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Plastic bronchitis
Published in Alisa McQueen, S. Margaret Paik, Pediatric Emergency Medicine: Illustrated Clinical Cases, 2018
Reactive airway disease and pneumonia are common reasons for patients to present to the emergency department with pulmonary symptoms. However, when symptoms fail to respond to standard therapies or when other parts of the history or physical exam do not align, alternative diagnoses should be explored. In this case the finding of bronchial casts should lead to consideration of plastic bronchitis.
Toxicology
Published in Aruna Bakhru, Nutrition and Integrative Medicine, 2018
Irritants can also trigger an asthma-type response. This was first described by Brooks et al., and is termed reactive airways disease or RADS.9 The irritant agents at worksites that can produce RADS include numerous solvents, benzene-1,2,4-tricarboxylic acid, 1,2-anhydride (trimetallic anhydride), chlorine, platinum salts, cobalt, cement, environmental tobacco smoke, grain, welding fumes, construction work, as well as fumes from swine confinement. This condition is sometimes difficult in that the pulmonary function test at times does not look very abnormal and is disproportionate to the clinical manifestations. To verify, the patient may require a methacholine challenge test.
Ribavirin
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Emily Woolnough, Amanda Wade, Joe Sasadeusz
Whether ribavirin has an impact on the long-term sequelae after RSV infection is also unclear. A retrospective (nonrandomized) analysis of 41 infants with RSV infection compared the prevalence of reactive airway disease in those treated with aerosolized ribavirin and those who were not. A significant reduction in the proportion of patients developing airway reactivity and number of episodes of reactive airway disease was noted (Edell et al., 1998). However, other, and newer, studies have failed to demonstrate a long-term benefit from ribavirin therapy (Krilov et al., 1997; Everard et al., 2001; Edell et al., 2002).
Outcomes of children with life-threatening status asthmaticus requiring isoflurane therapy and extracorporeal life support
Published in Journal of Asthma, 2023
Sneha Kolli, Cydney Opolka, Adrianna Westbrook, Scott Gillespie, Carrie Mason, Brittany Truitt, Pradip Kamat, Anne Fitzpatrick, Jocelyn R. Grunwell
This is a retrospective cohort study of children under 18 years of age admitted to the Children’s Healthcare of Atlanta Egleston or Scottish Rite campus PICUs with life-threatening asthma between March 2009–May 2020. Children were identified with asthma or reactive airway disease on the problem and diagnosis lists from the electronic medical record (eMR). The eMR was independently reviewed for each child to confirm that the child was admitted to the PICU for asthma or reactive airway disease. We further identified children who received isoflurane and/or ECLS by reviewing the medication administration record, respiratory flow sheet, lines and drains flow sheet, procedure notes, and physician notes in the eMR. The Egleston PICU is a 36-bed academic unit affiliated with Emory University School of Medicine; the Scottish Rite PICU is a 56-bed private unit. The inpatient rehabilitation unit for the Children’s Healthcare of Atlanta system is located within the Scottish Rite hospital. Both campuses are able to perform mechanical ventilation with isoflurane for life-threatening asthma. ECLS is only offered in the Egleston PICU.
COVID-19-associated hospitalizations among children less than 12 years of age in the United States
Published in Journal of Medical Economics, 2022
Manuela Di Fusco, Shailja Vaghela, Mary M. Moran, Jay Lin, Jessica E. Atwell, Deepa Malhotra, Thomas Scassellati Sforzolini, Alejandro Cane, Jennifer L. Nguyen, Leah J. McGrath
In the overall study population aged 0–11 years, 56.1% had no comorbidities, 39.2% had one or two comorbidities, and 4.8% children had ≥3 comorbid conditions. The mean number of comorbidities was 0.7, which increased with disease progression from 0.5 in the general ward to 1.3 in the ICU and IMV cohort. Additionally, approximately one-quarter (25.7%) had one or more immunocompromised conditions; rheumatological/other inflammatory conditions, primary immunodeficiencies, and chronic kidney disease (CKD)/end-stage renal disease (ESRD) were the most prevalent. Other prevalent comorbid conditions included asthma/reactive airway disease (10.3%) and neurological disease (7.7%). Immunocompromised conditions were even more prevalent (>35%) among those with an ICU admission; CKD/ESRD and rheumatological conditions were reported most in both the ICU but no IMV and the ICU with IMV cohorts. This trend was generally true for neurologic disease and asthma/reactive airway disease.
Reviewing the evidence surrounding preservative-free tafluprost/timolol fixed-dose combination therapy in open-angle glaucoma and ocular hypertension management: a focus on efficacy, safety, and tolerability
Published in Expert Opinion on Drug Safety, 2022
The addition of timolol has been shown to enhance the tolerability of PGA agents in FC therapies [35]. Timolol is associated with few topical side effects, although it has some important systemic adverse effects on the cardiac and respiratory systems [40,41,59,60]. It is associated with symptomatic bradycardia and bronchospasms [40,41,59,60]. Timolol-containing FC glaucoma medications are therefore contraindicated in people with sinus bradycardia, sick sinus syndrome, including sinoatrial block, second- or third-degree atrioventricular block not controlled with pacemaker, overt cardiac failure, and cardiogenic shock [1]. People with reactive airway disease, including current bronchial asthma, history of bronchial asthma, or severe chronic obstructive pulmonary disease, should not be prescribed a timolol-containing therapy [1]. Individuals with cardiac disorders (e.g. coronary heart disease and cardiac failure) and hypotension should be critically assessed and monitored for deterioration or adverse events (AEs) when treated with timolol-containing therapies/regimens [1]. In addition, beta-blockers such as timolol may mask the signs and symptoms of acute hypoglycemia and should be used with caution in individuals with labile diabetes [1]. Tafluprost and other PGAs may be associated with peri-orbitopathy, including eyelash growth, darkening of the eyelid skin, and increased iris pigmentation [1]. Some of these changes may be permanent and can lead to differences in appearance between the eyes when only one eye is treated [1].