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https://www.readbyqxmd.com/read/28443680/periodic-breathing-during-incremental-exercise
#1
Piergiuseppe Agostoni, Ugo Corrà, Michele Emdin
Periodic breathing during incremental cardiopulmonary exercise testing is a regularly recurring waxing and waning of tidal volume due to oscillations in central respiratory drive. Periodic breathing is a sign of respiratory control system instability, which may occur at rest or during exercise. The possible mechanisms responsible of exertional periodic breathing might be related to any instability of the ventilatory regulation caused by: 1) increased circulatory delay (i.e., circulation time from the lung to the brain and chemoreceptors, due to reduced cardiac index leading to delay in information transfer), 2) increase in controller gain (i...
April 26, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28441238/diaphragm-activation-in-ventilated-patients-using-a-novel-transvenous-phrenic-nerve-pacing-catheter
#2
Steven Reynolds, Adrian Ebner, Tracy Meffen, Viral Thakkar, Matt Gani, Kaity Taylor, Linda Clark, Gautam Sadarangani, Ramasamy Meyyappan, Rodrigo Sandoval, Elizabeth Rohrs, Joaquín A Hoffer
OBJECTIVES: Over 30% of critically ill patients on positive-pressure mechanical ventilation have difficulty weaning from the ventilator, many of whom acquire ventilator-induced diaphragm dysfunction. Temporary transvenous phrenic nerve pacing using a novel electrode-bearing catheter may provide a means to prevent diaphragm atrophy, to strengthen an atrophied diaphragm, and mitigate the harms of mechanical ventilation. We tested the initial safety, feasibility, and impact on ventilation of this novel approach...
April 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28420762/resting-heart-rate-variability-and-exercise-capacity-in-type-1-diabetes
#3
Luke C Wilson, Karen C Peebles, Neil A Hoye, Patrick Manning, Catherine Sheat, Michael J A Williams, Gerard T Wilkins, Genevieve A Wilson, James C Baldi
People with type 1 diabetes (T1D) have lower exercise capacity (V̇O2max) than their age-matched nondiabetic counterparts (CON), which might be related to cardiac autonomic dysfunction. We examined whether Heart Rate Variability (HRV; indicator of cardiac autonomic modulation) was associated with exercise capacity in those with and without T1D. Twenty-three participants with uncomplicated T1D and 17 matched CON were recruited. Heart rate (HR; ECG), blood pressure (BP; finger photo-plethysmography), and respiratory rate (respiratory belt) were measured during baseline, paced-breathing and clinical autonomic reflex tests (CARTs); deep breathing, lying-to-stand, and Valsalva maneuver...
April 2017: Physiological Reports
https://www.readbyqxmd.com/read/28416458/on-the-origins-of-sex-based-differences-in-respiratory-disorders-lessons-and-hypotheses-from-stress-neuroendocrinology-in-developing-rats
#4
REVIEW
Jean-Philippe Rousseau, Luana Tenorio-Lopes, Cécile Baldy, Tara Adele Janes, Stéphanie Fournier, Richard Kinkead
The environment plays a critical role in shaping development and function of the brain. Stress, especially when experienced early in life, can interfere with these processes. In the context of respiratory control, perinatal stress can therefore alter the ability to achieve the "fine-tuning" necessary for proper detection of chemosensory stimuli and production of an adequate motor (respiratory) command. Depending on the timing, intensity, and duration, the detrimental consequences of perinatal exposure to adverse conditions on the respiratory network become manifest at various life stages and can persist into adulthood...
April 14, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28396860/aortic-valve-replacement-for-moderate-aortic-stenosis-with-severe-calcification-and-left-ventricualr-dysfunction-a-case-report-and-review-of-the-literature
#5
Nikhil Narang, Roberto M Lang, Vladimir M Liarski, Valluvan Jeevanandam, Marion A Hofmann Bowman
A 55-year-old man with a history of erosive, seropositive rheumatoid arthritis (RA), and interstitial lung disease presented with shortness of breath. Echocardiography showed new-onset severe left ventricular (LV) dysfunction with an ejection fraction (EF) of 15% and moderately increased mean aortic valve gradient of 20 mmHg in a trileaflet aortic valve with severe sclero-calcific degeneration. Coronary angiography revealed no significant obstructive coronary disease. Invasive hemodynamic studies and dobutamine stress echocardiography were consistent with moderate aortic stenosis...
2017: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28394263/elevating-expression-of-mecp2-t158m-rescues-dna-binding-and-rett-syndrome-like-phenotypes
#6
Janine M Lamonica, Deborah Y Kwon, Darren Goffin, Polina Fenik, Brian S Johnson, Yue Cui, Hengyi Guo, Sigrid Veasey, Zhaolan Zhou
Mutations in the X-linked gene encoding methyl-CpG-binding protein 2 (MeCP2) cause Rett syndrome (RTT), a neurological disorder affecting cognitive development, respiration, and motor function. Genetic restoration of MeCP2 expression reverses RTT-like phenotypes in mice, highlighting the need to search for therapeutic approaches. Here, we have developed knockin mice recapitulating the most common RTT-associated missense mutation, MeCP2 T158M. We found that the T158M mutation impaired MECP2 binding to methylated DNA and destabilized MeCP2 protein in an age-dependent manner, leading to the development of RTT-like phenotypes in these mice...
April 10, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28381508/clinical-manifestations-of-the-anti-iglon5-disease
#7
Carles Gaig, Francesc Graus, Yarko Compta, Birgit Högl, Luis Bataller, Norbert Brüggemann, Caroline Giordana, Anna Heidbreder, Katya Kotschet, Jan Lewerenz, Stefan Macher, Maria J Martí, Teresa Montojo, Jesus Pérez-Pérez, Inmaculada Puertas, Caspar Seitz, Mateus Simabukuro, Nieves Téllez, Klaus-Peter Wandinger, Alex Iranzo, Guadalupe Ercilla, Lidia Sabater, Joan Santamaría, Josep Dalmau
OBJECTIVE: To report the presentation, main syndromes, human leukocyte antigen (HLA) association, and immunoglobulin G (IgG) subclass in the anti-IgLON5 disease: a disorder with parasomnias, sleep apnea, and IgLON5 antibodies. METHODS: This was a retrospective clinical analysis of 22 patients. The IgG subclass was determined using reported techniques. RESULTS: Patients' median age was 64 years (range 46-83). Symptoms that led to initial consultation included sleep problems (8 patients; 36%), gait abnormalities (8; 36%), bulbar dysfunction (3; 14%), chorea (2; 9%), and cognitive decline (1; 5%)...
April 5, 2017: Neurology
https://www.readbyqxmd.com/read/28377567/chronic-granulomatous-disease-presenting-as-aspergillus-fumigatus-pneumonia-in-a-previously-healthy-young-woman
#8
David Williams, Dipen Kadaria, Amik Sodhi, Roy Fox, Glenn Williams, Stephen Threlkeld
BACKGROUND Chronic Granulomatous Disease (CGD) is a rare immunodeficiency disease caused by a genetic defect in the NADPH (nicotinamide adenine dinucleotide phosphate) oxidase enzyme, resulting in increased susceptibility to bacterial and fungal infections. The inheritance can be X-linked or autosomal recessive. Patients usually present with repeated infections early in life. We present an unusual case of a 23-year-old patient diagnosed with CGD. CASE REPORT A 23-year-old white woman with no previous history of recurrent infections presented with complaints of fever, shortness of breath, and diffuse myalgia...
April 5, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28374233/neurological-deficits-in-obstructive-sleep-apnea
#9
REVIEW
Luigi Ferini-Strambi, Giulia Elisabetta Lombardi, Sara Marelli, Andrea Galbiati
Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder characterized by repetitive episodes of complete or partial obstruction of the upper airway. The prevalence of this disorder is strictly dependent on its gravity. At ≥15 events/h apnea-hypopnea index (AHI), it ranges from 6 to 17% in the general population, with higher rates in men and increasing with age. The hypoxia induced by OSA severely affects the structure and function of blood vessels, culminating in mortality and morbidity...
April 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28373993/efficacy-of-administration-of-an-angiotensin-converting-enzyme-inhibitor-for-two-years-on-autonomic-and-peripheral-neuropathy-in-patients-with-diabetes-mellitus
#10
Triantafyllos Didangelos, Konstantinos Tziomalos, Charalambos Margaritidis, Zisis Kontoninas, Ioannis Stergiou, Stefanos Tsotoulidis, Eleni Karlafti, Alexandros Mourouglakis, Apostolos I Hatzitolios
Aim. To evaluate the effect of quinapril on diabetic cardiovascular autonomic neuropathy (CAN) and peripheral neuropathy (DPN). Patients and Methods. Sixty-three consecutive patients with diabetes mellitus [43% males, 27 with type 1 DM, mean age 52 years (range 22-65)], definite DCAN [abnormal results in 2 cardiovascular autonomic reflex tests (CARTs)], and DPN were randomized to quinapril 20 mg/day (group A, n = 31) or placebo (group B, n = 32) for 2 years. Patients with hypertension or coronary heart disease were excluded...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28368706/resting-physiological-correlates-of-reduced-exercise-capacity-in-smokers-with-mild-airway-obstruction
#11
Amany F Elbehairy, Azmy Faisal, Jordan A Guenette, Dennis Jensen, Katherine A Webb, Rashid Ahmed, J Alberto Neder, Denis E O'Donnell
Smokers with minor spirometric abnormalities can experience persistent activity-related dyspnea and exercise intolerance. Additional resting tests can expose heterogeneous physiological abnormalities, but their relevance and association with clinical outcomes remain uncertain. Subjects included sixty-two smokers (≥20 pack-years), with cough and/or dyspnea and minor airway obstruction [forced expiratory volume in one-second (FEV1) ≥80% predicted and >5th percentile lower limit of normal (LLN) (i.e., z-score >-1...
April 3, 2017: COPD
https://www.readbyqxmd.com/read/28368127/is-centric-relation-always-the-position-of-choice-for-tmds-case-report-of-how-tmd-and-airway-dimension-may-be-associated
#12
William E Harrell, Tim Tatum, Mike Koslin
Centric occlusion (CO) and centric relation (CR) have been controversial topics in dentistry for almost 100 years. The concept of CR emerged due to the search for a reproducible mandibular position that would enable the prosthodontic rehabilitation of patients needing denture treatment. The following case study is unique because of 2 questions. Which mandibular treatment splint position (CR or CO) was appropriate for the initial and eventual final treatment of this patient for her temporomandibular disorder/myofascial pain and dysfunction? Also, how might the mandibular position of CR and CO affect the size and shape of the airway? The airway's size and shape is important as it relates to sleep-disordered breathing and potentially leading to obstructive sleep apnea later in life...
April 2017: Compendium of Continuing Education in Dentistry
https://www.readbyqxmd.com/read/28365802/biomarkers-in-the-evaluation-and-management-of-chronic-rhinosinusitis-with-nasal-polyposis
#13
REVIEW
Yao Yao, Shumin Xie, Chunguang Yang, Jianhui Zhang, Xuewen Wu, Hong Sun
Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a group of multifactorial and heterogeneous disorders with a significant economic strain on society, likely made up of different endotypes, each with a unique pathomechanism. In addition to the traditional clinical measures, there is a recognized need for reliable biomarkers to provide predictive information regarding diagnosis, endotypes, treatment responses, and future risk of recurrence. Fueled by the advances in basic research, various biomarkers have been explored in recent years...
April 1, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28362819/hydrogen-gas-alleviates-oxygen-toxicity-by-reducing-hydroxyl-radical-levels-in-pc12-cells
#14
Junchao Yu, Qiuhong Yu, Yaling Liu, Ruiyun Zhang, Lianbi Xue
Hyperbaric oxygen (HBO) therapy through breathing oxygen at the pressure of above 1 atmosphere absolute (ATA) is useful for varieties of clinical conditions, especially hypoxic-ischemic diseases. Because of generation of reactive oxygen species (ROS), breathing oxygen gas at high pressures can cause oxygen toxicity in the central nervous system, leading to multiple neurological dysfunction, which limits the use of HBO therapy. Studies have shown that Hydrogen gas (H2) can diminish oxidative stress and effectively reduce active ROS associated with diseases...
2017: PloS One
https://www.readbyqxmd.com/read/28361079/ultrasound-to-assess-diaphragmatic-function-in-the-critically-ill-a-critical-perspective
#15
EDITORIAL
Mark Haaksma, Pieter Roel Tuinman, Leo Heunks
Ultrasound of the diaphragm in critically ill patients has become a diagnostic technique of emerging interest among clinicians and scientists. The advantages include that it is widely available, non-invasive and examination can be performed after relatively short training and at low costs. It is used to estimate muscle mass by measurement of muscle thickness and diagnose weakness by the assessment of diaphragm movement during unassisted breathing. Thickening of the muscle during inspiration has been used to quantify force generation...
March 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28358288/profile-of-orofacial-dysfunction-in-brazilian-children-using-the-nordic-orofacial-test-screening
#16
Bianca Lopes Cavalcante-Leão, Sara Regina Barancelli Todero, Fernanda Morais Ferreira, Maria Beatriz Duarte Gavião, Fabian Calixto Fraiz
OBJECTIVE: The parameters of orofacial dysfunction (OFD) in children can guide clinicians and researchers in the monitoring of deviations from normality. The aim for this study was to evaluate manifestation patterns and the prevalence of OFD in children. MATERIALS AND METHODS: A population-based cross-sectional study was conducted involving 531 schoolchildren (8-10 years old) in a small city in southern Brazil. OFD was evaluated using the Nordic Orofacial Test-Screening (NOT-S)...
May 2017: Acta Odontologica Scandinavica
https://www.readbyqxmd.com/read/28357505/identification-of-left-ventricle-failure-on-pulmonary-artery-cta-diagnostic-significance-of-decreased-aortic-left-ventricle-enhancement
#17
Abhishek Chaturvedi, Joel P Thompson, Katherine Kaproth-Joslin, Susan K Hobbs, Karl Q Schwarz, Vijay K Krishnamoorthy, Apeksha Chaturvedi, Timothy Baran
PURPOSE: This study aimed to identify findings on non-ECG-gated CT pulmonary angiography (CTPA) indicating decreased left ventricle (LV) systolic function, later confirmed by echocardiogram. METHODS: After obtaining institutional review board approval, review was performed of emergency department (ED) patients who had CTPA and follow-up echocardiogram within 48 h, over 18 months. Patients with pulmonary embolus, suboptimal CTPA, arrhythmias or pericardial tamponade were excluded...
March 29, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28353593/warming-infusion-improves-perioperative-outcomes-of-elderly-patients-who-underwent-bilateral-hip-replacement
#18
RANDOMIZED CONTROLLED TRIAL
He Ma, Bingjie Lai, Shanshan Dong, Xinyu Li, Yunfeng Cui, Qianchuang Sun, Wenhua Liu, Wei Jiang, Feng Xu, Hui Lv, Hongyu Han, Zhenxiang Pan
BACKGROUND: This prospective, randomized, and controlled study was performed to determine the benefits of prewarmed infusion in elderly patients who underwent bilateral hip replacement. METHODS: Between September 2015 and April 2016, elderly patients who underwent bilateral hips replacement that met the inclusion and exclusion criteria were included in this study. After inclusion, patients were randomized into one of the study groups: in the control group, patients received an infusion of fluid kept at room temperature (22-23°C); in the warming infusion group, patients received an infusion of fluid warmed using an infusion fluid heating apparatus (35°C)...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28351539/cardiovascular-autonomic-dysfunction-in-children-and-adolescents-with-rett-syndrome
#19
Ajay Kumar, Ashok Jaryal, Sheffali Gulati, Biswaroop Chakrabarty, Akanksha Singh, K K Deepak, R M Pandey, Neerja Gupta, Savita Sapra, Madhulika Kabra, Rajni Khajuria
BACKGROUND: Autonomic dysfunction is common in children with Rett syndrome. They usually manifest with agitation, persistent screaming, constipation, gastroesophageal reflux, aerophagia, hyperventilation, and breath-holding episodes. Cardiovascular autonomic dysfunction may result in fatal a arrhythmia. Many of these events are mistaken for seizures and treated with antiepileptics. METHODS: The present study was conducted in a tertiary care teaching hospital in north India for more than a six month period...
January 17, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28343445/a-case-of-anagrelide-induced-nonischemic-cardiomyopathy-in-a-patient-with-essential-thrombocythemia
#20
Pritpal Singh
BACKGROUND: Anagrelide is an established treatment option for essential thrombocythemia (ET). Cardiovascular adverse events can occur with its use including heart failure and cardiomyopathy. CASE REPORT: A 52-year-old African American male with ET presented with chest pain, shortness of breath, and dyspnea on exertion. His ET was managed with hydroxyurea 1500 mg by mouth twice a day and anagrelide 1 mg by mouth 3 times a day. The patient was receiving anagrelide for approximately 2 years prior to presentation...
January 1, 2017: Journal of Pharmacy Practice
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