The Sequential Clinical Assessment of Respiratory Function (SCARF) score: A dynamic pulmonary physiologic score that predicts adverse outcomes in critically ill rib fracture patients

BACKGROUND Rib fracture scoring systems are limited by a lack of serial pulmonary physiologic variables. We created the Sequential Clinical Assessment of Respiratory Function (SCARF) score and hypothesized that admission, maximum, and rising scores predict adverse outcomes among critically ill rib fracture patients. METHODS Prospective cohort study of rib fracture patients admitted to the surgical intensive care unit (ICU) at a Level I trauma center from August 2017 to June 2018. The SCARF score was developed a priori and validated using the cohort. One point was assigned for: 20, numeric pain score ≥5, and inadequate cough. Demographics, injury patterns, analgesics, and adverse pulmonary outcomes were abstracted. Performance characteristics of the score were assessed using the receiver operator curve area under the curve. RESULTS Three hundred forty scores were available from 100 patients. Median admission and maximum SCARF score was 2 (range 0-4). Likelihood of pneumonia (p = 0.04), high oxygen requirement (p
Source: The Journal of Trauma: Injury, Infection, and Critical Care - Category: Orthopaedics Tags: CWIS 2019 SUMMIT ARTICLES Source Type: research

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Authors: Underner M, Peiffer G, Perriot J, Jaafari N Abstract Cocaine can be responsible for many psychiatric and/or somatic disorders. The aim of this systematic literature review of data was to expose relations between cocaine use and pulmonary complications. Cocaine can be responsible for acute respiratory symptoms (cough, black sputum, hemoptysis, dyspnea, wheezing, chest pain) and for various pulmonary disorders including barotrauma (pneumothorax, pneumomediastinum, subcutaneous emphysema, pneumopericardium), airway damage, asthma, bronchiolitis obliterans with organizing pneumonia, acute pulmonary edema, alve...
Source: Revue des Maladies Respiratoires - Category: Respiratory Medicine Tags: Rev Mal Respir Source Type: research
A Woman With Dyspnea, Weight Loss, and Splenic Lesions. Chest. 2020 Jan;157(1):e13-e16 Authors: Hanberg JS, Dunne D Abstract CASE PRESENTATION: The patient is a 37-year-old hospital employee and current smoker with a 10 pack-year smoking history, who presented with dyspnea, chest pain, and weight loss. She was in her usual state of health until 4 months prior to admission when she developed intermittent left-sided chest pain, cough productive of scant yellow sputum, fevers, and anorexia. Initial chest radiograph was normal and her outpatient physician prescribed azithromycin, which she took ...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
This is a previously healthy male teenager who was awoken by chest pain.  He was seen at another hospital and found to have a slightly elevated troponin, then underwent a CT pulmonary angiogram (PE) protocol which revealed a right sided pneumonia.  He was treated with Ceftriaxone and azithromycin.p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Calibri; background-color: #fefefe}The pain is described as located in the midsternal area, radiating to the right arm, described as 8-9/10 and worse with deep inspirations.  He endorsed cough, fever, and body aches in the previous day...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
By SAURABH JHA, MD Slumdog TB No one knows who gave Rahul Roy tuberculosis. Roy’s charmed life as a successful trader involved traveling in his Mercedes C class between his apartment on the plush Nepean Sea Road in South Mumbai and offices in Bombay Stock Exchange. He cared little for Mumbai’s weather. He seldom rolled down his car windows – his ambient atmosphere, optimized for his comfort, rarely changed. Historically TB, or “consumption” as it was known, was a Bohemian malady; the chronic suffering produced a rhapsody which produced fine art. TB was fashionable in Victorian Britain...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Artificial Intelligence Health Tech Saurabh Jha TB tuberculosis Source Type: blogs
This report describes a fatal S stercoralis hyperinfection in a patient with nephrotic syndrome after treatment with steroids. Patient concerns: A 70-year-old male presented with a history of progressive edema, skin infection, persistent fever, cough, intermittent abdominal pain, and progressive respiratory failure after steroid treatment. Diagnosis: Nephrotic syndrome; cellulitis; S stercoralis hyperinfection; Klebsiella pneumonia. Interventions: During the first hospital admission, the patient was administered full-dose glucocorticoid and antibiotic therapy after suffering from cellulitis. During the second admi...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
ConclusionsRegular intravenous immunoglobulins combined with low-dose immunosuppression in addition to thymectomy appear to be safe when myasthenia gravis occurs in association with Good syndrome.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
Conclusion: There was no significant advantage of adding Codeine with paracetamol in suppressing cough during and after flexible bronchoscopy.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional pulmonology Source Type: research
A 74-year-old cis man presented to the emergency department (ED) with a 10-day history of diarrhea, cough, and fevers. The diarrhea began 10 days prior, was characterized by 15-20 watery, non-bloody stools per day, and associated with fevers. In the preceding week, he had developed a non-productive cough, shortness of breath, and pleuritic chest pain. Review of systems was unremarkable.
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Diagnostic Dilemma Source Type: research
Publication date: November 2019Source: Journal of the American College of Radiology, Volume 16, Issue 11, SupplementAuthor(s): Expert Panel on Thoracic Imaging, Christopher Lee, Patrick M. Colletti, Jonathan H. Chung, Jeanne B. Ackman, Mark F. Berry, Brett W. Carter, Patricia M. de Groot, Stephen B. Hobbs, Geoffrey B. Johnson, Fabien Maldonado, Barbara L. McComb, Betty C. Tong, Christopher M. Walker, Jeffrey P. KanneAbstractThe immunocompromised patient with an acute respiratory illness (ARI) may present with fever, chills, weight loss, cough, shortness of breath, or chest pain. The number of immunocompromised patients con...
Source: Journal of the American College of Radiology - Category: Radiology Source Type: research
We report an uncommon case of septic arthritis of the ankle from a Streptococcus pneumoniae infection and provide an update of the literature reported since 2002. A 58-year-old female presented to the hospital with right ankle pain and an inability to bear weight. She reported a history of productive cough, vomiting, diarrhea, and subjective fevers 4 days earlier. Streptococcus pneumonia was identified in her ankle aspirate, and she was treated urgently with operative incision and debridement, followed by postoperative intravenous antibiotics. At her 7-week follow-up, she demonstrated complete resolution of symptoms and ne...
Source: The Journal of Foot and Ankle Surgery - Category: Orthopaedics Source Type: research
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