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Upper airway respiratory syndrome

Hadil Ak AlOtair, Abdulaziz H Alzeer, Mohammed A Abdou, Shaden O Qasrawi
Central alveolar hypoventilation is rarely encountered. This case report describes a young woman who was recently diagnosed with hypertension and ischemic heart disease. She presented to the emergency room with hypercapnic respiratory failure, for which she was mechanically ventilated. This was preceded by an acute upper respiratory tract infection. She was initially suspected to have Guillain-Barré syndrome, but further investigations ruled out neuromuscular or autoimmune disorders. Sleep-related hypoventilation was suspected after she experienced recurrent apneas at night that resulted in re-intubation...
March 2018: Saudi Medical Journal
Paula Colvara de Souza, Vanessa Souza Gigoski, Camila Lúcia Etges, Lisiane da Rosa Barbosa
PURPOSE: Describe the findings of postoperative clinical evaluation of swallowing in infants with congenital heart disease (CHD) in a reference hospital in southern Brazil. METHODS: This is a cross-sectional study conducted postoperatively with infants with medical diagnosis of CHD aged 0-6 months in a Pediatric Intensive Care Unit. Exclusion criteria comprised infants with neurological and respiratory impairments, craniofacial malformation, structural alteration in the upper airways, and suspicion or diagnosis of genetic syndromes...
March 1, 2018: CoDAS
Robrecht J H Logjes, Maartje Haasnoot, Petra M A Lemmers, Mike F A Nicolaije, Marie-José H van den Boogaard, Aebele B Mink van der Molen, Corstiaan C Breugem
Although Robin sequence (RS) is a well-known phenomenon, it is still associated with considerable morbidity and even mortality. The purposes of this study were to gain greater insight into the mortality rate and identify risk factors associated with mortality in RS. We retrospectively reviewed all RS infants followed at the Wilhelmina Children's Hospital from 1995 to 2016. Outcome measurements were death and causes of death. The authors identified 103 consecutive RS infants with a median follow-up of 8.6 years (range 0...
February 28, 2018: European Journal of Pediatrics
Roberto Herrera, Héctor Rojas, Ariel Estramian, Julieta Gómez, José Luis Ledesma, José Pablo, Julián Pastore
Background: Craniocervical junction pathology is infrequent in daily neurosurgical practice. In general, most of these lesions are of traumatic or rheumatic origin. Atlantoaxial instability of inflammatory origin (Grisel syndrome) is a rare entity of which only 16 adult cases have been reported in the literature. This pathology is characterized by the development of an osteolytic lesion at the level of the atlantoaxial joint after an infectious event, usually of the upper airways. Case Description: We present the case of a 76-year-old patient who attended our office for clinical symptoms of spinal instability secondary to an osteolytic lesion, with involvement of C1 and C2...
2018: Surgical Neurology International
Christiane Cavalcante Feitoza, Matheus Corrêa da-Silva, Yasmim Lima Nascimento, Elaine Sobral Leite, Corintho Viana Pereira, Lucas Gomes Patrocínio
Obstructive Sleep Apnea Syndrome (OSA) is a multifactorial disease that highly alters a persons quality of life. It is characterized by the repeated interruption of breathing during sleep, due to an obstruction or the collapse of the upper airways. Since it is a multifactorial etiological disorder, it requires a thorough diagnosis and treatment with an interdisciplinary team, which comprises several professionals such as a surgical dentist, phonoaudiologist, otorhinolaryngologist, sleep doctor, neurologist and physiotherapist...
October 2017: Sleep Science
Federica Lovisari, Valeria Terzi, Monica G Lippi, Paolo R Brioschi, Roberto Fumagalli
RATIONALE: We present a case of hemophagocytic lymphohistiocytosis (HLH) with severe pulmonary complication and acute respiratory distress syndrome (ARDS) hospitalized in our intensive care unit (ICU) in 2014; distinctive trait of this case has been the challenging diagnosis, with a bone marrow biopsy always negative, the severe pulmonary complication with ARDS and severe pulmonary hypertension, and the ferritin temporal kinetics that precisely followed the clinical course of disease...
December 2017: Medicine (Baltimore)
Margaret A Kenna, Alexandria L Irace, Julie E Strychowsky, Kosuke Kawai, Devon Barrett, Juliana Manganella, Michael J Cunningham
Importance: Children with Klippel-Feil syndrome (KFS), characterized principally by abnormal fusion of 2 or more cervical vertebrae, may have many additional congenital anomalies. The overall prevalence of otolaryngologic manifestations among patients with KFS has not been previously characterized. Objective: To define the otolaryngologic diagnoses made and procedures performed in 95 patients with KFS, which, to our knowledge, is the largest series of this challenging patient population published to date...
January 25, 2018: JAMA Otolaryngology—Head & Neck Surgery
Annie Wang, Sheila Kun, Bonnie Diep, Sally L Davidson Ward, Thomas G Keens, Iris A Perez
STUDY OBJECTIVES: To determine presence of obstructive sleep apnea (OSA) in patients with congenital central hypoventilation syndrome (CCHS) ventilated by diaphragm pacing (DP) without tracheostomy, and to determine if OSA can be improved by DP setting changes. METHODS: We reviewed polysomnography (PSG) results of 15 patients with CCHS from October 2001 to April 2014, age 15.4 ± 7.8 years, body mass index 22.0 ± 6.0 kg/m2, and 60% female. RESULTS: Of the 22 PSG results obtained for the 15 patients with CCHS, 9 were performed with tracheostomy capped, and 13 were performed after patients underwent decannulation...
January 16, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Thomas Godet, Matthieu Jabaudon, Raïko Blondonnet, Aymeric Tremblay, Jules Audard, Benjamin Rieu, Bruno Pereira, Jean-Marc Garcier, Emmanuel Futier, Jean-Michel Constantin
BACKGROUND: High frequency percussive ventilation (HFPV) combines diffusive (high frequency mini-bursts) and convective ventilation patterns. Benefits include enhanced oxygenation and hemodynamics, and alveolar recruitment, while providing hypothetic lung-protective ventilation. No study has investigated HFPV-induced changes in lung aeration in patients with early acute respiratory distress syndrome (ARDS). METHODS: Eight patients with early non-focal ARDS were enrolled and five swine with early non-focal ARDS were studied in prospective computed tomography (CT) scan and animal studies, in a university-hospital tertiary ICU and an animal laboratory...
January 11, 2018: Critical Care: the Official Journal of the Critical Care Forum
D DI Venere, M Corsalini, G M Nardi, A Laforgia, F R Grassi, B Rapone, F Pettini
Purpose: Obstructive Sleep Apnea Syndrome (OSAS) is a respiratory disorder characterized by repeated obstructive episodes affecting upper airways.This study aims at examining the anatomical craniofacial and pharyngeal characteristics of the patient as to identify the obstructive site which triggers the pathologic process.Correlations between otolaryngologic data observed in the patient and the cephalometric ones for the identification of the obstructive site were also highlighted. Materials and methods: We worked on a sample of 16 patients, 12 males and 4 females, attended to at the Otolaryngology Operative Unit of Bari University Hospital...
July 2017: Oral & Implantology
Athanasios G Kaditis, Maria Luz Alonso Alvarez, An Boudewyns, Francois Abel, Emmanouel I Alexopoulos, Refika Ersu, Koen Joosten, Helena Larramona, Silvia Miano, Indra Narang, Hui-Leng Tan, Ha Trang, Marina Tsaoussoglou, Nele Vandenbussche, Maria Pia Villa, Dick Van Waardenburg, Silke Weber, Stijn Verhulst
The present statement was produced by a European Respiratory Society Task Force to summarise the evidence and current practice on the diagnosis and management of obstructive sleep disordered breathing (SDB) in children aged 1-23 months. A systematic literature search was completed and 159 articles were summarised to answer clinically relevant questions. SDB is suspected when symptoms or abnormalities related to upper airway obstruction are identified. Morbidity (pulmonary hypertension, growth delay, behavioural problems) and coexisting conditions (feeding difficulties, recurrent otitis media) may be present...
December 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
C D Turnbull, S H Wang, A R Manuel, B T Keenan, A G McIntyre, R J Schwab, J R Stradling
PURPOSE: Obesity is associated with both obstructive sleep apnea (OSA) and obesity hypoventilation. Differences in adipose tissue distribution are thought to underlie the development of both OSA and hypoventilation. We explored the relationships between the distribution of upper airway, neck, chest, abdominal and muscle fat in very obese individuals. METHODS: We conducted a cross-sectional cohort study of individuals presenting to a tertiary sleep clinic or for assessment for bariatric surgery...
December 2, 2017: Sleep & Breathing, Schlaf & Atmung
Thomas Penzel, AbdelKebir Sabil
Tracheal sounds have been the subject of many research studies. In this review, we describe the state of the art, original work relevant to upper airways obstruction during sleep, and ongoing research concerning the methods used when analysing tracheal sounds. Tracheal sound sensors are a simple and noninvasive means of measurement and are more reliable than other breathing sensors. Developments in acoustic processing techniques and enhancements in tracheal sound signals over the past decade have led to improvements in the accuracy and clinical relevance of diagnoses based on this technology...
June 2017: Breathe
Isabella Nicola, Francesco Cerutti, Elena Grego, Iride Bertone, Paola Gianella, Antonio D'Angelo, Simone Peletto, Claudio Bellino
BACKGROUND: The microbiota of the bovine upper respiratory tract has been recently characterized, but no data for the lower respiratory tract are available. A major health problem in bovine medicine is infectious bronchopneumonia, the most common respiratory syndrome affecting cattle. With this study, we used 16S rRNA gene sequencing to characterize and compare the microbial community composition of the upper and lower respiratory tracts in calves. RESULTS: The microbiota of the upper (nasal swab [NS]) and the lower (trans-tracheal aspiration [TTA]) respiratory tracts of 19 post-weaned Piedmontese calves with (8/19) and without (11/19) clinical signs of respiratory disease, coming from six different farms, was characterized by 16S rRNA gene metabarcoding...
November 21, 2017: Microbiome
Gillian R Diercks, Carissa Wentland, Donald Keamy, Thomas Bernard Kinane, Brian Skotko, Vanessa de Guzman, Ellen Grealish, John Dobrowski, Ryan Soose, Christopher J Hartnick
Importance: Obstructive sleep apnea (OSA) affects up to 60% of children with Down syndrome (DS) and may persist in half of patients after adenotonsillectomy. Children with DS who have persistent OSA often do not tolerate treatment with positive pressure airway support devices or tracheotomy for their residual moderate to severe OSA. The hypoglossal nerve stimulator is an implantable device that delivers an electrical impulse to anterior branches of the hypoglossal nerve in response to respiratory variation, resulting in tongue base protrusion that alleviates upper airway obstruction in adults...
November 2, 2017: JAMA Otolaryngology—Head & Neck Surgery
Richard S Irwin, Cynthia L French, Anne B Chang, Kenneth W Altman
BACKGROUND: We performed systematic reviews using the population, intervention, comparison, outcome (PICO) format to answer the following key clinical question: Are the CHEST 2006 classifications of acute, subacute and chronic cough and associated management algorithms in adults that were based on durations of cough useful? METHODS: We used the CHEST Expert Cough Panel's protocol for the systematic reviews and the American College of Chest Physicians (CHEST) methodological guidelines and Grading of Recommendations Assessment, Development, and Evaluation framework...
January 2018: Chest
Q Yan, B Guan
Obstructive sleep apnea hypopnea syndrome(OSAHS) is a clinical and critical disease to health, which the accuratly pathogenesis is not very explicit. The mainstream research suggested that dysfunction of upper airway dilator muscles is one of the hazard factors. Genioglossus innervated by the hypoglossal nerve plays crucial roles. It could expand volume of pharyngeal cavity, and increase airflow rate when stimulate it.With the development of anatomy and physiology, hypoglossal nerve stimulation(HGNS) entered into clinical trials, and had made tremendous progress since 2001...
October 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
Luciana B M Godoy, Luciana Palombini, Dalva Poyares, Cibele Dal-Fabbro, Thaís Moura Guimarães, Priscila Calixto Klichouvicz, Sergio Tufik, Sonia Maria Togeiro
Objectives: To evaluate the long term effects of an oral appliance on clinical symptoms, respiratory sleep parameters, sleep quality and sustained attention in patients with Upper Airway Resistance Syndrome (UARS) compared with placebo. Methods: This study was a randomized placebo-controlled clinical trial. Thirty UARS patients were randomized in two groups: placebo and mandibular advancement device (MAD) groups. UARS criteria were presence of sleepiness (Epworth Sleepiness Scale ≥ 10) and/or fatigue (Modified Fatigue Impact Scale ≥ 38) associated with an apnea/hypopnea index (AHI) ≤ 5 and a respiratory disturbance index (RDI) > 5 events/hour of sleep, and/or flow limitation in more than 30% of total sleep time...
October 17, 2017: Sleep
Chen Lin, Men-Tzung Lo, Christian Guilleminault
Patients with nasal flow limitation and upper airway resistance syndrome (UARS) during sleep can present with low blood pressure and disturbing symptoms associated with hypervagotony. We hypothesized that the dynamic changes of the autonomic system related to inspiratory flow limitation can be quantified by the developed analytic technique applied on beat-to-beat heart rate (RR intervals) and finger photoplethysmography (PPG). METHOD: A breath-by-breath investigation based on the Hilbert-Huang transform was performed to explore autonomic nervous system changes observed during inspiratory flow limitation...
2017: Frontiers in Medicine
Wentao Li, Ruben J G Hulswit, Ivy Widjaja, V Stalin Raj, Ryan McBride, Wenjie Peng, W Widagdo, M Alejandra Tortorici, Brenda van Dieren, Yifei Lang, Jan W M van Lent, James C Paulson, Cornelis A M de Haan, Raoul J de Groot, Frank J M van Kuppeveld, Bart L Haagmans, Berend-Jan Bosch
Middle East respiratory syndrome coronavirus (MERS-CoV) targets the epithelial cells of the respiratory tract both in humans and in its natural host, the dromedary camel. Virion attachment to host cells is mediated by 20-nm-long homotrimers of spike envelope protein S. The N-terminal subunit of each S protomer, called S1, folds into four distinct domains designated S1(A) through S1(D) Binding of MERS-CoV to the cell surface entry receptor dipeptidyl peptidase 4 (DPP4) occurs via S1(B) We now demonstrate that in addition to DPP4, MERS-CoV binds to sialic acid (Sia)...
October 3, 2017: Proceedings of the National Academy of Sciences of the United States of America
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