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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
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Oedema Glottidis is defined as the abnormal accumulation of fluid in tissues involving the supraglottic and subglottic region where laryngeal mucosa is loose. It is also known as Laryngeal Oedema.
Three or more of the following six criteria must be met:
- Age when disease starts is under 50
- Decreased brachial artery pulse
- Systolic blood pressure differs by more than 10mmHg between arms
- Cramping caused by exercise in the extremities
- Abnormal sounds (through stethoscope) over subclavian arteries or abdominal aorta
- A narrowing or blockage in the aorta, its primary branches, or large arteries as seen through a radiograph of the arteries.
Starts with nonspecific symptoms such as:
- Localized joint pain
- Fever
- Fatigue
- Headaches
- Rashes
- Weight loss
- Diagnosis usually does not happen until the blockage causes deficient blood flow to the extremities or to a stroke.
Fever, sore throat, odynophagia (painful swallowing), swelling in neck.
High-altitude pulmonary edema (HAPE) ("HAPO" spelled oedema in British English) is a life-threatening form of non-cardiogenic pulmonary edema (fluid accumulation in the lungs) that occurs in otherwise healthy mountaineers at altitudes typically above . However, cases have also been reported at lower altitudes (between in highly vulnerable subjects), though what makes some people susceptible to HAPE is currently unknown. HAPE remains the major cause of death related to high-altitude exposure, with a high mortality rate in the absence of adequate emergency treatment.
The most common clinical sign is subcutaneous edema of the limbs and hemorrhages on mucous membranes. Other clinical signs include depression, anorexia, fever, elevated heart and respiratory rate, reluctance to move, drainage from lymph nodes, exudation of serum from the skin, colic, epistaxis and weight loss. Rarely, horses may also develop disseminated intravascular coagulation (DIC), leading to infarction of various organs, or chronic myositis and muscle atrophy.
Physiological and symptomatic changes often vary according to the altitude involved.
The Lake Louise Consensus Definition for High-Altitude Pulmonary Edema has set widely used criteria for defining HAPE symptoms:
Symptoms: at least two of:
- Difficulty in breathing (dyspnea) at rest
- Cough
- Weakness or decreased exercise performance
- Chest tightness or congestion
Signs: at least two of:
- Crackles or wheezing (while breathing) in at least one lung field
- Central cyanosis (blue skin color)
- Tachypnea (rapid shallow breathing)
- Tachycardia (rapid heart rate)
The initial cause of HAPE is a shortage of oxygen caused by the lower air pressure at high altitudes.
The mechanisms by which this oxygen shortage causes HAPE are poorly understood, but two processes are believed to be important:
1. Increased pulmonary arterial and capillary pressures (pulmonary hypertension) secondary to hypoxic pulmonary vasoconstriction.
2. An idiopathic non-inflammatory increase in the permeability of the vascular endothelium.
Although higher pulmonary arterial pressures are associated with the development of HAPE, the presence of pulmonary hypertension may not in itself be sufficient to explain the development of edema: severe pulmonary hypertension can exist in the absence of clinical HAPE in subjects at high altitude.
Infection can occur from:
- Pharynx: acute and chronic infection of tonsil and adenoids
- Teeth: dental infection occurs from lower last molar tooth
- Ear: bezold abscess and petrositis
- Other space: infection of parotid retropharyngeal space
- External trauma: penetrating injuries of neck, injection of local anaesthetic
Pulmonary aspiration is the entry of material (such as pharyngeal secretions, food or drink, or stomach contents) from the oropharynx or gastrointestinal tract into the larynx (voice box) and lower respiratory tract (the portions of the respiratory system from the trachea—i.e., windpipe—to the lungs). A person may either inhale the material, or it may be delivered into the tracheobronchial tree during positive pressure ventilation. When pulmonary aspiration occurs during eating and drinking, the aspirated material is often colloquially referred to as "going down the wrong pipe."
Consequences of pulmonary aspiration range from no injury at all, to chemical pneumonitis or pneumonia, to death within minutes from asphyxiation. These consequences depend in part on the volume, chemical composition, particle size, presence or absence of infectious agents, and underlying health status of the person. In healthy people, aspiration of small quantities of material is common and rarely results in disease or injury. People with significant underlying disease or injury, especially hospitalized patients, are at greater risk for developing respiratory complications following pulmonary aspiration because of certain factors such as depressed level of consciousness and impaired airway defenses (gag reflex and/or respiratory tract antimicrobial defense system). As the lumen of the right main bronchus is more vertical and of slightly wider diameter than that of the left, aspirated material is more likely to end up in this bronchus or one of its subsequent .
About 3.6 million cases of pulmonary aspiration or foreign body in the airway occurred in 2013.
PVS sufferers often complain of a burning sensation with the tongue and oral mucosa, and atrophy of lingual papillae produces a smooth, shiny, red, dorsum of the tongue. Symptoms include:
Serial contrasted gastrointestinal radiography or upper gastrointestinal endoscopy may reveal the web in the esophagus. Blood tests show a hypochromic microcytic anemia that is consistent with an iron-deficiency anemia. Biopsy of involved mucosa typically reveals epithelial atrophy (shrinking) and varying amounts of submucosal chronic inflammation. Epithelial atypia or dysplasia may be present.It may also present as a post-cricoid malignancy which can be detected by loss of laryngeal crepitus. Laryngeal crepitus is found normally and is produced because the cricoid cartilage rubs against the vertebrae.
Diabetic myonecrosis is a complication of diabetes. It is caused by infarcted muscle tissue, usually in the thigh.
The mean age at presentation is thirty-seven years with a reported range of nineteen to sixty-four years. The mean age of onset since diagnosis of diabetes is fifteen years. The female:male ratio is 1.3:1. Other diabetic complications such as nephropathy, neuropathy, retinopathy and hypertension are usually present. Its major symptom is the acute onset muscle pain, usually in the thigh, in the absence of trauma. Signs include exquisite muscle tenderness and swelling.
Enlarged adenoids can become nearly the size of a ping pong ball and completely block airflow through the nasal passages. Even if enlarged adenoids are not substantial enough to physically block the back of the nose, they can obstruct airflow enough so that breathing through the nose requires an uncomfortable amount of work, and inhalation occurs instead through an open mouth. Adenoids can also obstruct the nasal airway enough to affect the voice without actually stopping nasal airflow altogether.
Nasal blockage is determined by at least two factors: 1) the size of the adenoids, and 2) the size of the nasal pharynx passageway.
The adenoid usually reaches its greatest size by about age 5 years or so, and then fades away ("atrophies") by late childhood - generally by the age of 7 years. The lymphoid tissue remains under the mucosa of the nasopharynx, and could be seen under a microscope if the area was biopsied, but the mass is so reduced in size that the roof of the nasopharynx becomes flat rather than mounded. Just as the size of the adenoids is variable between individuals, so is the age at which adenoids atrophy.
The symptoms caused by enlarged adenoids are mostly due to "where" this lymphoid tissue is located. The adenoids are in the midline of the nasopharynx, and the Eustachian tubes open from either ear to the right and left of them. In children with excessive middle ear infections and chronic middle ear fluid, there is a high bacterial count in the adenoids as compared to children without problematic otitis media, even if the size of the adenoids is small. The adenoids in these cases provides a reservoir of pathogenic bacteria that cause ear infections and subsequent middle ear effusions (fluid).
The nasopharynx lies right above the throat. Splashes of excessive "drip" from infected adenoids may land directly on the vocal cords. Although the larynx and vocal cords do not ordinarily become infected from adenoiditis, their mucosa does become irritated. The vocal cords are extremely sensitive to touch, and any fluid drops falling on them cause an irresistible urge to cough. Adenoiditis therefore is one of the causes of cough.
Chemosis is the swelling (or edema) of the conjunctiva. It is due to the oozing of exudate from abnormally permeable capillaries. In general, chemosis is a nonspecific sign of eye irritation. The outer surface covering appears to have fluid in it. The conjunctiva becomes swollen and gelatinous in appearance. Often, the eye area swells so much that the eyes become difficult or impossible to close fully. Sometimes, it may also appear as if the eyeball has moved slightly backwards from the white part of the eye due to the fluid filled in the conjunctiva all over the eyes except the iris. The iris is not covered by this fluid and so it appears to be moved slightly inwards.
Following clinical presentations may be used in the diagnosis of this condition.
1. Dizziness
2. Pallor of the conjuctiva and face
3. Erythematous oral mucosa with burning sensation
4. Breathelessness
5. Atropic and smooth tongue
6. Peripheral rhaggades around the oral cavity
The following tests are helpful in the diagnosis of Plummer–Vinson syndrome.
Risk factors for pulmonary aspiration include conditions which depress the level of consciousness (such as traumatic brain injury, alcohol intoxication, drug overdose, and general anesthesia). A decreased gag reflex, upper esophageal sphincter and lower esophageal sphincter tone, gastroesophageal reflux, full stomach, as well as obesity, stroke, and pregnancy can all increase the risk of aspiration in the semiconscious. Tracheal intubation or presence of a gastric tube (for example, a feeding tube) may also increase the risk.
Purpura haemorrhagica is a rare complication of equine strangles and is caused by bleeding from capillaries which results in red spots on the skin and mucous membranes together with oedema (swelling) of the limbs and the head. Purpura hemorrhagica is more common in younger animals.
It is usually caused by allergies or viral infections, often inciting excessive eye rubbing. Chemosis is also included in the Chandler Classification system of orbital infections.
If chemosis has occurred due to excessive rubbing of the eye, the first aid to be given is a cold water wash for eyes.
Other causes of chemosis include:
- Superior vena cava obstruction, accompanied by facial oedema
- Hyperthyroidism, associated with exophthalmos, periorbital puffiness, lid retraction, and lid lag
- Cavernous sinus thrombosis, associated with infection of the paranasal sinuses, proptosis, periorbital oedema, retinal haemorrhages, papilledema, extraocular movement abnormalities, and trigeminal nerve sensory loss
- Carotid-cavernous fistula - classic triad of chemosis, pulsatile proptosis, and ocular bruit
- Cluster headache
- Trichinellosis
- Systemic lupus erythematosus (SLE)
- Angioedema
- Acute glaucoma
- Panophthalmitis
- Orbital cellulitis
- Gonorrheal conjunctivitis
- Dacryocystitis
- Spitting cobra venom to the eye
- High concentrations of phenacyl chloride in chemical mace spray
- Urticaria
- Trauma
- Post surgical
- Rhabdomyosarcoma of the orbit
The adenoids, like all lymphoid tissue, enlarge when infected. Although lymphoid tissue does act to fight infection, sometimes bacteria and viruses can lodge within it and survive. Chronic infection, either viral or bacterial, can keep the pad of adenoids enlarged for years, even into adulthood. Some viruses, such as the Epstein-Barr Virus, can cause dramatic enlargement of lymphoid tissue. Primary or reactivation infections with Epstein Barr Virus, and certain other bacteria and viruses, can even cause enlargement of the adenoidal pad in an adult whose adenoids had previously become atrophied.
A URI may be classified by the area inflamed.
Rhinitis affects the nasal mucosa, while rhinosinusitis or sinusitis affects the nose and paranasal sinuses, including frontal, ethmoid, maxillary, and sphenoid sinuses. Nasopharyngitis (rhinopharyngitis or the common cold) affects the nares, pharynx, hypopharynx, uvula, and tonsils generally. Without involving the nose, pharyngitis inflames the pharynx, hypopharynx, uvula, and tonsils. Similarly, epiglottitis (supraglottitis) inflames the superior portion of the larynx and supraglottic area; laryngitis is in the larynx; laryngotracheitis is in the larynx, trachea, and subglottic area; and tracheitis is in the trachea and subglottic area.
Keratosis Pharyngis is a medical condition where keratin grows on the surface of the pharynx, that is the part of the throat at the back of the mouth. Keratin is a protein that normally occurs as the main constituent of hair and nails.
It is characterized by the presence of whitish-yellow dots on the pharyngeal wall, tonsils or lingual tonsils.
They are firmly adherent and cannot be wiped off.
The surrounding region does not show any sign or inflammation or any other constitutional signs.
The disease usually shows spontaneous regression.
One patient who was diagnosed with Keratosis Pharyngis had white spots on the base of the tongue and on the pharynx, and hurt a little when swallowing. No treatment was found to help, but the condition went away by itself eventually.
Among the signs and symptoms of acute proliferative glomerulonephritis are the following:
- Hematuria:
- Oliguria
- Edema
- Hypertension
- Fever, headache, malaise, anorexia, nausea.
Ear pain can be caused by disease in the external or middle ear(because of infection), or inner ear, but the three are indistinguishable in terms of the pain experienced.
External ear pain may be:
- Mechanical: trauma, foreign bodies such as hairs, insects or cotton buds.
- Infective (otitis externa): "Staphylococcus", "Pseudomonas", "Candida", herpes zoster, or viral Myringitis. (See Otitis externa)
Middle ear pain may be:
- Mechanical: barotrauma (often iatrogenic), Eustachian tube obstruction leading to acute otitis media.
- Inflammatory / infective: acute otitis media, mastoiditis.
Although some disagreement exists on the exact boundary between the upper and lower respiratory tracts, the upper respiratory tract is generally considered to be the airway above the glottis or vocal cords. This includes the nose, sinuses, pharynx, and larynx.
Typical infections of the upper respiratory tract include tonsillitis, pharyngitis, laryngitis, sinusitis, otitis media, certain types of influenza, and the common cold. Symptoms of URIs can include cough, sore throat, runny nose, nasal congestion, headache, low grade fever, facial pressure and sneezing.
In uncomplicated colds, cough and nasal discharge may persist for 14 days or more even after other symptoms have resolved.
Acute upper respiratory tract infections include rhinitis, pharyngitis/tonsillitis and laryngitis often referred to as a common cold, and their complications: sinusitis, ear infection and sometimes bronchitis (though bronchi are generally classified as part of the lower respiratory tract.) Symptoms of URTIs commonly include cough, sore throat, runny nose, nasal congestion, headache, low-grade fever, facial pressure and sneezing.
Symptoms of rhinovirus in children usually begin 1–3 days after exposure. The illness usually lasts 7–10 more days.
Color or consistency changes in mucous discharge to yellow, thick, or green are the natural course of viral upper respiratory tract infection and not an indication for antibiotics.
Group A beta hemolytic streptococcal pharyngitis/tonsillitis (strep throat) typically presents with a sudden onset of sore throat, pain with swallowing and fever. Strep throat does not usually cause runny nose, voice changes, or cough.
Pain and pressure of the ear caused by a middle ear infection (otitis media) and the reddening of the eye caused by viral conjunctivitis are often associated with upper respiratory infections.