Pulse oximetry in acute asthma

Article Abstract:

The airways in the lungs of patients with asthma are overly sensitive to substances present in the air. This means that a very small amount of one of these substances can cause the airways to become narrow so that breathing becomes difficult. Asthmatic patients are treated with bronchodilators, which open the airways in the lungs. When an asthma attack occurs and becomes so severe that bronchodilators do not relieve the symptoms, the patient may require hospitalization. It can be difficult to determine how long the patient should be kept in the hospital and when the patient should be discharged. The lungs must be functioning properly, and not be constricted or plugged with mucus, in order for the proper amount of oxygen to be maintained in the blood. Therefore, the amount of oxygen in the blood may provide a clue to the status of the lungs following an asthma attack and may be appropriate for determining whether a patient should be held or discharged from the hospital. Pulse oximetry is a technique that is used to measure the amount of oxygen in the blood. To determine if pulse oximetry is useful in predicting whether a patient should be admitted or discharged, 100 children who went to the emergency department because of an asthma attack were studied. Blood oxygen content was measured before drug treatment in 30 patients, in 24 patients after drug treatment, and in 46 patients both before and after drug treatment. When performed before drug treatment, pulse oximetry was not as effective in predicting the outcome as it was when it was performed after drug treatment. Pulse oximetry gave too many false negative results, meaning that too many of the patients were discharged too early and had to be readmitted. It is concluded that this technique, when used by itself, is not sensitive enough to be used as a predictor of patient admission or discharge. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Evaluation, Asthma, Asthmatics, Blood gases, Oximetry, Blood gas analysis

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Haem arginate in acute hereditary coproporphyria

Article Abstract:

Hemoglobin is a protein that is found in red blood cells and is responsible for carrying oxygen in the blood. Hemoglobin contains a substance called heme, which contains iron, which in turn binds to and carries the oxygen. Heme is made by a series of biochemical reactions that require several different enzymes. A deficiency in one of these enzymes will reduce the amount of heme in the blood. This type of enzyme deficiency can cause several different types of diseases that are collectively called porphyrias. These diseases can be inherited or they can be acquired from exposure to toxic substances such as hexachlorobenzene or lead. Hereditary coproporphyria is one of the least common forms, and involves the production of large amounts of a substance called delta-amino levulinic acid (DALA). When DALA accumulates in the body it can cause high blood pressure, abdominal pain, brain disturbances that impair mental function, and nerve damage. These symptoms usually appear at puberty. DALA is present in the urine of patients with this disease and it causes the urine to turn dark when it is exposed to light and air. This article describes the case report of an 11-year-old boy who was admitted to the hospital with symptoms of abdominal pain, seizures, high blood pressure, fast heart rate, vomiting and constipation. A urine sample was analyzed and found to contain large amounts of DALA. The patient was diagnosed as having hereditary coproporphyria and was treated with a substance called heme arginate. The heme arginate increased the synthesis of heme and reduced the amount of DALA. The patient's severely deteriorated condition improved after treatment with heme arginate and after three weeks the patient was released from the hospital. It is concluded that heme arginate may be beneficial for treating patients with hereditary coproporphyria. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abnormalities, Porphyria, Porphyrin metabolism

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Roseola infantum and other syndromes associated with acute HHV6 infection

Article Abstract:

Infection with human herpesvirus type 6 (HHV6) is associated with the production of antibodies specifically targeting this virus. The detection of immunoglobulin M (IgM)-type antibody to HHV6 confirmed the diagnosis of acute HHV6 infection in eight infants. Six of the infants had a significant change in their total anti-HHV6 antibody levels. Of four infants ill enough to be admitted to the hospital, one had encephalitis (inflammation of the brain), and three had enlarged livers and spleens associated with infections by other types of herpesvirus. The remaining four infants developed a condition resembling roseola infantum, a skin condition characterized by high fever, enlargement of the spleen, and a rose-colored rash that develops as the fever subsides. Two of the infants with rash had pregnant mothers and their blood was analyzed for rubella (German measles). The other two infants with rash had been treated with antibiotics during the fever phase of their illness, which may have triggered an allergic reaction in the form of a rash. These findings suggest that HHV6 infection may be associated with certain clinical syndromes, including roseola infantum. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Complications and side effects, Physiological aspects, Herpesvirus diseases, Herpesvirus infections, Exanthema subitum, Roseola

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