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https://www.readbyqxmd.com/read/28915135/otolaryngologic-management-of-down-syndrome-patients-what-is-new
#1
Ethan C Bassett, Mary F Musso
PURPOSE OF REVIEW: The management of children with Down syndrome as it pertains to the otolaryngologist continues to evolve. Obstructive sleep apnea (OSA) has dominated the recent literature, but other topics including hearing loss, swallowing, and perioperative considerations are also reported. RECENT FINDINGS: The prevalence of OSA in children with Down syndrome ranges from 57 to 73% in certain cohorts, and, whereas adentonsillectomy can decrease Apnea-Hypopnea Index, up to 80% may have persistent OSA...
September 14, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28895039/wheezing-in-infancy-an-overview-of-recent-literature
#2
REVIEW
Christine Muglia, John Oppenheimer
PURPOSE OF REVIEW: Wheezing in infancy is a common presentation with many potential causes. In writing this review, we sought to summarize the newest recommendations and testing available for the more common etiologies of wheezing. RECENT FINDINGS: Regarding the diagnosis of asthma, the modified asthma predictive index has recently been established as a useful predictive tool. Non-breath held multidetector CT with 3D volume rendering airway images is also a newer helpful diagnostic tool for tracheomalacia due to ease of use and its 100% positive predictive value...
September 11, 2017: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/28890564/laryngeal-mask-airway-protector%C3%A2-advanced-uses-for-laparoscopic-cholecystectomies
#3
Leng Zoo Tan, Daryl Jian'An Tan, Edwin Seet
The laryngeal mask airway (LMA) Protector™ is a second-generation perilaryngeal sealer type supraglottic airway device recently introduced into clinical practice. We describe our initial experiences with the use of the LMA Protector™ in three patients undergoing laparoscopic cholecystectomies. In all patients, we found the LMA Protector™ to have acceptable placements on the first attempt, adequate oropharyngeal leak pressures and ventilation adequacy.
August 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28885520/caring-for-trauma-patients-with-coexisting-heart-failure
#4
Karen Bergman Schieman, Kelley Pattison, Conor Early
The coexisting conditions of traumatic injury coupled with a comorbid condition such as heart failure create a complex scenario for the trauma nurse to manage. Initial care of the trauma patient includes following the Advanced Trauma Life Support guidelines and managing the airway, breathing, and circulation (ABC) of the patient. Once the airway is secure and breathing is managed, the team addresses circulation. At this point in the patient's care, the team typically does not know which, if any, comorbid conditions exist...
September 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28880020/novel-gp64-envelope-variants-for-improved-delivery-to-human-airway-epithelial-cells
#5
P L Sinn, B-Y Hwang, N Li, J L S Ortiz, E Shirazi, K R Parekh, A L Cooney, D V Schaffer, P B McCray
Lentiviral vectors pseudotyped with the baculovirus envelope protein GP64 transduce primary cultures of human airway epithelia (HAE) at their apical surface. Our goal in this study was to harness a directed evolution approach to develop a novel envelope glycoprotein with increased transduction properties for HAE. Using error-prone PCR, a library of GP64 mutants was generated and used to prepare a diverse pool of lentiviral virions pseudotyped with GP64 variants. The library was serially passaged on HAE and three GP64 mutations were recovered...
September 7, 2017: Gene Therapy
https://www.readbyqxmd.com/read/28879332/anesthetic-management-for-simultaneous-drug-induced-sleep-endoscopy-and-maxillomandibular-advancement-in-a-patient-with-obstructive-sleep-apnea
#6
Tae Seong Kuk, Eunsun So, Myong-Hwan Karm, Jimin Kim, Seong In Chi, Hyun Jeong Kim, Kwang-Suk Seo, Sung Woon On, Jin-Young Choi
Drug-induced sleep endoscopy (DISE) is used to identify areas of upper airway obstruction, which occurs when patients with obstructive sleep apnea (OSA) snore. DISE enables effective diagnosis and appropriate treatment of the obstruction site. Among surgical treatment methods for OSA, maxillomandibular advancement surgery (MMA) is performed to move a jaw forward; the surgery has a high success rate for OSA treatment. In DISE, anesthetics such as propofol and midazolam must be administered to induce snoring while the patient is deeply sedated for an accurate diagnosis to be made...
March 2017: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28870074/exhaled-volatile-organic-compounds-of-infection-a-systematic-review
#7
Waqar M Ahmed, Oluwasola Lawal, Tamara M Nijsen, Royston Goodacre, Stephen J Fowler
With heightened global concern of microbial drug resistance, advanced methods for early and accurate diagnosis of infection are urgently needed. Analysis of exhaled breath volatile organic compounds (VOCs) toward detecting microbial infection potentially allows a highly informative and noninvasive alternative to current genomics and culture-based methods. We performed a systematic review of research literature reporting human and animal exhaled breath VOCs related to microbial infections. In this Review, we find that a wide range of breath sampling and analysis methods are used by researchers, which significantly affects interstudy method comparability...
September 13, 2017: ACS Infectious Diseases
https://www.readbyqxmd.com/read/28866134/wnt-%C3%AE-catenin-signaling-links-embryonic-lung-development-and-asthmatic-airway-remodeling
#8
REVIEW
Musaddique Hussain, Chengyun Xu, Meiping Lu, Xiling Wu, Lanfang Tang, Ximei Wu
Embryonic lung development requires reciprocal endodermal-mesodermal interactions; mediated by various signaling proteins. Wnt/β-catenin is a signaling protein that exhibits the pivotal role in lung development, injury and repair while aberrant expression of Wnt/β-catenin signaling leads to asthmatic airway remodeling: characterized by hyperplasia and hypertrophy of airway smooth muscle cells, alveolar and vascular damage goblet cells metaplasia, and deposition of extracellular matrix; resulting in decreased lung compliance and increased airway resistance...
August 30, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28864055/tracheobronchopathy-from-inhaled-corticosteroids
#9
REVIEW
Bryan C Husta, Suhail Raoof, Serpil Erzurum, Atul C Mehta
Inhaled corticosteroids (ICSs) have become the mainstay of asthma control. They are also recommended as an add-on therapy to long-acting beta agonists and anticholinergics in moderate to severe COPD with recurrent exacerbations. Ultimately this clinical practice has led to the widespread use of ICSs, which are supported by a more favorable side effect profile than that of systemic steroids.
August 31, 2017: Chest
https://www.readbyqxmd.com/read/28862414/asthma-copd-overlap-syndrome-recent-advances-in-diagnostic-criteria-and-prognostic-significance
#10
Claudio Sorino, Nicola Scichilone, Maria D'Amato, Vincenzo Patella, Fabiano DI Marco
The term asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) has been proposed for individuals with features of both asthma and COPD. Several attempts have been done to define ACOS on the basis of medical history, symptoms, and functional findings. The main diagnostic criteria include airflow obstruction with a strong although incomplete reversibility to bronchodilation tests, a significant exposure to cigarette or biomass smoke, and a history of atopy or asthma. Additional diagnostic elements include eosinophilic airway and systemic inflammation, a good response to corticosteroid treatment, and a high concentration of exhaled nitric oxide...
June 2017: Minerva Medica
https://www.readbyqxmd.com/read/28858969/obstructive-sleep-apnoea-of-mild-severity-should-it-be-treated
#11
Walter T McNicholas
PURPOSE OF REVIEW: To provide guidance in the management of mild obstructive sleep apnoea syndrome (OSAS) in the context of a very high prevalence, poor correlation with symptom profile, and lack of evidence that mild OSAS significantly contributes to comorbidity or early mortality. RECENT FINDINGS: Mild obstructive sleep apnoea defined by hourly frequency of apnoeas or hypopnoeas (AHI) between 5 and 15 affects up to 35% of the general adult population but is much less prevalent when associated daytime symptoms are included...
August 30, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28853428/obstructive-sleep-apnea-syndrome-osas-evaluation-and-treatment-of-odontostomatological-problems
#12
Gaetano Ierardo, Valeria Luzzi, Antonella Polimeni
The Obstructive Sleep Apnea Syndrome (OSAS) is a breathing disorder characterized by repeated episodes of apnea/hypopnea occurring during sleep and caused by the obstruction of the upper airway. As OSAS can have a significant impact on quality of life, an early diagnosis and a multi-specialized recognition become important. Therapeutic proposals include the Mandibular Advancement Devices (MADs), intraoral devices that induce a mandibular advancement during the night to eliminate snoring and apnea. Italian guidelines on dental aspects of OSAS in adults and children focus primarily on anamnestic and clinical methods by which the dentist, in a role of epidemiological sentinel, can first identify a patient with OSAS and then participate in the therapeutic process using specific orthodontic intraoral devices...
August 28, 2017: La Medicina del Lavoro
https://www.readbyqxmd.com/read/28846537/a-comparison-of-the-video-laryngoscopes-with-macintosh-laryngoscope-for-nasotracheal-intubation
#13
Kuang-Yi Tseng, I-Cheng Lu, Ya-Chun Shen, Chia-Heng Lin, Po-Nien Chen, Kuang-I Cheng
Nasotracheal intubation (NTI) is usually required in patients undergoing maxillofacial surgery. Though video-scopes have been demonstrated to perform well in oral endotracheal intubation, limited information is available concerning NTI. The aim of the study is to compare the efficiency of video-scopes and the traditional direct laryngoscopy in NTI. One hundred and eight patients scheduled for elective oro-maxillofacial surgery under nasotracheal intubation general anesthesia were randomly allocated into one of 3 groups of GlideScope, Pentax AirWay Scope, or Macintosh laryngoscope respectively...
March 2017: Asian J Anesthesiol
https://www.readbyqxmd.com/read/28845957/sleep-disorders-sleep-related-breathing-disorders
#14
Deepa Burman
Sleep-related breathing disorders or sleep-disordered breathing are characterized by abnormal respiration during sleep. They are grouped into obstructive sleep apnea (OSA), central sleep apnea, sleep-related hypoventilation, and sleep-related hypoxemia disorder. OSA is a common disorder encountered in the family medicine setting that is increasingly being recognized because of the obesity epidemic and greater public and physician awareness. OSA is characterized by recurrent episodes of partial or complete closure of the upper airway resulting in disturbed breathing during sleep...
September 2017: FP Essentials
https://www.readbyqxmd.com/read/28840025/development-of-acute-parotitis-after-non-invasive-ventilation
#15
Eduardo Martinez, Peter V Dicpinigaitis
A 90-year-old woman underwent laparoscopic exploratory laparotomy for evaluation of suspected mesenteric ischemia. She was promptly extubated postoperatively and transferred to the intensive care unit, where on the first postoperative day she developed hypoxemia necessitating initiation of noninvasive ventilation (NIV) with bilevel positive airway pressure (BiPAP). After 8 hours of BiPAP, she was noted to have swelling, erythema and tenderness in the right preauricular area. Ultrasound evaluation demonstrated an enlarged right parotid gland...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28839409/profile-changes-and-stability-following-distraction-osteogenesis-with-rigid-external-distraction-in-adult-cleft-lip-and-palate-deformities
#16
Jaeson M Painatt, Ravi Veeraraghavan, Ushass Puthalath, Sherry Peter, Latha P Rao, Maria Kuriakose
OBJECTIVES: The objective of this study is to analyze the hard and soft-tissue profile changes as well as the upper airway changes after distraction osteogenesis (DO) using rigid external distraction device in adult cleft lip and palate (CLP) patients. The study also evaluates the stability of the surgical result. MATERIALS AND METHODS: Three lateral cephalometric radiographs were taken: Predistraction (T1), postdistraction (T2), and 1 year after distractor removal (T3)...
April 2017: Contemporary Clinical Dentistry
https://www.readbyqxmd.com/read/28822020/polysomnographic-determinants-of-requirement-for-advanced-positive-pressure-therapeutic-options-for-obstructive-sleep-apnea
#17
Anupama Gupta, Garima Shukla
BACKGROUND: A small percentage of adult patients with severe obstructive sleep apnea (OSA) has been recognized to be extraordinarily difficult to treat with conventional continuous or Bi-level positive airway pressure (together referred to as PAP) therapy. AIM AND OBJECTIVES: The aim of this study was to determine polysomnographic (PSG) characteristics, which may help predict the requirement for advanced therapeutic options for OSA. METHODS: Consecutive patients who underwent PAP titration at our sleep laboratory over a 2-year period were included...
August 18, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28821366/safety-events-in-pediatric-out-of-hospital-cardiac-arrest
#18
Matt Hansen, Carl Eriksson, Barbara Skarica, Garth Meckler, Jeanne-Marie Guise
OBJECTIVE: The objective of this study was to explore the types of patient safety events that take place during pediatric out-of-hospital cardiac arrest resuscitation. METHODS: Retrospective medical record review from a single large urban EMS system of EMS-treated pediatric (<18years of age) out-of-hospital cardiac arrests (OHCA) occurring between 2008 and 2011. A chart review tool was developed for this project and each chart was reviewed by a multidisciplinary review panel...
August 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28819688/airway-reconstruction-using-decellularized-tracheal-allografts-in-a-porcine-model
#19
Michinobu Ohno, Yasushi Fuchimoto, Huai-Che Hsu, Masataka Higuchi, Makoto Komura, Tetsuji Yamaoka, Akihiro Umezawa, Shin Enosawa, Tatsuo Kuroda
PURPOSE: Tracheal cartilage reconstruction is an essential approach for the treatment of tracheal congenital abnormalities or injury. Here, we evaluated the use of allogeneic decellularized tracheas as novel support scaffolds. METHODS: Six weaned pigs (4-week-old domestic males) were transplanted with allogeneic tracheal graft patches (three decellularized and three fresh tracheal scaffolds) onto artificial defects (approximately 15 × 15 mm). After 11 weeks, the tracheas were evaluated by bronchoscopy and histological studies...
August 17, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28819175/in-vivo-therapeutic-efficacy-of-frog-skin-derived-peptides-against-pseudomonas-aeruginosa-induced-pulmonary-infection
#20
Chen Chen, Maria Luisa Mangoni, Y Peter Di
Pseudomonas aeruginosa is an opportunistic and frequently drug-resistant pulmonary pathogen especially in cystic fibrosis sufferers. Recently, the frog skin-derived antimicrobial peptide (AMP) Esc(1-21) and its diastereomer Esc(1-21)-1c were found to possess potent in vitro antipseudomonal activity. Here, they were first shown to preserve the barrier integrity of airway epithelial cells better than the human AMP LL-37. Furthermore, Esc(1-21)-1c was more efficacious than Esc(1-21) and LL-37 in protecting host from pulmonary bacterial infection after a single intra-tracheal instillation at a very low dosage of 0...
August 17, 2017: Scientific Reports
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