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Respiratory Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Ian Pavord, Nayia Petousi, Nick Talbot
Aspiration pneumonia occurs when material is aspirated from the upper airway into the lower respiratory tract, typically into the right lower lobe. This may include stomach contents, upper airway secretions and commensal organisms. Clinical syndrome results from a combination of chemical pneumonitis, bacterial infection (often anaerobes) and airway obstruction. Risk factors include: Reduced conscious level (e.g. sedation, seizures, overdose)Poor swallow (e.g. neuromuscular disease, stroke)Abnormal upper gastrointestinal (GI) anatomy (e.g. hiatus hernia, nasogastric feeding)
Pulmonary diseases in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Leah Lande, Abraham Sanders, Dana Zappetti
Aspiration into the lung of stomach contents occurs most often during or immediately after labor. The combination of delayed gastric emptying, a relaxed lower esophageal sphincter, and increased intra-abdominal pressure with recumbency and sedation or analgesia increase the risk of vomiting and aspiration. Acutely, aspiration can lead to a chemical pneumonitis or bronchospasm, and aspiration of upper airway organisms such as anaerobes and streptococci can ultimately lead to a bacterial pneumonia. Chemical pneumonitis, while hard to distinguish from pneumonia, generally has an acute onset with dyspnea, cough, and low-grade fever. Radiographs reveal multifocal infiltrates with basilar predominance and treatment is supportive. Bronchospasm can be indistinguishable from asthma with dyspnea and wheezing and is treated with bronchodilators (91,92).
Respiratory Effects
Published in Lars Friberg, Tord Kjellström, Carl-Gustaf Elinder, Gunnar F. Nordberg, Cadmium and Health: A Toxicological and Epidemiological Appraisal, 2019
Acute inhalation of freshly generated cadmium fumes is a well-known hazard in industry, especially during the welding or cutting of materials containing cadmium. Usually there is only slight discomfort at the time of exposure and thus, lethal exposure is possible without prior warning. Typical cases of such poisonings have been described by Paterson,75 Huck,45 Reinl,86 Lamy et al.,56 Kleinfeld,53 Blejer et al.,10 Beton et al.,9 Townshend,101 and Tibbits and Milroy.100 From a review prepared by MacFarland65 it is apparent that more than 100 acute human intoxications with cadmium oxide fumes have taken place, and that at least 17 fatalities have occurred as a direct result of acute exposure. Initial symptoms include irritation and dryness of the nose and throat, cough, headache, dizziness, weakness, chills, fever, and chest pain. The initial symptoms are similar to metal fume fever, a benign condition which can be generated by exposure to, e.g., zinc fumes.93 Severe pulmonary edema and/or chemical pneumonitis develop later, not infrequently leading to fatalities several days after exposure. The clinical signs and findings from autopsies of deceased subjects agree very well with what has been reported from findings in animals (Section II.A).
Perimortem caesarean section in COVID-19 era
Published in Journal of Obstetrics and Gynaecology, 2022
Yudianto Budi Saroyo, Noroyono Wibowo, Damar Prasmusinto, Yuditiya Purwosunu, Rima Irwinda, Mohammad Adya Firmansha Dilmy, Angela Putri, Andrew Wijaya
Maternal physiological changes may worsen the acute decompensation, especially in critically ill pregnant patients. We must made aware that due to progesterone effect to lower oesophageal sphincter, mothers are put on a high risk of aspiration of gastric content. The mortality rate of chemical pneumonitis caused by gastic content have a high mortality rate up to 70%. In an emergency setting, we might not have a detailed history of the patient. We must aware that the patient also might have an underlying cause the cardiac arrest, such as malignant arrhythmia, cardiomyopathies or myocardial infarct (Habek et al. 2021). Prompt oxygenation should be done and while CPR being performed, foetal heart rate monitoring should be postponed as it might disturbs the algorithm (American Heart Association 2020). Attending physicians should be aware to perform perimortem delivery after 4 minutes of resuscitation.
Hemoptysis after exposure to a household insecticide spray: A case report and review of the literature
Published in Canadian Journal of Respiratory, Critical Care, and Sleep Medicine, 2019
A. J. Ruberto, H. D. Morakis, C. L. D’Arsigny
Pyrethroids, insecticides derived from chrysanthemum flowers and pyrethrins, a synthetic insecticide, share a similar chemical structure and mechanism of action.2 This case demonstrates findings that are characteristic of respiratory distress secondary to chemical pneumonitis after exposure to an aerosolized pyrethroid or pyrethrin.3–10 Although such case reports are infrequent and usually result in isolated respiratory irritation, the patient’s underlying COPD and active anticoagulation likely increased her risk of more serious adverse respiratory events.1,11 The lack of ventilation in the apartment after the windows were closed may also have contributed to the increased risk of developing respiratory symptoms.3
Sodium azide poisoning: a narrative review
Published in Clinical Toxicology, 2021
John Tat, Karen Heskett, Shiho Satomi, Renate B. Pilz, Beatrice A. Golomb, Gerry R. Boss
In 13 patients, azide exposure occurred from airbag deployment (Table 1(A-1) [9,24–33]). The patients developed symptoms after either inhaling or having dermal or ocular contact with undecomposed NaN3 released when an airbag ripped during a vehicular accident. Seven people had chemical burns and one person was diagnosed with contact dermatitis [24–27,31,33]. Five patients without prior history of respiratory disease developed pulmonary symptoms such as dyspnea or stridor, and two were diagnosed with chemical pneumonitis [9,28–30,32]. Three patients sustained ocular injury [9,31,32].