Ameen Amanian, Oleksandr Butskiy, Kevin Zhao, Donald W Anderson
Intraoral hirudotherapy is traditionally used for venous congestion following head and neck free flap reconstruction. Many institutions and healthcare teams have been reluctant to use intraoral leech therapy due to risks such as migration into the airway, increased infection from intraoral manipulation, and patient discomfort. Several protocols recommend blocking the path to the oropharynx via gauze or leaving a tracheotomy in place to protect the airway. This report pre-sents a novel technique for intraoral hirudotherapy that is safe and simple for treatment of free flap venous congestion...
July 22, 2021: ORL; Journal for Oto-rhino-laryngology and its related Specialties
Yaping Wang, Bo Liu, Chao Niu, Wenjing Zou, Lili Yang, Ting Wang, Daiyin Tian, Zhengxiu Luo, Jihong Dai, Qubei Li, Enmei Liu, Caihui Gong, Zhou Fu, Fengxia Ding
GITRL/GITR signaling pathway plays an important role in allergy, inflammation, transplantation and autoimmunity. However, its role in asthma remains unclear. Thus, the present study aimed to investigate changes in this pathway and observe the therapeutic effect of its blocking on asthma. By using house dust mite-induced asthma model, changes of GITRL/GITR and its downstream molecules MAPKs (e.g., p38 MAPK, JNK and Erk) and NF-κB were observed. After that, GITRL in lung of mice was knocked down by recombinant adeno-associated virus to observe the impact on its downstream molecules and assess the therapeutic effect on asthma...
July 20, 2021: Molecular Immunology
Pawan Sharma, Santosh K Yadav, Sushrut D Shah, Elham Javed, John M Lim, Shi Pan, Ajay P Nayak, Reynold A Panettieri, Raymond B Penn, Taku Kambayashi, Deepak A Deshpande
Exaggerated airway smooth muscle (ASM) contraction regulated by the Gq family of G protein-coupled receptors (GPCRs) causes airway hyperresponsiveness (AHR) in asthma. Activation of Gq-coupled GPCRs leads to phospholipase C (PLC)-mediated generation of inositol triphosphate (IP3) and diacylglycerol (DAG). DAG signaling is terminated by the action of DAG kinase (DGK) that converts DAG into phosphatidic acid (PA). Our previous study demonstrated that DGKα and ζ isoform knockout mice are protected from the development of allergen-induced AHR...
July 22, 2021: American Journal of Respiratory Cell and Molecular Biology
Gokhan Ceylan, Sevgi Topal, Gulhan Atakul, Mustafa Colak, Ekin Soydan, Ozlem Sandal, Ferhat Sari, Hasan Ağın
INTRODUCTION: In mechanically ventilated patients, driving pressure (ΔP) represents the dynamic stress applied to the respiratory system and is related to ICU mortality. An evolution of the Adaptive Support Ventilation algorithm (ASV® 1.1) minimizes inspiratory pressure in addition to minimizing the work of breathing. We hypothesized that ASV 1.1 would result in lower ΔP than the ΔP measured in APV-CMV (controlled mandatory ventilation with adaptive pressure ventilation) mode with physician-tailored settings...
July 22, 2021: Pediatric Pulmonology
John W Stokes, James M Katsis, Whitney D Gannon, Todd W Rice, Robert J Lentz, Otis B Rickman, Sameer K Avasarala, Clayne Benson, Matthew Bacchetta, Fabien Maldonado
OBJECTIVES: Practice patterns for the use of extracorporeal membrane oxygenation (ECMO) during high-risk airway interventions vary, and data are limited. We aim to characterize our recent experience using ECMO for procedural support during whole-lung lavage (WLL) and high-risk bronchoscopy for central airway obstruction (CAO). METHODS: We performed a retrospective cohort study of adults who received ECMO during WLL and high-risk bronchoscopy from 1 July 2018 to 30 March 2020...
July 19, 2021: Interactive Cardiovascular and Thoracic Surgery
Xin Xia, Yonghua Cai, Xiaoli Zhu, Yingying Zhu, Le Shen, Yalin Zhou, Wenwen Diao, Xingming Chen
OBJECTIVES: The aim of this study was to present surgical techniques and evaluate outcomes of a sternocleidomastoid muscle (SCM) myoperiosteal flap used for the reconstruction of tracheal or laryngotracheal defects after the radical resection of invasive thyroid carcinoma. METHODS: A retrospective study was performed for patients at Peking Union Medical College Hospital from January 2008 to December 2018 of papillary thyroid carcinoma with tracheal or laryngotracheal invasion...
July 19, 2021: Interactive Cardiovascular and Thoracic Surgery
Emiko Desvaux, Antoine Hamon, Sandra Hubert, Cheïma Boudjeniba, Bastien Chassagnol, Jack Swindle, Audrey Aussy, Laurence Laigle, Jessica Laplume, Perrine Soret, Pierre Jean-François, Isabelle Dupin-Roger, Mickaël Guedj, Philippe Moingeon
While establishing worldwide collective immunity with anti SARS-CoV-2 vaccines, COVID-19 remains a major health issue with dramatic ensuing economic consequences. In the transition, repurposing existing drugs remains the fastest cost-effective approach to alleviate the burden on health services, most particularly by reducing the incidence of the acute respiratory distress syndrome associated with severe COVID-19. We undertook a computational repurposing approach to identify candidate therapeutic drugs to control progression towards severe airways inflammation during COVID-19...
2021: PloS One
Russell Rosenberg, Paula K Schweitzer, Joerg Steier, Jean-Louis Pepin
Excessive daytime sleepiness (EDS) affects approximately half of patients with obstructive sleep apnea (OSA) and can persist in some despite normalization of breathing, oxygenation, and sleep quality with primary OSA therapy, such as continuous positive airway pressure (CPAP). EDS is often overlooked and under discussed in the primary care setting and in the follow-up of CPAP-treated patients due to difficult assessment of such a multi-dimensional symptom. This review aims to provide suggestions for procedures that can be implemented into routine clinical practice to identify, evaluate, and manage EDS in patients treated for OSA, including how to appropriately use various self-report and objective assessments along the clinical pathway and options for pharmacotherapy...
July 22, 2021: Postgraduate Medicine
Barbara Loi, Costanza Casiraghi, Chiara Catozzi, Matteo Storti, Monica Lucattelli, Barbara Bartalesi, Nadya Yousef, Fabrizio Salomone, Daniele De Luca
Evolving broncho-pulmonary dysplasia (BPD) is a regionally heterogeneous disorder characterized by impaired alveolarization leading to lung aeration inhomogeneities. Hyperoxia-exposed preterm rabbits have been proposed to mimic evolving BPD and we aim to verify if this model has the same lung ultrasound and mechanical features of evolving BPD in human neonates. Twenty-five preterm rabbits and twenty-five neonates with evolving BPD were enrolled and subjected to semi-quantitative lung ultrasound and lung mechanics measurement...
July 22, 2021: Journal of Applied Physiology
Franchesca Rivera-Calonje, Shiu-Yi Emily Chen, Carl Lo, Sang Le, Makoto Nagoshi
BACKGROUND: We present a case of COVID-19-positive pediatric patient for urgent urological surgery by spinal anesthesia to avoid aerosolizing procedure. CASE PRESENTATION: A 12-year-old, COVID-19-positive boy presented for urgent wound incision and drainage at the circumcision site. Our anesthetic plan consisted of spinal anesthesia with sedation. He was transported from the COVID-19 isolation floor to the negative pressure operating room. He was placed in lateral decubitus position and oxygen was delivered through facemask...
July 22, 2021: JA Clinical Reports
Alexandra J Berges, Ioan A Lina, Rafael Ospino, Hsiu-Wen Tsai, Michael J Brenner, Vinciya Pandian, Ana M Rule, Alexander T Hillel
Importance: During respiratory disease outbreaks such as the COVID-19 pandemic, aerosol-generating procedures, including tracheostomy, are associated with the risk of viral transmission to health care workers. Objective: To quantify particle aerosolization during tracheostomy surgery and tracheostomy care and to evaluate interventions that minimize the risk of viral particle exposure. Design, Setting, and Participants: This comparative effectiveness study was conducted from August 2020 to January 2021 at a tertiary care academic institution...
July 22, 2021: JAMA Otolaryngology—Head & Neck Surgery
Bryan Garcia, Janina Wilmskoetter, Abigail Grady, Christina Mingora, Susan Dorman, Patrick Flume
BACKGROUND: Asymptomatic colonization by nontuberculous mycobacteria (NTM) found in sputum isolates are commonly encountered and clinicians lack a biomarker for prognosticating the risk of transition asymptomatic colonization to active clinical disease. Chest computed tomography (CT) imaging is commonly obtained in this patient population and may serve a role for this purpose. METHODS: We conducted a single-center, cross-sectional study of patients followed in the NTM clinic at our center between August 2019 and August 2020...
July 21, 2021: Journal of Thoracic Imaging
Laura Veschetti, Angela Sandri, Cristina Patuzzo, Paola Melotti, Giovanni Malerba, Maria M Lleo
Achromobacter species are increasingly being detected in cystic fibrosis (CF) patients, where they can establish chronic infections by adapting to the lower airway environment. To better understand the mechanisms contributing to a successful colonization by Achromobacter species, we sequenced the whole genome of 54 isolates from 26 patients with occasional and early/late chronic lung infection. We performed a phylogenetic analysis and compared virulence and resistance genes, genetic variants and mutations, and hypermutability mechanisms between chronic and occasional isolates...
July 2021: Microbial Genomics
Lucas M Harrison, Spencer R Anderson, Kelly E Spiller, Kaitlynne Y Pak, Steven P Schmidt, Salim N Mancho
Complete congenital arhinia is a rare defect of embryogenesis leading to the absence of the external nose and airway. We report our novel multistaged reconstructive approach and literature review. Nasal methyl methacrylate prosthesis was created from a stereolithographic model for use as a temporary prosthesis and tissue expander. Lefort 1 with cannulization was utilized for midface advancement and airway formation. External framework was reconstructed with bilateral conchal bowl cartilage and rib osteocartilagenous grafts...
July 22, 2021: Cleft Palate-craniofacial Journal
Hey Sung Baek, Ha Young Won, Ju Hee Kim, Eun Kyo Ha, Hye Mi Jee, Youn Ho Shin, Mi-Ae Kim, Man Yong Han
BACKGROUND: Phthalates can cause respiratory and immunological disorders. However, little is known about the role of serum periostin and YKL-40 levels in mediating the effects of phthalates. We investigated the mediating role of these biomarkers in the relationship between phthalates and airway dysfunction. METHODS: A total of 487 children (aged 10 to 12 years-old) were examined. Four high-molecular-weight phthalate (HMWP) [Σ4 HMWP] metabolites and 3 low-molecular-weight phthalate (LMWP) [Σ3 LMWP] metabolites in urine samples were measured...
July 22, 2021: Pediatric Allergy and Immunology
Steven M Zeitels, Brandon J Baird
OBJECTIVES/HYPOTHESIS: Laryngeal chondrosarcomas are rare malignancies with a spectrum of presentations due to varying size, local extension, and biological behavior. Moreover, these neoplasms have differing effects on respiration, phonation, and deglutition. Consequently, it is valuable to assess endoscopic and transcervical treatment strategies. STUDY DESIGN: Retrospective case series. METHODS: A retrospective review was done from 2001 to 2020; 25 patients were identified with laryngeal chondrosarcomas...
July 22, 2021: Laryngoscope
Rodrigo Gonçalves Dias, Roland Giger, Philipp Latzin, Thomas Riva, Carmen Casaulta, Francis Ulmer, Yves Jaquet, Lluís Nisa
Major congenital anomalies are known to play a role in the management and prognosis of airway obstruction. Most studies assess acquired forms of airway obstruction. Data on congenital or otherwise non-acquired forms of airway obstruction is sparse. In this retrospective, single-institution cohort study, we sought to evaluate and compare the patterns of airway obstruction in children with and without major congenital anomalies, and to assess the impact of management and outcome, irrespective of aetiology. Fifty-five patients were included, 23 with and 32 without underlying major congenital anomalies...
July 21, 2021: European Journal of Pediatrics
Anne B Chang, Jeanette Boyd, Leanne Bell, Vikas Goyal, I Brent Masters, Zena Powell, Christine Wilson, Angela Zacharasiewicz, Efthymia Alexopoulou, Andrew Bush, James D Chalmers, Rebecca Fortescue, Adam T Hill, Bulent Karadag, Fabio Midulla, Gabrielle B McCallum, Deborah Snijders, Woo-Jung Song, Thomy Tonia, Keith Grimwood, Ahmad Kantar
The global burden of children and young people (CYP) with bronchiectasis is being recognised increasingly. They experience a poor quality of life and recurrent respiratory exacerbations requiring additional treatment, including hospitalisation. However, there are no published data on patient-driven clinical needs and/or research priorities for paediatric bronchiectasis. Parent/patient-driven views are required to understand the clinical needs and research priorities to inform changes that benefit CYP with bronchiectasis and reduce their disease burden...
July 2021: ERJ Open Research
Natalie M Niessen, Peter G Gibson, Jodie L Simpson, Hayley A Scott, Katherine J Baines, Michael Fricker
Background: Dysregulation of tumour necrosis factor-α (TNF-α) signalling is implicated in neutrophilic asthma. TNF-α signalling involves membrane-bound and soluble ligand (TNF-α) and receptors (TNFRs); however, little is known about how these proteins are altered in asthma. We hypothesised that intercompartment-, immune cell- and/or asthma inflammatory phenotype-dependent regulation could relate to TNF dysregulation in neutrophilic asthma. Methods: Measurements were made in 45 adults with asthma (36 non-neutrophilic, 9 neutrophilic) and 8 non-asthma controls...
July 2021: ERJ Open Research
Matthew F Fantauzzi, Steven P Cass, Joshua J C McGrath, Danya Thayaparan, Peiyao Wang, Martin R Stampfli, Jeremy A Hirota
Cannabis is widely used for both recreational and medicinal purposes. Inhalation of combusted cannabis smoke is the most common mode of drug consumption, exposing the lungs to the pharmacologically active ingredients, including tetrahydrocannabinol (THC) and cannabidiol (CBD). While the relationship between cannabis smoke exposure and compromised respiratory health has yet to be sufficiently defined, previous investigations suggest that cannabis smoke may dysregulate pulmonary immunity. Presently, there exist few preclinical animal models that have been extensively validated for contemporary cannabis smoke exposure...
July 2021: ERJ Open Research
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