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Upper airway respiratory syndrome

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https://www.readbyqxmd.com/read/27907966/getting-rid-of-weakness-in-the-icu-an-updated-approach-to-the-acute-management-of-myasthenia-gravis-and-guillain-barr%C3%A3-syndrome
#1
Alexis A Lizarraga, Karlo J Lizarraga, Michael Benatar
After prompt diagnosis, severe myasthenia gravis and Guillain-Barré syndrome (GBS) usually require management in the intensive care unit. In the myasthenic patient, recognition of precipitating factors is paramount, and frequent monitoring of bulbar, upper airway, and/or respiratory muscle strength is needed to identify impending myasthenic crisis. Noninvasive ventilation can be attempted prior to intubation and mechanical ventilation in the setting of respiratory failure. Cholinesterase inhibitors should be discontinued, but resumed prior to extubation, and steroid dosage could be increased once the airway is secured...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27889372/-non-invasive-ventilation-in-children-do-we-need-more-evidence
#2
G Mortamet, G Emeriaud, P Jouvet, B Fauroux, S Essouri
Respiratory failure is the leading cause of hospital admissions in the pediatric intensive care unit (PICU) and is associated with significant morbidity and mortality. Mechanical ventilation, preferentially delivered by a non-invasive route (NIV), is currently the first-line treatment for respiratory failure since it is associated with a reduction in the intubation rate. This ventilatory support is increasingly used in the PICU, but its wider use contrasts with the paucity of studies in this field. This review aims to describe the main indications of NIV in acute settings: (i) bronchiolitis; (ii) postextubation respiratory failure; (iii) acute respiratory distress syndrome; (iv) pneumonia; (v) status asthmaticus; (vi) acute chest syndrome; (vii) left heart failure; (viii) exacerbation of chronic respiratory failure; (ix) upper airway obstruction and (x) end-of-life care...
November 23, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27884793/sex-stress-and-sleep-apnoea-decreased-susceptibility-to-upper-airway-muscle-dysfunction-following-intermittent-hypoxia-in-females
#3
REVIEW
Ken D O'Halloran, Philip Lewis, Fiona McDonald
Obstructive sleep apnoea syndrome (OSAS) is a devastating respiratory control disorder more common in men than women. The reasons for the sex difference in prevalence are multifactorial, but are partly attributable to protective effects of oestrogen. Indeed, OSAS prevalence increases in post-menopausal women. OSAS is characterized by repeated occlusions of the pharyngeal airway during sleep. Dysfunction of the upper airway muscles controlling airway calibre and collapsibility is implicated in the pathophysiology of OSAS, and sex differences in the neuro-mechanical control of upper airway patency are described...
November 21, 2016: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/27865877/cough-in-the-athlete-chest-guideline-and-expert-panel-report
#4
Louis-Philippe Boulet, Julie Turmel, Richard S Irwin
BACKGROUND: Cough is a common symptom experienced by athletes, particularly after exercise. We performed a systematic review to assess in this population: 1) the main etiologies of acute and recurrent cough, either exercise-induced or not; 2) how it is assessed; and 3) how cough is treated in this population. From the systematic review, suggestions for management were developed. METHOD: ology: This review was done according to the CHEST methodological guidelines and GRADE framework up to April 2015...
November 16, 2016: Chest
https://www.readbyqxmd.com/read/27822340/stem-progenitor-cells-and-obstructive-sleep-apnea-syndrome-new-insights-for-clinical-applications
#5
REVIEW
Miruna Mihaela Micheu, Ana-Maria Rosca, Oana-Claudia Deleanu
Obstructive sleep apnea syndrome (OSAS) is a widespread disorder, characterized by recurrent upper airway obstruction during sleep, mostly as a result of complete or partial pharyngeal obstruction. Due to the occurrence of frequent and regular hypoxic events, patients with OSAS are at increased risk of cardiovascular disease, stroke, metabolic disorders, occupational errors, motor vehicle accidents and even death. Thus, OSAS has severe consequences and represents a significant economic burden. However, some of the consequences, as well as their costs can be reduced with appropriate detection and treatment...
October 26, 2016: World Journal of Stem Cells
https://www.readbyqxmd.com/read/27807016/coexistence-of-osa-may-compensate-for-sleep-related-reduction-in-neural-respiratory-drive-in-patients-with-copd
#6
Bai-Ting He, Gan Lu, Si-Chang Xiao, Rui Chen, Joerg Steier, John Moxham, Michael I Polkey, Yuan-Ming Luo
BACKGROUND: The mechanisms underlying sleep-related hypoventilation in patients with coexisting COPD and obstructive sleep apnoea (OSA), an overlap syndrome, are incompletely understood. We compared neural respiratory drive expressed as diaphragm electromyogram (EMGdi) and ventilation during stage 2 sleep in patients with COPD alone and patients with overlap syndrome. METHODS: EMGdi and airflow were recorded during full polysomnography in 14 healthy subjects, 14 patients with OSA and 39 consecutive patients with COPD...
November 2, 2016: Thorax
https://www.readbyqxmd.com/read/27788778/alcohol-and-lung-injury-and-immunity
#7
REVIEW
Samantha M Yeligar, Michael M Chen, Elizabeth J Kovacs, Joseph H Sisson, Ellen L Burnham, Lou Ann S Brown
Annually, excessive alcohol use accounts for more than $220 billion in economic costs and 80,000 deaths, making excessive alcohol use the third leading lifestyle-related cause of death in the US. Patients with an alcohol-use disorder (AUD) also have an increased susceptibility to respiratory pathogens and lung injury, including a 2-4-fold increased risk of acute respiratory distress syndrome (ARDS). This review investigates some of the potential mechanisms by which alcohol causes lung injury and impairs lung immunity...
September 2016: Alcohol
https://www.readbyqxmd.com/read/27784422/dynamic-volume-ct-imaging-of-the-upper-airway-in-obstructive-sleep-apnea-syndrome
#8
Robert J Fleck, Stacey L Ishman, Sally R Shott, Ephraim J Gutmark, Keith B McConnell, Mohamed Mahmoud, Goutham Mylavarapu, Dhananjay R Subramaniam, Rhonda Szczesniak, Raouf S Amin
STUDY OBJECTIVES: To describe a dynamic three-dimensional (3D) computed tomography (CT) technique for the upper airway and compare the required radiation dose to that used for common clinical studies of a similar anatomical area, such as for subjects undergoing routine clinical facial CT. METHODS: Dynamic upper-airway CT was performed on eight subjects with persistent obstructive sleep apnea, four of whom were undergoing magnetic resonance imaging and an additional four subjects who had a contraindication to magnetic resonance imaging...
October 20, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/27783860/neural-control-of-the-upper-airway-respiratory-and-state-dependent-mechanisms
#9
Leszek Kubin
Upper airway muscles subserve many essential for survival orofacial behaviors, including their important role as accessory respiratory muscles. In the face of certain predisposition of craniofacial anatomy, both tonic and phasic inspiratory activation of upper airway muscles is necessary to protect the upper airway against collapse. This protective action is adequate during wakefulness, but fails during sleep which results in recurrent episodes of hypopneas and apneas, a condition known as the obstructive sleep apnea syndrome (OSA)...
September 15, 2016: Comprehensive Physiology
https://www.readbyqxmd.com/read/27729114/asthma-outcomes-after-adenotonsillectomy-a-systematic-review
#10
Nikita Kohli, Dana DeCarlo, Nira A Goldstein, Joshua Silverman
OUTCOME OBJECTIVE: For over fifty years, otolaryngologists, allergists, and immunologists have debated the effect of adenoidectomy or adenotonsillectomy on asthma outcomes in children. Although some have suggested that adenotonsillectomy may contribute to the subsequent development of asthma in children, others have argued that a common mechanism may cause both upper and lower airway disease, and that children who have symptoms severe enough to warrant adenotonsillectomy are also at increased risk of asthma and atopic disease...
November 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27701747/oral-appliances-and-functional-orthopaedic-appliances-for-obstructive-sleep-apnoea-in-children
#11
REVIEW
Fernando R Carvalho, Débora A Lentini-Oliveira, Lucila Bf Prado, Gilmar F Prado, Luciane Bc Carvalho
BACKGROUND: Apnoea is a breathing disorder marked by the absence of airflow at the nose or mouth. In children, risk factors include adenotonsillar hypertrophy, obesity, neuromuscular disorders and craniofacial anomalies. The most common treatment for obstructive sleep apnoea syndrome (OSAS) in childhood is adeno-tonsillectomy. This approach is limited by its surgical risks, mostly in children with comorbidities and, in some patients, by recurrence that can be associated with craniofacial problems...
October 5, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27673426/respiratory-manifestations-of-hypothyroidism-a-systematic-review
#12
Jesper Roed Sorensen, Kristian Hillert Winther, Steen Joop Bonnema, Christian Godballe, Laszlo Hegedus
BACKGROUND: Hypothyroidism has been associated with increased pulmonary morbidity and overall mortality. We conducted a systematic review to identify the prevalence and underlying mechanisms of respiratory problems among patients with thyroid insufficiency. METHODS: PubMed and EMBASE databases were searched for relevant literature from January 1950 through January 2015 with study eligibility criteria: English-language publications; Adult subclinical or overt hypothyroid patients; Intervention, observational or retrospective studies; and respiratory manifestations...
September 27, 2016: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/27645974/surgical-reconstruction-for-severe-tracheal-obstruction-in-morquio-a-syndrome
#13
Christian Pizarro, Ryan R Davies, Mary Theroux, Ellen A Spurrier, Lauren W Averill, Shunji Tomatsu
Progressive tracheal obstruction is commonly seen in Morquio A syndrome and can lead to life-threatening complications. Although tracheostomy can address severe upper airway obstruction, lower airway obstruction, commonly associated with a narrow thoracic inlet and vascular compression, requires an alternative approach. We describe the case of a 16-year-old patient with Morquio A syndrome whose near-fatal tracheal obstruction was relieved by timely surgical tracheal vascular reconstruction with dramatic resolution of his respiratory symptoms...
October 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27627733/the-relationship-between-airway-antioxidant-levels-alcohol-use-disorders-and-cigarette-smoking
#14
Ellen L Burnham, Alicia McNally, Jeanette Gaydos, Lou Ann S Brown
BACKGROUND: Alcohol use disorders (AUDs) and cigarette smoking are associated with pulmonary oxidative stress, likely related to antioxidant depletion. Pulmonary oxidative stress may adversely affect innate immunity, leading to increased pneumonia susceptibility and severity, including development of the acute respiratory distress syndrome. In people with AUDs, most of whom smoke, antioxidant therapy can potentially restore immune cell function and attenuate pneumonia development. Challenges to human investigations of antioxidant therapies include an inability to identify pulmonary oxidative stress noninvasively and the optimal route to deliver pulmonary antioxidants...
October 2016: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/27608271/prolonged-partial-upper-airway-obstruction-during-sleep-an-underdiagnosed-phenotype-of-sleep-disordered-breathing
#15
REVIEW
Ulla Anttalainen, Mirja Tenhunen, Ville Rimpilä, Olli Polo, Esa Rauhala, Sari-Leena Himanen, Tarja Saaresranta
Obstructive sleep apnea syndrome (OSAS) is a well-recognized disorder conventionally diagnosed with an elevated apnea-hypopnea index. Prolonged partial upper airway obstruction is a common phenotype of sleep-disordered breathing (SDB), which however is still largely underreported. The major reasons for this are that cyclic breathing pattern coupled with arousals and arterial oxyhemoglobin saturation are easy to detect and considered more important than prolonged episodes of increased respiratory effort with increased levels of carbon dioxide in the absence of cycling breathing pattern and repetitive arousals...
2016: European Clinical Respiratory Journal
https://www.readbyqxmd.com/read/27602807/pressure-monitoring-of-the-mueller-maneuver-our-experience-in-twenty-five-obstructive-sleep-apnea-hypopnoea-syndrome-patients-with-oropharyngeal-obstruction
#16
Jacopo Cambi, Paola Staffa, Maria Carla Spinosi
Obstructive Sleep Apnea Hypopnoea Syndrome (OSAHS) is a common disorder characterized by partial (hypopnoea) or total (apnea) closure of the upper airways during sleep. It is associated with hypertension, stroke, car accidents, diabetes, metabolic syndrome and depression. Although this disease is related to major morbidity and mortality(1) , the prevalence of OSAHS is underestimated. The physiopathology of OSAHS is multifactorial and not yet fully understood. Numerous pathophysiological risk factors have been recognized: anatomical abnormalities, impaired upper airway dilators, unstable respiratory control and diminished arousal threshold...
September 7, 2016: Clinical Otolaryngology
https://www.readbyqxmd.com/read/27590203/fgf-and-eda-pathways-control-initiation-and-branching-of-distinct-subsets-of-developing-nasal-glands
#17
Alison J May, Denis Headon, David P Rice, Alistair Noble, Abigail S Tucker
Hypertrophy, hyperplasia and altered mucus secretion from the respiratory submucosal glands (SMG) are characteristics of airway diseases such as cystic fibrosis, asthma and chronic bronchitis. More commonly, hyper-secretion of the nasal SMGs contributes to allergic rhinitis and upper airway infection. Considering the role of these glands in disease states, there is a significant dearth in understanding the molecular signals that regulate SMG development and patterning. Due to the imperative role of FGF signalling during the development of other branched structures, we investigated the role of Fgf10 during initiation and branching morphogenesis of murine nasal SMGs...
August 30, 2016: Developmental Biology
https://www.readbyqxmd.com/read/27559681/microbiome-in-the-pathogenesis-of-cystic-fibrosis-and-lung-transplant-related-disease
#18
Sushma K Cribbs, James M Beck
Significant advances in culture-independent methods have expanded our knowledge about the diversity of the lung microbial environment. Complex microorganisms and microbial communities can now be identified in the distal airways in a variety of respiratory diseases, including cystic fibrosis (CF) and the posttransplantation lung. Although there are significant methodologic concerns about sampling the lung microbiome, several studies have now shown that the microbiome of the lower respiratory tract is distinct from the upper airway...
August 4, 2016: Translational Research: the Journal of Laboratory and Clinical Medicine
https://www.readbyqxmd.com/read/27549684/viral-bronchiolitis
#19
Todd A Florin, Amy C Plint, Joseph J Zorc
Viral bronchiolitis is a common clinical syndrome affecting infants and young children. Concern about its associated morbidity and cost has led to a large body of research that has been summarised in systematic reviews and integrated into clinical practice guidelines in several countries. The evidence and guideline recommendations consistently support a clinical diagnosis with the limited role for diagnostic testing for children presenting with the typical clinical syndrome of viral upper respiratory infection progressing to the lower respiratory tract...
August 20, 2016: Lancet
https://www.readbyqxmd.com/read/27549623/receiver-operating-characteristics-of-impulse-oscillometry-parameters-for-predicting-obstructive-sleep-apnea-in-preobese-and-obese-snorers
#20
Arikin Abdeyrim, Liang Tang, Arzugl Muhamat, Kelimu Abudeyrim, YongPing Zhang, NanFang Li, Yinchun Wang, Minghua Zhao
BACKGROUND: Inability to maintain upper-airway patency during sleep is a cause of obstructive sleep apnea (OSA) and its sequelae. The associated syndrome (OSAS) is common in obese populations, currently, nocturnal polysomnography is the gold standard for diagnosing this conditions, but the diagnostic procedures are expensive and time-consuming. Therefore, identification of new markers of OSAS would be useful. This study aims to examine the receiver operating characteristics of impulse oscillometry (IOS) parameters for the prediction of OSAS in preobese and obese snoring patients...
August 22, 2016: BMC Pulmonary Medicine
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