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https://www.readbyqxmd.com/read/28523136/phenotypic-presentation-of-chronic-cough-in-children
#1
EDITORIAL
Ahmad Kantar
Chronic cough in children is increasingly defined as a cough that lasts more than four weeks. It is recognized as a different entity than cough in adults. As a result, the diagnostic approach and management of chronic cough in children are no longer extrapolated from adult guidelines. These differences are attributed to the various characteristics of the respiratory tract, immunological system and nervous system in children. Specific paediatric guidelines and algorithms for chronic cough are now widely applied...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28507245/conformational-changes-of-inter-domain-linker-mediate-mechanical-signal-transmission-in-sensor-kinase-bvgs
#2
Elodie Lesne, Elian Dupré, Camille Locht, Rudy Antoine, Françoise Jacob-Dubuisson
The whooping cough agent, Bordetella pertussis, controls the expression of its large virulence regulon in a coordinated manner through the two-component system BvgAS. BvgS is a dimeric, multi-domain sensor-kinase. Each monomer comprises in succession tandem periplasmic Venus flytrap (VFT) domains, a transmembrane segment, a cytoplasmic Per-ArnT-Sim (PAS) domain, a kinase module and additional phosphorelay domains. BvgS shifts between kinase and phosphatase modes of activity in response to chemical modulators that modify the clamshell motions of the VFT domains...
May 15, 2017: Journal of Bacteriology
https://www.readbyqxmd.com/read/28503280/etiological-approach-of-chylothorax-in-babol-northern-iran
#3
Novin Nikbakhsh, Mohammad Zamani, Askari Noorbaran, Ali Naghshineh, Danial Rastergar-Nejad
BACKGROUND: Chylothorax results from leakage of lymph in the pleural cavity because of thoracic duct injury which is associated with severe metabolic disorders. The aim of this study was to evaluate the rate of chylothorax and its causes among hospitalized patients in Shahid Beheshti Hospital of Babol city, North of Iran. METHODS: In this cross-sectional study, all patients with chylothorax admitted to the surgery department of Shahid Beheshti Hospital during 2002-2015 were included...
2017: Caspian Journal of Internal Medicine
https://www.readbyqxmd.com/read/28484598/the-evidence-on-tiotropium-bromide-in-asthma-from-the-rationale-to-the-bedside
#4
REVIEW
Dejan Radovanovic, Pierachille Santus, Francesco Blasi, Marco Mantero
Severe and poorly controlled asthma still accounts for a great portion of the patients affected. Disease control and future risk management have been identified by international guidelines as the main goals in patients with asthma. The need for new treatment approaches has led to reconsider anticholinergic drugs as an option for asthma treatment. Tiotropium is the first anticholinergic drug that has been approved for children and adults with poorly controlled asthma and is currently considered as an option for steps 4 and 5 of the Global Initiative for Asthma...
2017: Multidisciplinary Respiratory Medicine
https://www.readbyqxmd.com/read/28476638/cough-management-in-primary-secondary-and-tertiary-settings
#5
REVIEW
Kay Wang, Nikki Milojevic, Bryan Sheinman, Omar S Usmani
This review reflects upon the management of cough in primary, secondary and tertiary care settings. It reviews the burden of cough, the diagnostic tools employed to investigate the cause of cough and pragmatic treatment strategies. A clinical case vignette presenting in primary care highlights the challenges of managing cough by family practitioners. An approach to establishing a persistent cough clinic service in secondary care is described. Finally, the entity of idiopathic cough in tertiary care and the specialist approaches to treating recalcitrant cough are addressed...
May 2, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28476019/mediastinal-lesions-across-the-age-spectrum-a-clinicopathological-comparison-between-pediatric-and-adult-patients
#6
Tingting Liu, Lika'a Fasih Y Al-Kzayer, Xiao Xie, Hua Fan, Shamil Naji Sarsam, Yozo Nakazawa, Lei Chen
The objective of this study was to identify the differences in histopathological distribution and clinical features of mediastinal lesions (MLs) across the age spectrum in Chinese series of patients and to compare with the available literature. A total of 409 cases of MLs, including 137 pediatric and 272 adult patients from a single institution, was reviewed and categorized into groups according to age. Among the 409 cases, the age showed a bimodal distribution with an increased incidence of MLs among (< 10 year) and (60-< 70 year) age groups...
April 18, 2017: Oncotarget
https://www.readbyqxmd.com/read/28474959/is-a-multidisciplinary-aerodigestive-clinic-more-effective-at-treating-recalcitrant-aerodigestive-complaints-than-a-single-specialist
#7
Janine M Rotsides, Gina M Krakovsky, Dinesh K Pillai, Sona Sehgal, Maura E Collins, Carolyn E Noelke, Nancy M Bauman
OBJECTIVE: To determine the utility of a pediatric multidisciplinary aerodigestive clinic (ADC) in treating recalcitrant aerodigestive conditions. METHODS: Longitudinal observational study of presenting complaints, evaluation, management, and outcome of patients seen during 12 monthly ADCs beginning August 2013. RESULTS: Fifty-five patients were seen by the ADC team (otolaryngology/gastroenterology/pulmonology/speech pathology/nurse practitioner) and followed for a mean 17...
May 1, 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28470130/impact-of-centor-scores-on-determining-antibiotic-prescribing-in-children
#8
Joseph Freer, Tasneem Ally, Rossa Brugha
Purpose The purpose of this paper is to establish the effect of incorporating Centor scoring into antibiotic prescribing in primary care in London, UK, before and after the introduction of an educational package and prescribing software tool. Design/methodology/approach A quality improvement project with analysis of all sore throat presentations in patients aged 3-14 years, in two phases. Phase 1 (retrospective): 1 January-31 December 2013, followed by an intervention (software tool/education package) and Phase 2 (prospective): 1 March 2014-28 February 2015...
May 8, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28454289/iris-metastasis-as-the-first-sign-of-small-cell-lung-cancer-a-case-report
#9
Shi-Liang Liu, Yu-Hong Nie, Tao He, Xi-Xi Yan, Yi-Qiao Xing
The current study documents an unusual case of iris metastasis as the first sign of small cell lung cancer (SCLC) and reviews the relevant literature to increase understanding and awareness of this rare condition. A 59-year-old male chronic smoker presented with a painful and red right eye without any disturbance of vision. The patient also complained of associated chronic cough and anorexia. Upon examination, an exfoliative, pinkish-white lesion of the right iris was observed. A systemic work-up was performed, which incidentally detected metastatic SCLC in the lower lobe of the right lung and was confirmed by histopathological examination...
March 2017: Oncology Letters
https://www.readbyqxmd.com/read/28448239/extranodal-marginal-zone-lymphoma-no-longer-just-a-sidekick
#10
Manali K Kamdar, Sonali M Smith
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice...
April 27, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28422846/application-of-remifentanil-for-conscious-sedation-and-analgesia-in-short-term-ercp-and-est-surgery
#11
RANDOMIZED CONTROLLED TRIAL
Guo-Qiang Sun, Bao-Feng Gao, Guan-Jun Li, Yun-Long Lei, Jie Li
This study aims to observe and evaluate the use of remifentanil in conscious sedation and analgesia for the safety and comfort of patients undergoing short-term endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (EST).Sixty-eight patients who underwent ERCP and EST were randomly divided into two groups: research group and control group. Patients in the research group were intravenously injected with remifentanil (80-2/3* age) for 1 to 2 minutes, combined with the intravenous injection of propofol (20-30 mg) during the course of treatment...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28412479/cough-in-exercise-and-athletes
#12
REVIEW
J H Hull, J W Dickinson, A R Jackson
Cough is the most common respiratory symptom reported by athletes and can significantly impact on health status, ability to train and athletic performance. The presence of cough in an athlete is typically taken to indicate exercise-induced bronchoconstriction (EIB), yet in many athletes with chronic cough there is no objective evidence of airway hyper-responsiveness (AHR) or heightened airway inflammation. Moreover, cough in athletes often fails to respond to a therapeutic asthma strategy, thus further work is urgently needed to progress our understanding of the pathophysiology of exercise-associated cough in this unique population...
April 12, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28407803/orchitis-reveals-an-extragonadal-primary-mediastinal-thymic-seminoma-a-coincidence-or-not
#13
Athanasios Tampakis, Ekaterini Christina Tampaki, Christos Damaskos, Themistoklis Feretis, Irene Thymara, Konstantinos Kontzoglou, Periklis Tomos, Gregory Kouraklis
BACKGROUND: Mediastinal thymic seminomas are rare male germ cell tumors with extragonadal origin that appear predominately with a cystic appearance. CASE PRESENTATION: A 22-year-old male was referred to our department for further investigation of a mediastinal mass discovered incidentally during routine chest X-ray. The patient has denied any symptoms including dyspnea, chest pain, cough, fever, dysphagia, hemoptysis, weight loss, and weakness. His past medical history was remarkable for orchitis, for which he had undergone a bilateral testicular biopsy, without the latter however, indicating the presence of a germ cell tumor or a premalignant lesion...
April 13, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28387090/-how-to-approach-a-chronic-cough
#14
R Louis
Cough is the most common symptom for which patients seek medical attention. Chronic cough is defined when the symptom lasts for more than 8 weeks. It significantly alters quality of life. Chronic cough may be the dominant symptom which reveals a large number of diseases, not only respiratory. It is classic to distinguish chronic cough according to the chest X Ray results. In case of normal chest X ray, which is the most frequent condition, the diagnosis of tobacco-associated chronic bronchitis, drug induced cough, asthma, oesophageal reflux and rhinosinusitis should be considered...
February 2017: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28386925/vagus-nerve-stimulation-surgical-technique-of-implantation-and-revision-and-related-morbidity
#15
Flavio Giordano, Anna Zicca, Carmen Barba, Renzo Guerrini, Lorenzo Genitori
Indications for vagus nerve stimulation (VNS) therapy include focal, multifocal epilepsy, drop attacks (tonic/atonic seizures), Lennox-Gastaut syndrome, tuberous sclerosis complex (TSC)-related multifocal epilepsy, and unsuccessful resective surgery. Surgical outcome is about 50-60% for seizures control, and may also improve mood, cognition, and memory. On this basis, VNS has also been proposed for the treatment of major depression and Alzheimer's' disease. The vagus nerve stimulator must be implanted with blunt technique on the left side to avoid cardiac side effects through the classic approach for anterior cervical discectomy...
April 2017: Epilepsia
https://www.readbyqxmd.com/read/28370977/diagnostic-protocols-a-consultation-tool-still-to-be-discovered
#16
Waltraud Fink, Gustav Kamenski, Martin Konitzer
RATIONALE: Experienced primary care physicians handle most illnesses to everyone's satisfaction despite limited resources of time and means. However, cases can be multifaceted in that harmless-presenting symptoms may also be warning signals or an indicator of a health disorder that too infrequently presents in family practice to be diagnosed correctly. On the basis of these observations, RN Braun developed 82 diagnostic protocols for a structured recording of various complaints. METHOD: All consultations during the years 2001 to 2014, in which 1 author (WF) had used diagnostic protocols in her single-handed practice, were analyzed retrospectively regarding reasons for encounter, diagnostic classification, and long-term outcome...
March 31, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28365873/effects-of-esophageal-acidification-on-troublesome-symptoms-an-approach-to-characterize-true-acid-gerd-in-dysphagic-neonates
#17
Maneesha Sivalingam, Swetha Sitaram, Kathryn A Hasenstab, Lai Wei, Frederick W Woodley, Sudarshan R Jadcherla
To quantify and compare maximal extent (height) of acid reflux events (AREs) on symptom generation in dysphagic neonates. Dysphagic neonates (N = 53), born at 30 ± 5.3 weeks gestation, underwent 24-hour pH-impedance study for the evaluation of troublesome symptoms purported to be due to gastroesophageal reflux disease (GERD). AREs (pH < 4 for >4 s) detected by impedance (Z) were categorized by maximal extent as refluxate reaching distal (Z6, Z5), middle (Z4, Z3), or proximal (Z2, Z1) impedance channels...
April 1, 2017: Dysphagia
https://www.readbyqxmd.com/read/28359296/motorbike-handlebar-hernia-a-rare-traumatic-abdominal-wall-hernia-a-case-report-and-review-of-the-literature
#18
Frank-Leonel Tianyi, Valirie Ndip Agbor, Tsi Njim
BACKGROUND: Handlebar hernias are very rare and arise following a sudden force from a handle-like object impacting a focal area of the abdomen, which results in a disruption of the underlying abdominal muscle and fascia without necessarily disrupting the overlying skin. Other than a reducible swelling on the abdominal wall, the physical examination of such patients is usually unremarkable and the diagnosis could easily be missed. CASE PRESENTATION: An 8-year-old Cameroonian boy with no significant past history presented to our emergency service with a tender left flank swelling following a road traffic accident...
March 31, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28352199/survey-on-attitudes-of-italian-pediatricians-toward-cough
#19
Alessandro Zanasi, Luigi Morcaldi, Salvatore Cazzato, Massimiliano Mazzolini, Marzia Lecchi, Antonio Maria Morselli-Labate, Marianna Mastroroberto, Roberto W Dal Negro
CONTEXT: Children's cough is a daily concern for most pediatricians. The management of both acute and chronic cough requires a systematic and comprehensive approach. Despite the approved protocols for management, the pediatric assessment of cough and the corresponding prescribing attitude frequently do not fit these protocols, which can be affected by parental suggestions - sometimes substantially. OBJECTIVE: The objective of this study was to investigate both the perception and the behavior of a representative sample of Italian pediatricians toward cough in real life...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28331610/a-reappraisal-of-the-mucoactive-activity-and-clinical-efficacy-of-bromhexine
#20
REVIEW
Alessandro Zanasi, Massimiliano Mazzolini, Ahmad Kantar
Since its introduction to the market in 1963, bromhexine, an over-the-counter drug, has been investigated for its activity in animal models and in humans with diverse respiratory conditions. Bromhexine is a derivate of the Adhatoda vasica plant used in some countries for the treatment of various respiratory diseases. Bromhexine has been found to enhance the secretion of various mucus components by modifying the physicochemical characteristics of mucus. These changes, in turn, increase mucociliary clearance and reduce cough...
2017: Multidisciplinary Respiratory Medicine
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