hyperventilation syndrome
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2022 ◽  
pp. 35-44
Author(s):  
N. V. Pizova

Vertigo is a fairly common complaint with which patients present to physicians of various profiles, and especially to general practitioners, neurologists, and otorhinolaryngologists. Vertigo is a condition where a person has the illusion of movement or of surrounding objects moving when they are not. Vertigo is a symptom of a wide range of diseases, both benign and life-threatening. Vertigo can have a variety of causes, and the suggested treatment should depend on the cause. Due to the multifactorial etiology of medical care, many patients receive inadequate treatment under the primary healthcare scheme, especially during initial presentation. The main causes of vertigo are benign paroxysmal positional vertigo, Meniere’s disease, vestibular neuritis, vestibular migraine, and cerebrovascular diseases. Patients with other disorders, such as depression and hyperventilation syndrome, may present with complaints of nonrotary vertigo. Differential diagnosis of vertigo can be made using easy-to-perform tests during physical examination, including assessment of nystagmus, Dix-Hallpike maneuver, and blood pressure measurements with head-up tilt table tests. Treatment of patients with complaints of vertigo includes drug and non-drug therapy, depending on the established nosological form. However, due to the multifactorial etiology, many patients receive inadequate treatment under the primary healthcare scheme, especially during initial presentation. The dimensionhydrinate/cinnarizine combination is one of the drugs for the symptomatic treatment of vertigo of various origins in adults.


Author(s):  
Никита Игоревич Воронин ◽  
Дмитрий Сергеевич Кузнецов

В статье представлены данные оригинального исследования по созданию терапевтического комплекса, направленного на улучшение интенсивного лечения нозологической ассоциации «нестабильная стенокардия (в качестве основного заболевания) + сахарный диабет второго типа (в качестве фоновой патологии) + гипервентиляционный синдром (в качестве сопутствующего состояния)». Разработанный комплекс основан на контролируемом изменении вспомогательной респираторной оксигенации «в сторону уменьшения» при условии обязательного дополнения базисной фармакотерапии сбалансированной комбинацией препаратов антигипоксического действия и дезагрегантом нового поколения. Проведено сравнительное исследование двух групп тематических пациентов - с применением разработанного комплекса и с использованием «традиционного подхода». Изучены ключевые параметры клинического кардиологического и респираторно-метаболического статуса пациентов. При использовании разработанного терапевтического комплекса по сравнению с «традиционным подходом» установлено принципиальное улучшение параметров клинико-кардиологического статуса при сохранении параметров респираторно-метаболического статуса в пределах адаптивных и безопасных значений. Полученные результаты имеют высокий уровень статистической значимости. Это доказало достаточную обоснованность авторской научно-практической разработки. Представленные в статье данные отличает новизна и практическая применимость, что позволяет рекомендовать их к дальнейшему использованию в практике специалистов клиники внутренних болезней The article presents the data of the original research on the creation of a therapeutic complex aimed at improving the intensive treatment of the nosological association «unstable angina pectoris (as the main disease) + type 2 diabetes mellitus (as a background pathology) + hyperventilation syndrome (as a concomitant condition)». The developed complex is based on a controlled change in auxiliary respiratory oxygenation «downward», provided that basic pharmacotherapy must be supplemented with a balanced combination of antihypoxic drugs and a new generation of antiaggregants. A comparative study of two groups of thematic patients was carried out - using the developed complex and using the «traditional approach». The key parameters of the clinical cardiological and respiratorymetabolic status of patients were studied. When using the developed therapeutic complex in comparison with the «traditional approach», a fundamental improvement in the parameters of the clinical and cardiological status was established while maintaining the parameters of the respiratory and metabolic status within the adaptive and safe values. The results obtained have a high level of statistical significance. This proved the sufficient validity of the author's scientific and practical development. The data presented in the article are distinguished by novelty and practical applicability, which makes it possible to recommend them for further use in the practice of specialists in the clinic of internal diseases


Author(s):  
Никита Игоревич Воронин ◽  
Дмитрий Сергеевич Кузнецов

В статье представлены данные оригинального исследования по оценке фактической частоты встречаемости и значимости в формировании тяжести соматического состояния организма у трех групп обследуемых с различным кардиологическим статусом - условно здоровых лиц молодого возраста, пациентов пожилого возраста с хронической сердечной недостаточностью и пациентов с нестабильной стенокардией, протекающей на фоне сахарного диабета второго типа. Установлено, что во всех трех группах фактическая встречаемость гипервентиляционного синдрома является выше таковой, чем это считалось ранее на уровне традиционных представлений. Помимо этого, его присутствие имеет соматическую значимость для обследуемых с любым кардиологическим статусом, причем она возрастает по мере увеличения тяжести вовлечения в патологический процесс сердечно-сосудистой системы. Для условно здоровых лиц молодого возраста он вызывает субклинические негативные последствия, для пациентов с хронической сердечной недостаточностью - умеренные клинически значимые негативные последствия, для пациентов с нестабильной стенокардией на фоне сахарного диабета второго типа - выраженные клинические негативные последствия в виде ухудшения течения и исходов заболевания. Полученные результаты отличает новизна и практическая значимость, что позволяет рекомендовать их к дальнейшему учету в практике специалистов клиники внутренних болезней The article presents data from an original study to assess the actual frequency of occurrence and significance in the formation of the severity of the somatic state of the body in three groups of subjects with different cardiac status - conventionally healthy young people, elderly patients with chronic heart failure and patients with unstable angina pectoris occurring against the background of type 2 diabetes mellitus. It was found that in all three groups the actual incidence of hyperventilation syndrome is higher than it was previously thought at the level of traditional ideas. In addition, its presence has somatic significance for subjects with any cardiac status, and it increases as the severity of involvement in the pathological process of the cardiovascular system increases. For conventionally healthy young people, it causes subclinical negative consequences, for patients with chronic heart failure - moderate clinically significant negative consequences, for patients with unstable angina pectoris associated with type 2 diabetes mellitus - pronounced clinical negative consequences in the form of worsening of the course and outcomes of the disease. The results obtained are distinguished by their novelty and practical significance, which makes it possible to recommend them for further consideration in the practice of specialists in the clinic of internal diseases


2021 ◽  
Vol 3 (5) ◽  
pp. 01-10
Author(s):  
Yasser Mohammed Hassanain Elsayed

Introduction: Psychogenic coma, generally is one of the most anxious and irritant problems in clinical medicine for all medical practitioners. Using recurrent painful or mischievous stimuli is contraindicated in a psychogenic coma. Method of study and patients: My study was technical, prospective, observational, and interventional for 321 cases. The study was conducted in a physician outpatient clinic, Fraskour Central Hospital, and Ras-Al-bar Central Hospital. The author reported the 321 cases of psychogenic coma over nearly 5 years and 7-months, started from August 07, 2015, and, ended on March 07, 2021. Three selective groups were included in the study. Three groups were selected and evaluated for safety or complications and efficacy or responses. Suggesting hypothesis: Yasser’s maneuver can regaining the consciousness in a psychogenic coma. The research objectives to evaluate this hypothesis might include: What is psychogenic coma? What is Yasser’s maneuver? How can Yasser’s maneuver do improvement of psychogenic coma? Is the study supported by past publicized literature studies? Results: The range of age in the study was 16-55 years with an insignificant P-value (0.231). There is a female sex predominance for all groups (67%). The response for the group I was: (97.35%)) vs. (85.85%)) in group II, and (81.37%) in group III. The most common associated risk factor was psychogenic hyperventilation syndrome (HVS); in the group, I was 79.6%, in group II was 78.4%, and in group III was 96.2±1.7 with no statistical significance (P-value 0.74). Conclusions: The author concluded thatYasser’s maneuver is easy, available, quick, non-costive, time-saving, and extremely safe in the psychogenic coma. Very few and mild few mild complications for this maneuver encourage the generalizing use in the psychogenic coma.


Author(s):  
K. I. Ismoilov ◽  
Sh. S. Muzaffarov

Aim. To study the features of the gas composition and acid-base state in newborns with specific intrauterine infections.Material and methods. The examination was conducted based on the neonatal pathology unit of the SI NMCShifobakhsh.The degree of oxygenation of blood and skin was determined using daily pulse-oximetry. The partial pressure of gases and the study of the acid-base state (CBS) of blood was carried out using Convergys/liquid device.Result and discussion. The results of our study of blood gases and the acid-base indicator of blood in newborns with severe IUI showed noticeable hypoxemia, moderate hypercapnia, and a deficiency of buffer States, which indicate a violation of gas exchange function in the lungs with the development of compensatory respiratory-metabolic acidosis in children of this group. In patients with a very severe course of IUI, as the syndrome of respiratory disorders and the severity of hyperventilation syndrome increased, deeper changes in blood gas parameters and the acid-base state of the blood were noted. It indicates significant damage to the ventilation function of the lungs, diffuse perfusion processes, gas, and acid-base homeostasis.Conclusions. Impairment of the function of organs and systems that developed against the background of a severe or very severe course of IUI, depending on the degree of severity of deviations in blood gas parameters and acid-base balance, shows the need for adequate corrective therapy.


2021 ◽  
pp. 8-12
Author(s):  
С.Ж. СЕРИКБАЕВА ◽  
Н.Ж. ОРМАНОВ

Вегетативно сосудистые и вегетативнотрофические изменения наблюдались у абсолютного большинства пациентов с ПКВИ с преобладанием частоты эмоциональных нарушений (страха смерти) 100%, генерализованный гипергидроз у 75,9%, наличие гипервентиляционного синдрома 71%, субфебрилитет, наличие вегетососудистых кризов, мигрени, склонности к обморокам 50,6%, боли в икроножных мыщах 48,1%, чувствительность к перемене климатических условий при ПКВИ наличие ухудшения самочувствия при смене погоды у 48,1% пациентов. Дисдинамические и дизритмические расстройства лабильности артериального давления (АД) с тенденцией к повышению и сердечного ритма с тенденцией к тахикардии 46,9% больных с ПКВИ. Под влиянием пятикратной и десятикратной применение грудотерапии обшое количество баллов симптомов вегетативных расстройств после перенесенной КВИ составили 557 баллов и 31 баллов и снизились на 82,4% и 99,1%. Индекс выраженности вегетативных нарушении сизились от 2,23±0,11 условных единиц (уе) на 0,39±0,01 и 0,02±0,001 уе.Результаты нейропсихологического тестирования у больных, принимавших гирудотерапии, показали объективное улучшение у них вегатативных нарушении, средний балл индекс выраженности вегетативных нарушении достоверно снизился после пятикратного и 10 дненого применение на 82,6% и 99,1% (р < 0,001) по сравнению с фоновым показателем.Таким образом, у больных с ПКВИ, принимавших 10 дневный курс гирудотерапии, показали объективное улучшение у них вегатативных функций. Autonomic vascular and autonomictrophic changes were observed in the vast majority of patients with PCVI with a predominant frequency of emotional disturbances (fear of death) 100%, generalized hyperhidrosis in 75.9%, the presence of hyperventilation syndrome 71% , subfebrile, presence of vegetovascular crises, migraine, tendency to fainting 50.6% , calf pain 48.1% , sensitivity to changes in climatic conditions in PCVI presence of worsening of wellbeing at a change of weather in 48.1% patients. Dysdynamic and dysrhythmic disorders of arterial pressure (BP) lability with a tendency to increase and cardiac rhythm with a tendency to tachycardia 46.9% of patients with PKVI. Under the influence of fivefold and tenfold application of chest therapy, the total score of symptoms of autonomic disorders after CPVI was 557 and 31 and decreased by 82.4% and 99.1%, respectively. The index of severity of autonomic disturbances sized up from 2.23±0.11 conventional units (ue) by 0.39±0.01 and 0.02±0.001 ue.The results of neuropsychological testing in the patients who took hirudotherapy showed the objective improvement of vegetative disturbances in them, the average index score of vegetative disturbances expression reliably decreased after 5 and 10 day application by 82,6 % and 99,1 % (p <0,001) in comparison with the background index.Thus, patients with PKVI who underwent hirudotherapy for 10 days showed objective improvement of vegetative functions.


2021 ◽  
Vol 10 (12) ◽  
pp. 2591
Author(s):  
Álvaro Aparisi ◽  
Cristina Ybarra-Falcón ◽  
Mario García-Gómez ◽  
Javier Tobar ◽  
Carolina Iglesias-Echeverría ◽  
...  

Introduction: Coronavirus disease 2019 (COVID-19) is a systemic disease characterized by a disproportionate inflammatory response in the acute phase. This study sought to identify clinical sequelae and their potential mechanism. Methods: We conducted a prospective single-center study (NCT04689490) of previously hospitalized COVID-19 patients with and without dyspnea during mid-term follow-up. An outpatient group was also evaluated. They underwent serial testing with a cardiopulmonary exercise test (CPET), transthoracic echocardiogram, pulmonary lung test, six-minute walking test, serum biomarker analysis, and quality of life questionaries. Results: Patients with dyspnea (n = 41, 58.6%), compared with asymptomatic patients (n = 29, 41.4%), had a higher proportion of females (73.2 vs. 51.7%; p = 0.065) with comparable age and prevalence of cardiovascular risk factors. There were no significant differences in the transthoracic echocardiogram and pulmonary function test. Patients who complained of persistent dyspnea had a significant decline in predicted peak VO2 consumption (77.8 (64–92.5) vs. 99 (88–105); p < 0.00; p < 0.001), total distance in the six-minute walking test (535 (467–600) vs. 611 (550–650) meters; p = 0.001), and quality of life (KCCQ-23 60.1 ± 18.6 vs. 82.8 ± 11.3; p < 0.001). Additionally, abnormalities in CPET were suggestive of an impaired ventilatory efficiency (VE/VCO2 slope 32 (28.1–37.4) vs. 29.4 (26.9–31.4); p = 0.022) and high PETCO2 (34.5 (32–39) vs. 38 (36–40); p = 0.025). Interpretation: In this study, >50% of COVID-19 survivors present a symptomatic functional impairment irrespective of age or prior hospitalization. Our findings suggest a potential ventilation/perfusion mismatch or hyperventilation syndrome.


2021 ◽  
Vol 31 (3) ◽  
pp. 375-382
Author(s):  
O. V. Fesenko

Among the extensive list of manifestations of post COVID syndrome, cough is often found. Most researchers interpret its character as post infection. In some patients, post infection cough becomes productive, and combined mucoactive therapy is required for effective treatment. Since the onset of the pandemic, clinical descriptions of spontaneous pneumothorax have accumulated in the literature. The risk of this complication is present even in patients who are not burdened with chronic lung diseases, as well as those who are breathing spontaneously. The study of the mechanisms of development of spontaneous pneumothorax in COVID-19 is necessary for the development of further therapeutic and preventive measures. Traction bronchiectasis occurs in 27 – 52.5% of cases of new coronavirus infection. Changes in the structure of the bronchi predispose to chronic cough and recurrent infections. Respiratory viral infection has been considered in the past as a trigger for bronchial asthma. There is controversy over the new coronavirus. Asthma has been suggested as a protective factor in COVID-19, due to the specific inflammation profile that protects patients. In some patients who have had COVID-19, the cough is due to hyperventilation syndrome. To explain it, a hypothesis of impaired respiratory control was proposed. The paper presents clinical examples illustrating a wide range of pathological conditions accompanied by cough. Possible relationships between cough and previous coronavirus infection are discussed.


Author(s):  
Luis J Nannini ◽  

Introduction: Severe asthma is a complex airway disease characterised by multiple aggravating-factors, and frequent comorbidities. Poor asthma control does not always correspond to the severity of airflow obstruction. One cause of disproportionate breathlessness in asthma is dysfunctional breathing/hyperventilation syndrome which is increasingly recognized. Case study: This female individual arrived at our asthma centre for the first time, coming from a primary care site 20 years ago. During the past 20 years she was intubated 16 times. Airway obstruction was never assessed surrounding the acute asthma episodes. Asthma diagnosis was confirmed by spirometry many times during routine visits at the asthma centre, where she never came to our asthma centre during an acute asthma exacerbation. Despite warranting the availability of controller medication with high ICS dose plus LABA, she repeated the episodes of severe dyspnoea requiring endotracheal intubations. Results: At a routine outpatient visit to our asthma centre for claiming her asthma medication, she developed an extreme dyspnoea as it occurred so many times earlier, using accessory respiratory muscles. The modified Borg scale for dyspnoea was 9/10. Pulse oximetry showed 96% O2 saturation breathing at room air. Baseline FEV1 was 1.96 L. Dyspnoea did not improve after 30 minutes of treatment. However, the FEV1 increased 29% to 2.53 L (96% predicted). Relaxation respiratory techniques began and the extreme dyspnoea slowly disappeared. Conclusion: Hyperventilation syndrome was confirmed with a score 32 with the Nijmegen Questionnaire (normal <23). Hyperventilation syndrome could coexist with severe asthma in 47% of cases. Keywords: Asthma; Asthma primary care; Hyperventilation syndrome.


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