scholarly journals Pharmacological treatment of the patients with croup

2021 ◽  
Vol 64 (7) ◽  
pp. 501-507
Author(s):  
Yoon Young Jang ◽  
Hai Lee Chung
Keyword(s):  
Single Dose ◽  
Hospital Admissions ◽  
Upper Airway ◽  
Respiratory Illness ◽  
Abrupt Onset ◽  
Inspiratory Stridor ◽  
Acute Viral Infection ◽  
Life Threatening ◽  
Rare Occasion ◽  
Viral Croup

Background: Croup is a respiratory illness usually caused by acute viral infection of the larynx, trachea, and bronchi, and characterized by the abrupt onset of a barking cough, inspiratory stridor, hoarseness, and respiratory distress due to upper airway obstruction. Croup commonly affects children younger than 6 years of age, with peak incidence between 7 and 36 months. Although the disease is usually self-limited, it may occasionally become life threatening, and can, on rare occasion, lead to respiratory failure.Current Concepts: Treatment of viral croup depends on the severity of symptoms as denoted by Westley croup score (i.e., mild, moderate, or severe). A single dose of oral or intramuscular dexamethasone (0.15-0.6 mg/kg) is the mainstay of treatment for viral croup, irrespective of severity. A single dose of nebulized budesonide (2 mg) is equally effective as systemically administered dexamethasone, and is considered when a patient is unable to take a medicine orally. Nebulized L-epinephrine (1:1,000, 3-5 mL) causes vasoconstriction in the mucosa, rapidly reducing airway edema. Addition of nebulized L-epinephrine is indicated in the patients with croup of at least moderate severity, displaying chest retraction and signs of labored breathing.Discussion and Conclusion: The most effective pharmacological treatments for patients with viral croup are oral or intramuscular dexamethasone, and nebulized L-epinephrine. Especially, corticosteroids can significantly decrease the intensity of croup symptoms and reduce hospital admissions, return visits to emergency department and length of stay in the hospital.

scholarly journals Congenital laryngeal cyst causing respiratory distress in a neonate: a rare case report

2021 ◽  
Vol 8 (8) ◽  
pp. 1448
Author(s):  
Aniruddha Basak ◽  
Debaleena Dey
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Upper Airway ◽  
Needle Aspiration ◽  
Inspiratory Stridor ◽  
Lateral Pharyngotomy ◽  
Rare Case Report ◽  
Life Threatening ◽  
Surgical Options ◽  
Laryngeal Cyst

Congenital laryngeal cyst is a rare but responsible of upper airway obstruction which can be potentially life-threatening. The most common symptoms are inspiratory stridor, dyspnea, cyanosis, abnormal voice and difficulty with feeding. It should be differentiated from laryngomalacia. It is diagnosed by flexible fibro-optic laryngoscopy. Surgical options are endoscopic excision, needle aspiration, de-roofing, external laryngo-fissure and lateral pharyngotomy. The best treatment consists in the entire removal of the cyst. This case report described the case of 28 days old neonate with a severe airway distress and stridor caused by a congenital laryngeal cyst which has been managed by de-roofing of the cyst entirely with flexible laryngoscope.

scholarly journals Changes in the epidemiology of epiglottitis following introduction of Haemophilus influenzae type b (Hib) conjugate vaccines in England: a comparison of two data sources

2005 ◽  
Vol 134 (3) ◽  
pp. 570-572 ◽  
Author(s):  
J. McVERNON ◽  
M. P. E. SLACK ◽  
M. E. RAMSAY
Keyword(s):  
Haemophilus Influenzae ◽  
Hospital Admissions ◽  
Upper Airway ◽  
Haemophilus Influenzae Type ◽  
Type B ◽  
Minimal Impact ◽  
Airway Infections ◽  
Life Threatening ◽  
High Index Of Suspicion ◽  
Vaccine Availability

Paediatric cases of epiglottitis declined markedly in England following the introduction of safe effective immunization against Haemophilus influenzae type b (Hib). With the recently described resurgence in Hib infections, a corresponding rise in the number of presentations of clinical epiglottitis in children was observed, although numbers were still well below those reported prior to vaccine availability. This was seen both in microbiology reports and hospital admissions data for England. In keeping with the more diverse aetiology of epiglottitis in adults, Hib vaccination had minimal impact on hospital presentations with upper airway infections in those aged 15 years and over, which showed an overall increasing trend over 10 years. The need for a high index of suspicion to allow early diagnosis of this life-threatening clinical presentation is reinforced.

A dangerous cause of airway obstruction: deep neck infection

2020 ◽  
Keyword(s):  
Airway Obstruction ◽  
Upper Airway ◽  
Deep Neck Infection ◽  
Jugular Vein Thrombosis ◽  
Neck Infection ◽  
Vein Thrombosis ◽  
Lethal Complications ◽  
Life Threatening ◽  
Fascial Spaces ◽  
Emergency Doctors

Deep neck infection (DNI) is an infection in the fascial spaces of the neck. Complications of DNI, including mediastinitis, internal jugular vein thrombosis, and upper airway obstruction, are severe and potentially life threatening. Therefore, early identification and accurate management of DNI are essential. We review the anatomy of the deep spaces of the neck to determine the route of DNI spread so that emergency doctors, physicians, and otorhinolaryngologists can quickly recognize the development of lethal complications of DNI, such as asphyxia from airway obstruction.

scholarly journals Acute upper airway obstruction as a life-threatening complication of ventral bulla osteotomy: report of two consecutive cases

2021 ◽  
Vol 7 (1) ◽  
pp. 205511692110059
Author(s):  
Michal Vlasin ◽  
Richard Artingstall ◽  
Barbora Mala
Keyword(s):  
Airway Obstruction ◽  
Clinical Signs ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Single Session ◽  
Inflammatory Polyp ◽  
Case Summary ◽  
First Case ◽  
Life Threatening

Case summary This paper presents two cases of acute postoperative upper airway obstruction following ventral bulla osteotomy (VBO) in cats. The first cat underwent a unilateral left-sided VBO for a suspected inflammatory polyp. The second cat underwent a single-session bilateral VBO procedure for bilateral otitis media. In the first case, immediate re-intubation and a gradual lightening of the anaesthetic plane resolved the clinical signs; in the second case, the patient deteriorated and went into acute cardiorespiratory arrest and received cardiopulmonary resuscitation. Both patients recovered well and were discharged home 3 days after surgery. Both cases were reported to show no further clinical signs on postoperative follow-up 3 weeks and 4 months after surgery, respectively. Relevance and novel information Upper airway obstruction should be regarded as a potential complication of VBO in cats.

Caregivers’ role in managing hereditary angioedema and perceptions of treatment-related burden

2021 ◽  
Vol 42 (3) ◽  
pp. S11-S16 ◽  
Author(s):  
Timothy J. Craig ◽  
Aleena Banerji ◽  
Marc A. Riedl ◽  
Jessica M. Best ◽  
Jinky Rosselli ◽  
...  
Keyword(s):  
Hereditary Angioedema ◽  
Genetic Disease ◽  
Online Survey ◽  
Scientific Literature ◽  
Upper Airway ◽  
The United States ◽  
Care Recipient ◽  
Psychosocial Impacts ◽  
Life Threatening ◽  
Familial Caregivers

Hereditary angioedema (HAE) is a rare genetic disease that results in recurrent, debilitating, and potentially life-threatening swelling episodes in the extremities, genitals, gastrointestinal tract, and upper airway. Patients can experience significant burdens related to their disease. Informal or familial caregivers often support patients with HAE and likely share in the disease-related burdens, although there are limited HAE caregiver‐focused reports in the scientific literature. In the United States, we conducted an online survey of adults caring for an individual with HAE to better understand their experiences with the disease and identify psychosocial impacts of providing care for a patient with HAE. Thirty caregivers provided responses to the survey. Most caregivers were family members of the care recipient and many had HAE themselves. Caregivers reported participating in a number of medical-related tasks and experiencing some burdens as a result of caring for a person with HAE.

Cancer and COVID-19: A proposed mechanism with therapeutic interventions.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 3135-3135
Author(s):  
Yan Leyfman ◽  
Nancy Emmanuel ◽  
Aleksey Tentler ◽  
Jared Cappelli ◽  
Timothy K Erick ◽  
...  
Keyword(s):  
Respiratory Illness ◽  
Organ Damage ◽  
Multiple Organ ◽  
Therapeutic Interventions ◽  
Actual Number ◽  
Data Registry ◽  
Number Of Patients ◽  
Increased Risk ◽  
Life Threatening ◽  
Active Cancer

3135 Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel betacoronavirus that causes the respiratory illness coronavirus disease 2019 (COVID-19). COVID-19 ranges in severity from an asymptomatic viral infection to life-threatening cases of pneumonia, acute respiratory distress syndrome (ARDS), multi-organ damage and sepsis. Cancer patients are at an increased risk of severe SARS-CoV-2 infection due to their immunocompromised status. We propose a mechanism by which SARS-CoV-2 infection causes multiple organ damage through IL-6-mediated inflammation and hypoxia-induced cellular metabolic alterations leading to cell death. Hypoxia is also induced by malignancy due to alterations in metabolism, resulting in greater IL-6 secretion. Methods: To highlight the possible effect of active cancer on the likelihood of hypoxia in COVID-19, we analyzed the correlation between cancer status and the severity of COVID-19 from the COVID-19 and Cancer Consortium data registry. For cancer status, we looked at progressive cancer and remission of cancer only -- those being the two extremes of presence and absence of uncontrolled cancer. Similar to prior studies, the severity of COVID-19 was used as an indication of hypoxia. Results: We observed a 24% positive deviation between expected and actual number of patients with actively progressing cancer who had hypoxic COVID-19 (moderate to severe), and a 26.9% negative deviation between expected and actual number of patients with active cancer who had no hypoxia with COVID-19 (p<0.0001). Conversely, for patients with cancer in remission, there was only a +5.8% and -5.1% deviation between expected and actual number of patients who did not have hypoxia and who had hypoxia, respectively. Conclusions: These results suggest that in the presence of poorly controlled malignancy, there is an increased likelihood of hypoxia in patients with COVID-19, thereby exacerbating downstream cytokine release syndrome and contributing to prolonged systemic inflammatory injury. Appreciating this pathway, future therapies can be developed to target the pathogenesis of both diseases and prevent progression, as seen with mesenchymal stem cells, which demonstrated a 91% overall survival and 100% survival in patients younger than 85 years old at one month after a single treatment.[Table: see text]

scholarly journals Efficiency and safety of single dose Magnesium sulphate in eclamptic convulsion

2017 ◽  
Vol 6 (7) ◽  
pp. 3058
Author(s):  
Vinaya Goudar ◽  
Rashmi Naganagoudaru
Keyword(s):  
Single Dose ◽  
Magnesium Sulphate ◽  
Urban Areas ◽  
Low Dose ◽  
Post Partum ◽  
Efficacy And Safety ◽  
Medical Sciences ◽  
Life Threatening ◽  
Clonic Seizures ◽  
Life Threatening Complication

Background: An acute and life-threatening complication of pregnancy is characterized by the appearance of tonic clonic seizures, in a patient with pre-eclampsia. Objective of the study was to study the efficacy and safety of a ‘single dose’ of magnesium sulphate in treatment of eclamptic convulsions.Methods: The present prospective study was undertaken among women aged between 18-35 years outpatient’s Department of gynecology in Karnataka Institute of Medical Sciences (KIMS) Hubli, Karnataka, India. The study was undertaken during December 2009 to November 2010.Results: The incidence of eclampsia in our study was 2.12%. Eclapmsia is more common in patients from rural (89%) as compared to urban areas (11%) in our study. In our study eclampsia is more common in unbooked cases (80%). Majority of patients (72%) in our study group were illiterates. 61%, 28% of patients had antepartum and intrapartum eclampsia respectively in our study. We had only 11 post-partum convulsions Table 2. 80% of patients in our study were more than 28 weeks of gestations. 65% of the patients had <5 episodes of convulsions. The number of convulsions did not affect the recurrence, and 35% had >5 episodes. In present study 5 Patients had Systolic Blood Pressure less than 140 mmHg. Majority (52) had more than 160 mmHg 42 had in between 140 and 160 mmHg. Diastolic arterial pressure was >110 in 81% of cases. The convulsions were controlled in 75% of women. Recurrence of convulsions occurred in 25% of women after receiving the single dose magnesium sulphate regime. In our study 75% of cases, there was no recurrence of convulsions and in 25% of cases, there was recurrence of convulsions, out of which 20 cases received low dose magnesium sulphate regime and the other 5 cases received Phenytoin regime as 2nd line of treatment.Conclusions: Hence the single dose Magnesium sulphate is safe and effective in controlling convulsions.

scholarly journals Life–threatening Pulmonary Oedema Secondary to Tracheal Compression

2002 ◽  
Vol 30 (6) ◽  
pp. 804-806 ◽  
Author(s):  
H. Butterell ◽  
R. H. Riley
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Airway Obstruction ◽  
Pulmonary Oedema ◽  
Negative Pressure ◽  
Upper Airway ◽  
Tracheal Compression ◽  
Negative Pressure Pulmonary Oedema ◽  
Life Threatening ◽  
Thyroid Goitre

We present a case of negative pressure pulmonary oedema due to an overlooked cause. A 45-year-old female patient presented to the emergency department unconscious with severe pulmonary oedema. Subsequent investigations revealed a thyroid goitre causing significant tracheal compression. This case report highlights an extremely rare but potentially dangerous sequela of upper airway obstruction.

scholarly journals Suicide, the main cause of referral of patients from a general hospital for psychiatric evaluation

2021 ◽  
Vol 5 (1) ◽  
pp. 018-021
Author(s):  
Gómez Elena ◽  
Guzmán Marianela ◽  
Torres Oriol Yuguero
Keyword(s):  
Suicide Attempts ◽  
Hospital Admissions ◽  
Cross Sectional Study ◽  
Psychiatric Evaluation ◽  
Outpatient Basis ◽  
Test Results ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test ◽  
Life Threatening

Introduction: Psychiatric emergencies constitute between 1% - 10% of general emergencies in Spain, of which a quarter will end up being hospital admissions. There is little literature on patients who are referred from general to specialized hospitals. Methods: Cross-Sectional study of all the patients referred in 2018. Sociodemographic variables and clinical variables, such as diagnosis and discharge destination, were analyzed. An analysis was performed by comparing means with the Chi Square test. Results: 433 derived emergencies were analyzed. Most of the patients were women. The main reason for derivation were suicide attempts. Of those patients, 40% required hospitalizations. More than 50% of the derived emergencies were referred to the home and followed up on an outpatient basis. Conclusion: Most derived emergencies are referred to the home after evaluation. This implies that most are not life-threatening and that with adequate tools for evaluating suicide risk, we could avoid transfers and improve the resolution of these cases.

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