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https://www.readbyqxmd.com/read/29927760/anesthetic-management-of-a-pediatric-patient-with-pelizaeus-merzbacher-syndrome-a-case-report
#1
Roshan Patel, Madelyn Kahana
A 3-year-old pediatric patient with previously diagnosed Pelizaeus-Merzbacher syndrome presented for outpatient dental restoration. Given the infrequency of this demyelinating disorder, an anesthetic plan was tailored to address the patient's hypotonia and aspiration risk, as well as minimize potential complications including seizures, hemodynamic instability, and postoperative respiratory support. Multimodal analgesia, along with an appropriate ventilation strategy and normothermia, allowed the patient to successfully undergo a general anesthetic and be safely discharged home the same day...
June 18, 2018: A&A practice
https://www.readbyqxmd.com/read/29926544/clinical-effectiveness-of-high-flow-nasal-cannula-in-hypoxaemic-patients-during-bronchoscopic-procedures
#2
Sang Mi Chung, Ju Whan Choi, Young Seok Lee, Jong Hyun Choi, Jee Youn Oh, Kyung Hoon Min, Gyu Young Hur, Sung Yong Lee, Jae Jeong Shim, Kyung Ho Kang
BACKGROUND: Bronchoscopy is a useful diagnostic and therapeutic tool. However, the clinical use of high-flow nasal cannula (HFNC) in adults with acute respiratory failure for diagnostic and invasive procedures has not been well evaluated. We present our experiences of well-tolerated diagnostic bronchoscopy as well as cases of improved saturation in hypoxaemic patients after a therapeutic bronchoscopic procedure. METHODS: We retrospectively reviewed data of hypoxaemic patients who had undergone bronchoscopy for diagnostic or therapeutic purposes from October 2015 to February 2017...
June 19, 2018: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29926010/pulmonary-tumor-thrombotic-microangiopathy-induced-by-prostate-cancer
#3
Satoshi Katayama, Tadasu Takenaka, Aya Nakamura, Sinichi Sako, Akihiro Bessho, Nobuya Ohara
Pulmonary tumor thrombotic microangiopathy (PTTM) is a fatal, malignancy-related respiratory complication; we herein report a PTTM case induced by metastatic prostate cancer. An 81-year-old Japanese man developed dyspnea. High-resolution computed tomography (HRCT) revealed ground-glass opacities spread across bilateral lung fields. Pulmonary microvascular aspiration cytology detected prostate cancer cells. As PTTM was highly suspected, docetaxel chemotherapy was performed immediately. His respiratory condition and HRCT findings improved temporarily, but he died approx...
June 2018: Acta Medica Okayama
https://www.readbyqxmd.com/read/29925726/methotrexate-associated-lymphoproliferative-disorder-complicated-by-severe-acute-respiratory-failure-and-ileal-perforation-a-case-report
#4
Eiji Suzuki, Takashi Kanno, Satoru Kimura, Takumi Irie, Hajime Odajima, Kiyoshi Migita
Lymphoproliferative disorder (LPD) is a potentially severe adverse effect of methotrexate (MTX) administration in patients with rheumatoid arthritis (RA). We report a case of MTX-associated LPD (MTX-LPD) in a patient with RA who developed severe pulmonary failure complicated by perforation of the terminal ileum. A 61-year-old woman with RA receiving MTX complained of dyspnea and abdominal pain. She was diagnosed with intestinal perforation and peritonitis, and underwent immediate abdominal surgery. Pathological examinations of the specimen obtained from the resected ileum and a bone marrow aspirate revealed diffuse large B-cell lymphoma...
June 19, 2018: Fukushima Journal of Medical Science
https://www.readbyqxmd.com/read/29925629/incidence-morbidity-and-mortality-of-patients-with-achalasia-in-england-findings-from-a-study-of-nationwide-hospital-and-primary-care-data
#5
Philip R Harvey, Tom Thomas, Joht S Chandan, Jemma Mytton, Ben Coupland, Neeraj Bhala, Felicity Evison, Prashant Patel, Krishnarajah Nirantharakumar, Nigel J Trudgill
BACKGROUND: Achalasia is an uncommon condition characterised by failed lower oesophageal sphincter relaxation. Data regarding its incidence, prevalence, disease associations and long-term outcomes are very limited. METHODS: Hospital Episode Statistics (HES) include demographic and diagnostic data for all English hospital attendances. The Health Improvement Network (THIN) includes the primary care records of 4.5 million UK subjects, representative of national demographics...
June 20, 2018: Gut
https://www.readbyqxmd.com/read/29922736/nasopharyngeal-airway-aspiration-an-uncommon-cause-of-sudden-respiratory-distress-in-hospitalized-patients
#6
Kosar Hussain, Sara Hussain, Jawed Abubaker, Raees Ahmed
An elderly, bed ridden patient with a history of stroke was admitted for management of aspiration pneumonia. Two days after insertion of a nasopharyngeal airway, sudden respiratory distress prompted further investigations which led to the eventual diagnosis and removal of the nasopharyngeal airway that had been aspirated. The device was removed under conscious sedation with fiber optic bronchoscopy.
June 2018: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29917256/exhaled-breath-condensate-hydrogen-peroxide-ph-and-leukotriene-b-4-are-associated-with-lower-airway-inflammation-and-airway-cytology-in-the-horse
#7
S du Preez, S L Raidal, G S Doran, M Prescott, K J Hughes
BACKGROUND: Exhaled breath condensate (EBC) analysis is a non-invasive method to assess the lower respiratory tract. In humans, EBC hydrogen peroxide (H2 O2 ), pH and leukotriene B4 (LTB4 ) are useful for detection and monitoring of inflammatory lung diseases, including asthma. OBJECTIVES: To determine associations between EBC biomarkers and cytological and endoscopic definitions of lower airway inflammation whilst controlling for sampling and environmental variables...
June 19, 2018: Equine Veterinary Journal
https://www.readbyqxmd.com/read/29916280/similar-and-differential-canonical-pathways-and-biological-processes-associated-with-multiwalled-carbon-nanotube-and-asbestos-induced-pulmonary-fibrosis-a-1-year-postexposure-study
#8
Julian M Dymacek, Brandi N Snyder-Talkington, Rebecca Raese, Chunlin Dong, Salvi Singh, Dale W Porter, Barbara Ducatman, Michael G Wolfarth, Michal E Andrew, Lori Battelli, Vincent Castranova, Yong Qian, Nancy L Guo
Respiratory exposure to multiwalled carbon nanotubes (MWCNT) or asbestos results in fibrosis; however, the mechanisms to reach this end point may be different. A previous study by our group identified pulmonary effects and significantly altered messenger RNA (mRNA) signaling pathways following exposure to 1, 10, 40, and 80 µg MWCNT and 120 µg crocidolite asbestos on mouse lungs over time at 1-month, 6-month, and 1-year postexposure following pulmonary aspiration. As a continuation to the above study, this current study took an in-depth look at the signaling pathways involved in fibrosis development at a single time point, 1 year, and exposure, 40 µg MWCNT, the lowest exposure at which fibrosis was pathologically evident...
January 1, 2018: International Journal of Toxicology
https://www.readbyqxmd.com/read/29910086/respiratory-physiotherapy-in-intensive-care-unit-bibliographic-review
#9
R Goñi-Viguria, E Yoldi-Arzoz, L Casajús-Sola, T Aquerreta-Larraya, P Fernández-Sangil, E Guzmán-Unamuno, B M Moyano-Berardo
INTRODUCTION AND AIMS: Patients in intensive care unit are susceptible to complications due to different causes (underlying disease, immobilisation, infection risk…) The current main intervention in order to prevent these complications is respiratory physiotherapy, a common practice for nurses on a daily basis. Therefore, we decided to carry out this bibliographic review to describe the most efficient respiratory physiotherapy methods for the prevention and treatment of lung complications in patients in intensive care, taking into account the differences between intubated and non-intubated patients...
June 14, 2018: Enfermería Intensiva
https://www.readbyqxmd.com/read/29908521/respiratory-viruses-among-children-with-non-severe-community-acquired-pneumonia-a-prospective-cohort-study
#10
Amanda C Nascimento-Carvalho, Ana-Luisa Vilas-Boas, Maria-Socorro H Fontoura, Tytti Vuorinen, Cristiana M Nascimento-Carvalho
BACKGROUND: Community-acquired pneumonia (CAP) causes a major burden to the health care system among children under-5 years worldwide. Information on respiratory viruses in non-severe CAP cases is scarce. OBJECTIVES: To estimate the frequency of respiratory viruses among non-severe CAP cases. STUDY DESIGN: Prospective study conducted in Salvador, Brazil. Out of 820 children aged 2-59 months with non-severe CAP diagnosed by pediatricians (respiratory complaints and radiographic pulmonary infiltrate/consolidation), recruited in a clinical trial (ClinicalTrials...
June 6, 2018: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/29906597/saliva-as-a-diagnostic-specimen-for-testing-respiratory-virus-by-a-point-of-care-molecular-assay-a-diagnostic-validity-study
#11
Kelvin Kw To, Cyril Cy Yip, Cherie Yw Lai, Carlos Kh Wong, Deborah Ty Ho, Polly Kp Pang, Anthony Ck Ng, Kit-Hang Leung, Rosana Ws Poon, Kwok-Hung Chan, Vincent Cc Cheng, Ivan Fn Hung, Kwok-Yung Yuen
OBJECTIVES: Automated point-of-care molecular assays have greatly shortened the turnaround time of respiratory virus testing. One of the major bottlenecks now lies at the step of the specimen collection especially in a busy clinical setting. Saliva is a convenient specimen type which can be provided easily from adult patients. This study assessed the diagnostic validity, specimen collection time, and cost associated with the use of saliva. METHODS: This was a prospective diagnostic validity study comparing the detection rate of respiratory viruses between saliva and nasopharyngeal aspirate (NPA) among adult hospitalized patients using Xpert® Xpress Flu/RSV...
June 12, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29898751/the-impact-of-nasal-aspiration-with-an-automatic-device-on-upper-and-lower-respiratory-symptoms-in-wheezing-children-a-pilot-case-control-study
#12
Antonio Pizzulli, Serena Perna, Anja Bennewiz, Holger Roeblitz, Salvatore Tripodi, Jakob Florack, Petra Wagner, Stephanie Hofmaier, Paolo Maria Matricardi
BACKGROUND: The impact of proper aspiration of nasal secretions during upper respiratory infection on the frequency and severity of symptoms of lower airways has never been investigated. The study was aimed at testing if cleaning the nasal cavities of children with recurrent wheezing using an automatic nasal aspirator improves the upper and lower respiratory symptoms during the cold season. METHODS: Parents of wheezing children (age 3-72 mo.) answered questionnaires and learned using a nebulizer equipped (cases) or not equipped (controls) with an automatic nasal aspirator (DuoBaby, OMRON, Japan)...
June 14, 2018: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29889726/evolution-of-delivery-room-management-for-meconium-stained-infants-recent-updates
#13
Shilpi Chabra
BACKGROUND: The approach to intrapartum and postnatal management of an infant born through meconium-stained amniotic fluid (MSAF) in the delivery room (DR) has changed several times over the last few decades, leading to confusion and anxiety among health care providers (nurses, nurse practitioners, respiratory therapists, midwives, and physicians). This article provides state-of-the-art insight into the evidence or lack thereof for the changes in guidelines. PURPOSE: To discuss the evidence for evolution of DR management of vigorous and nonvigorous infants born through any type of MSAF...
June 8, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29883628/duplex-real-time-polymerase-chain-reaction-assay-for-the-detection-of-human-kipyv-and-wupyv-in-nasopharyngeal-aspirate-pediatric-samples
#14
Marco Ligozzi, Liliana Galia, Maria Carelli, Pier Paolo Piccaluga, Erica Diani, Davide Gibellini
In this study, we describe a duplex real-time PCR assay for the simultaneous detection of KIPyV and WUPyV polyomaviruses based on TaqMan probes. This assay detected 500 copies/mL both for KIPyV and WUPyV in 100% of tested positive samples. We assessed this technique on 482 nasopharyngeal aspirate specimens from hospitalized pediatric patients with respiratory symptoms, previously analyzed with commercial multiplex assay for 16 major respiratory viruses. Our assay detected KIPyV genome in 15 out of 482 samples (3...
June 5, 2018: Molecular and Cellular Probes
https://www.readbyqxmd.com/read/29878264/surfactant-lung-lavage-vs-standard-care-in-the-treatment-of-meconium-aspiration-syndrome-a-randomized-trial
#15
Prathik Bandiya, Sushma Nangia, Arvind Saili
Objective: The objective of this study was to evaluate the effect of surfactant lung lavage (SLL) on duration of respiratory support in neonates with meconium aspiration syndrome (MAS). Patients and methods: Sixty term infants with MAS who had moderate to severe respiratory distress (Downes score >4) were randomized toSLL (n = 31) or no lung lavage-NLL (n = 29). Neonates in intervention group underwent lung lavage with dilute surfactant and those in control group were managed as per unit protocol...
June 6, 2018: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/29878077/muc5ac-levels-associated-with-respiratory-syncytial-virus-disease-severity
#16
Devi Rajan, Evan L O'Keefe, Curtis Travers, Courtney McCracken, Sarah Geoghegan, Mauricio T Caballero, Patricio L Acosta, Fernando Polack, Larry J Anderson
To assess MUC5AC as a biomarker for respiratory syncytial virus (RSV) disease severity, we tested nasal aspirates from RSV+ children with mild, moderate, and severe disease. Levels were significantly higher in those in the severe and moderate groups compared to mild group, indicating MUC5AC may be a useful biomarker for RSV disease severity.
June 6, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29877718/management-of-a-case-of-unacknowledged-foreign-body-in-the-upper-airway
#17
Federica Gilda D'Agostino, Francesco Monaco, Baldassare Mondello, Dario Familiari, Mario Barone
Tracheobronchial foreign body aspiration occurs rarely in adults and may go unrecognized for a long time, but early detection and immediate retrieval of the foreign body are essential to prevent major morbidity. We describe the case of an adult who unusually aspirated part of his dental prosthesis during an attempted strangulation, which was unacknowledged until 6 months later when he was hospitalized with acute respiratory failure and required an emergency surgical tracheotomy. The foreign body was successfully removed via flexible bronchoscopy...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29868143/central-sleep-apnea-a-rare-cause-for-acute-respiratory-insufficiency-in-children-case-report
#18
Nicoleta Aurelia Popescu, Marcela Daniela Ionescu, Georgiana Balan, Simina Visan, Eliza Cinteza, Diana Stanescu, Ionut Gobej, Mihaela Balgradean
Central sleep apnea is characterized by frequent cessation of breathing during sleep, resulting in repetitive episodes of insufficient ventilation and abnormalities of acid-base balance. It may be primary or secondary, and it is uncommon in children, with limited data for this population. We present here the case of a five-year-old girl, known to have thoracolumbar myelomeningocele (for which she underwent a surgical procedure in infancy), secondary hydrocephalus (with a ventriculoperitoneal shunt) and flaccid paralysis, who was admitted in our hospital with prolonged fever syndrome, productive cough, severe dyspnea and perioral cyanosis...
March 2018: Mædica
https://www.readbyqxmd.com/read/29866070/undiagnosed-cryptococcus-gattii-meningitis-leading-to-subsequent-ventriculoperitoneal-shunt-infection-in-a-patient-with-symptoms-of-normal-pressure-hydrocephalus-case-report-and-literature-review
#19
Wutthiseth Dhitinanmuang, Piriyaporn Chongtrakool, Anupop Jitmuang
BACKGROUND: Cryptococcus gattii is known to be an etiologic agent of human cryptococcosis, particularly in immunocompetent persons. C. gattii infection usually involves the central nervous system, the respiratory tract, or may be disseminated. Here we report an atypical manifestation of C. gattii infection in a patient who had C. gattii meningitis complicating the ventriculoperitoneal (VP) shunt infection and concurrent infected intraabdominal VP shunt pseudocyst. CASE PRESENTATION: A 66-year-old Thai female was initially diagnosed with normal pressure hydrocephalus (NPH) and underwent programmable VP shunt placement...
June 4, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29862364/aquaporine-5-and-epithelial-sodium-channel-%C3%AE-subunit-gene-expression-in-gastric-aspirates-in-human-term-newborns
#20
Fabiola Castorena-Torres, Mario René Alcorta-García, Víctor Javier Lara-Díaz
Both transient tachypnea of the newborn and neonatal respiratory distress syndrome have been associated with changes in gene expression of aquaporine-5 (AQP5) and the β subunit of the epithelial sodium channel (β-ENaC) in the respiratory epithelium. Gastric aspirate (GA) obtained immediately after birth could represent a new source for gene expression analysis for these respiratory diseases. The aims of this study were to determine the feasibility of estimating AQP5 and β-ENaC gene expression in exfoliated respiratory epithelial cells from the GA of term neonates, and to compare the values with those found in scraped nasal epithelial cells, previously validated as a surrogate for distal lung epithelium in terms of ionic channel activity...
April 2018: Heliyon
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