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https://www.readbyqxmd.com/read/28719697/diagnosis-and-management-of-asthma-in-adults-a-review
#1
Jennifer L McCracken, Sreenivas P Veeranki, Bill T Ameredes, William J Calhoun
Importance: Asthma affects about 7.5% of the adult population. Evidence-based diagnosis, monitoring, and treatment can improve functioning and quality of life in adult patients with asthma. Observations: Asthma is a heterogeneous clinical syndrome primarily affecting the lower respiratory tract, characterized by episodic or persistent symptoms of wheezing, dyspnea, and cough. The diagnosis of asthma requires these symptoms and demonstration of reversible airway obstruction using spirometry...
July 18, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28718249/frequency-of-undiagnosed-chronic-obstructive-pulmonary-disease-in-patients-with-coronary-artery-disease
#2
Raza Ullah, Shahid Salam, Tahir Ghaffar, Rahim Muhammad, Imran Khan
BACKGROUND: Chronic obstructive airway disease (COPD) is considered as risk factor for coronary artery disease (CAD) along with other risk factors. This study was conducted to determine the frequency of undiagnosed chronic obstructive pulmonary disease in patients with coronary artery disease. METHODS: This cross-sectional study was conducted in the Pulmonology and Cardiology wards/OPD's of Khyber Teaching Hospital Peshawar. Patients more than 35 years of age, diagnosed with CAD of either gender were included...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28717510/post-obstructive-pulmonary-edema-from-aspirated-nuts
#3
Ahsan Bashir, Sabina Qureshi Ahmad, Joshua Silverman, Emily Concepcion, Haesoon Lee
OBJECTIVES: Post-obstructive pulmonary edema is thought to occur from hemodynamic changes secondary to forced inspiration against the closed airway due to acute or chronic airway obstruction. We report a case of a 13 month-old boy who developed pulmonary edema from aspirated foreign body, nuts. METHODS: He underwent emergency bronchoscopy to confirm the clinical diagnosis of aspirated nuts in the trachea and nuts were removed endoscopically. His trachea was then intubated and he was mechanically ventilated with oxygen...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28716723/pharmacological-characterization-of-the-interaction-between-umeclidinium-and-vilanterol-in-human-bronchi
#4
Luigino Calzetta, Paola Rogliani, Francesco Facciolo, Erino Rendina, Mario Cazzola, Maria Gabriella Matera
The long-acting β2-agonist (LABA) / long-acting muscarinic antagonist (LAMA) fixed dose combination (FDC) therapy represents the cornerstone for the treatment of chronic obstructive pulmonary disease (COPD). Nevertheless, conflicting clinical findings still exist on the real benefit of the LABA/LAMA FDCs. Therefore, we investigated whether combining the LABA vilanterol with the LAMA umeclidinium may induce synergistic bronchorelaxant effect in isolated airways. The effect of umeclidinium and vilanterol, administered alone, in combination at the ratio of concentrations reproducing the doses delivered by Anoro(®) Ellipta(®) (55:22), or at isoeffective low concentrations, was investigated on the cholinergic contractile tone induced by the parasympathetic activation of human isolated airways...
July 14, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28716644/muc5ac-and-a-glycosylated-variant-of-muc5b-alter-mucin-composition-in-children-with-acute-asthma
#5
Kathryn G Welsh, Karine Rousseau, Gemma Fisher, Luke R Bonser, Peter Bradding, Chris E Brightling, David J Thornton, Erol A Gaillard
BACKGROUND: Diffuse airway mucus obstruction is an important feature of severe and fatal asthma. MUC5AC and MUC5B are the principal gel-forming mucins found in airway mucus. The mucin composition of airway mucus likely affects its functional properties. METHODS: We quantified the principal airway mucins MUC5AC and MUC5B in the sputum of age-matched children with acute and stable asthma and healthy controls using Western blotting. RESULTS: Sputum samples from 38 children (13 acute asthma, 15 stable asthma, 10 controls) were obtained...
July 14, 2017: Chest
https://www.readbyqxmd.com/read/28714612/weaning-from-long-term-continuous-positive-airway-pressure-or-noninvasive-ventilation-in-children
#6
Meriem Mastouri, Alessandro Amaddeo, Lucie Griffon, Annick Frapin, Samira Touil, Adriana Ramirez, Sonia Khirani, Brigitte Fauroux
OBJECTIVES: A significant number of children are able to discontinue long term continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV) but the underlying disorders, weaning criteria, and outcome of these children have not been studied. STUDY DESIGN: Retrospective cohort follow up. SUBJECT SELECTION: Consecutive children who were weaned from long term CPAP/NIV between October 2013 and January 2016. METHODOLOGY: Underlying disorders, weaning criteria, and clinical outcome were analyzed...
July 17, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28714541/full-night-measurement-of-level-of-obstruction-in-sleep-apnea-utilizing-continuous-manometry
#7
Hahn Jin Jung, Jee Hye Wee, Chae-Seo Rhee, Jeong-Whun Kim
OBJECTIVES/HYPOTHESIS: To determine the average proportion of retropalatal or retroglossal obstruction occurring during a whole night in single patients with obstructive sleep apnea. STUDY DESIGN: Retrospective analysis. METHODS: Patients who underwent full-night polysomnography and upper airway pressure manometry at the same time were retrospectively enrolled. Airway obstruction levels were categorized into retropalatal or retroglossal obstruction according to the pressure change shown during pressure manometry...
July 17, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28714534/adjustable-thermoplastic-oral-appliance-versus-positive-airway-pressure-for-obstructive-sleep-apnea
#8
Wish Banhiran, Paraya Assanasen, Cherdchai Nopmaneejumrudlers, Nongyoaw Nujchanart, Wimontip Srechareon, Cheerasook Chongkolwatana, Choakchai Metheetrairut
OBJECTIVES/HYPOTHESIS: To compare outcomes of continuous positive airway pressure (CPAP) and the adjustable thermoplastic mandibular advancement splint (AT-MAS) for obstructive sleep apnea treatment. STUDY DESIGN: Randomized crossover, noninferiority, tertiary center setting. METHODS: Fifty patients with a mean age of 49.5 ± 10.6 years were enrolled. Inclusion criteria were age ≥18 years, apnea-hypopnea index (AHI) ≥5 events/hour, and oxygen saturation ≥70%...
July 17, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28714430/laparoscopic-instrument-use-in-laryngeal-surgery-transoral-resection-of-a-supraglottic-haemangioma
#9
R Bannon, R Gohil, J Manickavasagam
BACKGROUND: Adult laryngeal haemangiomas are rare vascular tumours that have been managed by a variety of surgical techniques. METHODS: This paper describes a case of near-fatal acute airway obstruction secondary to such a lesion, followed by our approach to surgical resection using a laparoscopic bipolar tissue-sealing device. RESULTS: This technique resulted in successful excision of the lesion, with no evidence of recurrence at one year of follow up...
July 17, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28714226/extranasopharyngeal-angiofibroma-revisited
#10
Jochen P Windfuhr, Julia Vent
BACKGROUND: Angiofibromas in the head and neck region usually arise in the nasopharynx, but may also occur elsewhere. This study aims at evaluating the incidence and clinical features of extranasopharyngeal angiofibroma (ENA). MATERIAL AND METHODS: Systematic review of the literature (Medline(®) and Google(™) ) up to December 31(st) , 2015. RESULTS: 174 cases of ENA were retrieved from a total of 170 publications. In contrast to former publications and previous understanding, the nasal septum was by far the most common site of the disease...
July 17, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28713745/recovering-breathing-and-feeding-of-a-newborn-with-pierre-robin-sequence
#11
Francisnele Maria de Aquino Fraporti Tomáz, Alvaro Henrique Borges, Alexandre Meireles Borba, Luiz Evaristo Ricci Volpato
Pierre Robin sequence (PRS) is characterized by the triad micrognathia, glossoptosis, and airway obstruction, commonly associated with cleft palate. This study reports the case of a patient with characteristics consistent with the diagnosis of PRS in the 1(st) week of life. To stabilize the airway, oro-tracheal intubation was performed without success, followed by tracheostomy and glossopexy and after a small improvement in symptoms, it was decided to perform the mandibular distraction osteogenesis (MDO). At the age of 6, her maxillofacial development was within expectations, with patent airway, the presence of deciduous teeth, and without neurological impairment...
January 2017: Annals of Maxillofacial Surgery
https://www.readbyqxmd.com/read/28711601/catecholaminergic-a1-c1-neurons-contribute-to-the-maintenance-of-upper-airway-muscle-tone-but-may-not-participate-in-nrem-sleep-related-depression-of-these-muscles
#12
Irma Rukhadze, Nancy J Carballo, Sathyajit S Bandaru, Atul Malhotra, Patrick M Fuller, Victor B Fenik
Neural mechanisms of obstructive sleep apnea, a common sleep-related breathing disorder, are incompletely understood. Hypoglossal motoneurons, which provide tonic and inspiratory activation of genioglossus (GG) muscle (a major upper airway dilator), receive catecholaminergic input from medullary A1/C1 neurons. We aimed to determine the contribution of A1/C1 neurons in control of GG muscle during sleep and wakefulness. To do so, we placed injections of a viral vector into DBH-cre mice to selectively express the hMD4i inhibitory chemoreceptors in A1/C1 neurons...
July 12, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28710688/death-by-food
#13
Roger W Byard
Although death from food is not an uncommon finding in forensic facilities worldwide, the range of underlying lethal mechanisms and associated conditions that should be sought at the time of autopsy is quite disparate. Deaths may occur from i) infectious agents including bacteria, viruses, protozoa, cestodes, nematodes and prions; ii) natural toxins including amanita toxins, tetrodotoxin, ciguatera and scombroid; iii) anaphylaxis; iv) poisoning; v) mechanical issues around airway and gut obstruction and/or perforation; and vi) miscellaneous causes...
July 15, 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/28709779/bronchial-hyper-responsiveness-after-preterm-birth
#14
REVIEW
Hege H Clemm, Merete Engeseth, Maria Vollsæter, Sailesh Kotecha, Thomas Halvorsen
Being born preterm often adversely affects later lung function. Airway obstruction and bronchial hyperresponsiveness (BHR) are common findings. Respiratory symptoms in asthma and in lung disease after preterm birth might appear similar, but clinical experience and studies indicate that symptoms secondary to preterm birth reflect a separate disease entity. BHR is a defining feature of asthma, but can also be found in other lung disorders and in subjects without respiratory symptoms. We review different methods to assess BHR, and findings reported from studies that have investigated BHR after preterm birth...
June 20, 2017: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/28707983/signs-of-gas-trapping-in-normal-lung-density-regions-in-smokers
#15
Sandeep Bodduluri, Joseph M Reinhardt, Eric A Hoffman, John D Newell, Hrudaya Nath, Mark T Dransfield, Surya P Bhatt
RATIONALE: A substantial proportion of subjects without overt airflow obstruction have significant respiratory morbidity and structural abnormalities on computed tomography (CT). Whether regions of the lung that appear normal using traditional CT criteria have mild disease is not known. OBJECTIVE: To identity subthreshold structural disease in normal appearing lung regions in smokers. METHODS: We analyzed 8034 subjects with complete inspiratory and expiratory CT data participating in COPDGene including 103 lifetime non-smokers...
July 14, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28707978/immunomodulatory-cell-therapy-to-target-cystic-fibrosis-inflammation
#16
Oula Khoury, Christopher Barrios, Victor Ortega, Anthony Atala, Sean V Murphy
Cystic fibrosis (CF) is associated with exaggerated and prolonged inflammation in the lungs, which contributes to lung injury, airway mucus obstruction, bronchiectasis and loss of lung function. This hyper-inflammatory phenotype appears to be caused by an imbalance between the pro- and anti-inflammatory regulatory pathways, with heightened pro-inflammatory stimuli, a decreased counter-regulatory response, and reduced effectiveness of immune cell function and inflammatory resolution. Thus, therapies that can target this inflammatory environment would have a major impact in preventing the progression of lung disease...
July 14, 2017: American Journal of Respiratory Cell and Molecular Biology
https://www.readbyqxmd.com/read/28707161/a-weight-independent-association-between-atypical-antipsychotic-medications-and-obstructive-sleep-apnea
#17
Habibolah Khazaie, Amir Sharafkhaneh, Sepideh Khazaie, Mohammad Rasoul Ghadami
BACKGROUND: With increasing use of atypical antipsychotic (AAP) agents, the concern has been raised about the association between AAP agents and medical complications. Obstructive sleep apnea (OSA) is a common breathing disorder that adversely affects health and quality of life. Because the major risk factors for OSA are weight gain and obesity by altering the upper airway anatomy, an association between AAP and development of OSA is predictable. However, we hypothesized that AAP may promote OSA not only by weight gain but also because of its potential effects on upper airway muscle function...
July 13, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28706536/the-videofluorographic-swallowing-study-in-rheumatologic-diseases-a-comprehensive-review
#18
REVIEW
Ambra Di Piazza, Federica Vernuccio, Massimo Costanzo, Laura Scopelliti, Dario Picone, Federico Midiri, Francesco Salvaggi, Francesco Cupido, Massimo Galia, Sergio Salerno, Antonio Lo Casto, Massimo Midiri, Giuseppe Lo Re, Roberto Lagalla
Autoimmune connective tissue diseases are a heterogeneous group of pathologies that affect about 10% of world population with chronic evolution in 20%-80%. Inflammation in autoimmune diseases may lead to serious damage to other organs including the gastrointestinal tract. Gastrointestinal tract involvement in these patients may also due to both a direct action of antibodies against organs and pharmacological therapies. Dysphagia is one of the most important symptom, and it is caused by failure of the swallowing function and may lead to aspiration pneumonia, malnutrition, dehydration, weight loss, and airway obstruction...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28705307/a-new-method-for-enhanced-expectoration-of-sputum-by-vibratory-stimulation-of-the-cervical-trachea
#19
Mitsuhiro Kamimura, Nobuhisa Kameyama, Chie Homma, Tatsuya Ibe, Shinjiro Takeoka, Atsuto Mouri, Yoichiro Hamamoto
BACKGROUND: Expectoration of sputum can be difficult for patients with respiratory conditions such as chronic obstructive pulmonary disease, chronic bronchitis, or bronchiectasis because of the effects of decreased pulmonary function, respiratory muscle fatigue, altered sputum properties, and impaired ciliary function. We developed a new method for the vibratory stimulation of the cervical trachea and this study aimed to compare it with the Acapella (a current oscillation device) method...
July 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/28704797/knockout-of-rage-ameliorates-mainstream-cigarette-smoke-induced-airway-inflammation-in-mice
#20
Mei Chen, Tao Wang, Yongchun Shen, Dan Xu, Xiaoou Li, Jing An, Jiajia Dong, Diandian Li, Fuqiang Wen, Lei Chen
BACKGROUND: The receptor for advanced glycation end products (RAGE), a multiligand receptor, has been proved to be implicated in inflammatory responses in chronic obstructive pulmonary disease (COPD). In this study, we investigated the role of RAGE in cigarette smoke (CS)-induced airway inflammation in COPD. METHODS: Wild-type (WT) and RAGE gene knockout (KO) mice were exposed to mainstream CS or room air for 2h twice daily, 6days per week for consecutive 4weeks...
July 10, 2017: International Immunopharmacology
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