Respiratory disorders

Sleep apnea syndrome is a sleep disorder that patients have at least 5 periods of apnea-hypopnea for at least 10 seconds during sleep. In Asia, a frequency of approximately 4.1% - 7.5% in men and 2.1% - 3.2% in women, similar to the European-American. Airway narrowing associated with reduced nerve impulses leading to the upper respiratory during sleep and the onset of apnea, can cause sudden respiratory closed in part or entirely.

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This research project aimed to: (a) determine the demographic profile and common conditions of patients in a Teaching Clinic; (b) describe the adverse events from Chinese medicine treatment; (c) examine the overall treatment outcomes and treatment interventions of Chinese medicine in patients with respiratory disorders; and (d) assess the level of knowledge and compliance with Chinese medicine in patients with respiratory disorders.

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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học 'Respiratory Research cung cấp cho các bạn kiến thức về ngành y đề tài: "Idiopathic pulmonary fibrosis: an epithelial/fibroblastic cross-talk disorder...

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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học 'Respiratory Research cung cấp cho các bạn kiến thức về ngành y đề tài: "Cigarette smoking, cadmium exposure, and zinc intake on obstructive lung disorder...

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Có 5 loại : 1. Nhiễm toan chuyển hóa (metabolic acidosis) (ví dụ ngừng tim). 2. Nhiễm toan hô hấp (respiratory acidosis) (ví dụ bệnh phổi tắc mãn tính với ứ đọng CO2). 3. Nhiễm kiềm chuyển hóa (metabolic alkolosis) (ví dụ mửa kéo dài) 4. Nhiễm kiềm hô hấp (respiratory acidosis) (ví dụ hội chứng tăng thông khí). 5. Rối loạn axít-kiềm hỗn hợp (nghĩa là nhiễm kiềm hô hấp và nhiễm toan chuyển hóa, như được thấy nơi một người trưởng thành với ngộ độc salicylate ; nhiễm toan chuyển hóa với bù hô hấp). ...

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Neutrophil Abnormalities A defect in the neutrophil life cycle can lead to dysfunction and compromised host defenses. Inflammation is often depressed, and the clinical result is often recurrent with severe bacterial and fungal infections. Aphthous ulcers of mucous membranes (gray ulcers without pus) and gingivitis and periodontal disease suggest a phagocytic cell disorder. Patients with congenital phagocyte defects can have infections within the first few days of life. Skin, ear, upper and lower respiratory tract, and bone infections are common. Sepsis and meningitis are rare.

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Palpable purpura are further subdivided into vasculitic and embolic. In the group of vasculitic disorders, cutaneous small-vessel vasculitis, also known as leukocytoclastic vasculitis (LCV), is the one most commonly associated with palpable purpura (Chap. 319). Underlying etiologies include drugs (e.g., antibiotics), infections (e.g., hepatitis C virus), and autoimmune connective tissue diseases. Henoch-Schönlein purpura is a subtype of acute LCV that is seen primarily in children and adolescents following an upper respiratory infection.

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Chronic respiratory alkalosis is the most common acid-base disturbance in critically ill patients and, when severe, portends a poor prognosis. Many cardiopulmonary disorders manifest respiratory alkalosis in their early to intermediate stages, and the finding of normocapnia and hypoxemia in a patient with hyperventilation may herald the onset of rapid respiratory failure and should prompt an assessment to determine if the patient is becoming fatigued. Respiratory alkalosis is common during mechanical ventilation. The hyperventilation syndrome may be disabling.

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Alcoholic Ketoacidosis: Treatment Extracellular fluid deficits almost always accompany AKA and should be repleted by IV administration of saline and glucose (5% dextrose in 0.9% NaCl). Hypophosphatemia, hypokalemia, and hypomagnesemia may coexist and should be corrected. Hypophosphatemia usually emerges 12–24 h after admission, may be exacerbated by glucose infusion, and, if severe, may induce rhabdomyolysis. Upper gastrointestinal hemorrhage, pancreatitis, and pneumonia may accompany this disorder. Drug- and Toxin-Induced Acidosis Salicylates (See also Chap.

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Approach to the Patient: Acid-Base Disorders A stepwise approach to the diagnosis of acid-base disorders follows (Table 48-3). Care should be taken when measuring blood gases to obtain the arterial blood sample without using excessive heparin. Blood for electrolytes and arterial blood gases should be drawn simultaneously prior to therapy, since an increase in [HCO3–] occurs with metabolic alkalosis and respiratory acidosis. Conversely, a decrease in [HCO3–] occurs in metabolic acidosis and respiratory alkalosis.

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Figure 48-1 Acid-base nomogram. Shown are the 90% confidence limits (range of values) of the normal respiratory and metabolic compensations for primary acidbase disturbances. (From DuBose, used with permission.) Mixed Acid-Base Disorders Mixed acid-base disorders—defined as independently coexisting disorders, not merely compensatory responses—are often seen in patients in critical care units and can lead to dangerous extremes of pH (Table 48-2).

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Table 48-1 Prediction of Compensatory Responses on Simple AcidBase Disturbances and Pattern of Changes Range of Values Disorder Prediction Compensation of pH HCO3– PaCO2 Metabolic PaCO2= (1.5 x Low Low Low acidosis HCO3-) + 8 ± 2 or PaCO2 will 1.25 mmHg per mmol/L in [HCO3-] or PaCO2 = [HCO3] + 15 Metabolic alkalosis PaCO2 will 0.75 mmHg per mmol/L in [HCO3-] High High High or PaCO2 will 6 mmHg per 10 mmol/L in [HCO3-] or PaCO2= [HCO3-] + 15 Respiratory alkalosis High Low Low Acute 0.2 [HCO3-] mmol/L will per mmHg in PaCO2 Chronic 0.

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Infections of the Ear and Mastoid Infections of the ear and associated structures can involve both the middle and external ear, including the skin, cartilage, periosteum, ear canal, and tympanic and mastoid cavities. Both viruses and bacteria are known causes of these infections, some of which result in significant morbidity if not treated appropriately. Infections of the External Ear Structures Infections involving the structures of the external ear are often difficult to differentiate from noninfectious inflammatory conditions with similar clinical manifestations.

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Approach to the Patient: Disorders of the Sense of Smell Unilateral anosmia is rarely a complaint and is only recognized by testing of smell in each nasal cavity separately. Bilateral anosmia, on the other hand, brings patients to medical attention. Anosmic patients usually complain of a loss of the sense of taste even though their taste thresholds may be within normal limits. In actuality, they are complaining of a loss of flavor detection, which is mainly an olfactory function.

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Orbital Cellulitis This causes pain, lid erythema, proptosis, conjunctival chemosis, restricted motility, decreased acuity, afferent pupillary defect, fever, and leukocytosis. It often arises from the paranasal sinuses, especially by contiguous spread of infection from the ethmoid sinus through the lamina papyracea of the medial orbit. A history of recent upper respiratory tract infection, chronic sinusitis, thick mucous secretions, or dental disease is significant in any patient with suspected orbital cellulitis. Blood cultures should be obtained, but they are usually negative.

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Drugs Acting on Motor Systems spinal disorders. Benzodiazepines enhance the effectiveness of the inhibitory transmitter GABA (p. 226) at GABAA receptors. Baclofen stimulates GABAB receptors. !2-Adrenoceptor agonists such as clonidine and tizanidine probably act presynaptically to inhibit release of excitatory amino acid transmitters. The convulsant toxins, tetanus toxin (cause of wound tetanus) and strychnine diminish the efficacy of interneuronal synaptic inhibition mediated by the amino acid glycine (A).

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