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https://www.readbyqxmd.com/read/29238905/biologic-agents-for-severe-asthma-patients-clinical-perspectives-and-implications
#1
REVIEW
Massimo Caruso, Jaymin Morjaria, Rosalia Emma, Maria Domenica Amaradio, Riccardo Polosa
Asthma is a chronic inflammatory multifactorial disorder of the airways characterized by the involvement of immune cells and mediators in its onset and maintenance. Traditional therapeutic strategies have been unsatisfactory in controlling the underlying pathology, especially in the more severe states. Hence in the last couple of decades, new biological approaches targeting molecular mediators have been developed. In this narrative review we examine biological agents currently available for the management of severe asthma, focusing our attention on their clinical application, pros and cons, and in particular on gaps regarding the use of these agents...
December 14, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29238576/a-case-of-legionella-pneumonia-caused-by-home-use-of-continuous-positive-airway-pressure
#2
Ruby Schnirman, Nasifa Nur, Alice Bonitati, Gerardo Carino
A 67-year-old woman with morbid obesity and severe obstructive sleep apnea presented to the emergency department with 2 days of productive cough, fever, shortness of breath and loose stools. A chest x-ray showed extensive bilateral infiltrates, and she was quickly intubated for acute hypoxic respiratory failure. A urine legionella antigen test was positive, and she was admitted to the intensive care unit with a diagnosis of severe legionella pneumonia. She improved over the next week with a course of levofloxacin...
2017: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29238519/how-to-manage-anaphylaxis-in-primary-care
#3
REVIEW
Alberto Alvarez-Perea, Luciana Kase Tanno, María L Baeza
Anaphylaxis is defined as a severe life-threatening generalized or systemic hypersensitivity reaction characterized by rapidly developing airway and/or circulation problems. It presents with very different combinations of symptoms and apparently mild signs and can progress to fatal anaphylactic shock unpredictably. The difficulty in recognizing anaphylaxis is due, in part, to the variability of diagnostic criteria, which in turn leads to a delay in administration of appropriate treatment, thus increasing the risk of death...
2017: Clinical and Translational Allergy
https://www.readbyqxmd.com/read/29237658/emergency-salpingectomy-for-ruptured-ectopic-pregnancy-in-patient-with-melnick-needles-syndrome-a-rare-otopalatodigital-syndrome
#4
Mark Zachary Johnson, Cormac Francis Mullins, Declan Keane, Ingrid Browne
Melnick-Needles syndrome (M-NS) is a rare genetic disorder which primarily affects skeletal developments. M-NS may also affect the cardiorespiratory and renal systems. A 35 kg patient presented complaining of abdominal pain. Following a positive pregnancy test and ultrasound examination, she was diagnosed with a ruptured ectopic pregnancy. She had a significant background history of M-NS, obstructive sleep apnoea (with narrow gauge tracheostomy in situ), obstructive lung disease and scoliosis. She received fluid resuscitation, and the case was managed using an open salpingectomy and clot evacuation under combined spinal/epidural anaesthesia...
December 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29232352/case-report-of-a-5-year-old-with-epiglottitis-an-atypical-presentation-of-an-uncommon-disease
#5
Amanda J Kasem
Epiglottitis is a rarely encountered infection in pediatrics since the advent of the conjugate Haemophilus influenzae type b vaccine first introduced in the United States in 1985. However, the disease remains a much feared infection in pediatrics. The literature reiterates the importance of early recognition, avoidance of agitating the patient, and the need for securing the airway in the operating room as key and essential features to a good outcome. However, with only 1 case per 200,000 children reported in the United States in 2006, most practitioners have never encountered this infection...
December 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29230286/asthma-mimic-case-report-and-literature-review-of-vocal-cord-nodule-associated-with-wheezing
#6
Muhammad Kashif, Tushi Singh, Ahsan Aslam, Misbahuddin Khaja
Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. Various clinical conditions can mimic asthma, such as foreign body aspiration, subglottic stenosis, congestive heart failure, diffuse panbronchiolitis, aortic arch anomalies, reactive airway dysfunction syndrome, chronic obstructive pulmonary disease, retrosternal goiter, vocal cord tumors, other airway tumors, and vocal cord dysfunction. Upper airway obstruction can be a life-threatening emergency. Here, we present the case of a 58-year-old female with recurrent hospital visits for wheezing and exacerbations of asthma, who was later found to have a vocal cord nodule confirmed to be squamous cell carcinoma, which was mimicking like asthma...
2017: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29229538/association-of-prehospital-intubation-with-decreased-survival-among-pediatric-trauma-patients-in-iraq-and-afghanistan
#7
Steven G Schauer, Jason F Naylor, Guyon J Hill, Allyson A Arana, Jamie L Roper, Michael D April
INTRODUCTION: Airway compromise is the second leading cause of preventable death on the battlefield among US military casualties. Airway management is an important component of pediatric trauma care. Yet, intubation is a challenging skill with which many prehospital providers have limited pediatric experience. We compare mortality among pediatric trauma patients undergoing intubation in the prehospital setting versus a fixed-facility emergency department. METHODS: We queried the Department of Defense Trauma Registry (DODTR) for all pediatric encounters in Iraq and Afghanistan from January 2007 to January 2016...
December 1, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29228935/dosimetrically-administered-nebulized-morphine-for-breathlessness-in-very-severe-chronic-obstructive-pulmonary-disease-a-randomized-controlled-trial
#8
Piotr Janowiak, Małgorzata Krajnik, Zygmunt Podolec, Tomasz Bandurski, Iwona Damps-Konstańska, Piotr Sobański, David C Currow, Ewa Jassem
BACKGROUND: Systemic morphine has evidence to support its use for reducing breathlessness in patients with severe chronic obstructive pulmonary disease (COPD). The effectiveness of the nebulized route, however, has not yet been confirmed. Recent studies have shown that opioid receptors are localized within epithelium of human trachea and large bronchi, a target site for a dosimetric nebulizer. The aim of this study was to compare any clinical or statistical differences in breathlessness intensity between nebulized 2...
December 11, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29225146/microbial-diversity-within-the-airway-microbiome-in-chronic-pediatric-lung-diseases
#9
Andrea Hahn, Stephanie Warnken, Marcos Pérez-Losada, Robert J Freishtat, Keith A Crandall
The study of the airway microbiome in children is an area of emerging research, especially in relation to the role microbial diversity may play in acute and chronic inflammation. Three such pediatric airway diseases include cystic fibrosis, asthma, and chronic lung disease of prematurity. In cystic fibrosis, the presence of Pseudomonas spp. is associated with decreased microbial diversity. Decreasing microbial diversity is also associated with poor lung function. In asthma, early viral infections appear to drive changes in bacterial diversity which may be associated with asthma risk...
December 7, 2017: Infection, Genetics and Evolution
https://www.readbyqxmd.com/read/29225086/circulating-allergen-specific-th2-lymphocytes-ccr4-rather-than-cla-is-the-predominant-phenotype-in-peanut-allergic-subjects
#10
Lars H Blom, Nanna Juel-Berg, Lau Fabricius Larsen, Kirsten S Hansen, Lars K Poulsen
The skin and airway homing chemokine CCR4, but not CLA, emerged as the primary discriminating homing factor, of Th2 lymphocytes, suggesting that peanut sensitization occurs both via the skin and airways.
December 7, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29224757/reproducing-severe-acute-subglottic-stenosis-in-a-rabbit-model
#11
Wesley R McIlwain, Paul R Wistermayer, Tyler P Swiss, Shannon T Marko, Nicholas M Ieronimakis, Derek J Rogers
OBJECTIVES: The objectives of this study were to develop an animal model with consistent, severe subglottic stenosis (SGS), and to develop the timeline needed for intervention to limit rabbit mortality. METHODS: Subglottic stenosis was created endoscopically using either a nylon or polypropylene brush in sixteen New Zealand White rabbits. The subglottic cross-sectional area was measured endoscopically using a right-angled probe and an open source image analysis software The cross-sectional areas of the stenotic and native airways were compared to calculate the subglottic stenosis percentage and Myer-Cotton grade classification...
December 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29224657/cta-as-an-adjuvant-tool-for-acute-intra-abdominal-or-gastrointestinal-bleeding
#12
Mitchell Storace, Jonathan G Martin, Jay Shah, Zachary Bercu
Hematemesis and acute postsurgical upper gastrointestinal hemorrhage are common emergent on-call consultations for the interventional radiologist. Upper GI bleleding (UGIB) is a relatively frequent problem. The incidence and mortality vary among patient populations, but studies have shown an overall incidence ranging from 36-172 cases per 100,000 adults per year, with a mortality rate of 5%-14%. The incidence is significantly higher in men. Peptic ulcer disease is the predominant etiology, responsible for 28%-59% of UGIB...
December 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29223612/predictive-value-of-focused-assessment-with-sonography-for-trauma-fast-for-laparotomy-in-unstable-polytrauma-egyptians-patients
#13
Adel Hamed Elbaih, Sameh T Abu-Elela
PURPOSE: The emergency physicians face significant clinical uncertainty when multiple trauma patients arrive in the emergency department (ED). The priorities for assessment and treatment of polytrauma patients are established in the primary survey. Focused assessment with sonography for trauma (FAST) is very essential clinical skill during trauma resuscitation. Use of point of care ultrasound among the trauma team working in the primary survey in emergency care settings is lacking in Suez Canal University Hospitals even ultrasound machine not available in ED...
November 23, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29222618/complex-sleep-apnea-after-full-night-and-split-night-polysomnography-the-greek-experience
#14
Katerina Baou, Charalampos Mermigkis, Aliki Minaritzoglou, Emmanouil Vagiakis
PURPOSE: Treatment-emergent central sleep apnea (TE-CSA) is defined as the emergence or persistence of central respiratory events during the initiation of positive airway pressure (PAP) without a back-up rate in obstructive sleep apnea (OSA) patients and after significant resolution of obstructive events. Previous studies have estimated a prevalence from 0.56 to 20.3%. The aim of this study was to establish the prevalence of TE-CSA in a Greek adult population. METHODS: One thousand fifty nine patients with newly diagnosed OSA, who were referred to the Sleep Disorders Center of Evangelismos Hospital of Athens over an 18-month period, were included in this study...
December 8, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/29221291/airway-stenting-in-patients-requiring-intubation-due-to-malignant-airway-stenosis-a-10-year-experience
#15
Masahide Oki, Hideo Saka, Kazumi Hori
Background: Critically ill patients with severe acute respiratory failure due to malignant airway stenosis often require emergency intubation and mechanical ventilation. Urgent intervention is necessary for the survival of such patients. The aim of this study was to determine the efficacy and outcomes of airway stenting in patients with malignant airway stenosis requiring emergency intubation. Methods: Patients with malignant airway stenosis who underwent emergency intubation prior to airway stent placement from September 2005 to September 2015 in a single center were retrospectively reviewed...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29220719/house-dust-mite-allergen-causes-certain-features-of-steroid-resistant-asthma-in-high-fat-fed-obese-mice
#16
Vijay Pal Singh, Ulaganathan Mabalirajan, Kunal Pratap, Devika Bahal, Deepanshu Maheswari, Atish Gheware, Aabha Bajaj, Lipsa Panda, Ashish Jaiswal, Arjun Ram, Anurag Agrawal
Obesity is a high risk factor for diseases such as cardiovascular, metabolic syndrome and asthma. Obese-asthma is another emerging phenotype in asthma which is typically refractive to steroid treatment due to its non-classical features such as non-eosinophilic cellular inflammation. The overall increased morbidity, mortality and economical burden in asthma is mainly due to steroid resistant asthma. In the present study, we used high fat diet induced obese mice which when sensitized with house dust mite (HDM) showed steroid resistant features...
December 4, 2017: International Immunopharmacology
https://www.readbyqxmd.com/read/29220407/respiratory-resistance-and-reactance-in-adults-with-sickle-cell-anemia-correlation-with-functional-exercise-capacity-and-diagnostic-use
#17
Cirlene de Lima Marinho, Maria Christina Paixão Maioli, Jorge Luis Machado do Amaral, Agnaldo José Lopes, Pedro Lopes de Melo
BACKGROUND: The improvement in sickle cell anemia (SCA) care resulted in the emergence of a large population of adults living with this disease. The mechanisms of lung injury in this new population are largely unknown. The forced oscillation technique (FOT) represents the current state-of-the-art in the assessment of lung function. The present work uses the FOT to improve our knowledge about the respiratory abnormalities in SCA, evaluates the associations of FOT with the functional exercise capacity and investigates the early detection of respiratory abnormalities...
2017: PloS One
https://www.readbyqxmd.com/read/29214627/a-12-month-descriptive-analysis-of-emergency-intubations-at-brooke-army-medical-center-a-national-emergency-airway-registry-study
#18
Michael D April, Steven G Schauer, Calvin A Brown Rd, Patrick C Ng, Jessie Fernandez, Andrea E Fantegrossi, Joseph K Maddry, Shane Summers, Daniel J Sessions, Robert M Barnwell, Mark Antonacci
Emergency airway management is a critical skill for military healthcare providers. Our goal was to describe the Emergency Department (ED) intubations at Brooke Army Medical Center (BAMC) over a 12-month period. MATERIAL AND METHODS: Physicians performing endotracheal intubations in the BAMC ED complete data collection forms for each intubation event as part of the National Emergency Airway Registry, including patient demographics, intubation techniques, success and failure rates, adverse events, and patient disposition...
October 2017: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/29214067/malignant-central-airway-obstruction
#19
REVIEW
Lakshmi Mudambi, Russell Miller, George A Eapen
This review comprehensively describes recent advances in the management of malignant central airway obstruction (CAO). Malignant CAO can be a dramatic and devastating manifestation of primary lung cancer or metastatic disease. A variety of diagnostic modalities are available to provide valuable information to plan a therapeutic intervention. Clinical heterogeneity in the presentation of malignant CAO provides opportunities to adapt and utilize endoscopic technology and tools in many ways. Mechanical debulking, thermal tools, cryotherapy and airway stents are methods and instruments used to rapidly restore airway patency...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29214060/interstitial-lung-disease-the-diagnostic-role-of-bronchoscopy
#20
REVIEW
Jad Kebbe, Tony Abdo
Interstitial lung diseases (ILDs) form one of the most fascinating fields in pulmonary medicine. They also pose one of the greatest challenges for accurate diagnosis and proper treatment. Even within the recommended and warranted multidisciplinary approach, differentiating between one disease and another may lead to frustration, especially when proper lung tissue is not available for adequate pathological review. A surgical lung biopsy (SLB) might render enough tissue for histopathology, but this could come at the expense of high morbidity and even mortality, as in the case of usual interstitial pneumonia (UIP)...
September 2017: Journal of Thoracic Disease
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