Journal articles on the topic 'Respiratory insufficiency Etiology'
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1
Goncalves, Isabel, Dominique Hermans, Dominique Chretien, Pierre Rustin, Arnold Munnich, Jean Marie Saudubray, François Van Hoof, et al. "Mitochondrial respiratory chain defect: a new etiology for neonatalcholestasis and early liver insufficiency." Journal of Hepatology 23, no. 3 (September 1995): 290–94. http://dx.doi.org/10.1016/s0168-8278(95)80008-5.
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Sirbu, H., Th Busch, D. Zenker, I. Aleksic, C. Hoffmann, B. Schorn, and H. Dalichau. "Bronchial stump insufficiency after pneumonectomy: etiology, risk factors, therapy." Zeitschrift für Herz-, Thorax- und Gefäßchirurgie 13, no. 7 (1999): S025. http://dx.doi.org/10.1007/s003980050111.
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Aghili, Hossein, Seyed Mohammad Ali Tabatabaei, and Mahdjoube Goldani Moghadam. "Clinical and Radiographic Features of Pycnodysostosis with Emphasis on Dentofacial Problems." Case Reports in Dentistry 2017 (2017): 1–5. http://dx.doi.org/10.1155/2017/4352485.
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Pycnodysostosis (PDO) is a rare genetic disorder characterized by cathepsin K deficiency which plays an important role in bone metabolism. Among clinical features of this disease which are mainly caused by altered bone remodeling are craniofacial abnormalities such as hypoplastic maxilla and obtuse gonial angle which consequently lead to respiratory insufficiency in forms of pharyngeal narrowing and severe snoring. In this paper, another case of this rare disorder is presented along with a review on etiology and management issues of respiratory insufficiency in these patients.
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Eghbalkhah, Asgar, Kamyar Kamrani, Nahid Khosroshahi, Hossein Yousefimanesh, Zahra Eskandarizadeh, and Mojdeh Habibi Zoham. "Distal Spinal Muscular Atrophy: An Overlooked Etiology of Weaning Failure in Children with Respiratory Insufficiency." Journal of Pediatric Intensive Care 07, no. 03 (January 4, 2018): 159–62. http://dx.doi.org/10.1055/s-0037-1617434.
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AbstractSpinal muscular atrophy with respiratory distress type 1 (SMARD1) is a rare autosomal recessive neuromuscular disorder that involves the anterior horn motor neurons. It is a disease with a poor prognosis presenting with progressive distal motor weakness and respiratory insufficiency from diaphragmatic paralysis followed by distal muscle weakness before 6 months of age. With the intent to spread the awareness of this rare and life-threatening disease, we report a 2.5-month-old female infant with a subsequent diagnosis of SMARD1, who was admitted in our pediatric intensive care unit with chief complaint of progressive respiratory distress and poor feeding.
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SUGA, MORITAKA. "Respiratory insufficiency Advances in diagnosis and treatments. I. Diagnosis and disease state of respiratory insufficiency. 6. Etiology and disease state of the underlying disease." Nihon Naika Gakkai Zasshi 88, no. 1 (1999): 37–44. http://dx.doi.org/10.2169/naika.88.37.
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Goncalves, I. "Mitochondrial respiratory chain defect: a new etiology for neonatal cholestasis and early liver insufficiency." Journal of Hepatology 23, no. 3 (September 1995): 290–94. http://dx.doi.org/10.1016/0168-8278(95)80473-0.
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Stogova, N. A. "Bilateral pleural effusion: etiology, diagnostics." PULMONOLOGIYA 32, no. 6 (December 11, 2022): 885–90. http://dx.doi.org/10.18093/0869-0189-2022-32-6-885-890.
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The problem of etiologic diagnosis of bilateral pleural effusions is important because of the relatively large number and variety of diseases accompanied by this syndrome, the complexity of diagnosis verification, and the frequent diagnostic errors. The aim of this review is to describe the spectrum of diseases causing bilateral pleural effusion and to consider a set of diagnostic measures to clarify the etiology of the process. Analysis of 60 literature sources showed that the most common causes of bilateral transudative pleural effusions are cardiac, hepatic, and renal insufficiency. Exudative bilateral pleural effusions are found in inflammatory processes in the pleura, including tuberculosis, and develop when inflammation is transmitted by contact or lymphohematogenous routes from the lungs or other organs. Bilateral localization of pleural effusion in tumor processes is observed in 5.7% of cases. Bilateral pleural effusion is seen in pulmonary embolism, diffuse connective tissue diseases, acute idiopathic pericarditis, postinfarction Dressler syndrome, after pericardotomy, and after pacemaker placement. It may be observed in such rare diseases as sarcoidosis, yellow nail syndrome, and Meigs syndrome, and may be induced by some drugs. Conclusion. The choice of therapeutic measures for bilateral pleural effusion is determined by an accurate etiological diagnosis of the underlying disease. The diagnosis should be based on the patient's clinical data and cytologic, microbiologic, and biochemical analysis of pleural fluid obtained by pleural puncture. In some cases, additional examination methods such as pleural biopsy, bronchoscopy, ultrasound, computed, magnetic resonance imaging of the chest and abdomen, and positron emission tomography are required.
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Holst, John M., and Mary J. Willis. "A Fatal Case of Cor Pulmonale with Undetected Chronic Hypoventilation in an Infant with a Known Congenital Myopathy." Case Reports in Pediatrics 2012 (2012): 1–4. http://dx.doi.org/10.1155/2012/836420.
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The authors of this paper wish to present a case of fatal cor pulmonale with right ventricular hypertrophy complicated by a congenital myopathy. It is our intention to demonstrate the importance of vigilant clinical assessment of children with a congenital myopathy, regardless of the exact etiology of their disease, or family history of disease severity. This case highlights the risk for fatal complications if hypoventilation and respiratory insufficiency go unrecognized in myopathic children. Consequently, we recommend respiratory and cardiac monitoring surveillance as well as appropriate referral to specialists in the management of such children.
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Ferian, Paulo Eduardo, and Marília Gabriela Luciani. "Canine chronic bronchitis – a review." Clínica Veterinária XXII, no. 129 (July 1, 2017): 74–80. http://dx.doi.org/10.46958/rcv.2017.xxii.n.129.p.74-80.
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Canine chronic bronchitis (CCB) is considered to be one of the most common chronic respiratory diseases of dogs. The hallmark of CCB is chronic and progressive cough that leads to poor life quality of the dog. Severe cases may progress to respiratory insufficiency and death. The cause is an inflammatory process of unknown origin. The disease is most common in adult and older dogs of small animal breeds. In severe cases, this chronic inflammatory process progresses to irreversible structural changes in the airways, resulting in respiratory failure. Despite this, information about the disease is extremely limited in the literature, and the recommended treatment is based on poor scientific evidence. Thus, the aim of this study is to review the subject and describe the etiology, pathophysiology, clinical features, complementary diagnosis and treatment of CCB.
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Jiménez-Zarazúa, Omar, Lourdes N. Vélez-Ramírez, José C. Padilla–López, Juana R. García-Ramírez, Pedro L. González–Carillo, and Jaime D. Mondragón. "Invasive Pulmonary Adenocarcinoma with Lepidic Growth Pattern in a Pregnant Patient." Case Reports in Oncology 11, no. 3 (December 11, 2018): 822–34. http://dx.doi.org/10.1159/000495460.
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Among the differential diagnoses that should be considered in acute respiratory failure (ARF) are infectious processes, autoimmune diseases, interstitial pulmonary fibrosis, and pulmonary neoplasia. Timely diagnosis of lung neoplasia is complicated in the early stages. An opportune diagnosis, as well as the specific treatment, decrease mortality. ARF occurs 1 in 500 pregnancies and is most common during the postpartum period. Among the specific etiologies that cause ARF during pregnancy that must be considered are: (1) preeclampsia; (2) embolism of amniotic fluid; (3) peripartum cardiomyopathy; and (4) trophoblastic embolism. The case of a 36-year-old patient with a 33-week pregnancy and ARF is presented. The patient presented dyspnea while exerting moderate effort that progressed to orthopnea and type 1 respiratory insufficiency. Imaging studies showed bilateral alveolar infiltrates and predominantly right areas of consolidation. Blood cultures, a galactomannan assay and IgG antibodies against mycoplasma pneumoniae, were reported as negative. Autoimmune etiology was ruled out through an immunoassay. A percutaneous pulmonary biopsy was performed and an invasive pulmonary adenocarcinoma with lepidic growth pattern (i.e. lepidic pulmonary adenocarcinoma, LPA) result was reported. This etiology is rare and very difficult to recognize in acute respiratory failure cases. After infectious, autoimmune and interstitial lung fibrosis have been excluded the clinician must suspect of lung cancer in a patient with acute respiratory failure and chest imaging compatible with the presence of ground-glass nodular opacities, a solitary nodule or mass with bronchogram, and lung consolidation. In the presence of acute respiratory failure, the suspicion of pulmonary neoplasia in an adult of reproductive age must be timely. Failure to recognize this etiology can lead to fatal results.
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Аbuldinov, А. S., and I. А. Аndrievskaya. "Disturbance of utero-placental-fetus blood flow in pregnant women with community-acquired pneumonia of bacterial and viral (COVID-19) etiology." Bulletin Physiology and Pathology of Respiration, no. 83 (April 23, 2022): 59–65. http://dx.doi.org/10.36604/1998-5029-2022-83-59-65.
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Introduction. Placental insufficiency is one of the most frequently developing complications in pregnant women with acute respiratory failure, which is a consequence of community-acquired pneumonia (CAP), including viral etiology. The impact of COVID-19 infection on the course of pregnancy, the condition of the fetus and newborns has not been studied enough. Aim. To study the state of uteroplacental-fetal circulation, placenta and fetus in women with bacterial and COVID-19-associated CAP in the second and third trimesters of pregnancy. Materials and methods. The history of childbirth and the results of examinations of 120 women in the second and third trimesters of pregnancy were analyzed, including 37 women with moderate CAP of bacterial etiology, 48 women with COVID-19 infection. The comparison group consisted of 35 women with uncomplicated pregnancy. The state of the placenta and fetus was assessed according to the data of ultrasound and utero-placental-fetal blood flow – Doppler study. Pulsation indices (PI) and cerebro-placental ratio (CPR) were analyzed. Results. According to our data, the risk of developing chronic placental insufficiency in pregnant women with COVID-19-associated CAP of moderate severity was higher than in groups of women with CAP of bacterial etiology and in the comparison group. In groups with CAP, significant differences were found in the indices of CPR, PI of the uterine arteries, umbilical cord arteries and middle cerebral artery, corresponding to I (A, B) or II degree of disturbance of the uteroplacental and/or placental-fetal blood flow. Chronic intrauterine fetal hypoxia and fetal growth retardation were more frequently detected in the group with COVID-19-associated CAP. Newborns born to mothers with COVID-19 infection have an increased risk of neonatal damage to the central nervous system (CNS). Conclusion. COVID-19-associated CAP, compared with CAP of bacterial etiology, increases the risk of chronic placental insufficiency, intrauterine fetal hypoxia and fetal growth retardation, and the development of neonatal CNS damage.
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Sayfullin, R. F., M. A. Sayfullin, N. N. Zvereva, O. E. Ambrosi, V. R. Vengerov, and S. K. Pylaeva. "A case of adenovirus infection complicated by diffuse alveolar haemorrage in a tourist from Sri Lanka." Tuberculosis and Lung Diseases 100, no. 7 (August 12, 2022): 47–52. http://dx.doi.org/10.21292/2075-1230-2022-100-7-47-52.
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The article describes a rare case of adenovirus infection complicated by diffuse alveolar hemorrhage in a 29 y.o. immunocompetent patient which developed during a trip to Sri Lanka. The course of the disease was accompanied by severe anemia and respiratory insufficiency, etiology of the disease was confirmed by polymerase chain reaction of pharyngeal swabs and sputum sample. After successful supportive treatment, the patient was discharged on the 13th day of hospital stay to continue treatment in the out-patient settings. This case demonstrates the possibility of severe complications in case of adenovirus infection.
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Gorzkowska-Pasik, Katarzyna, Elżbieta Wiatr, Barbara Burakowska, Urszula Nowicka, Jarosław Kober, Przemysław Malong, Piotr Pasik, and Krystyna Folcik. "Severe hypoxemic respiratory insufficiency in a patient with hepato-pulmonary syndrome coexisting with interstitial lung disease of unknown etiology." Pneumonologia i Alergologia Polska 81, no. 3 (April 19, 2013): 267–72. http://dx.doi.org/10.5603/arm.34106.
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Karpenko, M. A., D. Yu Ovsyannikov, M. A. Zhestkova, E. M. Gabliya, V. E. Chekashkina, O. G. Malyshev, I. V. Danelyan, E. A. Troshnina, A. D. Ovsyannikov, and E. A. Degtyareva. "CLINICAL CASE OF A PATIENT WITH NEUROENDOCRINE CELL HYPERPLASIA OF INFANCY, WHO IS ON LONG-TERM OXYGEN THERAPY AT HOME." Pediatria. Journal named after G.N. Speransky 101, no. 2 (April 15, 2022): 164–67. http://dx.doi.org/10.24110/0031-403x-2022-101-2-164-167.
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Neuroendocrine cell hyperplasia of infancy (NEHI) is an interstitial lung disease of unknown etiology that develops in infancy and manifests as persistent tachypnea syndrome. A highly informative scale for the clinical diagnosis of NEHI and CT of the lungs is used to diagnos the disease. The presence of a typical CT picture allows the diagnosis of NEHI to be made. We present a clinical case of a patient diagnosed on the basis of the scale of clinical diagnostics and a typical CT picture of NEHI, complicated by protein-energy insufficiency, chronic respiratory failure of II degree, who is on long-term home oxygen therapy.
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Panacheva, L. A. "Prevention of nosocomial pneumonia in conditions of resuscitation and intensive care unit: literature review." Perm Medical Journal 37, no. 4 (November 6, 2020): 62–70. http://dx.doi.org/10.17816/pmj37462-70.
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The article presents a review of literature on the prevention of nosocomial pneumonia (NP), which has a high frequency in the resuscitation and intensive care unit, severe complications (up to 52.1 % of cases) and mortality. The following aspects are shown: risk factors for NP and multiple antimicrobial resistance; the goal and program of NP prevention aimed at reducing the likelihood of contamination and infection of patients; the need for epidemiological surveillance of health care associated infections and observance of principles of asepsis and antiseptics by medical personnel; the prevention of oropharyngeal colonization and aspiration; methods of timely verticalization of patients who suffered from acute cerebral insufficiency of any etiology; stimulating spirometry, respiratory gymnastics and chest massage.
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Vucinic, Slavica, Biljana Antonijevic, Nela Ilic, and Tihomir Ilic. "Oxime and atropine failure to prevent intermediate syndrome development in acute organophosphate poisoning." Vojnosanitetski pregled 70, no. 4 (2013): 420–23. http://dx.doi.org/10.2298/vsp120229037v.
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Introduction. Intermediate syndrome (IMS) was described a few decades ago, however, there is still a controversy regarding its exact etiology, risk factors, diagnostic parameters and required therapy. Considering that acute poisonings are treated in different types of medical institutions this serious complication of organophosphate insecticide (OPI) poisoning is frequently overlooked. The aim of this paper was to present a case of IMS in organophosphate poisoning, which, we believe, provides additional data on the use of oxime or atropine. Case report. After a well-resolved cholinergic crisis, the patient developed clinical presentation of IMS within the first 72 h from deliberate malathion ingestion. The signs of IMS were weakness of proximal limb muscles and muscles innervated by motor cranial nerves, followed by the weakness of respiratory muscles and serious respiratory insufficiency. Malathion and its active metabolite were confirmed by analytical procedure (liquid chromatography-mass spectrometry). Pralidoxime methylsulphate, adiministered as a continuous infusion until day 8 (total dose 38.4 g), and atropine until the day 10 (total dose 922 mg) did not prevent the development of IMS, hence the mechanical ventilation that was stopped after 27 h had to be continued until the day 10. Conclusion. Continuous pralidoxime methylsulphate infusion with atropine did not prevent the development of IMS, most likely due to the delayed treatment and insufficient oxime dose but also because of chemical structure and lipophilicity of ingested OPI. A prolonged intensive care monitoring and respiratory care are the key management for the intermediate syndrome.
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Faiz, Saadia A., Cezar Iliescu, Juan Lopez-Mattei, Bela Patel, Lara Bashoura, and Uday Popat. "Resolution of Myelofibrosis-Associated Pulmonary Arterial Hypertension following Allogeneic Hematopoietic Stem Cell Transplantation." Pulmonary Circulation 6, no. 4 (December 2016): 611–13. http://dx.doi.org/10.1086/687291.
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We present the case of a 62-year-old man with myelofibrosis-associated pulmonary arterial hypertension (PAH) who underwent allogeneic hematopoietic stem cell transplantation with subsequent resolution of disease and PAH. Right heart catheterization was used to guide PAH therapy before and after transplantation. Drug interactions, adverse effects, and renal insufficiency posed clinical challenges for the management of PAH-specific medications after transplantation. PAH improved soon after transplantation, and vasoactive medications were tapered off. Resolution of PAH was confirmed with repeat measurement of pulmonary hemodynamic characteristics. Although the etiology and pathophysiology for the resolution of PAH was unclear, the myelopulmonary pathophysiologic link was likely to have contributed. This is the first report describing resolution of myelofibrosis-associated PAH after allogeneic hematopoietic stem cell transplantation.
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Bianchi, Diana W., and Linda J. Van Marter. "An Approach to Ventilator-Dependent Neonates with Arthrogryposis." Pediatrics 94, no. 5 (November 1, 1994): 682–86. http://dx.doi.org/10.1542/peds.94.5.682.
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Objective. To identify the clinical factors and/or test results necessary to determine the diagnosis and prognosis for a group of neonates who presented with respiratory insufficiency and multiple contractures. Methods. We performed a retrospective review of medical records and identified 15 newborns over a 10-year period (1980 through 1990) who had arthrogryposis multiplex congenita and required ventilator support at birth. We designed a 104 item data base to record clinical information; this was subsequently analyzed using the Clinfo data base program for statistical analysis. Results. Fourteen of the 15 patients died. Of the fourteen, 13 were electively extubated after a variable time course (2 hours to 64 days). Autopsies performed on all 14 revealed an approximately equal distribution of central nervous system (CNS) malformations, peripheral neuropathies, and peripheral myopathies as the etiology. The single survivor had myasthenia gravis. Conclusion. In neonates with arthrogryposis, ventilator dependence at birth carries a poor prognosis. Prenatal factors that potentially predict respiratory insufficiency for the fetus with arthrogryposis include decreased fetal movements, polyhydramnios, micrognathia, and thin ribs. The combination of a thorough physical examination and radiographic and neuromuscular studies may not result in a specific diagnosis, but it can indicate whether the abnormality is in the CNS, peripheral nerves or muscles. Before elective withdrawal of ventilatory support, an edrophonium chloride challenge test should be performed to rule out myasthenia gravis.
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Ruiz, Geovanny, Norberto J. Torres-Lugo, Pablo Marrero-Ortiz, Humberto Guzmán, Gerardo Olivella, and Norman Ramírez. "Early-onset scoliosis: a narrative review." EFORT Open Reviews 7, no. 8 (August 1, 2022): 599–610. http://dx.doi.org/10.1530/eor-22-0040.
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Early-onset scoliosis (EOS) is defined as any spinal deformity that is present before 10 years old, regardless of etiology. Deformity must be evaluated based on the intercorrelation between the lungs, spine, and thorax. Curvatures of early-onset have increased risk of progression, cardiorespiratory problems, and increased morbidity and mortality. Progression of the deformity may produce thoracic insufficiency syndrome, where a distorted thorax is unable to support normal respiratory function or lung growth. Management and treatment of EOS should pursue a holistic approach in which the psychological impact and quality of life of the patient are also taken into consideration. Growth-friendly surgical techniques have not met the initial expectations of correcting scoliotic deformity, promoting thoracic growth, and improving pulmonary function.
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Miniati, Doug, Eric B. Jelin, Jennifer Ng, Jianfeng Wu, Timothy R. Carlson, Xiaoqing Wu, Mark R. Looney, and Rong A. Wang. "Constitutively active endothelial Notch4 causes lung arteriovenous shunts in mice." American Journal of Physiology-Lung Cellular and Molecular Physiology 298, no. 2 (February 2010): L169—L177. http://dx.doi.org/10.1152/ajplung.00188.2009.
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Lung arteriovenous (AV) shunts or malformations cause significant morbidity and mortality in several distinct clinical syndromes. For most patients with lung AV shunts, there is still no optimal treatment. The underlying molecular and cellular etiology for lung AV shunts remains elusive, and currently described animal models have insufficiently addressed this problem. Using a tetracycline-repressible system, we expressed constitutively active Notch4 (Notch4*) specifically in the endothelium of adult mice. More than 90% of mice developed lung hemorrhages and respiratory insufficiency and died by 6–7 wk after gene expression began. Vascular casting and fluorescent microsphere analysis showed evidence of lung AV shunts in affected mice. Cessation of Notch4* expression reversed these pathophysiological effects. Assessment of the vascular morphology revealed enlarged, tortuous vessels in the lungs that resembled arteriovenous malformations. By using whole lung organ culture, we demonstrated the effects of constitutively active Notch4 on the lung vasculature to be a primary lung phenomenon. Together, our results indicate the importance of Notch signaling in maintaining the lung vasculature and offer a new, reliable model with which to study the pathobiology of lung arteriovenous shunts and malformations.
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Magnani, Jessie E., and Steven M. Donn. "Persistent Respiratory Distress in the Term Neonate: Genetic Surfactant Deficiency Diseases." Current Pediatric Reviews 16, no. 1 (April 9, 2020): 17–25. http://dx.doi.org/10.2174/1573396315666190723112916.
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: Respiratory distress is one of the most common clinical presentations in newborns requiring admission to a Neonatal Intensive Care Unit (NICU). Many of these infants develop respiratory distress secondary to surfactant deficiency, which causes an interstitial lung disease that can occur in both preterm and term infants. Pulmonary surfactant is a protein and lipid mixture made by type II alveolar cells, which reduces alveolar surface tension and prevents atelectasis. : The etiology of surfactant deficiency in preterm infants is pulmonary immaturity and inadequate production. Term infants may develop respiratory insufficiency secondary to inadequate surfactant, either from exposure to factors that delay surfactant synthesis (such as maternal diabetes) or from dysfunctional surfactant arising from a genetic mutation. : The genetics of surfactant deficiencies are very complex. Some mutations are lethal in the neonatal period, while others cause a wide range of illness severity from infancy to adulthood. Genes that have been implicated in surfactant deficiency include SFTPA1, SFTPA2, SFTPB, SFTPC, and SFTPD (which encode for surfactant proteins A, B, C, and D, respectively); ABCA3 (crucial for surfactant packaging and secretion); and NKX2 (a transcription factor that regulates the expression of the surfactant proteins in lung tissue). : This article discusses the interplay between the genotypes and phenotypes of newborns with surfactant deficiency to assist clinicians in determining which patients warrant a genetic evaluation.
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Jansson, I., R. Eriksson, S. O. Liljedahl, L. Lovén, L. Rammer, and S. Lennquist. "Importance of Early Fracture Stabilization in Preventing Post-Traumatic Pulmonary Changes." Prehospital and Disaster Medicine 1, no. 3 (1985): 213–18. http://dx.doi.org/10.1017/s1049023x00065675.
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Adult respiratory distress syndrome (ARDS) is the most fatal complication after severe trauma (1,3). ARDS is seen in multiple injured patients with fractures and the risk for ARDS increases with the number of fractures (9). One of the theories concerning the etiology in ARDS is, that tissue thromboplastine from the site of the fracture and surrounding soft tissue activates the coagulation system resulting in pulmonary microembolism (6). Riska (8) has noticed by clinical experience that increased frequency of early fracture stabilization by internal fixation in multiply injured patients has dramatically reduced the frequency of post-traumatic respiratory insufficiency. The aim of the present study was to investigate the effect of primary fracture immobilization on post-traumatic pulmonary changes in pigs. We used a model in which anesthetized pigs can be subjected to trauma and then observed for several days, while still under anesthesia, under careful respiratory and circulatory control, by means of repeated chest x-rays and postmortem macroscopic and microscopic examination of lung tissue.Twenty-six pigs (Swedish Landrace), weight 17–23 kg were used. Chest x-rays were done in all animals before the experiment excluding those pigs with any pulmonary changes. The pigs were anesthetized with pentobarbital and pethidine, and tracheostomy, carotid artery cateterization and cystostomy were performed.
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Hadzic, Devleta, Nada Mladina, Mirsada Praso, Selmira Brkic, and Belkisa Colic. "CHARACTERISTICS OF CHILDHOOD DIFFICULTIES IN BREATHING SYNDROME." Acta Medica Saliniana 37, no. 2 (December 28, 2008): 151–56. http://dx.doi.org/10.5457/ams.v37i2.14.
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Introduction: Syndrome of difficulties in breathing has an important position in pathology of childhood. It is manifested as in diseases of respiratory tract so in series of diseases and pathological conditions linked to other organs and systems. Patients and Methods: Patient with difficulties in breathing develops clinical presentation of respiratory distress, which is characterized with many different clinical symptoms and signs. Acute respiratory failure with discrepancy between utility of oxygen and produces of carbon dioxide is the last point of respiratory distress, so the primary care of clinician is quickly recognition of abnormal blood gasses values. Early identification and appropriate treatment of incoming respiratory failure is essential for good prognosis and decreasing long term complications. The aim of this paper was to analyze retrospectively histories of diseases of children treated at the Department of Intensive care Pediatrics clinic in Tuzla and to establish type and frequency of diseases characterized with syndrome of difficult breathing, frequency of non-respiratory diseases in etiology of this syndrome, and to estimate correlation of clinical findings in admission with pulse oximetry and blood gases findings. Analysis was based on population of patients treated at the Department of Intensive care unit Pediatrics clinic in Tuzla with recorded, clinically manifested syndrome of difficult breathing. Patient selection was performed consecutively from January 1st till 31st December 2006. All selected patients were from Tuzla Canton. Source of data for this investigation was Admission protocol for Pediatric Clinics and Intensive care unit protocol and personal histories of children treated at the Intensive care unit of Pediatric Clinics January 1st till 31st December 2006. Method of work was retrospective study which analyzed anamnestic data, clinical and laboratory findings, therapeutical procedures and length of hospitalization at the Intensive care unit and outcome of the treatment. Results: The results of investigation demonstrated that in anlized period (from January 1st till 31st December 2006) in Pediatric Clinic, Tuzla a total number of 3932 children were treated, out of them 767 (19.5%) children were treated at the Department of Intensive care unit. Syndrome of difficulties in breathing was recorded in 608 patients (79.3%). The biggest number of children in this group were treated for syndrome of broncho-obstruction, total of 332 children (54.6%). Other large group was neurological disorders: convulsions and epilepsy, total number of 125 patients (20.6%). Out of total number of patients 11 (1.8%) suffered from complete failure of breathing and required mechanical ventilation support. Out of this number 10 of them were chronic ill patients. The most common causal factor for respiratory insufficiency in strict meaning of this word and endangering respiratory arrest was epileptic attack and recidivated pneumonia. Discussion: Clinical findings, pulse oximetry and blood gases analysis were in correlation and in favor of hypoxemic type of respiratory insufficiency. Results of gas analysis for group of neurological disorders and poisoning spoke in favor of acute hypercapnic respiratory insufficiency. Clinical parameters for dyspnea were absent and finding of pulse oximetry monitored isolated for these disorders demonstrated partly unreliable.
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Ribeiro-Mourão, Francisco, Ana Vilan, Sara Passos-Silva, Fernando Silveira, Miguel Leão, and Mafalda Sampaio. "Intrafamilial Variability of the R694C Variant in BICD2 Presenting with Lethal Severe Arthrogryposis." Journal of Neonatology 36, no. 1 (January 11, 2022): 63–68. http://dx.doi.org/10.1177/09732179211068815.
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Arthrogryposis multiplex congenita (AMC) is a heterogeneous condition comprising congenital multiple joint contractures, and it is secondary to decreased fetal mobility following environmental/genetic abnormalities. BICD2 pathogenic variants have been associated with autosomal dominant spinal muscular atrophy with lower extremity predominance (SMALED2). We report the case of a newborn with decreased fetal movements and ventriculomegaly diagnosed in utero, born with severe AMC, multiple bone fractures, congenital hip dislocation, and respiratory insufficiency that led to neonatal death. His mother had AMC diagnosis without established etiology. Her phenotype characterization was key to guide the genetic investigation. A BICD 2 heterozygous variant (NM_001003800.1; c.2080C > T; p. [Arg694Cys]) was detected both in the mother and the newborn. This variant had previously been reported in 3 cases, all having de novo severe SMALED-type 2B (MIM#618291) phenotype. This is the first report of this variant (p. [Arg694Cys]) presenting with an inherited, severe, and lethal phenotype associated to intrafamilial variability, suggesting a more complex phenotype-genotype correlation than previously stated.
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Radunz, Sonia, Carmen Kirchner, Jürgen Treckmann, Andreas Paul, and Fuat H. Saner. "AspergillusTracheobronchitis Causing Subtotal Tracheal Stenosis in a Liver Transplant Recipient." Case Reports in Transplantation 2013 (2013): 1–4. http://dx.doi.org/10.1155/2013/928289.
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Invasive aspergillosis is recognized as one of the most significant opportunistic infections after liver transplantation. Diagnosis of invasive aspergillosis in transplant recipients has been proven to be challenging, and optimal approach to the treatment of invasive aspergillosis is still controversial. We here present an unusual case ofAspergillustracheobronchitis in the setting of liver transplantation. A 47-year-old female patient with persistent dry cough after liver transplantation developed respiratory insufficiency and was readmitted to the intensive care unit 55 days after liver transplantation. A CT scan revealed subtotal tracheal stenosis; bronchoscopy was performed, and extended white mucus coverings causative of the tracheal stenosis were removed. Microbiological assessment isolatedAspergillus fumigatus. The diagnosis was obstructiveAspergillustracheobronchitis. The patient was started on a treatment of voriconazole 200 mg orally twice daily, adjusted to a trough level of 1–4 mg/L. For further airway management, a tracheal stent had to be implanted. The patient is alive and well 28 months after liver transplantation. Invasive aspergillosis should be considered a possible etiology in liver transplant patients presenting with unspecific symptoms such as persistent dry cough. Optimal strategies for improved and early diagnosis as well as prophylaxis need to be defined.
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Ermolaeva, Yuliya A., Yu G. Samoilova, O. A. Oleynik, and D. A. Kudlay. "The clinical case: COVID-19 in a child with chronic kidney disease." Russian Journal of Infection and Immunity 12, no. 3 (July 4, 2022): 585–90. http://dx.doi.org/10.15789/2220-7619-tcc-1732.
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Since the spread of the novel coronavirus infection, most researchers have noted a low proportion of sick children in general pediatric cohort compared to adults, who had a mild disease course and rare complications. The most frequent clinical manifestations of the disease are respiratory and, some less frequently diarrheal syndromes. The disease has predominantly mild or asymptomatic course. The risk of adverse outcomes in children, similar to adults, clearly correlate with the presence of background chronic pathology. The need for respiratory support prevails in children with a severe premorbid burden. Here, a clinical case of ongoing novel coronavirus infection in adolescent patient comorbid with chronic kidney pathology is described. In adolescence, the patient was diagnosed with mesangioproliferative glomerulonephritis (IgA-nephropathy), and further registered at the dispensary receiving a combination therapy with angiotensin converting enzyme inhibitors and disaggregation drugs. The epidemiological history contained no established contacts with infectious patients. The clinical manifestations of COVID-19 in the patient are represented by catarrhal and diarrheal syndromes, transient renal dysfunction in the acute period of the disease. The onset of coronavirus infection was clinically characterized by symptoms of damaged gastrointestinal tract and was considered as acute gastroenteritis of infectious etiology. Empirically prescribed antibacterial therapy in combination with antiplatelet agents and symptomatic drugs had no effect. The diagnosis of the novel coronavirus infection was verified only on day 4 of hospitalization, clinical and laboratory signs of lung damage emerged. The inflammatory process developed in the patient lungs was secondary to the main pathology. The severity of the patients condition was determined by the presence of respiratory and renal insufficiency. Lung damage with minimal severity complaints and clinical data had a bimodal pattern and required respiratory support. A comprehensive approach to treatment, including respiratory, antiviral, enterosorption, anticoagulation, anti-inflammatory, antihypertensive, hepatoprotective, symptomatic therapy with change in antibacterial drugs allowed to achieve positive dynamics. On day 12 of the illness, the patient required no respiratory support. The presence of symptoms of gastrointestinal tract damage in COVID-19 necessitates the mandatory inclusion of PCR assay for SARS-CoV-2 into diagnostic protocol in patients with diarrheal syndrome to perform etiological disease interpretation.
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Arcellana, Anna Elvira, Kenneth Wilson Lim, Marlon Arcegono, and Cecilia Jimeno. "PSUN32 Critical Illness-Related Corticosteroid Insufficiency (CIRCI) Among Patients with COVID-19 at a Tertiary Hospital: Clinical Characteristics and Outcomes." Journal of the Endocrine Society 6, Supplement_1 (November 1, 2022): A129. http://dx.doi.org/10.1210/jendso/bvac150.263.
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Abstract Introduction A significant number of patients afflicted with COVID-19, a viral illness caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), present with refractory shock, hemodynamic instability, acute respiratory distress syndrome and other severe manifestations of infection, warranting intensive care. Among critically ill patients, there is usually impairment of the hypothalamic-pituitary- adrenal axis, leading to a condition known as critical illness-related corticosteroid insufficiency (CIRCI). Currently, the incidence of CIRCI among critically ill patients with COVID-19 is unknown. There is also a paucity of data on how CIRCI is likely a significant risk factor for poor clinical outcomes in COVID-19 infected patients. Addressing this knowledge gap will shape decision-making in the intensive care setting because CIRCI is a treatable condition, and intervention for CIRCI in the form of glucocorticoids, when utilized in the appropriate context, is potentially lifesaving. Objectives The aims of this investigation were to determine the occurrence of CIRCI among patients with COVID-19 as well as to analyze the clinical characteristics and outcomes of these critically ill patients. Methodology This was a single-center, retrospective, cohort study that investigated the occurrence of CIRCI among critically ill patients infected with COVID-19. A chart review among admitted patients was done. Results In this cohort, there were 145 COVID-19 patients included. The median age of the patients was at 63 years old and the study population comprised of 57.24% males. Septic shock was the top etiology of shock at 72.22% of the population. The median Sequential Organ Failure Assessment (SOFA) score was 13 which suggests that most of the patients included in the study had a very high mortality rate, 40-50% risk of death. There was a high rate of organ dysfunction. For COVID-19 patients in refractory shock, there was a high rate of utilization of steroids at 70.83%. After corticosteroids were initiated, blood pressure improved in 70.45% of the patients. Patients who were given corticosteroids were found to have statistically significant longer median days on ventilator (p= 0.001). However, those on the corticosteroid arm were at higher risk of morbidity and mortality as signified by statistically significant higher APACHE II scores (p = 0.0233), MPM scores (p = 0.006), and a greater proportion of patients with acute kidney injury (p= 0.028), oliguria, (p= 0.020) and CNS dysfunction (p = 0.019). Significant predictors of mortality in CIRCI are higher MPM and APACHE II scores and longer time to initiation of steroids. Conclusion There is a substantially high incidence of CIRCI among critically ill patients infected with COVID-19. CIRCI has a unique presentation among COVID-19 patients because of the presence of a high level of inflammation in this life-threatening infection. It is a harbinger of markedly increased risk of mortality in these patients. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.
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Irqsusi, Marc, Azza Labene Mansouri, Anette Ramaswamy, Peter Rexin, Midhat Salman, Saqib Mahmood, Nikolas Mirow, et al. "Role of matrix metalloproteinases in mitral valve regurgitation: Association between the of MMP‐1, MMP‐9, TIMP‐1, and TIMP‐2 expression, degree of mitral valve insufficiency, and pathologic etiology." Journal of Cardiac Surgery 37, no. 6 (March 28, 2022): 1613–22. http://dx.doi.org/10.1111/jocs.16449.
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Макарова, Galina Makarova, Ушакова, Elena Ushakova, Решетникова, Larisa Reshetnikova, Судаков, et al. "THE IMPORTANCE OF UNFAVOURABLE FACTORS OF POSTNATAL ONTOGENESIS IN THE DEVELOPMENT OF THE THREAT OF PREMATURE DELIVERY IN THE SECOND TRIMESTER OF PREGNANCY IN WOMEN INFECTED WITH THE HERPES SIMPLEX VIRUS." Bulletin physiology and pathology of respiration 1, no. 61 (September 15, 2016): 59–65. http://dx.doi.org/10.12737/21455.
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The features of postnatal development in 160 women with physiologic course of pregnancy and with chronic placental insufficiency in the second trimester of pregnancy in the patients infected with the herpes simplex virus type 1 (HSV-1) were studied. The first group (the control group) included 30 women with physiologic course of pregnancy. The second group had 41 patients with chronic placental insufficiency of herpes etiology. The third group consisted of 89 women with chronic placental insufficiency and the threat of premature delivery caused by HSV-1. It was found out that in neonatal period of development and in the course of the first year of life the patients of the third group unlike the women of the second group oftener had bottle feeding (30.3 and 9.8%, respectively, р<0.05) and the period of breast feeding of less than 6 months (39.3 and 14.6%, respectively, р<0.05), and in the early childhood and infancy there was the combination of chicken pox and Botkin’s disease (39.3 and 7.3%, respectively, p<0.05), as well as enteritis and enterocolitis (28.1 and 7.3%, respectively, р<0.05). The women in the third group unlike the patients of the second group in the early childhood oftener had acute respiratory virus infections (40.4 and 14.6%, respectively, р<0.05) and lymphadenopathy (37.1 and 12.2%, respectively, р<0.05), and in the school and middle age there was algodismenorrhea (34.8 and 12.2%, respectively, р<0.05), cervical erosion (56.2 and 24,4%, respectively, р<0.05), a big number of gynecological operations (21.3 and 4.9%, respectively, р<0.05) and chronic rhinitis (47.2 and 19.5%, respectively, р<0.05). In the third group unlike the second one the signs of the secondary immunodeficiency prevailed. They were revealed through early infecting with VSH-1 (26.9 and 7.3%, respectively, р<0.05%), reactivation (identification of IgM to HSV-1) of chronic herpesvirus infection (21.3 and 4.9%, respectively, р<0.05%), thrush (16.9 and 2.4%, respectively, р<0.05) and relapsing course of Herpes labialis (22.5 and 4.9%, respectively, p<0.05). We suggest an important role of immunodeficiency in pathogenesis of the threat of premature delivery of herpes virus genesis in the second trimester of gestation and the necessity of the use of immunomodulatory medications for its treatment.
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Hayes, Clarissa, Emily Skutnik, Fatima Kutty, Shamsuddin Shaik, Marc Stezzi, and Theresa Maitz. "ODP273 Schmidt Syndrome Causing Multiorgan Failure." Journal of the Endocrine Society 6, Supplement_1 (November 1, 2022): A434. http://dx.doi.org/10.1210/jendso/bvac150.902.
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Abstract Introduction To our knowledge there has not been a case report published on the acute presentation of Schmidt syndrome (Polyglandular Autoimmune Syndrome Type 2) in which all three manifestations of type 1 diabetes mellitus (T1DM), primary adrenal insufficiency, and hypothyroidism were found and diagnosed at the same time. Case Description A 32-year-old male with suspected alcohol abuse presented to the hospital with nausea, vomiting, and weakness of two weeks duration after sustaining a fall. He was admitted for Diabetic Ketoacidosis (DKA) and shock requiring three pressors with unclear etiology. Labs were significant for severe hyponatremia of 113 mmol/L (136-145), elevated anion gap of 22, glucose 206 mg/dL (70-100), bicarbonate 11mmol/L (21-31), beta hydroxybutyrate 5.90 mmol/L (0. 0-0.42), and pH 7.22 (7.35-7.45) with Hemoglobin A1c 14.5% (<5.7). An insulin drip was instituted for DKA and the hyponatremia persisted. Cortisol was found to be suppressed at 3. 0 ug/dL (3.1-22.4) with significantly elevated ACTH 220.4 pg/mL (7.2-63.3) suggesting a new diagnosis of primary adrenal insufficiency. IV hydrocortisone 100 mg q8H was started on day 2 of hospitalization. Thyroid labs showed elevated TSH 10.10 uIU/mL (0.36-3.74) confirming hypothyroidism, prompting initiation of IV levothyroxine. His hospital course was complicated by cardiac arrest and acute respiratory failure requiring intubation. Cardiac work up was negative except for severe non-ischemic cardiomyopathy with significantly reduced ejection fraction of 20-25%. Bronchoscopy was performed and showed no evidence of obstructing pulmonary etiologies. SARS Coronavirus PCR was negative. He also had shock liver along with Disseminated intravascular coagulation (DIC). His kidney function worsened requiring continuous kidney replacement therapy (CRRT). Urine microscopy showed granular casts consistent with acute tubular necrosis. TPO antibodies, adrenal antibodies, GAD antibodies, and Zinc Transporter 8 antibodies all came back positive along with an undetectable C- peptide confirming the diagnosis of Hashimotos hypothyroidism, primary adrenal insufficiency, and T1DM respectively. He was eventually discharged on basal bolus insulin regimen, levothyroxine 75 mcg po daily, fludrocortisone 0. 05 mg po daily, and prednisone 5 mg po daily. The patient had multifactorial shock from an acute presentation of DKA, primary adrenal insufficiency, and hypothyroidism all presenting simultaneously. Conclusion This case illustrates the severe impact of having three endocrine organs affected all at once. The prevalence of Schmidt syndrome is very low at 1: 20,000 in the general population and can be associated with other non-endocrine autoimmune disorders. Prevalence of autoimmune thyroid disease is 70%, T1DM 50%, and Addison's disease is almost 100%. Due to the low prevalence, one needs a high clinical suspicion with the correct lab findings to diagnose this disease. Incorrect diagnoses or a late diagnosis can lead to life threatening consequences to the patient. The mainstay of treatment is hormone replacement, with corticosteroids given before thyroid replacement. Presentation: No date and time listed
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Bohra, Jasraj, and Chuba Kumzuk L. C. R. "Etiological study of jaundice in neonates." International Journal of Contemporary Pediatrics 6, no. 5 (August 23, 2019): 1881. http://dx.doi.org/10.18203/2349-3291.ijcp20193600.
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: Jaundice is the commonest abnormal finding with an incidence of about 60% in term babies and 80% in preterm babies. It is the commonest cause of admission to hospitals in the newborn period. In preterm babies, the percentage is exceedingly high due to their physiological handicaps and other hazards of prematurity like Asphyxia, septicemia, respiratory and circulatory Insufficiency. Non-physiological or pathological jaundice is also known to occur in (8-9)% of newborns. Its timely detection and optimal management are crucial to prevent brain damage and subsequent neuro-motor retardation. Aims of this study to find out the etiology of jaundice in neonates, admitted in neonates unit attached to SMS medical college Jaipur.Method: This Observational study was conducted in Neonatal Intensive Care Unit (NICU) and Post Natal Ward attached to SMS medical college Jaipur, after approval from the hospital ethical committee, over a period of 12 months(October 2011 to September 2012. Study was carried on 500 neonates presenting clinically with neonatal hyperbilirubinemia.Result: The onset of jaundice was seen maximum between live hour 24-72 hours (n=290, 58% cases), followed by live hour 72 hours-14 days (n=160, 32%). At more than 2 weeks there was only 3 case (0.6%). The etiological factors in the causation of jaundice in the decreasing order of frequency were exaggerated physiological jaundice accounts for (28%), ABO-incompatibility (24.4%), Rh-incompatibility (13.8%), Idiopathic (10.4%), cephalhematoma (10.2%), septicemia (6%), intrauterine infections (4%), BMJ (1.8%), Galactocemia (0.8%) and G6PD Deficiency (0.6%) respectively.Conclusion: Hyperbilirubinemia is more severe in newborns, therefore precautionary measure should be adopted by both parents, and clinicians to diagnose and treat the diseases properly.
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Deetjen, Birgit, Ulf Liljenqvist, Tobias L. Schulte, Carolin Schmidt, Tobias Lange, Nani Osada, and Viola Bullmann. "Left convex thoracic scoliosis: retrospective analysis of 25 patients after surgical treatment." Coluna/Columna 10, no. 3 (2011): 205–10. http://dx.doi.org/10.1590/s1808-18512011000300008.
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OBJECTIVE: A retrospective analysis of clinical and radiological data was conducted, with an emphasis on perioperative complications and risk factors and a minimum follow-up period of two years. The postoperative quality of life was assessed using the SRS-22 questionnaire. METHODS: Between 1999 and 2009, 25 patients (nine male, 16 female) with LCTS, with a mean age of 13.7 years (2.3-29.8 years), were treated with correction and instrumented fusion at a single institution. Seven patients had congenital scoliosis and 18 patients had noncongenital scoliosis (idiopathic, n = 5; neuropathic, n = 4; neoplasm-associated/iatrogenic, n = 3; secondary to other conditions, n = 6). The average preoperative Cobb angle was 74° (49-102°). RESULTS: A mean correction of 51% was achieved postoperatively. The mean Cobb angle at the final follow-up examination was 45° (19-85°), with a significant loss of correction of 8.8° on average. Major complications affected five patients (20%): respiratory insufficiency requiring prolonged intubation, intraoperative cardiac arrest with resuscitation being necessary twice in one patient, persistent clonus, low-grade infection, implant-based complications requiring revision surgery, and adding-on. Minor complications were observed in 22 patients (88%), mainly gastrointestinal and pulmonary. No cases of paraplegia or death occurred. A noncongenital etiology had been diagnosed before the age of 10 years in all of the patients who had major complications. The best score on the SRS-22 questionnaire was achieved in the domain of pain (87%), while the poorest was in the domain of self-image (68%). CONCLUSIONS: The results of this study emphasize an increased complication rate in patients with LCTS scheduled for scoliosis surgery. Additional preoperative examinations (MRI, paediatric consultation, cardiologic consultation, pulmonary function test) are mandatory in patients with LCTS. Preoperatively, patients should be informed about the increased cardiopulmonary and neurological risk which may be associated with scoliosis surgery.
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Bezhenar, Vitaly F., Lidia A. Ivanova, and Mikhail Yu Korshunov. "Analysis of perinatal losses in Saint Petersburg and the Leningrad region in 2006–2018." Journal of obstetrics and women's diseases 69, no. 2 (June 21, 2020): 93–102. http://dx.doi.org/10.17816/jowd69293-102.
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Hypothesis/aims of study. Prevention of the most common causes of perinatal mortality provides an opportunity to reduce perinatal losses. It is customary to distinguish between maternal, fetal and placental factors, dividing them into preventable and unavoidable subfactors. Of all nosologies, intrauterine hypoxia and asphyxia of the newborn, infectious (viral and / or microbial) damage to the placenta and fetus / newborn, and placental insufficiency (acute and chronic) are most important. The aim of this study was to analyze perinatal losses most often diagnosed in Saint Petersburg and the Leningrad Region in order to assess the possibility of developing a set of measures to reduce perinatal mortality.
Study design, materials and methods. The analysis of perinatal losses in Saint Petersburg and the Leningrad Region in 20062018 is based on the official reports of the Saint Petersburg State Budgetary Healthcare Institution Medical Information and Analytical Center and the Leningrad Regional State Budgetary Healthcare Institution Medical Information and Analytical Center, as well as the reports of the Leningrad Regional Pathological and Anatomical Bureau (LRPAB).
Results. The main causes of perinatal losses in Saint Petersburg and the Leningrad Region for 20062018 were: fetal hypoxia (acute and chronic), intrauterine infections, respiratory distress syndrome (for premature babies), congenital malformations, and chromosomal abnormalities. Throughout the period, intrauterine hypoxia and asphyxia of the newborn (which are the pathology manifestation, not etiology) were indicated as leading diagnoses in the conclusions of perinatal death. Moreover, according to the LRPAB pathomorphological findings, intrauterine infections were the leading (over 60% of cases) cause of perinatal losses over the years. During the analyzed period in Saint Petersburg and the Leningrad Region, a high frequency of individual states arising in the perinatal period remained unchanged without determination of a specific diagnosis, which significantly complicates our analysis.
Conclusion. For an adequate diagnosis of the etiological mechanisms of perinatal losses, it is necessary to improve histological examination of the afterbirth and pathomorphological examination of the fetus / newborn using virological and immunological tests. It is also necessary to change the structure of statistical reports, obliging medical institutions to indicate the exact cause of perinatal death, excluding whenever possible the diagnoses of intrauterine hypoxia and asphyxia in labor that indicate no etiological diagnosis explaining the occurrence of hypoxia / asphyxia.
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Ricci, Marco, Maria R. Suarez, Anthony L. Panos, Francisco Igor B. Macedo, Michael Brown, Julia Alba, and Tomas A. Salerno. "Complex Aortic Valve Surgery for Endocarditis Using the Beating-Heart Technique." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 4, no. 2 (March 2009): 106–12. http://dx.doi.org/10.1097/imi.0b013e3181a20e52.
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Objective Surgical outcomes of aortic valve surgery for endocarditis are poor. Postoperative deterioration of left ventricular (LV) function may contribute to this process. To enhance preservation of myocardial function during aortic valve surgery, we have used a beating-heart technique of myocardial protection without cardioplegic arrest. The aim of this article is to report our initial clinical experience with this technique. Methods We identified 30 consecutive patients with endocarditis who underwent aortic valve repair (one patient) or replacement using either a mechanical prosthesis (four patients) or a biologic prosthesis (25 patients) with beating-heart technique. There were 22 men and eight women (mean age 52.8 ± 16.1 years). There were one elective, 22 urgent/emergent, and seven “salvage” operations. Two patients had preoperative stroke, five respiratory failure, three renal failure, 12 congestive heart failure, eight septic shock, and one previous coronary artery bypass grafting. The etiology of the infection was identified in 15 patients (50%). Ten patients had severe, seven moderate, and four mild aortic insufficiency. All patients had vegetations, four had annular abscesses, and two had intracardiac fistulas. Results Eight patients (26.6%) had redo procedures. Concomitant procedures included aortic and mitral valve procedure (14 patients), tricuspid valve procedure (two patients), and coronary artery bypass grafting (one patient). Aortic annular reconstruction was required in four patients (13.2%). Total CPB time was 125 ± 67 minutes. Intra-aortic balloon pump was needed in one patient. Two patients (6.6%) had a stroke unrelated to air embolism. Mean follow-up was 7.9 ± 12 months. Early mortality (30 days) was 13.3% (four patients), and late mortality was 10% (three patients). Total mortality was 18% in urgent/emergent cases, and 42% in salvage operations. There was no statistical difference between preoperative and postoperative echocardiographic values of LV function (ejection fraction and fractional shortening). LV end-diastolic dimension decreased postoperatively (P = 0.03), whereas LV end-systolic dimension and left atrial size were unchanged. Conclusions Our study did not show improved survival benefits of beating-heart aortic valve surgery compared with historical series in which conventional myocardial protection was used. However, our findings suggest that beating-heart technique is an alternative strategy of myocardial protection that may contribute to preservation of LV function in patients undergoing complex operations for aortic valve endocarditis.
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Golomidov, A. V., E. V. Grigoriev, V. G. Moses, and K. B. Moses. "Pathogenesis, Prognosis and Outcomes of Multiple Organ Failure in Newborns (Review)." General Reanimatology 18, no. 6 (December 20, 2022): 37–49. http://dx.doi.org/10.15360/1813-9779-2022-6-37-49.
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Multiple organ failure (MOF) is the leading cause of neonatal mortality in intensive care units. The prevalence of MOF in newborns is currently unclear, since its incidence varies in asphyxia, sepsis, prematurity, and comorbidity, and depends on the level of development and funding of health care in different countries. Sepsis and acute respiratory distress syndrome prevail among the causes of MOF in this category of patients.Aim of the review. To summarize the available literature data on the pathogenesis, therapeutic strategies and outcomes of MOF in newborns.Material and methods. We searched PubMed, Scopus, Web of Science, and RSCI databases using the following keywords: «newborns, multiple organ failure, etiology, pathogenesis, premature, diagnosis, treatment, respiratory support, cardiotonic support», without language limitations. A total of 144 full-text sources were selected for analysis, 70% of which were published in the last five years and 50% were published in the last three years. Criteria for exclusion were low information value and outdated data.Results. The prevalence of MOF in neonates is currently unclear. This could be due to common association of neonatal MOF (as well as the adult one) with various diseases; thus, its incidence is not the same for asphyxia, sepsis, prematurity, and comorbidities. There is no precise data on neonatal mortality in MOF, but according to some reports, it may be as high as 13-50%.In newborns, MOF can be caused by two major causes, intrapartum/postnatal asphyxia and sepsis, but could also be influenced by other intranatal factors such as intrauterine infections and acute interruption of placental blood flow.The key element in the pathogenesis of neonate MOF is cytokinemia, which triggers universal critical pathways. Attempts to identify different clinical trajectories of critical illness in various categories of patients have led to the discovery of MOF phenotypes with specific patterns of systemic inflammatory response. This scientific trend is very promising for the creation of new classes of drugs and individual therapeutic pathways in neonates with MOF of various etiologies.The pSOFA scale is used to predict the outcome of neonatal MOF, however, the nSOFA scale has higher validity in premature infants with low birth weight.Central nervous system damage is the major MOF-associated adverse outcome in newborns, with gestational age and the timing of treatment initiation being key factors affecting risk of MOF development in both full-term and premature infants.Conclusion. The study of cellular messengers of inflammation, MOF phenotypes, mitochondrial insufficiency, and immunity in critically ill infants with MOF of various etiologies is a promising area of research. The pSOFA scale is suggested for predicting the outcome of MOF in full-term infants, while the nSOFA scale should be used in premature infants with low birth weight.
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Saleh, Mohammed A. A., Ewoudt M. W. van de Garde, and J. G. Coen van Hasselt. "Host-response biomarkers for the diagnosis of bacterial respiratory tract infections." Clinical Chemistry and Laboratory Medicine (CCLM) 57, no. 4 (March 26, 2019): 442–51. http://dx.doi.org/10.1515/cclm-2018-0682.
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Abstract Appropriate antibiotic treatment for respiratory tract infections (RTIs) necessitates rapid and accurate diagnosis of microbial etiology, which remains challenging despite recent innovations. Several host response-based biomarkers due to infection have been suggested to allow discrimination of bacterial and non-bacterial microbial RTI etiology. This review provides an overview of clinical studies that investigated the diagnostic performance of host-response proteomic biomarkers to identify RTI microbial etiology. Procalcitonin and C-reactive protein have been studied most extensively; whereof procalcitonin has demonstrated the strongest diagnostic performance compared to other biomarkers. Proadrenomedullin, soluble triggering receptor expressed on myeloid cells-1, neopterin and pentraxin-3 need more studies to confirm their diagnostic value. For syndecan-4 and lipocalin-2 currently insufficient evidence exists. Common limitations in several of the studies were the relatively small scale setting, heterogeneous patient population and the absence of statistical power calculation.
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Asad, Z., A. Chaudhary, and UZ Bhutta. "ID: 55: FIBRILLARY GLOMERULONEPHRITIS:LOOKS LIKE AMYLOID BUT ITS NOT!" Journal of Investigative Medicine 64, no. 4 (March 22, 2016): 958.2–959. http://dx.doi.org/10.1136/jim-2016-000120.97.
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IntroductionFibrillary glomerulonephritis is a rare disorder with a prevalence of 1% in renal biopsies.The mean age of presentation is 50 years, proteinurea in 100%, nephrotic syndrome in 70–75%, renal insufficiency (Cr≥1.5) in 50–55%, hypertension 70% and hematuria in 70% cases.Etiology is unknown and diagnosis is established by pathognomonic electron microscopy findings. This case illustrates the presentation, workup and diagnosis of fibrillary glomerulonephritis (FGN).Case DescriptionA 49 year-old-female with history of hypertension, obstructive sleep apnea,non-steroidal anti inflammatory drug use for chronic back pain presented with shortness of breath on exertion and bilateral lower extremity swelling.Vital signs showed temperature 35.6 C, heart rate 75/min, respiratory rate 21/min and blood pressure 112/68 mm Hg.She had mild respiratory distress, bilateral crackles at lung bases and bilateral +2 pedal edema on physical examination.Complete blood count showed hemoglobin 10.7 g/dl and normal white cell count. Complete metabolic panel showed creatinine 1.1 mg/dl, blood urea nitrogen 21 mg/dl, albumin 2.6 g/dl and normal electrolytes. Urinalysis showed pH 6.0,specific gravity 1.028,+4 proteinuria,+2 hematuria and no casts. 24hour urine collection showed 4.3 g/day nephrotic proteinuria. Lipid profile showed cholesterol 308 mg/dl and non-HDL cholesterol 246 mg/dl.Hepatitis C, HIV, Goodpasture Disease, Cryoglobulinemia, Systemic Lupus Erythematosus and other autoimmune diseases were ruled out by appropriate tests. Serum and urine protein electrophoresis were without M-spike but with high free Lambda (29.7 mg/dl) and Kappa chains (23.6 mg/dl). A diagnosis of nephrotic syndrome was made due to the presence of edema, proteinuria, hypoalbuminemia and hyperlipidemia.A renal biopsy was done to evaluate the etiology of nephrotic syndrome. Biopsy showed focal segmental and global glomerulosclerosis with mild to moderate interstitial fibrosis and tubular atrophy. Immunofluorescence showed staining of glomerular capillary walls and mesangium for IgG, kappa and lambda. Electron microscopy showed linear, non-branching fibrils in the mesangium that averaged 20 nm in width (11.7–28.6 nm).Congo red staining was negative.DiscussionA study of 66 cases identified most common histologic patterns as mesangial, membranoproliferative, endocapillary proliferative, crescentic and necrotizing, membranous and diffuse sclerosing in order of likelihood.This case had focal segmental and global glomerulosclerosis that is a rare finding.In the same study immunofluorescence staining was positive for IgG in 100%, C3 in 92% and both kappa and lambda in 84% cases. This case also demonstrated positive staining for IgG, kappa and lambda.The pathognomonic finding is presence of fibrillary deposits in the mesangium and glomerular capillary walls distinct from amyloidosis.The size of fibrils ranges from 8–15 nm in Amyloid and 12–24 nm in FGN. IgG is usually monoclonal in AL Amyloid as compared to polyclonal in FGN. The characteristic difference from amyloid is absence of reaction to histochemical dyes like Congo Red and Thioflavin T in FGN.One third of FGN cases are associated with malignancy, monoclonal gammopathy and autoimmune disorders. In our case an extensive workup was negative for all these conditions.Angiotensin inhibitors (ACEI) are used if the glomerular filtration rate is normal and proteinuria is present,to control blood pressure and reduce disease progression. Evidence for use of steroids and immunosuppressants is based on uncontrolled studies with variable success.In our patient a limited trial of corticosteroids with mycophenolate resulted in some improvement in proteinuria alongwith ACEI.
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Ivan I. Kalyuzhny, Ivan A. Nikulin, Aleksandr M. Gertman, Andrey A. Elenshleger, Sergey Yu. Smolentsev, Olga A. Gracheva, Dina M. Mukhutdinova, and Zulfiyat M. Zukhrabova. "Peculiarities of respiratory pathology of young cattle in the lower Volga region Russian Federation." International Journal of Research in Pharmaceutical Sciences 11, no. 2 (May 7, 2020): 2360–64. http://dx.doi.org/10.26452/ijrps.v11i2.2214.
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An important element in solving problems relating to the preservation of young cattle livestock and production increase of livestock products is a timely diagnosis, prevention and treatment of diseases of non-communicable etiology, among which one of the most common is bronchopneumonia. Therefore, the development of effective methods of treatment and prevention of this pathology is an urgent problem of veterinary medicine. Despite a large number of scientific researches, many issues of etiology, pathogenesis, treatment and prevention of this disease remain insufficiently studied, especially the state of the natural resistance of calves suffering from catarrhal bronchopneumonia, which is the basis for choosing a method of treatment and prevention of this disease. The disease leads to calves deep, sometimes irreversible disturbances of bronchopulmonary system functions. Lung function is one of the first to be disrupted, playing an important role in the protective immunological reactions of the body, through which there is an increase in virulence of microorganisms, which leads to the general intoxication and severe bronchopneumonia. The situation on non-specific bronchopneumonia of calves in the Lower Volga region is tense, but it is to the same extent as in other regions having problems with this pathology. It is obvious that the susceptibility of calves to respiratory diseases is formed under the influence of antenatal influences and is manifested in the presence of adverse environmental factors leading to depletion of reserves adaptation in the first months of animal life. The obtained set of regional characteristics of bronchopneumonia of non-infectious etiology allows to consider this pathology as an indicator of the ecological unwell-being of big cattle herds in the Lower Volga region.
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Kanner, E. V., A. V. Gorelov, D. V. Pechkurov, M. L. Maksimov, and A. S. Ermolayeva. "Why do acute respiratory infections in children remain a pressing problem? Current, prevention and treatment options." Medical Council, no. 17 (November 24, 2019): 198–206. http://dx.doi.org/10.21518/2079-701x-2019-17-198-206.
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Literary data on peculiarities of immune system, anti-infectious immunity, including local protection of respiratory tract (lymphaticepithelial pharyngeal system), in children of early and preschool age, causing their higher incidence of acute respiratory infections (ARI) are given in the article. This age period is characterized by «physiological» humoral immune deficiency, reduced activation of the complement system, insufficient synthesis of cytokines, including interferons, T-cell immunosuppression, impaired intercellular cooperation, poor functional activity of natural killers and phagocytes. Despite the large range of means and methods of prophylaxis of infectious and inflammatory diseases of viral and bacterial etiology, it is necessary to search for new approaches taking into account the peculiarities of immune status in young children. The article presents the possibilities of controlling the system of congenital and adaptive immunity with medications, in particular, by using the bacterial lysate Broncho-munal®. The immunoregulatory role of bacterial lysates is presented in detail. The pathogenetic substantiation of the use of bacterial lysate Broncho-munal® for the prevention of acute respiratory infections in children, including children with recurrent respiratory infections is given.
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Skopets, A. A., I. A. Kornilov, and E. S. Afonin. "Importance of extracorporeal membrane oxygenation (ECMO) in therapy for legionella pneumonia in patient with hairy-cell leucosis." Innovative medicine of Kuban, no. 3 (September 21, 2019): 44–48. http://dx.doi.org/10.35401/2500-0268-2019-15-3-44-48.
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Clinical observation of the patient with legionella pneumonia which developed in the setting of hairy-cell leukosis, required use of extracorporeal membrane oxygenation for controlling life-threatening hypoxia is presented. Active diagnostic approach for identification of the etiologic agent (Legionella pneumophila, Acinetobacter baumannii) that caused pneumonia, allowed to choose an optimum set of antibacterial agents and medicines for specific therapy of hemoblastosis (BRAFV600E mutation and use of Zelboraf). After correction of respiratory insufficiency and discontinue the patient from ECMO, we could reach hematologic remission and transfer the patient to the Institute of Hematology for further treatment.
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Rüegg, Stephan. "Nonconvulsive Status Epilepticus in Adults: Types, Pathophysiology, Epidemiology, Etiology, and Diagnosis." Neurology International Open 01, no. 03 (June 2017): E189—E203. http://dx.doi.org/10.1055/s-0043-103383.
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AbstractNonconvulsive status epilepticus (NCSE) is defined by permanent electroclinical nonconvulsive epileptic activity or a series of nonconvulsive seizures without recovery to baseline. This “silent” manifestation of lasting neurological symptoms, like aphasia, confusion, etc., impedes easily recognizing NCSE. The most important diagnostic step often is to consider the possibility of NCSE. NCSE can only be confirmed by an immediate EEG recording. Epidemiological studies show slight preponderance of convulsive status epilepticus (CSE) over NCSE (60:40%); however, this might result from lack of recognition of NCSE because of its very unspectacular manifestation. Regarding pathophysiology, the neuronal mechanisms are identical for both NCSE and CSE, but they spare the primary motor neurons. Permanent hyperexcitability may damage the neurons involved in NCSE the same way as the motor neurons in CSE. However, NCSE is spared from the life-threatening secondary pathophysiological sequelae of CSE (lactic acidosis, respiratory exhaustion, rhabdomyolsis, etc.). Nevertheless, autonomic dysregulation (arrhythmias (ventricular tachycardia/asystolia), apneas) may also expose the patient to substantial acute risks. There are a myriad of causes for NCSE and they are mainly medication errors (insufficient adherence or addition of new drugs with interactions) in patients with known epilepsy. In these patients and in those without known epilepsy, other causes include metabolic, toxic, structural (tumors, hemorrhages, ischemia), infectious, inflammatory, and autoimmune causes. Thus, it is germane to extensively search for the cause of the NCSE because the immediate and proper therapy of the underlying cause of, especially the acute symptomatic, forms of NCSE is at least as important as the antiictal treatment.
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Louie, M., B. Dyck, S. Parker, L. Sekla, and L. E. Nicolle. "Nosocomial Pneumonia in a Canadian Tertiary Center: A Prospective Surveillance Study." Infection Control & Hospital Epidemiology 12, no. 6 (June 1991): 356–63. http://dx.doi.org/10.1086/646356.
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AbstractObjective:To determine the contribution of etiologic agents, including Legionellapneumophilaand respiratory viruses to nosocomial pneumonia at a tertiary care center.Design:Prospective surveillance of nosocomial pneumonia with standardized laboratory investigations.Setting:A 1,100-bed tertiary care center.Patients:All adult inpatients.Results:One hundred and thirty-five Nosocomial pneumonias (5.7/1,000 discharges) were identified. Four (3.0%) were L pneumophila sero-group 1 infections (0.17/1,000 discharges). LegionelIosis occurred in non-high-risk patients, and three cases would not have been identified without active surveillance. viral seroconversion was identified in seven (19%) of 36 cases with specimens available (0.59/1,000 discharges): five influenza B, one influenza A, and one respiratory syncytial virus. IgM serology was positive in one case each for Mycoplasma pneumoniae and Chlamydia species. No geographical clustering was observed for viral infections, and these would not have been identified without active surveillance. Mortality for all nosocomial pneumonia was 25%. Patient factors significantly associated with a poorer outcome included older age, underlying disease, low serum albumin, renal insufficiency, lower platelet count, endotracheal intubation, respiratory failure, bacteremia, and use of antacids.Conclusions:This prospective surveillance suggested that L pneumophila and viral agents were uncommon causes of nosocomial pneumonia at our institution during this surveillance period.
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Fesenko, M. Yе, L. S. Zyuzina, M. M. Fastovets, O. O. Kalyuzhka, and O. I. Melashchenko. "ACUTE RESPIRATORY RECURRENT INFECTIONS IN CHILDREN." Актуальні проблеми сучасної медицини: Вісник Української медичної стоматологічної академії 19, no. 4 (November 13, 2019): 34–38. http://dx.doi.org/10.31718/2077-1096.19.4.34.
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Introduction. Insufficient research work on the study of local immunity in children with frequent respiratory recurrent diseases has become the basis for this work. Goal. To study the negative impact of various pathogenic factors on the formation of acute respiratory recurrent infections in children. Materials and methods. 201 children under 3 years of age and 219 children from 3 to 7 years old who attended children's preschools in Kyiv were observed in the dynamics. Indices of local immunity, by the content of immunoglobulins in the secretion of the nasal passages, were studied in comparison with the data of the anamnesis and clinical examination of children; with functional condition of the nasal mucosa (presence of catarrhal phenomena); with the presence and excretion of viral and bacterial microflora in the upper respiratory tract; with the presence of chronic foci of infection in the nasopharynx (tonsillitis, adenotonitis); with a period that has elapsed after preventive vaccinations and transferred respiratory diseases. Research results. Based on the obtained data, changes in local immunity in the examined children were detected under the influence of factors of external and internal environment: birth of children from pathological pregnancy and childbirth; presence of hypochromic anemia, exudative diathesis, chronic tonsillitis of staphylococcal etiology, adenotonsillitis, recurrent and asthmatic bronchitis in children; high infection rate of children with viruses, pathogenicity of pathogenic staphylococcus and streptococcus, fungi of the genus Candida. It was found that the lowest frequency of detection of immunoglobulins of all classes was observed in children with streptococcus in pharynx and its associations with staphylococcus. Conclusions. The published data on the value of local immunity in terms of immunoglobulins in children with frequent respiratory recurrent diseases and its tendency to various changes under the influence of external and internal environmental factors indicate the feasibility of improving treatment and prevention measures, which include the use of agents that enhance the effectiveness of local respiratory protection.
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Bardenikova, S. I., N. K. Shumeyko, O. V. Zaitseva, S. Y. Snitko, E. A. Melnikova, E. V. Kulikova, and O. B. Dovgun. "Reflux-associated respiratory syndrome in children: a survey of algorithms in medical practice." Russian Journal of Allergy 15, no. 5 (December 15, 2018): 64–75. http://dx.doi.org/10.36691/rja127.
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Purpose. Based on the clinical analysis of the course of BOS with GER, rational diagnostic algorithms are available in practical medicine. Materials and methods. The study included BOS children examined in the pulmonology department of the DGKB St. Vladimir in 2010-2017 years: patients with asthma (annually from 850 to 1000) and children with obstructive bronchitis (annually from 122 to 400). General clinical, laboratory, serological, instrumental studies were conducted. In cases of insufficient control of asthma and recurrent (or prolonged) BOS esophagogastroduodenofibroscopy and radiopaque examination of the esophagus was performed for revealing GER. Results. The mutual risks of weighting the symptoms of combined asthma with GERD in children are discussed. Attention is focused on the peculiarities of complaints, history and the status of patients with BOS in combination with comorbid diseases. Pulmonology department statistics data demonstrate the growing need for gastroenterological research. The rational algorithms for examination of BOS patients for the detection of GERD are discussed. Conclusion. Due to the high frequency of GER in patients with bronchial asthma and its influence on disease control, a comprehensive study of its symptoms is necessary. The presence of recurrent BOS, ETN comorbidity, night cough demands to exclude the role of GER in etiology of respiratory disorders.
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Smirnova, A. V., Iu F. Semiglazova, and D. A. Kuzmina. "Evaluation of hemomicrocirculation of periodontal tissues in localized periodontitis of traumatic etiology." Parodontologiya 26, no. 1 (March 5, 2021): 73–79. http://dx.doi.org/10.33925/1683-3759-2021-26-1-73-79.
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Relevance. The necessity of somatic health evaluation in patients with local inflammatory periodontal processes is determined by frequent relapses of the periodontal diseases. Low effectiveness of the widespread treatment methods and the lack of long-term remission of the disease is caused by the insufficient assessment Based on the clinical examination, diagnosis and laboratory tests, to determine the correlation between the somatic pathology and adaptability of the adult body in patients with localized periodontitis due to trauma. Materials and methods. Advanced examination was carried out in 169 subjects, aged 45-75 y.o., with mild to moderate localized periodontitis due to trauma. The somatic condition was assessed by laboratory and functional tests. Results. 1-2 somatic diseases were revealed in 39.3% of patients with mild localized periodontitis caused by trauma (periodontal pocket depth up to 4 mm). 3 and more comorbidities were detected in 35.3% of patients. Gastrointestinal problems, cardiovascular diseases, allergic conditions, anemiа and respiratory diseases were most frequently encountered. In moderate localized periodontitis caused by trauma and periodontal depth of 4-6 mm, 23.9% of patients had 1-2 comorbidities, while 62.7% of patients had 3 and more diseases. Gastrointestinal problems, cardiovascular diseases, anemia, allergic conditions and urogenital diseases were more frequent. A strong correlation was revealed between the type of adaptive reaction and the degree of localized periodontitis caused by trauma. Thus, the risk of moderate localized traumatic periodontitis development increases by 1.8 times in tense adaptive reaction, and by 3.45 times - in poor adaptation reaction. Conclusion. Functional condition of the body adaptability, which is essential for the development of the treatment strategy, could be determined by the evaluation of the physical condition, peripheral blood tests (entropy of WBC differential, C-reactive protein) in patients with localized periodontitis caused by trauma. The adaptive reaction tension and decrease were detected in patients with 3 or more comorbidities.
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Briko, Nikolay I., Vladimir A. Korshunov, and Kirill S. Lomonosov. "Pneumococcal infection in Russia: state of the issue." Annals of the Russian academy of medical sciences 76, no. 1 (April 12, 2021): 28–42. http://dx.doi.org/10.15690/vramn1404.
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Background: Pneumococcal disease is common cause of morbidity and mortality in adults and children worldwide. The severity of pneumococcal diseases determines their high socio-economic significance.
Aims: Estimate the burden of pneumococcal infection and vaccination coverage in Russia.
Methods: The data was obtained from federal surveillance system. The information obtained was analyzed using descriptive statistics methods.
Results: The annual incidence of community-acquired pneumonia in Russia was 491.7/100000 in 2011-2019. It ranges from 359.8/100000 among adults of working age to 1505.4/100000 among children 1-2 years old. The upward trend of incidence is observed throughout the period, most expressive among school-age children (7-17 years old). Total 29.2% of all pneumonia have an identified etiology. 94% of pneumonia with known etiology are bacterial, 8.4% among it are pneumococcal.
Pneumonia accounts for 57% of all deaths from respiratory diseases among children under five (3.7/100000) and 34% among elderly. The death rate from pneumonia in 2009-2018 tends to decrease. In 2018, 25.5 thousand deaths from pneumonia were registered (17.5/100000). The highest rate is observed among children under one year (14.0 /100000) and elderly (41.2 /100000).
There is a downward trend in incidence of otitis media. The incidence in children under 14 was 2612.6/100 000 in 2018. The incidence of bacterial meningitis is 1.4/100 000. Every year 2-3 thousand cases are registered, 43-52% of which are among children (3.04/100000., maximally in children under one year old, 13.2/100000).
The level of vaccination against pneumococcal infection is increasing annually, but the proportion of children who have received a completed course of vaccination remains insufficient (64.6% in 2019). Coverage among the adult population was 2.3% (3.8% among those over 60). The main contingents of vaccinated adults are conscripts (coverage 67.4%) and people with chronic lung diseases (coverage 15.1%).
Conclusions: The socio-economic and epidemiological burden of diseases associated with pneumococcal infection in Russia remains high. Accurate assessment of morbidity and mortality rates caused by St. pneumoniae diseases isnt possible due to the insufficient level of their ethological identification. Further efforts are required to achieve high level of herd immunity against pneumococcal infection through vaccine prevention during COVID-19 pandemic.
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Ghia, Canna J., and Gautam S. Rambhad. "A systematic literature review on the prevalence and etiology of meningitis among critically ill and hospitalized patients in India." Therapeutic Advances in Infectious Disease 8 (January 2021): 204993612110464. http://dx.doi.org/10.1177/20499361211046453.
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Background: In India, owing to multiple factors, such as insufficient laboratory capacity, poor reporting systems due to limited access to healthcare facilities and limited disease surveillance programmes, the actual disease burden of meningitis is unknown and may be largely under-reported. Objective: A systematic literature review was performed to describe: (a) the prevalence of meningitis; and (b) its etiological pathogen across different regions, age groups and patients with comorbidities. Method: A systematic literature search was conducted between 1990 and 2020 using PubMed and Google Scholar databases to identify Indian studies reporting the prevalence rates and etiology of meningitis. A total of 51 studies were included in the final analysis. Results: A total of 38 studies reported prevalence of meningitis and 21 studies reported data on the etiology of meningitis in India. These studies included mixed patient populations: (a) pyogenic meningitis; (b) meningitis in sick or hospitalized patients with tuberculosis, acute febrile encephalopathy syndrome, septicaemia, invasive pneumococcal disease or respiratory compromise; and (c) meningitis patients with comorbidities. The prevalence of confirmed bacterial meningitis in the pediatric population (0–14 years) ranged between 0.5% and 61.8%. A total of seven studies reported the prevalence of meningitis in patients of all age groups (0–75 years), with prevalence ranging between 8.68% and 78.85%. Cryptococcal meningitis was predominant in patients with positive HIV/AIDS, with a prevalence ranging between 2.09% and 53.1%. Streptococcus pneumoniae was found to be the predominant pathogen causing meningitis across different regions of India, with a frequency ranging from 4% to 61.8% in patients of all age groups. Conclusion: This systematic literature review displayed the possible range of frequency of bacterial meningitis pathogens across a wide variety of age groups in different regions of India. Further studies are warranted to monitor meningitis cases, which may facilitate the development of prevention and treatment strategies in India.
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Friman, Göran, and Christer Rolf. "INFECTIONS AND RELATED DISORDERS IN SKELETAL MUSCLE, HEART MUSCLE, CONNECTIVE TISSUES, TENDONS AND LIGAMENTS IN ATHLETES." Journal of Musculoskeletal Research 04, no. 04 (December 2000): 231–47. http://dx.doi.org/10.1142/s0218957700000331.
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Elite athletics requires maximum effort by the pursuer, exposing the tendons, ligaments and muscles, including the heart muscle, to intense and frequent mechanical and metabolic demands, which may increase the susceptibility to, and severity of, infections in these tissues. Furthermore, intense and frequent exercise with insufficient resting periods can compromise the immune system. Muscles and tendons are more vulnerable to overuse injuries in the recovery period following various infections. Although the etiology and pathogenesis of a substantial proportion of cases of tendinitis and tendinosis are still largely unknown, gram-positive cocci prevail as the most common etiologies in soft tissue infections. The recent identification of binding sites of staphylococci to intercellular tissue matrix components have opened up the possibility of selectively blocking such binding by prior vaccination. New molecular biological methods, enabling the identification of slow-growing bacteria that are difficult to culture, including Bartonella and Rickettsia, have created the possibility of studying the potential role also of such organisms in soft tissue conditions, including myocarditis. Acute myocarditis remains the most frequent form of myocarditis, commonly emerging in the course of an acute respiratory infection. Since myocarditis episodes are frequently subclinical and self-healing, athletes (and others) should generally be recommended rest during infections, especially during the early phase of the infection.
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Argollo, Nayara, Ines Lessa, Suely Ribeiro, Katiusha C. Abreu, Juliana M. S. Pinto, Raquel P. Faria, Tatiana G. Telles, and Gabriel Santos. "Brain white matter lesions correlated to newborns death and lethality." Revista Brasileira de Saúde Materno Infantil 6, no. 2 (June 2006): 231–38. http://dx.doi.org/10.1590/s1519-38292006000200011.
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OBJECTIVES: to describe hospital lethality rates and factors correlated to death in neonates with brain white matter lesions. METHODS: a retrospective study was performed from January 1994 to December 2001. Neonates with white brain matter lesions were divided into survival and death groups and their medical files reviewed through the single blind method to determine evolution. Death certificates provided the cause of death. The groups were compared through correlation coefficients. Hospital lethality rate was calculated. RESULTS: ninety three cases of white brain matter lesions and seven deaths were determined. Hospital lethality rate was of 8.2.% (95%CI: 2.4-14.0) independently from lesion occurrence time, and of 10.3% (95%CI: 3.3-17.3) for deaths occurred during prenatal and perinatal periods. Death was correlated to: Apgar score, non-cephalic presentation, gestational age, hyperglicemia, hypercalcemia, convulsion, respiratory insufficiency and atelectasy. CONCLUSIONS: hospital lethality was of 10.3% generating the following hypothesis: perinatal asphyxia must be the principal direct and indirect etiologic factor (aggravating the expression of prematurity and infection diseases), of prenatal and perinatal mortality among newborns with white brain matter lesions; and <7 Apgar score in the 5th minute associated to brain white matter lesions, are markers for perinatal asphyxia diagnosis.
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Berger, Joseph R., Rachel Brandstadter, and Amit Bar-Or. "COVID-19 and MS disease-modifying therapies." Neurology - Neuroimmunology Neuroinflammation 7, no. 4 (May 15, 2020): e761. http://dx.doi.org/10.1212/nxi.0000000000000761.
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ObjectiveTo address concerns regarding the effect of MS disease-modifying therapies (DMTs) on the expression of coronavirus 2019 (COVID-19).MethodsReview of the current state of knowledge regarding the viral etiology of COVID-19, mechanisms of injury by SARS-CoV-2 infection, and the effect of individual DMTs on the risk of infection and COVID-19 disease expression.ResultsAlthough data are limited, MS DMTs do not obviously increase the risk of acquiring symptomatic SARS-CoV-2 infection. The severe morbidity and mortality of SARS-CoV-2 appear to be largely the consequence of an overly robust immune response rather than the consequence of unchecked viral replication. The effects of specific MS DMTs on the immune response that may increase the risk of impaired viral clearance and their potential counterbalancing beneficial effects on the development of COVID-19–associated acute respiratory distress syndrome are reviewed.ConclusionAlthough there is currently insufficient real-world experience to definitively answer the question of the effect of a specific MS DMT on COVID-19, registries presently in nascent form should provide these answers. This review provides an approach to addressing these concerns while the data are being accumulated. Early insights suggest that the risk of infection and associated morbidity of COVID-19 in this population is little different than that of the population at large.