• Title/Summary/Keyword: severe distress

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Association among Lifestyle and Risk Factors with SARS-CoV-2 Infection

  • Yi Ko;Zi-Ni Ngai;Rhun-Yian Koh;Soi-Moi Chye
    • Tuberculosis and Respiratory Diseases
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    • v.86 no.2
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    • pp.102-110
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    • 2023
  • Coronavirus disease 2019 (COVID-19) has become a major health burden worldwide, with over 600 million confirmed cases and 6 million deaths by 15 December 2022. Although the acute phase of COVID-19 management has been established, the long-term clinical course and complications due to the relatively short outbreak is yet to be assessed. The current COVID-19 pandemic is causing significant morbidity and mortality around the world. Interestingly, epidemiological studies have shown that fatality rates vary considerably across different countries, and men and elderly patients are at higher risk of developing severe diseases. There is increasing evidence that COVID-19 infection causes neurological deficits in a substantial proportion to patients suffering from acute respiratory distress syndrome. Furthermore, lack of physical activity and smoking are associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) susceptibility. We should therefore explore why lack of physical activity, smoking, etc causing a population more susceptible to SARS-CoV-2 infection, and mechanism involved. Thus, in this review article, we summarize epidemiological evidence related to risk factors and lifestyle that affect COVID-19 severity and the mechanism involved. These risk factors or lifestyle interventions include smoking, cardiovascular health, obesity, exercise, environmental pollution, psychosocial social stress, and diet.

Early Surgical Stabilization of Ribs for Severe Multiple Rib Fractures (중증 다발성 늑골골절에 대한 조기 수술적 늑골고정술)

  • Hwang, Jung-Joo;Kim, Young-Jin;Ryu, Han-Young;Cho, Hyun-Min
    • Journal of Trauma and Injury
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    • v.24 no.1
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    • pp.12-17
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    • 2011
  • Purpose: A rib fracture secondary to blunt thoracic trauma continues to be an important injury with significant complications. Unfortunately, there are no definite treatment guidelines for severe multiple rib fractures. The purpose of this study was to evaluate the result of early operative stabilization and to find the risk factors of surgical fixation in patients with bilateral multiple rib fractures or flail segments. Methods: From December 2005 to December 2008, the medical records of all patients who underwent operative stabilization of ribs for severe multiple rib fractures were reviewed. We investigated patients' demographics, preoperative comorbidities, underlying lung disease, chest trauma, other associated injuries, number of surgical rib fixation, combined operations, perioperative ventilator support, and postoperative complications to find the factors affecting the mortality after surgical treatment. Results: The mean age of the 96 patients who underwent surgical stabilization for bilateral multiple rib fractures or flail segments was 56.7 years (range: 22 to 82 years), and the male-to-female ratio was 3.6:1. Among the 96 patients, 16 patients (16.7%) underwent reoperation under general or epidural anesthesia due to remaining fracture with severe displacement. The surgical mortality of severe multiple rib fractures was 8.3% (8/96), 7 of those 8 patients (87.5%) dying from acute respiratory distress syndrome or sepsis. And the other one patient expired from acute myocardial infarction. The risk factors affecting mortality were liver cirrhosis, chronic obstructive pulmonary disease, concomitant severe head or abdominal injuries, perioperative ventilator care, postoperative bleeding or pneumonia, and tracheostomy. However, age, number of fractured ribs, lung parenchymal injury, pulmonary contusion and combined operations were not significantly related to mortality. Conclusion: In the present study, surgical fixation of ribs could be carried out as a first-line therapeutic option for bilateral rib fractures or flail segments without significant complications if the risk factors associated with mortality were carefully considered. Furthermore, with a view of restoring pulmonary function, as well as chest wall configuration, early operative stabilization of the ribs is more helpful than conventional treatment for patients with severe multiple rib fractures.

Chronic Pain Control of SCI Patients after Cervical Epidural Block -Case report on 2 cases- (경부 경막외 차단에 의한 척수손상 환자의 만성 통증 조절 -2예 보고-)

  • Lee, Ji-Young;Sung, Choon-Ho
    • The Korean Journal of Pain
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    • v.5 no.2
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    • pp.273-278
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    • 1992
  • With the medical progress that has given spinal cord injured(SCI) individuals greater longevity and better overall health, chronic pain is emerged as major challenge in treating this population. According to past reports, estimates of prevalance of severe/disabling chronic pain in SCI patients have ranged from 18% to 63%. In etiologies of chronic pain in SCI patients, psychic or psychogenic pain categories should be included and more recent data have demonstrated that the persistant pain is directly related to higher levels of psychosocial distress and impairment. Recently, neurophysiological classification of the SCI pain syndrome into three etiologic groups(a; mechanical pain, b; radicular pain, c; deafferentation pain) is more frequently adopted for the classification of chronic SCI pain syndrome. The deafferentation pain is most common of the pain syndromes associated with SCI. After cervical epidural anesthesia for the surgical intervention of decubitus ulcer on the hip of two SCI patients, there were much reduction of existing chronic deafferentation character pain.

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Clinical presentations of critical cardiac defects in the newborn: Decision making and initial management

  • Lee, Jae-Young
    • Clinical and Experimental Pediatrics
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    • v.53 no.6
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    • pp.669-679
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    • 2010
  • The risk of mortality and morbidity of patients with congenital heart defects (CHDs) is highest during neonatal period and increases when diagnosis and proper management are delayed. Neonates with critical CHDs may present with severe cyanosis, respiratory distress, shock, or collapse, all of which are also frequent clinical presentations of various respiratory problems or sepsis in the newborn. Early diagnosis and stabilization and timely referral to a tertiary cardiac center are crucial to improve the outcomes in neonates with CHDs. In this review, the clinical presentation of critical and potentially life-threatening CHDs is discussed along with brief case reviews to help understand the hemodynamics of these defects and ensure proper decision-making in critically ill patients.

Monitoring of Lubrication Conditions in Journal Bearing by Acoustic Emission (AE를 이용한 저어널 베어링에서의 윤활유 이물질 혼입의 영향 감시)

  • 윤동진;권요양;정민화;김경웅
    • Proceedings of the Korean Society of Tribologists and Lubrication Engineers Conference
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    • 1993.12a
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    • pp.77-84
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    • 1993
  • Systems with journal bearings generally operate in large scale and under severe loading conditions such as steam generator turbines and internal combustion engines, in contrast to the machineries using rolling element bearings. Failure of the bearings in these machineries can result in the system breakdown. To avoid the time consuming repair and considerable economic loss, the detection of incipient failure in journal bearings becomes very important. In this experimental approach, acoustic emission monitoring is employed to the detection of incipient failure caused by intervention of foreign particles most probable in the journal bearing systems. It has been known that the intervention of foreign materials, insufficient lubrication and misassembly etc. are principal factors to cause bearing failure and distress. The experiment was conducted under such designed conditions as inserting alumina particles to the lubrication layer in the simulated journal bearing system. The results showed that acoustic emission could be an effective tool to detect the incipient failure in journal bearings.

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Co-infection of Canine Distemper Virus and Toxoplasma gondii in a Dog (개에서 디스템퍼 바이러스와 톡소플라즈마의 혼합 감염)

  • 강홍원;강상철;양형석;배종희;김재훈
    • Journal of Veterinary Clinics
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    • v.21 no.1
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    • pp.80-82
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    • 2004
  • A 3 month-old male dog with clinical signs of anorexia, soft stool, ocular and nasal discharge, cough and respiratory distress was submitted to the Cheju National University for diagnosis. At necropsy, tan to pulp]e-red sublobar to lobar consolidations were presented in apical and cardiac lobe of lung. Histopathologically, severe diffuse bronchointerstitial pneumonia with necrotic bronchiolitis was noted in the lung. The demyelinating encephalitis and astrocytosis were presented in cerebellum and cerebrum. Numerous round, ovoid or cluster of tachyzoites were also identified in alveolar lumen, alveolar wall and cytoplasm of macrophages in the lung. The orgasnisms were demonstrated as Toxoplasma (T) gondii by immunohistochemistry. Intranuclear or intracytoplasmic eosinophilic inclusion bodies were seen in the glial cells of the cerebellum. Canine distemper virus (CDV) specific antigens were demonstrated in the cerebellum by the immunohistochemistry. In our knowledge, this is believed to be the first confirmed report of co-infection of CDV and T gondii in dog in Korea.

High-flow nasal cannula oxygen therapy in children: a clinical review

  • Kwon, Ji-Won
    • Clinical and Experimental Pediatrics
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    • v.63 no.1
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    • pp.3-7
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    • 2020
  • High-flow nasal cannula (HFNC) is a relatively safe and effective noninvasive ventilation method that was recently accepted as a treatment option for acute respiratory support before endotracheal intubation or invasive ventilation. The action mechanism of HFNC includes a decrease in nasopharyngeal resistance, washout of dead space, reduction in inflow of ambient air, and an increase in airway pressure. In preterm infants, HFNC can be used to prevent reintubation and initial noninvasive respiratory support after birth. In children, flow level adjustments are crucial considering their maximal efficacy and complications. Randomized controlled studies suggest that HFNC can be used in cases of moderate to severe bronchiolitis upon initial low-flow oxygen failure. HFNC can also reduce intubation and mechanical ventilation in children with respiratory failure. Several observational studies have shown that HFNC can be beneficial in acute asthma and other respiratory distress. Multicenter randomized studies are warranted to determine the feasibility and adherence of HFNC and continuous positive airway pressure in pediatric intensive care units. The development of clinical guidelines for HFNC, including flow settings, indications, and contraindications, device management, efficacy identification, and safety issues are needed, particularly in children.

A Case of Acute Fulminant Fat Embolism Syndrome after Liposuction Surgery

  • Byeon, Seong Wook;Ban, Tae Hyun;Rhee, Chin Kook
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.4
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    • pp.423-427
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    • 2015
  • Fat embolism syndrome (FES) is a clinical manifestation that consists of multiple organ dysfunction due to fat emboli. FES occurs as a complication after trauma or procedures such as surgery. The diagnostic criteria of FES have not yet been established, so clinical criteria are used for its diagnosis. The clinical course of acute fulminant FES can be rapid. Liposuction surgery, in which adipocytes are mechanically disrupted, is one cause of FES. As the number of liposuction surgeries increases, clinicians should be aware of the possibility of FES. This was the first report of a case of acute fulminant FES with severe acute respiratory distress syndrome after liposuction surgery, in Korea.

Congenital Cystic Adenomatoid Malformation of the Lung [2 cases] (폐의 선천성 낭포성 유선종치험 2례)

  • 조광현
    • Journal of Chest Surgery
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    • v.18 no.4
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    • pp.785-791
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    • 1985
  • The congenital cystic adenomatoid malformation [C.C.A.M.] of the lung is a rare lesion consisted of multiple cysts in the pulmonary parenchyma lined cuboidal or columnar epithelium. The C.C.A.M. presents clinically in three ways:[1] stillborn or perinatal death, [2] progressive respiratory distress in the newborn, and [3] acute and chronic pulmonary nfections in the older infant and child. We recently experienced two cases of C.C.A.M. of the lung, and have good surgical results. The first case was 29 days old male and the second case was 16 month old female who have been suffered from severe respiratory difficulty and pulmonary infection repeatedly each other. The lobectomies were performed, and the postoperative course was uneventful.

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Diaphragm Translocation as Surgical Treatment for Agenesis of the Right Lung and Secondary Tracheal Compression

  • Kim, Dong Hee;Choi, Se Hoon
    • Journal of Chest Surgery
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    • v.49 no.1
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    • pp.59-62
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    • 2016
  • A 12-month-old boy was diagnosed with agenesis of the right lung. Mediastinal deviation progressed to the diseased side as the patient matured; therefore, tracheal distortion developed. As a result, tracheal compression developed between the vertebral body and aorta. The patient was repeatedly admitted to the hospital because of recurrent pulmonary infection and combined severe respiratory distress. Diaphragm translocation was performed to treat the patient. The postoperative course was favorable, and computed tomography scan findings and symptoms had improved at 1 year after surgery.