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https://www.readbyqxmd.com/read/29456861/critical-airway-compression-caused-by-a-large-mediastinal-tumour-with-spontaneous-haemorrhage
#1
Shih-Peng Liu, Hung-Che Chien, Chun-Ku Chen, Chih-Cheng Hsieh, Chien-Sheng Huang
We report the case of a 77-year-old woman presenting with out-of-hospital cardiac arrest, which was then interpreted as an acute, life-threatening critical airway compression by a huge mediastinal tumour without appropriate diagnosis. Emergency extracorporeal membrane oxygenation was cannulated for sufficient respiratory support after spontaneous circulation was regained. After the multidisciplinary team, involving thoracic surgeons, discussed the resectability of the mediastinal tumour, the patient underwent successful resection of the mediastinal tumour through a median sternotomy...
April 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29452814/deep-or-awake-removal-of-laryngeal-mask-airway-in-children-at-risk-of-respiratory-adverse-events-undergoing-tonsillectomy-a-randomised-controlled-trial
#2
A Ramgolam, G L Hall, G Zhang, M Hegarty, B S von Ungern-Sternberg
BACKGROUND: Laryngeal mask airways (LMA) are widely used during tonsillectomies. Contrasting evidence exists regarding the timing of the removal and the risk of perioperative respiratory adverse events. We assessed whether the likelihood of perioperative respiratory adverse events is influenced by the timing of LMA removal in children with at least one risk factor for these events. METHODS: Participants (n=290, 0-16 yr) were randomised to have their LMA removed either deep (in theatre by anaesthetist at end-tidal sevoflurane >1 minimum alveolar concentration) or awake (in theatre by anaesthetist or in postanaesthesia care unit by anaesthetist or trained nurse)...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29452722/traumatic-lingual-hematoma-resulting-in-bilateral-temporal-mandibular-joint-dislocations
#3
Dhara P Amin, Michael N Cooper, Kim I Newton
BACKGROUND: Lingual hematoma (LH) is a relatively uncommon entity seen after both medical and traumatic etiologies. Regardless of the cause, the feared complication is acute airway obstruction. CASE REPORT: Our case involves a 39-year-old man who presented to the Emergency Department via emergency medical services with an enlarging LH after an unwitnessed fall, suspected to be an alcohol withdrawal seizure. The bleeding was likely exacerbated by previously undiagnosed thrombocytopenia...
February 13, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29448350/role-of-spatial-heterogeneity-in-the-collective-dynamics-of-cilia-beating-in-a-minimal-one-dimensional-model
#4
Supravat Dey, Gladys Massiera, Estelle Pitard
Cilia are elastic hairlike protuberances of the cell membrane found in various unicellular organisms and in several tissues of most living organisms. In some tissues such as the airway tissues of the lung, the coordinated beating of cilia induces a fluid flow of crucial importance as it allows the continuous cleaning of our bronchia, known as mucociliary clearance. While most of the models addressing the question of collective dynamics and metachronal wave consider homogeneous carpets of cilia, experimental observations rather show that cilia clusters are heterogeneously distributed over the tissue surface...
January 2018: Physical Review. E
https://www.readbyqxmd.com/read/29447818/sirolimus-for-management-of-complex-vascular-anomalies-a-proposed-dosing-regimen-for-very-young-infants
#5
Josephine A Czechowicz, Janel R Long-Boyle, Kristina W Rosbe, Erin F Mathes, Ilona J Frieden, Kristin A Shimano
Neonates with vascular anomalies causing airway compromise and other complications require early initiation of medical therapy. Sirolimus has emerged as a safe and effective treatment, but standard recommendations for dosing start at seven months. Guidelines are needed for dosing in very young infants, who have reduced hepatic metabolism of sirolimus. We present our experience treating six neonates (mean age 14.8 days) with complicated vascular anomalies. Standard dosing caused supratherapeutic levels in this population...
February 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29447055/advanced-microengineered-lung-models-for-translational-drug-discovery
#6
Brian F Niemeyer, Peng Zhao, Rubin M Tuder, Kambez H Benam
Lung diseases impose a significant socioeconomic burden and are a leading cause of morbidity and mortality worldwide. Moreover, respiratory medicine, unlike several other therapeutic areas, faces a disappointingly low number of new approved therapies. This is partly due to lack of reliable in vitro or in vivo models that can reproduce organ-level complexity and pathophysiological responses of human lung. Here, we examine new opportunities in application of recently emerged organ-on-chip technology to model human lung alveolus and small airway in preclinical drug development and biomarker discovery...
February 1, 2018: SLAS Discovery
https://www.readbyqxmd.com/read/29445528/an-update-on-mandibular-advancement-devices-for-the-treatment-of-obstructive-sleep-apnoea-hypopnoea-syndrome
#7
REVIEW
Shadi Basyuni, Michal Barabas, Tim Quinnell
Continuous positive airway pressure (CPAP) remains the gold standard treatment for obstructive sleep apnoea hypopnoea syndrome (OSAHS). However, the high efficacy of CPAP is offset by intolerance and poor compliance, which can undermine effectiveness. This means that alternatives to CPAP are also necessary. In recent years, oral appliances have emerged as the leading alternative to CPAP. There is now a strong body of evidence supporting their use in OSAHS and clinical guidelines now recommend their use in mild OSAHS and in more severe cases when CPAP fails...
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29441123/circulation-first-the-time-has-come-to-question-the-sequencing-of-care-in-the-abcs-of-trauma-an-american-association-for-the-surgery-of-trauma-multicenter-trial
#8
Paula Ferrada, Rachael A Callcut, David J Skarupa, Therese M Duane, Alberto Garcia, Kenji Inaba, Desmond Khor, Vincent Anto, Jason Sperry, David Turay, Rachel M Nygaard, Martin A Schreiber, Toby Enniss, Michelle McNutt, Herb Phelan, Kira Smith, Forrest O Moore, Irene Tabas, Joseph Dubose
Background: The traditional sequence of trauma care: Airway, Breathing, Circulation (ABC) has been practiced for many years. It became the standard of care despite the lack of scientific evidence. We hypothesized that patients in hypovolemic shock would have comparable outcomes with initiation of bleeding treatment (transfusion) prior to intubation (CAB), compared to those patients treated with the traditional ABC sequence. Methods: This study was sponsored by the American Association for the Surgery of Trauma multicenter trials committee...
2018: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/29440393/granule-stored-muc5b-mucins-are-packed-by-the-non-covalent-formation-of-n-terminal-head-to-head-tetramers
#9
Sergio Trillo-Muyo, Harriet E Nilsson, Christian V Recktenwald, Anna Ermund, Caroline Ridley, Lauren N Meiss, Andrea Bahr, Nikolai Klymiuk, Jeffrey J Wine, Philip J Koeck, David J Thornton, Hans Hebert, Gunnar C Hansson
Most MUC5B mucin polymers in the upper airways of humans and pigs are produced by submucosal glands. MUC5B forms N-terminal covalent dimers, which are further packed into larger assemblies because of low pH and high Ca2+ in the secretory granule of the mucin-producing cell. We purified the recombinant MUC5B N-terminal covalent dimer and used single-particle electron microscopy to study its structure under intracellular conditions. We found that at intragranular pH, the dimeric MUC5B organized into head-to-head noncovalent tetramers where the von Willebrand D1-D2 domains hooked into each other...
February 13, 2018: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/29434527/visualisation-of-multiple-tight-junctional-complexes-in-human-airway-epithelial-cells
#10
Alysia G Buckley, Kevin Looi, Thomas Iosifidis, Kak-Ming Ling, Erika N Sutanto, Kelly M Martinovich, Elizabeth Kicic-Starcevich, Luke W Garratt, Nicole C Shaw, Francis J Lannigan, Alexander N Larcombe, Graeme Zosky, Darryl A Knight, Paul J Rigby, Anthony Kicic, Stephen M Stick
Background: Apically located tight junctions in airway epithelium perform a fundamental role in controlling macromolecule migration through paracellular spaces. Alterations in their expression may lead to disruptions in barrier integrity, which subsequently facilitates entry of potential bacterial and other pathogens into the host. Furthermore, there is emerging evidence that the barrier integrity of the airway in certain airway inflammatory diseases may be altered. However, there is little consensus on the way this is assessed and measured and the type of cells used to achieve this...
2018: Biological Procedures Online
https://www.readbyqxmd.com/read/29427987/advances-and-evolving-concepts-in-allergic-asthma
#11
Hui-Ying Tung, Evan Li, Cameron Landers, An Nguyen, Farrah Kheradmand, J Morgan Knight, David B Corry
Allergic asthma is a heterogeneous disorder that defies a unanimously acceptable definition, but is generally recognized through its highly characteristic clinical expression of dyspnea and cough accompanied by clinical data that document reversible or exaggerated airway constriction and obstruction. The generally rising prevalence of asthma in highly industrialized societies despite significant therapeutic advances suggests that the fundamental cause(s) of asthma remain poorly understood. Detailed analyses of both the indoor (built) and outdoor environments continue to support the concept that not only inhaled particulates, especially carbon-based particulate pollution, pollens, and fungal elements, but also many noxious gases and chemicals, especially biologically derived byproducts such as proteinases, are essential to asthma pathogenesis...
February 2018: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29423947/the-effects-of-a-ccr3-inhibitor-axp1275-on-allergen-induced-airway-responses-in-adults-with-mild-to-moderate-atopic-asthma
#12
G M Gauvreau, J M FitzGerald, L P Boulet, R M Watson, L Hui, H Villineuve, T X Scime, A R Schlatman, C Obminski, J Kum, S Boehme, T W Ly, K B Bacon, P M O'Byrne
BACKGROUND: CCR3 is the cognate receptor for major human eosinophil chemoattractants from the eotaxin family of proteins that are elevated in asthma and correlate with disease severity. OBJECTIVE: This proof-of-mechanism study examined the effect of AXP1275, an oral, small-molecule inhibitor of CCR3, on airway responses to inhaled allergen challenge. METHODS: Twenty-one subjects with mild atopic asthma and documented early and late asthmatic responses to an inhaled aeroallergen completed a randomized double-blind crossover study to compare early and late allergen-induced asthmatic responses, methacholine PC20 , blood and sputum eosinophils, and exhaled nitric oxide after 2 weeks of treatment with once-daily doses of AXP1275 (50 mg) or placebo...
February 9, 2018: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29419332/alcohol-as-a-factor-in-911-calls-in-denver
#13
Daniel Joseph, Jody A Vogel, C Sam Smith, Whitney Barrett, Gary Bryskiewicz, Aaron Eberhardt, David Edwards, Lara Rappaport, Christopher B Colwell, Kevin E McVaney
BACKGROUND: Excessive alcohol consumption is associated with a substantial number of emergency department visits annually and is responsible for a significant number of lives lost each year in the United States. However, a minimal amount is known about the impact of alcohol on the EMS system. OBJECTIVES: The primary objective was to determine the proportion of 9-1-1 calls in Denver, Colorado in which (1) alcohol was a contributing factor or (2) the individual receiving EMS services had recently ingested alcohol...
February 8, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29417920/emergency-airway-management-in-a-simulation-of-highly-contagious-isolated-patients-both-isolation-strategy-and-device-type-matter
#14
Eike Plazikowski, Robert Greif, Jonas Marschall, Tina H Pedersen, Maren Kleine-Brueggeney, Roland Albrecht, Lorenz Theiler
OBJECTIVE To compare 6 airway-management devices in 3 isolation scenarios regarding their effect on airway management: portable isolation unit (PIU), personal protective equipment (PPE), and standard protection measures METHODS In total, 30 anesthesiologists working in emergency medical services performed airway management on mannequins in 3 isolation settings using 6 different airway management devices (in random order): (1) standard Macintosh laryngoscope; (2) Airtraq SP-video-laryngoscope; (3) i-gel; (4) LMA-Fastrach; (5) Ambu fiberoptic-aScope; and (6) Melker cricothyrotomy-set...
February 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29416585/predicting-difficult-intubation-in-emergency-department-by-intubation-assessment-score
#15
Winchana Srivilaithon, Sombat Muengtaweepongsa, Yuwares Sittichanbuncha, Jayanton Patumanond
Background: The difficult intubation is associated with failure of emergency tracheal intubation. This study aimed to develop and validate a model for predicting difficult intubation in emergency department (ED). Methods: A cross-sectional study was conducted in the ED. We collected data from all consecutive adult patients who underwent emergency tracheal intubation. Patients were excluded if they were intubated by low experience intubator. The difficult intubation was defined by grade III or IV of Cormack and Lehane classification...
March 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29416383/obstructive-sleep-apnea-current-perspectives
#16
REVIEW
Amal M Osman, Sophie G Carter, Jayne C Carberry, Danny J Eckert
The prevalence of obstructive sleep apnea (OSA) continues to rise. So too do the health, safety, and economic consequences. On an individual level, the causes and consequences of OSA can vary substantially between patients. In recent years, four key contributors to OSA pathogenesis or "phenotypes" have been characterized. These include a narrow, crowded, or collapsible upper airway "anatomical compromise" and "non-anatomical" contributors such as ineffective pharyngeal dilator muscle function during sleep, a low threshold for arousal to airway narrowing during sleep, and unstable control of breathing (high loop gain)...
2018: Nature and Science of Sleep
https://www.readbyqxmd.com/read/29416244/comparison-of-maintenance-emergence-and-recovery-characteristics-of-sevoflurane-and-desflurane-in-pediatric-ambulatory-surgery
#17
Manish B Kotwani, Anila D Malde
Background and Aims: Increasing number of pediatric ambulatory surgeries are being carried out in general anesthesia using supraglottic airways (SGAs). Literature comparing sevoflurane and desflurane for the maintenance of SGA-based anesthesia is limited. Hence, we planned this prospective randomized study to compare the maintenance, emergence and recovery characteristics of sevoflurane and desflurane for pediatric ambulatory surgery. Material and Methods: Sixty children aged 6 months to 6 years posted for short surgical procedures were enrolled into the study...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29416237/front-of-neck-access-a-survey-among-anesthetists-and-surgeons
#18
Cyprian Mendonca, Imran Ahmad, Achuthapillai Sajayan, Rathinavel Shanmugam, Manu Sharma, Will Tosh, Emily Pallister, Peter K Kimani
Background and Aims: Emergency front of neck access (FONA) is the final step in a Can't Intubate-Can't Oxygenate (CICO) scenario. In view of maintaining simplicity and promoting standardized training, the 2015 Difficult Airway Society guidelines recommend surgical cricothyroidotomy using scalpel, bougie, and tube (SBT) as the preferred technique. Material and Methods: We undertook a survey over a 2-week period to evaluate the knowledge and training, preferred rescue technique, and confidence in performing the SBT technique...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29414720/comparison-of-techniques-for-visualisation-of-the-airway-anatomy-for-ultrasound-assisted-intubation-a-prospective-study-of-emergency-department-patients
#19
Michael J Romano, Jacques S Lee, Jordan Chenkin
PURPOSE: Ultrasound has been shown to be a highly accurate adjunct for confirming endotracheal tube (ETT) placement, however there is no universally accepted scanning technique. The objective of this study was to determine which ultrasound technique provides the highest rate of adequate airway visualisation in a sample of stable emergency department (ED) patients. METHODS: We conducted a prospective observational study using a convenience sample of ED patients. Airway imaging was performed using the following five techniques: 1) transcricothryoid membrane (TCM), 2) suprasternal notch (SSN) without transducer pressure, 3) SSN with pressure, 4) SSN with pressure to the left of the trachea and 5) SSN with pressure to the right of the trachea...
February 4, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29413501/integration-of-3d-printing-and-additive-manufacturing-in-the-interventional-pulmonologist-s-toolbox
#20
Nicolas Guibert, Laurent Mhanna, Alain Didier, Benjamin Moreno, Pierre Leyx, Gavin Plat, Julien Mazieres, Christophe Hermant
New 3D technologies are rapidly entering into the surgical landscape, including in interventional pulmonology. The transition of 2D restricted data into a physical model of pathological airways by three-dimensional printing (3DP) allows rapid prototyping and fabrication of complex and patient-specific shapes and can thus help the physician to plan and guide complex procedures. Furthermore, computer-assisted designed (CAD) patient-specific devices have already helped surgeons overcome several therapeutic impasses and are likely to rapidly cover a wider range of situations...
January 2018: Respiratory Medicine
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