Difficulty In Breathing Research Articles

Current Trends in the Treatment of Misophonia

Misophonia is a disorder characterized by emotional and physiological responses that occur in response to certain auditory stimuli. Visual, tactile, and olfactory stimuli, primarily oral and nasal sounds such as eating, nose, and respiratory sounds, reveal misophonic responses. People with misophonia may have difficulty in social interactions, and work or school performance may be adversely affected. Misophonia symptoms can also cause anxiety, depression, and other mental health problems. Physiological reactions in the body, such as pain, sweating, tachycardia, hot flashes, and breathing difficulties, negatively affect people's physical health. For this reason, people's physical and mental health and quality of life are significantly affected. The absence of agreed diagnostic criteria for the diagnosis of misophonia and the lack of sufficient data to classify it as a psychiatric disorder has led to the lack of validated treatment guidelines. However, there are treatment recommendations discussed in the literature for misophonia, which has a prevalence of 20% in a limited number of studies and negatively affects the functionality of the individual. In the management of misophonia, tinnitus re-education therapy (TRT) was used as audiological treatment, antidepressants, and anxiolytics were used as pharmacological treatment and cognitive behavioral therapies were used as therapy. Other suggested treatment recommendations are neural remodeling technique, sequential remodeling hypnotherapy, trauma prevention technique, and trauma and tension reduction exercises. This review aims to present the treatment approaches available in the literature together and to understand the need for experimental evidence for treatment methods.

First Molecular Identification and Clinical Presentation of Crenosomosis in a Dog from Slovakia

PurposeCrenosoma vulpis (Dujardin,1845) is a lungworm which has spread worldwide in canines and is associated with upper respiratory infections. In a majority of cases, the infections are accompanied with chronic cough. Diagnosis of lungworms is often underdiagnosed and can be misinterpreted as other respiratory diseases.MethodsThe Small Animal Clinic of the University Veterinary Hospital admitted an 11-month-old dog presented with persistent cough associated with difficulty in breathing and even asphyxia. Based on clinical symptoms, the patient underwent radiological and bronchoscopic examination. Bronchoscopy revealed the presence of lungworms obturating the branches of the tracheobronchial tree. Larvae were collected by bronchoscopic lavage and subjected to parasitological and molecular examination.ResultsMicroscopic detection and morphological identification of the worms removed during the bronchoscopy confirmed the presence of female adult worms. The subsequent molecular characterisation of the mitochondrial (cytochrome c oxidase subunit I gene (cox1) and 12S ribosomal DNA (rDNA)), nuclear (18S rDNA) genes, as well as the analysis of the second internal transcribed spacer (ITS-2) region of the ribosomal DNA, confirmed the Crenosoma vulpis species. Faecal samples were processed using the Baermann method, which confirmed the presence of the larval stage 1 of C. vulpis. The therapy with fenbendazole at a dose of 50 mg/kg of live weight once daily for the period of 7 days was initiated for the patient.ConclusionThis paper presents the first molecularly confirmed clinical case of a Crenosoma vulpis infection in an 11-month-old female dog of the Miniature Schnauzer breed in Slovakia.

Research Progress in the Degradation of Chemical Warfare Agent Simulants Using Metal-Organic Frameworks.

Chemical warfare agents primarily comprise organophosphorus nerve agents, saliva alkaloids, cyanides, and mustard gas. Exposure to these agents can result in severe respiratory effects, including spasms, edema, and increased secretions leading to breathing difficulties and suffocation. Protecting public safety and national security from such threats has become an urgent priority. Porous metal-organic framework (MOF) materials have emerged as promising candidates for the degradation of chemical warfare agents due to their large surface area, tunable pore size distribution, and excellent catalytic performance. Furthermore, combining MOFs with polymers can enhance their elasticity and processability and improve their degradation performance. In this review, we summarize the literature of the past five years on MOF-based composite materials and their effectiveness in degrading chemical warfare agents. Moreover, we discuss key factors influencing their degradation efficiency, such as MOF structure, pore size, and functionalization strategies. Furthermore, we highlight recent developments in the design of MOF-polymer composites, which offer enhanced degradation performance and stability for practical applications in CWA degradation. These composite materials exhibit good performance in degrading chemical warfare agents, playing a crucial role in protecting public safety and maintaining national security. We can expect to see more breakthroughs in the application of metal-organic framework porous materials for degrading chemical warfare agents. It is hoped that these innovative materials will play a positive role in achieving social stability and security.

Hypoxemia and its clinical predictors among children with respiratory distress admitted to the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

IntroductionHypoxemia is a common complication of childhood respiratory tract infections and non-respiratory infections. Hypoxemic children have a five-fold increased risk of death compared to children without hypoxemia. In addition, there is limited evidence about hypoxemia and clinical predictors in Ethiopia. Therefore, this study was conducted to assess the prevalence and clinical predictors of hypoxemia among children with respiratory distress admitted to the University of Gondar Comprehensive Specialized Hospital.MethodsAn institutional-based cross-sectional study was conducted from December 2020 to May 2021 in northwest Ethiopia. A total of 399 study participants were selected using systematic random sampling. The oxygen saturation of the child was measured using Masimo rad-5 pulse oximetry. SPSS version 21 software was used for statistical analysis.ResultIn this study, the prevalence of hypoxemia among children with respiratory distress was 63.5%. The clinical signs and symptoms significantly associated with hypoxemia were: head-nodding (AOR: 4.1, 95% CI: 1.81–9.28) and chest indrawing (AOR: 3.08, 95% CI: 1.32–7.16) which were considered statistically the risk factors for hypoxemia while inability to feed (AOR: 0.13, 95% CI: 0.02–0.77) was the protective factor for hypoxemia. The most sensitive predictors of hypoxemia were fast breathing with sensitivity (98.4%), nasal flaring (100.0%), chest indrawing (83.6%), and intercostal retraction (93.1%). The best specific predictors of hypoxemia were breathing difficulty with specificity (79.4%), inability to feed (100.0%), wheezing (83.0%), cyanosis (98.6%), impaired consciousness (94.2%), head-nodding (88.7%), and supra-sternal retraction (96.5%).Conclusion and recommendationThe prevalence of hypoxemia among children was high. The predictors of hypoxemia were the inability to feed, head nodding, and chest indrawing. It is recommended that the health care settings provide immediate care for the children with an inability to feed, head nodding, and chest indrawing. The policymakers better to focus on preventive strategies, particularly those with the most specific clinical predictors.

Atraumatic Infected Septal Hematoma in a Pediatric Patient.

We present a case of a 10-year-old male who developed an atraumatic, nasal septal hematoma with abscess following several days of rhinorrhea and cough. His chief complaint to the emergency department was a two-day history of nasal swelling and discomfort, associated with difficulty breathing through his nose. The patient was well-appearing with swelling and tenderness along the external nasal ridge and nasal septal swelling that occluded both nares. Contrast-enhanced maxillofacial computed tomography revealed a rim-enhancing, fluid-filled collection to the anterior nasal septum. The patient underwent successful incision and drainage by otolaryngology. Infected septal hematomas are rare but important to recognize as they can result in septal deformity and potentially life-threatening sequelae, such as intracranial infections. Most are secondary to nasal trauma in adult patients. This case highlights a unique presentation of atraumatic septal hematoma with abscess formation in an immunocompetent pediatric patient.

Role of Pathya-Apathya in Pranavaha Srotas

In Ayurveda food is considered as superior medicine and one among the vital supporting pillars of health [1]. A diet should provide physical and mental well-being, along with the dynamic equilibrium of various structural and functional units of the individual. Pranavaha srotas includes diseases of respiratory system ie, swasa, kasa, hikka, rajayakshma where aetiology prevention is the primary treatment. Difficulty in breathing or shortness of breath caused due to excessive intake of kapha aggravating food and regimen the kapha along with vata gets into pitta sthana which is termed as swasa (Asthma). Vitiated vata dosha along with kapha dosha obstructs the pranavaha, udakavaha and annavaha srotasa (respiratory system, watery elements & digestive system) and produces different types of hikka vyadhi. Hikka canbe correlated in modern science with hiccup. The vitiated Prana vayu along with udana vayu which further gets aggravated in association with other doshas and expelled out forcefully with a coughing sound like the broken bronze vessel, called as Kasa. Rajayakshma is one among the Asta mahagadas (eight dreadful diseases) described by Acharya Charaka and is known as the "king of the disease", it can be correlated to pulmonary tuberculosis due to similarity in symptoms. Globally, respiratory diseases both communicable and noncommunicable, are among the leading causes of mortality, morbidity, economic and societal burden, and disability-adjusted life years. Respiratory diseases are abnormalities that affect the air passages, the bronchi, and the lungs. By understanding the parameters of pathya/wholesome and apathy/unwholesome relating to respiratory system one can easily prevent, cure and avoid recurrence of the disease pertaining to the same. Pathya can be understood as those practices which do not afflict the patha/srotas/channels of circulation and is relishing to manas (mind). On the contrary, Apathya is that which is Apriya (Not relished) to Manas, such a Dravya should not be consumed on daily basis.

Pneumonia caused by Enterococcus faecalis and tropical candida in a maintenance hemodialysis patient concomitant with COVID-19: A case report and literature review [RETRACTED

Rationale: Maintenance hemodialysis (MHD) represents a crucial form of renal replacement therapy for patients suffering from end-stage renal disease. These MHD individuals are especially susceptible to pulmonary infections due to compromised immune defenses. High throughout metagenomic sequencing technologies allow for the precise identification of pathogens at the genetic level, leading to personalized treatment plans that improve patient outcomes. This case represents the first reported instance of a mixed pulmonary infection with Enterococcus faecium and Candida tropicalis in a MHD man concomitant with coronavirus disease 2019 (COVID-19), which responded well to anti-infection treatment. The objective of this article is to enhance comprehension of concurrent pulmonary infections in individuals undergoing MHD and to enhance the capability for prompt detection and differential diagnosis. Patient concerns: A MHD man who developed COVID-19 and subsequently experienced recurring chills, high fever, coughing, expectoration, and difficulty breathing after a week. Laboratory analyses indicated elevated markers of inflammation, while a computed tomography scan detected inflammation in both of the patient’s lungs. Diagnosis: Chronic kidney disease stage V, pneumonia, and COVID-19. Interventions: Following initial treatment with a wide range of antibiotics guided by blood and sputum cultures, there was no improvement in the patient’s health. Further examination of the bronchoalveolar lavage fluid through metagenomic next-generation sequencing revealed the exact pathogens responsible for the infection. Outcomes: We lead to a tailored antimicrobial treatment plan that significantly alleviated the patient’s pulmonary inflammation and overall symptoms. The patient’s body temperature reverted back to its normal range, with an absence of any notable coughing or sputum generation. Additionally, there was a marked decrease in inflammatory markers. Furthermore, a chest computed tomography scan exhibited enhanced absorption of pulmonary lesions in comparison to previous scans. Lessons: The greater risk and mortality of pneumonia in MHD patients have not received adequate attention. Such uncommon cases require heightened awareness among clinicians to prevent delays in diagnosis and treatment.

Precision symptom phenotyping identifies early clinical and proteomic predictors of distinct COVID-19 sequelae.

Post-COVID conditions (PCC) are difficult to characterize, diagnose, predict, and treat due to overlapping symptoms and poorly understood pathology. Identifying inflammatory profiles may improve clinical prognostication and trial endpoints. 1,988 SARS-CoV-2 positive U.S. Military Health System beneficiaries with quantitative post-COVID symptom scores were included in this analysis. Among participants who reported moderate-to-severe symptoms on surveys collected 6-months post-SARS-CoV-2 infection, principal component analysis (PCA) followed by K-means clustering identified distinct clusters of symptoms. Three symptom-based clusters were identified: a sensory cluster (loss of smell and/or taste), a fatigue/difficulty thinking cluster, and a difficulty breathing/exercise intolerance cluster. Individuals within the sensory cluster were all outpatients during their initial COVID-19 presentation. The difficulty breathing cluster had a higher likelihood of obesity and COVID-19 hospitalization compared to those with no/mild symptoms at 6-months post-infection. Multinomial regression linked early post-infection D-dimer and IL-1RA elevation to fatigue/difficulty thinking, and elevated ICAM-1 concentrations to sensory symptoms. We identified three distinct symptom-based PCC phenotypes with specific clinical risk factors and early post-infection inflammatory predictors. With further validation and characterization, this framework may allow more precise classification of PCC cases and potentially improve the diagnosis, prognostication, and treatment of PCC.

Patients Engaged in Losing Weight Preoperatively Experience Improved Outcomes After Hiatal Hernia Repair.

Adherence to preoperative weight loss recommendations may serve as a surrogate for the level of engagement in hiatal hernia (HH) patients. This study aims to evaluate the relationship between achieving preoperative weight loss goals and outcomes after HH repair. A retrospective review of 235 patients undergoing laparoscopic HH repair at a single institution was performed. Patients were grouped based on the percentage of weight loss goal achieved. Low achievement was defined as the bottom quartile of goal achievement (≤75%); high achievement was defined as the top quartile (≥140%). Baseline characteristics, clinical outcomes, and patient reported outcomes (PROMs) were compared between groups. 131/235 (55.7%) achieved their weight loss goal. No differences in baseline characteristics or clinical outcomes were observed between the low and high achievement groups. While both groups experienced improvements in PROMs postoperatively, patients in the high achievement group demonstrated significantly lower symptom burden at one-month postoperatively. Further, high-achievement patients were more likely to experience complete resolution of common HH symptoms at one-month postoperatively, including no difficulty swallowing food, no breathing difficulties or choking episodes, no choking when eating food, no choking when drinking liquid, and no regurgitation of food or liquid. In patients undergoing laparoscopic HH repair, patients achieving their preoperative weight loss goals experienced less overall symptom burden and lower prevalence of common symptoms one-month postoperatively than those with low levels of goal achievement. These results demonstrate that patients can take an active role in improving their own surgical outcomes and health status.

A study on the safety and efficacy of endoscopic thyroidectomy via axillary approach for the treatment of thyroid cancer.

This study aims to evaluate the safety and efficacy of endoscopic thyroid cancer treatment using an axillary approach. Participants were allocated into 2 groups: one undergoing transaxillary endoscopic surgery and the other, traditional open surgery. We compared intraoperative and postoperative conditions, focusing on parameters such as intraoperative blood loss, duration of surgery, length of postoperative hospitalization, volume of postoperative drainage, number of lymph nodes cleared in the central region, neck pain scores, neck injury indices, cosmetic satisfaction, postoperative complications, and total hospitalization duration. Patients in the endoscopic treatment (ET) group experienced longer surgical times, less intraoperative bleeding, and increased postoperative drainage. These indicators showed significant differences between the groups (P < .05). For the group undergoing endoscopic surgery via the axillary approach, there was a lower neck pain score on the third postoperative day and higher cosmetic satisfaction at 3 months. However, there were no significant differences between the groups in terms of the number of lymph nodes cleared in the central area, and the incidence of complications such as difficulty breathing, difficulty swallowing, hoarseness, and subcutaneous hematoma (P > .05). The axillary approach endoscopic surgery group also showed significantly prolonged surgery times and postoperative hospital stays, with a significant increase in postoperative drainage fluid (P < .05). Concurrently, this technique involved smaller surgical incisions and effectively concealed scars in the armpit, leading to better outcomes in terms of intraoperative bleeding, neck pain scores, and postoperative cosmetic satisfaction. Non-inflatable ET via the axillary approach for treating thyroid cancer demonstrates promising efficacy and safety. It offers additional benefits of minimal pain and enhanced cosmetic outcomes, making it a viable option for clinical adoption and application.

Morbidity and unplanned healthcare encounters after hospital discharge among young children in Dar es Salaam, Tanzania and Monrovia, Liberia

BackgroundResearchers and healthcare providers have paid little attention to morbidity and unplanned healthcare encounters for children following hospital discharge in low- and middle-income countries. Our objective was to compare symptoms...

Nasal Airflow Dynamics following LeFort I Advancement in Cleft Nasal Deformities: A Retrospective Preliminary Study.

Unilateral cleft lip and palate (UCLP) nasal deformity impacts airflow patterns and pressure distribution, leading to nasal breathing difficulties. This study aims to create an integrated approach using computer-aided design (CAD) and computational fluid dynamics (CFD) to simulate airway function and assess outcomes in nasal deformities associated with unilateral cleft lip and palate (UCLP) after LeFort I osteotomy advancement. Significant alterations were observed in nasal geometry, airflow velocity, pressure dynamics, volumetric flow rate, and nasal resistance postoperatively, indicating improved nasal airflow. The cross-sectional area increased by 26.6%, airflow rate by 6.53%, and nasal resistance decreased by 6.23%. The study offers quantitative insights into the functional impacts of such surgical interventions, contributing to a deeper understanding of UCLP nasal deformity treatment and providing objective metrics for assessing surgical outcome.

Asymmetrical Lateral Crus Steal in Geometric Tip Reshaping.

A key component of a well-performed rhinoplasty is to obtain the proper, aesthetic shape of the nasal tip. Various surgical techniques have been developed to achieve this effect. In this work, the author wanted to focus not only on the satisfactory shape of the nose, but above all on its main role-functionality. In this article, the asymmetrical lateral crus steal (ALCS) technique is proposed, which in its assumption will enable narrowing, better defining and rotating of the nasal tip, and at the same time enhancing nasal patency. We present a retrospective analysis within the group of 267 patients who underwent primary open-approach rhinoplasty that included the ALCS technique. The mean follow-up time was 12 months. A total of 232 patients achieved very good postoperative results without observation of any serious complications related to breathing difficulties or asymmetry of the nasal tip shape. ALCS is a relatively simple surgical technique to perform. The use of the ALCS suture creates the possibility of proper profiling of the nasal tip while improving the respiratory functions of the nose.

Gossypiboma larynx: a rare cause of post-tracheostomy stridor—case report and review of literature

BackgroundGossypiboma, a retained surgical sponge with a foreign body reaction, is an unusual but serious complication seen in open abdominal surgeries. It is exceptionally rare following head and neck surgeries. Here, we present a case of Gossypiboma of the upper airway following tracheostomy.Case presentationA 32-year-old male presented with stridor and difficulty breathing one-month post-tracheostomy after a severe head injury following a road traffic accident. A neck radiograph was unremarkable, and a computed tomography (CT) scan of the neck showed a well-defined homogenous curvilinear membrane extending from the hypopharynx to the upper trachea. Bronchoscopic evaluation of the larynx and upper trachea revealed a retained surgical sponge, which was retrieved. The patient’s breathing improved drastically post intervention.ConclusionGossypiboma may go undetected in radiographs and may also present atypically as a homogenous membrane on a CT scan of the neck. Though rare, retained surgical items can have profound medicolegal and professional consequences on physicians. Hence, a strong clinical suspicion and vigilance for gossypiboma is necessary for patients presenting with respiratory distress post-tracheostomy.

Diagnosis of Empyema as a Complication of Liver Abscess in Peripheral Area

Right pleural empyema is one of the rare complications in liver abscess. This condition is life-threatening as it causes breathing difficulties and requires immediate life-saving. This case report aims to diagnose and manage empyema in a male patient with a liver abscess in a limited diagnostic setting. Methods: According to medical records, a 44-year-old man came to the emergency room (ER) of Umbu Rara Meha General Hospital with complaints of shortness of breath that had been getting worse for two months, accompanied by a cough with phlegm for one week, fever, and weight loss. The patient also complained of pain in the right upper abdomen for the last four months. History of pulmonary tuberculosis, diabetes mellitus, or hypertension was denied. The patient is not a smoker. On physical examination, there was an increase in the frequency of breathing and a decrease in the vesicular sounds on the right side. Right thorax X-ray examination revealed massive right pleural effusion without pulmonary infiltrates. Abdominal ultrasound showed a liver abscess. Emergency pleural puncture was performed in the ER, and 1600 cc of purulent pleural fluid was removed, followed by Water Sealed Draignase (WSD) installation. The patient was given intravenous broad-spectrum antibiotics and treated for 12 days. Conclusion: Empyema can be a rare but life-threatening complication of liver abscess. Medical action must be taken immediately in the ER to save the patient. Delaying pus drainage can increase morbidity and mortality rates.

Genome-wide association study identifies novel susceptible loci and evaluation of polygenic risk score for chronic obstructive pulmonary disease in a Taiwanese population

BackgroundChronic Obstructive Pulmonary Disease (COPD) describes a group of progressive lung diseases causing breathing difficulties. While COPD development typically involves a complex interplay between genetic and environmental factors, genetics play a role in disease susceptibility. This study used genome-wide association studies (GWAS) and polygenic risk score (PRS) to elucidate the genetic basis for COPD in Taiwanese patients.ResultsGWAS was performed on a Taiwanese COPD case–control cohort with a sample size of 5,442 cases and 17,681 controls. Additionally, the PRS was calculated and assessed in our target groups. GWAS results indicate that although there were no single nucleotide polymorphisms (SNPs) of genome-wide significance, prominent COPD susceptibility loci on or nearby genes such as WWTR1, EXT1, INTU, MAP3K7CL, MAMDC2, BZW1/CLK1, LINC01197, LINC01894, and CFAP95 (C9orf135) were identified, which had not been reported in previous studies. Thirteen susceptibility loci, such as CHRNA4, AFAP1, and DTWD1, previously reported in other populations were replicated and confirmed to be associated with COPD in Taiwanese populations. The PRS was determined in the target groups using the summary statistics from our base group, yielding an effective association with COPD (odds ratio [OR] 1.09, 95% confidence interval [CI] 1.02–1.17, p = 0.011). Furthermore, replication a previous lung function trait PRS model in our target group, showed a significant association of COPD susceptibility with PRS of Forced Expiratory Volume in one second (FEV1)/Forced Vital Capacity (FCV) (OR 0.89, 95% CI 0.83–0.95, p = 0.001).ConclusionsNovel COPD-related genes were identified in the studied Taiwanese population. The PRS model, based on COPD or lung function traits, enables disease risk estimation and enhances prediction before suffering. These results offer new perspectives on the genetics of COPD and serve as a basis for future research.

Evaluation of the predictors and frequency of silent hypoxemia in COVID-19 patients and the gap between pulse oximeter and arterial blood gas levels: A cross-sectional study.

Silent hypoxemia is when patients do not experience breathing difficulty in the presence of alarmingly low O2 saturation. It could cause rapid deterioration and higher mortality rates among patients, so prompt detection and identifying predictive factors could result in significantly better outcomes. This study aims to document the evidence of silent hypoxemia in patients with COVID-19 and its clinical features. A total of 78 hospitalized, nonintubated patients with confirmed COVID-19 infection were included in this study. Their O2 saturation was measured with a pulse oximeter (PO), and arterial blood gas (ABG) was taken. Demographic and clinical features were recorded. The Borg scale was used to evaluate dyspnea status, and patients with a score of less than two accompanied by O2 saturation of less than 94% were labeled as silent hypoxic. Univariate analysis was utilized to evaluate the correlation between variables and their odds ratio (OR) and 95% confidence interval (CI). Silent hypoxemia was observed in 20 (25.6%) of the participants. The average difference between the PO and ABG methods was 4.36 ± 3.43. Based on regression analysis, dyspnea and respiratory rate demonstrated a statistically significant correlation with the O2 saturation difference between PO and ABG (OR: 2.05; p = 0.026; 95% CI: 0.248-3.847 and OR: 0.144; p = 0.048, 95% CI: 0.001-0.286). Furthermore, the Borg scale (OR: 0.29; p = 0.009; 95% CI: 0.116-0.740) had a significant reverse correlation with silent hypoxia. Silent hypoxemia can be a possible complication that affects some COVID-19 patients. Further care should be bestowed upon the younger population and those with underlying neurological or mental illnesses. Furthermore, the respiratory rate, pulse oximeter, and arterial blood gas O2 levels should be considered alongside each other.

Assessing the health consequences of indoor air pollution from biomass fuel combustion on pediatric populations in rural communities of Pakistan

ABSTRACT Indoor air pollution arising from burning of biomass fuels poses a significant threat to child health in rural areas of Pakistan. This cross-sectional study aimed to assess health implications associated with indoor air pollution resulting from biomass burning among children under 12 years of age in rural Punjab. A questionnaire-based survey was conducted in six randomly selected rural districts of Punjab, characterized by their primary reliance on biomass fuels. The findings revealed that several characteristics, such as monthly household income, number of living rooms, secondary use of solid fuels, kitchen type, type of cooking stove, and presence of child in the kitchen with their mother, exhibited significant associations (p < 0.05) with negative health impacts among children. Reported health effects among the children included coughing (18.7%), watery eyes (17.7%), eye irritation (12.3%), runny nose (11.8%), breathing difficulties (8.5%), phlegm (38%), headache (25%), nausea (20.1%), dizziness (6.7%), asthma (6.4%), tuberculosis (1.8%), and pneumonia (1.5%).

Bilateral Combined Laryngocele: Comprehensive Review of the Literature.

Laryngocele, an abnormal dilation of the appendix of the laryngeal ventricle filled with air, is a rare condition predominantly presenting unilaterally. However, bilateral occurrences are exceedingly rare. In this article, we present a case of bilateral laryngocele along with a comprehensive literature review. A 57-year-old male presented with dyspnea, stridor, and bilateral neck masses. His medical history included chronic cough and intermittent hoarseness. Over a 3 month period, the neck masses progressively enlarged, resulting in respiratory distress. Interestingly, he denied experiencing weight loss, decreased appetite, or fever. Clinical examination revealed sizable, soft masses on both sides of the neck, obstructing lymph node assessment. Computed tomography (CT) imaging confirmed the presence of a left combined laryngopyocele and a right combined laryngocele. Subsequently, the patient underwent tracheostomy. Benign biopsy results excluded malignancy. Surgical excision of bilateral laryngoceles resulted in an uneventful recovery. The term "laryngocele" was introduced by Virchow in 1867 to describe the abnormal dilation of the saccule associated with Morgagni's ventricle. Diagnosis involves a thorough patient history, physical examination, and radiological imaging, notably CT, to differentiate laryngoceles from other conditions. Typically asymptomatic, they are often incidentally discovered around age 50, although symptoms such as voice changes or breathing difficulties can manifest. A review of the literature identified 77 documented cases, primarily in males, exhibiting various symptoms and treatment modalities. This case underscores the rarity of bilateral combined laryngocele, emphasizing the importance of timely diagnosis and surgical intervention for favorable outcomes. Comprehensive research reveals diverse clinical aspects, highlighting the necessity for continued investigation to enhance management strategies.

Long COVID and financial outcomes: evidence from four longitudinal population surveys

BackgroundLong-term sequelae of COVID-19 (long COVID) include muscle weakness, fatigue, breathing difficulties and sleep disturbance over weeks or months. Using UK longitudinal data, we assessed the relationship between long COVID...