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Congestive Heart Failure
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Pulmonary edema causes anxiety because of a sensation of suffocation, severe dyspnea, and restlessness. Often, there is coughing that produces a reddened sputum, cyanosis, pallor, and extreme sweating. There may be frothing from the mouth, but extreme hemoptysis is rare. While the BP can be variable, the pulse is rapid but of low volume. Significant hypertension indicates that the cardiac reserve is increased. A dangerous sign is hypotension in which the systolic BP is lower than 100 mg Hg. Over both lung fields, inspiratory fine crackles are dispersed anteriorly and posteriorly. Severe cardiac asthma may develop, causing wheezing. Efforts to breathe are noisy and often complicate auscultation of heart sounds. A merger of the third and fourth heart sounds, known as a summation gallop, may develop. Signs of RV failure may occur, including neck vein distention and peripheral edema.
Pulmonary Medicine
Published in James M. Rippe, Manual of Lifestyle Medicine, 2021
Wheezing: Wheezing is the sound that emanates from the lower airways (below the larynx) resulting in turbulent airflow (4). The sound is produced by turbulent flow through the narrowed airways and in some cases may reflect a rapid oscillation of airway narrowing. Common causes of wheezing include primary airway reactivity (e.g., asthma) interstitial edema, airway inflammation and mucous hypersecretion, endobronchial obstruction (e.g., neoplasm or foreign body), vocal cord dysfunction, or exercise-induced bronchial obstruction.
The Toxic Environment and Its Medical Implications with Special Emphasis on Smoke Inhalation
Published in Jacob Loke, Pathophysiology and Treatment of Inhalation Injuries, 2020
Jacob Loke, Richard A. Matthay, G. J. Walker. Smith
When wheezing is detected or there is a history of obstructive airway disease (e.g., asthma), bronchodilator therapy can be administered by the oral, inhaled, or intravenous route. Beta2 agonists can be given by inhalation or nebulization, and racemic epinephrine aerosol inhalation may benefit patients with upper airway obstruction who do not require endotracheal intubation. Aminophylline should be administered in an initial intravenous bolus of 5.6 mg/kg over 20-30 min followed by a continuous intravenous infusion of 0.4-0.5 mg/kg/hr.' Theophylline blood levels should be monitored to ensure therapeutic blood levels of 10-20 µg/ ml and to guide adjustment of the aminophylline infusion. Chest physiotherapy in conjunction with beta2 agonist aerosol therapy may be of value in patients with significant sputum production.
Factors associated with medication adherence among adults with asthma
Published in Journal of Asthma, 2023
Kudret C. Özdemir, Ramune Jacobsen, Morten Dahl, Eskild Landt
Asthma was defined as affirmative answers to both of the following two questions “Has a doctor ever told you that you have asthma” and “Do you still have asthma?” (Figure 1). Asthma medication adherence was defined as an affirmative response to the question “Do you, daily or almost daily, take medication for asthma (including spray/powder)?”. Wheezing in this study was defined as confirmation of whistling or wheezing while breathing, coughing with mucus was coughing up mucus in the morning or during the daytime, and shortness of breath was often being troubled by shortness of breath. Participants also reported on asthma attacks during the past year, that merited use of reliever medications, hay-fever symptoms, use of allergy medication, acute fever, bronchitis or cystisis in the past month, pneumonia that resulted in medical visits during the last 10 years, age at asthma diagnosis, smoking status, physical activity, education, household income, and marital status. Lung function was measured using a hand-held spirometer (MicroLoop, Micro Medical Ltd, Kent, UK) as described (21). Body Mass Index (BMI) was measured weight divided by measured height squared (kg/m2).
Association between early childhood lower respiratory tract infections and subsequent asthma
Published in Journal of Asthma, 2022
Mark S. Brittan,, Angela Moss,, John D. Watson,, Monica J. Federico,, John D. Rice,, Amanda F. Dempsey,, Lilliam Ambroggio,
Covariates included variables with known or potential association with asthma, including gender, race, ethnicity, history of prematurity, family history of asthma, history of wheezing, and presence of atopy (11). Asthma family history, wheezing and prematurity were defined by available ICD-9 and -10 codes within the dataset (Appendix A). Atopy was characterized through ICD-9 and -10 diagnosis codes into separate categories of food allergy, atopic dermatitis, allergic rhinitis, or allergic reaction/anaphylaxis (Appendix A). We examined exposure to 0, 1, 2, or ≥3 atopic categories before 2 years of age. While wheezing can be associated clinically with both LRTI and asthma, it is a distinct diagnostic code found in the dataset exclusive of the asthma and LRTI diagnostic codes. As recurrent early childhood wheeze is predictive of asthma, we included this covariate in the analysis.
The effects of different parity and delivery mode on wheezing disorders in the children—a retrospective cohort study in Fujian, China
Published in Journal of Asthma, 2022
Haiyan Gao, Chong Miao, Haibo Li, Meng Bai, Huijie Zhang, Zhengqin Wu, Wei Li, Wenjuan Liu, Libo Xu, Guanghua Liu, Yibing Zhu
Our research is one of the few studies that focuses on the effect of cesarean section delivery on wheezing in cases of parity greater than two. The results showed that cesarean section had a greater risk of wheezing in children with parity greater than two. On the one hand, many measures can be taken to reduce the risk of wheezing in children, such as strengthening family care education, improving the living environment, and avoiding contact with allergic substances (34). This would help to ensure that wheezing in such children, especially in non-severe cases, is prevented from developing into repeated wheezing or into asthma, therefore helping reduce medical expenses. On the other hand, pregnant women, especially those with parity greater than two, should consider the balance between benefits and risks when choosing delivery methods. The national, provincial, and municipal health committees should follow medical rules and strictly control surgical indications for cesarean section. Various forms of health education promote natural childbirth and control non-medically necessary cesarean sections, which can help avoid wheezing caused by cesarean section (35).