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https://www.readbyqxmd.com/read/28540765/an-update-on-pediatric-bronchiectasis
#1
Danielle F Wurzel, Anne B Chang
The prevalence and awareness of bronchiectasis not related to cystic fibrosis (CF) is increasing and it is now recognized as a major cause of respiratory morbidity, mortality and healthcare utilization worldwide. The need to elucidate the early origins of bronchiectasis is increasingly appreciated and has been identified as an important research priority. Current treatments for pediatric bronchiectasis are limited to antimicrobials, airway clearance techniques and vaccination. Several new drugs targeting airway inflammation are currently in development...
May 25, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28539439/contribution-of-human-lung-parenchyma-and-leukocyte-influx-to-oxidative-stress-and-immune-mediated-pathology-following-nipah-infection
#2
Olivier Escaffre, Tais B Saito, Terry L Juelich, Tetsuro Ikegami, Jennifer K Smith, David D Perez, Colm Atkins, Corri B Levine, Matthew B Huante, Rebecca J Nusbaum, Janice J Endsley, Alexander N Freiberg, Barry Rockx
Nipah virus (NiV) is a zoonotic emerging paramyxovirus that can cause a fatal respiratory illness or encephalitis in humans. Despite many efforts, the molecular mechanisms of NiV-induced acute lung injury (ALI) remain unclear. We previously showed that NiV replicates to high titers in human lung grafts in NOD scid gamma mice, resulting in a robust inflammatory response. Interestingly, these mice can undergo human immune system reconstitution by the Bone marrow, Liver, and Thymus (BLT) reconstitution method, in addition to lung tissue engraftment, giving altogether a realistic model to study human respiratory viral infections...
May 24, 2017: Journal of Virology
https://www.readbyqxmd.com/read/28533934/mortality-outcomes-in-trauma-patients-undergoing-prehospital-red-blood-cell-transfusion-a-systematic-literature-review
#3
REVIEW
Gregory S Huang, C Michael Dunham
The value of prehospital red blood cell (RBC) transfusion for trauma patients is controversial. The purposes of this literature review were to determine the mortality rate of trauma patients with hemodynamic instability and the benefit of prehospital RBC transfusion. A 30-year systematic literature review was performed in 2016. Eligible studies were combined for meta-analysis when tests for heterogeneity were insignificant. The synthesized mortality was 35.6% for systolic blood pressure ≤ 90 mmHg; 51.1% for ≤ 80 mmHg; and 63...
2017: International Journal of Burns and Trauma
https://www.readbyqxmd.com/read/28532495/development-and-validation-of-the-angiotensin-converting-enzyme-inhibitor-acei-induced-angioedema-investigator-rating-scale-and-proposed-discharge-criteria
#4
Nicola Bonner, Charlotte Panter, Alan Kimura, Rich Sinert, Joseph Moellman, Jonathan A Bernstein
BACKGROUND: The use of angiotensin-converting enzyme inhibitors (ACEI) has been associated with the development of bradykinin-mediated angioedema. With ever-widening indications for ACEI in diseases including hypertension, congestive heart failure and diabetic nephropathy, a concomitant increase in ACEI-Angioedema (ACEI-A) has been reported. At present there is no validated severity scoring or discharge criteria for ACEI-A. We sought to develop and validate an investigator rating scale with corresponding discharge criteria using clinicians experienced in treating ACEI-A...
May 22, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28531866/bilateral-peritonsillar-abscess-a-case-report-and-pertinent-literature-review
#5
Ibrahim AlAwadh, Turki Aldrees, Saleh AlQaryan, Sami Alharethy, Hassan AlShehri
INTRODUCTION: The peritonsillar space is defined as the area between the palatine tonsillar capsule medially and the superior pharyngeal constrictor muscle laterally. Unilateral peritonsillar abscess (PTA) is more common than the bilateral condition. To the best of our knowledge, only 13 cases of bilateral PTA have been reported worldwide; this is the first case reported from Saudi Arabia. PRESENTATION OF CASE: We present a case involving a 16-year-old boy who presented to the emergency department with a5-day history of sore throat, dysphagia, trismus, drooling, and a muffled "hot-potato" voice, but with no symptoms of airway compromise...
May 15, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28530140/associations-of-nasopharyngeal-metabolome-and-microbiome-with-severity-among-infants-with-bronchiolitis-a-multi-omic-analysis
#6
Christopher J Stewart, Jonathan M Mansbach, Matthew C Wong, Nadim J Ajami, Joseph F Petrosino, Carlos A Camargo, Kohei Hasegawa
RATIONALE: Bronchiolitis is the most common lower respiratory infection in infants; however, it remains unclear which infants with bronchiolitis will develop severe illness. In addition, while emerging evidence indicates associations of the upper-airway microbiome with bronchiolitis severity, little is known about the mechanisms linking airway microbes and host response to disease severity. OBJECTIVES: To determine the relations among the nasopharyngeal airway metabolome profiles, microbiome profiles, and severity in infants with bronchiolitis...
May 21, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28529824/to-cough-or-not-to-cough-examining-the-potential-utility-of-cough-testing-in-the-clinical-evaluation-of-swallowing
#7
Stephanie A Watts, Lauren Tabor, Emily K Plowman
PURPOSE: The clinical swallowing evaluation (CSE) represents a critical component of a comprehensive assessment of deglutition. Although universally utilized across clinical settings, the CSE demonstrates limitations in its ability to accurately identify all individuals with dysphagia. There exists a need to improve assessment and screening techniques to improve health outcomes, treatment recommendations and ultimately mortality in individuals at risk for dysphagia. The following narrative review provides a summary of currently used validated CSE's and examines the potential role of cough testing and screening in the CSE...
December 2016: Current Physical Medicine and Rehabilitation Reports
https://www.readbyqxmd.com/read/28526466/-comparison-of-three-different-insertion-techniques-with-lma-unique%C3%A2-in-adults-results-of-a-randomized-trial
#8
Merih Eglen, Bahar Kuvaki, Ferim Günenç, Sule Ozbilgin, Semih Küçükgüçlü, Ebru Polat, Emel Pekel
BACKGROUND: The triple airway maneuver insertion technique allowed faster insertion of the LMA. This study compared three different insertion techniques of the laryngeal mask airway-Unique™. METHODS: One hundred and eighty ASA I-II patients aged 18-65 years were included into the study. Patients were randomly allocated to the standard, rotational and triple airway maneuver (triple) group. In the standard group (n=60), the LMA (Laryngeal Mask Airway) was inserted with digital intraoral manipulation...
May 16, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28513521/otorhinolaryngological-emergencies-in-a-tertiary-hospital-in-port-harcourt
#9
U M Ibekwe
BACKGROUND: Emergencies are not uncommon in a typical otorhinolaryngological (ORL) clinic. The knowledge of the profile and prevalence of these emergencies will go a long way in helping to equip as well as aid proper and prompt management of these conditions so as to reduce their morbidity and mortality. PATIENTS AND METHODS: A descriptive retrospective 8 years review of all patients that presented to the ENT Surgery Department from January 2004 to December 2012...
May 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28511644/relationship-between-glycemic-levels-and-treatment-outcome-among-critically-ill-children-admitted-into-emergency-room-in-enugu
#10
Nwachinemere Davidson Uleanya, Elias Chikee Aniwada, Ikenna Chidiebele Nwokoye, Ikenna Kingsley Ndu, Christopher Bismarck Eke
BACKGROUND: Critically ill children are those in need of immediate attention on arrival to an emergency room. The importance of glycemic level measurement as well as maintaining the patency of the airway, effective breathing and circulation cannot be overemphasied. It has been highlighted that the peak hyperglycemia and hypoglycemia predict poor prognosis, longer lengths of hospital stay and higher mortality. The study aims to assess the relationship between glycemic level and treatment outcomes as well as length of hospital stay...
May 16, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28508288/repetitive-postoperative-extubation-failure-and-cardiac-arrest-due-to-laryngomalacia-after-general-anesthesia-in-an-elderly-patient-a-case-report
#11
Jun Takeshita, Kei Nishiyama, Masashi Fujii, Hiroyuki Tanaka, Satoru Beppu, Nozomu Sasahashi, Nobuaki Shime
The authors report a case involving an elderly patient who experienced repetitive perioperative cardiac arrest caused by laryngomalacia. The patient underwent surgery under general anesthesia; however, 2 h after initial extubation, he experienced cardiopulmonary arrest. Return of spontaneous circulation was achieved by immediate resuscitation. Four hours later, a second extubation was performed without any neurological complications. However, 2 h later, he experienced cardiopulmonary arrest again. Immediately after the third extubation, 12 h after the second cardiopulmonary arrest, fiberoptic laryngoscopy revealed laryngomalacia...
May 15, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28504992/trends-in-perioperative-practice-and-resource-utilization-in-patients-with-obstructive-sleep-apnea-undergoing-joint-arthroplasty
#12
Crispiana Cozowicz, Jashvant Poeran, Ashley Olson, Madhu Mazumdar, Eva E Mörwald, Stavros G Memtsoudis
BACKGROUND: Emerging evidence associating obstructive sleep apnea (OSA) with adverse perioperative outcomes has recently heightened the level of awareness among perioperative physicians. In particular, estimates projecting the high prevalence of this condition in the surgical population highlight the necessity of the development and adherence to "best clinical practices." In this context, a number of expert panels have generated recommendations in an effort to provide guidance for perioperative decision-making...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28503749/a-prospective-evaluation-of-transverse-tracheal-sonography-during-emergent-intubation-by-emergency-medicine-resident-physicians
#13
Shadi Lahham, Jamie Baydoun, James Bailey, Sandra Sandoval, Sean P Wilson, John C Fox, David E Slattery
OBJECTIVES: Establishing a definitive airway is often the first step in emergency department treatment of critically ill patients. Currently, there is no agreed upon consensus as to the most efficacious method of airway confirmation. Our objective was to determine the diagnostic accuracy of real-time sonography performed by resident physicians to confirm placement of the endotracheal tube during emergent intubation. METHODS: We performed a prospective cohort study of adult patients in the emergency department undergoing emergent endotracheal intubation...
May 15, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28501412/sudden-death-in-a-diver-a-diagnostic-conundrum
#14
Scott Dougherty, Maziar Khorsandi, Myra Adelbai, Vipin Zamvar, James Francis
We discuss the case of an experienced diver who ran out of air during his final ascent while scuba diving. He lost consciousness rapidly after surfacing and despite immediate cardiopulmonary resuscitation, could not be revived. On arrival at the emergency department he was noted to have copious amounts of blood in his upper airway and had developed extensive subcutaneous emphysema. Large amounts of air were observed in the central circulation following a postmortem computerized tomography scan as well as pneumomediastinum, a small right-sided hemothorax, and extensive subcutaneous emphysema...
May 10, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28499927/disruption-of-the-hepcidin-ferroportin-regulatory-system-causes-pulmonary-iron-overload-and-restrictive-lung-disease
#15
Joana Neves, Dominik Leitz, Simone Kraut, Christina Brandenberger, Raman Agrawal, Norbert Weissmann, Christian Mühlfeld, Marcus A Mall, Sandro Altamura, Martina U Muckenthaler
Emerging evidence suggests that pulmonary iron accumulation is implicated in a spectrum of chronic lung diseases. However, the mechanism(s) involved in pulmonary iron deposition and its role in the in vivo pathogenesis of lung diseases remains unknown. Here we show that a point mutation in the murine ferroportin gene, which causes hereditary hemochromatosis type 4 (Slc40a1(C326S)), increases iron levels in alveolar macrophages, epithelial cells lining the conducting airways and lung parenchyma, and in vascular smooth muscle cells...
April 29, 2017: EBioMedicine
https://www.readbyqxmd.com/read/28499580/transient-receptor-potential-trp-channels-as-molecular-targets-in-lung-toxicology-and-associated-diseases
#16
REVIEW
Alexander Dietrich, Dirk Steinritz, Thomas Gudermann
The lungs as the gateways of our body to the external environment are essential for gas exchange. They are also exposed to toxicants from two sides, the airways and the vasculature. Apart from naturally produced toxic agents, millions of human made chemicals were produced since the beginning of the industrial revolution whose toxicity still needs to be determined. While the knowledge about toxic substances is increasing only slowly, a paradigm shift regarding the proposed mechanisms of toxicity at the plasma membrane emerged...
April 26, 2017: Cell Calcium
https://www.readbyqxmd.com/read/28498063/preliminary-evaluation-of-a-novel-rigid-bronchoscopy-simulator
#17
Grace E Hsiung, Ben Schwab, Ellen K O'Brien, Colin D Gause, Ferdynand Hebal, Katherine A Barsness, Deborah M Rooney
PURPOSE: Emergent retrieval of airway foreign bodies (AFBs) in children remains a priority skill set for pediatric surgeons. In the setting of low procedural volume, simulation-based education with deliberate practice is essential to ensure trainees reach expected surgical competency. The purposes of this work were to (1) create a realistic rigid bronchoscopy for AFB retrieval simulation model and (2) to evaluate preliminary validity evidence of a novel simulator for the use of training and assessing pediatric surgical trainees' rigid bronchoscopy skills...
May 12, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28492404/trend-and-outcomes-of-video-laryngoscope-use-across-picus
#18
Jocelyn R Grunwell, Pradip P Kamat, Michael Miksa, Ashwin Krishna, Karen Walson, Dennis Simon, Conrad Krawiec, Ryan Breuer, Jan Hau Lee, Eleanor Gradidge, Keiko Tarquinio, Asha Shenoi, Justine Shults, Vinay Nadkarni, Akira Nishisaki
OBJECTIVE: Video (indirect) laryngoscopy is used as a primary tracheal intubation device for difficult airways in emergency departments and in adult ICUs. The use and outcomes of video laryngoscopy compared with direct laryngoscopy has not been quantified in PICUs or cardiac ICUs. DESIGN: Retrospective review of prospectively collected observational data from a multicenter tracheal intubation database (National Emergency Airway Registry for Children) from July 2010 to June 2015...
May 10, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28491199/emergent-sclerotherapy-of-a-newborn-with-expanding-lymphatic-malformation-causing-respiratory-distress
#19
Cameron C Sheehan, Winslo Idicula, Andrew Raabe, Kris Jatana, Tendy Chiang, Charles A Elmaraghy
The present report describes a case of acute airway obstruction in a newborn caused by an expanding hemorrhagic macrocystic lymphatic malformation (LM), which was successfully treated with emergent decompression and interventional radiology-guided sclerotherapy. The use of sclerotherapy for macrocystic LMs has been well described for various indications. The urgent interventional treatment obviated the need for a tracheostomy. This case describes the rapid diagnosis and use of sclerotherapy in a large expanding macrocystic LM...
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28483222/endoscopic-management-of-bilateral-vocal-fold-paralysis-in-newborns-and-infants
#20
Sahba Sedaghat, Mario Tapia, Felipe Fredes, Pablo Rojas
INTRODUCTION: Bilateral vocal cord paralysis in adducted position (BVCPAd) is a severe cause of airway obstruction and usually debuts with stridor and airway distress necessitating immediate intervention. Tracheostomy has long been the gold standard for treating this condition, but has significant associated morbidity and mortality in pediatric patients. New conservative procedures have emerged to treat this condition thus avoiding tracheostomy, like endoscopic anterior and posterior cricoid split (EAPCS)...
June 2017: International Journal of Pediatric Otorhinolaryngology
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