Bronchitis, Acute

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ADULT BEST PRACTICE FLASH CARD Bronchitis, Acute Reference DIAGNOSIS Link Acute Cough Symptoms Possible yes Chest (+) Pneumonia pneumonia? x-ray CPM no (-) Asthma yes Possible asthma? CPM no Antibiotics ONLY if severe Possible rhinosinusitis? yes or persistent symptoms no • Symptom relief, education Possible influenza? yes • Consider flu test, antiviral Check if within 48 hrs of onset Germ no Watch • Test & treat ONLY if sx with known exposure or Possible pertussis? yes local outbreak no • Get vaccination up to date Possible exacerbation yes COPD of chronic bronchitis? CPM no Treat acute bronchitis (chest cold) ©2013 Intermountain Healthcare. CPM014fca - 12/13 Reference: Acute Cough (Bronchitis) (CPM014) Not intended to replace physician judgment with respect to individual variations and needs. ADULT BEST PRACTICE FLASH CARD Bronchitis, Acute Reference TREATMENT Link Acute Bronchitis (Chest Cold) MANAGE with NO antibiotics • Withhold antibiotics. NO antibiotics. • Provide education: – Refer to illness as a “chest cold” (not bronchitis). – Explain antibiotic risks (see Colds and Coughs in Adults: Managing Viral Infections fact sheet). – Offer contingency plan if cough worsens. • Recommend symptom relief: – Fever, aches, pains: NSAIDs, acetaminophen. – Nasal congestion: decongestant may help. – Cough: ipratropium (Atrovent), tiotropium (Spiriva), guaifenesin (Mucinex, Robitussin) may help; albuterol (Proventil) if wheezing or asthma. Other remedies not proven effective. FOLLOW UP • Follow-up appt. for new/worsening symptoms, or if cough lasts longer than 3 weeks total. • Re-evaluate; consider chest x-ray. • If cough lasts 3 to 8 weeks, CXR is normal, and pertussis ruled out, consider diagnosis of post- infectious cough. Avoid antibiotics; consider ipratropium (or if ineffective, inhaled corticosteroids). ©2013 Intermountain Healthcare. CPM014fca - 12/13 Reference: Acute Cough (Bronchitis) (CPM014) Not intended to replace physician judgment with respect to individual variations and needs. .

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Bronchiolitis
6 Sand Hill Road, Suite 102 Flemington, NJ 08822 PHONE 908-782-6700 FAX 908-788-5861 hunterdonpediatrics.org BRONCHIOLITIS Bronchiolitis is an infection of the small breathing tubes (bronchioles) that lead to the lung. Bronchiolitis is not the same as bronchitis, which is an infection in the large breathing tubes (bronchi). Bronchiolitis is usually seen in infants and young toddlers. It is not usually seen in older children or adults. A virus causes bronchiolitis. The most common virus is RSV (respiratory syncytial virus). Since RSV infection does not usually result in immunity, people can get it again; however, beyond the age of two, RSV usually causes just a bad cold. RSV is very contagious and spreads rapidly through childcare groups and families from October through April. Some studies suggest that babies who get RSV are more likely to have asthma in the future. Also, people with asthma who get RSV infection may trigger an asthma attack. Babies with RSV have severe nasal congestion, usually followed by a worsening cough. There may be a mild fever at the beginning of the illness. Signs of trouble with RSV include: ● Poor feeding/decreased urine output ● Rapid breathing ● Grunting sound with breathing ● Tightening of chest or stomach muscles with breathing ● Wheezing (high pitched whistling sound with breathing out) ● Blue tint around mouth or fingers/toes ● Fever lasting more than two days, or over 104 The vast majority of patients with bronchiolitis recover well. Certain children are especially likely to have trouble with bronchiolitis: ● Infants under two months of age ● Infants who were premature and have not reached their “due date” yet ● Patients with lung diseases like cystic fibrosis or bronchopulmonary dysplasia (BPD) ● Patients with severe heart disease ● Patients with AIDS or other immunity problems ● Patients on chemotherapy or with organ transplants Treatment for bronchiolitis is mostly supportive; that is, treatment is aimed at helping the patient breathe better.
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The Common Cold.Pdf
PATIENT TEACHING AID The Common Cold PERFORATION ALONG TEAR Everyone has experienced the misery of the common Rhinovirus Infection cold. A cold causes familiar symptoms such as a runny nose, sore throat, congestion, postnasal drip, and cough. For most sufferers, these symptoms are annoying, but not serious. Cold symptoms gradually improve and disappear over 7 to 10 days without complications. Colds are viral infections, so treatment with an antibiotic is not helpful. The best treatment for a cold is rest, fluids, and nonprescription medicines to help relieve symptoms. Although there is no vaccine to prevent colds, the spread of cold viruses can be slowed by frequent hand washing and avoiding close contact with those suffering from a cold. ILLUSTRATION: KRISTEN WIENANDT MARZEJON 2016 MARZEJON WIENANDT KRISTEN ILLUSTRATION: Copyright Jobson Medical Information LLC, 2016 continued MEDICAL PATIENT TEACHING AID Antibiotics Should Not Be Used to Treat a Cold Colds are caused by a variety of viruses, most commonly rhinoviruses. These viruses are highly contagious, and they are spread through the air or when someone is in contact with an infected person or contaminated object. There is no good evidence that exposure to cold or being overheated © Jobson Medical Information LLC, 2016 LLC, Information Medical Jobson © increases the risk of contracting a cold. Although most Wash your hands thoroughly and frequently colds occur in the winter months, some viruses that cause to prevent the spread of cold viruses. colds are more common in the fall or spring. Infants and young children are more prone to colds, as are people with weakened immunity.
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SEPTOPLASTY SURGICAL INFORMED CONSENT the Nasal
.SEPTOPLASTY SURGICAL INFORMED CONSENT The nasal septum is the wall inside your nose that divides it into two separate nasal passages. It is made of cartilage and bone. In a healthy nose, there is usually nearly equal airflow on both sides. Sometimes, the nasal septum is crooked or twisted. This condition is called a deviated nasal septum, and it can be caused by trauma to the nose, or patients can be born this way. The primary problem with a deviated nasal septum is nasal blockage, either on one or both sides. This nasal blockage can also contribute to nosebleeds, sinus infections, and often worsens obstructive sleep apnea. Occasionally, a deviated septum can be associated with a specific type of headache. A deviated septum can be surgically repaired with an operation called a septoplasty. This is typically done through a closed approach, which takes about one hour. More complicated or severely deviated septa may require an open approach, which can take up to 2-3 hours. In either case, septoplasty surgery is done under general anesthesia. It is an outpatient procedure so patients will be discharged home the same day. Some patients have multiple causes of nasal obstruction. Aside from a deviated septum, other reasons for a stuffy nose include chronic sinusitis, turbinate hypertrophy, nasal polyps, or nasal valve collapse. In these cases, septoplasty surgery may be performed in conjunction with other procedures such as endoscopic sinus surgery, turbinate reduction, or insertion of alar batten or spreader grafts. These procedures are discussed in their own individual sections on our website. Your physician will discuss what surgery is most appropriate for you.
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Acute (Serious) Bronchitis
Acute (serious) Bronchitis This is an infection of the air tubes that go down to your lungs. It often follows a cold or the flu. Most people do not need treatment for this. The infection normally goes away in 7-10 days. We make every effort to make sure the information is correct (right). However, we cannot be responsible for any actions as a result of using this information. Getting Acute Bronchitis How the lungs work Your lungs are like two large sponges filled with tubes. As you breathe in, you suck oxygen through your nose and mouth into a tube in your neck. Bacteria and viruses in the air can travel into your lungs. Normally, this does not cause a problem as your body kills the bacteria, or viruses. However, sometimes infection can get through. If you smoke or if you have had another illness, infections are more likely to get through. Acute Bronchitis Acute bronchitis is when the large airways (breathing tubes) to the lungs get inflamed (swollen and sore). The infection makes the airways swell and you get a build up of phlegm (thick mucus). Coughing is a way of getting the phlegm out of your airways. The cough can sometimes last for up to 3 weeks. Acute Bronchitis usually goes away on its own and does not need treatment. We make every effort to make sure the information is correct (right). However, we cannot be responsible for any actions as a result of using this information. Symptoms (feelings that show you may have the illness) Symptoms of Acute Bronchitis include: • A chesty cough • Coughing up mucus, which is usually yellow, or green • Breathlessness when doing more energetic activities • Wheeziness • Dry mouth • High temperature • Headache • Loss of appetite The cough usually lasts between 7-10 days.
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Allergic/Non-Allergic Rhinitis
Tips to Remember: Rhinitis Do you have a runny or stuffy nose that doesn't seem to go away? If so, you may have rhinitis, which is an inflammation of the mucous membranes of the nose. Rhinitis is one of the most common allergic conditions in the United States, affecting about 40 million people. It often coexists with other allergic disorders, such as asthma. It is important to treat rhinitis because it can contribute to other conditions such as sleep disorders, fatigue and learning problems. There are two general types of rhinitis: Allergic rhinitis is caused by substances called allergens. Allergens are often common, usually harmless substances that can cause an allergic reaction in some people. Causes • When allergic rhinitis is caused by common outdoor allergens, such as airborne tree, grass and weed pollens or mold, it is called seasonal allergic rhinitis, or "hay fever." • Allergic rhinitis is also triggered by common indoor allergens, such as animal dander (dried skin flakes and saliva), indoor mold or droppings from cockroaches or dust mites. This is called perennial allergic rhinitis. Symptoms • Sneezing • Congestion • Runny nose • Itchiness in the nose, roof of the mouth, throat, eyes and ears Diagnosis If you have symptoms of allergic rhinitis, an allergist/immunologist can help determine which specific allergens are triggering your reaction. He or she will take a thorough health history, and then test you to determine if you have allergies. Skin tests or Blood (RAST) tests are the most common methods for determining your allergic triggers. Treatment Once your allergic triggers are determined, your physician or nurse will work with you to develop a plan to avoid the allergens that trigger your symptoms.
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Octreotide Treatment of Idiopathic Pulmonary Fibrosis: a Proof-Of-Concept Study
drugs, while two patients underwent surgery in addition to Roncaccio 16, 21049, Tradate, Italy. E-mail: giovannibattista. chemotherapy. [email protected] As in other reference centres, the E. Morelli Hospital needs to transfer out all admitted cases to the hospitals referring them for Support Statement: This study was supported by the current specialised treatment, when culture conversion and clinical research funds of the participating institutions. For this stability have been achieved. Patients were transferred out after publication, the research leading to these results has received a median (IQR) hospital stay of 75.5 (51.5–127.5) days; 12 (100%) funding from the European Community’s Seventh Framework out of 12 and nine (75%) out of 12 achieved sputum-smear and Programme (FP7/2007-2013) under grant agreement FP7- culture conversion, after a median (IQR) time of 40.5 (24–64) and 223681. 70 (44–95) days, respectively. As of June 2011, one patient was cured, two had died and nine were still under treatment. Statement of Interest: None declared. Four (33.3%) cases reported adverse events, two being major (16.7%; neuropathy and low platelet count, needing temporary REFERENCES interruption of linezolid) and two minor (neuropathy and mild 1 Villar M, Sotgiu G, D’Ambrosio L, et al. Linezolid safety, anaemia). All adverse events were reversible. tolerability and efficacy to treat multidrug- and extensively drug-resistant tuberculosis. Eur Respir J 2011; 38: 730–733. In conclusion, despite the intrinsic difficulty of evaluating the 2 World Health Organization. Multidrug and extensively drug safety and tolerability of linezolid (administered within different resistant TB (M/XDR-TB): 2010 global report on surveillance and regimens including multiple anti-TB drugs guided by drug response.
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Influenza (PDF)
INFLUENZA Outbreaks of influenza, or “flu”, typically occur every winter. Colds may occur at any time of year with seasonal peaks occurring in fall and spring. Influenza is a respiratory illness usually caused by infection with one of two influenza viruses – influenza A or influenza B. Outbreaks of influenza (flu) typically occur every winter. Influenza is characterized by an abrupt onset of fever, chills, headache, body aches, and lack of energy accompanied by respiratory symptoms, most frequently cough and sore throat. Most people are largely recovered in one week, although many feel fatigued for several weeks. Serious complications of flu, such as pneumonia, however, can occur, especially if the body’s defenses are weakened by age or disease. Influenza is spread by inhaling the influenza virus which is usually carried on tiny, invisible water droplets in the air generated by coughs and sneezes. Hand-to-hand contact as well as contact with infected secretions on a hard surface may also cause transmission of the virus. Each year influenza viruses change and new vaccines are made to combat the particular strains that are expected to cause illness that year. The flu vaccine may reduce the chance of getting the flu by 60-80%, and lessen the severity of illness in the person who does get the flu. According to the Centers for Disease Control (CDC), everyone 6 months or order should get a yearly flu vaccine. The following people are at high risk for complications of flu and are especially urged to get vaccinated: Individuals with chronic heart or lung problems that have required regular medical follow-up or hospitalization during the last year.
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Bronchiolitis
Bronchiolitis What is bronchiolitis? Bronchiolitis is a viral infection of the lungs that usually affects infants. There is swelling in the smaller airways or bronchioles of the lung, which causes coughing and wheezing. Bronchiolitis is the most common reason for children under 1 year old to be admitted to the hospital. What are the symptoms of bronchiolitis? The following are the most common symptoms of bronchiolitis. However, each child may experience symptoms differently. Symptoms may include: Runny nose or nasal congestion Fever Cough Changes in breathing patterns (wheezing and breathing faster or harder are common) Decreased appetite Fussiness Vomiting What causes bronchiolitis? Bronchiolitis is a common illness caused by different viruses. The most common virus causing this infection is Respiratory Syncytial Virus (RSV). However, many other viruses can cause bronchiolitis including: Influenza, Parainfluenza, Rhinovirus, Adenovirus, and Human metapneumovirus. Initially, the virus causes an infection in the upper airways, and then spreads downward into the lower airways of the lungs. The virus causes swelling of the airways. Mucus is also produced in the airways. This narrowing of the airways can make it difficult for your child to breath, eat, or nurse. How is bronchiolitis diagnosed? Bronchiolitis is usually diagnosed on the history and physical examination of the child. Antibiotics are not helpful in treating viruses and are not needed to treat bronchiolitis. Because there is no cure for the disease, the goal of treatment is to make your child comfortable and to support their symptoms. This treatment may include suctioning to keep the airways clear, extra oxygen if the blood oxygen levels are low, or hydration if your child is not able to feed well.
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New Medical Treatments for Nasal Polyps
New Medical Treatments for Nasal Polyps February 7, 2020 Brian Modena, MD, MSc 1 Disclosures Research support: NHLBI‐Supported Researcher Self Care Catalysts: architect of Health StorylinesTM app Personal Fees: AstraZeneca, GSK, Regeneron, Sanofi 42nd Annual Pulmonary and Allergy Update Objectives 1. Discuss the epidemiology, biology, pathophysiology, and symptoms of CRS with nasal polyposis (CRSwNP). 2. Review treatment guidelines and recommendations for CRSwNP. 3. Review the many scoring systems used to evaluate CRSwNP. 4. Discuss in detail the Phase II and Phase III clinical trials using biologics for treatment of CRSwNP. Nasal Polyposis Epidemiology Prevalence = ~4%1; (CRS = ~11‐12%)2 Costs: Genetic inheritance = ~14% 2 Increases with age; peak ~50 years CRS = ~$8 billion/year Caucasians = Th2‐driven inflammation. Per patient per year: $13,000; Male to female = 2:1 $26,000 if surgery performed. Asians = Th1‐driven inflammation. Association with allergic rhinitis is weak. Surgeries/year = ~500,000 Disease Prevalence estimates 1. Hastan, Fokkens, et al, 2011 Allergic rhinitis Adult: 0.1%; Children 1.5%1 2. Lange, Holst, et al., Clin Otolaryngol 2013. 3. Mygind. JACI. 1990 Dec;86(6 Pt 1):827‐9. Asthma 5‐22% 4. Schleimer RP. Annu Rev Pathol. 2017;12:331‐57. 5. Hunter TD, DeConde AS, Manes RP. J Med Econ. 2018;21(6):610‐5. CRS 20‐25%1‐4 6. Palmer JN, Messina JC, Biletch R, et al. Allergy Asthma Proc. 2018;39:1‐9. NSAID intolerance 36‐72% 7. Pearlman AN, Chandra RK, Chang D, et al. Am J Rhinol Allergy. 2009;23(2):145‐8. NSAID intolerance and asthma 80% 8.
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Frequently Asked Questions About Sinusitis Table of Contents
FREQUENTLY ASKED QUESTIONS ABOUT SINUSITIS TABLE OF CONTENTS Chapter 1: Do I have acute sinusitis or chronic sinusitis? 3 Chapter 2: Do I need antibiotics for my acute sinusitis? 4 Chapter 3: What kind of chronic sinusitis do I have? 5 Chapter 4: Why do I have chronic sinusitis? 7 Chapter 5: What are my treatment options for chronic sinusitis? 9 Chapter 6: When should I consider surgery? 11 Chapter 7: Are my allergies causing my chronic sinusitis? 12 Chapter 8: Is there a connection between chronic sinusitis and asthma? 13 Chapter 9: What can I do to keep my chronic sinusitis under control? 14 Chapter 10: About Metropolitan ENT & Facial Plastic Surgery 15 DISCLAIMER: This information is for educational and informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this e-book. While all attempts have been made to verify information provided in this publication, the Publisher assumes no responsibility for errors, omissions, or contrary interpretation of the subject matter herein. The content of this e-book was developed and published by eos Healthcare Partners, LLC. Accordingly the information and material in this book is copyright, 2015 © eos Healthcare Partners, LLC.Therefore no part of this book may in any form be reproduced, stored, broadcast, sold or transmitted without the prior permission of the publisher, eos Healthcare Partners, LLC.
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Bronchitis) 2013 Update
Care Process Model DECEMBER 2013 DIAGNOSIS AND MANAGEMENT OF Acute Cough (Bronchitis) 2013 update This care process model (CPM) is produced by Intermountain Healthcare’s Lower Respiratory Tract Infection Team, a workgroup of the Primary Care Clinical Program. The CPM provides best-practice recommendations for differential IN THIS UPDATE? diagnosis and management of acute cough and bronchitis. WHAT’S NEW Germ Watch is available at • New data showing an upward trend in unnecessary KEY POINTS intermountainphysician.org use of antibiotics for treatment of acute bronchitis — • Diagnosis of acute bronchitis should be made only after ruling reinforcing our need to do better! out other sources of cough — including pneumonia, asthma, influenza, pertussis, • Updated information on sinusitis, and acute exacerbations of chronic bronchitis (AECB). 1 The algorithm on pages 2 and 3 influenza, and pertussis testing and treatment, guides that evaluation and diagnostic process. Local infection surveillance programs such as with links to more information. Germ Watch can provide up-to-date information about communicable diseases that routinely • Summary of evidence base for symptom affect our communities. relief of acute cough (see ACUTE BRONCHITIS • If acute bronchitis is the diagnosis, antibiotics are TREATMENT RECOMMENDATIONS box inside). Unnecessary Antibiotic Use NOT the answer! Despite ongoing evidence that antibiotics • New and revised provider and patient NOT are needed for acute bronchitis, latest data show that their % of adults with acute bronchitis who received an antibiotic education materials to support physicians in prescription within 3 days of ofﬁce visit (based on SelectHealth data) use is actually increasing. SelectHealth rates rose from 70% in differential diagnosis and evidence-based treatment 2008 to nearly 75% in 2010 (see graph at right), which mirrors 76 74.87% of acute cough (bronchitis) and related illnesses.
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Sinusitis, NIAID Fact Sheet
January 2006 Sinusitis OVERVIEW You’re coughing and sneezing and tired and achy. You think that you might be getting a cold. Later, when the medicines you’ve been taking to relieve the symptoms of the common cold are not working and you’ve now got a terrible headache, you finally drag yourself to the doctor. After listening to your history of symptoms, examining your face and forehead, and perhaps doing a sinus X-ray, the doctor says you have sinusitis. Sinusitis simply means your sinuses are infected or inflamed, but this gives little indication of the misery and pain this condition can cause. Health experts usually divide sinusitis cases into • Acute, which last for 4 weeks or less • Subacute, which lasts 4 to 8 weeks • Chronic, which usually last up to 8 weeks but can continue for months or even years • Recurrent, which are several acute attacks within a year, and may be caused by different organisms Health experts estimate that 37 million Americans are affected by sinusitis every year. Health care providers report nearly 32 million cases of chronic sinusitis to the Centers for Disease Control and Prevention annually. Americans spend $5.8 billion each year on health care costs related to sinusitis. What are sinuses? Sinuses are hollow air spaces in the human body. When people say, “I'm having a sinus attack,” they usually are referring to symptoms in one or more of four pairs of cavities, or sinuses, known as paranasal sinuses . These cavities, located within the skull or bones of the head surrounding the nose, include • Frontal sinuses over the eyes in the brow area • Maxillary sinuses inside each cheekbone • Ethmoid sinuses just behind the bridge of the nose and between the eyes • Sphenoid sinuses behind the ethmoids in the upper region of the nose and behind the eyes Each sinus has an opening into the nose for the free exchange of air and mucus, and each is joined with the nasal passages by a continuous mucous membrane lining.
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