure to extreme physical or environmental factors.

scholarly journals Acute Pesticide Poisoning in Children: A Review of 50 Cases

2018 ◽  
Vol 12 (6) ◽  
pp. 27-31
Author(s):  
Fatma Khalsi ◽  
◽  
Ines Trablesi ◽  
Imen Belhadj ◽  
Nozha Brahmi ◽  
...  
Keyword(s):  
Gastric Lavage ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Lavage Fluid ◽  
The Body ◽  
Pesticide Poisoning ◽  
Early Management ◽  
Clinical Presentations ◽  
Major Factors ◽  
Poisoning In Children

Background: Pesticide poisoning is very common in Tunisia. Various factors are involved in the analysis of the clinical presentations and the severity of this condition. Major factors are the chemical nature of the pesticides and the quantity entered the body. Methods: This is a retrospective study, reporting the pediatric cases that presented to us with signs and symptoms of pesticide poisoning. Fifty cases pesticide poisoning were admitted to the hospital between January 2013 and October 2016. Results: A total of 50 pediatric cases were included in this study with the mean age of 3 years and 4months. The poisoning was accidental in 49 cases and self-inflicted in one, with the mode being oral (N=45), respiratory (N=2) and cutaneous (N=3). The average duration of hospital care for these patients was 2 hours and 30 minutes (range: 30 min-24 hr). The clinical manifestations of poisoning noted were due to muscarinic and nicotinic receptors inhibition. Upon clinical examination, 29 patients had no pesticide in the gastric lavage fluid and urine and demonstrated no abnormal cholinesterase activity. The therapeutic management was mainly symptomatic with antidote medications prescribed (atropine and oxime). All patients had favorable outcomes and no death occurred. Conclusion: This study demonstrated the frequency of pesticide poisoning in a pediatric setting and the importance of early management. Optimal therapeutic approaches were evaluated, demonstrating that prevention still remains the best solution in such cases.

Gas Embolism: Part II. Arterial Gas Embolism and Decompression Sickness

1996 ◽  
Vol 11 (5) ◽  
pp. 261-283 ◽  
Author(s):  
Mark M. Wilson ◽  
Frederick J. Curley
Keyword(s):  
Health Care Providers ◽  
Decompression Sickness ◽  
Tissue Injury ◽  
Clinical Manifestations ◽  
The Body ◽  
Care Providers ◽  
Gas Embolism ◽  
Treatment Regimens ◽  
Organ Systems ◽  
High Index Of Suspicion

Gas emboli syndromes are known to occur in many different settings, and they may result in life-threatening emergencies. Venous gas embolization was discussed previously in Part I of this review. Gas emboli that gain access to the arterial circulation or that result from exposures to decreased ambient pressures in the environment are discussed in Part II. The prevalence of arterial gas emboli and decompression sickness are likely not as high as for venous gas emboli. Most cases are preventable, and prompt treatment is frequently effective. Once present, gas bubbles generally distribute themselves throughout the body based on the relative blood flow at the time, thus making the nervous system, heart, lung, and skin the primary organ systems involved. Both mechanical and biophysical effects lead to intravascular and extracellular alterations that result in tissue injury. The clinical manifestations of these disorders are varied, and a high index of suspicion in the appropriate settings will aid health care providers in prompt recognition of these problems and allow timely intervention with specific therapy. Management of arterial gas emboli and decompression sickness is similar, with a focus on hyberbaric chamber therapy and intermittent hyperoxygenation. Recompression schedules in current use have withstood the test of time. Research continues to refine our understanding of these diseases and to optimize the treatment regimens available.

A new class of biophysical models for predicting the probability of decompression sickness in scuba diving

2007 ◽  
Vol 103 (2) ◽  
pp. 484-493 ◽  
Author(s):  
Saul Goldman
Keyword(s):  
Decompression Sickness ◽  
Risk Function ◽  
Central Compartment ◽  
The Body ◽  
Inert Gases ◽  
Inert Gas ◽  
Washout Rate ◽  
Peripheral Compartment ◽  
New Class ◽  
Better Than

Interconnected compartmental models have been used for decades in physiology and medicine to account for the observed multi-exponential washout kinetics of a variety of solutes (including inert gases) both from single tissues and from the body as a whole. They are used here as the basis for a new class of biophysical probabilistic decompression models. These models are characterized by a relatively well-perfused, risk-bearing, central compartment and one or two non-risk-bearing, relatively poorly perfused, peripheral compartment(s). The peripheral compartments affect risk indirectly by diffusive exchange of dissolved inert gas with the central compartment. On the basis of the accuracy of their respective predictions beyond the calibration regime, the three-compartment interconnected models were found to be significantly better than the two-compartment interconnected models. The former, on the basis of a number of criteria, was also better than a two-compartment parallel model used for comparative purposes. In these latter comparisons, the models all had the same number of fitted parameters (four), were based on linear kinetics, had the same risk function, and were calibrated against the same dataset. The interconnected models predict that inert gas washout during decompression is relatively fast, initially, but slows rapidly with time compared with the more uniform washout rate predicted by an independent parallel compartment model. If empirically verified, this may have important implications for diving practice.

scholarly journals Epidemiological aspects of centipede (Scolopendromorphae: Chilopoda) bites registered in Greater S. Paulo, SP, Brazil

1998 ◽  
Vol 32 (6) ◽  
pp. 514-518 ◽  
Author(s):  
Irene Knysak ◽  
Rosana Martins ◽  
Carlos R. Bertim
Keyword(s):  
Urban Areas ◽  
Rainy Season ◽  
Medical Center ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Reproductive Period ◽  
The Body ◽  
Basic Knowledge ◽  
Venomous Animals ◽  
Hands And Feet

INTRODUCTION: The lack of basic knowledge on venomous arthropods and the benignity of the clinical manifestations contribute to the centipede bite victims' not being taken to a treatment reference center, leading to underestimation of the number of cases and minimizing the possibility of a broader epidemiological view. An inventory of the centipede bite occurrences in Greater S. Paulo, Brazil, and the therapeutic methods employed, by the main Brazilian medical center for the notification of poisoning by venomous animals, is presented. METHOD: All patient cards of the period 1980-1989 have been checked as to place, month and time of occurrence; sex, age, affected part of the body, signs and symptoms have been observed, as well as the therapeutic methods employed. The centipedes that caused the accidents were identified at the Arthropods Laboratory. RESULTS: It was registered 216 accidents, with a 69% predominance of the Greater S. Paulo and in only 63% of the cases (136) was the agent brought in by the victim for identification. The genera most frequently represented were Cryptops (58%), Otostigmus (33%) and Scolopendra (4%). Of the 136 cases, 87% showed erythema, edema, hemorrhage, burns, cephalalgia, and intense pain. There was a predominance of accidents in the warm rainy season, in the morning and for females between 21 and 60 years of age. Hands and feet were the parts of the body most affected. The benign evolution of the clinical picture (54%) made therapeutical treatment unnecessary. Only the victims of Scolopendra and Otostigmus (46%) were medicated with anesthetics (51%), analgesics (25%), antihistamines and cortisone (24%). CONCLUSION: The reproductive period of the centipedes, associated with their sinanthropic habits, contributes to the greater incidence of accidents in urban areas in the warm rainy season. Only patients bitten by Scolopendra and Otostigmus require therapeutical treatment.

Decompression outcome following saturation dives with multiple inert gases in rats

1985 ◽  
Vol 59 (5) ◽  
pp. 1503-1514 ◽  
Author(s):  
R. S. Lillo ◽  
E. T. Flynn ◽  
L. D. Homer
Keyword(s):  
Decompression Sickness ◽  
Equation Model ◽  
Hill Equation ◽  
The Body ◽  
Inert Gases ◽  
Inert Gas ◽  
Albino Rats ◽  
Experimental Conditions ◽  
Decompression Stress ◽  
Relative Potencies

This investigation examined the question of whether gas mixtures containing multiple inert gases provide a decompression advantage over mixtures containing a single inert gas. Unanesthetized male albino rats, Rattus norvegicus, were subjected to 2-h simulated dives at depths ranging from 145 to 220 fsw. At pressure, the rats breathed various He-N2-Ar-O2 mixtures (79.1% inert gas-20.9% O2); they were then decompressed rapidly (within 10 s) to surface pressures. The probability of decompression sickness (DCS), measured either as severe bends symptoms or death, was related to the experimental variables in a Hill equation model incorporating parameters that account for differences in the potencies of the three gases and the weight of the animal. The relative potencies of the three gases, which affect the total dose of decompression stress, were determined as significantly different in the following ascending order of potency: He less than N2 less than Ar; some of these differences were small in magnitude. With mixtures, the degree of decompression stress diminished as either N2 or Ar was replaced by He. No obvious advantage or disadvantage of mixtures over the least potent pure inert gas (He) was evident, although limits to the expectation of possible advantage or disadvantage of mixtures were defined. Also, model analysis did not support the hypothesis that the outcome of decompression with multiple inert gases in rats under these experimental conditions can be explained totally by the volume of gas accumulated in the body during a dive.

scholarly journals Assessment of the effect of long-term continuous stay in the artificial hypoxic gas-air environment at normal atmospheric pressure on the functional state of the cardiovascular system

2018 ◽  
Vol 16 (3) ◽  
pp. 47-53
Author(s):  
Andrei V. Lyubimov ◽  
Andrei O. Ivanov ◽  
Eduard N. Bezkishkii ◽  
Pavel G. Shakhnovich ◽  
Dmitrii V. Cherkashin
Keyword(s):  
Cardiovascular System ◽  
Atmospheric Pressure ◽  
Clinical Manifestations ◽  
The Body ◽  
Diagnostic Methods ◽  
Continuous Exposure ◽  
Functional Fitness ◽  
Functional Changes ◽  
Normal Atmospheric Pressure ◽  
Hypoxic State

In the vast majority of clinical cases, hypoxia and hypoxia are considered as negative pathological processes that require urgent correction with subsequent pharmacological support for the restoration of functioning, and in some cases, the structure of the involved organ and system. The loss of full functionality as a result of local or general exposure to the hypoxia is confirmed by numerous studies. However, there are research data showing that subliminal exposure to hypoxia can be used as a positive adaptation factor, which increases the overall health of the body, stamina, and tolerance to physical load. This mechanism is actively used in training athletes of different levels of functional fitness, sports and ages. There is a question of balance of adaptive and damaging properties of hypoxia. Threshold values at which the hypoxic state will have positive adaptive or negative — damaging properties are not clearly defined at the moment. The key criterion for a hypoxic environment is the concentration of oxygen in the inhaled air. At the same time, physiological or pathophysiological response to changes in concentration is purely individual and primarily depends on the parameters of homeostasis. This issue is relevant because clinical manifestations characteristic of the hypoxic state develop in patients with different forms of coronary heart disease. The purpose of our study was an attempt to document the functional changes from the cardiovascular system of healthy individuals with prolonged continuous exposure to artificial hypoxic conditions while maintaining normal atmospheric pressure using standard diagnostic methods that are generally available.

Management of cocaine poisoning

2016 ◽  
Author(s):  
Nicholas J. Johnson ◽  
Judd E. Hollander
Keyword(s):  
Chest Pain ◽  
Excitatory Amino Acid ◽  
Beta Blockers ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
The Body ◽  
Cardiac Biomarkers ◽  
Severe Toxicity ◽  
Clinical Signs And Symptoms

Cocaine is powerful central nervous system (CNS) stimulant derived from the coca plant. It affects the body via a number of mechanisms including blockade of fast sodium channels, increased catecholamine release, inhibition of catecholamine reuptake, and increased concentration of excitatory amino acid concentrations in the CNS. It is rapidly absorbed via the aerodigestive, respiratory, gastrointestinal, and genitourinary mucosa, and also may be injected. When injected intravenously or inhaled, cocaine is rapidly distributed throughout the body and CNS, with peak effects in 3–5 minutes. With nasal insufflation, absorption peaks in 20 minutes. Its half-life is approximately 1 hour. Common clinical manifestations include agitation, euphoria, tachycardia, hyperthermia, and hypertension. Chest pain is a common presenting complaint among cocaine users; 6% of these patients will have myocardial infarction. Other life-threatening sequelae include stroke, intracranial haemorrhage, seizures, dysrhythmias, and rhabdomyolysis. Clinical signs and symptoms, as well as severity of intoxication, should dictate the diagnostic evaluation and treatment of cocaine intoxicated patients. If the patient has chest pain, an ECG, chest radiograph, and measurement of cardiac biomarkers should be performed. A brief observation period may be useful in these patients. Many manifestations of cocaine intoxication, including agitation, hypertension, and chest pain, are effectively treated with benzodiazepines. Beta-blockers should be avoided in patients with suspected cocaine intoxication. Special attention should be paid to pregnant patients and those who present after ingesting packets filled with cocaine, as they may exhibit severe toxicity if these packets rupture.

Clinical, morphological and biochemical signs of polymycotoxicosis in highly productive cows

2020 ◽  
pp. 14-17
Author(s):  
Irina A. Shkuratova ◽  
◽  
Lyudmila I. Drozdova ◽  
Aleksander I. Belousov ◽  
Keyword(s):  
Metabolic Disorders ◽  
Hepatorenal Syndrome ◽  
Morphological Changes ◽  
Clinical Manifestations ◽  
The Body ◽  
Feed Mixture ◽  
Milk Productivity ◽  
Structural Disorders ◽  
Increased Sensitivity ◽  
Penicillium Spp

Mycotoxicological monitoring of forages shows that the problem of mycotoxicosis has been relevant for several decades. Minimal doses of mycotoxins in feed lead to a decrease in milk productivity, increased sensitivity to infectious and non-infectious diseases. When several mycotoxins enter the body simultaneously, a synergistic effect develops, causing a significant increase in toxicity. Feed contaminated with several types of fungi and their toxins is dangerous for dairy cattle. It was found that the feed mixture contained the types of associations of Aspergillus spp. fungi + Fusarium; Aspergillus spp. + Penicillium spp. + Mucor spp; Fusarium + Penicillium; Mucor spp. + Fusarium + Ustilaginales. Pathogenetic features of metabolic and morphological changes in highly productive cows with polymycotoxicosis were studied. Feeding food contaminated with various metabolites of mold fungi leads to the development of signs of chronic toxemia in animals. Clinical manifestations are the development of diarrhea and dehydration, with a decrease in milk productivity. Metabolic disorders feature the development of an inflammatory process, metabolic acidosis, hyperfermentonemia, with an increase in the amount of creatinine and urea in the blood serum. Metabolic signs indicate the development of hepatorenal syndrome due to structural disorders of the liver and kidneys. Histological signs of polymicotoxicosis are intracapillary and hemorrhagic glomerulonephritis, hepatocyte micronecrosis, and proliferation of connective tissue stroma cells, which leads to the development of atrophic cirrhosis in the interstitial and circular phases.

HISTOLOGICAL CHANGES IN THE INTESTINES OF POULTRY DURING FODDER INTOXICATION

2020 ◽  
Author(s):  
E.P. Dolgov ◽  
◽  
A.A. Abramov ◽  
E.V. Kuzminova ◽  
E.V. Rogaleva ◽  
...  
Keyword(s):  
Body Weight ◽  
Histological Examination ◽  
Aflatoxin B1 ◽  
Structural Changes ◽  
Clinical Manifestations ◽  
Feed Additives ◽  
The Body ◽  
Histological Changes ◽  
Beet Pulp

The article presents the data on the study of the influence of mycotoxins combination (T-2 toxin at the concentration of 0.095 mg/kg and aflatoxin B1 in the concentration of 0.019 mg/kg) on the body of quails and the results of pharmacocorrection of toxicosis with a complex consisting of beet pulp and lecithin. Structural changes in the intestines of quais at fodder mycotoxicosis are described. The use of antitoxic feed additives in poultry led to a weakening of the action of xenobiotics, which was confirmed by an increase in the safety of poultry and increase in body weight of quails, a decrease in the clinical manifestations of intoxication, as well as in positive changes in the structure of the intestine of the poultry during histological examination.

Dziedinošās darbības un to veicēji folkloras un valodas liecībās

2020 ◽  
pp. 372-389
Author(s):  
Ieva Ančevska
Keyword(s):  
General Term ◽  
Spoken Word ◽  
The Body ◽  
Folk Healing ◽  
Medical Practitioners ◽  
Medical Terms ◽  
Healing Tradition

This article summarizes the various healing-related activities used in the Latvian healing tradition. To explain these activities and describe their performers and specialization, folklore sources and linguistic materials were used. The aim of this article is to demonstrate the diversity of folk healing activities and their names, while also clarifying their nature and use as much as possible. The linguistic and etymological analysis was used to investigate the healing activities and the names of their performers, but folklore examples were used for clarifying the meanings. By studying the healing tradition, the names of medical practitioners were collected from various sources, adding up to over 60 labels. When compiling the report, the representatives of the healing activities were divided into conditional groups according to the type of their main medical activities. Thus, the following groups of healing activities were formed: healing activities using the body, actions with spoken word and blowing, ritual and magic activities, defense techniques and liberating rituals. In addition to the medicinal practitioners who were active in healing, there were also counselors who sought out the causes of diseases through various means and searched for their best remedies. The survey in the article shows that the healing tradition uses diverse and specialized medical terms. However, as the examples show, most of them have used a combination of different practices. The name of the healer in question usually described the skills that were particularly developed and had been used most frequently. During tradition bans, names of healers became more general, and tabooed names were used instead. The general term “healer” has only been naturalized into society after the restoration of national independence.

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