A 64-Year-Old Man With Rapidly Progressive Respiratory Failure and Pneumomediastinum.

A 64-Year-Old Man With Rapidly Progressive Respiratory Failure and Pneumomediastinum. Chest. 2020 Jan;157(1):e5-e8 Authors: Kwon M, Mira-Avendano I, Khoor A, Mallea J Abstract CASE PRESENTATION: A 64-year-old man presented for consideration for lung transplant. He had a history of previous tobacco use, OSA on CPAP therapy, and gastroesophageal reflux disease. He worked as a design engineer. The patient had a 4-year history of dyspnea on exertion, followed with periodic CT scan of the chest. Nine months prior to his evaluation for lung transplant, the patient developed worsening of dyspnea, dry cough, poor appetite, and weight loss. At times, the cough was violent and associated with chest pressure. He was prescribed systemic corticosteroids and antibiotics without improvement. Four months later, the patient noted sudden onset of severe chest pain and worsening dyspnea. A CT scan of the chest demonstrated extensive pneumomediastinum in addition to changes consistent with pulmonary fibrosis. An esophagogram showed thickening of the distal esophagus, but no signs of perforation. He was prescribed supplemental oxygen and advised to stop the use of CPAP. The patient sought a second opinion. A CT scan of the chest showed improvement of the pneumomediastinum and extensive fibrotic lung disease. Pulmonary function tests (PFTs) were consistent with a restrictive pattern, decreased diffusing capacity (Dlco), and a preserved residual volume over total lung capacity...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research

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Dr. David Prezant was knocked fully airborne at 9:59 on the morning of Sept. 11, 2001. He didn’t see the impact coming, but he felt it when it hit—and it nearly killed him. Little more than an hour earlier, Prezant, then the deputy chief medical officer of the Fire Department of New York, was headed for his usual workplace at the FDNY’s Office of Medical Affairs, just across the Manhattan Bridge in Brooklyn. He had already heard that a plane had hit the North Tower of the World Trade Center, and he reckoned that it was an accident. By the time he reached his office, however, the South Tower had been struc...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized healthscienceclimate Source Type: news
Chest. 2021 Sep;160(3):e285-e288. doi: 10.1016/j.chest.2021.04.051.ABSTRACTA 58-year-old woman was referred to our department with a cough of 1 year duration; her condition was unresponsive to the administration of inhaled steroid and beta-2 agonists. She denied the presence of dyspnea, chest pain, or other extrapulmonary symptoms. She was a never-smoker with a negative medical history and no occupational or domestic exposures. There was no history of cancer, gastroesophageal reflux disease, asthma, allergic rhinitis, or other allergies.PMID:34488969 | DOI:10.1016/j.chest.2021.04.051
Source: Chest - Category: Respiratory Medicine Authors: Source Type: research
CONCLUSIONS: Treatment of GERD in children with CF seems not to have a stronger effect than a placebo on the severity of cough and abdominal pain. Considering this, as well as the previously raised concerns about the impact of chronic proton pump inhibitor treatment on the course of CF, perhaps one should be more careful in intensively treating suspected atypical GERD symptoms in patients with CF. PMID: 33577055 [PubMed - as supplied by publisher]
Source: European Review for Medical and Pharmacological Sciences - Category: Drugs & Pharmacology Tags: Eur Rev Med Pharmacol Sci Source Type: research
Patients with esophageal symptoms potentially associated with gastroesophageal reflux disease such as heartburn, regurgitation, chest pain, or cough represent one of the most frequent reasons for referral to gastroenterological evaluation. The utility of esophageal reflux monitoring in clinical practice is: (1) to accurately define reflux burden, (2) to segregate patients according to reflux monitoring results as true GERD, reflux hypersensitivity and functional heartburn, and (3) to establish a treatment plan.
Source: Digestive and Liver Disease - Category: Gastroenterology Authors: Tags: Review Article Source Type: research
Int Arch Otorhinolaryngol DOI: 10.1055/s-0039-3402437 Introduction Current practice guidelines in gastroesophageal reflux disease (GERD) often require invasive diagnostic testing. Objective The aim of the present study was to evaluate the significance of extra-esophageal symptoms and reliability of a screening risk score that is simple to use. Methods A longitudinal retrospective single-institution cohort study. Setting: A university clinical hospital tertiary referral center. The present study enrolled pediatric patients with symptoms suggestive of GERD: epigastric pain, occasional nausea, regurgit...
Source: International Archives of Otorhinolaryngology - Category: ENT & OMF Authors: Tags: Original Research Source Type: research
A few studies have shown that esophageal air events (EAEs), such as air-swallows, may be associated with symptoms that have historically been associated with gastroesophageal reflux disease (GERD). To objectively test a hypothesis that all EAE types (air-swallows, supragastric belches and gastric belches) can be associated with GERD-like symptoms, we removed the impedance “tags” from the GER episodes (placed during autoscan) and instead tagged either air-swallows, supragastric belches or gastric belches in each of 3 copies of the 24-hour impedance tracing for 2 infant patients who presented with symptoms sugges...
Source: Journal of Pediatric Gastroenterology and Nutrition - Category: Gastroenterology Tags: Short Communication: Gastroenterology Source Type: research
CONCLUSION Male gender and hiatal hernia were associated with EE. Aged patients, smoking and hiatal herni a were related to severe EE. It is suggested that the risk factors for EE and non-EE types are different. Cohort studies are necessary to identify the exact mechanisms involved in each disease form.RESUMO CONTEXTO: A doen ça do refluxo gastroesofágico (DRGE) é uma das doenças digestivas mais comuns na prática médica e deve ser suspeitada de acordo com os seus sintomas clínicos, podendo ser classificada em esofagite erosiva (EE) de acordo com os achados de endoscopia. OBJ...
Source: Arquivos de Gastroenterologia - Category: Gastroenterology Source Type: research
Discussion Gastrostomy tubes (GT or GTubes) have been used to support patients for about a century. They are placed between the abdominal skin and the stomach either percutaneously or surgically. The tubes can be a standard long tube with either a bumper or inflatable balloon internally and externally they have a retention piece to hold the GT in place. A button or low profile tube are similar but extend just beyond the skin. Reasons for GT placement include: Nutritional support Hydration maintenance Medication management Aspiration avoidance Gastric stasis decompression Obstruction bypass Quality of life improvement for...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
MK Abstract BACKGROUND: Many physicians insist patients lose weight before their hiatal hernia (HH) condition and related symptoms including intermittent esophageal dysphagia (IED) and gastroesophageal reflux disease (GERD) can be treated, but it is not proven that body mass index (BMI) has an impact on exercise-based treatment of HH-related symptoms. AIMS/OBJECTIVES: To investigate whether BMI has significance on IQoro® neuromuscular training (IQNT) effectiveness in treating HH-related symptoms. MATERIAL AND METHODS: Eighty-six patients with sliding HH and enduring IED and GERD symptoms, despite pr...
Source: Acta Oto-Laryngologica - Category: ENT & OMF Authors: Tags: Acta Otolaryngol Source Type: research
Discussion Potassium (K+) is an alkali metal (Group 1 of periodic table with Hydrogen, Lithium and Sodium) with an anatomic number of 19. Its chemical symbol K, comes from the medieval Latin, kalium which means potash (mainly potassium carbonate or potassium hydroxide), the substance it was first isolated from. Potassium is an important cation and it mainly resides in the intracellular fluid with only a small amount in the extracellular fluid. Potassium regulates cell volume, pH and enzyme functions. Hyperkalemia is defined as a potassium level> 5.5 mEq/L in children and> 6.0 mEq/L in newborns. Hyperkalemia incre...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
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