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https://www.readbyqxmd.com/read/28629918/trajectories-of-emergent-central-sleep-apnea-during-continuous-positive-airway-pressure-therapy
#1
Dongquan Liu, Jeff Armitstead, Adam Benjafield, Shiyun Shao, Atul Malhotra, Peter A Cistulli, Jean-Louis Pepin, Holger Woehrle
BACKGROUND: Emergence of central sleep apnea (CSA) during positive airway pressure (PAP) therapy has been observed clinically in ≈10% of OSA titration studies. This study assessed a PAP database to investigate trajectories of treatment-emergent CSA during continuous PAP (CPAP) therapy. METHODS: US telemonitoring device data were analyzed for the presence/absence of emergent CSA at baseline (Week 1) and Week 13. Defined groups were: obstructive sleep apnea (OSA; average central apnea index [CAI] <5/hour in Week 1, <5/hour in Week 13); transient CSA (CAI ≥5/hour in Week 1, <5/hour in Week 13); persistent CSA (CAI ≥5/hour in Week 1, ≥5/hour in Week 13); emergent CSA (CAI <5/hour in Week 1, ≥5/hour in Week 13)...
June 16, 2017: Chest
https://www.readbyqxmd.com/read/28623537/durability-of-silicone-airway-stents-in-the-management-of-benign-central-airway-obstruction
#2
Justin M Karush, Christopher W Seder, Anish Raman, Gary W Chmielewski, Michael J Liptay, William H Warren, Andrew T Arndt
PURPOSE: The literature is devoid of a comprehensive analysis of silicone airway stenting for benign central airway obstruction (BCAO). With the largest series in the literature to date, we aim to demonstrate the safety profile, pattern of re-intervention, and duration of silicone airway stents. METHODS: An institutional database was used to identify patients with BCAO who underwent rigid bronchoscopy with dilation and silicone stent placement between 2002 and 2015 at Rush University Medical Center...
June 16, 2017: Lung
https://www.readbyqxmd.com/read/28616369/management-of-an-obstructed-tracheostomy-in-a-limited-resource-setting
#3
Julie Chiaravalli, Norman Lufesi, Elwin Shawa, Vitumbiko Nkhoma, Elaine Sigalet, Adam Dubrowski
Obstruction of a tracheostomy tube is a common cause of respiratory compromise in adults and pediatric patients, which can lead to a life-threatening emergency if it is not properly managed. Compromised airway patency has many potential etiologies; however, the scenario described in this technical report focuses specifically on the management of tracheostomy obstruction through the presence of a mucus plug, blood clot, or highly viscous secretions. The simulation described in this technical report was written to be conducted as an in-situ simulation within the intensive care unit (ICU) at Mzuzu Central Hospital, Malawi...
May 13, 2017: Curēus
https://www.readbyqxmd.com/read/28614224/a-case-report-of-local-treatment-of-inoperable-squamous-cell-lung-carcinoma-with-convex-probe-endobronchial-ultrasound-guided-intratumoral-injection-of-cisplatin-in-a-patient-with-severe-copd
#4
Xiaochen Li, Xiansheng Liu, Xiaoling Rao, Jianping Zhao, Yongjian Xu, Min Xie
RATIONALE: Endobronchial ultrasound as a powerful diagnostic technology can also be used to perform intratumoral chemotherapy for extraluminal tumor. PATIENT CONCERNS: A 69-year-old man with chronic obstructive pulmonary disease (COPD) presented with worsening dyspnea. A pulmonary function test showed severe airway obstruction and that forced expiratory volume in 1 s was 43% of the predicted value after a bronchodilator. DIAGNOSES: A bronchoscopy and histopathological analyses revealed a squamous cell carcinoma mostly located outside of the lumen with central airway obstruction...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28606600/maximizing-functional-outcomes-in-head-and-neck-cancer-survivors-assessment-and-rehabilitation
#5
REVIEW
Nausheen Jamal, Barbara Ebersole, Andrew Erman, Dinesh Chhetri
With increases in survivorship for patients with head and neck cancer, attention is turning to quality-of-life issues for survivors. Care for these patients is multifaceted. Dysphagia and issues of voice/speech, airway obstruction, neck and shoulder dysfunction, lymphedema, and pain control are important to address. Rehabilitation interventions are patient-specific and aim to prevent, restore, compensate, and palliate symptoms and sequelae of treatment for optimal functioning. Central to providing comprehensive interdisciplinary care are the head and neck surgeon, laryngologist, and speech-language pathologist...
June 9, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28592026/-clinical-analysis-of-therapeutic-bronchoscopy-for-tracheal-neoplasm
#6
Y F Ding, L Chen, H D Huang, Y C Dong, X P Yao, Y Huang, Q Wang, W Zhang, Q Li, C Bai
Objective: To analyze the clinical features in adults with tracheal neoplasm and to evaluate the efficacy of interventional bronchoscopic treatment. Methods: We retrospectively analyzed the clinical features of 43 adults undergoing therapeutic bronchoscopy for tracheal neoplasm diagnosed in Changhai Hospital affiliated to the Second Military Medical University from January 2004 to July 2014.The degree of stenosis, the grade of dyspnea, and Karnofsky performance status scale were evaluated before and after the last procedure...
June 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28571678/central-airway-obstruction-due-to-inflammatory-bowel-disease-and-rescue-with-extracorporeal-membrane-oxygenation
#7
M Ramírez-Romero, B Hernández-Alonso, C García-Polo, A J Abraldes-Bechiarelli, A Garrino-Fernández, A Gordillo-Brenes
No abstract text is available yet for this article.
May 29, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28562365/role-of-the-inflammasome-in-chronic-obstructive-pulmonary-disease-copd
#8
Chiara Colarusso, Michela Terlizzi, Antonio Molino, Aldo Pinto, Rosalinda Sorrentino
Inflammation is central to the development of chronic obstructive pulmonary disease (COPD), a pulmonary disorder characterized by chronic bronchitis, chronic airway obstruction, emphysema, associated to progressive and irreversible decline of lung function. Emerging genetic and pharmacological evidence suggests that IL-1-like cytokines are highly detected in the sputum and broncho-alveolar lavage (BAL) of COPD patients, implying the involvement of the multiprotein complex inflammasome. So far, scientific evidence has focused on nucleotide-binding oligomerization domain-like receptors protein 3 (NLRP3) inflammasome, a specialized inflammatory signaling platform that governs the maturation and secretion of IL-1-like cytokines through the regulation of caspase-1-dependent proteolytic processing...
May 13, 2017: Oncotarget
https://www.readbyqxmd.com/read/28555461/high-flow-nasal-cannulae-for-respiratory-support-in-adult-intensive-care-patients
#9
REVIEW
Amanda Corley, Claire M Rickard, Leanne M Aitken, Amy Johnston, Adrian Barnett, John F Fraser, Sharon R Lewis, Andrew F Smith
BACKGROUND: High-flow nasal cannulae (HFNC) deliver high flows of blended humidified air and oxygen via wide-bore nasal cannulae and may be useful in providing respiratory support for adult patients experiencing acute respiratory failure in the intensive care unit (ICU). OBJECTIVES: We evaluated studies that included participants 16 years of age and older who were admitted to the ICU and required treatment with HFNC. We assessed the safety and efficacy of HFNC compared with comparator interventions in terms of treatment failure, mortality, adverse events, duration of respiratory support, hospital and ICU length of stay, respiratory effects, patient-reported outcomes, and costs of treatment...
May 30, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28543355/nurse-versus-physician-led-care-for-obstructive-sleep-apnea-a-systematic-review-and-meta-analysis-of-randomised-trials
#10
REVIEW
Fengqiu Gong, Xiaojun Chen, Yaoye Wu, Dianye Yao, Lihong Xie, Qiuyi Ouyang, Ping Wang, Gang Niu
AIM: To evaluate the effectiveness of nurse-led care for obstructive sleep apnoea compared with physician-led care. BACKGROUND: The incidence of obstructive sleep apnoea is increasing worldwide. There is a need for cost-effective care models to ease off the pressure on tertiary care centres and divert care to the community. DESIGN: Systematic review and meta-analysis. DATA SOURCES: We searched major electronic databases (MEDLINE, EMBASE, AMED, British Nursing Index, CINAHL, HMIC, PsycINFO, Health Business Elite and the Cochrane Central Register of Controlled Trials CENTRAL) from inception till December 2016 using a structured search strategy for all randomised trials evaluating nurse-led treatment interventions for adults with obstructive sleep apnoea compared with physician-led ones...
May 24, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28539541/sleep-disordered-breathing-in-heart-failure%C3%A3-a-therapeutic-dilemma
#11
Nobuhiko Haruki, John S Floras
Sleep-disordered breathing (SDB) occurs in approximately 50% of patients with reduced left ventricular ejection fraction receiving contemporary heart failure (HF) therapies. Obstructive (OSA) and central sleep apneas (CSA) interrupt breathing by different mechanisms but impose qualitatively similar autonomic, chemical, mechanical, and inflammatory burdens on the heart and circulation. Because contemporary evidence-based drug and device HF therapies have little or no mitigating effect on the acute or long-term consequences of such stimuli, there is a sound mechanistic rationale for targeting SDB to reduce cardiovascular event rates and prolong life...
May 23, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28535331/computer-and-mobile-technology-interventions-for-self-management-in-chronic-obstructive-pulmonary-disease
#12
REVIEW
Catherine McCabe, Margaret McCann, Anne Marie Brady
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is characterised by airflow obstruction due to an abnormal inflammatory response of the lungs to noxious particles or gases, for example, cigarette smoke. The pattern of care for people with moderate to very severe COPD often involves regular lengthy hospital admissions, which result in high healthcare costs and an undesirable effect on quality of life. Research over the past decade has focused on innovative methods for developing enabling and assistive technologies that facilitate patient self-management...
May 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28527878/obstructive-sleep-apnea-and-diabetes-a-state-of-the-art-review
#13
REVIEW
Sirimon Reutrakul, Babak Mokhlesi
Obstructive sleep apnea (OSA) is a chronic treatable sleep disorder and a frequent comorbidity in patients with type 2 diabetes. Cardinal features of OSA, including intermittent hypoxemia and sleep fragmentation, have been linked to abnormal glucose metabolism in laboratory-based experiments. OSA has also been linked to the development of incident type 2 diabetes. The relationship between OSA and type 2 diabetes may be bidirectional in nature given that diabetic neuropathy can affect central control of respiration and upper airway neural reflexes promoting sleep-disordered breathing...
May 17, 2017: Chest
https://www.readbyqxmd.com/read/28526665/the-sensor-study-protocol-for-a-mixed-methods-study-of-self-management-checks-to-predict-exacerbations-of-pseudomonas-aeruginosa-in-patients-with-long-term-respiratory-conditions
#14
Claire Roberts, Thomas L Jones, Samal Gunatilake, Will Storrar, Scott Elliott, Sharon Glaysher, Ben Green, Steven Rule, Carole Fogg, Ann Dewey, Kevin A Auton, Anoop J Chauhan
BACKGROUND: There are an estimated three million people in the United Kingdom with chronic obstructive pulmonary disease (COPD), and the incidence of bronchiectasis is estimated at around 0.1% but is more common in COPD and severe asthma. Both COPD and bronchiectasis are characterized by exacerbations in which bacteria play a central role. Pseudomonas aeruginosa is isolated from sputum samples from 4% to 15% of adults with COPD and is more likely to be isolated from patients with severe disease...
May 19, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28523137/complex-multimodality-central-airway-management-of-aspergillus-pseudomembranous-tracheobronchitis
#15
Samjot Singh Dhillon, Marwan Saoud, Kassem Harris
A 69-year-old woman developed central airway obstruction due to invasive Aspergillus infection resulting in pseudomembranous tracheobronchitis (PTB). Several challenges were encountered in the airway management of this patient including her having relatively smaller airways which were more prone to obstruction by pseudomembranes and made airway interventions difficult. The patient had clinical deterioration in spite of antifungal therapy and bronchoscopic debridement. The multimodality airway techniques included the use of smaller biliary balloons for dilatation, using a hybrid stent to slowly dilate and maintain patency of right main stem and finally the insertion of right secondary carina peripheral Y stent, which resulted in clinical improvement and allowed time for antifungal therapy to take effect...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28522081/natural-course-and-potential-prognostic-factors-for-sleep-disordered-breathing-in-multiple-system-atrophy
#16
Yasuyoshi Ohshima, Hideaki Nakayama, Naho Matsuyama, Satoshi Hokari, Takuro Sakagami, Tomoe Sato, Toshiyuki Koya, Tetsuya Takahashi, Toshiaki Kikuchi, Masatoyo Nishizawa, Takayoshi Shimohata
OBJECTIVE/BACKGROUND: Multiple system atrophy (MSA) frequently results in the development of sleep-disordered breathing (SDB). Few reports have described the natural course of this phenomenon. The aim of the present study was to determine the natural course of SDB and prognostic factors associated with such conditions in MSA. PATIENTS/METHODS: Twenty-four consecutive patients were recruited with probable MSA, who had not been treated with continuous positive airway pressure (CPAP) and had undergone overnight polysomnography (PSG) more than once following the development of snoring or stridor...
June 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28507531/noradrenergic-activation-of-hypoglossal-nucleus-modulates-the-central-regulation-of-genioglossus-in-chronic-intermittent-hypoxic-rats
#17
Xinshi Nie, Ling Zhou, Aidi Wang, Hongyu Jin, Zheng Qin, Jian Pang, Wei Wang, Jian Kang
Neuromuscular compensation of the genioglossus muscle can be induced by chronic intermittent hypoxia (CIH) in obstructive sleep apnea to maintain upper airway stability. Noradrenergic activation of hypoglossal nucleus plays a critical role in the central control of the genioglossus. However, it remains unknown whether norepinephrine takes part in the central regulation of the genioglossus during CIH. Adult male Wistar rats (n = 32) were studied to explore the influence of noradrenergic activation of hypoglossal nucleus on the central control of the genioglossus at different stages of CIH...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28485989/non-invasive-positive-airway-pressure-in-obesity-hypoventilation-syndrome-and-chronic-obstructive-pulmonary-disease-present-and-future-perspectives
#18
Victor R Ramírez-Molina, Francisco J Gómez-de-Terreros, Javier Barca-Durán, Juan F Masa
Obesity hypoventilation syndrome (OHS) is a sleep disorder that has acquired great importance worldwide because of its prevalence and association with obesity leading to increased morbidity and mortality with reduced quality of life. The primary feature is insufficient sleep-related ventilation, resulting in abnormally elevated arterial carbon dioxide pressure (PaCO2) during sleep and demonstration of daytime hypoventilation. There are three main mechanisms that can generate diurnal hypoventilation in obese patients: alteration of the respiratory mechanics secondary to obesity; central hypoventilation secondary to leptin resistance and sleep disorder with sleep hypoventilation and obstructive apnoeas, which can be potentially solved with the use of positive airway pressure: non-invasive ventilation (NIV) and continuous positive airway pressure (CPAP)...
May 9, 2017: COPD
https://www.readbyqxmd.com/read/28483860/rapid-eye-movement-sleep-predominant-central-sleep-apnea-relieved-by-positive-airway-pressure-a-case-report
#19
Noah P Jouett, Michael L Smith, Donald E Watenpaugh, Maryam Siddiqui, Maleeha Ahmad, Farrukh Siddiqui
Central Sleep Apnea (CSA) is characterized by intermittent apneas and hypopneas during sleep that result from absent central respiratory drive. CSA occurs almost exclusively during non-rapid-eye-movement (NREM) sleep due to enhanced neuronal ventilatory drive during REM sleep that makes central apneas highly unlikely to form. A 45-year-old obese African American female presented with co-existing Obstructive Sleep Apnea (OSA) and CSA, not in the form of mixed or complex sleep apnea. Peculiarly, her CSA occurred only during rapid-eye-movement (REM) sleep, which is exceedingly rare...
May 2017: Physiological Reports
https://www.readbyqxmd.com/read/28480154/congenital-tracheobronchomegaly-mounier-kuhn-syndrome-in-a-woman-with-human-immunodeficiency-virus-a-case-report
#20
Amanda Fletcher, Justin Stowell, Socrates Jamoulis
Congenital tracheobronchomegaly (Mounier-Kuhn Syndrome, MKS) is a rare idiopathic disorder characterized by dilation of the central airways, including the trachea and first through fourth order bronchi. MKS disproportionately affects men and results in chronic respiratory tract infections. The diagnosis is made through the synthesis of clinical and radiological data. Here we report a unique case of MKS in a patient with human immunodeficiency virus (HIV) infection. A 45-year-old African American woman with a past medical history of HIV, tobacco and recreational drug abuse, chronic obstructive pulmonary disease, sleep apnea, and a 15-year history of recurrent respiratory infections presented with dyspnea, wheezing, a productive cough, increased yellow-green sputum production, and subjective fevers...
April 4, 2017: Curēus
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