Cases reported "Bronchial Spasm"

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1/19. Reactive airways dysfunction and systemic complaints after mass exposure to bromine.

    Occasionally children are the victims of mass poisoning from an environmental contaminant that occurs due to an unexpected common point source of exposure. In many cases the contaminant is a widely used chemical generally considered to be safe. In the following case, members of a sports team visiting a community for an athletic event were exposed to chemicals while staying at a local motel. bromine-based sanitizing agents and other chemicals such as hydrochloric acid, which were used in excess in the motel's swimming pool, may have accounted for symptoms experienced by the boy reported here and at least 16 other adolescents. Samples of pool water contained excess bromine (8.2 microg/mL; ideal pool bromine concentration is 2-4 microg/mL). Symptoms and signs attributable to bromine toxicity included irritative skin rashes; eye, nose, and throat irritation; bronchospasm; reduced exercise tolerance; fatigue; headache; gastrointestinal disturbances; and myalgias. While most of the victims recovered within a few days, the index case and several other adolescents had persistent or recurrent symptoms lasting weeks to months after the exposure.
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keywords = headache
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2/19. Severe unilateral bronchospasm mimicking inadvertent endobronchial intubation: a complication of the use of a topical lidocaine Laryngojet injector.

    A healthy young woman is described in whom the left chest was unable to be inflated after intubation. The differential diagnosis and management are discussed. Severe unilateral bronchospasm was probably caused by topical lidocaine injected at the vocal cords and, inadvertently, into the left main bronchus with a Laryngojet device.
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ranking = 1.097920565696
keywords = chest
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3/19. Bronchospasm induced by propofol in a patient with sick house syndrome.

    IMPLICATIONS: propofol is often used in patients with asthma, but it can induce bronchospasm. We report a patient with sick house syndrome (nonspecific complaints of mucosal irritation, headache, nausea, and chest symptoms) who suffered bronchospasm. This case suggests that propofol is not always a safe anesthetic for patients with asthma, especially drug-induced asthma.
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ranking = 2.097920565696
keywords = chest, headache
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4/19. Spontaneous negative pressure changes: an unusual cause of noncardiogenic pulmonary edema.

    The principal physiologic mechanism underlying the formation of negative pressure pulmonary edema (NPPE) is thought to be the creation of excessive negative intrathoracic force from inspiration against a critical obstruction of the upper airway. The increased subatmospheric transpulmonary pressures result in transudation of fluid from the pulmonary capillaries to the interstitium and alveoli. The clinical picture is that of pulmonary edema. Aggressive diagnostic and therapeutic intervention can be avoided if the syndrome is recognized early. This report highlights the clinical features of NPPE and serves as a reminder to the clinician that although NPPE can cause significant morbidity, conservative supportive therapy typically results in a good outcome.
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ranking = 0.27666287749448
keywords = upper
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5/19. Intraoperative bronchospasm after intravenous adenosine during general anesthesia.

    adenosine with its rapid onset and brief duration of action has a number of clinical applications including treatment of paroxysmal supraventricular tachycardia and maximal coronary vasodilatation during pharmacologic stress testing. The adverse effects of adenosine include dyspnea, nausea, headache, chest pain, flushing and bronchospasam. Although there were few reports which mentioned the occurrence of bronchospam after administration of adenosine, a number of studies indicated that the use of adenosine was not contraindicated in patients with chronic obstructive pulmonary disease (COPD) or asthma. We report here a male patient with pulmonary emphysema and lung bullous disease who developed severe constriction of the main bronchi after intravenous adenosine during general anesthesia. After treatment, the patient was discharged without complications. We have reviewed the related current literature and herein discuss the reason and management of the adenosine induced bronchospasm.
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ranking = 2.097920565696
keywords = chest, headache
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6/19. Bee stings of children: when to perform endotracheal intubation?

    hymenoptera stings account for more deaths in united states that any other envenomation. Oropharyngeal stings, although rare, may produce life-threatening airway obstruction by way of localized swelling. We present 4 cases of bee stings in children that necessitated tracheal intubation and mechanical ventilation. Two children had breathing difficulties at admission; the other 2 presented with minimal symptoms but were preventively intubated and mechanically ventilated. Orofacial bee sting victims should be given parenteral treatment with epinephrine, steroids, antihistamines, and inhalational bronchodilators even when they initially present with minimal symptoms, with general anaphylaxis management in large envenomations, as well as immediate endotracheal intubation and mechanical ventilation for at least 24 hours in patients with signs of airway compromise.
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ranking = 90.962419119904
keywords = breathing
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7/19. Severe bronchospasm during laryngeal mask airway placement in an infant.

    A 35-day-old male infant was scheduled for bilateral inguinal herniorrhaphy. No history of recent upper airway infection or other reactive respiratory disease was noted before anesthesia. breath holding was noted immediately after laryngeal mask airway (LMA) insertion. Removal of the LMA and positive pressure ventilation via face mask did not solve the problem. On suspicion of laryngospasm, tracheal intubation facilitated by muscule relaxant was performed. However, when the patient was ventilated, high airway pressure, absence of chest wall movement and elevated end-tidal CO2 were noted. Despite visual confirmation of correct placement of tracheal tube, oxygen desaturation and bradycardia developed rapidly. After deepening the inhalational anesthesia of sevoflurane and concomitant administration of intravenous lidocaine, the patient's respiratory condition turned for the better and became compliable. Respiratory dysfunction may be caused by severe bronchospasm induced by placement of the LMA. The pathophysiology and risk factors of bronchospasm related to the LMA placement are discussed in the text.
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ranking = 1.3745834431905
keywords = chest, upper
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8/19. Variant forms of asthma.

    asthma is an important cause of morbidity in children, and prompt diagnosis and treatment are essential. asthma has a wide variety of clinical manifestations. chest pain variant asthma is an important subset of cough variant asthma. A high index of suspicion is required to make the diagnosis. Wheezing is not always present in asthma. Another manifestation, such as chronic cough or chest pain, may be the sole presenting complaint.
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ranking = 1.097920565696
keywords = chest
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9/19. airway obstruction due to inhalation of ammonia.

    ammonia is an important chemical in industry. Accidental inhalation of ammonia has resulted in upper airway and bronchoalveolar injury, and even fatal inhalation of anhydrous ammonia has occurred. We present herein a 5-year follow-up on a patient who had no prior history of smoking or pulmonary symptoms and had overwhelming exposure to ammonia which resulted in acute respiratory failure with diffuse lung parenchymal and airway involvement. The extreme inflammation and desquamation of the mucosa of the central bronchial tree, as observed bronchoscopically, have apparently resulted in a hyperreactive bronchoconstrictive component. Because our patient had never smoked and had no history of pulmonary symptoms or wheezing, we speculate that both the central and the peripheral residual airway obstructions were a result of his inhalation injury. In addition, peripheral airway disease, suggested by the postbronchodilator flow-volume curves present during the first year of follow-up, has gradually cleared even though there is evidence of parenchymal scarring.
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ranking = 0.27666287749448
keywords = upper
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10/19. timolol eyedrop-induced severe bronchospasm.

    A patient with glaucoma simplex and chronic pulmonary obstruction was treated with the non-selective beta-adrenergic blocking agent timolol in ophthalmic solution of 0.25% for 11/2 years, when he had daily asthma attacks. In a provocation test, forced expiratory volume in the first second was reduced by 56% and bradycardia was induced after application of two drops of timolol eyedrops 0.25%. The severe systemic side-effects of timolol, when used as eyedrops, are related to the liver bypass and perhaps to the fast absorption from the cornea. It is suggested that when timolol ophthalmic solution is given for the first time to glaucoma patients with chronic obstructive pulmonary disease, they should be observed for one hour with special reference to difficulty in breathing.
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ranking = 90.962419119904
keywords = breathing
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