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Airway physiology

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https://www.readbyqxmd.com/read/29148851/airway-geometry-airway-flow-and-particle-measurement-methods-implications-on-pulmonary-drug-delivery
#1
A Kourmatzis, S Cheng, H-K Chan
The effectiveness of drug delivery to the lungs is inextricably linked to the fundamental interactions that occur between particles and flow in the extrathoracic airway. Research in this field requires time resolved in-vivo and in-vitro measurements of three separate, yet intricately linked parameters: i) airway flow, ii) airway geometry, and iii) drug particle characteristics. A number of recent significant developments have been made in the experimental diagnostic tools used to characterise these parameters...
November 17, 2017: Expert Opinion on Drug Delivery
https://www.readbyqxmd.com/read/29144160/high-flow-nasal-cannula-oxygen-in-adults-an-evidence-based-assessment
#2
Matthew G Drake
High flow nasal cannula oxygenation has distinct advantages over other oxygen devices due to its unique effects on respiratory physiology. In particular, adjustable oxygen delivery and flow-dependent carbon dioxide clearance from the upper airway reduce work of breathing and can better match inspiratory demand during respiratory distress. Historically, few studies had evaluated whether the physiologic effects of these devices translated into clinical benefit. However, recent publications have begun to address this knowledge gap...
November 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29144056/oropharyngeal-dysphagia-profiles-in-individuals-with-oculopharyngeal-muscular-dystrophy
#3
L C Tabor, E K Plowman, C Romero-Clark, S Youssof
BACKGROUND: Although dysphagia represents a hallmark manifestation of oculopharyngeal muscular dystrophy (OPMD), limited knowledge exists regarding the underlying nature of oropharyngeal swallowing impairments in this patient population. We aimed to delineate global pharyngeal dysphagia profiles in OPMD and identify the prevalence and physiologic associations of impairments in swallowing safety and efficiency. METHODS: Twenty-two individuals with OPMD completed a videofluoroscopic swallowing evaluation...
November 16, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29140632/grain-entrapment-pressure-on-the-torso-can-you-breathe-while-buried-in-grain
#4
Kevin G Moore, Carol L Jones
The pressure applied to the chest and back of a simulated grain entrapment victim was measured. Pressure sensors were attached to the chest and back of a manikin that was buried in grain in the vertical position. Measurements were made in four grain types at four grain depths ranging from the top of the manikin's shoulders to 0.61 m (24 in.) over the head. The pressure ranged from 1.6 to 4.0 kPa (0.23 to 0.57 psi). Based on available physiological information, this amount of pressure is unlikely to limit the respiration of an otherwise healthy adult male victim...
April 26, 2017: Journal of Agricultural Safety and Health
https://www.readbyqxmd.com/read/29134245/esophageal-pressure-research-or-clinical-tool
#5
REVIEW
E Baedorf Kassis, S H Loring, D Talmor
Esophageal manometry has traditionally been utilized for respiratory physiology research, but clinicians have recently found numerous applications within the intensive care unit. Esophageal pressure (PEs) is a surrogate for pleural pressures (PPl), and the difference between airway pressure (PAO) and PEs provides a good estimate for the pressure across the lung also known as the transpulmonary pressure (PL). Differentiating the effects of mechanical ventilation and spontaneous breathing on the respiratory system, chest wall, and across the lung allows for improved personalization in clinical decision making...
November 13, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29132745/-membranous-microparticles-and-respiratory-disease
#6
REVIEW
B Renaud-Picard, J Toussaint, A Leclercq, J Reeb, L Kessler, F Toti, R Kessler
Microparticles (MP) are plasmic membrane fragments released from cells after physiological stimulation or stress conditions like inflammation or infection. Their production is correlated to the rate of cell apoptosis. All types of cells can produce MP but they are produced mainly by platelets, endothelial cells, and leukocytes. They carry many bio-active molecules on their surface, specific to the parental cell, giving them the ability to be biomarkers and bio-effectors. MP are present in circulating blood, tissues and many biological fluids...
November 10, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/29132582/airway-management-in-trauma
#7
REVIEW
George Kovacs, Nicholas Sowers
Airway management in the trauma patient presents numerous unique challenges beyond placement of an endotracheal tube and outcomes are dependent on the provider's ability to anticipate difficulty. Airway management strategies for the care of the polytrauma patient are reviewed, with specific considerations for those presenting with traumatic brain injury, suspected c-spine injury, the contaminated airway, the agitated trauma patient, maxillofacial trauma, and the traumatized airway. An approach to airway management that considers the potential anatomic and physiologic challenges in caring for these complicated trauma patients is presented...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29108607/testing-the-performance-of-positive-airway-pressure-generators-from-bench-to-bedside
#8
REVIEW
Kaixian Zhu, Claire Colas des Francs, Amélie Sagniez, Pierre Escourrou
Positive airway pressure (PAP) devices use different proprietary algorithms for sleep-disordered breathing event detection and response. Most device evaluations are based on clinical studies, which have obvious limitations. As a complementary approach, bench studies provide an analysis of algorithms in predefined conditions, which allows understanding contradictory results observed in clinical studies. But such studies cannot provide long-term treatment data and physiologic effects of treatment. It is important to understand the advantages and the limitations of both kinds of studies...
December 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29107399/airway-diseases-and-health-literacy-hl-measurement-tools-a-systematic-review-to-inform-respiratory-research-and-practice
#9
REVIEW
Jessica Shum, Iraj Poureslami, Darrin Wiebe, Mary M Doyle-Waters, Laura Nimmon, J Mark FitzGerald
OBJECTIVE: To identify and evaluate asthma/COPD measurement tools that assess any of the five health literacy (HL) domains: (1) access, (2) understand, (3) evaluate, (4) communicate, and (5) use, as well as numeracy. METHODS: MEDLINE/Embase (via Ovid) databases from 1974 to 2016 were searched and complimented by grey literature. Study selection and data extraction were conducted by two reviewers independently. RESULTS: We identified 65 tools including 40 asthma, 22 COPD, and 3 asthma/COPD focused tools...
October 27, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/29106997/interferon-response-to-rsv-by-bronchial-epithelium-from-children-with-asthma-is-inversely-correlated-with-pulmonary-function
#10
M C Altman, S R Reeves, A R Parker, E Whalen, K M S Misura, K A Barrow, R G James, T S Hallstrand, S F Ziegler, J S Debley
BACKGROUND: Respiratory viral infection in early childhood, including that from respiratory syncytial virus (RSV), has been previously associated with the development of asthma. OBJECTIVE: We aimed to determine whether ex vivo RSV infection of bronchial epithelial cells (BECs) from children with asthma would induce specific gene expression patterns, and whether such patterns associate with lung function among BEC donors. METHODS: Primary BECs from carefully characterized children with asthma (n=18) and matched healthy children without asthma (n=8) were differentiated at an air-liquid interface (ALI) for 21 days...
October 26, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29104014/continuous-positive-airway-pressure-an-early-intervention-to-prevent-phosgene-induced-acute-lung-injury
#11
Stuart Graham, Sarah Fairhall, Steve Rutter, Philippa Auton, Rachel Rendell, Adam Smith, Rosi Perrott, Tim Nicholson Roberts, Bronwen Jugg
Exposure to toxic industrial chemicals such as phosgene may occur through accidental or deliberate release. Inhalation may result in an acute lung injury which manifests as hypoxaemia with insufficient oxygen being delivered to the tissues resulting in hypoxia, respiratory failure and death. No effective pharmacological therapy currently exists and treatment remains supportive, often requiring intensive care facilities. In a mass casualty scenario the logistical burden of managing exposed individuals would rapidly overwhelm healthcare systems...
November 2, 2017: Toxicology Letters
https://www.readbyqxmd.com/read/29103994/sputum-cell-interleukin-1-receptor-expression-level-is-a-marker-of-airway-neutrophilia-and-airflow-obstruction-in-asthma
#12
Michael D Evans, Stephane Esnault, Loren C Denlinger, Nizar N Jarjour
BACKGROUND: Various clinical, biologic or physiologic markers of asthma have been used to identify patient clusters and potential targets for therapy. However, these identifiers frequently overlap among the different asthma groups. For instance, both eosinophils and neutrophils are often increased in the airway of asthma patients despite their typical association with type-2 and type-17 immune response, respectively. OBJECTIVES: To determine whether inflammatory gene expressions are related to patterns of airway inflammation and lung function, and identify molecular markers for neutrophilic asthma...
November 2, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29100865/clinical-phenotypes-of-nasal-polyps-and-comorbid-asthma-based-on-cluster-analysis-of-disease-history
#13
Dawei Wu, Benjamin S Bleier, Lun Li, Xiaojun Zhan, Lichuan Zhang, Qianwen Lv, Jianting Wang, Yongxiang Wei
BACKGROUND: Nasal polyps and comorbid asthma (NPcA) is a common united airway disease and is highly heterogeneous with respect to clinical, physiologic, and pathologic parameters. The clinical phenotypes of NPcA are poorly understood. OBJECTIVE: We sought to explore clinical phenotypes in patients with NPcA. METHODS: Patients first diagnosed with NPcA were recruited from Rhinological Clinics and Respiratory Clinics. We clustered patients with NPcA based on parameters regarding natural courses and demographic characteristics...
October 31, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29099872/a-pilot-randomized-controlled-trial-of-ekg-for-neonatal-resuscitation
#14
Anup Katheria, Kathy Arnell, Melissa Brown, Kasim Hassen, Mauricio Maldonado, Wade Rich, Neil Finer
BACKGROUND: The seventh edition of the American Academy of Pediatrics Neonatal Resuscitation Program recommends the use of a cardiac monitor in infants that need resuscitation. Previous trials have shown that EKG heart rate is available before pulse rate from a pulse oximeter. To date no trial has looked at how the availability of electrocardiogram (EKG) affects clinical interventions in the delivery room. OBJECTIVE: To determine whether the availability of an EKG heart rate value and tracing to the clinical team has an effect on physiologic measures and related interventions during the stabilization of preterm infants...
2017: PloS One
https://www.readbyqxmd.com/read/29097629/increased-respiratory-neural-drive-and-work-of-breathing-in-exercise-induced-laryngeal-obstruction
#15
Emil Schwarz Walsted, Azmy Faisal, Caroline J Jolley, Laura L Swanton, Matthew J Pavitt, Yuan-Ming Luo, Vibeke Backer, Michael I Polkey, James H Hull
Rationale: Exercise induced laryngeal obstruction (EILO), a phenomenon in which the larynx closes inappropriately during physical activity, is a prevalent cause of exertional dyspnea in young individuals. The physiological ventilatory impact of EILO and its relationship to dyspnea are poorly understood. Objectives: To evaluate exercise related changes in laryngeal aperture on ventilation, pulmonary mechanics and respiratory neural drive. Methods: We prospectively evaluated 12 subjects (six with EILO and six healthy age- and gender-matched controls)...
November 2, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29079338/advances-in-experimental-and-mechanistic-computational-models-to-understand-pulmonary-exposure-to-inhaled-drugs
#16
Per Bäckman, Sumit Arora, William Couet, Ben Forbes, Wilbur de Kruijf, Amrit Paudel
Prediction of local exposure following inhalation of a locally acting pulmonary drug is central to the successful development of novel inhaled medicines, as well as generic equivalents. This work provides a comprehensive review of the state of the art with respect to multiscale computer models designed to provide a mechanistic prediction of local and systemic drug exposure following inhalation. The availability and quality of underpinning in vivo and in vitro data informing the computer based models is also considered...
October 25, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29079097/assessing-the-relationship-between-movement-and-airflow-in-the-upper-airway-using-computational-fluid-dynamics-with-motion-determined-from-magnetic-resonance-imaging
#17
Alister J Bates, Andreas Schuh, Gabriel Amine-Eddine, Keith McConnell, Wolfgang Loew, Robert J Fleck, Jason C Woods, Charles L Dumoulin, Raouf S Amin
BACKGROUND: Computational fluid dynamics simulations of respiratory airflow in the upper airway reveal clinically relevant information, including sites of local resistance, inhaled particle deposition, and the effect of pathological constrictions. Unlike previous simulations, which have been performed on rigid anatomical models from static medical imaging, this work utilises ciné imaging during respiration to create dynamic models and more closely represent airway physiology. METHODS: Airway movement maps were obtained from non-rigid image registration of fast-cine MRI and applied to high-spatial-resolution airway surface models...
October 14, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/29077751/use-of-ferrets-for-electrophysiologic-monitoring-of-ion-transport
#18
Niroop Kaza, S Vamsee Raju, Joan M Cadillac, John A Trombley, Lawrence Rasmussen, Liping Tang, Erik Dohm, Kevin S Harrod, Steven M Rowe
Limited success achieved in translating basic science discoveries into clinical applications for chronic airway diseases is attributed to differences in respiratory anatomy and physiology, poor approximation of pathologic processes, and lack of correlative clinical endpoints between humans and laboratory animal models. Here, we discuss advantages of using ferrets (Mustela putorus furo) as a model for improved understanding of human airway physiology and demonstrate assays for quantifying airway epithelial ion transport in vivo and ex vivo, and establish air-liquid interface cultures of ferret airway epithelial cells as a complementary in vitro model for mechanistic studies...
2017: PloS One
https://www.readbyqxmd.com/read/29076654/the-respiratory-system-in-pediatric-chronic-heart-disease
#19
REVIEW
Sotiria C Apostolopoulou
Cardiovascular disease in the pediatric population closely affects the respiratory system inducing water retention in the lungs and pulmonary edema, airway compression by cardiovascular structures, restrictive pulmonary physiology as a result of hemodynamic changes and surgical repair, susceptibility to respiratory infections, development of pulmonary hypertension, thrombosis, or hemorrhage. Chronic heart failure and congenital heart disease are characterized by various respiratory manifestations and symptoms mimicking lung disease, which are frequently difficult to diagnose and treat...
December 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29070581/personalised-medicine-in-sleep-respiratory-disorders-focus-on-obstructive-sleep-apnoea-diagnosis-and-treatment
#20
Maria R Bonsignore, Monique C Suarez Giron, Oreste Marrone, Alessandra Castrogiovanni, Josep M Montserrat
In all fields of medicine, major efforts are currently dedicated to improve the clinical, physiological and therapeutic understanding of disease, and obstructive sleep apnoea (OSA) is no exception. The personalised medicine approach is relevant for OSA, given its complex pathophysiology and variable clinical presentation, the interactions with comorbid conditions and its possible contribution to poor outcomes. Treatment with continuous positive airway pressure (CPAP) is effective, but CPAP is poorly tolerated or not accepted in a considerable proportion of OSA patients...
December 31, 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
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