Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0476273 (respiratory distress)
 19,632 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Idiopathic nontransplant-related childhood bronchiolitis obliterans is an uncommon disease. Most patients present with chronic recurrent dyspnea, cough and wheezing, which are also features of asthma, by far a much more common condition. The present case study reports on a six-year-old girl who presented to a tertiary care centre with recurrent episodes of respiratory distress on a background of baseline tachypnea, chronic hypoxemia and exertional dyspnea. Her past medical history revealed significant lung disease in infancy, including respiratory syncytial virus bronchiolitis and repaired gastroesophageal reflux. She was treated for 'asthma exacerbations' throughout her early childhood years. Bronchiolitis obliterans was subsequently diagnosed with an open lung biopsy. She did not have sustained improvement with systemic corticosteroids, hydroxychloroquine or clarithromycin. Cardiac catheterization confirmed the presence of secondary pulmonary hypertension. Treatment options remain a dilemma for this patient because there is no known effective treatment for this condition, and the natural history is not well understood. The present case demonstrates the need for careful workup in 'atypical asthma', and the urgent need for further research into the rare lung diseases of childhood.
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PMID:Pediatric interstitial lung disease masquerading as difficult asthma: management dilemmas for rare lung disease in children. 1624 29

Respiratory syncytial virus, the most common cause of bronchiolitis, is the leading cause of infant hospitalization in developed countries and accounts for substantial mortality and morbidity in developing countries. Children at increased risk of developing severe bronchiolitis are those <6 weeks of age, those born prematurely and those with an underlying cardiopulmonary disorder or immunodeficiency. Approximately 80% of cases occur in the first year of life. By two years of age, virtually all children have been infected by at least one strain of the virus. Classically, respiratory syncytial virus bronchiolitis manifests as cough, wheezing and respiratory distress. The mainstay of treatment is supportive care, consisting of adequate fluid intake, antipyretics to control fever and use of supplemental oxygen if necessary. Frequent and meticulous hand-washing is the best measure to prevent secondary spread. Treatment of respiratory syncytial virus bronchiolitis beyond supportive care should be individualized. Palivizumab has been shown to be effective in preventing severe respiratory syncytial virus bronchiolitis in high-risk children when given prophylactically. In the majority of cases, the disease is usually self-limited. The mortality rate is <1% and occurs predominantly in children at high risk for severe disease.
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PMID:Respiratory syncytial virus bronchiolitis. 1639 64

Many doctors consider wheezing infants and young children who respond to beta-adrenergic agents to be asthmatics, or at least at risk for later asthma. The aim of this study was to compare responses to inhaled albuterol and racemic epinephrine in infancy between children with and without asthma later in childhood. In a crossover study setting, 100 acutely wheezing infants aged less than 24 months were randomized to receive inhalations of either racemic epinephrine and placebo, or albuterol and placebo. Clinical evaluation consisted of measurements of respiratory rate, heart rate, and oxygen saturation, and clinical assessment of the respiratory distress assessment instrument (RDAI) score, consisting of wheezing and chest indrawings. The asthma status of the children was evaluated at three clinical follow-up visits, at 4.0, 7.2, and 12.3 (median) years of age. Responses to bronchodilating agents, when respiratory rates and RDAI scores were used as outcome measures, were not different in future asthmatics compared to nonasthmatics. However, oxygen saturation was significantly higher after albuterol inhalation in children who had asthma at all three visits (92.67% confidence interval (CI), 91.39-93.96) than in those without asthma at these visits (92.52% CI, 91.79-93.25), but lower, correspondingly, after racemic epinephrine (91.97% CI, 90.74-93.19 vs. 93.04% CI, 92.29-93.79) and placebo (91.38% CI, 90.49-92.28 vs. 93.12% CI, 92.60-93.65) inhalations (P = 0.04). In conclusion, we were not able to confirm that future asthmatics respond better than future nonasthmatics to bronchodilating agents during wheezing in infancy. More studies are needed to characterize the subset of infants who benefit from bronchodilating treatment in infancy.
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PMID:Responses to inhaled bronchodilators in infancy are not linked with asthma in later childhood. 1654 59

We describe an infant with recurrent wheezing and cough caused by an oropharyngeal cyst. Mucosal oropharyngeal cysts arise from obstruction or traumatic severance of a duct in a minor salivary gland, which leads to retention of mucous secretion . The mucosal cyst of the oropharynx is a rare cause of respiratory distress in the infants. The clinical symptoms depend on the size, shape, and location of the cyst.
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PMID:A rare cause of wheezing in infancy. 1676 27

Vocal cord dysfunction (VCD) is a respiratory condition characterized by the paradoxical closure of the vocal cords. This condition results in a myriad of symptoms that would be expected from an upper airway obstruction including anxiety, hyperventilation, wheezing, stridor, shortness of breath, dyspnea, and suprasternal and neck muscle retraction. with known VCD who underwent local anesthesia with intravenous sedation for perianal skin tag removal. Postoperatively, the patient experienced respiratory distress, prompting interventions and investigation. A review of the literature revealed limited information on VCD, and no anesthesia literature was found regarding this entity.
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PMID:Vocal cord dysfunction: a case report. 1704 57

Two girls developed symptoms of wheezing which started shortly after birth. The symptoms did not respond to bronchodilators. At the age of 5 months, the first infant developed severe respiratory distress with decreased left-sided breathing sounds on auscultation. The chest X-ray showed left-sided hyperinflation. Bronchoscopy revealed isolated malacia of the left main stem bronchus. The second patient, who had a history ofcor vitium, was referred to a paediatric pulmonologist in an academic hospital for chronic coughing and wheezing. Bronchoscopy and CT angiogram, performed at the age of 14 months, revealed tracheal malacia due to compression from a right descending aortic arch. Broncho- and tracheomalacia are disorders which may rarely result in severe respiratory distress. These disorders should be considered when unexplained symptoms of wheezing or coughing are present in young infants, especially if the symptoms start shortly after birth and persist without signs of viral infection.
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PMID:[Wheezing and cough related to congenital airway abnormalities in young infants]. 1720 3

Spontaneous pneumomediastinum (SPM) is a rare, generally benign condition in young children caused by alveolar rupture and dissection of air into the mediastinum and hilum. In children, SPM is seen most commonly in asthmatics but may also occur in any patient who induces a Valsalva maneuver, including coughing, forceful vomiting, or first-time wheezing. There are limited reports on SPM in first-time wheezing episodes. We report a case of a 4-year-old girl with no history of wheezing who presents with wheezing, mild respiratory distress, and salient radiographic findings of pneumomediastinum, including spinnaker sail sign and continuous diaphragm sign. The SPM is generally a benign entity that requires supportive care, and resolution occurs spontaneously. This article will allow the clinician to become familiar with the specific clinical and radiological signs associated with SPM.
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PMID:Spontaneous pneumomediastinum in children: a literature review. 1722 18

Controversy over the efficacy of systemic corticosteroids for acute bronchiolitis initiated this study. We conducted a randomized, double-blind, placebo-controlled trial to examine the efficacy of single dexamethasone injection for the treatment of acute bronchiolitis in young hospitalized children. The study, performed at the pediatric wards of a University Hospital and its affiliated hospital in Thailand, included 174 previously healthy children under 2 years of age, hospitalized with acute bronchiolitis. Each child received either a single intramuscular injection of 0.6 mg/kg dexamethasone or a placebo in addition to regular management. The primary outcome was the time from study entry to resolution of respiratory distress, determined by a clinical score derived from the respiratory rate, occurrence of wheezing, chest retraction, and oxygen saturation. Survival analysis using the Kaplan-Meier method and a log-rank test were performed. A single-dose, dexamethasone injection versus placebo produced a significant: (1) decrease in the time needed for resolution of respiratory distress (hazard ratio 1.56; 95% CI, 1.14-2.13; P = 0.005), (2) decrease in the mean duration of symptoms of 11.8 hr (95% CI, 3.9-19.7; P = 0.004), (3) decrease in the mean duration of oxygen therapy of 14.9 hr (95% CI, 5.3-24.4; P = 0.003), and (4) decrease in the mean length of hospital stay of 13.4 hr (95%CI, 2.6-24.2; P = 0.02). In conclusion, a single injection of dexamethasone yielded a significant clinical benefit for the treatment of previously healthy, young children hospitalized with acute bronchiolitis.
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PMID:Efficacy of dexamethasone injection for acute bronchiolitis in hospitalized children: a randomized, double-blind, placebo-controlled trial. 1758 44

Episodes of respiratory distress with chest retraction and wheezing, sometimes associated with facial edema, were noted after administering the proton pump inhibitors omeprazole and esomeprazole in an infant with gastroesophageal reflux. The disturbances relieved dramatically after withdrawing the proton pump inhibitor.
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PMID:Severe systemic adverse reaction to proton pump inhibitors in an infant. 1746 50

This case discussion is part of the Integrating Basic Science into Clinical Teaching Initiative. It is intended to examine wheezing as a symptom and to describe the underlying physiology that explains the physical findings and blood gas features in an attempt to localize the site of obstruction. The information contained in this case is a compilation and derived from 2 similar patients. This case discussion describes a 13-month-old girl who presents with wheezing and respiratory distress. A close examination of her physical findings and blood gas analysis indicate that she is experiencing overall alveolar hypoventilation without significant hypoxemia, suggesting her airway obstruction is located above the carina. Subsequent investigations reveal a right aortic arch and vascular ring as the cause of her symptoms. An understanding of the physiology of airway obstruction and pulmonary gas exchange allows for better localization of sites of airway obstruction and the institution of appropriate diagnostic tests and therapy.
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PMID:Wheezing child. 1787 41


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