Konrad Schultz, Andreas Rembert Koczulla
Pulmonary rehabilitation of asthma and COPD patients can improve their physical performance and quality of life, maintain participation in social and professional life and actively promote self-help. In addition, the resources for acute medical treatment can be spared. In case of COPD, rehabilitation directly after exacerbation can also improve the poor survival prognosis and reduce the risk of emergency hospital readmission. Therefore, pulmonary rehabilitation is an essential component of evidence-based long-term management of both bronchial asthma and, in particular, COPD...
June 2021: Pneumologie
Ajay P Nayak, John M Lim, Eylon Arbel, Ruping Wang, Dominic R Villalba, Tahn L Nguyen, Niccole Schaible, Ramaswamy Krishnan, Dale D Tang, Raymond B Penn
Current therapeutic approaches to avoid or reverse bronchoconstriction rely primarily on β2 adrenoceptor agonists (β-agonists) that regulate pharmacomechanical coupling/cross bridge cycling in airway smooth muscle (ASM). Targeting actin cytoskeleton polymerization in ASM represents an alternative means to regulate ASM contraction. Herein we report the cooperative effects of targeting these distinct pathways with β-agonists and inhibitors of the mammalian Abelson tyrosine kinase (Abl1 or c-Abl). The cooperative effect of β-agonists (isoproterenol) and c-Abl inhibitors (GNF-5, or imatinib) on contractile agonist (methacholine, or histamine) -induced ASM contraction was assessed in cultured human ASM cells (using Fourier Transfer Traction Microscopy), in murine precision cut lung slices, and in vivo (flexiVent in mice)...
July 2021: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
Kristin Schwab, Russell G Buhr, Anne V Grossetreuer, Lakshman Balaji, Edward S Lee, Ari L Moskowitz
OBJECTIVES: Airway management during in-hospital cardiac arrest represents a fundamental component of resuscitative efforts, yet little is known about temporal trends in intubation during in-hospital cardiac arrest. Our objective was to investigate changes in in-hospital cardiac arrest airway management over time and in response to national guideline updates. DESIGN: Observational cohort study of a prospectively collected database. SETTING: Multicenter study of hospitals participating in the "Get With The Guidelines-Resuscitation" registry from January 1, 2001, to December 31, 2018...
June 9, 2021: Critical Care Medicine
Nancy Carney, Annette M Totten, Tamara Cheney, Rebecca Jungbauer, Matthew R Neth, Chandler Weeks, Cynthia Davis-O'Reilly, Rongwei Fu, Yun Yu, Roger Chou, Mohamud Daya
Objective. To assess comparative benefits and harms across three airway management approaches (bag valve mask [BVM], supraglottic airway [SGA], and endotracheal intubation [ETI]) used by prehospital emergency medical services (EMS) to treat patients with trauma, cardiac arrest, or medical emergencies, and how they differ based on techniques and devices, EMS personnel and patient characteristics. Data sources. We searched electronic citation databases (Ovid® MEDLINE® , CINAHL® , the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and Scopus® ) from 1990 to September 2020...
June 11, 2021: Prehospital Emergency Care
Rebecca Nantanda, Joakim Bloch, Marianne Stubbe Østergaard, Bruce J Kirenga, James K Tumwine, Grace Ndeezi, Susanne Reventlow, Anja Poulsen, Jesper Kjærgaard
INTRODUCTION: Globally, acute lower respiratory infections are the leading cause of mortality among children under 5 years. Following World Health Organization primary care guidelines, pneumonia is diagnosed based on cough/difficult breathing and fast breathing. We aimed to describe the practices of healthcare workers in primary care health facilities in Uganda in the management of young children with respiratory symptoms especially regarding asthma as opposed to pneumonia. METHODS: Health workers were observed during clinical consultations with children 1-59 months of age presenting with cough and/or difficult breathing at recruitment...
May 17, 2021: Journal of Tropical Pediatrics
Andrew Talon, Muhammad Arif, Sreeja Biswas, Saad Alkhider, Ali Saeed
Central airway obstruction due to the tumor can present as near-complete tracheal obstruction. The results can be life-threatening requiring emergent intervention. Rigid bronchoscopy has been preferred for the management of central airway obstruction. However, there are relatively few studies comparing rigid bronchoscopy and flexible bronchoscopy in treating these cases. We describe a 61-year-old woman with a lower trachea tumor with ball valve occlusion of the left mainstem bronchus and complete occlusion of the right mainstem bronchus successfully managed with flexible bronchoscopy and iCAST® stent...
June 8, 2021: Curēus
Reena Gupta, Ariel M Azhdam, Michela Borrelli
Hoarseness lasting greater than 2 weeks should be thoroughly evaluated. Here, a case is presented of a 38-year-old female with a 10-year history of dysphonia. Endoscopic examination confirmed the presence of a supraglottic mass, for which operative biopsy and imaging were performed. Pathology confirmed the diagnosis of supraglottic schwannoma. This was excised endoscopically with close management postoperatively to monitor for rapid recurrence and airway compromise. At one month postoperatively, the patient is still mildly dysphonic but vocally improved and the operative site continues to heal well...
June 10, 2021: Ear, Nose, & Throat Journal
Russell J Hopp, Mark C Wilson, M Asghar Pasha
Objective . Standard spirograms are used in the respiratory disease management community to help diagnosis asthma and provide longitudinal information. Surprisingly, basic information obtained on the spirogram, beyond the FEV1 and change in FEV1 after bronchodilator is, however, underutilized. We sought to update the information on pulmonary function and bronchodilator response in children since 2016. We also present here a discussion of other elements of the standard spirogram that can be used for pediatric asthma management...
June 10, 2021: Journal of Asthma
Claire Usala, Patrick Wilson
Introduction: Noninvasive ventilation (NIV) is sometimes used in refractory pediatric status asthmaticus for its potential benefits of stenting airways and dispersing albuterol. However, its effectiveness in pediatric asthma remains unproven. The usage pattern, outcomes, and safety of NIV in pediatric status asthmaticus are described. Methods: Patients 1 to 21 years of age admitted to a tertiary hospital's pediatric intensive care unit (PICU) with status asthmaticus between January 2016 and December 2018 were eligible...
June 10, 2021: Journal of Asthma
Shoko Hasegawa, Kenichiro Koda, Masashi Uzawa, Haruka Kimura, Rie Kimura, Takayuki Kitamura
BACKGROUND: Most patients with congenital tracheal stenosis (CTS) develop respiratory symptoms early in life. CTS remaining undiagnosed until adulthood is rare. CASE PRESENTATION: A 51-year-old female was scheduled for cardiovascular surgery. She had undergone laparoscopic surgery 3 years earlier and was found to have a difficult airway. Postoperatively, she was diagnosed with CTS. For the current cardiovascular surgery, combined use of a McGRATHTM MAC videolaryngoscope and fiberoptic bronchoscope allowed sufficient visualization of the glottis and trachea, resulting in successful intubation...
June 9, 2021: JA Clinical Reports
Yousif Al-Saiegh, Jenna Spears, Tim Barry, Christopher Lee, Howard Haber, Sheldon Goldberg
Background: Effusive-constrictive pericarditis (ECP) is a rare syndrome involving pericardial effusion and concomitant constrictive pericarditis. The hallmark is a persistently elevated right atrial pressure of >10 mmHg or reduction of less than 50% from baseline despite pericardiocentesis. Aetiologies include radiation, infection, malignancy, and autoimmune disease. Case summary: A 71-year-old man with a history of atrial fibrillation, obesity, hypertension, obstructive sleep apnoea, managed with continuous positive airway pressure presented with acute pericarditis complicated by pericardial effusion leading to cardiac tamponade...
May 2021: European Heart Journal. Case Reports
Annemarie L Lee, Susy Baenziger, Amanda Louey, Sophie Jennings, Peter Solin, Ryan Hoy
A combination of airway clearance techniques are applied for people with bronchiectasis, together with recommendations for exercise and suggestions for management of common comorbidities
April 2021: ERJ Open Research
Salma G Abdelhady, Eman M Fouda, Malak A Shaheen, Faten A Ghazal, Ahmed M Mostafa, Ahmed M Osman, Andrew G Nicholson, Heba M Hamza
Background: Childhood interstitial and diffuse lung diseases (chILD) encompass a broad spectrum of rare pulmonary disorders. In most developing Middle Eastern countries, chILD is still underdiagnosed. Our objective was to describe and investigate patients diagnosed with chILD in a tertiary university hospital in Egypt. Methods: We analysed data of consecutive subjects (aged <18 years) referred for further evaluation at the Children's Hospital, Ain Shams University (Cairo, Egypt)...
April 2021: ERJ Open Research
Ayako Inoshita, Fumihiko Matsumoto, Shinichi Ohba, Naoko Sata, Rina Matsuoka, Yo Suzuki, Shin Ito, Hiroko Koiwai, Nanako Shiroshita, Takatoshi Kasai, Katsuhisa Ikeda
Concurrent chemoradiotherapy (CCRT) is one of the most promising treatments for advanced head and neck cancer (HNC). On the other hand, CCRT may induce severe edema in laryngo-pharyngeal structures in association with radiation. This is a report of a 66-year-old man with severe obstructive sleep apnea (OSA) associated with edema in laryngo-hypopharynx after CCRT for advanced laryngeal and hypopharyngeal cancer. Tracheostomy was avoided and OSA was controlled by continuous positive airway pressure (CPAP). Subjective symptoms of sleepiness were improved...
June 6, 2021: Auris, Nasus, Larynx
Gianluigi Li Bassi, Jacky Y Suen, Heidi J Dalton, Nicole White, Sally Shrapnel, Jonathon P Fanning, Benoit Liquet, Samuel Hinton, Aapeli Vuorinen, Gareth Booth, Jonathan E Millar, Simon Forsyth, Mauro Panigada, John Laffey, Daniel Brodie, Eddy Fan, Antoni Torres, Davide Chiumello, Amanda Corley, Alyaa Elhazmi, Carol Hodgson, Shingo Ichiba, Carlos Luna, Srinivas Murthy, Alistair Nichol, Pauline Yeung Ng, Mark Ogino, Antonio Pesenti, Huynh Trung Trieu, John F Fraser
BACKGROUND: Heterogeneous respiratory system static compliance (CRS ) values and levels of hypoxemia in patients with novel coronavirus disease (COVID-19) requiring mechanical ventilation have been reported in previous small-case series or studies conducted at a national level. METHODS: We designed a retrospective observational cohort study with rapid data gathering from the international COVID-19 Critical Care Consortium study to comprehensively describe CRS -calculated as: tidal volume/[airway plateau pressure-positive end-expiratory pressure (PEEP)]-and its association with ventilatory management and outcomes of COVID-19 patients on mechanical ventilation (MV), admitted to intensive care units (ICU) worldwide...
June 9, 2021: Critical Care: the Official Journal of the Critical Care Forum
Sotiria Genetzaki, Evangelia Tsakiropoulou, Vasilios Nikolaidis, Konstantinos Markou, Iordanis Konstantinidis
INTRODUCTION: There are limited treatment options for postinfectious olfactory dysfunction (PIOD). Olfactory training has recently been used in clinical practice, but no medical treatment is widely accepted. Although there is weak evidence for their value, some physicians use oral corticosteroids as first-line treatment. The aim of this study was to compare combined oral methylprednisolone and olfactory training with olfactory training alone in the management of PIOD. METHODS: This prospective cohort study included 131 patients with PIOD over a 2-year period before the COVID-19 pandemic...
June 9, 2021: ORL; Journal for Oto-rhino-laryngology and its related Specialties
Thomas E Grissom, Ron E Samet
No abstract text is available yet for this article.
December 2020: Advances in Anesthesia
J Adam Law, Laura V Duggan, Mathieu Asselin, Paul Baker, Edward Crosby, Andrew Downey, Orlando R Hung, George Kovacs, François Lemay, Rudiger Noppens, Matteo Parotto, Roanne Preston, Nick Sowers, Kathryn Sparrow, Timothy P Turkstra, David T Wong, Philip M Jones
PURPOSE: Since the last Canadian Airway Focus Group (CAFG) guidelines were published in 2013, the published airway management literature has expanded substantially. The CAFG therefore re-convened to examine this literature and update practice recommendations. This second of two articles addresses airway evaluation, decision-making, and safe implementation of an airway management strategy when difficulty is anticipated. SOURCE: Canadian Airway Focus Group members, including anesthesia, emergency medicine, and critical care physicians were assigned topics to search...
June 8, 2021: Canadian Journal of Anaesthesia
Elizabeth M Putnam, Lauryn R Rochlen, Erik Alderink, James Augé, Vitaliy Popov, Robert Levine, Alan R Tait
Background: Pediatric airway emergencies are relatively rare, but have potentially devastating consequences. Simulation based education is important in providing zero-risk management experience for these critical events. Aims: The aim of the study was to assess usability and feasibility of combined interactive instructional videos and a novel Virtual Reality (VR) trainer for healthcare professionals and to evaluate the impact of this combination on learners' knowledge of critical airway events in children...
February 25, 2021: Journal of Clinical and Translational Research
Manjula V Ramsali, Koshy G Puduchira, Sitaram P Maganti, Sarada Devi Vankaylapatti, Surender Pasupuleti, Dilipkumar Kulkarni
Background and Aims: Steven-Johnson Syndrome (SJS) is a rare and severe form of erythema exudative multiforme. Multisystem involvement in SJS and the suspicion of precipitation of the disease with exposure to anesthetic drugs makes anesthesia a challenging task. The concerns during anesthesia are the mucosal lesions and special care that is required to prevent injury to the oropharynx and larynx during airway management and also the drugs used for anesthesia. In the literature, very few isolated case reports or case series are available...
January 2021: Journal of Anaesthesiology, Clinical Pharmacology
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