Background: Anecdotally it has been noted that the traditional chest signs associated with bronchiolitis appear inconsistently in infants clinically diagnosed with bronchiolitis. We wished to explore this more formally.
Objective: The aim of this study was to assess whether the auscultatory chest signs at presentation in infants with bronchiolitis were influenced by age or by the underlying pathogen.
Materials And Methods: We conducted a prospective opportunistic cohort study, recruiting infants less than 12 months old who presented with bronchiolitis to the Emergency Department of the Royal Hospital for Sick Children in Edinburgh.
Results: Eighty-six infants were recruited. Infants who presented with wheeze were significantly older [26.6 (±1.9) weeks] than those without wheeze [17.3 (±2.1) weeks] (analysis of variance, P=0.002). Those who presented without any chest signs on auscultation were younger than those with chest signs [15.1 (±2.6) weeks compared with 24.4 (±1.7) weeks] (analysis of variance, P=0.006). We did not detect any difference in any of the auscultatory chest signs (crackles, wheeze or absence of signs) depending on the virus responsible for bronchiolitis.
Conclusion: Clinical signs associated with bronchiolitis vary according to age. Infants older than 6 months are more likely to present with wheeze and infants less than 4 months old are likely to present without chest signs on auscultation.
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http://dx.doi.org/10.1097/MEJ.0000000000000115 | DOI Listing |
Eur J Cardiovasc Nurs
January 2025
Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University, and Liverpool Heart and Chest Hospital, Liverpool, UK.
Aim: (i) To explore the attitudes of patients with atrial fibrillation (AF) towards oral anti-coagulation (OAC) for stroke prevention post-intracerebral haemorrhage (ICH) and (ii) to explore factors that influence patients' decision-making process for stroke prevention.
Methods And Results: Patients with documented diagnosis of AF and history of a non-traumatic ICH, who were eligible for long-term OAC were recruited from eight hospitals in England, using purposive sampling. Data were collected using semi-structured interviews and analysed using Framework analysis.
Echocardiography
February 2025
Department of Cardiology, MedStar Georgetown University Hospital, Washington, DC, USA.
Objective: This study evaluated the safety and efficacy of isoproterenol administration as an adjunct for achievement of target heart rate (HR) during dobutamine stress echocardiography (DSE).
Background: In DSE, optimal accuracy is achieved when a target HR of 85% of maximal predicted heart rate (MPHR) is attained. Although rarely studied, intravenous isoproterenol has been used as an adjunct therapy to dobutamine and atropine to increase chronotropic response during pharmacologic stress testing.
Hemorrhagic pleural effusion as the sole manifestation of pancreatitis is exceedingly rare and often presents diagnostic challenges due to its misleading symptoms. We report the case of an adult male with a large left-sided black pleural effusion secondary to chronic necrotizing pancreatitis. The patient presented with progressive shortness of breath and cough, with a history of alcohol use and a previous diagnosis of acute severe pancreatitis.
View Article and Find Full Text PDFEur Heart J Case Rep
January 2025
Department of Cardiology, Azorg, Merestraat 80, 9300 Aalst, Belgium.
Background: Patients after transcatheter pulmonary valve implantation (TPVI) are at increased risk for infective prosthetic valve endocarditis. Diagnosis of infective endocarditis (IE) following TPVI is particularly difficult due to impaired visualization of the transcatheter pulmonary valve (TPV) with echocardiography [Delgado V, Ajmone Marsan N, de Waha S, Bonaros N, Brida M, Burri H, et al. 2023 ESC guidelines for the management of endocarditis.
View Article and Find Full Text PDFEur Heart J Case Rep
January 2025
Child and Adolescent Center, Hospital CUF Descobertas, R. Mário Botas S/N, 1998-018 Lisboa, Portugal.
Background: While viruses remain the leading cause of infectious myocarditis, improved diagnostic methods have highlighted the role of bacteria as a possible cause. We report two cases of myocarditis as a complication of infection.
Case Summaries: Patient A, a 17-year-old Caucasian male with a history of asthma, presented to the emergency department (ED) after experiencing fever and nausea for four days, followed by 1 day of diarrhoea and chest discomfort.
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