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asthma fatal

Usman Maqsood, Nehal Patel
We describe a case of near-fatal asthma, treated successfully by initiation of extracorporeal membrane oxygenation (ECMO). A 29-year-old woman, known asthmatic on steroid inhalers, inhaled/nebulised bronchodilators, long-term oral prednisolone, theophylline and montelukast, presented with acute shortness of breath. She deteriorated following initial treatment with nebulised bronchodilators and magnesium sulfate requiring intubation and mechanical ventilation. Severe bronchospasm ensued following mechanical ventilation and peak airway pressures remained at 55 cm H2 O with intrinsic positive end expiratory pressure(PEEP) of 14 cm H2 O...
March 20, 2018: BMJ Case Reports
Thais Mauad, Felipe B P do Nascimento, Marisa Dolhnikoff, Milena C M Picka, Paulo H N Saldiva
BACKGROUND: Mortality related to asthma has decreased worldwide since the introduction of inhaled corticosteroid therapy in the past decades. However, there are still some asthma fatalities identified mainly in populations with less access to regular treatment. Pulmonary interstitial emphysema due to alveolar rupture has been rarely described as a complication of an acute severe asthma attack, and its identification in pathological analysis can be difficult. Previous studies reported the association of pulmonary interstitial emphysema and bronchial ductal gland ectasia in asthma...
March 20, 2018: BMC Pulmonary Medicine
Jenny Tran, Robyn Norton, Nathalie Conrad, Fatemeh Rahimian, Dexter Canoy, Milad Nazarzadeh, Kazem Rahimi
BACKGROUND: Multimorbidity in people with cardiovascular disease (CVD) is common, but large-scale contemporary reports of patterns and trends in patients with incident CVD are limited. We investigated the burden of comorbidities in patients with incident CVD, how it changed between 2000 and 2014, and how it varied by age, sex, and socioeconomic status (SES). METHODS AND FINDINGS: We used the UK Clinical Practice Research Datalink with linkage to Hospital Episode Statistics, a population-based dataset from 674 UK general practices covering approximately 7% of the current UK population...
March 2018: PLoS Medicine
Tricia McKeever, Kevin Mortimer, Andrew Wilson, Samantha Walker, Christopher Brightling, Andrew Skeggs, Ian Pavord, David Price, Lelia Duley, Mike Thomas, Lucy Bradshaw, Bernard Higgins, Rebecca Haydock, Eleanor Mitchell, Graham Devereux, Timothy Harrison
Background Asthma exacerbations are frightening for patients and are occasionally fatal. We tested the concept that a plan for patients to manage their asthma (self-management plan), which included a temporary quadrupling of the dose of inhaled glucocorticoids when asthma control started to deteriorate, would reduce the incidence of severe asthma exacerbations among adults and adolescents with asthma. Methods We conducted a pragmatic, unblinded, randomized trial involving adults and adolescents with asthma who were receiving inhaled glucocorticoids, with or without add-on therapy, and who had had at least one exacerbation in the previous 12 months...
March 3, 2018: New England Journal of Medicine
Shinen Naranmandakh, Toshihiro Murata, Batsukh Odonbayar, Keisuke Suganuma, Javzan Batkhuu, Kenroh Sasaki
Fomitopsis officinalis is a medicinal fungus, known as 'Agarikon', and is used traditionally in the treatment of asthma and rheumatism in Mongolia. The investigation of the chemical constituents of F. officinalis led to the isolation of 4 new lanostane triterpenoids together with 4 known triterpenoids. Inhibitory activity against Trypanosoma congolense, which causes fatal diseases in animals including livestock, was estimated for the isolated compounds. Compounds 2-5 and 8 exhibited moderate inhibition activities with IC50 values ranging from 7...
February 7, 2018: Journal of Natural Medicines
R A Fernandes, F Regateiro, C Pereira, E Faria, J Pita, A Todo-Bom, I Carrapatoso
Background. Anaphylaxis is an acute, potentially fatal, multi-organ allergic reac-tion. Our aim was to characterize the population with food induced anaphylaxis followed over a one-year period. Methods. Retrospective analysis of clinical files of patients with food anaphylaxis observed in our food allergy consultation during 2016. Results. Sixty-two patients were included. In the pediatric group, the implicated allergens were cow's milk, egg and fish and in the adults' group, the commonest allergens were nuts and wheat...
March 2018: European Annals of Allergy and Clinical Immunology
Sultan Albuhairi, Tatyana Sare, Paul Lakin, Kristel El Khoury, Elena Crestani, Lynda C Schneider, Rocco Anzaldi, Al Patterson, Rima Rachid
BACKGROUND: The 2003 Joint Task Force on Practice Parameters recommended standardizing allergen subcutaneous immunotherapy (SCIT). Data from longitudinal surveillance survey in North America reported a systemic reaction (SR) rate of 0.1% to 0.2% of injection visits. The rate of SR to standardized SCIT in pediatric patients has not been well evaluated. OBJECTIVE: The objective of this study was to evaluate the rate of SRs to standardized SCIT in pediatric patients aged 5 to 18 years in a single tertiary care center in the United States...
January 12, 2018: Journal of Allergy and Clinical Immunology in Practice
Christopher D Pascoe, Ma'en Obeidat, Bryna A Arsenault, Yunlong Nie, Stephanie Warner, Dorota Stefanowicz, Samuel J Wadsworth, Jeremy A Hirota, S Jasemine Yang, Delbert R Dorscheid, Chris Carlsten, Tillie L Hackett, Chun Y Seow, Peter D Paré
BACKGROUND: Gene expression changes in the structural cells of the airways are thought to play a role in the development of asthma and airway hyperresponsiveness. This includes changes to smooth muscle contractile machinery and epithelial barrier integrity genes. We used a targeted gene expression arrays to identify changes in the expression and co-expression of genes important in asthma pathology. METHODS: RNA was isolated from the airways of donor lungs from 12 patients with asthma (8 fatal) and 12 non-asthmatics controls and analyzed using a multiplexed, hypothesis-directed platform to detect differences in gene expression...
December 11, 2017: BMC Pulmonary Medicine
Hye Ju Yeo, Dohyung Kim, Doosoo Jeon, Yun Seong Kim, Peter Rycus, Woo Hyun Cho
BACKGROUND: The use of extracorporeal membrane oxygenation (ECMO) in cases of near-fatal asthma (NFA) has increased, but the benefits and potential complications of this therapy have yet to be fully investigated. METHODS: Cases were extracted from the Extracorporeal Life Support Organization Registry between March 1992 and March 2016. All patients with a diagnosis of asthma (according to the International Classification of Diseases 9th edition), who also received ECMO, were extracted...
December 6, 2017: Critical Care: the Official Journal of the Critical Care Forum
H Tanaka, E Nakatani, Y Fukutomi, K Sekiya, H Kaneda, M Iikura, M Yoshida, K Takahashi, K Tomii, M Nishikawa, N Kaneko, Y Sugino, M Shinkai, T Ueda, Y Tanikawa, T Shirai, M Hirabayashi, T Aoki, T Kato, K Iizuka, M Fujii, M Taniguchi
BACKGROUND: Reducing near-fatal asthma exacerbations is a critical problem in asthma management. OBJECTIVES: To determine patterns of factors preceding asthma exacerbations in a real-world setting. METHODS: In a nationwide prospective study of 190 patients who had experienced near-fatal asthma exacerbation, cluster analysis was performed using asthma symptoms over the 2-week period before admission. RESULTS: Three distinct clusters of symptoms were defined employing the self-reporting of a visual analogue scale...
December 1, 2017: Allergy
Francesco Menzella, Carla Galeone, Mirco Lusuardi, Anna Simonazzi, Claudia Castagnetti, Patrizia Ruggiero, Nicola Facciolongo
Severe asthma affects between 5% and 10% of patients with asthma worldwide and requires best standard therapies at maximal doses, but there is a subgroup of patients refractory to all treatments. We share a case report of a 53-year-old woman with a history of severe allergic asthma that progressively worsened over the years despite the best therapy. She had been hospitalized 35 times, including nine admissions to the respiratory intensive care unit due to severe exacerbations. To rule out other possible diagnoses, several investigations were performed, such as computed tomography scan of the chest and neck, fiberoptic laryngoscopy, antineutrophil cytoplasmic antibodies, and complete blood cell count...
2017: Therapeutics and Clinical Risk Management
Hedley Knewjen Quintana, Imre Janszky, Alkass Kanar, Bruna Gigante, Henrik Druid, Anders Ahlbom, Ulf de Faire, Johan Hallqvist, Karin Leander
INTRODUCTION: Present knowledge concerning potential associations between comorbidities and the fatality of a first myocardial infarction (MI) is limited. AIM: To identify comorbidities in 45-70-year-old individuals who suffered a first MI and died within 7 days in Stockholm County from 1992-1994. In addition, to assess how each of the comorbidities identified, as well as the number of hospitalizations during the 10-year period prior to the MI, was associated with MI fatality...
January 2018: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
C J M Poole, S Basu
Background: The waste and recycling sector is a growing part of industry. Whether health surveillance is indicated and how it should be undertaken is unclear. Aims: To undertake a review of the literature to identify hazards to health, biological effects and occupational illnesses for workers in the sector. Methods: A systematic review of the published literature and two UK databases. Results: Rates of fatal, non-fatal injuries and self-reported work-related illness were found to be higher in the waste and recycling sector than in UK industry as a whole...
December 2, 2017: Occupational Medicine
L Volkan Tümay, Osman Serhat Güner, Abdullah Zorluoğlu
Lymphangioleiomyomatosis (LAM) is a rare and fatal disease which occurs almost exclusively in young women. The disease often affects lungs and most of the patients die from respiratory failure. It is often initially misdiagnosed as asthma or chronic obstructive pulmonary disease. The most common presentations of pulmonary LAM (P-LAM) include dyspnea and coughing. Chylothorax and spontaneous pneumothorax may be seen in advanced cases. Although rare, it may present with extrapulmonary LAM (E-LAM). Renal angiomyolipomas and abdominal lymphadenopathies (LAPs) are common in E-LAM cases...
November 9, 2017: International Journal of Surgery Case Reports
Felix Reyes, Navneet Singh, Nigar Anjuman-Khurram, Jihae Lee, Lillian Chow
Citrobacter koseri is a gram-negative bacillius that belongs to the Enterobacteriaceae family. It is an uncommon pathogen that typically causes meningitis and brain abscesses in children, however central nervous system (CNS) infections are rarely found in adults. We present a case of C. koseri meningitis in an immunocompetent adult secondary to intestinal micro-perforation caused by Strongyloides A 76-year-old man admitted for asthma exacerbation developed septic shock. A lumbar puncture revealed bacterial meningitis...
2017: IDCases
Jose L Gomez, Xiting Yan, Carole T Holm, Nicole Grant, Qing Liu, Lauren Cohn, Vera Nezgovorova, Deborah A Meyers, Eugene R Bleecker, Gina M Crisafi, Nizar N Jarjour, Linda Rogers, Joan Reibman, Geoffrey L Chupp
The chitinase-like protein YKL-40 mediates airway inflammation and serum levels are associated with asthma severity. However, asthma phenotypes associated with YKL-40 levels have not been precisely defined.We conducted an unsupervised cluster analysis of asthma patients treated at the Yale Center for Asthma and Airways Disease (n=156) to identify subgroups according to YKL-40 level. The resulting YKL-40 clusters were cross-validated in cohorts from the Severe Asthma Research Programme (n=167) and the New York University/Bellevue Asthma Repository (n=341)...
October 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Stefanie Plenzig, Sara Heinbuch, Hannelore Held, Marcel A Verhoff, Constantin Lux
Although myocarditis is caused by viral infections in about 50% of cases in European countries, various other causative agents are known. We report the case of a 51-year-old man who died several months after being diagnosed with asthma by his general practitioner. This diagnosis had been confirmed by a pulmonologist approximately 6 weeks before the man's death. To rule out the possibility of medical malpractice the prosecuting authority ordered a forensic autopsy. At autopsy macroscopic indicators for perimyocarditis and pneumonia were found...
December 2017: Forensic Science, Medicine, and Pathology
Arthur Pavot, Jihad Mallat, Nicolas Vangrunderbeeck, Didier Thevenin, Malcolm Lemyze
RATIONALE: Mechanical ventilation of severe acute asthma is still considered a challenging issue, mainly because of the gas trapping phenomenon with the potential for life-threatening barotraumatic pulmonary complications. PATIENT CONCERNS: Herein, we describe 2 consecutive cases of near-fatal asthma for whom the recommended protective mechanical ventilation approach using low tidal volume of 6 mL/kg and small levels of PEEP was rapidly compromised by giant pneumomediastinum with extensive subcutaneousemphysema...
October 2017: Medicine (Baltimore)
David N O'Dwyer, Bethany B Moore
Periostin is a protein that plays a key role in development and repair within the biological matrix of the lung. As a matricellular protein that does not contribute to extracellular matrix structure, periostin interacts with other extracellular matrix proteins to regulate the composition of the matrix in the lung and other organs. In this review, we discuss the studies exploring the role of periostin to date in chronic respiratory diseases, namely asthma and idiopathic pulmonary fibrosis. Asthma is a major health problem globally affecting millions of people worldwide with significant associated morbidity and mortality...
December 2017: Cellular and Molecular Life Sciences: CMLS
John Lippmann, David McD Taylor, Christopher Stevenson, Jo Williams, Simon J Mitchell
INTRODUCTION: This is the second report based on a survey of Divers Alert Network Asia-Pacific (DAN AP) members who dive with cardiovascular and respiratory conditions and diabetes. It examines the medical management of the divers' conditions, any diving modifications used to mitigate the risk and outcomes. METHODOLOGY: An online cross-sectional survey was sent to 833 divers who had declared a targeted medical condition when applying for DAN AP membership between July 2009 and August 2013...
September 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
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