Mirja Mittermaier, Philipp Pickerodt, Florian Kurth, Laure Bosquillon de Jarcy, Alexander Uhrig, Carmen Garcia, Felix Machleidt, Panagiotis Pergantis, Susanne Weber, Yaosi Li, Astrid Breitbart, Felix Bremer, Philipp Knape, Marc Dewey, Felix Doellinger, Steffen Weber-Carstens, Arthur S Slutsky, Wolfgang M Kuebler, Norbert Suttorp, Holger Müller-Redetzky
Background: In face of the Coronavirus Disease (COVID)-19 pandemic, best practice for mechanical ventilation in COVID-19 associated Acute Respiratory Distress Syndrome (ARDS) is intensely debated. Specifically, the rationale for high positive end-expiratory pressure (PEEP) and prone positioning in early COVID-19 ARDS has been questioned. Methods: The first 23 consecutive patients with COVID-19 associated respiratory failure transferred to a single ICU were assessed...
October 11, 2020: EClinicalMedicine
Hamidreza Shetabi, Elnaz Jebelli, Amir Shafa
Background: In this study, we aimed to evaluate the safety and efficacy of three different doses of atracurium on conditions of laryngeal mask airway (LMA) insertion, first-try success rate, and possible complications. Materials and Methods: A total of 120 patient's ≥18 years old were randomly divided into three groups of 40. The study groups received fentanyl 2 μg/kg thiopental 5 mg/kg and atracurium in doses 0.2 mg/kg, 0.4 mg/kg, and 0.6 mg/kg, respectively, based on the patient group...
2020: Advanced Biomedical Research
Harsh Rawal, Sugandhi Mahajan, Andrea Brasch, Vishesh Paul
Fibrosing mediastinitis (FM) is a rare condition with extensive proliferation of fibrous tissue in the mediastinum usually happens few years after Histoplasma infection. FM usually occurs years later after presentation of Histoplasma infection, and usually what makes patients seek medical attention are symptoms from compression and occlusion of vital mediastinal structures, such as the central airways, superior vena cava, pulmonary arteries, and veins. Rarely, heart, pericardium, coronaries, and aorta are involved...
September 14, 2020: Curēus
Satoshi Suzuki
Most postoperative surgical patients routinely receive supplemental oxygen therapy to prevent the potential development of hypoxemia due to incomplete lung re-expansion, reduced chest wall, and diaphragmatic activity caused by surgical site pain, consequences of hemodynamic impairment, and residual effects of anesthetic drugs (most notably residual neuromuscular blockade), which may result in atelectasis, ventilation-perfusion mismatch, alveolar hypoventilation, and impaired upper airway patency. Additionally, the World Health Organization guidelines for reducing surgical site infection have recommended the perioperative administration of high-dose oxygen, including during the immediate postoperative period...
2020: Journal of Intensive Care
Rafaela Parreira, Rui Amaral, Luís Amaral, Teresa Elói, Maria Inês Leite, Armando Medeiros
Angiotensin-converting enzyme (ACE) inhibitors are the leading cause of drug-induced angioedema, being the face, tongue, lips and upper airway the most affected ones. We describe a case of a 32-year-old white female with angioedema of small intestine after 1 month of perindopril therapy. The patient presented severe abdominal pain, nausea and vomiting. Laboratory analyses revealed mild leukocytosis and abdominal computed tomography (CT) showed unspecific findings, including segmental jejunal wall thickening without obstruction and ascites...
October 2020: Journal of Surgical Case Reports
Fei Huang, Yang-Hua Ju, Hong-Bo Wang, Ya-Nan Li
Background: Vitamin D (VitD) can regulate immune responses and maternal VitD-deficiency can affect immune responses in the offspring. This study aimed at investigating the effects of maternal VitD-deficiency during pregnancy on Treg and Breg responses in offspring mice with house dust mite (HDM)-induced allergic airway inflammation. Methods: Female BALB/c mice were randomized and fed with normal chow or VitD-deficient diet until their offspring weaned. The offspring mice were fed with normal chow and injected with vehicle or HDM to induce allergic airway inflammation...
2020: Allergy, Asthma, and Clinical Immunology
Andrea R Teufelberger, Sharon Van Nevel, Paco Hulpiau, Maria Nordengrün, Savvas N Savvides, Sarah De Graeve, Srinivas Akula, Gabriele Holtappels, Natalie De Ruyck, Wim Declercq, Peter Vandenabeele, Lars Hellman, Barbara M Bröker, Dmitri V Krysko, Claus Bachert, Olga Krysko
Staphylococcus aureus ( S. aureus) can secrete a broad range of virulence factors, among which staphylococcal serine protease-like proteins (Spls) have been identified as bacterial allergens. The S. aureus allergen serine protease-like protein D (SplD) induces allergic asthma in C57BL/6J mice through the IL-33/ST2 signaling axis. Analysis of C57BL/6J, C57BL/6N, CBA, DBA/2, and BALB/c mice treated with intratracheal applications of SplD allowed us to identify a frameshift mutation in the serine (or cysteine) peptidase inhibitor, clade A, and member 3I (S erpina3i ) causing a truncated form of SERPINA3I in BALB/c, CBA, and DBA/2 mice...
2020: Frontiers in Immunology
Lifeng Qi, Yajuan Wang, Heping Wang, Jikui Deng
Human Adenovirus (AdV) infection is very common and usually has a significant impact on children. AdV-induced inflammation is believed to be one of the main causes of severe symptoms. However, an inflammatory response profile in the airway in AdV-infected children is still lacking, and the mechanism underlying AdV-induced inflammation in the airway is also poorly understood. In the current study, we determined the expression of a panel of inflammation cytokines in the airway samples from AdV 7 infected children and further investigated the molecular mechanism underlying AdV 7-induced cytokine expression...
2020: Frontiers in Immunology
N K Sahoo, Shiv Shankar Agarwal, Sanjeev Datana, S K Bhandari
Introduction: The spatial position and dimensions of oral and pharyngeal soft tissues change post-mandibular advancement (MA) surgery which involves changes in position of soft palate, tongue and associated musculature. There is no study which simultaneously evaluates changes in tongue length and height post-MA surgery and correlates these changes with changes in upper airway dimensions and the amount of MA. Materials and Methods: Treatment records of 18 patients that underwent MA with bilateral sagittal split ramus osteotomy were evaluated at T1 (01 week before surgery) and T2 (06 months post-surgery)...
December 2020: Journal of Maxillofacial and Oral Surgery
Jian Cui, Jian Gao, Yan Li, Ting Fan, Jiao Qu, Yang Sun, Wen Liu, Wenjie Guo, Qiang Xu
Pneumonia is a common illness that continues to be the major killer of remaining to be a significant source of morbidity and mortality in the patient population. Many microorganisms cause pneumonia, and now concern is turning to the importance of the cause the new therapies for viral pneumonia. In the current study, we report the effect of andrographolide sulfonate, a water-soluble form of andrographolide (trade name: Xi-Yan-Ping Injection), on poly I: C-induced pneumonia. Andrographolide sulfonate was administrated through intraperitoneal injection to mice with poly I: C-induced pneumonia...
December 2020: Journal of Pharmacological Sciences
Giada Procopio, Anna Cancelliere, Enrico Maria Trecarichi, Maria Mazzitelli, Eugenio Arrighi, Graziella Perri, Francesca Serapide, Corrado Pelaia, Elena Lio, Maria Teresa Busceti, Maria Chiara Pelle, Marco Ricchio, Vincenzo Scaglione, Chiara Davoli, Paolo Fusco, Valentina La Gamba, Carlo Torti, Girolamo Pelaia
The worldwide spread of coronavirus disease 2019 (COVID-19), caused by the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a pandemic by the World Health Organization (WHO) in March 2020. According to clinical studies carried out in China and Italy, most patients experience mild or moderate symptoms; about a fifth of subjects develop a severe and critical disease, and may suffer from interstitial pneumonia, possibly associated with acute respiratory distress syndrome (ARDS) and death...
January 2020: Therapeutic Advances in Respiratory Disease
Yasuhiro Tomita, Takatoshi Kasai
Patients with obstructive sleep apnea (OSA) are susceptible to developing atherosclerosis. Consequently, such patients are at a high risk of developing cardiovascular diseases, leading to poor prognosis. Many physiological parameters have been previously used to predict the development of atherosclerosis. One such parameter, the cardio-ankle vascular index (CAVI), a measure of arterial stiffness, has garnered much attention as it can also predict the degree of atherosclerosis. The CAVI can be calculated based on noninvasive measurements, and is less susceptible to blood pressure variations at the time of measurement...
September 30, 2020: Reviews in Cardiovascular Medicine
Wei-Long Ding, Yong-Sheng Xiang, Jian-Cheng Liao, Shi-Yong Wang, Xiang-Yu Wang
Brainstem hemorrhage is presumed to be invariably associated with a poor prognosis in people with spontaneous hypertensive cerebral hemorrhage. The optimal timing of tracheostomy placement in brainstem hemorrhage patients, who generally require endotracheal intubation for airway protection, remains uncertain. Our research aim was to analyze the impact of early tracheostomy versus late tracheostomy on brainstem hemorrhage patients related outcomes and prognostic factors at 30 days. We identified early tracheostomy and how it could benefit the patients with brainstem hemorrhage and ameliorate the predictors of functional recovery at 30 days...
September 30, 2020: Journal of Integrative Neuroscience
Emil Abd El-Qader, Lilach Israeli-Shani, Gali Epstein Shochet, Zamir Dovrish, Daniel A King, David Dahan, Ori Wand, David Shitrit
BACKGROUND: Patients with severe chronic obstructive pulmonary disease (COPD) experience frequent exacerbations and need to be hospitalized, resulting in an economic and social burden. Although data exist regarding reasons of frequent hospitalizations, there is no data available about the impact on the length of stay (LOS). OBJECTIVES: To characterize the causes of prolonged hospitalizations in COPD patients. METHODS: A retrospective study was conducted of patients who were diagnosed and treated in the pulmonary department for severe COPD exacerbations...
October 2020: Israel Medical Association Journal: IMAJ
Robert Yanko, Valeri Klitinich, Yaron Haviv, David Gozal, Doron J Aframian, Andra Ratman
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the pathogen that causes coronavirus disease-2019 (COVID-19), is thought to be transmitted via droplets and aerosols, and was detected in saliva of infected individuals. These droplets from the upper airway may infect the inhalation sedation mask and tubing. The authors determined the adequate measures needed to prevent the transmission of COVID-19 by nitrous-oxide (N2O) system during inhalation sedation in dentistry and provided evidence on mask and tubing sterilization...
October 2020: Israel Medical Association Journal: IMAJ
Jinxiang Xi, Junshi Wang, Xiuhua April Si, Shaokuan Zheng, Ramesh Donepudi, Haibo Dong
Uvula-induced snoring and associated obstructive sleep apnea (OSA) is a complex phenomenon characterized by vibrating structures and highly transient vortex dynamics. This study aimed to extract signature features of uvula wake flows of different pathological origins and develop a linear reduced-order surrogate model for flow control. Six airway models were developed with two uvula kinematics and three pharynx constriction levels. A direct numerical simulation (DNS) flow solver based on the immersed boundary method was utilized to resolve the wake flows induced by the flapping uvula...
October 17, 2020: International Journal for Numerical Methods in Biomedical Engineering
Saeed Dabbaghchian, Marc Arnela, Olov Engwall, Oriol Guasch
A link is established between biomechanical and acoustic 3D models for the numerical simulation of vowel-vowel utterances. The former rely on the activation and contraction of relevant muscles for voice production, which displace and distort speech organs. However, biomechanical models do not provide a closed computational domain of the 3D vocal tract airway where to simulate soundwave propagation. An algorithm is thus proposed to extract the vocal tract boundary from the surrounding anatomical structures at each time step of the transition between vowels...
October 17, 2020: International Journal for Numerical Methods in Biomedical Engineering
L Cecchi, E Scala, S Caronni, S Citterio, R Asero
BACKGROUND: The so-called "thunderstorm asthma" (TA) is an uncommon but dramatic outbreak of asthma attacks occurring during a thunderstorm in the pollen and molds season. Mechanisms which make the pollen able to enter the deeper airways and provoke severe asthma symptoms are still unclear. OBJECTIVE: To test the hypothesis that sub pollen particles (SPPs) originated from the rupture by an osmotic shock of pollen associated with TA contain allergens METHODS: After hydration, SPPs released from pollen grains of grass, pellitory, olive, cypress, ragweed and birch were isolated and determined by microscopy...
October 18, 2020: Clinical and Experimental Allergy
Geert M Verleden
Eosinophils are granulocytes, developing in the bone marrow. Differentiation and survival of these cells is dependent on interleukin (IL)-5 through the IL5Rα. Their half-life in the blood is around 1.8 days and after migration to different organs, they contribute in remodeling, metabolic and microbiome homeostasis, and may act as sentinels for infection (especially parasitic), fibrosis and cancer. The role of the eosinophil is very well known in allergic asthma, which is driven by T helper 2 cells, secreting IL 4, 5 and 13 which leads to eosinophilic airways inflammation (3)...
October 18, 2020: Transplant International
Wei-Chung Hsu, Kun-Tai Kang, Chung-Chen Jane Yao, Chen-Han Chou, Wen-Chin Weng, Pei-Lin Lee, Yunn-Jy Chen
OBJECTIVE: Cone-beam computed tomography (CBCT) offers three-dimensional structures in assessing upper airway of patients. This study aims to compare the cone-beam computerized tomography scan measurements between children with obstructive sleep apnea (OSA) and primary snoring. STUDY DESIGN: Case-control study. METHODS: This prospective study was conducted in a tertiary referral center. Thirty-six children with moderate-to-severe OSA (with apnea-hypopnea index [AHI] > 5 events/hour) and 36 age-, gender-, and obesity-matched children with primary snoring (AHI <1) were enrolled...
July 13, 2020: Laryngoscope
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