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inhalational agents

Jennifer H Madenspacher, Michael B Fessler
Although community-acquired pneumonia remains a major public health problem, murine models of bacterial pneumonia have recently facilitated significant preclinical advances in our understanding of the underlying cellular and molecular pathogenesis. In vivo mouse models capture the integrated physiology and resilience of the host defense response in a manner not revealed by alternative, simplified ex vivo approaches. Several methods have been described in the literature for intrapulmonary inoculation of bacteria in mice, including aerosolization, intranasal delivery, peroral endotracheal cannulation under 'blind' and visualized conditions, and transcutaneous endotracheal cannulation...
September 28, 2016: Journal of Visualized Experiments: JoVE
J P Cata, K B Hagan, S D O Bhavsar, R Arunkumar, R Grasu, A Dang, R Carlson, B Arnold, Y Potylchansky, I Lipski, T McHugh, F Jimenez, A T Nguyen, L Feng, T F Rahlfs
BACKGROUND: Several studies have examined the impact of anesthetics on cancer recurrence. Isoflurane but not desflurane has protumoral effects. We hypothesize the use of isoflurane but not desflurane during surgery for primary GBM is an independent predictor of disease progression and mortality. METHODS: 378 adult patients were included in the study. The progression free survival (PFS) and overall survival (OS) rates at 1 and 5years were compared in patients who had either desflurane or isoflurane alone or in combination with propofol infusion...
October 17, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Rajasree Omanakutty Amma, Subha Ravindran, Rachel Cherian Koshy, K M Jagathnath Krishna
BACKGROUND AND AIMS: With the availability of modern workstations and heightened awareness on the environmental effects of waste anaesthesia gases, anaesthesiologists worldwide are practicing low flow anaesthesia (LFA). Although LFA is being practiced in India, hard evidence on the current practice of the same from anaesthesiologists practicing in India is lacking and hence, we conducted this survey. METHODS: A questionnaire containing 16 questions was distributed among a subgroup of anaesthesiologists who attended the 2014 National Conference of Indian Society of Anaesthesiologists...
October 2016: Indian Journal of Anaesthesia
Jason J Rose, Ling Wang, Qinzi Xu, Charles F McTiernan, Sruti Shiva, Jesus Tejero, Mark T Gladwin
Carbon monoxide (CO) poisoning affects 50,000 people a year in the United States. The clinical presentation runs a spectrum, ranging from headache and dizziness to coma and death, with a mortality rate ranging from 1-3%. A significant number of patients who survive CO poisoning suffer from long term neurologic and affective sequelae. The neurologic deficits do not necessarily correlate with blood CO levels, but likely result from the pleiotropic effects of CO on cellular mitochondrial respiration, cellular energy utilization, inflammation and free radical generation, especially in the brain and heart...
October 18, 2016: American Journal of Respiratory and Critical Care Medicine
Jennifer M Willingham-Lane, Londa J Berghaus, Steeve Giguère, Mary K Hondalus
The soil-dwelling, saprophytic actinomycete Rhodococcus equi is a multihost, facultative intracellular pathogen of macrophages. When inhaled by susceptible foals, it causes severe bronchopneumonia. It is also a pathogen of pigs, which may develop submaxillary lymphadenitis upon exposure. R. equi isolates obtained from foals and pigs possess conjugative plasmids housing a pathogenicity island (PAI) containing a novel family of genes of unknown function called the virulence-associated protein or vap family. The PAI regions of the equine and swine plasmids differ in vap gene composition, with equine isolates possessing six vap genes, including the major virulence determinant vapA, while the PAIs of swine isolates house vapB and five other unique vap genes...
September 2016: MSphere
Alexandre Y Saito, Adriana A Marin Rodriguez, Danielle S Menchaca Vega, Rodrigo A C Sussmann, Emília A Kimura, Alejandro M Katzin
Malaria, an infectious disease that kills more than 438,000 people per year worldwide, is a major public health problem. The emergence of strains resistant to conventional therapeutic agents necessitates the discovery of new drugs. We previously demonstrated that various substances, including terpenes, have antimalarial activity in vitro and in vivo. Nerolidol is a sesquiterpene present as an essential oil in several plants that is used in scented products and has been approved by the US Food and Drug Administration as a food-flavouring agent...
September 30, 2016: International Journal of Antimicrobial Agents
Laveena Munshi, Hayley B Gershengorn, Eddy Fan, Hannah Wunsch, Niall D Ferguson, Therese A Stukel, Gordon D Rubenfeld
RATIONALE: Adoption and de-adoption of adjuvant strategies to mechanical ventilation for acute respiratory failure (ARF), and factors associated with their selection, have not been extensively evaluated. OBJECTIVES: To evaluate change in use of adjuvants to mechanical ventilation for ARF (2008-2013), the impact of landmark publications on adoption and de-adoption, and factors associated with use. METHODS: Changes in use of four adjuvants for ARF from 2008-2013, the impact of landmark publications on use, and factors associated with use were evaluated using the Premier Database...
October 13, 2016: Annals of the American Thoracic Society
Sarah E Bigby, Jennifer E Carter, Sébastien Bauquier, Thierry Beths
Anesthesia protocols for patients with intracranial lesions need to provide hemodynamic stability, preserve cerebrovascular autoregulation, avoid increases in intracranial pressure, and facilitate a rapid recovery. Propofol total intravenous anesthesia (TIVA) maintains cerebral blood flow autoregulation and is considered superior to inhalant agents as an anesthetic protocol for patients with intracranial lesions. A propofol-based TIVA subsequent to premedication with medetomidine and diazepam was used in a king penguin ( Aptenodytes patagonicus ) undergoing magnetic resonance imaging of the brain after a new onset of seizures...
September 2016: Journal of Avian Medicine and Surgery
Polpun Boonmak, Suhattaya Boonmak, Malinee Laopaiboon
BACKGROUND: Functional endoscopic sinus surgery (FESS) is a minimally invasive technique that is used to treat chronic sinusitis. Small bleeding areas can reduce operative visibility and result in destruction of surrounding structures. Deliberate hypotension (lowering the mean arterial blood pressure to between 50 and 65 mm Hg in normotensive patients) using a range of pharmacological agents during general anaesthesia reduces blood loss in many operations. This review was originally published in 2013 and updated in February 2016...
October 12, 2016: Cochrane Database of Systematic Reviews
Jinling Xue, Jinshan Zhang, Bi Xu, Jiani Xie, Wenzhao Wu, Yun Lu
Use of reclaimed water for non potable uses requires consideration of potential adverse health effects. Considering that inhalation can be a significant transmission route of microorganisms and inflammatory agents, this study used a mouse model to test the possible adverse effects of reclaimed water use during car washing where aerosols are generated. Intensive innate immune responses were found in the lungs after acute exposure, and lavage polymorphonuclear cell proportion was the most sensitive endpoint. Four types of evidence are presented to demonstrate that the main risk factor initiating innate inflammation is the free endotoxin: 1) Small molecules (<10KD) cannot induce inflammation; 2) The endotoxin levels of 11 water samples from 5 different plants showed positive correlations with inflammatory responses; 3) Actual water samples showed similar activities with free endotoxins other than bacteria-bound endotoxins; and 4) Specific removal of endotoxins with polymyxin B affinity chromatography further confirmed the role of free endotoxins...
October 6, 2016: Environmental Science & Technology
Carlos Ac Pereira, Andréa Gimenez, Lilian Kuranishi, Karin Storrer
Hypersensitivity pneumonitis (HSP) is a common interstitial lung disease resulting from inhalation of a large variety of antigens by susceptible individuals. The disease is best classified as acute and chronic. Chronic HSP can be fibrosing or not. Fibrotic HSP has a large differential diagnosis and has a worse prognosis. The most common etiologies for HSP are reviewed. Diagnostic criteria are proposed for both chronic forms based on exposure, lung auscultation, lung function tests, HRCT findings, bronchoalveolar lavage, and biopsies...
2016: Journal of Asthma and Allergy
Peiying Liu, Babu G Welch, Yang Li, Hong Gu, Darlene King, Yihong Yang, Marco Pinho, Hanzhang Lu
Diagnosis and treatment monitoring of cerebrovascular diseases routinely require hemodynamic imaging of the brain. Current methods either only provide part of the desired information or require the injection of multiple exogenous agents. In this study, we developed a multiparametric imaging scheme for the imaging of brain hemodynamics and function using gas-inhalation MRI. The proposed technique uses a single MRI scan to provide simultaneous measurements of baseline venous cerebral blood volume (vCBV), cerebrovascular reactivity (CVR), bolus arrival time (BAT), and resting-state functional connectivity (fcMRI)...
September 28, 2016: NeuroImage
Thomas J Johnson, Jahan Porhomayon, Nader D Nader, Enas Eldesouki, Kelly Smith, Geoffrey G Hobika
We present a case that involves anesthetic resistance during anesthesia for electroconvulsive therapy. Despite adequate dosing of both intravenous and inhalation anesthetics, our patient was resistant to induction of the state of general anesthesia. Subsequently, we noticed extreme hyperlipidemia. We hypothesized that the patient's extreme hyperlipidemia served as an anesthetic "sink" and prevented the full dose of intravenous agents from quickly reaching their intended site of action.
November 2016: Journal of Clinical Anesthesia
Richard J Albertini, Debra A Kaden
Formaldehyde (FA) is a mutagenic chemical - a property mitigated in vivo by rapid detoxification and limited tissue distribution following inhalation of the free agent. Endogenously produced FA is necessary for life and required for one-carbon transfer reactions; however, FA derived from external sources (exogenous FA), which may be in the form of methanol, may increase in vivo concentrations above naturally occurring physiological levels. Both endogenous and exogenous FA produce DNA monoadducts, DNA-DNA and DNA-protein cross-links (DDX and DPX) but, when exposed to exogenously-derived free FA, DNA monoadducts, DDX, and DPX are only produced at initial sites of contact...
August 11, 2016: Critical Reviews in Toxicology
Fabio Rosario Salerno, Grace Parraga, Christopher William McIntyre
Dyspnea is one of the most common symptoms associated with CKD. It has a profound influence on the quality of life of CKD patients, and its underlying causes are often associated with a negative prognosis. However, its pathophysiology is poorly understood. While hemodialysis may address fluid overload, it often does not significantly improve breathlessness, suggesting multiple and co-existing alternative issues exist. The aim of this article is to discuss the main pathophysiologic mechanisms and the most important putative etiologies underlying dyspnea in CKD patients...
September 28, 2016: Seminars in Dialysis
Nobuyuki Horita, Takeshi Kaneko
Corticosteroids are key medications to treat pulmonary diseases. A variety of medications, doses, administration route, and duration of corticosteroids were chosen for each of pulmonary diseases. Although corticosteroids are potent medications, they often cause serious adverse effects such as osteoporosis, diabetes, and immunosuppression. Thus, physicians have to properly assess the risk of adverse effects to prevent them. In this review, we discuss the risk of osteoporosis by corticosteroids that are prescribed for pulmonary diseases...
2016: Clinical Calcium
Silvia L Cruz, Marcia Y Gauthereau-Torres, María Teresa Rivera-García
Several organic solvents have anticonvulsant or convulsant actions depending on the dose and exposure time. To study if there is a structure-activity relationship for organic solvents as anticonvulsant agents we subjected independent groups of mice to a single 30-min exposure session to inhale n-hexane, cyclohexane, benzene (8000ppm each), toluene (500-6000ppm), m-xylene (1000-6000ppm), ethylbenzene (500-4000ppm) or propylbenzene (500-4000ppm). Immediately after, animals were injected i.p. with 90mg/kg pentylenetetrazol (PTZ) and re-exposed to the same solvent for another 30min...
September 20, 2016: Neurotoxicology
T Cloake, T Haigh, J Cheshire, D Walker
In South Africa, burns are a major public health problem responsible for significant morbidity and long-term physical disability. This is, in part, due to a significant proportion of the urban population living in poorly constructed, combustible accommodation. The presence of co-morbid diseases such as diabetes and malignancy in patients with burns has been associated with a poorer outcome. The impact of other diseases such as HIV has yet to be defined. A retrospective data collection study analysed the 221 patients admitted to Tygerberg Hospital Burns Unit in 2011 and the first six months of 2013...
September 19, 2016: Burns: Journal of the International Society for Burn Injuries
Fatemeh Moheimani, Alan C-Y Hsu, Andrew T Reid, Teresa Williams, Anthony Kicic, Stephen M Stick, Philip M Hansbro, Peter A B Wark, Darryl A Knight
Asthma is a global health problem with increasing prevalence. The airway epithelium is the initial barrier against inhaled noxious agents or aeroallergens. In asthma, the airway epithelium suffers from structural and functional abnormalities and as such, is more susceptible to normally innocuous environmental stimuli. The epithelial structural and functional impairments are now recognised as a significant contributing factor to asthma pathogenesis. Both genetic and environmental risk factors play important roles in the development of asthma with an increasing number of genes associated with asthma susceptibility being expressed in airway epithelium...
2016: Respiratory Research
Yoav Gal, Anita Sapoznikov, Reut Falach, Sharon Ehrlich, Moshe Aftalion, Tamar Sabo, Chanoch Kronman
The plant-toxin ricin, is considered a biological threat agent of concern and is most toxic when inhaled. Pulmonary exposure to a lethal dose of ricin can be redressed by treatment with anti-ricin antibodies, however late antitoxin intervention is of limited efficacy. This limitation is associated with the overt lung damage, clinically manifested as severe pulmonary inflammation, which develops over time. Increased evidence indicates that ciprofloxacin, a broad spectrum anti-microbial agent, possesses immunomodulatory properties...
September 19, 2016: Antimicrobial Agents and Chemotherapy
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