• Title/Summary/Keyword: Intermediate syndrome

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Two Cases of Respiratory Failure After Recovery of Cholinergic Crisis in Organophosphate Poisoning: The Intermediate Syndrome (유기인제 중독에서 콜린성 위기 회복후 급성 호흡부전을 보인 Intermediate Syndrome 2예)

  • Cho, Dae-Kyoung;Lee, Seung-Eun;Baik, Jae-Joong;Chung, Yeon-Tae;Chung, Keun-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.2
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    • pp.247-254
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    • 1999
  • Respiratory failure is the most serious manifestation and usual cause of death in acute organophosphate poisoning, and is common in acute cholinergic crisis. But the respiratory failure may appear suddenly in a patient who is recovering from the cholinergic crisis, even while receiving conventional therapy. These are case report of 37 years old male and 24 years old female with intermediate syndrome in organophosphate poisoning. The two patients ingested organophosphate(fenthion and mixture of DDVP with chlorpyrifos respectively) incidentally and in a sucide attempt respectively. After apparent recovery from the cholinergic crisis with a conventional therapy but before the expected onset of delayed polyneuropathy, the respiratory failure appeared suddenly with a muscular weakness, affecting predominantly the proximal limb muscles, neck flexors, territories of several motor cranial nerves. The two patients needed mechanical ventilatory support and recovery from the intermediate syndrome was complete in both patients, although one subsequently developed hypoxic encephalopathy. The clinical manifestation and electrophysiologic study support the clinical diagnosis of intermediate syndrome. The syndrome carries a risk of death. because of respiratory paralysis, if not recognized early and treated adequatedly. Prompt endotrachial intubation and mechanical ventilatory support is the cornerstone of treatment of the intermediate syndrome. Therefore, all patient should be observed in a hospital for up to 5 days after poisoning.

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The Association between hs-CRP Concentration of Blood and Metabolic Syndrome in the Residents of a Rural Community (일부 농촌지역 주민들의 혈중 hs-CRP 농도와 대사증후군 위험인자와의 관계)

  • Kim, Jong-Im
    • Korean Journal of Community Nutrition
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    • v.15 no.6
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    • pp.796-805
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    • 2010
  • This study investigated the correlations and risk distribution differences between high sensitivity C-reactive protein (hs-CRP) and the diagnosis factors of metabolic syndrome among the residents of a rural community. Two thousand adults aged from 40 to 70 were recruited and 1,968 subjects were included in the study after excluding those with infectious disease or with hs-CRP higher than 10 mg/L in blood. The subjects were then divided into three groups of hs-CRP to examine the correlations and risk ratio with the risk factors of metabolic syndrome. There was a tendency of hs-CRP increasing according to the number of risk factors of metabolic syndrome. The risk ratio with hs-CRP according to metabolic syndrome significantly increased by 2.0 and 2.2 times in the intermediate and high risk group, respectively, compared with the low risk group. The risk ratio with the risk factors of metabolic syndrome according to hs-CRP rose in abdominal obesity, triglyceride, and W/Ht in the intermediate risk group of hs-CRP. The risk ratio also surged in high pressure, W/Ht, ex-drinking (1.7 times), exsmoking (2.0 times) and current smoking (2.0 times) in the high risk group. The results indicate that hs-CRP is related to the risk factors of metabolic syndrome and that it's very important to manage obesity including abdominal obesity and W/Ht and everyday habits including drinking and smoking.

A Case of Organophosphate Insecticide Intoxication by Repetitive Parenteral Exposure, Complicated with Intermediate Syndrome and Acute Pancreatitis (반복적인 비경구노출에 의한 유기인계 중독: 중간형증후군과 급성췌장염 1례)

  • Oh, Se-Hyun;Kang, Hui-Dong;Lee, Boo-Soo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.4 no.2
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    • pp.161-165
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    • 2006
  • Organophosphate insecticides, commonly used in agriculture, are a gradually increasing cause of accidental and suicidal poisoning. Intoxication can occur by ingestion, inhalation or dermal contact. Exposure to organophosphorus agents causes a sequentially triphasic illness consisting of the cholinergic phase, the intermediate syndrome, and organophosphate-induced delayed polyneuropathy. Acute pancreatitis as a rare complication of organophosphate intoxication has also been infrequently observed. We report a case of intoxication with organophosphate (phos-phamidon) by parenteral exposure (inhalation and/or dermal contact). A 34-year-old male patient was transferred to our Emergency Medical Center and was intubated due to a progressive respiratory failure. He presented with meiotic pupils, cranial nerve palsies, weak respiration, and proximal limb motor weaknesses without sensory changes. He had been employed in filling syringes with phosphamidon during the previous month. Because the patient's history and symptoms suggested organophosphate intoxication with intermediate syndrome, he was mechanically ventilated for 18 days with continuous infusion of atropine and pralidoxime (total amounts of 159 mg and 216 g, respectively). During his admission, hyperamylasemia and hyperli-pasemia were detected, and his abdominal CT scan showed a finding compatible with acute pancreatitis. He was administered a conservative treatment with NPO and nasogastric drainage. The patient was discharged and showed neither gastrointestinal nor neurologic sequelae upon follow up at one week and three months.

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The hs-CRP Levels and the Metabolic Syndrome according to Glucose Intolerance in Inhabitants of Rural Communities (한 농촌지역 주민들의 혈당장애에 따른 hs-CRP와 대사증후군)

  • Kim, Jong-Im
    • Research in Community and Public Health Nursing
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    • v.20 no.2
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    • pp.143-151
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    • 2009
  • Purpose: This study was to investigate the relations and odds ratio between hs-CRP and the risk factors of metabolic syndrome according to glucose intolerance and diabetes among the residents of a rural community. Methods: The subjects include 1,968 adults aged from 40 to 70 who were divided into four groups and a diabetes group according to glucose intolerance to compare the relations and risk ratio between hs-CRP and the risk factors of metabolic syndrome. Results: The results reveal that the greater the subjects' glucose intolerance was, the higher their hs-CRP became and the more risk factors of metabolic syndrome they had. The impaired glucose tolerance group showed 1.7 times higher blood pressure than the control group. The diabetes group showed a high odds ratio with 2.3 times higher blood pressure, 2.2 times higher abdominal obesity, and 2.4 times higherW/Ht than the control group. And the odds ratio increased significantly by 1.7 times in the hs-CRP intermediate risk group and 2.5 times in the high risk group compared with the control group. Conclusion: Considering the study results, it is very important to monitor abdominal obesity, blood pressure and the intermediate and high risk group of hs-CRP in order to reduce the contraction of cardiovascular diseases.

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Multihop Rate Adaptive Wireless Scalable Video Using Syndrome-Based Partial Decoding

  • Cho, Yong-Ju;Radha, Hayder;Seo, Jeong-Il;Kang, Jung-Won;Hong, Jin-Woo
    • ETRI Journal
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    • v.32 no.2
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    • pp.273-280
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    • 2010
  • The overall channel capacity of a multihop wireless path drops progressively over each hop due to the cascading effect of noise and interference. Hence, without optimal rate adaptation, the video quality is expected to degrade significantly at any client located at a far-edge of an ad-hoc network. To overcome this limitation, decoding and forwarding (DF), which fully decodes codewords at each intermediate node, can be employed to provide the best video quality. However, complexity and memory usage for DF are significantly high. Consequently, we propose syndrome-based partial decoding (SPD). In the SPD framework an intermediate node partially decodes a codeword and relays the packet along with its syndromes if the packet is corrupted. We demonstrate the efficacy of the proposed scheme by simulations using actual 802.11b wireless traces. The trace-driven simulations show that the proposed SPD framework, which reduces the overall processing requirements of intermediate nodes, provides reasonably high goodput when compared to simple forwarding and less complexity and memory requirements when compared to DF.

Gender difference in the association of metabolic syndrome with hs-CRP Concentration of Blood

  • Park, Se-Kwon
    • Korean Journal of Clinical Laboratory Science
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    • v.44 no.2
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    • pp.86-96
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    • 2012
  • The high sensitivity C-reactive protein (hs-CRP) as one of the typical acute phase reactants is used for predictive factor of the cardiovascular disease and diabetes mellitus. In addition, there are claims that must be included as factors of metabolic syndrome. This research examined the relationship between the concentration of hs-CRP in blood and risk factors of the metabolic syndrome by gender, and the rates of metabolic syndrome depending on the hs-CRP level based on the general public who took the comprehensive medical check-up at Chonbuk National University Hospital in the Jeonbuk province. The subjects aged 17-87 years were participated, and 2,000 people were included as the final subjects except the persons with more than 10 mg/L of the hs-CRP of blood level. The hs-CRP concentrations increased according to the number of risk factors of metabolic syndrome in both men and women. In regards to the risk ratio of metabolic syndrome based on hs-CRP level in blood according to gender, the risk ratio increased by 3.07 times in male and 4.55 times in female intermediate risk group and 3.60 times in male and 6.15 times in female high risk group compared to hs-CRP low risk group. As a result, there was a proportional relation between hs-CRP level and the occurrence of metabolic syndrome, and it occurs more frequently among women than men.

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The Relationship between Metabolic Syndrome and Korean Cardiocerebrovascular Risk Assessment: for Male Researchers in a Workplace (대사증후군과 뇌심혈관질환 발병위험도 평가와의 연관성: 일개 사업장 남성 근로자를 대상으로)

  • Yoon, Jong-Wan;Yi, Kyung-Jin;Lee, Sang-Yun;Oh, Jang-Gyun
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.5
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    • pp.397-403
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    • 2007
  • Objectives: The prevalence of metabolic syndrome has recently increased, Payments from the Korea Labor Welfare Corporation for compensation for mortality in workers caused by cardiovascular and cerebrovascular diseases have also increased in Korea in recent years. The association of metabolic syndrome and cardiocerebrovascular disease has been investigated by several researchers in recent studies, This study was conducted in an attempt to characterize the relationship between metabolic syndrome and Korean cardiocerebrovascular disease risk assessment, and to provide basic data to group health practices for the prevention of cardiocerebrovascular disease. Methods: Health examinations were previously conducted for 1526 male researchers at a private laboratory. The prevalence by age and the odds ratio of metabolic syndrome scores into the "cardiocerebrovascular risk group" (sum of low, intermediate, and high risk groups) of the Korean cardiocerebrovascular disease risk assessment were assessed, in an effort to elucidate the associations between metabolic syndrome and cardiocere brovascular disease risk assessment. Results: The prevalence of metabolic syndrome and inclusion in the cardiocerebrovascular risk group was 11,7% and 22.1% respectively. The severity of metabolic syndrome and cardiocerebrovascular risk assessment showed that individuals in their 40's and 50's were at higher risk than those in their 30's (p<0,001). The age-adjusted odds ratio of metabolic syndrome to cardiocere brovascular risk group inclusion was 5.6. Conclusions: An active prevention program for cardiocerebrovascular disease needs to begin in the 40's, as the prevalence of metabolic syndrome and the risk group of cardiocerebrovascular risk assessment peak in the 40's age group. The odds ratio between metabolic syndrome and the cardiocerebrovascular risk group was high, which indicates that metabolic syndrome scores should be utilized as guidelines during the consultation and behavioral modification program for the workplace prevention of cardiocerebrovascular diseases in group health practices.

Mechanism, clinical consequences, and management of dyslipidemia in children with nephrotic syndrome

  • Baek, Hee Sun
    • Childhood Kidney Diseases
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    • v.26 no.1
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    • pp.25-30
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    • 2022
  • Dyslipidemia in nephrotic syndrome (NS) is often characterized by marked increases in the levels of total cholesterol, triglycerides, low-density lipoprotein cholesterol, and other lipoproteins, such as very low-density lipoprotein, intermediate-density lipoprotein, and lipoprotein(a). It has been suggested that impaired catabolism of lipoproteins and cholesterol is mainly due to decreased lipoprotein lipase and hepatic lipase activity, and increased biosynthesis of lipoproteins in the liver. The management strategies for dyslipidemia in patients with NS consist of lifestyle modification, lipid-lowering agents represented by statins, second-line agents such as fibrates and bile acid sequestrants, and lipid apheresis. Compared with dyslipidemia in adult NS patients, whose risks of atherosclerotic disease and progressive renal injury are considered high, clinical data on dyslipidemia in pediatric NS patients are limited. Therefore, it is necessary to pay more attention to the evaluation and management of dyslipidemia in pediatric patients with NS in clinical practice.

The Impact of Educational Status on 10-Year (2004-2014) Cardiovascular Disease Prognosis and All-cause Mortality Among Acute Coronary Syndrome Patients in the Greek Acute Coronary Syndrome (GREECS) Longitudinal Study

  • Notara, Venetia;Panagiotakos, Demosthenes B.;Kogias, Yannis;Stravopodis, Petros;Antonoulas, Antonis;Zombolos, Spyros;Mantas, Yannis;Pitsavos, Christos
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.4
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    • pp.220-229
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    • 2016
  • Objectives: The association between educational status and 10-year risk for acute coronary syndrome (ACS) and all-cause mortality was evaluated. Methods: From October 2003 to September 2004, 2172 consecutive ACS patients from six Greek hospitals were enrolled. In 2013 to 2014, a 10-year follow-up (2004-2014) assessment was performed for 1918 participants (participation rate, 88%). Each patient's educational status was classified as low (<9 years of school), intermediate (9 to 14 years), or high (>14 years). Results: Overall all-cause mortality was almost twofold higher in the low-education group than in the intermediate-education and high-education groups (40% vs. 22% and 19%, respectively, p<0.001). Additionally, 10-year recurrent ACS events (fatal and non-fatal) were more common in the low-education group than in the intermediate-education and high-education groups (42% vs. 30% and 35%, p<0.001), and no interactions between sex and education on the investigated outcomes were observed. Moreover, patients in the high-education group were more physically active, had a better financial status, and were less likely to have hypertension, diabetes, or ACS than the participants with the least education (p<0.001); however, when those characteristics and lifestyle habits were accounted for, no moderating effects regarding the relationship of educational status with all-cause mortality and ACS events were observed. Conclusions: A U-shaped association may be proposed for the relationship between ACS prognosis and educational status, with participants in the low-education and high-education groups being negatively affected by other factors (e.g., job stress, depression, or loneliness). Public health policies should be aimed at specific social groups to reduce the overall burden of cardiovascular disease morbidity.

Clinical and Electrophysiological Features of the Patients with POEMS Syndrome (POEMS 증후군의 임상적, 전기생리학적 특성)

  • Min, Joo-Hong;Hong, Yoon-Ho;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.6 no.1
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    • pp.14-19
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    • 2004
  • Backgrounds and objectives: POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes) syndrome is the rare cause of polyneuropathy. Although the polyneuropathy is essential for the diagnosis of the disease, the pattern of electrodiagnostic abnormalities has not been characterized in detail. The purpose of this study was to elucidate the features of nerve conduction abnormalities in POEMS syndrome. Methods: We reviewed the medical records and nerve conduction studies (NCS) of 12 consecutive patients with POEMS. Results: A total of 68 motor and 46 sensory nerves were examined. Compound muscle action potentials (CMAPs) and sensory nerve action potentials were abnormally attenuated or not elicited in majority of motor and sensory nerves (80.88% in motor, and 82.6% in sensory nerves). Frequency of the nerves with no potential was significantly higher in lower limbs than in upper limbs (p<0.01 in both motor and sensory nerves), and CMAP amplitude was more reduced in lower limbs than in upper limbs (p<0.01). Conduction slowing was very frequently observed with 95% and 76% of motor and sensory nerves, respectively, having the abnormally reduced values of conduction velocity. Distal motor latencies were abnormally prolonged in 75% of motor nerves, and terminal latency indices were significantly higher in patients than in normal controls (p < 0.05). Conduction block was observed only in 5% of motor nerves. Conclusions: NCS in POEMS syndrome showed characteristic patterns, in which conduction abnormalities were more frequently and severely affected in the lower limbs, and more predominantly in the intermediate nerve segments than in the distal portions. The recognition of these characteristic patterns may be helpful in early diagnosis of polyneuropathy in POEMS syndrome.

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