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Dysfunctions of COVID-19
Published in Wenguang Xia, Xiaolin Huang, Rehabilitation from COVID-19, 2021
The American Thoracic Society has defined dyspnea as “a symptom characterized by a subjective sense of labored breathing, which differs significantly in intensity”. This sense of labored breathing can result from the interaction of multidisciplinary factors, including physiological, psychosocial, social, and environmental factors, which may induce secondary physiological and behavioral responses. So, dyspnea is typically characterized by labored breathing, which is different from shortness of breath, polypnea, hyperpnea, and hyperventilation. It is a subjective feeling of the patient and is closely correlated with the life quality of the patient.
Breath Sounds in the Time Domain
Published in Noam Gavriely, David W. Cugell, Breath Sounds Methodology, 2019
Muscle sounds are low frequency noises produced during muscle contraction.37–39 Their frequency content is usually below 75 Hz. They may be detected during labored breathing if no high-pass filter is used and at times may interfere with the recording of breath sounds.40Figure 2.11 shows time domain tracings of sounds recorded during an isometric effort from the anterior chest over the pectoralis muscle.
Pathophysiology of Lymphatic Insufficiency and Principles of Treatment
Published in Waldemar L. Olszewski, Lymph Stasis: Pathophysiology, Diagnosis and Treatment, 2019
Charles L. Witte, Marlys H. Witte
Pulmonary lymphangiomyomatosis is a rare disorder exemplifying the more gradual but inexorable outcome of defective drainage of lung interstitial fluid.63 Typically, a young woman develops labored breathing from spontaneous pleural effusion (sometimes chylous) or generalized edema of the pulmonary interstitium (see Figure 8). Oil contrast lymphography usually discloses abnormal mediastinal, lung, and sometimes retroperitoneal lymphatics. Lung microscopy displays ectatic lymphatics surrounded by proliferating smooth muscle bundles while the lung itself appears honeycombed as in advanced emphysema. Eventually, interstitial pulmonary edema worsens, lung fibrosis progresses, and respiratory failure ensues. A similar sequence of events takes place in the more pervasive lymphatic disturbance of intestinal lymphangiectasia.64 Unlike lymphangiomyomatosis, patients with this disorder are sometimes young men and may exhibit other organ dysfunction such as lymphorrhea of the digestive tract (i.e., protein-losing enteropathy) and peripheral edema. Albeit rare, these latter disorders vividly illustrate how primary lymphedema of the lungs evolves over a long quiescent period into overt interstitial edema and terminates in severe fibrosis.
Acute motor axonal neuropathy following SARS-CoV-2 infection in the third trimester of pregnancy
Published in Baylor University Medical Center Proceedings, 2022
Mohamed M. G. Mohamed, Amar Jadhav, Polo Banuelos, Alexandre Lacasse, Vikas Kumar
On arrival, the patient was noted to have rapid, shallow, labored breathing; therefore, she was intubated and mechanically ventilated. In a few hours, spontaneous premature vaginal delivery of a viable male infant ensued. Motor weakness and paresthesia rapidly became global. Dysautonomia was also observed, with her heart rate ranging from 60 to 140 beats/min and systolic blood pressure ranging from 60 to 180 mm Hg. Of note, acetylcholine receptor binding, blocking, and modulating antibodies were negative. Campylobacter jejuni antibody was equivocal at 0.99 (with <0.90 not detected, >1.10 detected). Anti-GQ1 antibody was negative, but anti-GD1a antibody was positive. Electromyography with a nerve conduction study was consistent with multifocal axonal motor polyneuropathy without demyelinating features or active denervation. A 5-day course of intravenous immunoglobulin therapy (IVIG) (0.4 mg/kg/day) was completed. On hospital day 10, she was extubated. On discharge at day 16, she had a score of 3–4/5 on the Medical Research Council scale for upper and lower extremities. Tingling and numbness remarkably improved. She was able to walk 300 feet with assistance and a walker. She was discharged to an acute rehabilitation facility, where she spent 4 weeks.
Comparisons of acute inflammatory responses of nose-only inhalation and intratracheal instillation of ammonia in rats
Published in Inhalation Toxicology, 2019
Linda Elfsmark, Lina Ågren, Christine Akfur, Elisabeth Wigenstam, Ulrika Bergström, Sofia Jonasson
Directly after nose-only inhalation exposure, animals showed discomfort with labored breathing but returned to normal breathing patterns within 5 h. In Gr. 3 and Gr. 4, nose-only inhalation resulted in increased salivation, nasal hemorrhagic secretions, labored breathing directly after exposure and body weight-loss at 24 h post-exposure (Figure 1(A)). Visual appearance at 5 h of all exposed rats was similar to that of control animals. The exception to this was the animals of Gr. 6, exposed to 10-min inhalation of 15 000 ppm NH3, that after 5 h suffered from reduced body circulation and showed progressive discomfort. The animals in that group were hypersensitive to anesthesia and when dissected, the GI-tract was filled with trapped air at 5 h post-exposure. Therefore, 15 000 ppm or higher concentrations of NH3 were not examined further. Animals in the 14-day group were similar to that of age-matched control animals (data not shown).
The Impact of Physiological Factors on 30-day Unplanned Rehospitalization in Adults with Heart Failure
Published in Journal of Community Health Nursing, 2019
Omar Alzaghari, Debra C. Wallace
The initial analysis examined the impact of cardiovascular and non-cardiovascular conditions on 30-day HF unplanned rehospitalization. The proportion of patients with many chronic diseases were comparable to those reported by M. Hernandez et al. (2013). Also, the proportion of persons with a reduced ejection fraction equal to or less than 40% was similar to a previous report (Harjai et al., 1999). Multiple diagnoses were related to 30-day unplanned rehospitalization, with chronic kidney disease and use of CPAP as significant predictors. Korda et al. (2017) had reported previous renal disease as a predictor for 30-day HF readmission. Those findings could be explained by volume overload in patients with chronic kidney disease that increases the workload of the heart muscle requiring frequent readmission to remove fluid through diuresis. The use of CPAP will help support a patient’s airways, especially, at night. Patients with HF often sleep on several pillows to reach a comfortable position, which allows full expansion of the chest. Orthopnea was reported a predictor of HF readmission in a previous study (Davison et al., 2016). The use of CPAP can reduce labored breathing and can help HF patients rest. It was interesting to find that combined impact of physiological factors on 30-day HF rehospitalization showed non-cardiovascular indicators as predictors, but not cardiovascular conditions. This may reflect that most of the patients experienced multiple comorbidities and cardiac conditions.