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https://www.readbyqxmd.com/read/28333157/consensus-approach-to-nasal-high-flow-therapy-in-neonates
#1
B A Yoder, B Manley, C Collins, K Ives, A Kugelman, A Lavizzari, M McQueen
OBJECTIVE: Nasal high-flow therapy (nHFT) is commonly used for noninvasive respiratory support in the neonatal intensive care unit. Our objective was to determine which aspects of neonatal nHFT have achieved adequate evidence base to support consensus among experienced clinical investigators, and to document areas lacking consensus to promote future investigations. STUDY DESIGN: Prospective, modified Delphi collation of tabular queries related to specific aspects of neonatal nHFT...
March 23, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28331381/retrospective-nonrandomized-controlled-study-on-autoadjusting-dual-pressure-positive-airway-pressure-therapy-for-a-consecutive-series-of-complex-insomnia-disorder-patients
#2
Barry Krakow, Natalia D McIver, Victor A Ulibarri, Michael R Nadorff
PURPOSE: Emerging evidence shows that positive airway pressure (PAP) treatment of obstructive sleep apnea (OSA) and upper airway resistance syndrome (UARS) in chronic insomnia patients (proposed "complex insomnia" disorder) leads to substantial decreases in insomnia severity. Although continuous PAP (CPAP) is the pressure mode most widely researched, intolerance to fixed pressurized air is rarely investigated or described in comorbidity patients. This retrospective study examined dual pressure, autoadjusting PAP modes in chronic, complex insomnia disorder patients...
2017: Nature and Science of Sleep
https://www.readbyqxmd.com/read/28329851/short-tslp-attenuates-toluene-diisocyanate-tdi-induced-airway-inflammation-and-inhibits-hmgb1-rage-and-long-tslp-expression
#3
Yanhong Wang, Yanqing Le, Wenqu Zhao, Yun Lin, Yue Wu, Changhui Yu, Jing Xiong, Fei Zou, Hangming Dong, Shaoxi Cai, Haijin Zhao
Short thymic stromal lymphopoietin (short TSLP), one of TSLP variants, exerts anti-inflammatory activities in endotoxin shock and colitis mouse models. Our latest work reported that short TSLP prevented house dust mite (HDM)-induced epithelial barrier disruption. Yet the role of short TSLP in toluene diisocyanate (TDI)-induced asthma is unknown. Male BALB/c mice were sensitized and challenged with TDI to generate a chemical-induced asthma model. Synthetic short TSLP peptides were given intranasally (i.n.) or intraperitoneally (i...
February 27, 2017: Toxicological Sciences: An Official Journal of the Society of Toxicology
https://www.readbyqxmd.com/read/28326803/when-is-an-alveolar-type-2-cell-an-alveolar-type-2-cell-a-conundrum-for-lung-stem-cell-biology-and-regenerative-medicine
#4
Michael F Beers, Yuben Moodley
Generating mature, differentiated, adult lung cells from pluripotent cells such as induced pluripotent cells (iPS) and embryonic stem cells (ES) offers the hope of both generating disease specific in vitro models and creating definitive and personalized therapies for a host of debilitating lung parenchymal and airway diseases. With the goal of advancing lung regenerative medicine, several groups have developed and reported on protocols utilizing either defined media, co-culture with mesenchymal components, or sequential treatments mimicking lung development, to obtain distal lung epithelial cells from stem cell precursors...
March 22, 2017: American Journal of Respiratory Cell and Molecular Biology
https://www.readbyqxmd.com/read/28325461/neurocritical-care-of-acute-subdural-hemorrhage
#5
REVIEW
Fawaz Al-Mufti, Stephan A Mayer
Although urgent surgical hematoma evacuation is necessary for most patients with subdural hematoma (SDH), well-orchestrated, evidenced-based, multidisciplinary, postoperative critical care is essential to achieve the best possible outcome. Acute SDH complicates approximately 11% of mild to moderate traumatic brain injuries (TBIs) that require hospitalization, and approximately 20% of severe TBIs. Acute SDH usually is related to a clear traumatic event, but in some cases can occur spontaneously. Management of SDH in the setting of TBI typically conforms to the Advanced Trauma Life Support protocol with airway taking priority, and management breathing and circulation occurring in parallel rather than sequence...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28314808/cervical-diffuse-idiopathic-skeletal-hyperostosis-dish-causing-oropharyngeal-dysphagia
#6
Nellowe Candelario, Kevin Bryan Lo, Mario Naranjo
Diffuse idiopathic skeletal hyperostosis (DISH) is a non-inflammatory condition characterised by calcification and ossification of the vertebral ligaments. It is most commonly seen to affect the thoracic and lumbar vertebrae and is usually seen among elderly men. The cause of this condition is unknown. Risk factors include male gender, obesity, diabetes and advancing age. The majority of these cases are found incidentally on imaging and patients are generally asymptomatic. Cervical DISH is less common than its thoracic and lumbar counterparts...
March 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28299260/controlling-the-vector-of-distraction-osteogenesis-in-the-management-of-obstructive-sleep-apnea
#7
Dekel Shilo, Omri Emodi, Dror Aizenbud, Adi Rachmiel
BACKGROUND: Obstructive sleep apnea (OSA) in individuals with craniofacial anomalies can compromise airway and is a serious life-threatening condition. In many cases, tracheostomy is carried out as the treatment of choice. Distraction osteogenesis of the mandible as a treatment modality for OSA is very useful and may spare the need for tracheostomy or allow decannulation, yet controlling the vector of distraction is still a major challenge. We present a method for controlling the vector of distraction...
July 2016: Annals of Maxillofacial Surgery
https://www.readbyqxmd.com/read/28299255/changes-in-posterior-airway-space-and-mandibular-plane-hyoid-distance-following-mandibular-advancement-do
#8
Pushpa Kumari, S K Roy, Indranil Dev Roy, A K Rajput, M P Prasanna Kumar, Sanjeev Datana, Serat Rahman
AIM: To study the changes in posterior airway space (PAS) and mandibular plane hyoid (MPH) distance following mandibular advancement using distraction osteogenesis (DO). SUBJECTS AND METHODS: A prospective study was conducted at a tertiary care dental center from May 2009 to May 2014. Twenty-five consecutively operated patients of mandibular hypoplasia who underwent mandibular advancement using distraction with at least 12 months follow-up were included in the study...
July 2016: Annals of Maxillofacial Surgery
https://www.readbyqxmd.com/read/28299194/recent-trends-in-airway-management
#9
REVIEW
Joelle Karlik, Michael Aziz
Tracheal intubation remains a life-saving procedure that is typically not difficult for experienced providers in routine conditions. Unfortunately, difficult intubation remains challenging to predict and intubation conditions may make the event life threatening. Recent technological advances aim to further improve the ease, speed, safety, and success of intubation but have not been fully investigated. Video laryngoscopy, though proven effective in the difficult airway, may result in different intubation success rates in various settings and in different providers' hands...
2017: F1000Research
https://www.readbyqxmd.com/read/28298960/lung-volume-reduction-coils-as-a-novel-bronchoscopic-treatment-for-emphysema
#10
Timothy A Connolly
Chronic obstructive pulmonary disease remains a major cause of morbidity and mortality worldwide. Despite regular advances in pharmacology, there remains great potential for addressing structural deficiencies, especially in emphysema. The loss of alveolar attachments to small bronchial tubes results in diffuse loss of elastic recoil and airway collapse during exhalation. This appears physiologically as hyperinflation of lung volumes with flattened diaphragms and significantly elevated residual volumes (RV) on pulmonary function testing (predicted RV > 175%)...
October 2016: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28295020/lactobacillus-johnsonii-supplementation-attenuates-respiratory-viral-infection-via-metabolic-reprogramming-and-immune-cell-modulation
#11
W Fonseca, K Lucey, S Jang, K E Fujimura, A Rasky, H-A Ting, J Petersen, C C Johnson, H A Boushey, E Zoratti, D R Ownby, A M Levine, K R Bobbit, S V Lynch, N W Lukacs
Regulation of respiratory mucosal immunity by microbial-derived metabolites has been a proposed mechanism that may provide airway protection. Here we examine the effect of oral Lactobacillus johnsonii supplementation on metabolic and immune response dynamics during respiratory syncytial virus (RSV) infection. L. johnsonii supplementation reduced airway T helper type 2 cytokines and dendritic cell (DC) function, increased regulatory T cells, and was associated with a reprogrammed circulating metabolic environment, including docosahexanoic acid (DHA) enrichment...
March 15, 2017: Mucosal Immunology
https://www.readbyqxmd.com/read/28294946/continuing-the-original-stanford-sleep-surgery-protocol-from-upper-airway-reconstruction-to-upper-airway-stimulation-our-first-successful-case
#12
Stanley Yung Liu, Robert Wayne Riley
In 1993, a surgical protocol for dynamic upper airway reconstruction in patients with obstructive sleep apnea (OSA) was published, and it became commonly known as the Stanford phase 1 and 2 sleep surgery protocol. It served as a platform on which research and clinical studies have continued to perfect the surgical care of patients with OSA. However, relapse is inevitable in a chronic condition such as OSA, and a subset of previously cured surgical patients return with complaints of excessive daytime sleepiness...
February 20, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28294380/oral-appliance-therapy-versus-nasal-continuous-positive-airway-pressure-in-obstructive-sleep-apnea-syndrome-a-randomized-placebo-controlled-trial-on-self-reported-symptoms-of-common-sleep-disorders-and-sleep-related-problems
#13
Maria Nikolopoulou, Anna Byraki, Jari Ahlberg, Martijn W Heymans, H L Hamburger, Jan De Lange, Frank Lobbezoo, Ghizlane Aarab
Obstructive sleep apnea syndrome (OSAS) is associated with several sleep disorders and sleep-related problems. Therefore, the aim of this study was to compare the effects of a mandibular advancement device (MAD) with those of nasal continuous positive airway pressure (nCPAP) on self-reported symptoms of common sleep disorders and sleep-related problems in mild and moderate OSAS patients. In this randomized placebo-controlled trial sixty-four OSAS patients (52.0± 9.6 years) were randomly assigned to an MAD, nCPAP or an intra-oral placebo appliance in a parallel design...
March 10, 2017: Journal of Oral Rehabilitation
https://www.readbyqxmd.com/read/28292482/cost-savings-from-reduced-hospitalizations-with-use-of-home-noninvasive-ventilation-for-copd
#14
Steven Coughlin, Fred W Peyerl, Sibyl H Munson, Aditi J Ravindranath, Teofilo L Lee-Chiong
BACKGROUND: Although evidence suggests significant clinical benefits of home noninvasive ventilation (NIV) for management of severe chronic obstructive pulmonary disease (COPD), economic analyses supporting the use of this technology are lacking. OBJECTIVES: To evaluate the economic impact of adopting home NIV, as part of a multifaceted intervention program, for severe COPD. METHODS: An economic model was developed to calculate savings associated with the use of Advanced NIV (averaged volume assured pressure support with autoexpiratory positive airway pressure; Trilogy100, Philips Respironics, Inc...
March 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28291454/the-abc-s-of-pancreatic-trauma-airway-breathing-and-computerized-tomography-scan
#15
Matthew Vasquez, Cassandra Cardarelli, Jacob Glaser, Sarah Murthi, Deborah Stein, Thomas Scalea
OBJECTIVES: Missed pancreatic injury carries significant morbidity. Computerized tomography (CT) imaging is useful, but may lack sensitivity to identify pancreatic injury. New-generation CT scanners should improve sensitivity, but this has not been studied. A previous study published in 2002 evaluating the sensitivity for identifying pancreatic injury with single-slice CT scanners yielded a 68% correlation between operative and CT findings. We aim to study the accuracy of modern CT for diagnosis and grading of pancreatic injury...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291128/the-use-of-ultrasound-in-obstetric-anesthesia
#16
Carolyn F Weiniger, Limor Sharoni
PURPOSE OF REVIEW: The current review considers an array of recent applications for point-of-care ultrasound in clinical practice including diagnostic and therapeutic procedures that may be relevant for the obstetric anesthesiologist. The rapid advancement of technology and clinical applications for bedside ultrasound in obstetric anesthesiology requires an appraisal of the limitations and uses. RECENT FINDINGS: The review presents the most recent literature describing ultrasound-guided airway assessments, airway management, cricothyroidotomy, transthoracic echocardiography, gastric volume assessments, point-of-care lung ultrasound diagnoses, intracranial pressure assessments, vascular access, neuraxial blocks, and transversus abdominis plane blocks...
March 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28290929/advanced-trauma-life-support-time-standards
#17
Andrew B Hall, Felix S Boecker, Joseph M Shipp, Dennis Hanseman
INTRODUCTION: Trauma readiness is critical to military medicine. Without medical centers that include persistent volumes of trauma, simulation has become the means to maintain and practice those skills. To create those simulations, standards for both design and metrics to evaluate practitioners are required. MATERIALS AND METHODS: Forty-four traumas were monitored and times to completion of the various steps of Advanced Trauma Life Support were recorded and tabulated...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290925/two-decades-of-saving-lives-on-the-battlefield-tactical-combat-casualty-care-turns-20
#18
Frank K Butler
BACKGROUND: Twenty years ago, the original Tactical Combat Casualty Care (TCCC) article was published in this journal. Since TCCC is essentially a set of best-practice prehospital trauma care guidelines customized for use on the battlefield, the presence of a journal with a specific focus on military medicine was a profound benefit to the initial presentation of TCCC to the U.S. Military. METHODS: In the two ensuing decades, which included the longest continuous period of armed conflict in our nation's history, TCCC steadily evolved as the prehospital trauma care evidence base was augmented and as feedback from user medics, corpsmen, and pararescuemen was obtained...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28284294/optimal-strategies-for-severe-acute-respiratory-distress-syndrome
#19
REVIEW
Jeremy W Cannon, Jacob T Gutsche, Daniel Brodie
Acute respiratory distress syndrome (ARDS) occurs in more than 10% of intensive care unit admissions and in nearly 25% of ventilated patients. Mortality remains high at 40%, and, for patients who survive, recovery continues for months or even years. Early recognition and minimizing further lung injury remain essential to successful management of severe ARDS. Advanced treatment strategies, which complement lung protective ventilation, include short-term neuromuscular blockade, prone positioning, and extracorporeal membrane oxygenation...
April 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28282951/interactions-between-neutrophils-and-pseudomonas-aeruginosa-in-cystic-fibrosis
#20
REVIEW
Balázs Rada
Cystic fibrosis (CF) affects 70,000 patients worldwide. Morbidity and mortality in CF is largely caused by lung complications due to the triad of impaired mucociliary clearance, microbial infections and chronic inflammation. Cystic fibrosis airway inflammation is mediated by robust infiltration of polymorphonuclear neutrophil granulocytes (PMNs, neutrophils). Neutrophils are not capable of clearing lung infections and contribute to tissue damage by releasing their dangerous cargo. Pseudomonas aeruginosa is an opportunistic pathogen causing infections in immunocompromised individuals...
March 9, 2017: Pathogens
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