Javier Garcia Lopez, Paula Benedetti, Luis Puente Maest and Javier de Miguel Diez.

The Volume reduction in COPD (COPD) ‘Effective in all variants’. However, it does require a comprehensive study of patients who can benefit from these treatments, as explained by pulmonologists in Gregorio Maranon Hospital Who participated in the new Interhospital conference on pulmonology in Madridorganized by medical writing.

During the meeting, sponsored by Neumomadrid Foundation In cooperation with GSK s Oxymsa Nippon gasesA review of treatment options for patients with severe COPD, whose daily habits are limited, was conducted. He explained that “the patient expresses this great feeling of lack of air and the need to breathe very superficially.” Paola BenedettiDr., a medical specialist in the Respiratory Service of the Gregorio Marañone Hospital, has focused on the basics and indications for these alternatives.

Discussion table on volume reduction in severe COPD.

The main goal, as explained by the expert, is “a little more help” to the patient, that is, Reduce hyperinflation Improve respiratory mechanics and diaphragm muscle function. Also, improving the elastic contraction of the lung, favoring the gas exchange capacity of the remaining lung tissue or reversing the chronic decrease in the supply of tissues with oxygen.

Like all treatment, Benedetti warned, Size reduction has indications and contraindications. The first is that he is a patient with severe emphysema, with “severe” shortness of breath or who meets certain functional criteria. Among the contraindications, on the other hand, we find the presence of bronchiectasis or cancer as well Continuation of the tobacco habit or treatment with prednisone, among others.

The specialist explained that the types of lung volume reduction Valves for acute emphysema with intact incisionsAnd steam in acute emphysema with attached fissures.

One of the primary advantages of valves, the pulmonologist emphasized, is that they are reversible, while steam is “not a reversible option.” At this point, the expert indicated the speed with which this technique is being applied, not the exception to it Possible complications such as shortness of breath, fever or severe pneumonia.

“An essential thing is Careful selection of patientsthe main candidate to refer to these treatments, “notes the specialist, who emphasized that it is necessary”Offer benefit over risk. Another important aspect, he added, “is that there is no age limit and does not interfere with lung transplantation.”

Javier García-López, Paola Benedetti during the Inter-Hospital Conference on Pulmonology.


The experience of cashew nuts in reducing volume in chronic obstructive pulmonary disease

On the table, runs it Luis Puente MaestoHead of the Department of Pulmonology; s Javier de Miguel DiezHead of the Respiratory Service Division. I also intervened Javier Garcia Lopezwho is also the center’s chief of pulmonology services, which chronicled the hospital’s experience with this technology through a clinical case that demonstrated how the specialists worked.

In this case a 71-year-old woman, a former smoker, with a Long-term chronic obstructive pulmonary disease And that he has had two incomes in the past three years. With her, and with any patient, “the potential causes of exclusion must be carefully evaluated,” Garcia explained, emphasizing that “The patient must know the risks before deciding whether to seek treatment“.

After evaluating a file Emphysema via computed tomographyAn echocardiogram, which cannot be evaluated, is performed Pulmonary arterial hypertension Very concretely, the specialist recalls. At this point, he highlights that one of the contraindications, pulmonary hypertension, is the only one available to the patient, so “you have to go further and have a catheterization”, as pulmonologists assure it is neither severe nor moderate, so you can continue with treatment .

“Knowing that it’s a filter, we have to choose how we handle it: whether with valves or steam,” says the specialist. “We always prefer valves because they are reversible in case of complications,” he adds. The patient, remember, was laid Three valves four millimeters. All this just three months after he went to counseling. He remembers that after four days without immediate complications, he was discharged from the hospital. However, ten days after discharge, the patient went to the emergency department referring to a Source That after conducting a study, it was confirmed that it was LSD . atelectasisAlthough his shortness of breath improved.

Since 2015, the specialist noted, The hospital treated 21 patients through coils, valves and steam; With subjective improvement in 80 percent of patients, even after 5 years. However, these procedures “are not free,” Garcia emphasized, so they are associated with risks. In the hospital experience, there was a case of pneumothorax, a massive hemoptysis patient And three patients with serious infections. However, the pulmonologist stressed that “volume reduction is effective in all of its variants,” noting the need for a “comprehensive study” of each case because they are very fragile patients.

Javier de Miguel Diez, Luis Puente Maisto, Paula Benedetti and Javier Garcia Lopez.

Although it may contain statements, statements, or notes from health institutions or professionals, the information in medical writing is edited and prepared by journalists. We recommend the reader to consult a health professional for any health-related questions.

Source link

The healthcare vertical is expected to accelerate based on IoMT (Internet of Medical Technology). The key players in IoMT help in designing and tuning to sophisticated custom software. Also, iTunes or Google Play catalogs have encompassed healthcare and wellness mobile apps. With synchronization with wearables like fitness trackers or pulsometers for using data collected via sensors placed on body for reporting/analysing health conditions, the Oxygen Therapy Market is there to take the healthcare vertical by storm in the next 10 years.

Oxygen therapy is administered by use of oxygen gas as a medical intervention given acute or chronic patient care as it is essential for various cell metabolism whereas tissue oxygenation is essential for normal physiological function. Oxygen therapy is administered when the oxygen levels in blood is low.  It can be administered in various ways from nasal to hyperbaric oxygen in a closed chamber.To understand how oxygen therapy is implemented in use, we need to understand the respiratory system. The respiratory system is a group of organs and tissues that help in breathing. The lungs and the nasal tract along with the wind pipe together form the respiratory system.

Get Sample Copy of this [email protected] www.persistencemarketresearch.com/samples/11959

The air enters the body through nose or mouth through the wind pipe to the lungs via bronchi. The bronchi branches out into several tubes called bronchioles, which further branch out into tiny air sacs known as alveoli. These tiny air sacs are covered with a mesh of blood vessels called capillaries, which are connected to several arteries and veins which transfer oxygen throughout the body.

Certain acute or chronic disease conditions, which affect the transfer of oxygen from alveoli to the blood, such a pneumonia, cystic fibrosis, asthma, dysplasia, heart failure, sleep apnea, lung disorders, and COPD (chronic obstructive pulmonary disease). Oxygen therapy is administered on the basis of arterial blood gas test and a pulse oximetry test.

According to the World Health Organization (WHO), total deaths due to COPD is expected to rise approximately by 30% in the next decade, thereby driving the need to incorporate oxygen therapy as a treatment option. However it is estimated that COPD will be the third most fatal disease worldwide by 2024, thereby widening the consumer base for oxygen therapy market.

The growing demand for technologically advanced system, such as portable oxygen concentrator system has also boosted global oxygen therapy market growth. Some of the major advancements include pulse oximetry devices, and nasopharyngeal oxygen therapy.

Request for Table of [email protected] www.persistencemarketresearch.com/toc/11959

The global Oxygen Therapy market is segmented on basis of product type, disease, administration device, end user, and geography:

by Product type
  • Compressed oxygen
  • Liquid Oxygen
  • Oxygen Concentrates
by device
  • Hyperbaric oxygen chamber
  • Nasal Cannula
  • Face mask
  • Trans-tracheal therapy
by basis of disease
  • Respiratory Disorder:
    • Asthma
    • Dysplasia-Pacific
    • Cystic Fibrosis
    • COPD (Chronic Obstructive Pulmonary Disease)
  • Cardiovascular Disease
  • Pneumonia
  • Sleep Apnea
  • Others
by end User
  • Hospitals
  • Clinics
  • Rehab Centers
  • Home Healthcare

Major benefits of oxygen therapy are decreasing shortness of breath and fatigue, it helps people with sleep disorders and increases the lifespan of individuals with COPD. Depending on the need, oxygen therapy devices can purchased through insurance companies.

Access Full [email protected] www.persistencemarketresearch.com/checkout/11959

On the basis of regional presence, global oxygen therapy market is segmented into five key regions viz.  North America, Latin America, Europe, Asia-Pacific-Pacific, and Middle East & Africa. North America is expected to lead the global Oxygen Therapy testing market due to high prevalence of respiratory related diseases, increase in number of product approval, increase in aging population, increase in vulnerability to respiratory conditions, innovation in portable oxygen concentrators, rise in number of untreated sleep apnea cases, growing demand for oxygen filling devices and high RnD investment are driving the growth of oxygen therapy market in the region.

European market is also closely competing in terms of revenue generation because of favorable government initiatives taken for respiratory care.

The oxygen therapy market in Asia-Pacific Pacific region is expected to witness a rise in growth opportunities due to an increase in geriatric population requiring home-based oxygen therapy, and rising healthcare expenditure.  The other major restraining factor for growth of oxygen therapy market have been strict regulatory approval policies and complicated reimbursement process.

Some key players involved in oxygen therapy market are Care Fusion Corp., GE Healthcare, Hersill, Philips Respironics, Inc., De-Vilbiss Healthcare, MAQUET Medical Systems, Smiths Medical, Allied Healthcare Products, Fisher & Paykel Healthcare Limited, Teleflex Incorporated, and Invacare Corporation.

Persistence Market Research          
Address – 305 Broadway, 7th Floor, New York City,
NY 10007 United States
U.S. Ph. – +1-646-568-7751
USA-Canada Toll-free – +1 800-961-0353
Sales – [email protected]

Source link

(WXYZ) — It’s not just COVID-19 cases that are on the rise. Many Michiganders are surprised to learn they’re sick with the flu and not COVID-19.

I know many patients who were convinced that they had COVID-19 when they were actually sick with the flu. I get that there are similarities when it comes to COVID-19 and the flu because they are both upper respiratory infections.

For instance, both can cause symptoms like runny nose, sore throat, fever, cough, difficulty breathing and body aches.

So how can you tell them apart?

Well, a loss of taste or smell was once a telltale sign you had COVID-19 as this rarely happened with the flu. But those symptoms are not as prominent anymore.

Another indicator was to look at how fast symptoms appeared. Symptoms tend to come on faster with the flu, whereas it can take longer for a person who has COVID-19.

But here’s the bottom line. The only real way to really know if you have the flu or COVID19 is to get tested. Otherwise, it’s very difficult to tell the difference between the two viruses just by looking at symptoms alone as they are nearly identical.

Both the flu and COVID-19 can be asymptomatic, mild or severe. Both can lead to complications like pneumonia, respiratory failure, sepsis, fluid in the lungs, cardiac injury, multiple organ failure and inflammation of the heart, brain, or muscle tissues. Also, both the flu and COVID-19 can be fatal.

Is one virus deadlier than the other? The answer is: yes. COVID-19 appears to cause more serious illnesses, which can lead to hospitalization and death. While the people most at risk are older adults, pregnant women and people with certain underlying medical conditions, we know that severe illness and death can happen even to healthy people.

Also, some people can develop post-COVID-19 symptoms that last weeks or months. And long COVID can happen to anyone, even if their symptoms were mild or asymptomatic.

The good news is that we have vaccines for both COVID-19 and the flu that can help prevent serious illness and death. It is never too late to get either vaccine, especially as we’re seeing the flu season drag on a bit longer than usual and rising cases for both viruses.

Additional Coronavirus information and resources:

View a global coronavirus tracker with data from Johns Hopkins University.

See complete coverage on our Coronavirus Continuing Coverage page.



Source link

Introduction

Chronic obstructive pulmonary disease (COPD) is a clinical syndrome that features chronic respiratory symptoms and structural pulmonary abnormalities leading to lung function impairment with persistent airflow limitation.1 A recent study indicated that the overall prevalence of spirometry defined for COPD was 8.6% of adults in China, including 11.9% of men aged 40 years or older. The acute exacerbation of COPD (AECOPD) is a key factor that affects the disease prognosis and leads to hospitalization. Thus, AECOPD-related morbidity and mortality should be given more attention.2,3 Pulmonary hypertension (PH) is a common and severe comorbidity of COPD that results in an increased risk of hospitalization, reduced exercise capacity, and shorter survival. Right-heart catheterization (RHC) is the “gold standard” for the diagnosis of PH. However, RHC related significant risks and its difficulty of placement limits this procedure in patients with PH. Echocardiography is a noninvasive method that is widely used to assess PH in patients with AECOPD.4 A tricuspid regurgitant jet ≥3 m/s tested by echocardiography is diagnosed as PH, which may lead to underdetermined diagnoses of PH.5 Moreover, pulmonary artery systolic pressure detected by echocardiography is poorly correlated with the mean pulmonary artery pressure (mPAP) in severe COPD. A main pulmonary artery to ascending aorta diameter ratio (PA/A) of greater than one has been reported to be a promising indicator for revealing PH.6,7 Furthermore, an increased ratio of PA/A was closely associated with the poor survival of patients with COPD, particularly in individuals with moderate-to-severe cases.8 Nevertheless, the impact of the PA/A ratio in AECOPD remains to be elucidated. In this present study, we aim to disclose the associations between the PA/A ratio and clinical outcomes in hospitalized patients with AECOPD.

Patients and Methods

Study Population

This retrospective observational study was conducted at the Yijishan Hospital affiliated with the Wannan Medical College and was approved by the Research Ethics Committee of Yijishan Hospital. The clinical data of patients was maintained with confidentiality and in compliance with the Declaration of Helsinki. Written informed consent from patients was waived due to the retrospective nature of this study. Consecutive AECOPD patients admitted to the Department of Respiratory Medicine and Respiratory Intensive Care Units (RICU) were reviewed from September 2017 to July 2021. Patients with advanced lung cancer, pneumothorax, stroke, pneumonia, diffuse interstitial lung disease, hemodialysis, or left-heart failure, as well as those who only accepted palliative therapy, or had a lack of chest computed tomography (CT) images, were excluded from the final analysis.

AECOPD is defined as COPD with an acute worsening of respiratory symptoms (typically cough, dyspnea, increased sputum volume, and/or sputum purulence) requiring additional treatments.9 Indications for RICU admission were made according to the expert consensus released in 2014 on AECOPD in China.10 In brief, these consisted of a significant increase in symptom intensity (severe dyspnea, changes in mental status, moderate or severe hypoxemia with or without hypercapnia), failure of an exacerbation to respond to initial medical management, hemodynamic instability, and a patient requiring mechanical ventilation (MV). The treatment success of AECOPD patients was defined as improvement in the clinical condition when discharged from the hospital. Conversely, treatment failure was thought to occur as an event of in-hospital death or deterioration of the clinical condition prior to discharge.

Demographic characteristics, including gender, age, the age-adjusted Charlson Comorbidity Index (aCCI), length of stay, body mass index (BMI) and in-hospital death, were collected. Laboratory tests, including an arterial blood gas analysis (pH value, oxygenation index, the ratio of arterial partial pressure of oxygen to the fraction of inspired oxygen), PaCO2, and the blood lactate level), hemoglobin, blood red cell distribution width (RDW), D-dimer, brain natriuretic peptide (BNP), fibrinogen (Fib), and blood platelet (PLT), were initially recorded after admission. The percentage of ICU admissions requiring invasive MV (IMV) was also calculated. A chest CT was performed when the patient was admitted to the hospital. The procedure for measuring the pulmonary artery (PA) diameter and PA/A ratio determined by the chest CT conformed to a previous study.6 Briefly, the PA diameter and ascending aorta diameter were averaged from two perpendicular measurements at the PA bifurcation level collected from the same chest CT images, as shown in Figure 1.

Figure 1 Diameters of the PA and A were determined by CT scan at the PA bifurcation. (A) PA/A ratio < 1; (B) PA/A ratio > 1.

Abbreviations: A, aorta; PA, pulmonary artery.

Statistical Analysis

Continuous data were analyzed using a normal distribution test prior to further analysis. Continuous data are indicated as the mean (standard deviation [SD]) or median (inter-quartile range [25,75]). Categorical variables are presented as the number (n) or percentage. Continuous variables were analyzed using the independent t-test or the Mann-Whitney U-test, and categorical variables were analyzed using a Chi-square test. The logistic regression model was used as a multivariate analysis to reveal the independent risk factors of in-hospital worst outcomes in patients with AECOPD. The Kaplan–Meier survival method was used to analyze the effect of the PA/A ratio on outcomes of AECOPD patients. A Log rank test was applied to appraise the statistical differences between the two survival curves. A receiver operating characteristic (ROC) curve analysis was conducted to evaluate factors predicting an in-hospital worst outcome. A P value less than 0.05 was considered statistically significant. The statistical analyses were performed using SPSS for Windows (release 22.0, IBM Corporation, USA).

Results

As indicated in Figure 2, a total of 229 patients with AECOPD were reviewed. According to the inclusion criteria and exclusion criteria, 111 patients were excluded due to the condition being combined with advanced lung cancer (n = 10), pneumothorax (n = 4) stroke (n = 5), pneumonia (n = 29), diffuse interstitial lung disease (n = 7), hemodialysis (n = 6), left-heart failure (n = 19), palliative therapy (n = 23), and a lack of CT images (n = 10). Ultimately, 118 eligible individuals were reviewed in this study: 74 individuals with a PA/A ratio <1 and 44 individuals with PA/A ratio ≥1. The outcomes of 21 patients were treatment failures, and 97 patients were treatment successes when discharged from the hospital.

Figure 2 A flowchart of this study.

Characteristics of the AECOPD Patients with a PA/A Ratio <1 or a PA/A Ratio ≥1

The pH value in the PA/A ratio ≥1 group was significantly lower than that in the PA/A ratio <1 group (p = 0.026). Remarkably, the PA/A ratio ≥1 group had a significantly higher value of PaCO2, RDW, BNP, PA diameter, and RICU admissions, as well as worse outcomes than the PA/A ratio <1 group (P < 0.05). However, there were no significant statistical differences for the other indicators between the two groups (Table 1).

Table 1 Characteristics of AECOPD Patients with Different PA/A Ratio

Clinical Features of the AECOPD Patients with Treatment Failure

As indicated in Table 2, compared to the treatment success group, the treatment failure group had a much lower pH value (7.34 ± 0.11 vs 7.28 ± 0.13, respectively, p = 0.040) and less count of PLT (median 167 × 109/L vs 130 × 109/L, respectively, p = 0.018). The treatment failure group had higher levels of D-dimer and BNP compared with the improved group (P < 0.05). In addition, the percentage of RDW, rate of RICU admissions, and the proportion of IMV in the treatment failure group were significantly higher than that in the improved group (P < 0.05). Notably, the PA diameter and PA/A ratio were significantly increased in the treatment failure group than in the improved group (mean PA diameter: 3.71 vs 3.22, p = 0.001; mean PA/A ratio: 1.09 vs 0.89, p < 0.001).

Table 2 Characteristics of Treatment Success Group and Treatment Failure Group in Severe AECOPD

A PA/A Ratio ≥1 Was an Independent Risk Factor for Treatment Failure in AECOPD

The multivariate analysis indicated that the PA/A ratio ≥1 (OR value = 6.129, 95% CI: 1.665–22.565, p = 0.006) and IMV (OR value = 10.798, 95% CI: 2.072–56.261, p = 0.005) were two independent risk factors for treatment failure in patients with AECOPD. Although the RDW, D-dimer, PLT, and RICU admissions had observed significant differences between the two groups according to the univariate analysis, they did not reach significant statistical differences according to the multivariate analysis (Table 3). Additionally, the Kaplan–Meier survival analysis indicated that patients with a PA/A ratio ≥1 had worse outcomes than patients with a PA/A ratio <1 during hospitalization (HR = 5.277, 95% CI: 2.178–12.78, p < 0.001) (Figure 3).

Table 3 Multivariate Analysis for Risk Factors of Treatment Failure in AECOPD

Figure 3 Effect of the PA/A ratio on the outcomes of AECOPD patients.

Abbreviation: PA/A ratio: main pulmonary artery to ascending aorta diameter ratio.

Note: A Kaplan–Meier survival curve analysis was performed, and a Log rank test was used, and a P < 0.05 was considered statistically significant.

Predictors of Treatment Failure in Hospitalized Patients with AECOPD

Figure 4 displays the diverse ROC curve of the PA/A ratio, the PA value, the BNP, and the RDW for predicting treatment failure in hospitalized patients with AECOPD. Even though there were no significant statistical differences observed, the area under the curve (AUC) value of the PA/A ratio was numerically larger than that of the other indicators. The best cut-off value of the PA/A ratio for predicting treatment failure was 0.925. The sensitivity was 81.82%, and the specificity was 66.67% (Table 4).

Table 4 ROC Curve Analysis for Factors Predicting Treatment Failure

Figure 4 PA/A ratio, PA value, BNP, and RDW for predicting treatment failure in hospitalized patients with AECOPD.

Abbreviations: PA/A ratio, main pulmonary artery to ascending aorta diameter ratio; PA, main pulmonary artery; RDW, blood red cell distribution width; BNP, brain natriuretic peptide.

Note: The receiver operating characteristic (ROC) curve analysis was conducted to evaluate factors predicting in-hospital worst outcomes.

Discussion

The strengths of this study were its primary findings. First, patients with a PA/A ratio ≥1 had significantly higher PaCO2, RDW, BNP, PA diameters, RICU admission rates, and proportions of treatment failure. Second, the PA diameter and PA/A ratio were significantly increased in the treatment failure group compared with the treatment success group. Third, a PA/A ratio ≥1 was an independent risk factor for treatment failure in patients with AECOPD. The Kaplan–Meier survival analysis indicated that patients with a PA/A ratio ≥1 had worse outcomes than patients with a PA/A ratio <1 during hospitalization. Finally, the PA/A ratio may be a promising factor for predicting treatment failure in hospitalized AECOPD patients.

A previous study indicated that the relative pulmonary arterial enlargement (PA/A ratio >1 on CT scanning) predicted hospitalization for AECOPD, and a PA/A ratio >1 with increased blood troponin levels shared close associations with increased respiratory failure, ICU admission, and in-hospital mortality.11 Iliaz et al reported that the PA/A ratio was related to the frequency of hospitalizations and exacerbations due to COPD in one year after hospital discharge.12 However, the relationships between a PA/A ratio >1 alone and ICU admission or in-hospital mortality are still unclear. In the present study, we found that AECOPD patients with a PA/A ratio ≥1 had a decreased pH value and increased PaCO2 compared with patients with a PA/A ratio <1, implicating increased type II respiratory failure in patients with a PA/A ratio ≥1. A decreased pH value and increased PaCO2 may contribute directly to pulmonary vasoconstriction leading to a rise in pulmonary vascular resistance and pulmonary arterial pressure.13 In addition, we also disclosed a higher percentage of RICU admissions and a markedly increased rate of treatment failure in hospitalized AECOPD patients with a PA/A ratio ≥1. Thus, an increased PA/A ratio was associated with severity and worse outcomes in inpatients with AECOPD. Many studies have revealed that the RDW is a valuable biomarker for predicting pulmonary hypertension and its associated prognosis.14–16 In a previous study performed by our group, we indicated that the RDW shared positive relationships with the PA/A ratio in patients with pH secondary to COPD.17 Similar to previous studies, we found an increase in the RDW in AECOPD patients with a PA/A ratio ≥1. Likewise, the serum level of BNP was drastically elevated. BNP is an important indicator for identifying risk categories in PH. Increased BNP is related to a worse outcome of PH.18

In this study, we demonstrated that there was a decreased pH value, lower number of PLTs, and increases in the RDW, D-dimer, BNP, PA diameter, and PA/A ratio in AECOPD patients with treatment failure compared with the improved group. Patients with treatment failure also required more IMV supports and intensive care. It was reported that lower pH values were associated with short or long mortality in hospitalized AECOPD patients.19,20 RDW is an indicator that reflects the heterogeneity of red blood cell volume. Recently, RDW was found to be an independent negative prognostic factor closely associated with adverse outcomes in hospitalized AECOPD patients.21,22 Dysregulation of erythrocyte homeostasis and metabolic imbalance may account for significant changes in the RDW in AECOPD patients. However, the underlying pathophysiological mechanisms remain unknown.23 A hypercoagulable state is a feature of hospitalized AECOPD patients. An increased D-dimer level is not only an important independent risk factor for pulmonary embolism in inpatients with AECOPD but also a predictor of higher mortality in stable COPD patients.24,25 Cardiac failure is a frequent complication of AECOPD, deeply affecting exercise tolerance and life span in patients with COPD. BNP is widely used to evaluate heart function. BNP can be used to risk-stratify, and an elevated BNP is associated with a higher MV use and worse outcomes in AECOPD patients.26 An increased PA/A ratio is positively correlated with COPD severity. Previous studies have reported that pulmonary artery enlargement detected by CT is a risk predictor for a severe exacerbation of COPD.27,28 Intriguingly, the PA/A ratio is an important determinant of mortality in moderate-to-severe COPD.8 In our present study, we found that a PA/A ratio ≥1 was a strong independent risk-factor of in-hospital treatment failure in patients with AECOPD. In addition, the PA/A ratio might be a better predictor of in-hospital treatment failure compared with other indicators including the PA value, BNP, and RDW. Taken together, the results of the present study provide additional evidence for a close association between the PA/A ratio and the outcome of AECOPD.

In this study, AECOPD patients with a PA/A ratio ≥1 had markedly higher values of PaCO2, RDW, BNP, the PA diameter, ICU admission rates, and proportions of treatment failure and had worse outcomes during hospitalization. A PA/A ratio ≥1 was an independent risk factor for treatment failure in patients with AECOPD. The PA/A ratio may be a promising predictor for treatment failure. It is worth noting that there are several limitations in this study. First, the sample size was small, and this might lead to an interpretation bias in the final analysis. Further work is required to validate the initial conclusion for a larger sample size. Second, the PA/A ratio partially reflects a change in the pulmonary artery pressure. However, the association between the PA/A ratio and the pulmonary artery pressure was not assessed in this study. Finally, to reduce the chance of radioactive exposure, a dynamic change in the PA/A ratio during hospitalization was unclear.

Acknowledgments

We thank LetPub for its linguistic assistance during the preparation of this manuscript.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Funding

The design of the study and collection, analysis, and interpretation of data were supported by the Anhui Provincial Key projects of the Natural Science Foundation for Colleges and Universities (KJ2021A0834).

Disclosure

The authors report no conflicts of interest in this work.

References

1. Celli BR, Wedzicha JA. Update on clinical aspects of chronic obstructive pulmonary disease. N Engl J Med. 2019;381:1257–1266. doi:10.1056/NEJMra1900500

2. Wang C, Xu J, Yang L, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study): a national cross-sectional study. Lancet. 2018;391:1706–1717. doi:10.1016/S0140-6736(18)30841-9

3. Garcia-Sanz MT, Canive-Gomez JC, Senin-Rial L, et al. One-year and long-term mortality in patients hospitalized for chronic obstructive pulmonary disease. J Thorac Dis. 2017;9:636–645. doi:10.21037/jtd.2017.03.34

4. Nakayama S, Chubachi S, Sakurai K, et al. Characteristics of chronic obstructive pulmonary disease patients with pulmonary hypertension assessed by echocardiography in a three-year observational cohort study. Int J Chron Obstruct Pulmon Dis. 2020;15:487–499. doi:10.2147/COPD.S230952

5. Carpio AM, Goertz A, Kelly C, et al. Unrecognized pulmonary arterial hypertension in hospitalized patients. Int J Cardiovasc Imaging. 2021;37:1237–1243. doi:10.1007/s10554-020-02108-9

6. Iyer AS, Wells JM, Vishin S, et al. CT scan-measured pulmonary artery to aorta ratio and echocardiography for detecting pulmonary hypertension in severe COPD. Chest. 2014;145:824–832. doi:10.1378/chest.13-1422

7. Schneider M, Ran H, Pistritto AM, et al. Pulmonary artery to ascending aorta ratio by echocardiography: a strong predictor for presence and severity of pulmonary hypertension. PLoS One. 2020;15(7):e235716. doi:10.1371/journal.pone.0235716

8. Terzikhan N, Bos D, Lahousse L, et al. Pulmonary artery to aorta ratio and risk of all-cause mortality in the general population: the Rotterdam Study. Eur Respir J. 2017;49:1602168. doi:10.1183/13993003.02168-2016

9. Zeng Y, Cai S, Chen Y, et al. Current status of the treatment of COPD in China: a multicenter prospective observational study. Int J Chron Obstruct Pulmon Dis. 2020;15:3227–3237. doi:10.2147/COPD.S274024

10. Cai BQ, Cai SX, Chen RC, et al. Expert consensus on acute exacerbation of chronic obstructive pulmonary disease in the People’s Republic of China. Int J Chron Obstruct Pulmon Dis. 2014;9:381–395. doi:10.2147/COPD.S58454

11. Wells JM, Morrison JB, Bhatt SP, et al. Pulmonary artery enlargement is associated with cardiac injury during severe exacerbations of COPD. Chest. 2016;149:1197–1204. doi:10.1378/chest.15-1504

12. Iliaz S, Tanriverdio E, Chousein E, et al. Importance of pulmonary artery to ascending aorta ratio in chronic obstructive pulmonary disease. Clin Respir J. 2018;12:961–965. doi:10.1111/crj.12612

13. Morray JP, Lynn AM, Mansfield PB. Effect of pH and PCO2 on pulmonary and systemic hemodynamics after surgery in children with congenital heart disease and pulmonary hypertension. J Pediatr. 1988;113:474–479. doi:10.1016/S0022-3476(88)80631-0

14. Zuk M, Migdal A, Dominczak J, et al. Usefulness of Red Cell Width Distribution (RDW) in the assessment of children with Pulmonary Arterial Hypertension (PAH). Pediatr Cardiol. 2019;40:820–826. doi:10.1007/s00246-019-02077-4

15. Ulrich A, Wharton J, Thayer TE, et al. Mendelian randomisation analysis of red cell distribution width in pulmonary arterial hypertension. Eur Respir J. 2020;55:1901486.

16. Liu J, Yang J, Xu S, et al. Prognostic impact of red blood cell distribution width in pulmonary hypertension patients: a systematic review and meta-analysis. Medicine. 2020;99:e19089. doi:10.1097/MD.0000000000019089

17. Yang J, Liu C, Li L, et al. Red blood cell distribution width predicts pulmonary hypertension secondary to chronic obstructive pulmonary disease. Can Respir J. 2019;2019:3853454. doi:10.1155/2019/3853454

18. Hoeper MM, Pausch C, Olsson KM, et al. COMPERA 2.0: a refined 4-strata risk assessment model for pulmonary arterial hypertension. Eur Respir J. 2021;2102311. doi: 10.1183/13993003.02311-2021

19. Gayaf M, Karadeniz G, Guldaval F, et al. Which one is superior in predicting 30 and 90 days mortality after COPD exacerbation: DECAF, CURB-65, PSI, BAP-65, PLR, NLR. Expert Rev Respir Med. 2021;15:845–851. doi:10.1080/17476348.2021.1901584

20. Chen L, Chen L, Zheng H, et al. Emergency admission parameters for predicting in-hospital mortality in patients with acute exacerbations of chronic obstructive pulmonary disease with hypercapnic respiratory failure. BMC Pulm Med. 2021;21:258. doi:10.1186/s12890-021-01624-1

21. Hu GP, Zhou YM, Wu ZL, et al. Red blood cell distribution width is an independent predictor of mortality for an acute exacerbation of COPD. Int J Tuberc Lung Dis. 2019;23:817–823. doi:10.5588/ijtld.18.0429

22. Epstein D, Nasser R, Mashiach T, et al. Increased red cell distribution width: a novel predictor of adverse outcome in patients hospitalized due to acute exacerbation of chronic obstructive pulmonary disease. Respir Med. 2018;136:1–7. doi:10.1016/j.rmed.2018.01.011

23. Salvagno GL, Sanchis-Gomar F, Picanza A, et al. Red blood cell distribution width: a simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci. 2015;52:86–105. doi:10.3109/10408363.2014.992064

24. Wang J, Ym D. Prevalence and risk factors of pulmonary embolism in acute exacerbation of chronic obstructive pulmonary disease and its impact on outcomes: a systematic review and meta-analysis. Eur Rev Med Pharmacol Sci. 2021;25:2604–2616. doi:10.26355/eurrev_202103_25424

25. Husebo GR, Gabazza EC, D’Alessandro GC, et al. Coagulation markers as predictors for clinical events in COPD. Respirology. 2021;26:342–351. doi:10.1111/resp.13971

26. Vallabhajosyula S, Haddad TM, Sundaragiri PR, et al. Role of B-type natriuretic peptide in predicting in-hospital outcomes in acute exacerbation of chronic obstructive pulmonary disease with preserved left ventricular function: a 5-year retrospective analysis. J Intensive Care Med. 2018;33:635–644. doi:10.1177/0885066616682232

27. Yang T, Chen C, Chen Z. The CT pulmonary vascular parameters and disease severity in COPD patients on acute exacerbation: a correlation analysis. BMC Pulm Med. 2021;21:34. doi:10.1186/s12890-020-01374-6

28. Wells JM, Washko GR, Han MK, et al. Pulmonary arterial enlargement and acute exacerbations of COPD. N Engl J Med. 2012;367:913–921. doi:10.1056/NEJMoa1203830

Source link

(BPRW) Essential Oils that Help You Breathe Better

(Black PR Wire) Chronic obstructive pulmonary disease (COPD) refers to lung illnesses that make breathing challenging. It’s estimated that more than 11 million Americans have COPD. There’s no cure, but remedies can help ease symptoms, stop complications, and slow disease advancement.

Signs of COPD include shortness of breath, needing to clear your throat often, and frequent coughing. Individuals with COPD often have emphysema and chronic bronchitis

COPD can result from long-term exposure to pollutants or toxins, including the toxins found in cigarette smoke. Genetics may also play a part in developing COPD.

Primary therapies for COPD include:

  • Quitting smoking
  • Oxygen therapy
  • Drugs that widen your airway, including nebulizers and inhalers
  • Surgery

Home treatments and holistic therapies may also function to reduce your symptoms. Some research demonstrates that essential oils can treat COPD effectively when paired with traditional medical treatment.

COPD and essential oils

Research indicates essential oils may be useful in treating upper respiratory infections.

Upper respiratory infections include the common cold, sinusitis, and pharyngitis. These are acute disorders, meaning they endure for only a short period, generally a few weeks. By distinction, COPD is a chronic, lifelong condition. Nevertheless, both conditions concern inflammation of your bronchiole tubes.

Eucalyptus Oil

Eucalyptus oil has been used widely for centuries as a home remedy for respiratory conditions. Eucalyptus oil is also an anti-inflammatory and boosts your immune system. Using eucalyptus oil can kill destructive bacteria that worsen your COPD symptoms. It may also soothe your throat and chest and speed up healing.

Lavender Oil

Lavender oil is known for its calming scent and antibacterial effects.

Sweet Orange Oil

Orange oil has anti-inflammatory and anti-oxidant effects. In a study that likened a proprietary oil blend with eucalyptus oil and orange oil, orange oil demonstrated evident capabilities to help with COPD.

Bergamot Oil

Bergamot is another component of the citrus family. It’s famous for the way it smells and its ability to soothe the nervous system. Bergamot may work well to alleviate pain and soreness caused by the coughing symptoms during a COPD flare-up.

Frankincense and Myrrh

These two widespread, ancient essential oils have a long history of treating respiratory conditions. Research has shown their anti-inflammatory effects, and they have many other effects that may increase your health and help you feel better.

But what we know about how frankincense and myrrh help, particularly with symptoms of COPD, is primarily anecdotal. When other essential oils have been demonstrated to work for COPD, these two might rank lower on your list in terms of established remedies.

When to See a Physician

Individuals with COPD are at a more increased risk for other illnesses that affect their lungs, such as the flu and pneumonia. Even the common cold can put you at risk of further damaging your lung tissue. Don’t attempt to use essential oils to self-treat a COPD flare-up that stops you from breathing or results in shortness of breath. If you notice the following symptoms, you should seek out a medical professional within 24 hours: 

  • Presence of blood in your mucus
  • Green or brown mucus
  • Extreme coughing or wheezing
  • New symptoms like severe fatigue or difficulty breathing
  • Unexplained, sudden weight gain or weight loss (more than 5 pounds in a week)
  • Forgetfulness
  • Dizziness
  • Waking up short of breath
  • Swelling in your ankles or wrists

There’s no cure for COPD, but traditional treatment can be complemented by therapy with essential oils to control its symptoms. Research indicates that some essential oils can soothe symptoms, encourage healing, and boost your immune system to help prevent flare-ups for many people with COPD. You can shop for essential oils at your local pharmacy or online.

The content and opinions expressed within this press release are those of the author(s) and/or represented companies, and are not necessarily shared by Black PR Wire. The author(s) and/or represented companies are solely responsible for the facts and the accuracy of the content of this Press release. Black PR Wire reserves the right to reject a press release if, in the view of Black PR Wire, the content of the release is unsuitable for distribution.

Source link

The most common method of intubation is ‘endotracheal’ intubation, which can take place

  • orotracheally: the tube enters through the patient’s mouth (most common method);
  • rhinotracheally: the tube enters through the patient’s nose (less common method).

Intubation: when is it used?

The main purpose of all types of intubation is to allow the breathing of a person who, for various reasons, is unable to breathe independently, which puts the patient’s life at risk.

Another objective of intubation is to protect the airway from possible inhalation of gastric material.

Intubation is performed in many medical conditions, such as:

  • in coma patients;
  • under general anaesthesia;
  • in bronchoscopy;
  • in endoscopic operative airway procedures such as laser therapy or the introduction of a stent into the bronchi;
  • in resuscitation on patients requiring respiratory support (e.g. in cases of severe Covid 19 infection);
  • in emergency medicine, particularly during cardiopulmonary resuscitation.

Alternatives to intubation

There are some alternatives to intubation, but they are undoubtedly more invasive and certainly not risk-free, for example

  • tracheotomy: this is a surgical procedure usually used on patients requiring long-term respiratory support; read more: Tracheotomy possibility of speaking, duration, consequences, when it is done
  • cricothyrotomy: is an emergency technique used when intubation is not possible and tracheotomy is impossible.

Types of tubes used in intubation

There are various types of endotracheal tubes for oral or nasal intubation; there are flexible ones or semi-rigid ones, with a specific shape and therefore relatively more rigid.

Most tubes have in common that they have an inflatable margin to seal the lower airway, which does not allow air to escape or secretions to be aspirated.

Intubation: why is it done during anaesthesia?

Intubation is done by the anaesthesiologist during a general anaesthesia, since – to bring about anaesthesia – the patient is given drugs that inhibit his breathing: the patient is not able to breathe independently and the endotracheal tube, connected to an automatic respirator, allows the subject to breathe correctly during surgery.

In operations of short duration (up to 15 minutes) breathing is supported with a face mask, the tracheal tube is used if the operation lasts longer.

Will I feel pain?

Intubation is always performed after the patient has been put to sleep, so you will not feel any pain caused by it.

After the procedure you will not remember either the placement of the tube or its removal (i.e. extubation) from the airway when the procedure is over. Slight discomfort in the throat is possible, and quite frequent, after extubation.

Throat pain after intubation: is it normal?

As just mentioned, after a patient has undergone intubation, he or she may experience some unpleasant symptoms, including:

  • sore throat
  • sensation of a foreign body in the throat;
  • difficulty swallowing solids and liquids;
  • discomfort when making sounds;
  • hoarseness.

These symptoms, although annoying, are fairly frequent and not serious, and they tend to disappear quickly, usually within a maximum of two days.

If the pain persists and is frankly unbearable, seek advice from your doctor.

Intubation techniques

Tracheal intubation can be performed using various techniques.

  • Traditional technique: consists of a direct laryngoscopy in which a laryngoscope is used to visualise the glottis below the epiglottis. A tube is then inserted with a direct view. This technique is performed in patients who are comatose (unconscious) or under general anaesthesia, or when they have received local or specific anaesthesia of the upper airway structures (e.g. using a local anaesthetic such as lidocaine).
  • Rapid sequence induction (RSI) (crash induction) is a variant of the standard procedure on patients under anaesthesia. It is performed when immediate and definitive airway treatment through intubation is required, and particularly when there is an increased risk of inhalation of gastric secretions (aspiration) that would almost inevitably lead to pneumonia ab ingestis. For RSI, a short-term sedative such as etomidate, propofol, thiopentone or midazolam is administered, followed shortly by a depolarising paralysing drug such as succinylcholine or rocuronium.
  • Endoscope technique: an alternative to intubation of the conscious (or lightly sedated) patient under local anaesthesia is the use of a flexible endoscope or similar (e.g. using a video-laryngoscope). This technique is preferred when difficulties are anticipated, as it allows the patient to breathe spontaneously, thus ensuring ventilation and oxygenation even in the event of a failed intubation.

Does intubation present risks and complications?

Intubation can cause damage to teeth, especially in the case of previously damaged teeth or difficult anatomical relationships.

In addition to the frequent annoying throat symptoms seen above, in rarer cases intubation can cause more serious damage to the tissues it passes through, even leading to haemorrhaging.

Intubation may present some unforeseen problems, especially in cases of unforeseen difficult intubation, which is rare but possible, where the patient’s anatomical features make correct positioning of the tube in the airway more problematic.

Fortunately, in these cases, the doctor has tools at his disposal to help him limit the risks to the patient as much as possible, such as videolaryngoscopes and fiberscopes, which make up for the unforeseen or anticipated intubation difficulties encountered.

More schematically, the early and late risks are as follows:

Early risks

  • dental injury
  • throat pain;
  • haemorrhage;
  • oedema of the glottic structures;
  • pneumomediastinum;
  • hoarseness;
  • phonatory difficulties;
  • tracheal perforation;
  • cardiovascular arrest from vagal stimulation.

Late risks

  • tracheal injury
  • chordal decubitus;
  • decubitus buccal structures, pharynx, hypopharynx;
  • pneumonia;
  • sinusitis.

Read Also:

Emergency Live Even More…Live: Download The New Free App Of Your Newspaper For IOS And Android

UK / Emergency Room, Paediatric Intubation: The Procedure With A Child In Serious Condition

Endotracheal Intubation In Paediatric Patients: Devices For The Supraglottic Airways

Shortage Of Sedatives Aggravates Pandemic In Brazil: Medicines For Treatment Of Patients With Covid-19 Are Lacking

Sedation And Analgesia: Drugs To Facilitate Intubation

Anxiolytics And Sedatives: Role, Function And Management With Intubation And Mechanical Ventilation

New England Journal Of Medicine: Successful Intubations With High-Flow Nasal Therapy In Newborns

Source:

Medicina Online



Source link

Best Covid 19 Self Test Kit For Travelers

“A Convenient Covid 19 Self Test Kit for Travel”

Covid-19 has had a lasting impact on society regarding travel. As travel resumes there are options for best self test kits to take with you as you travel. Easy to use and convenient travel kits are key for travellers and makes re-entry into a country much easier. These are the best options for Covid 19 self test kits and how to best use them.

The COVID-19 outbreak remains an unprecedented disaster in most countries. It has become the biggest global health emergency since the influenza pandemic of 1918. The pandemic has been catastrophic for every single industry. Travel, in particular, has been one of the most affected, and the economy built around it has seen a decline since the very beginning of the crisis. Those infected by the COVID-19 virus may suffer both short and long-term health problems, financial distress, and even long-term mental health issues. The uncertainty of what is happening to the world today has caused a chain-reaction that makes travel seem like an unusually dangerous and problematic endeavor.

What is Covid-19? How does it affect travelers?

Coronavirus disease, known as COVID-19, is a highly transmittable disease caused by intense acute respiratory syndrome SARS-CoV-2. It had a devastating impact on the world demographics resulting in more than 5.3 million deaths worldwide. The first case of this predominant respiratory viral infection was reported first in Wuhan, Hubei Province, China; in late December 2019. SARS-CoV-2 rapidly spread across the globe in a short time, forcing the World Health Organization (WHO) to proclaim it a global pandemic on March 11, 2020.

Covid 19 has numerous signs and symptoms that go beyond respiratory issues. In the beginning, it was thought that many of those infected had no symptoms at all. Individuals with Covid 19 developed mild to moderate symptoms, though the illness would become severe if not effectively treated. Now it’s understood that some of those with no visible symptoms of the disease, may have had other complications that were simply thought as not related to COVID-19. The most known symptoms of coronavirus are:

  • Respiratory distress
  • Fever
  • Breathing difficulties
  • Tiredness
  • Irritated throat
  • Coughing

Some individuals present other more severe symptoms that require hospitalization. Some severe signs of covid 19 are pneumonia, Acute respiratory distress syndrome (ARDS), sepsis, and septic shock. Some Covid 19 emergency warning signs that require immediate medical attention include:

  • Problem breathing or shortness of breath
  • Persistent chest pain or pressure
  • Confusion
  • Bluish face or lips

Travel Restrictions and their effect on travelers

There are numerous ways in which the pandemic has affected travel. Due to the pandemic, different countries had travel restrictions in place to contain the spread of the deadly virus. These restrictions became bans and bans caused certain areas of tourism to be forced to shut down entirely. Though the world is recovering from the damage caused by the pandemic, travelers can still feel its effects. Here are some of the ways the COVID-19 is still affecting individual travelers and the tourism industry in general:

RISK MANAGEMENT PERCEPTION: 

We all like to have a certain amount of safety when traveling, be it for business or leisure travel. As humans, we mentally assign a threshold as to how much we’re willing to risk in achieving our goals. That is often referred to as risk management. Whether it’s touring famous destinations or traveling to a meeting in Florida, we assess our risk before we jump into a plane, cruise, or other method of transportation. Because of the Covid 19 pandemic, there’s an inherent risk of catching a disease that may directly or indirectly impact us, our work, and worst of all—our loved ones. This has changed our behavior as a social species. Before the pandemic, crowded destinations where acceptable and posed no major risk in our collective psyche. Nowadays, to prevent the spread of the virus, we’ve seen how individuals and families have opted to spend their time in less crowded places. This is due largely in part to the combined efforts of various institutions, such as the CDC, to reduce the spread of this deadly virus.

MENTAL HEALTH AND TRAVELERS ANXIETY: 

Travelers now experience an abnormal amount of stress and anxiety over what seems to be a never-ending stream of ever-changing travel restrictions. Everyone has a different threshold when it comes to their travel risk management. To some, facing flight cancellations due to the travel restrictions and other requirements for visitors, could possibly be the biggest deterrent of all. To others, it could be the lack of access to public transportation, or the temporary or permanent closure of businesses and attractions we they wanted to visit. This all leads to negative emotions, such as anxiety, and dismay – which we naturally never want associated with our travels.

ECONOMIC IMPLICATIONS: 

The consequences of the Covid-19 pandemic have antagonistic effects on the tourism sector and the world economy. A few countries imposed strict travel bans to contain the pandemic spread. Countries such as Barcelona, Rome, and Bali are tourist attractions that have suffered an economic breakdown. The United Nations World Tourism Organization announced that the global predicament caused by COVID-19 in the tourism industry led to the loss of US$300–450 billion.

How to safely go back to traveling?

As a traveler, you also have a role to play in reducing the spread of Covid 19, so the world will not face another lockdown. You do not have to be a health practitioner to know the effects of the disease and its impact on our lives and our quality of life. By testing for COVID-19 you can detect the virus early and report yourself to health workers for adequate treatment. This action can help prevent the spread of the virus and ensure that we can keep the pandemic under control for long enough to see the restrictions lifted and our ability to travel (and enjoy traveling!) restored.

The good news is that every traveler can now perform their own Covid 19 Rapid Test at their convenience and the comfort of their own home. Remember when we all had to travel to COVID testing locations? some near you, some way too far away—(and, oh the lines!); well, those days are gone. The introduction and FDA approval of At-Home Self-Test Kits has changed everything. They became the go-to for those wanting to travel and the method of choice accepted by airlines, cruises, restaurants, and tourist destinations.

Which COVID 19 self test kit is the best for Travelers?

Two of the most popular kits highly recommended for their accuracy are the BinaxNOW COVID 19 At-Home Antigen Self Test Kit and IHealth® Covid-19 Self Test Kit. Both kits have been approved by the FDA and guarantee same-day results. These kits efficiently detect covid virus infection with the accuracy expected from a lab, without the uncomfortable feeling of getting your nostrils swabbed by a 3rd party. You can test all covid 19 variants with the kits in under 15 minutes.

Convenience and Comfort: 

Both of these Covid 19 self-tests require no prescription, and they come with an instruction card you can easily follow, with the option to download an app to watch their instructional videos. They promise zero discomfort, and you can do the test any time of the day.

Accuracy: 

Each Covid 19 self-test box comes with 2 test kits for repeat testing. You only must test yourself twice within three days or at least after 36 hours. Frequent testing is one of the best ways to stop the virus from spreading and increase the accuracy of your results. Human error still plays a big part in the accuracy of these tests, which means that you should always exercise caution when performing and reading the test results to avoid false negatives or false positives. Taking your time and thoroughly reading the instructions included will improve the chances of an accurate test result significantly.

Covid 19 Variant Detection: 

BinaxNow and iHealth covid self-test kits can detect numerous COVID-19 strains, including the latest Delta and Omicron variants.

Where to buy BINAXNOW and IHealth® COVID 19 AT-HOME Antigen Self-Test Kits?

Since these test kits do not require a prescription, you can get them over the counter or you can purchase them from the comfort of your home by ordering it online from a trusted and authorized online supplier.

Early detection of the virus prevents the spread and keeps you from developing more severe symptoms. It means you will receive early effective intervention to keep you and your loved ones safe and healthy. It’s a small action that can have such a big impact in recovering from the pandemic so we can embark on travel adventures once again.

Media Contact
Company Name: Peach Medical Labs
Contact Person: Andriy Tkach
Email: Send Email
Country: Canada
Website: peachmedicallabs.com/

Source link

If you’re constantly sneezing, coughing, or experiencing a sore throat, the first thing you might think about is colds or flu. It is actually difficult to distinguish because they have similar symptoms. However, those can also be signs of allergies. Colds, flu, and allergy affect your respiratory system, mainly the nose and throat, which commonly causes sneezing.

Doctor Allergies Do you know why you're sneezing? Labcorp

Since the COVID-19 virus is still out there, you might also be concerned about whether the symptoms you’re experiencing—like sneezing—are COVID-related or just an allergy. It is important to understand their differences to help you choose the right treatment or method of relief. 

Differences Between Colds, Flu, and Allergy

Colds and flu are contagious respiratory illnesses caused by viruses. Flu is caused by influenza viruses specifically, while common colds can be caused by different viruses, such as rhinoviruses and parainfluenza, and several coronaviruses (from the same family of viruses as SARS-CoV-2, which causes COVID-19). Both can cause a runny or stuffy nose, congestion, coughing, sneezing, and sore throat. 

Flu can cause a high fever that lasts for three to four days, as well as headache, fatigue, and general aches and pains. It can lead to serious complications like pneumonia. On the other hand, colds are usually milder than flu and do not typically result in severe health problems. People with colds are more likely to have a runny or stuffy nose.

Breathe Breathe easy. Pexels

While flu and colds are contagious, an allergy can not be passed from one person to the other. Once you inhale a substance (also called an allergen) you are allergic to, such as pollen, dust mites, mold, animal dander, and other substances that are not infectious, your immune system will react to it, causing your nose to become stuffy or runny. Allergies typically last for as long as you’re exposed to the allergen. It can be up to six weeks during the spring, summer, and fall pollen seasons.

Allergy: Symptoms and Treatments 

Your body produces IgE (immunoglobulin E) antibodies when encountering allergens that can inflame your skin, sinuses, and airways. They cause the release of chemicals like histamine, which results in swelling and inflammation. As your body tries to get rid of the allergens, you may experience symptoms such as a runny nose, itchy or watery eyes, rashes, and sneezing. 

Allergy symptoms depend on the substance involved. Allergic reactions can range from mild to severe. In some severe cases, it can cause a potentially fatal reaction known as anaphylaxis. There are also different types of allergies: 

  • Seasonal allergy (Pollen allergy, dust allergy, hay fever) 
  • Mold allergy
  • Pet allergy
  • Food allergy
  • Drug allergy
  • Skin allergy
  • Eye allergy
  • Insect sting allergy
  • Latex allergy

One of the most effective and natural ways to prevent or manage allergy symptoms is to avoid triggers or allergens. Since allergens are everywhere, making it difficult to avoid, you can take medications to relieve your symptoms. Antihistamines, corticosteroids, and decongestants can be used to treat minor allergy symptoms.

Allergy Symptoms Keep your allergy symptoms at bay. Labcorp

If your symptoms are no longer manageable with over-the-counter medications, you should see a healthcare provider to determine if you might benefit from other treatments. If you are experiencing a severe allergic reaction like anaphylaxis, you must seek medical care immediately. 

Why Do You Sneeze When You Have an Allergy?

Many of you might be wondering why people are sneezing when experiencing allergies. Allergens commonly target the nose and sinuses, so your immune system will create a protective response like sneezing or coughing. It triggers the release of the harmful substance, alerting the brain to sneeze to force the allergen out of your system. 

When you’re cleaning the house or simply walking outside, you may notice that you’re suddenly sneezing a lot. It is probably because you inhale dust or pollen, causing irritation. When these substances enter your body, it responds by releasing histamine to attack the invading allergens through sneezing.

Accessible Allergy Blood Test

More than 50 million Americans suffer from allergies each year. However, most people are unaware of the allergen or allergens causing their symptoms. Allergies generally cannot be prevented, but allergic reactions can be. Once you know you’re allergic to a substance, you can identify strategies that help you avoid the allergen.  Strategies include being in an air-conditioned environment during peak hay fever season or eliminating dust mites and animal dander from your home.

Allergy Blood Test Get tested. Labcorp

According to AllergyInsider.com, up to 80 percent of people with allergies are sensitized to multiple things, making it complicated to track symptoms back to the specific sources. This underlies the reason to take an allergy blood test. Labcorp OnDemand has an Indoor and Outdoor Allergy Test that can easily assess potential allergens so you can seek the necessary treatment and lifestyle modifications. 

The Labcorp OnDemand Indoor and Outdoor Allergy Package includes the following:

  • Dust Mite (D pteronyssinus)
  • Dust Mite (D farinae)
  • Cat Dander
  • Dog Dander
  • Mouse Urine
  • German Cockroach
  • Bermuda Grass
  • Kentucky Bluegrass
  • Leaf Mold
  • White Oak
  • American Elm
  • Short Ragweed
  • English Plaintain (Lamb's Tongue)
  • Sheep Sorrel

Simply shop for the test at Labcorp OnDemand and pay via a credit card or HSA/FSA.   You can then schedule an appointment or walk in to nearly 2,000 convenient Labcorp locations for a quick blood collection.

In a few days, you will be notified to access and view your easy-to-read results online in your Labcorp OnDemand account. You can also download your results if you need a copy or bring them to the doctor.

Labcorp OnDemand’s Indoor and Outdoor Allergy Package is one of the most helpful ways to manage and understand your allergies. It will also guide you to make informed decisions about your health and the surrounding environment during allergy season or year-round. 

Although allergies are typically not severe, please keep in mind that you need to consult a doctor if your allergy causes trouble breathing, persists for many months or returns frequently.

To learn more about Labcorp OnDemand and the portfolio of tests that can be purchased, please visit OnDemand.Labcorp.com



Source link

In a soft, sad tone, Jagjyot Singh talks about “fighting till the end”. His mother, Sarabjeet, admitted for Covid-19 at Delhi’s Jaipur Golden Hospital, died on the fateful night of April 23, 2021, when oxygen ran out in the intensive care unit (ICU). She was left “gasping like a fish out of water”.

She was only 58.

A year later, her family, among those of the 25 others who died the same night, is struggling, not just for justice but for mere acknowledgment. The death certificate issued in Jagjyot’s mother’s name describes the manner of death as “natural,” and the cause of death column has been left blank.

Similar deaths, from oxygen shortage for Covid-19 patients, occurred at scores of hospitals across India. These hospitals were on record, admitting the interruption in supply and desperately seeking emergency interventions as the public health system went under siege during the pandemic’s second wave.

Yet this year, as hundreds of thousands of Indians mourn and mark the first year anniversary of the loss, devastation and a lifetime of grief, Parliament was told that not a single oxygen shortage death was reported by any state.

The travesty of this, the sheer brazenness, is underscored by our response to the World Health Organization (WHO) report on uncounted Covid-19 deaths. India has rubbished the claim that of nine million uncounted fatalities globally, nearly half — 4.7 million deaths — took place here. The government has challenged WHO’s mathematical model, the use of media reports as sources, and the one-size-fits-all formula across different states, to allege bias in the assertion that nearly 10 times more deaths took place than what the official count reveals.

Sure, WHO may be discredited and has not covered itself in glory over handling the Wuhan link to the pandemic. Its modelling may well be wrong. But the Indian counter to WHO would have had power and authenticity had it been accompanied by a simultaneous visible and transparent process to try and count every citizen whose life was lost during these two years.

It is the cold and clinical insistence that our formal death count is entirely accurate — when evidence on the ground clearly shows otherwise — that, in fact, weakens our argument.

That, and a lack of empathy.

When Dr Vinod Paul, the top government official at the helm of India’s Covid-19 response, says there is “nothing dramatic” in India’s death data, he is, perhaps unwittingly, discounting the guttural tragedies and daily struggles of hundreds of thousands of Indians, most often those who are abjectly poor, to merely procure a death certificate during the pandemic.

While we get all prickly and huffy about the WHO report, I am not sure how many know that Indians who did not get an RT-PCR (reverse transcription polymerase chain reaction) test have not been counted in the official tally. This effectively means the invisibilisation of Covid-19 deaths in large parts of rural India. Whether it was the rural belt of Hosur in Tamil Nadu or the hinterland of Uttar Pradesh, every hamlet I travelled to in 2021, recorded a spike in deaths in April and May. Relatives of those who died testified to fever and difficulty in breathing — Covid-19 symptoms — but spoke of the difficulty in getting a test in their vicinity.

Hospitals were tough to reach during state lockdowns and there was also the stigma associated with being positive. Most commonly, villagers treated locally were told they probaby had pneumonia or “motijhara” (an enteric fever like typhoid), till their condition worsened and it was too late.

And, what of those who died inside ambulances and outside the closed gates of hospitals that ran short of beds? Or those who were abandoned by the river banks of the Ganga in the darkness of the night as people were either unable to afford firewood or were too terrified? Or those who had tuberculosis, cancer, or kidney disease, who could have been treated and saved, but weren’t because ambulances, doctors, and ICUs were all snowed under and unavailable?

I witnessed devastated families who sold everything — land, gold, and even their phones — to pay hospital fees. They then made dozens of trips to an administrative office to get a death certificate. Worse, there was a formal order in some states advising officials to leave it to the hospitals to certify a Covid-19 death; subsequently, the “cause of death” column was left empty for countless Covid-hit families.

So desperate was the situation that in Jaipur, a government employee who worked in the division that issued death certificates could not get one for his wife who died from Covid-19, prompting him to write a letter urging a more transparent and humane system.

The debate around India’s uncounted deaths is not about arithmetic. It’s about truth-telling.

And what we owe as a nation to ourselves. And to our people.

Barkha Dutt is an award-winning journalist and author The views expressed are personal.

Source link

Courtesy Heather-Elizabeth Brown

(NEW YORK) — Heather-Elizabeth Brown feels grateful to have survived her bout with severe COVID-19. But more than two years after testing positive for the virus, she is still managing the physical and mental toll.

After contracting COVID-19 early in the pandemic and subsequently going on a ventilator for a month, she faced significant health challenges, from rehabilitation to chronic conditions including diabetes.

“COVID has taken a lot from me,” Brown, 37, a corporate training consultant in Detroit who is a COVID long hauler, told ABC News’ Good Morning America. “I took for granted how much I was just ‘go, go go’ before I became ill in April 2020.”

Doctors have made progress in treating people with lingering COVID-19 symptoms, though there is still much to still learn about who experiences it and why. With no test for long COVID, it also can be difficult to diagnose.

Studies so far estimate as many as 13% to 30% of people who get COVID-19 may later develop long COVID, which commonly include fatigue, shortness of breath and “brain fog” for weeks, months or, as in Brown’s case, years after the initial infection.

“I would be lying if I said that my life wasn’t irrevocably changed by this whole experience,” Brown said.

Admitted to the ICU

Brown first started showing symptoms in April 2020, though tested negative for COVID-19 twice, she said.

“I was starting to have trouble breathing,” she said. “I was so tired. I was barely able to perform basic functions to take care of myself.”

As her systems worsened, she went to the emergency department three times before she was admitted with symptoms including an elevated temperature.

An X-ray showed that Brown — who eventually tested positive for COVID — had COVID-induced pneumonia in both lungs, and she was put on the “highest level of oxygen,” she said.

Within two days of being admitted, doctors told her that her lungs were failing. She was put into a medically-induced coma and placed on a ventilator on April 18, 2020, she said. She remained on the ventilator for 31 days.

“It was an experience that I don’t think I can explain adequately,” Brown said. “I had a lot of vivid dreams and nightmares.”

When she woke up, she wasn’t able to talk due to a breathing tube and wasn’t able to walk.

“The whole left side of my body was so weak, I couldn’t even hit the call button for the nurses,” she said.

Due to COVID-19 protocols, she wasn’t allowed to see anyone beside the hospital staff.

“I was able to FaceTime with my mother but no one was able to visit me in the hospital,” she said.

Life post-COVID

For patients who have been on ventilators for a prolonged period of time, it’s common to use medications that may cause severe muscle weakness, according to Dr. Annas Aljassem, director of functional pain and rehabilitation at Beaumont Hospital in Royal Oak, who treated Brown.

“A lot of their post-recovery is retraining muscles,” he told Good Morning America. “On top of that, a lot of these long haulers will have debilitated lungs.”

That can translate to a “prolonged recovery time for the things that we take for granted, day-to-day kind of things,” Aljassem said.

Brown said she went to rehabilitation for about seven weeks due to her prolonged ICU stay, and has gone through months of physical therapy, pulmonary therapy and occupational therapy.

“You never think at 35 that you’ll be re-learning something so basic that we take for granted as walking,” she said.

Brown said she had to use a home healthcare company to help her do things around the home.

“I still walk with a limp. I’m still working on tackling the stairs, standing for long periods of time,” she said. “I haven’t started walking again in high heels yet but that’s on my list of things to do and I’m committed to that.”

In addition to recovering from an extensive ICU stay, Brown also now manages diabetes and high blood pressure — two health conditions she didn’t have before getting COVID-19.

“For a while, I was on a lot of insulin, but since I’ve been able to get it more managed,” she said of her diabetes.

Research has found that COVID-19 survivors are at an increased risk of being newly diagnosed with diabetes up to one year after recovering. There are several theories for why, though the exact cause has not yet been determined.

Brown said she has also had issues with nerve pain and brain fog, though the latter has gotten “infinitely better.”

Common long COVID symptoms include severe fatigue and impacts to thinking and breathing weeks or months after the initial infection, according to Dr. Jason Maley, the director of the Beth Israel Deaconess Medical Center’s Critical Illness and COVID-19 Survivorship Program and an assistant professor of medicine at Harvard Medical School.

For cognitive impacts, “We approach it in many ways similar to how we try to help patients who have had traumatic brain injury or concussion recover, because we see a lot of overlap in the symptoms and the ways it’s affecting people’s brain function,” Maley said.

Those experiencing fatigue may experience what’s known as post-exertional malaise, he said.

“They feel physical illness and worsening of all of their symptoms as a result of trying to be physically active, even if it’s just mild activity around the house,” Maley said. “That’s been described in other post-acute infectious illnesses prior to COVID-19.”

Other patients may be fatigued and weak due to an ICU stay and need to rebuild their muscles.

“That takes time and that’s really a more intensive rehab approach,” he said.

Mental toll, too

Long COVID has also been a mental struggle for Brown, as she’s often wondered, “Why me?” and has been frustrated by her extensive recovery. She said she also has post-traumatic stress disorder from her ICU experience.

“I want a normal week where I’m not constantly reminded in some way, shape or form of COVID. Of the struggle that I’ve had with COVID and the trauma that I’ve endured,” she said.

A study led by Maley that was published last month in Critical Care Explorations, the peer-reviewed journal of the Society of Critical Care Medicine, found that “significant symptoms” of post-traumatic stress were found in one-third of ventilated patients six months after they were discharged from the hospital.

Aljassem said he has seen COVID long haulers experience mental trauma from the prolonged isolation they experienced during their treatment and subsequent rehab.

“Mentally they may be in a place and physically their bodies are in another place,” he said. “Processing that mentally is a very important piece of your recovery.”

Maley said long haulers also may experience trauma if their illness is not recognized by their healthcare provider.

“It’s clear to us this is a real illness and there’s a lot of mounting scientific studies about this, but it doesn’t always show up easily on an X-ray, or it’s not showing up on a simple blood test,” he said. “When you can’t think straight and you’re exhausted all day and you were previously perfectly healthy before this, it’s really traumatizing to be searching for answers and have people largely ignoring you.”

Finding support and renewed faith

As she continues to battle COVID-19 symptoms, Brown said she is “getting back to the best parts of me” before she got sick. Part of that involves her faith.

“I definitely feel like my faith has been strengthened,” said Brown, who is a minister at her church. “I feel like I’ve gotten confirmation of the things that I was believing and professing in faith but then to have a moment to see it manifest in real life is much different.”

Seeing a therapist trained in PTSD has also helped Brown process the trauma she experienced and be patient in her healing journey, she said.

“She said you’ve been through so much, you have to be kind and you have to learn how to make sure that you’re gentle with yourself,” Brown said. “Something I had to remember and honor — I am still on a healing journey, and every day is not the same.”

Aljassem said that compared to where Brown is now versus when he first met her is “miraculous.”

“There’s always that discrepancy in how you view yourself, especially in how your healthcare team is viewing you,” he said. “I try to reinforce to her specifically on focusing on those little victories every day and not so much what I can’t do anymore.”

Brown has also devoted much of her time and emotional energy to long-hauler advocacy and being a voice for the community. She is involved with several support and advocacy groups for COVID-19 survivors, including the Body Politic Covid-19 Support Group and the COVID-19 Longhauler Advocacy Project.

“I am a fierce advocate for the COVID-19 long hauler community and for people who have survived this, and for families who are dealing with it in any capacity,” she said. “I take seriously the position I’ve been given to be able to just encourage people and to let people know that even though it can be difficult and even though it can be scary it’s definitely something that people can overcome.”

She does feel that there’s a lot more work to be done for the community and in understanding long COVID.

“[We’re] keeping our feet on the gas when it comes to research and when it comes to education and when it comes to really being vocal proponents for people who have been affected by COVID,” she said.

As more is learned about long COVID, doctors may be able to implement better strategies in treatment, Aljassem said.

“It’s tough to develop treatments without understanding disease, but at the same time, we as clinicians … feel the need and pressure to find things that will help people feel better,” Maley said.

Brown said it continues to be a challenge comparing herself to who she was before COVID-19, but that being a long hauler has made her more resilient and kinder to herself.

“I’m still thankful and I’m still grateful for my life,” she said. “I’m hopeful for my future but I just realized that I have to take it one day at a time.”

Copyright © 2022, ABC Audio. All rights reserved.

Source link

ReportLinker

ReportLinker

Major players in the respiratory devices and equipment market are Smiths Medical, Philips Healthcare, GE Healthcare, Chart Industries, Invacare Corporation, Fisher & Paykel Healthcare Limited, ResMed, Dragerwerk AG, Medtronic plc, Masimo corp.

New York, May 13, 2022 (GLOBE NEWSWIRE) -- Reportlinker.com announces the release of the report "Respiratory Devices And Equipment (Therapeutic And Diagnostic) Global Market Report 2022" - www.reportlinker.com/p06277193/?utm_source=GNW
, and CareFusion Corporation.

The global respiratory devices and equipment (therapeutic and diagnostic) market is expected to grow from $25.23 billion in 2021 to $28.97 billion in 2022 at a compound annual growth rate (CAGR) of 14.8%. The market is expected to grow to $47.86 billion in 2026 at a compound annual growth rate (CAGR) of 13.4%.

The respiratory devices and equipment (therapeutic and diagnostic) market consist of sales of respiratory devices and equipment (therapeutic and diagnostic) and related services. Respiratory devices and equipment are used to provide medication or assist a patient who is having difficulty in breathing and cannot achieve adequate oxygen levels to maintain life.

The main types of respiratory devices and equipment are diagnostic devices, therapeutic devices, and monitoring devices.The diagnostic devices are used to diagnose respiratory-related issues.

The various therapeutic devices are humidifiers, nebulizers, oxygen concentrators, positive airway pressure (PAP) devices, ventilators, and others.The diagnostic devices involved are spirometer, polysomnographs, and peak flow meters and monitoring devices are pulse oximeters, capnography, and gas analyzers.

These provide applications in chronic obstructive pulmonary disease (COPD), asthma, obstructive sleep apnea (OSA), respiratory distress syndrome (RDS), cystic fibrosis, and pneumonia. These are used by hospitals, clinics, home care settings, and ambulatory service centers.

Asia Pacific was the largest region in respiratory devices and equipment (therapeutic and diagnostic) market in 2021.Western Europe was the second-largest region in respiratory devices and equipment (therapeutic and diagnostic) market.

The regions covered in this report are Asia-Pacific, Western Europe, Eastern Europe, North America, South America, Middle East, and Africa.

The global therapeutic respiratory devices and equipment market will be driven by the increase in diseases such as Chronic Obstructive Pulmonary Disease (COPD), asthma, and lung cancer.Growth in the geriatric population, tobacco consumption, allergens, and air pollutants increase the prevalence of respiratory diseases, in turn driving the global therapeutic respiratory devices market.

According to World Health Organisation,4.9 million people die due to tobacco consumption, and smoking causes chronic obstructive pulmonary diseases (1 million deaths annually), cardiovascular and respiratory diseases (1.7 million deaths annually), and lung cancer (0.85 million deaths annually). According to an Italian journal, COPD in the U.S. is estimated to be 10% in the population aged 75 years or over. According to Asthma UK, 5.4 million people in the UK are currently receiving treatment for asthma out of these 1.1 million are children and 4.3 million are adults.

A longer duration of time taken in the approval process of the respiratory devices is restricting the respiratory devices and equipment market growth. Before a new respiratory device is introduced to the market, it takes 7.2 months for the FDA approval process, which adds to development costs to be borne by device manufacturers, thus acting as a restraint hindering the market growth. For instance, FDA reviews about 4,000 submissions every year and takes about 3 to 6 months in clearing most of them. In addition to this, to reduce incidences associated with the respiratory devices and ensure that the devices are safe and have the least adverse reactions, the Medicines and Healthcare products Regulatory Agency (MRHA), UK regulates and monitors the devices by restricting devices for use and sending field safety notice to correct the devices. These stringent approval processes and regulatory policies may impact the respiratory devices and equipment market.

Companies in the respiratory devices and equipment market are increasingly investing in enhanced mechanical ventilators for efficient patient management.These mechanical ventilators use artificial intelligence to improve patient management by examining, analyzing, integrating, and incorporating data from extensive sources.

These AI-enabled devices ensure consistency even in the absence of expert personnel, improve patients’ treatment, limit clinical mistakes, and predict prolonged mechanical ventilation by using artificial intelligence techniques. Some of the major companies offering intelligent mechanical ventilators such as Hamilton Medical AG, Koninklijke Philips N.V., and others.

In March 2019, the Medicines and Healthcare products Regulatory Agency (MRHA), a regulatory body for respiratory devices of the UK, sent a medical device alert to Draeger, a medical device manufacturer, on its breathing circuits VentStar Helix and Set2go products, as the breathing circuits used in conjunction with devices are not compatible.These devices impact patients’ health as cracks have formed in the breathing hose during ventilation.

MRHA sent a field safety notice to correct the device to reduce incidences associated with these devices and promote the use of hoses solely with devices that are declared as compatible in the instructions for use. Similarly, in March 2019, O-Two Medical Technologies, a Canada-based medical technology manufacturer, was sent an urgent field safety notice to stop use and return for inspection of O-Two eSeries Ventilators e700,e600, and e500 to inspect device functions, reset and analyze the data.

The countries covered in the respiratory devices and equipment market are Brazil, China, France, Germany, India, Indonesia, Japan, South Korea, Russia, the UK, USA, and Australia.
Read the full report: www.reportlinker.com/p06277193/?utm_source=GNW

About Reportlinker
ReportLinker is an award-winning market research solution. Reportlinker finds and organizes the latest industry data so you get all the market research you need - instantly, in one place.

__________________________

CONTACT: Clare: [email protected] US: (339)-368-6001 Intl: +1 339-368-6001

Source link

Three small children with junctional epidermolysis bullosa (JEB) developed extensive damage to the airways and lungs, which led to breathing problems that proved fatal, according to a U.S. report.

The report, “Junctional epidermolysis bullosa with extensive lung involvement in three patients with a LAMB3 mutation,” was published in the journal Pediatric Dermatology.

Epidermolysis bullosa occurs when the skin and the mucosa become too fragile, causing them to blister easily. The mucosa is a membrane that lines or covers the internal organs in the body.

In patients with JEB, this is most frequently a result of mutations in LAMA3, LAMB3, and LAMC2 — three genes that provide instructions for making different components of a protein called laminin 332.

Recommended Reading

Filsuvez | Epidermolysis Bullosa News | Europe | illustration of woman with megaphone

The mutations result in a protein that works poorly or does not work at all. Laminin 332 can be found in the basement membrane zone, which lies between two skin layers called epidermis and dermis, where it helps hold them attached.

When the mucosa is affected, internal organs, including those involved in breathing, can become damaged. This is well described for the upper respiratory tract — nose, mouth, throat, and voice box — but not so well for the lungs.

In this study, researchers at the Children’s Hospital of Philadelphia reported the cases of three children with generalized JEB who had extensive involvement of the lungs. All three had mutations in the LAMB3 gene.

The first case was a boy who was admitted to the hospital at age 6 months with worsening trouble breathing. He was born with abrasions on the left elbow and multiple fluid-filled blisters and erosions on the face, leading to a diagnosis of JEB.

Microlaryngoscopy and bronchoscopy — two procedures to examine the airways — revealed lesions in the vocal cords and glottis, which is the opening between the vocal cords. A tracheostomy — a surgical opening into the trachea — was performed to provide an airway to the lungs and help with breathing.

He was slowly weaned off breathing support and placed on continuous positive airway pressure (CPAP) therapy to receive constant and steady air pressure. However, his levels of oxygen in the blood dropped, and those of carbon dioxide went up. He also developed recurrent pneumothoraces (collpased lung), which occurs when air leaks into the space between the lungs and the chest wall. Imaging exams revealed widespread lesions in the chest.

At age 7 months, doctors decided to stop supporting the boy’s breathing given the level of disease and the associated complications. Examination of the airways and lungs after death revealed changes to the cells of the bronchi (the tubes connecting the windpipe to the lungs), a buildup of inflammatory cells, and infection (pneumonia).

The second case was a girl aged 1.5 months who presented with a history of noisy breathing, cough, and blood-tinged saliva. She had been diagnosed with JEB in the first weeks of life.

During her hospital stay, she was found to have a low volume of circulating blood. She had ulcers (sores) in the upper part of the voice box, and the vocal cords appeared blunt. She was placed on mechanical ventilation for one week to help with breathing. However, one week later, her breathing problems got worse.

Chest scans revealed a collapse of part of the lungs. Microlaryngoscopy and bronchoscopy revealed inflammation and swelling of the voice box, which narrowed the opening between the vocal cords.

She died at the age of 3 months after an episode of low oxygen levels in the blood. Examination of the airways and lungs after death revealed ulcers, a buildup of inflammatory cells, and enlarged airspaces.

The third case was a girl with a diagnosis of generalized severe JEB who had been admitted to the hospital at 3 months of age for wheezing. At 4.5 months, she was again admitted for trouble breathing with stridor, a harsh, vibrating noise when breathing caused by an obstruction. She also had extensive skin blistering.

Bronchoscopy revealed scarring and softening of the tissues of the voice box and narrowing of its upper part. At 9 months, she presented with trouble breathing and fever. She experienced several episodes of bleeding and septic shock, which occurs when a bodywide infection leads to dangerously low blood pressure. She died at age 1 year.

Examination of the airways revealed scarring of the mucosa lining the voice box and the trachea, which also was inflamed. The lungs had signs of bleeding and pneumonia.

In the three cases, “exacerbation of respiratory distress was associated with mucosal damage,” the researchers wrote.

“These cases illustrate the severe lower airway and parenchymal [functional tissue] complications that can occur in JEB in addition to the more commonly recognized upper airway mucosal involvement,” they wrote. “A multidisciplinary approach that includes families in respiratory management decisions is paramount, as prolonged ventilatory support in generalized severe JEB is generally not well tolerated.”



Source link

New York, May 13, 2022 (GLOBE NEWSWIRE) -- Reportlinker.com announces the release of the report "Respiratory Devices And Equipment (Therapeutic And Diagnostic) Global Market Report 2022" - www.reportlinker.com/p06277193/?utm_source=GNW
, and CareFusion Corporation.

The global respiratory devices and equipment (therapeutic and diagnostic) market is expected to grow from $25.23 billion in 2021 to $28.97 billion in 2022 at a compound annual growth rate (CAGR) of 14.8%. The market is expected to grow to $47.86 billion in 2026 at a compound annual growth rate (CAGR) of 13.4%.

The respiratory devices and equipment (therapeutic and diagnostic) market consist of sales of respiratory devices and equipment (therapeutic and diagnostic) and related services. Respiratory devices and equipment are used to provide medication or assist a patient who is having difficulty in breathing and cannot achieve adequate oxygen levels to maintain life.

The main types of respiratory devices and equipment are diagnostic devices, therapeutic devices, and monitoring devices.The diagnostic devices are used to diagnose respiratory-related issues.

The various therapeutic devices are humidifiers, nebulizers, oxygen concentrators, positive airway pressure (PAP) devices, ventilators, and others.The diagnostic devices involved are spirometer, polysomnographs, and peak flow meters and monitoring devices are pulse oximeters, capnography, and gas analyzers.

These provide applications in chronic obstructive pulmonary disease (COPD), asthma, obstructive sleep apnea (OSA), respiratory distress syndrome (RDS), cystic fibrosis, and pneumonia. These are used by hospitals, clinics, home care settings, and ambulatory service centers.

Asia Pacific was the largest region in respiratory devices and equipment (therapeutic and diagnostic) market in 2021.Western Europe was the second-largest region in respiratory devices and equipment (therapeutic and diagnostic) market.

The regions covered in this report are Asia-Pacific, Western Europe, Eastern Europe, North America, South America, Middle East, and Africa.

The global therapeutic respiratory devices and equipment market will be driven by the increase in diseases such as Chronic Obstructive Pulmonary Disease (COPD), asthma, and lung cancer.Growth in the geriatric population, tobacco consumption, allergens, and air pollutants increase the prevalence of respiratory diseases, in turn driving the global therapeutic respiratory devices market.

According to World Health Organisation,4.9 million people die due to tobacco consumption, and smoking causes chronic obstructive pulmonary diseases (1 million deaths annually), cardiovascular and respiratory diseases (1.7 million deaths annually), and lung cancer (0.85 million deaths annually). According to an Italian journal, COPD in the U.S. is estimated to be 10% in the population aged 75 years or over. According to Asthma UK, 5.4 million people in the UK are currently receiving treatment for asthma out of these 1.1 million are children and 4.3 million are adults.

A longer duration of time taken in the approval process of the respiratory devices is restricting the respiratory devices and equipment market growth. Before a new respiratory device is introduced to the market, it takes 7.2 months for the FDA approval process, which adds to development costs to be borne by device manufacturers, thus acting as a restraint hindering the market growth. For instance, FDA reviews about 4,000 submissions every year and takes about 3 to 6 months in clearing most of them. In addition to this, to reduce incidences associated with the respiratory devices and ensure that the devices are safe and have the least adverse reactions, the Medicines and Healthcare products Regulatory Agency (MRHA), UK regulates and monitors the devices by restricting devices for use and sending field safety notice to correct the devices. These stringent approval processes and regulatory policies may impact the respiratory devices and equipment market.

Companies in the respiratory devices and equipment market are increasingly investing in enhanced mechanical ventilators for efficient patient management.These mechanical ventilators use artificial intelligence to improve patient management by examining, analyzing, integrating, and incorporating data from extensive sources.

These AI-enabled devices ensure consistency even in the absence of expert personnel, improve patients’ treatment, limit clinical mistakes, and predict prolonged mechanical ventilation by using artificial intelligence techniques. Some of the major companies offering intelligent mechanical ventilators such as Hamilton Medical AG, Koninklijke Philips N.V., and others.

In March 2019, the Medicines and Healthcare products Regulatory Agency (MRHA), a regulatory body for respiratory devices of the UK, sent a medical device alert to Draeger, a medical device manufacturer, on its breathing circuits VentStar Helix and Set2go products, as the breathing circuits used in conjunction with devices are not compatible.These devices impact patients’ health as cracks have formed in the breathing hose during ventilation.

MRHA sent a field safety notice to correct the device to reduce incidences associated with these devices and promote the use of hoses solely with devices that are declared as compatible in the instructions for use. Similarly, in March 2019, O-Two Medical Technologies, a Canada-based medical technology manufacturer, was sent an urgent field safety notice to stop use and return for inspection of O-Two eSeries Ventilators e700,e600, and e500 to inspect device functions, reset and analyze the data.

The countries covered in the respiratory devices and equipment market are Brazil, China, France, Germany, India, Indonesia, Japan, South Korea, Russia, the UK, USA, and Australia.
Read the full report: www.reportlinker.com/p06277193/?utm_source=GNW

About Reportlinker
ReportLinker is an award-winning market research solution. Reportlinker finds and organizes the latest industry data so you get all the market research you need - instantly, in one place.

__________________________


        

Source link

The lungs are an essential part of the respiratory system. The respiratory system facilitates breathing and has two parts: the upper respiratory tract, which includes the airways like the nose, mouth, sinuses, and windpipe (trachea), and the lower respiratory tract, which consists of the lungs and bronchial tubes. 

The lungs’ main role is to deliver oxygen to the blood and remove carbon dioxide from the blood. Air enters the nose or mouth and passes through your windpipe and into the bronchial tubes when you breathe in. The bronchial tubes lead into the lungs and branch out into smaller tubes known as bronchioles, which end in small air sacs known as alveoli.

The alveoli are surrounded by capillaries (small blood vessels) that carry oxygen-low blood through them. Oxygen from the air in the alveoli flows into the blood, and carbon dioxide moves out of the blood and into the alveoli.

The carbon dioxide flows from the alveoli and back up through the respiratory system, where it is exhaled out of the mouth or nose.

In this article, you will learn about lung anatomy, how lungs function, and how to keep them healthy.

Igor Alecsander / Getty Images


Lung Anatomy

Though both lungs are similar in makeup, they are asymmetrical. The left lung is slightly smaller than the right lung to accommodate the heart. The right lung has three lobes—the right upper lobe, the right middle lobe, and the right lower lobe. The left lung has an upper and lower lobe.

The lungs are wrapped in pleura, a two-layer membrane. Fluid between the layers helps reduce friction when breathing.

Both lungs have a pulmonary artery, bronchial arteries, and pulmonary veins that carry blood in and out of the lungs.

The alveoli inside the lungs are small thin sacs that allow for an exchange of gases, bringing oxygen into the blood and carbon dioxide out of the blood.

Muscles around the lungs aid in breathing. These muscles include the diaphragm, a disk-shaped muscle that sits under the lungs, and the intercostal muscles that run between the ribs. Muscles in the neck and mouth also help with breathing.

Lung Function

Though it is possible to control your breathing—you can take a deep breath, a shallow breath, or even hold your breath for a short period—most breathing happens without thought.

The autonomic nervous system controls breath and works involuntarily. The system senses when you need more oxygen, such as when exercising, and makes adjustments.

The autonomic nervous system has two divisions that have different functions in breathing, which are:

  • The parasympathetic system narrows the bronchial tubes and widens the pulmonary blood vessels.
  • The sympathetic system widens the bronchial tubes to allow more air in and narrows the pulmonary blood vessels. 

To help these systems, there are various sensors throughout the body to signal the body to adjust breathing rate:

  • Sensors in the joints and muscles detect movement, which can signal to the body that you are exercising and an increase in breathing rate is necessary.
  • Sensors in the brain and blood vessels measure oxygen and carbon dioxide levels in the blood, which signals the type of breathing rate adjustment needed.
  • Sensors in the airways themselves can detect substances that may irritate the lungs, such as smoke or allergens, which may cause coughing or sneezing.

Lung Function Tests

A lung function test can determine the health of the lungs. These tests show how well the lungs work and can include:

  • Spirometry: Spirometry is the most common lung function test. The test consists of breathing in and blowing into a tube that records the volume of air inhaled and exhaled. A healthcare provider walks you through the test and has you inhale and exhale in different manners—sometimes forcefully and others at a normal rate.
  • Diffusion capacity test: During this test, a gas mixture is inhaled and then exhaled to determine how well the alveoli function at moving gases into and out of the lungs and blood.
  • Overnight pulse oximetry (OPO): Overnight pulse oximetry can detect the amount of oxygen in the blood over an extended period, mainly at night during sleep. A sensor is placed over the tip of your finger during the test, and the oxygen saturation levels (the amount of oxygen in the blood) are recorded.
  • Six-minute walk test: This test can measure how well your heart and lungs work during exercise or movement. You will walk for six minutes during the test while your heart rate, oxygen levels, and blood pressure are measured.

Respiratory Diseases Affecting the Lungs

There are various respiratory diseases that can affect the lungs and reduce their ability to function. These diseases include:

  • Asthma: Asthma can obstruct the airways, causing wheezing or difficulty breathing. While the cause of asthma is not fully understood, certain pollutants can make it worse such as tobacco smoke and air pollution.
  • Chronic obstructive pulmonary disease (COPD): "COPD" is a term used to describe a group of progressive diseases that causes damage to the tissues of the lungs. This results in a variety of symptoms from shortness of breath to chest pain, a chronic cough, and tiredness.
  • Cystic fibrosis (CF). Cystic fibrosis is a genetic condition that causes the mucus in the lungs to become sticky and disrupt normal breathing patterns.
  • Lung cancer: Cancer of the lungs is a major cause of cancer-related deaths. Cancer of the lungs can affect any part of the lung structures.
  • Pneumonia: Pneumonia is often caused by infection. It results in inflammation in the alveoli of the lungs and can cause difficulty breathing. 
  • Tuberculosis: Tuberculosis is a highly contagious bacterial infection that can damage the lungs if not treated.

Maintaining Lung Health

Taking good care of your overall health, such as by doing the following, can help maintain lung health as well:

  • Regular exercise can keep your lungs healthy and strong.
  • Seeing your healthcare provider regularly for checkups can help detect problems with the lungs early, even if you have no symptoms.
  • Quitting smoking can prevent many lung issues since smoking is the leading cause of lung cancer and COPD issues like emphysema.
  • Taking good care of yourself to minimize exposure to infections can also help prevent lung issues, including washing your hands often, getting recommended vaccinations, and avoiding being around others who are sick.
  • Avoid air pollutants by paying attention to the air quality in your area and staying indoors when air quality is bad, avoiding secondhand smoke, and limiting your exposure to chemicals in your house and at work.

Summary

The lungs play an important part in the respiratory system. Their main function is to provide oxygen to the blood and remove carbon dioxide from the blood. Various diseases can affect the lungs, including asthma, infections, COPD, and cancer. Keep the lungs healthy by avoiding pollutants, getting regular exercise, and ceasing smoking.

A Word From Verywell

The lungs are a vital part of your health. When they are working as they should they will provide the oxygen you need to enjoy life with energy and vigor. If you have difficulty breathing or any symptoms related to lung disease, it’s important to talk to your healthcare provider right away.

Frequently Asked Questions


  • What are the first signs of lung problems?

    Some of the first signs of lung problems are shortness of breath, difficulty breathing, and tiredness.


  • What role do the lungs play in the respiratory system?

    The lungs provide oxygen to the blood and remove carbon dioxide from the blood.


  • How can you take care of your lungs?

    Taking care of your overall health can help you take care of your lungs. Exercise regularly, get routine checkups and avoid inhaling pollutants that can damage your lungs.

Source link

Published on 05/11/2022 06:57.

With the proliferation of viruses that cause respiratory diseases and the great demand for care in pediatric emergencies, some medicines are starting to be out of stock in pharmacies.

Increases number of patients with respiratory syndromes at HEC in Feira de Santana

Photo: Ed Santos/Acorda Cidade | State Children’s Hospital (HEC)

Laiane Cruz

With the arrival of autumn, the number of children who received care at the State Children’s Hospital (HEC), in Feira de Santana, affected by flu syndromes grew. According to data provided by the unit, in February this year 1,185 children were admitted to the emergency room, in March 2,096 and in April 2,138. In the first eight days of May, 648 children with respiratory problems were treated.

Photo: Ed Santos/Acorda Cidade

According to pediatric infectious disease specialist Igo Araújo, who works at the HEC, the numbers are frightening and reveal an accelerated increase in cases of respiratory syndromes in children.

“Even if we compare it with other years, we will see that there is really an important difference in the increase in cases. We usually say that from March to August are the months that pediatricians work the most in the emergency room. There was a 100% increase in cases, but we can see that there was an increase if we compare it to 2019, maybe there is no way for us to confirm or be sure, these children who were isolated for a long time, now they started to circulate and started to increase the circulation of these viruses”, he justified, in an interview with Acorda Cidade.

According to the specialist, most of the symptoms present in children are cough, runny nose, fever, abdominal pain, headaches, and sometimes, wheezing and bronchospasm.

“The great difficulty for us is to determine if it is an asthma condition for those children who already have a history of diseases before or if it is just a flu condition. The cold we say is caused by rhinovirus and often there is no fever, the flu usually already has a fever within the frame, but there are other viruses that can cause it, and then, it is the famous common flu. Most children have arrived at the hospital with the pattern of coughing, tiredness, difficulty breathing, sometimes just a runny nose, a hoarseness. Small children, under 2 years of age to under 1 year of age, are the ones who most require care, they get tired very quickly, they do not have the ease of mobilizing the secretion, as an older child and they will not say what they are sense,” warned the doctor.

Igo Araújo clarified that the beginning of the autumn/winter period has a drier, less humid climate and that actually causes pollution and these viruses to circulate more. Children with the return of classes, daycare centers, schools end up being clustered, closer together, facilitating the transmission of these viruses, such as covid-19, which is transmitted by droplets of saliva.

“Influenza, influenza, acute respiratory syndrome tend to be more aggressive than a cold, but depending on the public or the patient they affect, either one can be aggressive. Then the mothers get crazy, they get tired of us saying that the treatment is nasal wash and nebulization and they can trust that this is really it, some patients need some specific therapy, like we have Oseltamivir, which is an inhibitor of a replication of the virus of Influenza, but for some specific populations, under 2 years of age, some use specific medications, with some medications in nebulization such as steroids, but in fact that old grandmother’s syrup with honey is what will help many of them, remembering that the honey should be given over one year of age”, oriented the infectious disease specialist during an interview with Acorda Cidade.

With the proliferation of viruses that cause respiratory diseases and the great demand for care in pediatric emergencies, some medicines are starting to be out of stock in pharmacies. According to the infectious disease specialist, there is a lack of antiallergic and children’s antibiotics.

“When I think of antibiotics, when I think of a viral infection, which causes a bacterial infection, the first treatment ends up being amoxicillin, amoxicillin with clavulanate, and for the flu, some patients who have an allergic condition or a condition associated with asthma are now in need of treatment. Salbutamol or butazolidine, which are inhaled corticosteroids. Every viral condition, especially in children, can cause an accumulation of secretion, the infectious process, low immunity, and the child is not prepared for the bacteria, which lives in that environment and takes advantage of the opportunity and makes the infection. So we have it from otitis, which is ear infection, sinusitis of the face, pneumonia with some cases and unfortunately from children with cerebral empyema, which is pus in the head, especially after a sinus disease”, he informed.

With information from reporter Ed Santos from Acorda Cidade



Source link

Covid-19 has taken at least 18 million lives, and it is anyone’s guess how many of those deaths were due to a lack of medical oxygen. Governments don’t want to talk about the issue, because that could mean admitting that thousands—or even hundreds of thousands—of their citizens died unnecessarily. But unless health systems take steps to ensure a sufficient supply of oxygen in the future, they will be risking a repeat of the past two years.

While high-income countries are already working to secure their supplies of medical oxygen, many low- and middle-income countries (LMICs) will continue to need international support. Deaths from a lack of medical oxygen in these countries preceded the pandemic because global health and development agencies made no serious effort to help LMIC governments close the gap between need and supply.

That gap is one factor underlying LMICs’ stubbornly high newborn and child mortality, adult deaths from infectious and chronic conditions, and deaths from injuries that require surgery. Research published prior to the pandemic found that four out of five children hospitalised with pneumonia in Nigerian hospitals did not receive the oxygen they needed, and that simply putting oxygen into pediatric wards could reduce child deaths by 50 percent.

As Mike Ryan of the World Health Organization puts it, Covid-19 ripped a bandage off an old wound, driving a tenfold increase in the need for oxygen in the space of just weeks in some countries. LMICs now need about 500,000 large oxygen cylinders every day to treat Covid-19 patients, and this is just the tip of the iceberg. For every Covid-19 patient who needs oxygen, there are at least five other patients who also need it, including the 7.2 million children with pneumonia who enter LMIC hospitals each year.

The main vehicle for the international response is the ACT-Accelerator (ACT-A) Covid-19 Oxygen Emergency Taskforce, expertly chaired by Unitaid, which has built a system to help LMICs prevent oxygen shortages. To date, the Taskforce has delivered almost $1 billion—including $560 million from the Global Fund alone—to LMIC governments and their United Nations and NGO partners. This money has been spent on liquid oxygen, pressure swing absorption oxygen-generating plants, mobile oxygen concentrators, oxygen therapies, and the workforce needed to install, operate, and maintain the equipment.

This funding has helped more than 100 countries, mostly in Africa and Asia. But there are still LMICs struggling to provide oxygen, so the Taskforce has asked for another $1 billion in 2022. US President Joe Biden’s Second Global Covid-19 Summit this week also will emphasise the issue with an appeal to governments, companies, and philanthropies to do more.

The case to make to donors is clear. There is a moral obligation to treat Covid-19 patients and to flatten the pandemic death curve once and for all. Investments in oxygen will serve that goal and also save lives in the future. Not only is oxygen an essential treatment for almost all of the health conditions targeted by the UN Sustainable Development Goals; it is also a critical pillar of effective pandemic preparedness and response (PPR).

As the world pivots to long-term Covid-19 management, oxygen production and distribution systems will need to be embedded in global health infrastructure. International organisations with mandates to improve newborn and child survival, infectious- and chronic-disease management, and PPR all have a stake in access to oxygen. These agencies should formalise their nascent ACT-A oxygen partnership by transforming it into a Global Oxygen Alliance with a mandate extending to 2030 (to align with the SDGs), and with a membership broadened to include international agencies focused on chronic diseases.

There are five components to a successful alliance to close the oxygen access gap. First, LMIC governments and the national institutions responsible for providing medical oxygen need to take the lead. Ideally, they would be guided by politically endorsed national plans for oxygen access, with governments financing the effort as part of their health budgets.

Second, LMIC governments that need external support to finance their national plans should be able to leverage loans and grants from a variety of multilateral, bilateral, and philanthropic sources. The Global Fund should continue to provide grant funding as part of its new PPR objective, and multilateral development banks should provide loans for this purpose as well.

Third, oxygen producers should be given more incentives and opportunities to work in partnership with LMIC governments and global health and development agencies. Memoranda of understanding, non-disclosure agreements, and transparent and competitive tenders for equipment procurement, installation, and maintenance should all be made available, building on the ACT-A Covid-19 Oxygen Emergency Taskforce’s existing blueprint for industry partnerships. Moreover, development finance institutions should offer loans, equity, and guarantees to oxygen producers, and support LMICs seeking to reduce their dependence on oxygen imports and fragile global supply chains.

Fourth, UN agencies and NGOs with a strong LMIC presence must continue to support these governments as they develop national oxygen plans, collect data, procure supplies, train health-care workers and biomedical engineers, and monitor and evaluate progress. To do so, they will need ongoing funding from bilateral development agencies (such as USAID, the European Commission, and others) and philanthropies (such as the Bill & Melinda Gates Foundation, the Skoll Foundation, and others).

Finally, LMIC governments need access to high-quality, timely data on national oxygen needs—such as the annual number of hypoxemic patients and how much oxygen they require—and oxygen capacity in the health system so that they can move quickly to close deficits. Donors should invest more in national health surveillance and statistical institutions, while using the available data to generate estimates of the hypoxemia burden as part of the Global Burden of Disease. And independent agencies such as the Access to Medicine Foundation should be funded to hold the oxygen industry accountable.

The next six months are critical as we move beyond the acute phase of the pandemic. Ideally, by September, the ACT-A Covid-19 Oxygen Emergency Taskforce will have become a Global Oxygen Alliance, chaired by Unitaid and continuing to meet regularly to coordinate investments, mobilise resources, and monitor the impact of efforts to ensure equitable access to an essential medicine.

—Project Syndicate



Source link

In 30 years of practice, I have on numerous occasions offered to FDA leadership the opportunity to meet directly with the people who consumed food that was tainted under the FDA’s watch.  I have always thought that if they only had the chance to meet the victims and their families, they would understand just how important their jobs really are. Regardless of administration, I have yet to have a taker.

Linda Rivera, 57-year-old married mother and stepmother of six adult children, in excellent health prior to illness.

Onset of symptoms on 05/03/09 with nausea, vomiting, bloody diarrhea, and painful cramping. Symptoms worsened over next two days and seen in ER on 05/05 where she was treated for probable acute gastroenteritis. Rushed back to hospital that night after dramatic decline in condition. Tentatively diagnosed with acute colitis. By 05/07 labs showed hallmark red blood cell destruction consistent with HUS. Kidneys started to fail, and labs confirmed E. coli. Underwent surgery to remove a portion of ischemic colon and create a colostomy. Remained intubated for ten days postop due to respiratory distress. Started on daily apheresis and dialysis to help relieve her fluid buildup resulting from her failing kidneys.

Exhibited confusion, inability to follow commands, and express words although brain imaging showed no signs of damage. Discharged to rehab facility on 05/27 but was rushed back to hospital on 5/30 because of respiratory distress and signs of fluid overload. Re-started on aggressive dialysis. Because of persistent vomiting and concern that she had torn her esophagus, underwent an endoscopic procedure which revealed a hiatal hernia and extensive stomach inflammation requiring placement of a suction tube to remove excess stomach acid. Was stable enough for transfer back to rehab on 06/15.

Remained in rehab facility for 30 days with some improvement, then transferred to another facility on 07/17 because of chronic nausea, vomiting and failure to thrive with acute weakness and deconditioning. Developed chest pain and elevated heart rate requiring treatment with nitroglycerin, and ultimately readmitted to acute care hospital on 07/24 for evaluation of heart symptoms. Discovered to have gallbladder damage requiring an open surgical procedure to remove it and a stone in her bile duct.

Was discharged home for one day before she again collapsed and was back and forth in the ER over the next several days because of postoperative pain. Was readmitted for 10 days then sent back to rehab facility with diagnoses of erosive esophagitis, urinary tract infection, respiratory insufficiency, kidney insufficiency, malnutrition, deconditioning and cognitive dysfunction. Developed a fever on 09/11 and returned to acute care hospital with sepsis and pneumonia, requiring intubation and mechanical ventilation.  Tracheostomy performed on 09/22 to replace the endotracheal breathing tube. Transferred back to rehab on 09/25 on the ventilator, unresponsive with signs of liver failure and on a feeding tube. Transferred to multidisciplinary rehab facility after several months.

Experienced multiple setbacks requiring readmission over the next several months, with some signs of slow improvement. By 04/12/10 she was still in rehab for intensive rehabilitation despite ongoing cognitive and physical limitations and pain. She was briefly hospitalized during this time for evaluation of possible bowel obstruction. Overall, suffered multi-organ failure (bowel, kidney, brain, lung, gallbladder, and pancreas).

Prognosis includes end stage renal failure with anemia, bone loss, high blood pressure requiring palliative care or dialysis, because she is not a candidate for transplant. In terms of her gastrointestinal disease, she will likely face complications related to her colostomy include bowel obstruction, infection, chronic bile duct blockage, ascites (free fluid in the abdomen), abnormal electrolytes, and post-infectious diarrhea, pain, nausea, vomiting and dyspepsia (heart burn). She has cirrhosis in connection with liver damage, she has dental damage and infections, contractures to her hands, and ongoing cognitive dysfunction.

Medical Bills……………………………………………$5,537,755.03

Richard Miller, 57-year-old married railroad superintendent in previously good health who became ill two weeks after eating food contaminated with Hepatitis A.

Onset of symptoms on 11/03/03. Seen in ER with low blood pressure, dehydration, elevated liver enzymes, and sweating—all suspicious for hepatitis A. Condition worsened to the point that he was physically and mentally incapacitated. Rushed back to ER with nausea, dark urine, jaundice (yellow tint to skin and eyes).  Lab confirmed hep A. Liver function began to deteriorate with lethargy, pain, disorientation, confusion, in fulminant liver failure. Medically paralyzed and intubated to manage his breathing and erratic behavior.

Liver transplant performed on 11/08/03 with postop brain swelling, body temperature dysregulation. On 11/16/03 developed impending respiratory failure from pneumonia/pulmonary fluid. Gradual recovery began two weeks post-implant and started on intensive rehab program. Sustained nerve damage in his left arm and vocal cords because of surgery positioning and intubation, respectively.

Discharged on 12/03/03 on anti-rejection medication, with regular outpatient follow up in transplant clinic. Spent a total of 27 days in hospital.

Developed nerve damage and pain in legs and underwent surgery to repair vocal cord damage. Required psychiatric care and medication for disability related depression and suffered cognitive/social dysfunction because of prolonged deprivation of oxygen to the brain. Left with debilitating pain in left arm and legs.  Will likely required another organ transplant in his lifetime.

Medical Bills……………………………………………$662,659.00

Ashley Armstrong, 2-year-old with no prior medical history before becoming ill.

Symptoms began on 09/08/06 with diarrhea and lethargy which persisted for several days, then turning to bloody stool. Seen twice by family doctor who on 09/12 referred her to hospital for further evaluation and treatment of dehydration. Condition quickly deteriorated to include vomiting and signs of acute kidney failure consistent with HUS. Transferred to tertiary children’s hospital for specialty care where lab confirmed E. coli O157:H7 and diagnosed with pancreatitis, HUS (hemolytic uremic syndrome) with red blood cells destruction, and rapidly deteriorating kidney function.

Peritoneal dialysis catheter placed on 09/14 and central line placed for medication and IV access. Dialysis continued around the clock and blood pressure began to increase. Her liver and spleen became enlarged, and she developed an infection in her dialysis catheter. After 18 days she began to show some signs of urine output and she was transferred out of the PICU to the general pediatric floor on 10/05. She was started on Epogen to stimulate the growth of new red blood cells.

By 12/13 she was doing well enough to reduce dialysis to 1 x per day over the course of 8 hours with once weekly Epogen injection. Completed dialysis therapy later that month and catheter was pulled on 01/24/07. Blood pressure remained labile. Hospitalized for 38 days. Will need medical management for the rest of her life and will need regular blood draws to monitor her kidney and red blood cell status.

Prognosis includes probable decline in kidney function during puberty with ESRD, inadequate growth requiring daily growth hormone therapy, long term dialysis, first kidney transplant in 3-10 years with life-long anti-rejection medication. Additional transplants anticipated after 15 years but could be more frequent due to transplant failure as a result of her type O blood antibodies. Probable ancillary complications include short stature, weak bones, high blood pressure, premature heart disease, life-threatening infections, and cancer.

Medical Bills……………………………………………$199,706.26

Suzanne Bandy, 57-year-old married woman, in excellent health before becoming ill.

Diarrhea and abdominal cramping began on 09/05/06. On 09/08 referred to ER for labs and stool culture by her regular MD after developing mucousy/bloody diarrhea. Hospitalized for two days for workup and started on empiric antibiotics. Discharged home after negative stool culture despite low platelet count with diagnosis of infectious colitis v. inflammatory bowel disease. While home, became weaker, lethargic, confused, uncoordinated with persistent bloody diarrhea, nausea and cramping.

Returned to hospital on 09/16 after voiding bloody urine. Labs concerning for HUS (red blood cell destruction and kidney failure). Transferred to tertiary care facility for specialty care, including plasmapheresis and dialysis. Remained hospitalized through 10/31 where she underwent plasmapheresis (total of 38 sessions). Was medicated with steroids, IV immunoglobulin, and Vincristine. A feeding tube was placed for nutrition.

Evaluated by psychiatry service and prescribed medication to treat depression. Experienced a grand mal seizure and placed on anti-convulsant medication, then developed facial tremors and weakness. Kidney function continued to decline along with increasing hemolysis (red blood cell destruction) and received her first blood transfusion.

Experienced two more seizures. Started on dialysis (total of 12 sessions) and blood pressure rose to dangerous levels (e.g., 200/104) with profound weakness and fatigue. Doctors struggled to manage kidney function, anemia and hypertension. Developed shortness of breath, dry mouth, visual disturbances, tremors, anxiety, and word finding difficulty with global cognitive deficits. Her extremities became increasingly swollen, and she developed numbness and tingling in her arm.

She improved sufficiently to be able to be discharged on 10/31, with dialysis catheter and a PICC (permanent IV line) in place for outpatient dialysis and administration of multiple medications, respectively. Spent 49 days in hospital.

Continued to suffer from and be treated for the debilitating effects of HUS, including kidney failure, high blood pressure, weakness, fatigue, nausea, flank pain, urinary frequency, and swelling. Diagnosed with chronic kidney disease.

Prognosis of increased risk of ESRD (end stage renal disease) within 5-10 years, cardiovascular disease, stroke, and heart failure.  Neuropsychological evaluation revealed diminished cognitive function related to HUS encephalopathy (brain swelling), unlikely to improve with the passage of time.

Medical Bills……………………………………………$454,971.47

Colleen Kortendick, 19-year-old college freshman who was in the process of moving into her dorm when she became ill. 

Onset of extreme fatigue and body pain on 08/27/06, progressing over next several days to stomach pain, diarrhea, bloody stools, and inability to urinate. Admitted to hospital with dehydration, elevated heart rate, low grade fever, copious diarrhea, abdominal cramping, frequent nausea, and vomiting. Labs confirmed acute kidney failure and hemolysis (red blood cell destruction) consistent with severe HUS, and liver compromise.

A catheter placed in neck to begin dialysis. Lab confirmed E. coli O157:H7 in her stool sample. Became increasingly anemic, requiring a blood transfusion.  Some overall improvement in her condition with repeated dialysis and supportive therapy. With gradual return of kidney function over the next week, was discharged on 09/15, after 14 days inpatient, with a tunneled central venous catheter for outpatient dialysis. Received outpatient dialysis through 09/27/06. Catheter removed on 10/05/06. Sustained permanent and irreversible kidney injury as a result of E. coli induced HUS.

Prognosis includes end stage renal disease (ESRD) in her lifetime with the probable need for prolonged dialysis, multiple kidney transplantations and anti-rejection medication.

Medical Bills……………………………………………$81,334.54

Victoria Covington, 61-year-old single, retired music professor, wheelchair bound from arthritis but living independently before becoming ill. 

Onset of severe digestive tract infection shortly after eating spinach. E. coli O157:H7 confirmed at emergency room visit on 09/03/06. Admitted for critical care treatment on 09/04/06 where she remained through 12/20/06. Suffered severe complications from infection including HUS (red blood cell destruction and kidney failure), shock, malnutrition, fluid in the lungs and respiratory failure, convulsions, urinary obstruction and infection, seizures, muscular, and neurological damage. Underwent tracheostomy for respiratory support, and dialysis for kidney failure. Spent 49 days in hospital.

Transferred to a skilled nursing facility from 12/20/06 to 04/21/07. After discharge moved into an apartment with her sister with 24 hour a day nursing care to assist with her persistent weakness, incontinence, nutrition, and all other personal and comfort needs. Confined to a bed as a result of the E. coli infection with only brief periods of sitting for the remainder of her life, with concern for recurring kidney failure.

Medical Bills……………………………………………$700,000.00

June Dunning, 86-year-old widow living with daughter and son in law, in good health, active, and independent in all daily activities. 

On 09/02/06 she experienced sudden onset of frequent, uncontrollable bloody diarrhea, and abdominal pain. Immediately admitted to hospital for treatment with fluids and IV antibiotics. By the next day was confused and disoriented, with persistent bloody diarrhea. Developed a fever, and her kidneys began to fail. Underwent surgery to remove a portion of her colon because of infarction due to toxicity. Heart rate and blood pressure were unstable postoperatively and kidneys continued to fail. Intubated and placed on a ventilator because of respiratory distress.

On 06/06/06 labs confirmed E. coli O157:7.  She was comatose, and HUS was destroying her red blood cells. On 06/07 she suffered two grand mal seizures and was placed on anti-seizure medication. Received a total of five units of transfused blood for worsening anemia. Over the course of the next several days she remained comatose, with ongoing multiple organ failure. She died on 06/13/06, after 11 days in the hospital.

Medical Bills……………………………………………$39,853.64

Regan Erickson, 4-year-old boy with no prior medical problems before becoming ill. 

Seen at urgent care on 09/04/06 for stomach pain and bloody diarrhea and immediately transferred to emergency room for evaluation of suspected bacterial enteric infection. Rapidly deteriorated and admitted with bloody diarrhea turning mucousy, with nausea, retching, vomiting and seriously impaired urine output. Experienced rectal prolapse (slippage of the rectum out of the anus). E. coli O157:H7 confirmed on 09/06 with concern for impending HUS—red blood cell destruction and failing kidneys. Transferred to a tertiary care children’s hospital for higher level specialty care.

By 09/08 in complete HUS kidney failure and catheter placed for peritoneal dialysis on 24-hour cycles. Nausea, low blood pressure, fever, and bloody diarrhea continued with worsening anemia. Was transfused blood. Was irritable, uncooperative, and uncommunicative due to unrelenting pain.

With supportive therapy and dialysis (22 days) by 09/25 began to show some improvement.  Started on medication for labile hypertension. Dialysis catheter removed on 09/29. Discharged on 09/30 after 26 days in hospital, with diagnoses of HUS, pancreatitis, rectal prolapse, acute renal failure, anemia, emesis, electrolyte imbalances and reactive airway disease.

Received ongoing outpatient nephrology care and evaluation of persistent rectal prolapse that had Regan back in diapers. Several attempts were made to reduce the prolapse non-surgically but all failed. Developed subsequent C. difficile enteric infection resulting in recurrent diarrhea and repeated rectal prolapses due to diarrhea and straining with defecation. He remained on blood pressure medication.

Developed PTSD and his frustration and anxiety began manifesting in emotional and behavioral problems, and along with his prolapse, set him back emotionally, developmentally, and socially, with oppositional behavior, anger, anxiety, aggression, and bowel and bladder incontinence.

Prognosis includes chronic renal failure due to permanent kidney damage leading to end stage renal disease (ESRD) by age 21, with a future of long-term dialysis and at least two kidney transplants with lifelong anti-rejection medication.

Medical Bills……………………………………………$126,738.02

Betty Howard, 83-year-old widow living with her son. Active and independent before infection, despite several age-related medical problems including high blood pressure, high cholesterol, and heart disease. 

First seen in the emergency room on 09/07/06 for a three-day history of frequent, watery, bloody diarrhea. Was admitted for treatment of presumed bacterial infection with IV antibiotics, in the setting of ongoing bloody diarrhea, nausea, declining platelets (loss of clotting factors–one of the hallmark features of HUS) and CT evidence of possible bowel ischemia.

E. coli O157:H7 confirmed on 09/10 and antibiotics stopped. Ongoing falling platelet count, hypertension, diarrhea, and abdominal pain. Signs of congestive heart failure on 09/13. Gradual improvement over the next several days and transferred to skilled nursing facility on 09/22 in severely weakened condition. Transferred to rehab facility closer to home on 09/27 where she remained through 10/18/06. Received regular therapy to try to restore strength and function but was hampered by somnolence from pain medication, weakness, malnutrition, and dehydration. Fell from bed on 10/08 and injured elbow. Persistent drowsiness and lethargy with low oxygenation levels, so transferred back to hospital on 10/17. Evaluation confirmed pneumonia, new-onset atrial fibrillation (irregular heart rate), heart muscle damage, urinary tract infection, blood clots in both legs, and lab confirmed C. difficile infection, worrisome for new strains of toxins, which responded to a change in antibiotics. Released back to rehab facility on 10/27.

Remained lethargic with periods of confusion, with assistance needed for all activities of daily living. By 11/02 she developed difficulty swallowing and she was short of breath with poor oxygenation levels. Labs worrisome for possible over-anticoagulation, combined with increased lethargy and weakness, and returned to hospital. Found to be in respiratory distress with mild congestive heart failure and acute kidney insufficiency, likely due to sepsis. Treated supportively with fluids, oxygen, and continuation of antibiotics for the C. diff infection with improvement and return to rehab on 11/06/06.

Further decline in strength and endurance due to illness and immobility with bowel and bladder incontinence and bed sores. In face of overwhelming physical decline and limitations, began to struggle cognitively and emotionally, with significant mood and behavior issues. Returned to the hospital on 12/31 in severe respiratory distress. Workup revealed pneumonia and family opted for no advanced life support measures beyond supportive measures. Improved enough for return to rehab facility on 01/06/07 where she became increasingly weaker, disoriented, anorexic. Stool testing confirmed recurrent C. diff. infection.

Despite increasing supplemental oxygen, her respiratory distress persisted, and she was transferred back to the hospital again on 01/26/07. This time she was unable to be resuscitated and she died in the ED. Hospitalized for 24 days.

Medical Bills……………………………………………$185.535.04

Ashlee Mattson, 23-year-old single, female nursing student with no prior health problems.

Onset of symptoms on 08/29/06 with nausea, diarrhea, cramping, becoming more severe over the course of the next two days, with new symptoms of vomiting, significant abdominal pain, and bloody stool. Seen at ER on 09/03 and received aggressive fluid hydration with transient improvement in symptoms. Stool sample obtained. Differential diagnosis: invasive enteritis v. inflammatory bowel disease pending results of stool analysis.  Sent home after several hours.

Symptoms worsened, with onset of low-grade fever and weakness.  Readmitted to hospital on 09/05. Blood studies evidenced hemolysis (low clotting factors and anemia) and kidney failure, consistent with HUS. Central line placed for anticipated plasmapheresis. Became increasingly swollen from fluid retention due to kidney failure, lethargic, uncommunicative, anorexic.  On 09/08 had first session of hemodialysis. Despite ongoing dialysis and blood transfusions, HUS worsened, and became confused, at times unarousable, hallucinating, with garbled speech, and falling oxygenation levels.

Because of escalating respiratory distress due to kidney failure, fluid overload and risk of multi-organ failure, was transferred to more advanced tertiary care facility on 09/14. Plasmapheresis increased to twice daily. Second dialysis catheter placed because of clotting in the original.

By 09/19 started to show some improvement in labs and by 09/23 her symptoms of nausea, vomiting, and diarrhea decreased, and her kidney function appeared to be returning. Discharged home on 09/26 with careful monitoring by nephrology and hematology.

Returned to hospital the next morning because of recurrent symptoms and found to be hypertensive with worsening anemia. Readmitted for fluids and blood transfusions. On 9/27 developed focal neurological problems with numbness, tingling of the tongue and left side of face, mildly slurred speech, and right-hand weakness, with spike in blood pressure. Condition stabilized and discharged home again on 9/30 after 17 days inpatient and a total of nine blood transfusions and 17 plasma exchanges. Spent 27 days in hospital.

Outpatient care included management of high blood pressure, and monitoring of kidney function which continued to be abnormal.

Prognosis includes gradual further loss of kidney function and ESRD (end stage renal disease) which will require dialysis and several kidney transplants over course of lifetime. Pregnancies ill-advised due to risk of toxicity from

preeclampsia, and at risk for hypertension, cardiac disease, failing bone health, cancer, life threatening infections, fatigue, weakness, and early mortality.

Medical Bills……………………………………………$207,840.16

Chloe Palmer, 6-year-old with no medical problems before becoming ill.

Symptoms began on 09/06/06 with crampy abdominal pain, loose watery stools, and low-grade fever, progressing to bloody stools. Continued deterioration and family MD prescribed a powerful anti-inflammatory used to treat ulcerative colitis.

Seen at ER on 09/09 for fluid hydration and released to home. Symptoms worsened that night with non-stop bloody diarrhea, pain, lethargy.  Returned to hospital on 09/10. Labs confirmed hemolysis (red blood cell destruction) consistent with HUS and acute kidney failure. Airlifted to tertiary children’s hospital for specialty care.

Developed high blood pressure and rapid heart rate, with fever, confusion, increasing lethargy. Catheter placed emergently for peritoneal dialysis and supplemental oxygen started for respiratory distress due to kidney failure and buildup of fluid in the lungs. Started on blood pressure medication for labile hypertension.  Intubated on 09/13 for respiratory support.  Required sedation in order to tolerate being on the ventilator. Dialysis continued for 13 days to deal with failing kidneys. On 9/24 developed leg pain, clots were found in her right leg, started on anti-coagulation therapy.

By 09/30 was beginning to show signs of improvement and on 10/04 her peritoneal catheter for dialysis was removed. Discharged home on 10/06 with orders for close follow up outpatient care after 27 days in hospital.

At high risk of ESRD (end stage renal disease) within 10-15 years with need for multiple kidney transplants, along with diabetes and pancreatic complications, heart disease, further blood clots and pregnancy complications. Will require lifelong anti-rejections medication with side effects of Cushingoid features, weight gain, emotional lability, cataracts, softening of bones, bone pain, hypertension, and acne.

Medical Bills……………………………………………$164,903.02

Donna Roy, 74-year-old retired, married woman. Active with no significant prior medical problems other than high blood pressure and hypothyroidism. 

Symptoms began on 08/27/06 with diarrhea which soon became bloody and increased in frequency.  Condition worsened and admitted to hospital on 08/31 with evidence of kidney failure. Progressive worsening with shortness of breath, EKG abnormalities, disorientation with mental status changes with a seizure on 09/03, after which her condition was so ominous that she was given last rites. Became so delirious that she pulled out her urinary catheter and tried to disconnect all of her other monitors, requiring medication with anti-psychotic drugs. Developed congestive heart failure and kidney function continued to decline with ongoing electrolyte imbalances. She received several blood transfusions and was otherwise managed supportively.

After more than 2 weeks she began to slowly stabilize, and she was discharged home on 09/26 after 27 days in hospital.

She continued to be treated outpatient for heart and lung complications, profound weakness and deconditioning, cognitive dysfunction (difficulty with memory, attention, problem solving and general intelligence), difficulty resuming a regular diet, and persistent gastrointestinal problems including diarrhea

and cramping. Prognosis includes early mortality due to heart disease and stroke, and possible end stage renal disease (ESRD) if her blood pressure is not well  managed and her health is not carefully monitored.

Medical Bills……………………………………………$103,001.33

Ruby Trautz, 81-year-old single, retired nurse living with daughter and son in law. Prior history of COPD and rheumatoid arthritis, but self-sufficient, active, and able to care for herself and help with grandchildren. 

Onset of symptoms on 08/26/06 with nausea, vomiting, abdominal pain, and diarrhea. Developed ominous bloody diarrhea the next day and admitted to hospital for treatment of dehydration, pain, vomiting, bleeding, and possible bowel obstruction.

Condition worsened, GI bleeding increased, she became anemic and received two blood transfusions. Kidneys began to fail as a result of HUS. Started on IV antibiotics before any stool cultures were obtained and tested for pathogens. Developed respiratory distress and abdominal pain/bloating. Central catheter placed in jugular vein for administration of drugs because she was unable to swallow liquid or medication.

Quickly developed an abnormal heartbeat, became obtunded, disoriented, and unresponsive. Despite supportive therapy, continued to deteriorate, with progressive heart, lung, and kidney failure. Developed seizure activity and became unresponsive.

Died on 08/31/06 after five days in hospital.

Medical Bills……………………………………………$86,694.00

Michael Hauser, 68-year-old married, retired podiatrist recovering from prior multiple myeloma treatment. vimeo.com/71908869 (VIDEO)

Onset of symptoms on 09/11/11 with rapid deterioration. Admitted to ICU for treatment of bacterial meningitis (brain swelling), seizures, severe sepsis/bacteremia (life-threatening response to infection), and coma. Intubated, tracheotomy performed.

Transferred to long term critical care facility on 09/29/11 where he remained through 10/15/11.

Condition worsened and readmitted to acute care ICU, where he was treated for continued brain swelling, respiratory distress requiring intubation, seizures, anemia/thrombocytopenia (red blood cell destruction), bed sores,  spinal cord compression, blood clots, urinary tract infection, and paralysis in the legs.  Underwent surgery to relieve brain swelling and spinal cord surgery to relieve spinal cord impingement.

Taken off ventilator for discharge back to long term acute care facility on 11/10/11 for treatment of chronic respiratory failure with intermittent re-intubations, septic shock, seizures, diminished mental status, aspiration pneumonia, acute kidney injury. Spent 44 days in hospital.

Transferred to rehab facility on 12/11/11 for almost two months. Released home severely debilitated, functionally paralyzed, with altered mental status, and swallow disorder. Choked on 02/17/12 and was re-hospitalized, intubated, diagnosed with SIRS (full body inflammation in response to infection), placed on DNR status. Died on 02/21/12, 5 months after becoming ill.

Medical Bills……………………………………………$1,569,826.70

Marie Jones, 89-year-old widow in exceptionally good health prior to becoming ill

Became ill on 09/09/11 with worsening weakness, anorexia, nausea, high fever, and altered mental status. Admitted to the hospital on 9/12 in atrial fibrillation (irregular heartbeat) and respiratory distress, confused and unresponsive.  Diagnosed with pulmonary embolism, and anemia. Spinal fluid culture confirmed Listeria and started on IV antibiotics. Hemodynamic instability with low blood pressure and rapid heart rate. Remained unresponsive. Developed a GI bleed and signs of kidney failure. Placed on a ventilator and given dire prognosis, the family decided to suspend all but comfort treatment. Marie died on 09/23/11 after 11 days in hospital.

Medical Bills……………………………………………$97,397.65

Charles Palmer, 70-year-old married, retired Marine with no significant medical problems prior to illness. 

Onset of symptoms on 08/30/11, hospitalized the next day with meningitis symptoms (headache, altered mental status, fever, lethargy, high white blood cells). Culture confirmed Listeria. Developed bloody diarrhea, abdominal pain, persistent confusion/disorientation. Imaging showed a rectosigmoid mass which was removed and found to be cancerous, and colostomy performed. Kidney mass also discovered. Treated with IV antibiotics and supportive therapy.

Developed kidney failure, shortness of breath, and complications with colostomy which required additional surgery. Discharged after 35 days on 10/03/11 in severely deconditioned state with assistance of home nursing care.

Medical Bills……………………………………………$268,797.19

Herbert Stevens, 84-year-old married, retired hydrologist with pre-existing history of heart, lung, kidney, neuro disease. Was living independently at home with wife prior to illness. 

Onset of symptoms on 08/24/11. Admitted to hospital for treatment of sepsis, pneumonia, red blood cell destruction, and exacerbation of underlying conditions. Culture confirmed Listeria. Treated with IV antibiotics and supportive therapy.

Discharged to skilled nursing facility in profoundly debilitated condition on 08/30/11 through 09/08/11. Developed extensive sores on his legs due to swelling and antibiotic induced rash, gastrointestinal bleeding due to anticoagulation therapy, and malnutrition. After one week, continued to deteriorate and was readmitted to acute hospital for management of extensive skin blistering/rash, anemia, bloody stools, and exacerbation of heart and lung complications. Spent 17 days in hospital.

Released to skilled rehab facility on 09/19/11 for therapy to try to return home. After one month of intensive therapy was strong enough for discharge home with multiple home assistive devices and strong family support. Continued to be seen outpatient for ongoing, complex medical issues.

Medical Bills……………………………………………$143,368.60

Lucas Parker, 2-year-old Canadian boy with possible pre-existing autism spectrum disorder exposed to Romaine lettuce contaminated with E. coli O157:H7 on a family road trip to Disneyland from British Columbia. (Insert Video)

Onset of pain and bloody diarrhea on 10/18/18 causing family to head home. Made it as far as Olympia, WA ER where Lucas presented with bloody diarrhea, vomiting, nausea, and pain, diagnosed as a gastrointestinal infection and dehydration. Continued their way home but condition deteriorated the following day with Lucas becoming only minimally responsive with high fever, high blood pressure, increasing diarrhea, and dehydration. Admitted to B.C. hospital. When his kidneys began to fail and his lab work showed red blood cell destruction, he was diagnosed with HUS. Transferred to tertiary care children’s hospital on 10/21/18.

Developed seizure activity with severe decline in his neurological functioning and started on anti-convulsant medication. Intubated for head imaging and surgery. Catheter surgically inserted in abdomen for peritoneal dialysis. On 10/25 Shiga toxin 2 confirmed in the lab. More seizures on 10/28 despite medication. Labile blood pressures increased white cell count, and recurrent high blood sugars concerning for sepsis. Remained on mechanical ventilation. More seizure activity on 10/28 worrisome for brain injury with ongoing kidney failure and hemolysis (red blood cell destruction).

Kidney function began to return after 13 days but prognosis was poor given evidence of worsening brain damage. Extubated on 16th hospital day but still on dialysis for fluid removal. At high risk for aspiration due to lack of consistent gag/cough reflex. Surgery on 11/16 to remove peritoneal dialysis catheter and implant a feeding tube. Transferred to rehab facility on 11/18 bedbound in fixed, supine position, with limited visual and neurological function.

Went into respiratory distress after inadvertent drug overdose and readmitted to hospital were treated for complications of HUS including stroke, severe neurological deficit, dystonia and autonomic dysregulation (slow heart rate, high blood pressure, irregular breathing). Head imaging confirmed further brain damage. Experienced intermittent drops in his oxygen saturation levels with possible additional seizure activity and apnea (episodes of cessation of breathing). By 12/03 he was intermittently hypotensive and experiencing recurrent vomiting.

Condition stabilized and returned to rehab on 12/11/18 for multidisciplinary therapy to try to maximize function. He was assessed at a “near coma” level of consciousness with severe cognitive impairment and severe cortical visual impairment. Unable to sit, stand or maintain his head/neck/trunk position independently, with spasticity in his arms and legs, consistent with quadriplegia. He had no meaningful vocalizations and was receiving nutrition through a feeding tube.

Prognosis includes ESRD (end stage renal disease), diabetes, lifelong monitoring of his renal status, multiple kidney transplants, and prolonged periods of dialysis. Neurological deficits unlike to improve over lifetime and is at risk for hip dislocation and scoliosis due to spasticity.

Medical Bills……………………………………………$593,230.38

Source link

A ‘pragmatic guide’ for GPs on use of point-of-care C-reactive protein (CRP) has been published by the Primary Care Respiratory Society in a bid to cut antibiotic prescribing.

An expert panel of PCRS members have developed algorithms for use of CRP testing in both COPD exacerbations and respiratory tract infections in general to support uptake of the technology in general practice.

It follows the experience of other countries such as the Netherlands in adopting point of care CRP tests as part of strict antibiotic stewardship leading them to use fewer antibiotics than any other European country.

Several trials, including a large English study published in 2019 in COPD patients have shown dramatic reductions in use of antibiotics when CRP testing is introduced but without any added harms, the PCRS said.

NICE 2014 guidelines on pneumonia included the use of point of care testing for CRP but were withdrawn during Covid, the PCRS guidance notes.

There have been several barriers to the use of CRP testing in primary care including determining the best model for implementing its use in general practice and funding its use.

Professor Jonathan Cooke, visiting professor in infectious diseases and immunity at Imperial College London and co-author of the guidelines said the issue seemed to have fallen between the gaps of various committees and organisations and so had not been taken up.

‘Unless there is prescriptive guidance from the centre to make these barriers come down it won’t happen,’ he said. ‘There have been a number of pilots but no-one has put a firm recommendation together to implement it. At the moment it’s not joined up.’

He added: ‘The technology exists, it’s a case of driving it through and once you do the advantages are enormous. We did a study in general practice in Manchester and there was a 50% reduction in antibiotic prescribing.’

The PCRS guidance said the clear algorithms they had developed should help improve the use of these diagnostic tests in primary care.

Triage steps include ruling out Covid-19 and influenza, taking account of other symptoms and using the point of care CRP test if the prescriber feels antibiotics are probably needed.

In someone with a respiratory tract infection, this can help determine when if they are not needed, if a delayed prescription may be warranted or if they should be prescribed.

Or in patients with COPD the algorithm and CRP test can help indicate when antibiotics may be needed, but also taking into account if purulent sputum is present.

In the guidance, the PCRS also called on NICE to re-open the review of the current COPD management guidelines and come to a position on the use of point of care CRP testing.

‘Without national guidance, the PCRS panel expressed concern that the NHS could face “postcode diagnostics” and, possibly, differences in antimicrobial resistance patterns’, it concluded.

Complete relevant Respiratory medicine CPD modules on Pulse Learning by registering for free, or upgrade to a premium membership for full access at only £89 a year.

Source link

NOIDA, India, May 11, 2022 /PRNewswire/ -- A comprehensive overview of the Ventilator Market is recently added by UnivDatos Market Insights to its humongous database. The Ventilator market report has been aggregated by collecting informative data on various dynamics such as market drivers, restraints, and opportunities. This innovative report makes use of several analyses to get a closer outlook on the Ventilator market. The Ventilator market report offers a detailed analysis of the latest industry developments and trending factors in the market that are influencing the market growth. Furthermore, this statistical market research repository examines and estimates the Ventilator market at the global and regional levels. The ventilator market is expected to grow at a CAGR of ~8% from 2021-2027.

UnivDatos_Logo

UnivDatos_Logo

Request Sample Copy of this Report @ univdatos.com/get-a-free-sample-form-php/?product_id=18837

Market Overview

A ventilator, breathing machine, or respirator is a machine that assists with breathing. It is mainly used in hospitals to treat chronic obstructive pulmonary disease (COPD), sleep apnea, acute lung injury, and hypoxemia. The market is experiencing significant growth on account of the rising incidence of Asthma and COPD cases, rise in the aging population, increasing prevalence of tobacco smoking, growing urbanization and pollution, increase in preterm birth cases, and lifestyle changes.

Furthermore, the increase in government initiatives and the increase in the focus of pharmaceutical companies to manufacture advanced and portable devices. The rising prevalence of respiratory diseases and rising number of ICU beds is expected to drive growth in the ventilators market during the forecast period. In addition, ventilator penetration for home healthcare is expected to rise significantly owing to the convenience and comfort provided by technologically advanced and portable ventilators.

With the increase in population and urbanization, air pollution is becoming a major public health concern all over the world. Exposure to the harmful chemicals present in the air leads to significant adverse effects on health. Air pollutants are the major cause of asthma and chronic obstructive pulmonary disease (COPD) like chronic diseases. These pollutants not only lead to the acute aggravation of Asthma and COPD attacks but also increases the rate of respiratory morbidity and mortality. South Asia, East Asia, and the Pacific are the major reasons that experience high mortality rates due to air pollution. In 2019, the exposure to air pollutants resulted in more than two million deaths in these regions, with high death rates in China and India.

COVID-19 Impact

One of the major equipment used to treat COVID-19 is a medical ventilator. The demand for medical ventilators has risen dramatically, pushing manufacturers to increase output by 30–50%. Various large firms were competing to manufacture and deliver as many ventilators as possible around the world. Prior to the coronavirus outbreak, the rising prevalence of respiratory diseases and the increasing number of ICU beds were among the major factors offering growth to the global ventilators industry. However, there is an enormous demand for ventilators is being stated by every COVID-19-affected country. As, COVID-19 caused various lung complications such as pneumonia and, in the most severe cases, acute respiratory distress syndrome, or ARDS. Thus, ventilators are most significantly required while dealing with the population suffering from COVID-19.

Ask for Price & Discounts @ univdatos.com/get-a-free-sample-form-php/?product_id=18837

Ventilator market report is studied thoroughly with several aspects that would help stakeholders in making their decisions more curated.

By Mobility, the market is primarily segmented into

Based on mobility, the ventilator market is categorized into Intensive care ventilators and Portable/ transportable ventilators. In 2020, the Intensive care ventilators category accounted for the majority share of the market. This is mainly attributed to the presence of various manufacturers and initiatives taken by the government to increase the production of ventilators to provide care for patients with serious respiratory diseases and the increasing number of ICU beds, which have propelled the growth of the market.

By Type, the market is primarily segmented into

Based on type, the market has been bifurcated into adult/pediatric ventilators and Neonatal/infant ventilators. Adult/pediatric ventilators accounted for a higher market valuation in 2020. This is mainly due to the growing incidence of chronic diseases such as COPD & asthma in the adult population coupled with the growing number of smokers and the rising number of lung cancer cases in the geriatric population. According to the WHO, in 2020, lung cancer is the leading cause of cancer death (18.0%) of the total cancer deaths worldwide. The estimated new cases and deaths caused by lung cancer include 2,206,771 cases and 1,796,144, respectively.

By End-User, the market is primarily segmented into

  • Hospitals & clinics

  • Ambulatory care centers

  • Home Care

  • Others

Based on End-User, the ventilator market is categorized into Hospitals & Clinics, Ambulatory care centers, Home Care, and Others. Amongst End-User, the Hospital and Clinics category accounted for a significant share in the market owing to the attributed to the financial capabilities of hospitals to purchase high-priced instruments and the availability of trained professionals to operate ventilators. The COVID-19 outbreak has not only created pressure on healthcare resources but also forced these facilities to update their medical devices and infrastructure to provide instant and better care to patients.

Ventilator Market Geographical Segmentation Includes:

  • NORTH AMERICA VENTILATOR MARKET

  • EUROPE VENTILATOR MARKET

  • ASIA-PACIFIC VENTILATOR MARKET

  • REST OF THE WORLD VENTILATOR

North America will dominate the Ventilator market on account of the increasing popularity of chronic diseases. Moreover, the North American market is expected to witness substantial growth on account of the highly developed healthcare infrastructure, healthcare spending, and presence of a large number of market players in the region. In addition, the legislative policies by the government coupled with the surging prevalence of sudden cardiac arrest in the countries such as the U.S and Canada owing to the changing lifestyle are leading to the growing demand for defibrillators. As per the Sudden Cardiac Arrest Foundation, each year in the U.S., more than 350,000 cardiac arrests occur outside of a hospital setting. Furthermore, promulgating demand for automated external defibrillators (AEDs) is acting as a growth catalyst in the market.

Ask for Report Customization @ univdatos.com/report/ventilator-market/

The major players targeting the market include

Competitive Landscape

The degree of competition among prominent global companies has been elaborated by analysing several leading key players operating worldwide. The specialist team of research analysts sheds light on various traits such as global market competition, market share, most recent industry advancements, innovative product launches, partnerships, mergers, or acquisitions by leading companies in the Ventilator market. The leading players have been analysed by using research methodologies for getting insight views on global competition.

Key questions resolved through this analytical market research report include:

  • What are the latest trends, new patterns, and technological advancements in the Ventilator market?

  • Which factors are influencing the Ventilator market over the forecast period?

  • What are the global challenges, threats, and risks in the Ventilator market?

  • Which factors are propelling and restraining the Ventilator market?

  • What are the demanding global regions of the Ventilator market?

  • What will be the global market size in the upcoming years?

  • What are the crucial market acquisition strategies and policies applied by global companies?

We understand the requirement of different businesses, regions, and countries, we offer customized reports as per your requirements of business nature and geography. Please let us know If you have any custom needs.

For more informative information, please visit us @ univdatos.com/report/ventilator-market/

Browse Other Related Research Reports from UnivDatos Market Insights

About UnivDatos Market Insights

UnivDatos Market Insights (UMI) is a passionate market research firm and a subsidiary of Universal Data Solutions. We believe in delivering insights through Market Intelligence Reports, Customized Business Research, and Primary Research. Our research studies are spread across topics across the world, we cover markets in over 100 countries using smart research techniques and agile methodologies. We offer in-depth studies, detailed analysis, and customized reports that help shape winning business strategies for our clients.

Contact
UnivDatos Market Insights
Ankita Gupta
Director Operations
Ph: +91-7838604911
Email: [email protected]
Website: univdatos.com/

Cision

Cision

View original content:www.prnewswire.com/news-releases/ventilator-market-is-expected-to-foresee-steady-growth-by-2027cagr-8-univdatos-market-insights-301545157.html

SOURCE UnivDatos Market Insights Pvt. Ltd.

Source link

In low- and middle-income countries, the COVID-19 pandemic exposed a long-neglected problem that was already contributing to untold preventable deaths every year. Now, a global mobilization to scale up the supply of medical oxygen must be transformed to last into the post-COVID era.

NEW YORK – COVID-19 has taken at least 18 million lives, and it is anyone’s guess how many of those deaths were due to a lack of medical oxygen. Governments don’t want to talk about the issue, because that could mean admitting that thousands – or even hundreds of thousands – of their citizens died unnecessarily. But unless health systems take steps to ensure a sufficient supply of oxygen in the future, they will be risking a repeat of the past two years.

While high-income countries are already working to secure their supplies of medical oxygen, many low- and middle-income countries (LMICs) will continue to need international support. Deaths from a lack of medical oxygen in these countries preceded the pandemic, because global health and development agencies made no serious effort to help LMIC governments close the gap between need and supply.

That gap is one factor underlying LMICs’ stubbornly high newborn and child mortality, adult deaths from infectious and chronic conditions, and deaths from injuries that require surgery. Research published prior to the pandemic found that four out of five children hospitalized with pneumonia in Nigerian hospitals did not receive the oxygen they needed, and that simply putting oxygen into pediatric wards could reduce child deaths by 50%.

As Mike Ryan of the World Health Organization puts it, COVID ripped a bandage off an old wound, driving a tenfold increase in the need for oxygen in the space of just weeks in some countries. LMICs now need about 500,000 large oxygen cylinders every day to treat COVID patients, and this is the just the tip of the iceberg. For every COVID patient who needs oxygen, there are at least five other patients who also need it, including the 7.2 million children with pneumonia who enter LMIC hospitals each year.

The main vehicle for the international response is the ACT-Accelerator (ACT-A) COVID-19 Oxygen Emergency Taskforce, expertly chaired by Unitaid, which has built a system to help LMICs prevent oxygen shortages. To date, the Taskforce has delivered almost $1 billion – including $560 million from the Global Fund alone – to LMIC governments and their United Nations and NGO partners. This money has been spent on liquid oxygen, pressure swing absorption oxygen-generating plants, mobile oxygen concentrators, oxygen therapies, and the workforce needed to install, operate, and maintain the equipment.

This funding has helped more than 100 countries, mostly in Africa and Asia. But there are still LMICs struggling to provide oxygen, so the Taskforce has asked for another $1 billion in 2022. US President Joe Biden’s Second Global COVID-19 Summit this week also will emphasize the issue with an appeal to governments, companies, and philanthropies to do more.

PS 2022 Reader Survey




Reader-Survey_Site



PS 2022 Reader Survey

There are exciting changes coming to PS, and we want to make sure they reflect your needs and preferences. Share your feedback today to help us to deliver the best possible experience to readers like you.


Take Survey

The case to make to donors is clear. There is a moral obligation to treat COVID patients and to flatten the pandemic death curve once and for all. Investments in oxygen will serve that goal and also save lives in the future. Not only is oxygen an essential treatment for almost all of the health conditions targeted by the UN Sustainable Development Goals; it is also a critical pillar of effective pandemic preparedness and response (PPR).

As the world pivots to long-term COVID management, oxygen production and distribution systems will need to be embedded in global health infrastructure. International organizations with mandates to improve newborn and child survival, infectious- and chronic-disease management, and PPR all have a stake in access to oxygen. These agencies should formalize their nascent ACT-A oxygen partnership by transforming it into a Global Oxygen Alliance with a mandate extending to 2030 (to align with the SDGs), and with a membership broadened to include international agencies focused on chronic diseases.

There are five components to a successful alliance to close the oxygen access gap. First, LMIC governments and the national institutions responsible for providing medical oxygen need to take the lead. Ideally, they would be guided by politically endorsed national plans for oxygen access, with governments financing the effort as part of their health budgets.

Second, LMIC governments that need external support to finance their national plans should be able to leverage loans and grants from a variety of multilateral, bilateral, and philanthropic sources. The Global Fund should continue to provide grant funding as part of its new PPR objective, and multilateral development banks should provide loans for this purpose as well.

Third, oxygen producers should be given more incentives and opportunities to work in partnership with LMIC governments and global health and development agencies. Memoranda of understanding, non-disclosure agreements, and transparent and competitive tenders for equipment procurement, installation, and maintenance should all be made available, building on the ACT-A COVID-19 Oxygen Emergency Taskforce’s existing blueprint for industry partnerships. Moreover, development finance institutions should offer loans, equity, and guarantees to oxygen producers, and support LMICs seeking to reduce their dependence on oxygen imports and fragile global supply chains.

Fourth, UN agencies and NGOs with a strong LMIC presence must continue to support these governments as they develop national oxygen plans, collect data, procure supplies, train health-care workers and biomedical engineers, and monitor and evaluate progress. To do so, they will need ongoing funding from bilateral development agencies (such as USAID, the European Commission, and others) and philanthropies (such as the Bill & Melinda Gates Foundation, the Skoll Foundation, and others).

Finally, LMIC governments need access to high-quality, timely data on national oxygen needs – such as the annual number of hypoxemic patients and how much oxygen they require – and oxygen capacity in the health system so that they can move quickly to close deficits. Donors should invest more in national health surveillance and statistical institutions, while using the available data to generate estimates of the hypoxemia burden as part of the Global Burden of Disease. And independent agencies such as the Access to Medicine Foundation should be funded to hold the oxygen industry accountable.

The next six months are critical as we move beyond the acute phase of the pandemic. Ideally, by September, the ACT-A COVID-19 Oxygen Emergency Taskforce will have become a Global Oxygen Alliance, chaired by Unitaid and continuing to meet regularly to coordinate investments, mobilize resources, and monitor the impact of efforts to ensure equitable access to an essential medicine.

Source link