Ayman Alhamdow, Anna Zettergren, Inger Kull, Jenny Hallberg, Niklas Andersson, Sandra Ekström, Marika Berglund, Craig E Wheelock, Yona J Essig, Annette M Krais, Antonios Georgelis, Christian H Lindh, Erik Melén, Anna Bergström
BACKGROUND: Exposure to polycyclic aromatic hydrocarbons (PAHs) has been linked to adverse pulmonary effects. However, the impact of low-level environmental PAH exposure on lung function in early adulthood remains uncertain. OBJECTIVES: To evaluate the associations between urinary PAH metabolites and lung function parameters in young adults. METHODS: Urinary metabolites of pyrene, phenanthrene, and fluorene were analysed in 1000 young adults from Sweden (age 22-25 years) using LC-MS/MS...
April 12, 2021: Environmental Research
Madelyn E Rosenthal, M Melanie Lyons, Jessica Schweller, Vedat O Yildiz, Eugene G Chio, Meena S Khan
PURPOSE: To evaluate relationships between hypoglossal nerve stimulator (HNS) adherence and the presence of anxiety, depression, and emotional distress. METHODS: This is a cross-sectional study of subjects with moderate to severe obstructive sleep apnea (OSA), who had HNS implanted and activated at The Ohio State University Medical Center (OSUMC). Patient usage data from the previous 6 months was obtained from 33 patients. Adherence was defined as ≥28 h of use per week...
April 15, 2021: Sleep & Breathing, Schlaf & Atmung
Alexis Dufour-Mailhot, Magali Boucher, Cyndi Henry, Fatemeh Khadangi, Sophie Tremblay-Pitre, Marine Clisson, Jonathan Beaudoin, Marie-Annick Clavel, Ynuk Bossé
The airway smooth muscle undergoes an elastic transition during a sustained contraction, characterized by a gradual decrease in hysteresivity caused by a relatively greater rate of increase in elastance than resistance. We recently demonstrated that these mechanical changes are more likely to persist after a large strain when they are acquired in dynamic versus static conditions; as if the microstructural adaptations liable for the elastic transition are more flexible when they evolve in dynamic conditions...
April 15, 2021: Journal of Applied Physiology
Anne Margareta Banghøj, Christoffer Krogager, Peter Lommer Kristensen, Klavs Würgler Hansen, Esben Laugesen, Jesper Fleischer, Simon Lebech Cichosz, Per Løgstrup Poulsen, Martin Glymer Kirkegaard, Birger Thorsteinsson, Lise Tarnow
Aim: Obstructive sleep apnoea (OSA) is frequent in type 2 diabetes (T2D). The aim was to investigate the effect of a 12-week treatment with continuous positive airway pressure (CPAP) on glycaemic control assessed by continuous glucose monitoring (CGM), HbA1c and fasting blood glucose in patients with T2D and newly detected OSA. Methods: In a randomized controlled multicentre study, 72 participants with T2D and moderate to severe OSA (78% male, age 62 ± 7, AHI 35 ± 15) were recruited from outpatient clinics in three Danish hospitals and were randomized to CPAP intervention or control...
April 2021: Endocrinology, Diabetes & Metabolism
Mischa Veen, Peer van der Zwaal, M Christien van der Linden
Introduction: Patients presenting to the emergency department (ED) frequently require procedural sedation and analgesia (PSA) to facilitate procedures, such as joint reduction. Proper documentation of screening demonstrates awareness of the necessity of presedation assessment. It is unknown if introducing emergency physicians (EPs) at the ED improves presedation assessment and documentation. In this study the differences in documentation of ED sedation and success rates for reduction of hip dislocations in the presence versus absence of EPs are described...
2021: Drug, Healthcare and Patient Safety
Rossella Esposito, Irene Esposito, Francesco Imperatore, Giovanni Liguori, Fabrizio Gritti, Chiara Cafora, Paolo Francesco Marsilia, Maria De Cristofaro
BACKGROUND: Acute severe asthma is a life-threatening medical emergency. Characteristics of asthma include increased airway resistance and dynamic pulmonary hyperinflation that can manifest in dangerous levels of hypercapnia and acidosis, with significant mortality and morbidity. Severe respiratory distress can lead to endotracheal intubation followed by mechanical ventilation, which can cause increased air trapping with dynamic hyperinflation, predisposing the lungs to barotraumas. CASE PRESENTATION: The present case report describes the use of the minimally invasive ECCO2 R ProLUNG® (Estor) with protective low-tidal-volume ventilation, in a Caucasian patient with near-fatal asthma and with no response to conventional therapy...
April 8, 2021: Journal of Medical Case Reports
J C Moreno Alfonso, A Y Molina Caballero, A Pérez Martínez, J Arredondo Montero, J Zubicaray Ugarteche, C Bardají Pascual
We describe the case of a 41-day-old infant with a left craniofacial cervical and subglottic hemangioma with respira-tory symptoms. Although infantile hemangiomas are occasional benign vascular tumors that appear predominantly on the skin, 1-2% of patients may have airway lesions that can sometimes cause potentially life-threatening respiratory condi-tions. The decision was made to immediately commence treatment with propranolol, without waiting to complete the exten-sion and syndromic diagnoses. There was a positive clinical response and respiratory symptoms dissipated in twelve hours...
April 12, 2021: Anales del Sistema Sanitario de Navarra
Hussain Alsaid Ahmad, Veena Deekonda, Waseemoddin Patel, Lehana Thabane, Prakesh S Shah, Amit Mukerji
OBJECTIVE:  The aim of this study was to compare outcomes following receipt of high continuous positive airway pressure (CPAP) versus nasal intermittent positive pressure ventilation (NIPPV) in extremely preterm neonates. STUDY DESIGN:  We retrospectively compared outcomes of preterm neonates (22-28 weeks' gestation) following their first episode of either high CPAP (≥ 9 cmH2 O) or NIPPV. Primary outcome was failure of high CPAP or NIPPV within 7 days, as determined by either need for intubation or use of an alternate noninvasive mode...
April 14, 2021: American Journal of Perinatology
Sonja G Schütz, Abbey Dunn, Tiffany J Braley, Bertram Pitt, Anita V Shelgikar
Obstructive sleep apnea (OSA) is the most common form of sleep-disordered breathing characterized by intermittent partial or complete closure of the upper airway during sleep. If left untreated, OSA is associated with adverse cardiovascular outcomes such as hypertension, coronary heart disease, heart failure, cardiac arrhythmia, stroke, and death. Positive airway pressure (PAP) is often considered the first-line treatment for OSA. While PAP can be very effective in reducing the number of obstructive apneas and hypopneas, its impact on prevention of adverse cardiovascular consequences remains controversial, and treatment adherence is often poor...
March 13, 2021: Sleep Medicine Reviews
Wilfried Posch, Jonathan Vosper, Asma Noureen, Viktoria Zaderer, Christina Witting, Giulia Bertacchi, Ronald Gstir, Przemyslaw A Filipek, Günther K Bonn, Lukas A Huber, Rosa Bellmann-Weiler, Cornelia Lass-Flörl, Doris Wilflingseder
BACKGROUND: Excessive inflammation triggered by a hitherto undescribed mechanism is a hallmark of severe SARS-CoV-2 infections and is associated with enhanced pathogenicity and mortality. OBJECTIVE: Complement hyper activation promotes lung injury and was observed in patients suffering from MERS-CoV, SARS-CoV-1 and SARS-CoV-2 infections. Therefore, we investigated the very first interactions of primary human airway epithelial cells upon exposure to SARS-CoV-2 in terms of complement C3-mediated effects...
April 11, 2021: Journal of Allergy and Clinical Immunology
James A Harker, Clare M Lloyd
Immunity in the human respiratory tract is provided by a diverse range of tissue-resident cells, including specialized epithelial and macrophage populations and a network of innate and innate-like lymphocytes, such as natural killer cells, innate lymphoid cells, and invariant T cells. Lung-resident memory T and B cells contribute to this network following initial exposure to antigenic stimuli. This review explores how advances in the study of human immunology have shaped our understanding of this resident immune network and its response to two of the most commonly encountered inflammatory stimuli in the airways: viruses and allergens...
April 13, 2021: Immunity
Ryo Yamamoto, Masaru Suzuki, Jo Yoshizawa, Yusho Nishida, Junichi Sasaki
BACKGROUND: The benefits of physician-staffed emergency medical services (EMS) for trauma patients remain unclear due to conflicting results on survival. Some studies suggested potential delays in definitive hemostasis due to prolonged prehospital stay when physicians are dispatched to the scene. We examined hypotensive trauma patients who were transported by ambulance, with the hypothesis that physician-staffed ambulances would be associated with increased inhospital mortality, compared with EMS-personnel-staffed ambulances...
April 12, 2021: Journal of Trauma and Acute Care Surgery
Jun Park, Hyun Ae Jung, Joon Ho Shim, Woong-Yang Park, Tae Hyuk Kim, Se-Hoon Lee, Sun Wook Kim, Myung-Ju Ahn, Keunchil Park, Jae Hoon Chung
BACKGROUND: Anaplastic thyroid cancer (ATC) has dismal prognosis, and there is no effective treatment. We aimed to evaluate the efficacy of tyrosine kinase inhibitor (TKI) therapy in real world clinic, and to suggest the most effective treatment modality according to the combination of treatments. METHODS: This retrospective study evaluated clinical outcomes and cause of death with multimodal treatments in patients with ATC at Samsung Medical Center. RESULTS: A total of 120 patients received anti-cancer treatment for ATC...
April 1, 2021: European Journal of Endocrinology
Orlagh O'Shea, Elizabeth Stovold, Christopher J Cates
BACKGROUND: Asthma is characterised by chronic inflammation of the airways and recurrent exacerbations with wheezing, chest tightness, and cough. Treatment with inhaled steroids and bronchodilators can result in good control of symptoms, prevention of further morbidity, and improved quality of life. However, an increase in serious adverse events with the use of both regular formoterol and regular salmeterol (long-acting beta₂-agonists) compared with placebo for chronic asthma has been demonstrated in previous Cochrane Reviews...
April 14, 2021: Cochrane Database of Systematic Reviews
Jingxi Zhang, Xiumin Feng, Yunxin Fan, Guanglin Zhu, Chong Bai
BACKGROUND: Asthma is one of the most common noninfectious chronic diseases characterized by type II inflammation. This study aimed to investigate the effects of molecular hydrogen on the pathogenesis of asthma. METHODS: OVA sensitized asthma mouse model and house dust mite treated 16HBE cellular model were established and hydrogen/oxygen mixture was used to treat asthmatic mice and 16HBE cells. Serum and BALF cytokines were measured with specific ELISA assays. E-cadherin and ZO-1 were detected by immunohistochemical staining and expression of caspase 3 and 9, NF-κB, IL-33 and ST2 was assessed by quantitative real-time PCR, western blot and/or immunofluorescence...
April 14, 2021: Inflammation Research: Official Journal of the European Histamine Research Society ... [et Al.]
Sean Runnels, John Frederick Pearson, Jon Dean Samuels, Rohan Kirit Panchamia
What does the COVID-19 false-negative exposure problem mean in the context of a local anesthesia practice? We present a customizable online calculator designed to quantify and better understand individual and aggregate provider exposure risk.
April 14, 2021: JMIR perioperative medicine
Ewelina Russjan, Dominika Zając, Dorota Sulejczak, Patrycja Kleczkowska, Katarzyna Kaczyńska
PK20 is an anti-inflammatory hybrid compound, composed of an endomorphin-2-like and neurotensin-like fragments. The aim of the present study was to assess the contribution of particular pharmacophores to the activity of the hybrid tested. For this purpose, airway hyperresponsiveness, accumulation of inflammatory cells in bronchoalveolar lavage fluid (BALF), concentration of mouse mast cell protease, malondialdehyde and secretory phospholipase 2 activity in lung tissue, as well as production of pro-inflammatory cytokines in BALF and lung were determined by using murine model of non-atopic asthma...
April 13, 2021: Clinical and Experimental Pharmacology & Physiology
Sophie Neuhaus, Christopher Neuhaus, Markus A Weigand, Dorothee Bremerich
As the incidence of diseases during pregnancy or in the puerperium necessitating intensive medical care is very low, intensive care physicians are faced with a multitude of unfamiliar challenges in the treatment of this patient collective. The physiological and pathophysiological alterations during pregnancy induce some specific features with respect to the intensive medical treatment of pregnant or postpartum patients. Therefore, the first article in this CME series summarizes the most important principles and current recommendations on the care of pregnant or postpartum patients who need intensive medical treatment, always under consideration of the well-being of mother and child...
April 13, 2021: Der Anaesthesist
Carter Merenstein, Guanxiang Liang, Samantha A Whiteside, Ana G Cobián-Güemes, Madeline S Merlino, Louis J Taylor, Abigail Glascock, Kyle Bittinger, Ceylan Tanes, Jevon Graham-Wooten, Layla A Khatib, Ayannah S Fitzgerald, Shantan Reddy, Amy E Baxter, Josephine R Giles, Derek A Oldridge, Nuala J Meyer, E John Wherry, John E McGinniss, Frederic D Bushman, Ronald G Collman
Rationale: Viral infection of the respiratory tract can be associated with propagating effects on the airway microbiome, and microbiome dysbiosis may influence viral disease. Objective: To define the respiratory tract microbiome in COVID-19 and relationship disease severity, systemic immunologic features, and outcomes. Methods and Measurements: We examined 507 oropharyngeal, nasopharyngeal and endotracheal samples from 83 hospitalized COVID-19 patients, along with non-COVID patients and healthy controls...
April 5, 2021: medRxiv: the preprint server for health sciences
Fred D Mast, Peter C Fridy, Natalia E Ketaren, Junjie Wang, Erica Y Jacobs, Jean Paul Olivier, Tanmoy Sanyal, Kelly R Molloy, Fabian Schmidt, Magda Rutkowska, Yiska Weisblum, Lucille M Rich, Elizabeth R Vanderwall, Nicolas Dambrauskas, Vladimir Vigdorovich, Sarah Keegan, Jacob B Jiler, Milana E Stein, Paul Dominic B Olinares, Theodora Hatziioannou, D Noah Sather, Jason S Debley, David Fenyö, Andrej Sali, Paul D Bieniasz, John D Aitchison, Brian T Chait, Michael P Rout
Despite the great promise of vaccines, the COVID-19 pandemic is ongoing and future serious outbreaks are highly likely, so that multi-pronged containment strategies will be required for many years. Nanobodies are the smallest naturally occurring single domain antigen binding proteins identified to date, possessing numerous properties advantageous to their production and use. We present a large repertoire of high affinity nanobodies against SARS-CoV-2 Spike protein with excellent kinetic and viral neutralization properties, which can be strongly enhanced with oligomerization...
April 10, 2021: the Preprint Server for Biology
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