1.External laryngocoele: A rare cause of stridor in neonate
Nor Idayu M YUSOF ; Mohamamad Tamim JAMIL ; Irfan MOHAMAD
Brunei International Medical Journal 2012;8(1):43-47
A laryngocoele is an abnormal dilatation of the laryngeal saccule. It is a rare cause of stridor in the newborn or in early infancy. Most laryngocoeles are asymptomatic but symptoms of hoarseness, feeding difficulty, lump in the neck and upper airway obstruction may occur. We report a case of external laryngocoele causing partial airway obstruction in early infancy. Spontaneous resolution occurred following conservative medical management thus avoiding surgical intervention.
Infant
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Complications
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Respiratory Distress Syndrome, Newborn
2.Progression in the application of machine learning in acute respiratory distress syndrome.
Weijun ZHANG ; Jianxiao CHEN ; Yuan GAO
Chinese Critical Care Medicine 2023;35(6):662-664
Acute respiratory distress syndrome (ARDS) is a clinical syndrome defined by acute onset of hypoxemia and bilateral pulmonary opacities not fully explained by cardiac failure or volume overload. At present, there is no specific drug treatment for ARDS, and the mortality rate is high. The reason may be that ARDS has rapid onset, rapid progression, complex etiology, and great heterogeneity of clinical manifestations and treatment. Compared with traditional data analysis, machine learning algorithms can automatically analyze and obtain rules from complex data and interpret them to assist clinical decision making. This review aims to provide a brief overview of the machine learning progression in ARDS clinical phenotype, onset prediction, prognosis stratification, and interpretable machine learning in recent years, in order to provide reference for clinical.
Humans
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Hypoxia/complications*
;
Respiratory Distress Syndrome/etiology*
;
Prognosis
;
Machine Learning
3.The investigation of pathologic oxygen supply dependency.
Chinese Journal of Pediatrics 2003;41(2):152-154
5.Acute respiratory distress syndrome associated with scrub typhus: diffuse alveolar damage without pulmonary vasculitis.
Jae Seuk PARK ; Young Koo JEE ; Kye Young LEE ; Keun Yeol KIM ; Na Hye MYONG ; Pil Weon SEO
Journal of Korean Medical Science 2000;15(3):343-345
Pathologic findings of scrub typhus have been characterized by vasculitis of the microvasculature of the involved organ resulting from a direct invasion by Orientia tsutsugamushi. We experienced a case of acute respiratory distress syndrome (ARDS) associated with scrub typhus. The case was proven by eschar and high titer of serum IgM antibody (positive at 1:1280). Open lung biopsy showed diffuse alveolar damage (DAD) in the organizing stage without evidence of vasculitis. Immunofluorescent antibody staining and polymerase chain reaction for O. tsutsugamushi failed to demonstrate the organism in the lung tissue. The patient expired due to progressive respiratory failure despite doxycycline therapy. Immunologic mechanism, without direct invasion of the organism, may participate in the pathogenesis of ARDS associated with scrub typhus.
Acute Disease
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Aged
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Case Report
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Fatal Outcome
;
Female
;
Human
;
Infant, Newborn
;
Pulmonary Alveoli/pathology
;
Pulmonary Alveoli/injuries
;
Respiratory Distress Syndrome/physiopathology
;
Respiratory Distress Syndrome/pathology
;
Respiratory Distress Syndrome/immunology
;
Respiratory Distress Syndrome/complications*
;
Scrub Typhus/physiopathology
;
Scrub Typhus/pathology
;
Scrub Typhus/immunology
;
Scrub Typhus/complications*
;
Vasculitis
6.Anesthetic Management of a Patient with Idiopathic Hypereosinophilic Syndrome: A case report.
Hye Ran CHO ; Sang Ji HAN ; Young Eun KWON ; Jun Hak LEE
Korean Journal of Anesthesiology 2007;52(6):728-732
Idiopathic hypereosinophilic syndrome is characterized by prolonged markedly elevated peripheral blood eosinophil count and eosinophil-related tissue damage to variable organs without an identifiable underlying cause. Eosinophilopoiesis is related with T-lymphocyte activation and cytokine cascade controlling eosinophilic production. It shows tissue infiltration in many organs including endomyocardium, lung, liver, gastrointestinal tract. Here we report a case of idiopathic hypereosinophilic syndrome presenting ruptured rectus sheath hematoma due to coagulopathy involving the liver. Severe postoperative complications were developed after general anesthesia. The patient suffered from life-threatening acute respiratory distress syndrome (ARDS). This case suggest that, in patients with marked eosinophilia requiring general anesthesia, perioperative steroid cover is advisable. This may reduce or prevent serious lung damage and other complications.
Anesthesia, General
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Eosinophilia
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Eosinophils
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Gastrointestinal Tract
;
Hematoma
;
Humans
;
Hypereosinophilic Syndrome*
;
Liver
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Lung
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Postoperative Complications
;
Respiratory Distress Syndrome, Adult
;
T-Lymphocytes
9.Mortality and morbidity of acute hypoxemic respiratory failure and acute respiratory distress syndrome in infants and young children.
Yan-Feng ZHU ; Feng XU ; Xiu-Lan LU ; Ying WANG ; Jian-Li CHEN ; Jian-Xin CHAO ; Xiao-Wen ZHOU ; Jian-Hui ZHANG ; Yan-Zhi HUANG ; Wen-Liang YU ; Min-Hui XIE ; Chao-Ying YAN ; Zhu-Jin LU ; Bo SUN ; null
Chinese Medical Journal 2012;125(13):2265-2271
BACKGROUNDAcute hypoxemic respiratory failure (AHRF) often develops acute respiratory distress syndrome (ARDS), and its incidence and mortalities in critically ill pediatric patients in China were 2% and 40% respectively. This study aimed at prospectively investigating incidence, causes, mortality and its risk factors, and any relationship to initial tidal volume (V(T)) levels of mechanical ventilation, in children £5 years of age with AHRF and ARDS.
METHODSIn 12 consecutive months in 23 pediatric intensive care units (PICU), AHRF and ARDS were identified in those requiring > 12 hour intratracheal mechanical ventilation and followed up for 90 days or until death or discharge. ARDS was diagnosed according to the American-European Consensus definitions. The mortality and ventilation free days (VFD) were measured as the primary outcome, and major complications, initial disease severity, and burden were measured as the secondary outcome.
RESULTSIn 13 491 PICU admissions, there were 439 AHRF, of which 345 (78.6%) developed ARDS, resulting in incidences of 3.3% and 2.6%, and corresponding mortalities of 30.3% and 32.8% respectively along with 8.2 and 6.7 times of relative risk of death in those with pneumonia (62.9%) and sepsis (33.7%) as major underlying diseases respectively. No association was found in V(T) levels during the first 7 days with mortality, nor for V(T) at levels < 6, 6 - 8, 8 - 10, and > 10 ml/kg in the first 3 days with mortality or length of VFD. By binary Logistic regression analyses, higher pediatric risk of mortality score III, higher initial oxygenation index, and age < 1 year were associated with higher mortality or shorter VFD in AHRF.
CONCLUSIONSThe incidence and mortalities of AHRF and ARDS in children £5 years were similar to or lower than the previously reported rates (in age up to 15 years), associated with initial disease severity and other confounders, but causal relationship for the initial V(T) levels as the independent factor to the major outcome was not found.
Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Pneumonia ; complications ; epidemiology ; mortality ; Respiratory Distress Syndrome, Adult ; epidemiology ; mortality ; Respiratory Insufficiency ; epidemiology ; mortality ; Sepsis ; complications ; epidemiology ; mortality
10. How should very low birthweight babies best be managed in Papua New Guinea?
Papua New Guinea medical journal 1996;39(1):12-15
Short-term outcome in very low birthweight babies has never been closely examined in Papua New Guinea. A cohort of neonates born over a year at Port Moresby General Hospital was followed from birth to death or discharge. Intrauterine growth retardation was an important contributor to low birthweight. Simple, inexpensive care resulted in respectable survival figures. Improving antenatal surveillance will have much more impact in reducing mortality in this group in the future than trying to emulate sophisticated and costly western neonatal care.
Antibiotic Prophylaxis
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Birth Weight
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Cohort Studies
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Exchange Transfusion, Whole Blood
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Female
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Fetal Growth Retardation - complications
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Respiratory Distress Syndrome, Newborn - therapy