Deadly Respiratory Distress Mimic

Conclusion It’s important for prehospital providers to be able to differentiate metabolic disturbances in the setting of respiratory distress and not be fooled into thinking tachypnea always has a respiratory cause. The physical exam and adjuncts such as end-tidal capnography can assist in the prehospital diagnosis. A COPD exacerbation generally presents as diminished lung sounds, wheezing on exhalation, and a prolonged expiratory phase. Here, a patient will attempt to compensate for the inflammation and mucus accumulation associated with the destruction and narrowing of peripheral airways and a subsequent lack of available space for air exchange. The EtCO2 may be increased in these patients as carbon dioxide accumulates due to air trapping; however, the physiologic deadspace associated with some forms or COPD may lower the EtCO2. Without knowing the patient’s baseline EtCO2, this value may be difficult to interpret in this setting and the physical exam will be more diagnostic. In this case, although the patient had a history of COPD and appeared to be in respiratory distress, her normal lung sounds and air entry heard on auscultation, the history of recent infection, and the decreased capnography  reading suggested she likely had a metabolic acidosis associated with sepsis. References 1. Kellum JA. Metabolic acidosis in patients with sepsis: Epiphenomenon or part of the pathophysiology? Crit Care Resusc. 2004;6(3):197–203. 2. Fuller BM, Dellinger RP. L...
Source: JEMS Special Topics - Category: Emergency Medicine Authors: Tags: Airway & Respiratory Exclusive Articles Patient Care Source Type: news

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CONCLUSION: Our three cases suggest that tocilizumab may be an effective and safe treatment for ocular manifestation associated with relapsing polychondritis. PMID: 32643976 [PubMed - as supplied by publisher]
Source: Ocular Immunology and Inflammation - Category: Allergy & Immunology Tags: Ocul Immunol Inflamm Source Type: research
CONCLUSION: Patients with thyroid disease were found to have a higher risk for uveitis. For certain age groups or patients without diabetes or hypertension, the role of thyroid disease might be more crucial for uveitis development. PMID: 32643974 [PubMed - as supplied by publisher]
Source: Ocular Immunology and Inflammation - Category: Allergy & Immunology Tags: Ocul Immunol Inflamm Source Type: research
This study aimed to investigate the prognostic value of PNR and PWR in acute ischemic stroke patients treated with EVT. METHODS: Poor functional outcome was defined as Modified Rankin Scale (mRS) of 3-6 at 3 months, Symptomatic intracranial hemorrhage (sICH) was diagnosed based on CT scan and classified according to the criterial of Heidelberg Bleeding Classification. Binary logistical regression was used to analyze the relationship of PWR, PNR with functional outcome and symptomatic intracranial hemorrhage (sICH). RESULTS: Patients with good prognosis had higher PNR and PWR value (29 vs. 24, P=0.002) (22 vs. 19, P...
Source: Neurological Research - Category: Neurology Tags: Neurol Res Source Type: research
Authors: Okosun IS, Nkemjika S, Okosun B, Lyn R, Airhihenbuwa CO Abstract AIM: To determine differences in lifestyle modification practices and use of prescription drugs in a representative sample of Mexican American (MA), non-Hispanic White (NHW), and non-Hispanic Black (NHB) elderly Americans with metabolic syndrome (MetS). METHODS: Data from the United States National Health and Nutritional Examination Surveys were used in this study. Lifestyle modification practices include ongoing physical activity, weight control, and ongoing diet modifications. Prescription drugs include anti-diabetic, anti-obesity, lipi...
Source: Journal of the National Medical Association - Category: General Medicine Tags: J Natl Med Assoc Source Type: research
Publication date: Available online 27 June 2020Source: Journal of NeuroradiologyAuthor(s): Jérôme Berge, Gaultier Marnat, Régis Hubrecht, Louis Veunac, François Rouanet
Source: Journal of Neuroradiology - Category: Radiology Source Type: research
HIGH blood pressure is a key risk factor for developing cardiovascular disease. A new research study has identified a certain type of berry that could slash the chances of developing the illness.
Source: Daily Express - Health - Category: Consumer Health News Source Type: news
Publication date: 11–17 July 2020Source: The Lancet, Volume 396, Issue 10244Author(s): Bruce C V Campbell, Pooja Khatri
Source: The Lancet - Category: General Medicine Source Type: research
Publication date: 11–17 July 2020Source: The Lancet, Volume 396, Issue 10244Author(s): Deepak L Bhatt, Philippe Gabriel Steg
Source: The Lancet - Category: General Medicine Source Type: research
Publication date: 11–17 July 2020Source: The Lancet, Volume 396, Issue 10244Author(s): Gerald Chi, Jolanta Marszalek
Source: The Lancet - Category: General Medicine Source Type: research
OBJECTIVES: Anemia and changes in platelets (PLT) are common in inflammatory bowel disease (IBD). In our study, we aimed to verify whether PLT count can independently reflect the severity of IBD. METHODS: In our hospital, 137 Crohn ’ s Disease (CD), 69 Ulcerative colitis (UC) patients, and 412 healthy controls were included to compare the differences in PLT count. In addition, the effect of anemia, C-reactive protein (CRP), age, CD activity index (CDAI) or Mayo on PLTs was also analyzed. If PLTs independently affected CD or UC, we used the receiver operating characteristic (ROC) curve to verify the diagnostic value a...
Source: Clinics - Category: General Medicine Source Type: research
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