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https://www.readbyqxmd.com/read/27933398/ecmo-for-intractable-status-asthmaticus-following-atracurium
#1
Vittorio Scaravilli, Giacomo Grasselli, Annalisa Benini, Michela Bombino, Daniele Ceriani, Uta Emmig, Alberto Zanella, Nicolò Patroniti, Antonio Pesenti
Intraoperative allergic reactions are rare but serious events associated with increased morbidity and mortality. We report the salvage of intraoperative anaphylaxis leading to extreme hypercapnic respiratory failure by veno-venous extracorporeal membrane oxygenation (ECMO). A 38-year-old woman undergoing thyroidectomy developed intractable bronchospasm after administration of atracurium, leading to extreme hypercapnic respiratory failure (PaCO2 > 250 mmHg, pH 6.773). After the failure of conventional medical therapy and ventilatory optimization, the patient was connected to a veno-venous ECMO circuit...
December 8, 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/27866183/resolution-of-allergic-rhinitis-and-reactive-bronchospasm-with-supplements-and-food-specific-immunoglobulin-g-elimination-a-case-report
#2
Laura Kwiatkowski, Jessica Mitchell, Jeffrey Langland
Context • Allergies are a common affliction, whether they are respiratory, food related, or dermatological. People often resort to continuous use of over-the-counter medications, such as antihistamines, to manage their symptoms. Controversy still remains over testing serum immunoglobulin (Ig) G to diagnose food allergies. Objective • This study intended to examine the benefits of treatment of a pediatric patient with natural supplements and an elimination diet for IgG food allergies. Design • The research team reported a case study...
October 2016: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/27784211/development-of-salbutamol-sulphate-sublingual-films-in-pullulan-matrix-for-enhanced-bioavailability-clinical-efficacy
#3
Nahed Sallam, Rania Sanad, Rasha Kharshoom, Mokhles Zeneldin
BACKGROUND: Salbutamol sulphate (SS) is a model short-acting β2-adrenergic receptor agonist used for the relief of bronchospasm having poor bioavailability (50%) due to its extensive first-pass effect. OBJECTIVE: Formulation of SS as fast dissolving sublingual films (FDSFs) using a biocompatible and biodegradable Pullulan polymer to bypass its metabolism in liver and offers a fast relieve of asthma. METHOD: Films were prepared by solvent casting technique adopting 32 factorial design to study the effect of two independent variables namely; polymer type (HPMC E5, Pullulan, and L-HPC) and polymer to Maltodextrin ratio (3:0, 3:1 or 5:1)...
October 24, 2016: Current Drug Delivery
https://www.readbyqxmd.com/read/27766364/applicability-of-predictive-toxicology-methods-for-monoclonal-antibody-therapeutics-status-quo-and-scope
#4
Arathi Kizhedath, Simon Wilkinson, Jarka Glassey
Biopharmaceuticals, monoclonal antibody (mAb)-based therapeutics in particular, have positively impacted millions of lives. MAbs and related therapeutics are highly desirable from a biopharmaceutical perspective as they are highly target specific and well tolerated within the human system. Nevertheless, several mAbs have been discontinued or withdrawn based either on their inability to demonstrate efficacy and/or due to adverse effects. Approved monoclonal antibodies and derived therapeutics have been associated with adverse effects such as immunogenicity, cytokine release syndrome, progressive multifocal leukoencephalopathy, intravascular haemolysis, cardiac arrhythmias, abnormal liver function, gastrointestinal perforation, bronchospasm, intraocular inflammation, urticaria, nephritis, neuropathy, birth defects, fever and cough to name a few...
October 20, 2016: Archives of Toxicology
https://www.readbyqxmd.com/read/27741128/risk-of-asthma-exacerbation-associated-with-nonsteroidal-anti-inflammatory-drugs-in-childhood-asthma-a-nationwide-population-based-cohort-study-in-taiwan
#5
Pei-Chia Lo, Yueh-Ting Tsai, Shun-Ku Lin, Jung-Nien Lai
Patients allergic to aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) who develop respiratory reactions such as bronchospasm or asthma exacerbation have aspirin-induced asthma or NSAIDs-exacerbated respiratory disease. However, large-scale studies have not been conducted to investigate the risk of aspirin/NSAIDs exposure in children with asthma. Therefore, this study evaluated the relationship between aspirin/NSAIDs and the risk of asthma exacerbation in children with asthma.This retrospective cohort study was conducted using the data of 1 million random beneficiaries of the Taiwan National Health Insurance program between 1997 and 2012...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27732743/clinical-approach-on-challenge-and-desensitization-procedures-with-aspirin-in-patients-with-ischemic-heart-disease-and-nsaid-hypersensitivity
#6
G Cortellini, A Romano, A Santucci, A Barbaud, S Bavbek, D Bignardi, M Blanca, P Bonadonna, M T Costantino, J J Laguna, C Lombardo, L Losappio, J Makowska, A Nakonechna, O Quercia, E A Pastorello, V Patella, I Terreehorst, S Testi, J R Cernadas, J Dionicio Elera, D Lippolis, S Voltolini, D Grosseto
BACKGROUND: Hypersensitivity to acetylsalicylic acid (ASA) constitutes a serious problem for subjects with coronary artery disease. In such subjects, physicians have to choose the more appropriate procedure between challenge and desensitization. As the literature on this issue is sparse, the present study aims to establish in these subjects clinical criteria for eligibility for an ASA challenge and/or desensitization. METHODS: Collection and analysis of data on ASA challenges and desensitizations from 10 allergy centers, as well as consensus among the related physicians and an expert panel...
October 12, 2016: Allergy
https://www.readbyqxmd.com/read/27713628/can-resistive-breathing-injure-the-lung-implications-for-copd-exacerbations
#7
Theodoros Vassilakopoulos, Dimitrios Toumpanakis
In obstructive lung diseases, airway inflammation leads to bronchospasm and thus resistive breathing, especially during exacerbations. This commentary discusses experimental evidence that resistive breathing per se (the mechanical stimulus) in the absence of underlying airway inflammation leads to lung injury and inflammation (mechanotransduction). The potential implications of resistive breathing-induced mechanotrasduction in COPD exacerbations are presented along with the available clinical evidence.
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27712763/pathogenesis-of-aspirin-induced-reactions-in-aspirin-exacerbated-respiratory-disease
#8
Katherine N Cahill, Tanya M Laidlaw
The acute clinical symptoms that develop following the oral ingestion of aspirin, or any other inhibitor of cyclooxygenase-1, are well established in aspirin-exacerbated respiratory disease: nasal congestion, rhinorrhea, and bronchospasm. Less commonly, gastrointestinal distress, rash, angioedema, or urticaria also develops. However, the pathobiology that drives these clinical reactions is poorly understood. Use of an intranasal aspirin challenge protocol or administration of premedications inhibiting the leukotriene pathway decreases the severity of clinical reaction, which suggests the involvement of both local effector cells and cysteinyl leukotrienes in the pathogenesis of aspirin-induced reactions...
November 2016: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/27712573/diagnosing-%C3%AE-lactam-hypersensitivity
#9
Francesco Gaeta, Maria J Torres, Rocco Luigi Valluzzi, Cristiano Caruso, Cristobalina Mayorga, Antonino Romano
Hypersensitivity reactions to β-lactam antibiotics are commonly reported. They can be classified as immediate or non-immediate according to the time interval between the last drug administration and their onset. Immediate reactions occur within one hour after the last drug administration and are manifested clinically by urticaria and/or angioedema, rhinitis, bronchospasm, and anaphylactic shock; they may be mediated by specific IgE-antibodies. Non-immediate reactions occur more than one hour after the last drug administration...
October 4, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27706456/evaluation-of-primary-prophylaxis-with-propranolol-and-elastic-band-ligation-in-variceal-bleeding-in-cirrhotic-children-and-adolescents
#10
Júlio Rocha Pimenta, Alexandre Rodrigues Ferreira, Paulo Fernando Souto Bittencourt, Camilo Brandão de Resende, Eleonora Druve Tavares Fagundes, Isabela Maria Lopes da Silva
Background: The efficacy of nonselective β-blocker and endoscopic procedures, such as endoscopic variceal ligation, as primary prophylaxis of variceal hemorrhage in cirrhotic adults was demonstrated by numerous controlled trials, but in pediatric population, few are the number of studies. Objective: The objective of this study is to evaluate the primary prophylaxis with β-blocker in cirrhotic children and adolescents with portal hypertension. Methods: This is a cohort study encompassing 26 cirrhotic patients...
October 2016: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/27695294/combined-computational-and-experimental-studies-of-molecular-interactions-of-albuterol-sulfate-with-bovine-serum-albumin-for-pulmonary-drug-nanoparticles
#11
Shao-Hui Lin, Wei Cui, Gui-Ling Wang, Shuai Meng, Ying-Chun Liu, Hong-Wei Jin, Liang-Ren Zhang, Ying Xie
Albumin-based nanoparticles (NPs) are a promising technology for developing drug-carrier systems, with improved deposition and retention profiles in lungs. Improved understanding of these drug-carrier interactions could lead to better drug-delivery systems. The present study combines computational and experimental methods to gain insights into the mechanism of binding of albuterol sulfate (AS) to bovine serum albumin (BSA) on the molecular level. Molecular dynamics simulation and surface plasmon resonance spectroscopy were used to determine that there are two binding sites on BSA for AS: the first of which is a high-affinity site corresponding to AS1 and the second of which appears to represent the integrated functions of several low-affinity sites corresponding to AS2, AS3, and AS8...
2016: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/27688361/safety-of-oral-propranolol-for-the-treatment-of-infantile-hemangioma-a-systematic-review
#12
Christine Léaute-Labrèze, Olivia Boccara, Caroline Degrugillier-Chopinet, Juliette Mazereeuw-Hautier, Sorilla Prey, Geneviève Lebbé, Stéphanie Gautier, Valérie Ortis, Martine Lafon, Agnès Montagne, Alain Delarue, Jean-Jacques Voisard
BACKGROUND AND OBJECTIVES: Given the widespread use of propranolol in infantile hemangioma (IH) it was considered essential to perform a systematic review of its safety. The objectives of this review were to evaluate the safety profile of oral propranolol in the treatment of IH. METHODS: We searched Embase and Medline databases (2007-July 2014) and unpublished data from the manufacturer of Hemangiol/Hemangeol (marketed pediatric formulation of oral propranolol; Pierre Fabre Dermatologie, Lavaur, France)...
September 29, 2016: Pediatrics
https://www.readbyqxmd.com/read/27687465/chlorhexidine-related-refractory-anaphylactic-shock-a-case-successfully-resuscitated-with-extracorporeal-membrane-oxygenation
#13
Man-Ling Wang, Ching-Tao Chang, Hsing-Hao Huang, Yu-Chang Yeh, Tzong-Shiun Lee, Kuan-Yu Hung
IMPORTANCE: We report a patient with a life-threatening anaphylactic reaction to a chlorhexidine-coated central venous catheter, confirmed with a high serum level of chlorhexidine-specific IgE. To our knowledge, this is the first case successfully resuscitated using extracorporeal membrane oxygenation (ECMO). Great caution is required when using chlorhexidine and chlorhexidine-impregnated catheters, given that its widespread use has the potential to sensitize certain patients and may result in life-threatening anaphylaxis on subsequent exposure...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27666395/pharmacological-evaluation-of-antiasthmatic-activity-of-myrica-nagi-bark-extracts
#14
Rinu K Rana, Rakesh K Patel
BACKGROUND: The involvement of debilitating side effects of allopathic antiasthmatic drugs provides a strong impetus for the development of new herbal therapeutics. Myrica nagi Thunb. (Syn. Kaiphal) of Myricaceae family is a known drug of the Ayurveda system used for the treatment of several diseases including asthma. METHODS: The present study deals with the preparation and phytochemical screening of polar, non-polar and methanolic extracts of Myrica nagi bark followed by the evaluation of their antiasthmatic activity using four different animal experimental models: acetylcholine induced bronchospasm in conscious guinea pigs, acetylcholine induced contraction on isolated guinea pig tracheal chain preparation, compound 48/80 induced mast cell degranulation using rat, and trypsin and egg albumin induced bronchospasm in conscious rat...
September 23, 2016: Anti-inflammatory & Anti-allergy Agents in Medicinal Chemistry
https://www.readbyqxmd.com/read/27594907/complications-from-carcinoid-syndrome-review-of-the-current-evidence
#15
REVIEW
José Mauricio Mota, Luana Guimarães Sousa, Rachel P Riechelmann
Patients with well-differentiated neuroendocrine tumours may develop carcinoid syndrome (CS), which is characterised by flushing, abdominal cramps, diarrhoea, and bronchospasms. In this scenario, long-term secretion of vasoactive substances-serotonin, tachynins, and others, may induce fibrogenic responses in local or distant tissues, leading to complications such as carcinoid heart disease (CHD), mesenteric and/or retroperitoneal fibrosis. Rare cases of lung/pleural fibrosis and scleroderma have also been described...
2016: Ecancermedicalscience
https://www.readbyqxmd.com/read/27585420/benzodiazepine-allergy-with-anesthesia-administration-a-review-of-current-literature
#16
Elliot Haybarger, Andrew S Young, Joseph A Giovannitti
The incidence of anaphylactic/anaphylactoid reactions has been reported to vary between 1 : 3500 and 1 : 20,000 cases with a mortality rate ranging from 3 to 9%. Clinical signs present as skin rash, urticaria, angioedema, bronchospasm, tachycardia, bradycardia, and hypotension. Rapid identification and treatment are crucial to overall patient prognosis, as delayed intervention is associated with increased mortality. Diagnosis may be confirmed with clinical presentation, serum tryptase levels, and skin test results...
2016: Anesthesia Progress
https://www.readbyqxmd.com/read/27578926/lack-of-efficacy-of-pre-bronchoscopy-inhaled-salbutamol-on-symptoms-and-lung-functions-in-patients-with-pre-existing-airway-obstruction
#17
Anant Mohan, Indrajit Momin, Rosemary Poulose, Charu Mohan, Karan Madan, Vijay Hadda, Randeep Guleria, R M Pandey
BACKGROUND: Fiberoptic bronchoscopy (FOB) may exaggerate symptoms and lung functions in patients with pre-existing airway obstruction. Interventions which can alleviate or minimize this procedure-related bronchospasm, especially in this high-risk group are, therefore, required. METHODS: A double-blinded randomized controlled trial was conducted to evaluate the efficacy of 400 μg of inhaled salbutamol on patients with spirometric evidence of airflow obstruction planned for FOB...
July 2016: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/27572546/safety-of-technoshere-insulin
#18
Nasser Mikhail
Technoshere insulin (TI), Afrezza, is a form of short-acting human insulin taken by oral inhalation with meals. Compared to subcutaneous insulin aspart, TI is slightly less effective, the difference in hemoglobin A1c (HbA1c) reduction being 0.19%. Use of TI is associated with lower risk of hypoglycemia and weight gain compared with insulin aspart. Apart from hypoglycemia, cough is the most common adverse effect of TI reported by 24-33% of patients. Cough induced by TI is mostly dry, occurs within 10 minutes after inhalation and usually subsides after few weeks of use...
August 29, 2016: Current Drug Safety
https://www.readbyqxmd.com/read/27547723/a-case-of-severe-acute-exacerbation-of-yokkaichi-asthma-treated-with-a-vibrating-mesh-nebulizer
#19
Takeshi Yano, Tetsu Yonaha, Koutaro Hidaka, Masumi Nagahama, Tomohiro Koshida, Hiroshi Matsuoka, Masahiko Taniguchi, Isao Tsuneyoshi
Yokkaichi asthma was one of the most common environmental pollution diseases in Japan in the 1960s and 1970s. The problem of air pollution in Yokkaichi was solved in the 1970s. However, mortality and life expectancy were still affected by the late effects of air pollution in patients with Yokkaichi asthma even in the 2000s. In this case report, we described the experience of successful treatment of a patient with severe asthmatic status due to Yokkaichi asthma. A 40s-year-old man, who was officially certified as a patient with Yokkaichi asthma from his infancy, was admitted to hospital due to acute exacerbation of asthma...
2016: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27545856/ischemic-stroke-after-wasp-sting
#20
Ashish Kulhari, Ashley Rogers, Han Wang, Vishakhadatta Mathur Kumaraswamy, Wei Xiong, Michael DeGeorgia
BACKGROUND: Despite the common occurrence of hymenopteran stings worldwide, primary neurologic manifestations including stroke are rare. We report a case of a healthy male who developed a right middle cerebral artery (MCA) territory ischemic stroke after getting stung by a wasp. CASE REPORT: A 44-year-old man with hypertension presented to the hospital with sudden-onset left hemiparesis, left facial weakness, and dysarthria after being stung by a wasp. Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) scans of the brain revealed a right MCA territory infarct and a lack of flow in the distal right internal carotid artery and MCA...
October 2016: Journal of Emergency Medicine
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