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Airway physiology

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https://www.readbyqxmd.com/read/28548545/mild-chronic-obstructive-pulmonary-disease-why-spirometry-is-not-sufficient
#1
Amany F Elbehairy, Grace Parraga, Katherine A Webb, J Alberto Neder, Denis E O'Donnell
Chronic obstructive pulmonary disease (COPD) - an inflammatory disease of the airways, alveoli and lung microvasculature - is a leading cause of death worldwide. Smokers with milder airway obstruction constitute the majority of patients with this disease. Many studies have shown increased morbidity, activity-related dyspnea, exercise intolerance and mortality in such patients, compared with age-matched healthy populations. Clinical evaluation of symptomatic smokers with ostensibly mild airway obstruction poses a challenge in clinical practice as spirometry can obscure extensive heterogeneous pathophysiological impairment...
May 26, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28544570/relative-susceptibility-of-airway-organisms-to-antimicrobial-effects-of-nitric-oxide
#2
Alan D Workman, Ryan M Carey, Michael A Kohanski, David W Kennedy, James N Palmer, Nithin D Adappa, Noam A Cohen
BACKGROUND: Nitric oxide (NO) is released in the airway as a critical component of innate immune defense against invading pathogenic organisms. It is well documented that bacteriostatic and bactericidal effects of NO are concentration-dependent. However, few data exist comparing relative susceptibility of common pathogens to NO at physiologic concentrations. In this study we evaluated the effects of NO on 4 common airway bacteria and 1 fungus, and examined the potential implications of discrepancies in sensitivity...
May 25, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28544082/a-resource-of-potential-drug-targets-and-strategic-decision-making-for-obstructive-sleep-apnoea-pharmacotherapy
#3
REVIEW
Richard L Horner, Kevin P Grace, Andrew Wellman
There is currently no pharmacotherapy for obstructive sleep apnoea (OSA) but there is no principled a priori reason why there should not be one. This review identifies a rational decision-making strategy with the necessary logical underpinnings that any reasonable approach would be expected to navigate to develop a viable pharmacotherapy for OSA. The process first involves phenotyping an individual to quantify and characterize the critical predisposing factor(s) to their OSA pathogenesis and identify, a priori, if the patient is likely to benefit from a pharmacotherapy that targets those factors...
May 25, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28534064/reflections-on-clinical-and-statistical-use-of-the-penetration-aspiration-scale
#4
REVIEW
Catriona M Steele, Karen Grace-Martin
The 8-point Penetration-Aspiration Scale (PAS) was introduced to the field of dysphagia in 1996 and has become the standard method used by both clinicians and researchers to describe and measure the severity of airway invasion during swallowing. In this article, we review the properties of the scale and explore what has been learned over 20 years of use regarding the construct validity, ordinality, intervality, score distribution, and sensitivity of the PAS to change. We propose that a categorical revision of the PAS into four levels of increasing physiological severity would be appropriate...
May 22, 2017: Dysphagia
https://www.readbyqxmd.com/read/28529824/to-cough-or-not-to-cough-examining-the-potential-utility-of-cough-testing-in-the-clinical-evaluation-of-swallowing
#5
Stephanie A Watts, Lauren Tabor, Emily K Plowman
PURPOSE: The clinical swallowing evaluation (CSE) represents a critical component of a comprehensive assessment of deglutition. Although universally utilized across clinical settings, the CSE demonstrates limitations in its ability to accurately identify all individuals with dysphagia. There exists a need to improve assessment and screening techniques to improve health outcomes, treatment recommendations and ultimately mortality in individuals at risk for dysphagia. The following narrative review provides a summary of currently used validated CSE's and examines the potential role of cough testing and screening in the CSE...
December 2016: Current Physical Medicine and Rehabilitation Reports
https://www.readbyqxmd.com/read/28528730/sir-charles-bell-unheralded-laryngologist
#6
Elliot Abemayor
INTRODUCTION: Sir Charles Bell is renowned and revered as an outstanding surgeon, anatomist, clinician and teacher and his many contributions to various medical fields have been amply described. What are less well-known are his contributions to the field of laryngology. METHODS: Selected clinical and physiological publications by Bell were examined that addressed issues related specifically to the airway or pharynx. These included both case reports and case series...
April 21, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28526665/the-sensor-study-protocol-for-a-mixed-methods-study-of-self-management-checks-to-predict-exacerbations-of-pseudomonas-aeruginosa-in-patients-with-long-term-respiratory-conditions
#7
Claire Roberts, Thomas L Jones, Samal Gunatilake, Will Storrar, Scott Elliott, Sharon Glaysher, Ben Green, Steven Rule, Carole Fogg, Ann Dewey, Kevin A Auton, Anoop J Chauhan
BACKGROUND: There are an estimated three million people in the United Kingdom with chronic obstructive pulmonary disease (COPD), and the incidence of bronchiectasis is estimated at around 0.1% but is more common in COPD and severe asthma. Both COPD and bronchiectasis are characterized by exacerbations in which bacteria play a central role. Pseudomonas aeruginosa is isolated from sputum samples from 4% to 15% of adults with COPD and is more likely to be isolated from patients with severe disease...
May 19, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28524027/-effect-of-chest-physiotherapy-in-patients-undergoing-mechanical-ventilation-a-prospective-randomized-controlled-trial
#8
Hui Zeng, Zhen Zhang, Yuan Gong, Miao Chen
OBJECTIVE: To investigate the effect of chest physiotherapy (CPT) on patients undergoing mechanical ventilation (MV). METHODS: A prospective randomized controlled trial (RCT) was conducted. Sixty-eight adult patients undergoing invasive MV over 48 hours admitted to intensive care unit (ICU) of Affiliated Hospital of Zunyi Medical College from December 2014 to October 2016 were enrolled, and they were divided into CPT group (n = 37) and control group (n = 31) by random number table...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28522758/regulation-of-erythropoiesis-after-normoxic-return-from-chronic-sustained-and-intermittent-hypoxia
#9
Jihyun Song, Krishna Sundar, Radhika Gangaraju, Josef T Prchal
Hypoxia increases erythropoiesis mediated by hypoxia-inducible transcription factors (HIF) which regulate erythropoietin (EPO) transcription. Neocytolysis is a physiological mechanism that corrects polycythemia from chronic sustained hypoxemia (CSH) by transient, preferential destruction of young RBCs after normoxia is restored. We showed that neocytolysis is caused by excessive mitochondrial-derived reactive oxygen species (ROS) in reticulocytes mediated by down-regulation of HIF-controlled BNIP3L regulated mitophagy and a decrease in RBC antioxidant catalase (CAT) in hypoxia-produced erythrocytes...
May 18, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28522150/implementation-of-a-wearable-ultrasound-device-for-the-overnight-monitoring-of-tongue-base-deformation-during-obstructive-sleep-apnea-events
#10
Chi-Kai Weng, Jeng-Wen Chen, Po-Yang Lee, Chih-Chung Huang
Obstructive sleep apnea (OSA) is a breathing disorder characterized by the repeated collapse of the pharyngeal airway during sleep. Previous studies have reported that tongue base deformation may be a major contributing factor. However, overnight monitoring of tongue motion in patients with OSA has previously been impracticable. We developed a wearable ultrasound device for prolonged recording during natural sleep of the changes in tongue base thickness (TBT) in patients with OSA. The maximum TBT was fed into a polysomnography system so that physiologic signals and TBT data were simultaneously monitored...
May 15, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28518116/the-wincf-model-an-inexpensive-and-tractable-microcosm-of-a-mucus-plugged-bronchiole-to-study-the-microbiology-of-lung-infections
#11
William J Comstock, Edwin Huh, Reiley Weekes, Connor Watson, Tianyang Xu, Pieter C Dorrestein, Robert A Quinn
Many chronic airway diseases result in mucus plugging of the airways. Lungs of an individual with cystic fibrosis are an exemplary case where their mucus-plugged bronchioles create a favorable habitat for microbial colonization. Various pathogens thrive in this environment interacting with each other and driving many of the symptoms associated with CF disease. Like any microbial community, the chemical conditions of their habitat have a significant impact on the community structure and dynamics. For example, different microorganisms thrive in differing levels of oxygen or other solute concentrations...
May 8, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28514613/kit-inhibition-by-imatinib-in-patients-with-severe-refractory-asthma
#12
RANDOMIZED CONTROLLED TRIAL
Katherine N Cahill, Howard R Katz, Jing Cui, Juying Lai, Shamsah Kazani, Allison Crosby-Thompson, Denise Garofalo, Mario Castro, Nizar Jarjour, Emily DiMango, Serpil Erzurum, Jennifer L Trevor, Kartik Shenoy, Vernon M Chinchilli, Michael E Wechsler, Tanya M Laidlaw, Joshua A Boyce, Elliot Israel
BACKGROUND: Mast cells are present in the airways of patients who have severe asthma despite glucocorticoid treatment; these cells are associated with disease characteristics including poor quality of life and inadequate asthma control. Stem cell factor and its receptor, KIT, are central to mast-cell homeostasis. We conducted a proof-of-principle trial to evaluate the effect of imatinib, a KIT inhibitor, on airway hyperresponsiveness, a physiological marker of severe asthma, as well as on airway mast-cell numbers and activation in patients with severe asthma...
May 18, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28505224/muscle-bioenergetic-considerations-for-intrinsic-laryngeal-skeletal-muscle-physiology
#13
Mary J Sandage, Audrey G Smith
Purpose: Intrinsic laryngeal skeletal muscle bioenergetics, the means by which muscles produce fuel for muscle metabolism, is an understudied aspect of laryngeal physiology with direct implications for voice habilitation and rehabilitation. The purpose of this review is to describe bioenergetic pathways identified in limb skeletal muscle and introduce bioenergetic physiology as a necessary parameter for theoretical models of laryngeal skeletal muscle function. Method: A comprehensive review of the human intrinsic laryngeal skeletal muscle physiology literature was conducted...
May 24, 2017: Journal of Speech, Language, and Hearing Research: JSLHR
https://www.readbyqxmd.com/read/28502415/effects-of-acute-psychological-stress-induced-in-laboratory-on-physiological-responses-in-asthma-populations-a-systematic-review
#14
REVIEW
Annik Plourde, Kim L Lavoie, Candace Raddatz, Simon L Bacon
BACKGROUND: Psychological stress has long been suspected to have a deleterious effect on asthma, with acute psychological stress being associated with physiological responses in asthma patients. OBJECTIVES: The purpose of this systematic review was to provide a narrative synthesis of the impact of acute laboratory psychological stress on physiological responses among asthma patients. METHODS: An extensive search was conducted by two independent authors using Pubmed, PsycINFO, PsyArticles and the Cochrane Library electronic databases (up to September 2016)...
June 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28493293/responsiveness-to-oral-prednisolone-in-severe-asthma-is-related-to-the-degree-of-eosinophilic-airway-inflammation
#15
Ana R Sousa, Richard P Marshall, Linda C Warnock, Sarah Bolton, Annette Hastie, Fiona Symon, Beverley Hargadon, Hilary Marshall, Matthew Richardson, Christopher E Brightling, Pranab Haldar, Roberta Milone, Peter Chalk, Rick Williamson, Reynold Panettieri, Richard Knowles, Eugene R Bleecker, Andrew J Wardlaw
BACKGROUND: Patients with severe asthma appear relatively corticosteroid resistant. Corticosteroid responsiveness is closely related to the degree of eosinophilic airway inflammation. The extent to which eosinophilic airway inflammation in severe asthma responds to treatment with systemic corticosteroids is not clear. OBJECTIVE: To relate the physiological and inflammatory response to systemic corticosteroids in asthma to disease severity and the baseline extent of eosinophilic inflammation...
May 10, 2017: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28485314/effects-of-propofol-on-respiratory-drive-and-patient-ventilator-synchrony-during-pressure-support-ventilation-in-postoperative-patients-a-prospective-study
#16
Ling Liu, Ai-Ping Wu, Yi Yang, Song-Qiao Liu, Ying-Zi Huang, Jian-Feng Xie, Chun Pan, Cong-Shan Yang, Hai-Bo Qiu
BACKGROUND: Propofol is increasingly used during partial support mechanical ventilation such as pressure support ventilation (PSV) in postoperative patients. However, breathing pattern, respiratory drive, and patient-ventilator synchrony are affected by the sedative used and the sedation depth. The present study aimed to evaluate the physiologic effects of varying depths of propofol sedation on respiratory drive and patient-ventilator synchrony during PSV in postoperative patients. METHODS: Eight postoperative patients receiving PSV for <24 h were enrolled...
May 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28483860/rapid-eye-movement-sleep-predominant-central-sleep-apnea-relieved-by-positive-airway-pressure-a-case-report
#17
Noah P Jouett, Michael L Smith, Donald E Watenpaugh, Maryam Siddiqui, Maleeha Ahmad, Farrukh Siddiqui
Central Sleep Apnea (CSA) is characterized by intermittent apneas and hypopneas during sleep that result from absent central respiratory drive. CSA occurs almost exclusively during non-rapid-eye-movement (NREM) sleep due to enhanced neuronal ventilatory drive during REM sleep that makes central apneas highly unlikely to form. A 45-year-old obese African American female presented with co-existing Obstructive Sleep Apnea (OSA) and CSA, not in the form of mixed or complex sleep apnea. Peculiarly, her CSA occurred only during rapid-eye-movement (REM) sleep, which is exceedingly rare...
May 2017: Physiological Reports
https://www.readbyqxmd.com/read/28483562/the-role-of-inkt-cells-on-the-phenotypes-of-allergic-airways-in-a-mouse-model
#18
Lennart K A Lundblad, Nazey Gülec, Matthew E Poynter, Victoria L DeVault, Oliver Dienz, Jonathan E Boyson, Nirav Daphtary, Minara Aliyeva, Jennifer L Ather, Felix Scheuplein, Robert Schaub
iNKT cells and mast cells have both been implicated in the syndrome of allergic asthma through their activation-induced release of Th2 type cytokines and secretion of histamine and other mediators, respectively, which can promote airways hyperresponsiveness (AHR) to agents such as methacholine. However, a mechanistic link between iNKT cells and mast cell recruitment or activation has never been explored. Our objective was to determine whether iNKT cells are necessary for the recruitment of mast cells and if iNKT cells can influence the acute allergen induced bronchoconstriction (AIB) caused by mast cell mediator release...
May 5, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28482837/selective-gene-expression-analysis-of-the-neuroepithelial-body-microenvironment-in-postnatal-lungs-with-special-interest-for-potential-stem-cell-characteristics
#19
Line Verckist, Robrecht Lembrechts, Sofie Thys, Isabel Pintelon, Jean-Pierre Timmermans, Inge Brouns, Dirk Adriaensen
BACKGROUND: The pulmonary neuroepithelial body (NEB) microenvironment (ME) consists of innervated cell clusters that occur sparsely distributed in the airway epithelium, an organization that has so far hampered reliable selective gene expression analysis. Although the NEB ME has been suggested to be important for airway epithelial repair after ablation, little is known about their potential stem cell characteristics in healthy postnatal lungs. Here we report on a large-scale selective gene expression analysis of the NEB ME...
May 8, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28482650/obesity-and-perioperative-noninvasive-ventilation-in-bariatric-surgery
#20
Michele Carron, Francesco Zarantonello, Giovanna Ieppariello, Carlo Ori
The incidence and prevalence of obesity continues to increase globally. Physicians will therefore provide care for an increasing number of obese patients in their clinical practice. Optimal management of these patients is required to minimize the risk of perioperative complications that increase morbidity and mortality. Obesity affects the respiratory function. It is generally associated with reduced lung volume with increased atelectasis, decreased lung and chest wall compliance, increased airway resistance, and moderate to severe hypoxemia...
June 2017: Minerva Chirurgica
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