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Airway physiology

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https://www.readbyqxmd.com/read/28443579/determining-the-efficiency-of-different-preoperative-difficult-intubation-tests-on-patients-undergoing-caesarean-section
#1
İlker Yıldırım, Mehmet Turan İnal, Dilek Memiş, F Nesrin Turan
BACKGROUND: Pregnancy induced anatomical and physiological changes in the airway makes airway management difficult in obstetric patients, thus the preoperative evaluation of the airway is important for obstetric patients. AIMS: The first aim was determine the effectiveness of the modified mallampati test, the interincisor, sternomental, thyromental distances, the upper limb bite tests and the second aim was to access the effectiveness of the combination of the upper limb bite test with the other tests in obstetric patients...
April 13, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28442310/copd-osa-overlap-syndrome-evolving-evidence-regarding-epidemiology-clinical-consequences-and-management
#2
REVIEW
Walter T McNicholas
Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea syndrome (OSA) are both highly prevalent, which implies that both disorders occurring together (overlap syndrome) is likely to be common based on chance association alone. However, different clinical COPD phenotypes influence the likelihood of co-existing OSA in that the increased lung volumes and low body mass index (BMI) associated with the predominant emphysema phenotype protects against OSA, whereas the higher likelihood of peripheral edema and increased BMI associated with the predominant chronic bronchitis phenotype promotes OSA...
April 22, 2017: Chest
https://www.readbyqxmd.com/read/28442070/comparing-airways-clearance-techniques-in-chronic-obstructive-pulmonary-disease-and-bronchiectasis-positive-expiratory-pressure-or-temporary-positive-expiratory-pressure-a-retrospective-study
#3
Francesco D'Abrosca, Barbara Garabelli, Gloria Savio, Agnese Barison, Lorenzo Appendini, Luis V F Oliveira, Paola Baiardi, Bruno Balbi
BACKGROUND: Airway clearance techniques include positive expiratory pressure, commonly used in our clinical practice, and a recently introduced temporary positive expiratory pressure device called UNIKO(®). It is unclear which one provides the best benefit to patients. OBJECTIVES: The aim of this observational 4-year study was to retrospectively compare the efficacy of and specific indications for temporary positive expiratory pressure compared to positive expiratory pressure in a standard rehabilitation program...
January 2017: Brazilian Journal of Physical Therapy
https://www.readbyqxmd.com/read/28438490/acute-nanoparticle-exposure-to-vocal-folds-a-laboratory-study
#4
Xinxin Liu, Tanaya Walimbe, William Pierre Schrock, Wei Zheng, M Preeti Sivasankar
OBJECTIVES: Airway exposure to nanoparticles is common in occupational settings. Inhaled nanoparticles have toxic effects on respiratory tissue. Vocal folds are also at direct risk from inhaled nanoparticles. This study investigated the effects of single-walled carbon nanotubes (SWCNT), a type of nanoparticle, on vocal fold epithelium and fibroblasts. These cell types were selected for study as the epithelium is the outer layer of the vocal folds and fibroblasts are the most common cell type in connective tissue underlying the epithelium...
April 21, 2017: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/28435870/nanoparticles-that-do-not-adhere-to-mucus-provide-uniform-and-long-lasting-drug-delivery-to-airways-following-inhalation
#5
Craig S Schneider, Qingguo Xu, Nicholas J Boylan, Jane Chisholm, Benjamin C Tang, Benjamin S Schuster, Andreas Henning, Laura M Ensign, Ethan Lee, Pichet Adstamongkonkul, Brian W Simons, Sho-Yu S Wang, Xiaoqun Gong, Tao Yu, Michael P Boyle, Jung Soo Suk, Justin Hanes
Mucoadhesive particles (MAP) have been widely explored for pulmonary drug delivery because of their perceived benefits in improving particle residence in the lungs. However, retention of particles adhesively trapped in airway mucus may be limited by physiologic mucus clearance mechanisms. In contrast, particles that avoid mucoadhesion and have diameters smaller than mucus mesh spacings rapidly penetrate mucus layers [mucus-penetrating particles (MPP)], which we hypothesized would provide prolonged lung retention compared to MAP...
April 2017: Science Advances
https://www.readbyqxmd.com/read/28431248/spontaneous-chitin-accumulation-in-airways-and-age-related-fibrotic-lung-disease
#6
Steven J Van Dyken, Hong-Erh Liang, Ram P Naikawadi, Prescott G Woodruff, Paul J Wolters, David J Erle, Richard M Locksley
The environmentally widespread polysaccharide chitin is degraded and recycled by ubiquitous bacterial and fungal chitinases. Although vertebrates express active chitinases from evolutionarily conserved loci, their role in mammalian physiology is unclear. We show that distinct lung epithelial cells secrete acidic mammalian chitinase (AMCase), which is required for airway chitinase activity. AMCase-deficient mice exhibit premature morbidity and mortality, concomitant with accumulation of environmentally derived chitin polymers in the airways and expression of pro-fibrotic cytokines...
April 20, 2017: Cell
https://www.readbyqxmd.com/read/28421631/subclinical-lower-airways-correlates-of-chronic-allergic-and-non-allergic-rhinitis
#7
Ricardo J Saranz, Alejandro Lozano, Natalia A Lozano, Marina F Ponzio, Álvaro A Cruz
The upper and lower airways behave as a physiological and pathophysiological unit. Subclinical lower airways abnormalities have been described in patients with rhinitis without asthma. These are expressed as bronchial hyperreactivity, abnormalities in lung function and bronchial inflammation, likely as a result of the same phenomenon with systemic inflammatory impact that reaches both the nose and the lungs, which for unknown reasons does not always have a full clinical expression. Patients with rhinitis are at increased risk of developing asthma; therefore most authors suggest a careful clinical evaluation and monitoring of these patients, especially if symptoms related to inflammation in the lower airways are observed...
April 19, 2017: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28416951/spirometry-and-bronchodilator-test
#8
REVIEW
Yun Su Sim, Ji-Hyun Lee, Won-Yeon Lee, Dong In Suh, Yeon-Mok Oh, Jong-Seo Yoon, Jin Hwa Lee, Jae Hwa Cho, Cheol Seok Kwon, Jung Hyun Chang
Spirometry is a physiological test for assessing the functional aspect of the lungs using an objective indicator to measure the maximum amount of air that a patient can inhale and exhale. Acceptable spirometry testing needs to be conducted three times by an acceptable and reproducible method for determining forced vital capacity (FVC). Until the results of three tests meet the criteria of reproducibility, the test should be repeated up to eight times. Interpretation of spirometry should be clear, concise, and informative...
April 2017: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28409851/response-to-a-combination-of-oxygen-and-a-hypnotic-as-treatment-for-obstructive-sleep-apnoea-is-predicted-by-a-patient-s-therapeutic-cpap-requirement
#9
Shane A Landry, Simon A Joosten, Scott A Sands, David P White, Atul Malhotra, Andrew Wellman, Garun S Hamilton, Bradley A Edwards
BACKGROUND AND OBJECTIVE: Upper airway collapsibility predicts the response to several non-continuous positive airway pressure (CPAP) interventions for obstructive sleep apnoea (OSA). Measures of upper airway collapsibility cannot be easily performed in a clinical context; however, a patient's therapeutic CPAP requirement may serve as a surrogate measure of collapsibility. The present work aimed to compare the predictive use of CPAP level with detailed physiological measures of collapsibility...
April 13, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28400685/republication-all-india-difficult-airway-association-2016-guidelines-for-tracheal-intubation-in-the-intensive-care-unit
#10
Sheila Nainan Myatra, Syed Moied Ahmed, Pankaj Kundra, Rakesh Garg, Venkateswaran Ramkumar, Apeksh Patwa, Amit Shah, Ubaradka S Raveendra, Sumalatha Radhakrishna Shetty, Jeson Rajan Doctor, Dilip K Pawar, Singaravelu Ramesh, Sabyasachi Das, Jigeeshu Vasishtha Divatia
Tracheal intubation (TI) is a routine procedure in the Intensive Care Unit (ICU) and is often lifesaving. In contrast to the controlled conditions in the operating room, critically ill patients with respiratory failure and shock are physiologically unstable. These factors, along with under evaluation of the airway and suboptimal response to preoxygenation, are responsible for a high incidence of life-threatening complications such as severe hypoxemia and cardiovascular collapse during TI in the ICU. The All India Difficult Airway Association (AIDAA) proposes a stepwise plan for safe management of the airway in critically ill patients...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28399379/physiology-of-arousal-in-osa-and-potential-impacts-for-sedative-treatment
#11
Amy S Jordan, Fergal J O'Donoghue, Jennifer M Cori, John Trinder
Treatment options for patients with obstructive sleep apnea (OSA) intolerant of continuous positive airway pressure (CPAP) are limited. Thus, new therapies are sought. Recently, there has been interest in using sedatives to delay arousal from sleep, allowing upper airway dilator muscle recruitment sufficient to re-open the airway while maintaining sleep. In this review the rationale for sedative use and prior sedative studies in OSA are presented, along with a description of six factors that may determine sedative treatment success...
April 11, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28392402/does-seasonal-allergic-rhinitis-increase-sensitivity-to-ammonia-exposure
#12
Marlene Pacharra, Stefan Kleinbeck, Michael Schäper, Meinolf Blaszkewicz, Klaus Golka, Christoph van Thriel
Allergic inflammation in the upper airways represents a wide-spread health issue: Little is known about whether it increases sensitivity to airborne chemicals thereby challenging established exposure limits that neglect such differences in susceptibility. To investigate the role of pre-existing allergic inflammation, 19 subjects with seasonal allergic rhinitis (SAR) and 18 control subjects with low risk of sensitization were exposed for 4h to ammonia in two concentrations (cross-over design): 2.5ppm (odor threshold) and 0-40ppm (occupational exposure limit: 20ppm TWA)...
April 2, 2017: International Journal of Hygiene and Environmental Health
https://www.readbyqxmd.com/read/28390510/acute-management-of-moderate-severe-traumatic-brain-injury
#13
REVIEW
Wittstatt Alexandra Whitaker-Lea, Alex B Valadka
Traumatic brain injury (TBI) continues to be a major public health problem. Proposed treatments have not withstood testing in clinical trials because of failure to account for different types of TBI and other weaknesses in trial design. Management goals continue to be prevention and prompt treatment of secondary insults (hypotension, hypoxia, and other physiologic derangements). This goal is best accomplished by careful attention to airway, breathing, circulation, and basic principles of intensive care unit management...
May 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/28388793/treating-the-deviated-or-wide-nasal-dorsum
#14
Richard E Davis, Allen I Foulad
Both deviation and excessive width of the nasal dorsum result in conspicuous facial disharmony and are often attended by nasal airway dysfunction. Whether the result of developmental growth disturbances, nasal trauma, failed nasal surgery, or combinations therein, deviation and splaying of the nasal dorsum can be exceedingly difficult to treat. Individualized treatment is paramount because contour variations are seemingly endless, and a careful preoperative assessment of the anatomic, physiologic, cosmetic, and psychosocial factors that characterize the deformity is necessary to devise an effective patient-specific treatment plan...
April 2017: Facial Plastic Surgery: FPS
https://www.readbyqxmd.com/read/28387543/effect-of-4-aminopyridine-on-genioglossus-muscle-activity-during-sleep-in-healthy-adults
#15
Luigi Taranto-Montemurro, Scott A Sands, Ali Azarbarzin, Melania Marques, Camila M de Melo, Bradley A Edwards, Danny J Eckert, Ludovico Messineo, David P White, Andrew Wellman
RATIONALE: The reduction in upper airway muscle activity from wakefulness to sleep plays a key role in the development of obstructive sleep apnea. Potassium (K+) channels have been recently identified as the downstream mechanisms through which hypoglossal motoneuron membrane excitability is reduced both in non-REM (NREM) and REM sleep. In animal models, the administration of 4-aminopyridine (4-AP), a voltage-gated K+ channel blocker, increased genioglossus activity during wakefulness and across all sleep stages...
April 7, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28385915/physiology-in-medicine-understanding-dynamic-alveolar-physiology-to-minimize-ventilator-induced-lung-injury-vili
#16
Gary F Nieman, Joshua Satalin, Michaela Kollisch-Singule, Penny L Andrews, Hani Aiash, Nader M Habashi, Louis A Gatto
The acute respiratory distress syndrome (ARDS) remains a serious clinical problem with the main treatment being supportive in the form of mechanical ventilation. However, mechanical ventilation can be a double edge sword, if set improperly can exacerbate the tissue damage caused by ARDS and is known as ventilator induced lung injury (VILI). In order to minimize VILI we must understand the pathophysiologic mechanisms of tissue damage at the alveolar level. In this Physiology in Medicine paper the dynamic physiology of alveolar inflation and deflation during mechanical ventilation will be reviewed...
April 6, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28381639/gestational-exposure-to-sidestream-secondhand-cigarette-smoke-promotes-transgenerational-epigenetic-transmission-of-exacerbated-allergic-asthma-and-bronchopulmonary-dysplasia
#17
Shashi P Singh, Hitendra S Chand, Raymond J Langley, Neerad Mishra, Ted Barrett, Karin Rudolph, Carmen Tellez, Piotr T Filipczak, Steve Belinsky, Ali I Saeed, Aryaz Sheybani, Vernat Exil, Hemant Agarwal, Venkataramana K Sidhaye, Thomas Sussan, Shyam Biswal, Mohan Sopori
Embryonic development is highly sensitive to xenobiotic toxicity and in utero exposure to environmental toxins affects physiological responses of the progeny. In the United States, the prevalence of allergic asthma (AA) is inexplicably rising and in utero exposure to cigarette smoke increases the risk of AA and bronchopulmonary dysplasia (BPD) in children and animal models. We reported that gestational exposure to sidestream cigarette smoke (SS), or secondhand smoke, promoted nicotinic acetylcholine receptor-dependent exacerbation of AA and BPD in mice...
April 5, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28379223/in-vitro-nasal-mucosa-gland-like-structure-formation-on-a-chip
#18
Kyuhwan Na, Mingyu Lee, Hyun-Woo Shin, Seok Chung
The emergence of microfluidic epithelial models using diverse types of cells within a physiologically relevant microenvironment has the potential to be a powerful tool for preclinical drug screening and pathophysiological studies. However, to date, few studies have reported the development of a complicated in vitro human nasal epithelial model. The aim of this study was to produce an in vitro human nasal mucosa model for reliable drug screening and clinical applications. Here, we integrated and optimized several culture conditions such as cell type, airway culture conditions, and hydrogel scaffolds into a microfluidic chip to construct an advanced in vitro human nasal mucosa model...
April 5, 2017: Lab on a Chip
https://www.readbyqxmd.com/read/28377402/assessing-initial-response-to-high-frequency-jet-ventilation-in-premature-infants-with-hypercapnic-respiratory-failure
#19
Craig R Wheeler, Craig D Smallwood, Iris O'Donnell, Daniel Gagner, Martha C Sola-Visner
BACKGROUND: High-frequency jet ventilation (HFJV) has been used in conjunction with conventional ventilation for infants with respiratory failure. We sought to identify parameters that were associated with successful application of HFJV in patients with hypercapnic respiratory failure. METHODS: A single-center, retrospective review of infants who received HFJV was conducted. Subjects were enrolled if birthweight was ≤2,000 g and capillary PCO2 was ≥55 mm Hg...
April 4, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28372575/implementing-a-bedside-assessment-of-respiratory-mechanics-in-patients-with-acute-respiratory-distress-syndrome
#20
Lu Chen, Guang-Qiang Chen, Kevin Shore, Orest Shklar, Concetta Martins, Brian Devenyi, Paul Lindsay, Heather McPhail, Ashley Lanys, Ibrahim Soliman, Mazin Tuma, Michael Kim, Kerri Porretta, Pamela Greco, Hilary Every, Chris Hayes, Andrew Baker, Jan O Friedrich, Laurent Brochard
BACKGROUND: Despite their potential interest for clinical management, measurements of respiratory mechanics in patients with acute respiratory distress syndrome (ARDS) are seldom performed in routine practice. We introduced a systematic assessment of respiratory mechanics in our clinical practice. After the first year of clinical use, we retrospectively assessed whether these measurements had any influence on clinical management and physiological parameters associated with clinical outcomes by comparing their value before and after performing the test...
April 4, 2017: Critical Care: the Official Journal of the Critical Care Forum
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