When preterm infants present with organ anomalies that require immediate surgical intervention after birth, their immature nervous systems often limit their ability to cope with the stress of surgery and subsequent treatments. This often results in difficulties with self-regulation and related health issues. The case described in this study involves a late preterm female infant born at 36+4 weeks of gestation who underwent cardiac surgery on the fifth day after birth. Postoperatively, she exhibited neonatal neurodevelopmental disorganization, ineffective suck-swallow reflexes, and inadequate nutritional intake. The first author provided nursing care between April 22 to May 10, 2025, with a telephone follow-up on May 14. The provided interventions were guided by Als' Synactive Theory of Development and integrated the Seven Neuroprotective Core Measures of the Neonatal Integrative Developmental Care Model, encompassing environmental regulation, sleep and positioning support, stress and pain management, and family-centered care. Objective evaluation was conducted using the Preterm Infant Oral Feeding Readiness Assessment Scale (POFRAS). The results demonstrated improvements in both self-regulation and feeding difficulties. Notably, the incidence of crying episodes decreased, the infant was able to sustain a calm state for longer periods, coordination of suck-swallow-breathing improved, and oral intake increased. Consequently, the amount of supplemental gavage feeding was reduced, caregivers were able to provide effective care, and the POFRAS score rose from 21 to 32. The comprehensive care approach described in this study integrates theoretical frameworks with behavioral cue-based observations to effectively improve feeding difficulties and self-regulation in preterm infants undergoing invasive surgery while simultaneously enhancing caregiver competence and confidence.

As a leading cause of chronic respiratory morbidity worldwide, asthma remains a complex disorder characterized by inflammation, recurrent exacerbations, and episodic symptoms. Pulmonary sarcoidosis is a potential misdiagnosis for asthma. Symptoms such as shortness of breath, chest tightness, and dry cough can be present in both conditions, making differentiation difficult. This case highlights the diagnostic challenges and clinical overlap between severe asthma and sarcoidosis in a patient with uncontrolled respiratory symptoms, underscoring the importance of considering other etiologies when standard asthma management is ineffective in controlling symptoms. We present the case of a 59-year-old man with a history of severe asthma who continued to have persistent and worsening respiratory symptoms despite high-dose inhaled steroids, long-acting beta agonists (LABAs), long-acting antimuscarinics, and biologic therapy. Pulmonary function testing evolved from reversible obstruction to a more restrictive pattern, prompting imaging of his chest and subsequent lung biopsy, revealing noncaseating granulomas. This case highlights the diagnostic challenges and clinical overlap between severe asthma and sarcoidosis in a patient with uncontrolled and exacerbating respiratory symptoms.

PurposeTo develop a mid-range theory for the nursing diagnosis Ineffective infant suck-swallow response.Data SourcesScientific findings were derived from two systematic reviews, one addressing etiological factors and the other focused on clinical indicators. Additional theoretical support from Roy's Adaptation Model guided the categorization of the elements identified in the reviews and the conceptual relationships defined during theory construction.Data SynthesisSeven stimuli and fifteen defining characteristics were identified and classified according to causal hierarchy and behavioral timing. Findings support revising the diagnosis to "Ineffective Infant Suck-Swallow-Breathing Response" and reclassifying it under the Nutrition domain. A pictorial diagram and nine theoretical propositions were developed to depict causal links and guide nursing practice.ConclusionsThe Mid-Range Theory supported revising the nursing diagnosis to "Ineffective Infant Suck-Swallow-Breathe Response," reclassifying it under the Nutrition domain, and refining defining characteristics, at-risk populations, and associated conditions. These adjustments aim to improve diagnostic accuracy and guide targeted neonatal nursing interventions. Further validation studies are recommended.Implications for Nursing PracticeThe proposed revisions can improve diagnostic accuracy, enable early identification of feeding difficulties, and guide targeted neonatal nursing interventions to promote safe and effective feeding.

Gastroesophageal reflux disease (GERD) is a prevalent comorbidity of chronic respiratory diseases including idiopathic pulmonary fibrosis (IPF), non-IPF interstitial lung disease, asthma, chronic obstructive pulmonary disease (COPD) and refractory chronic cough. Prevalence of symptoms of reflux and/ or refractory respiratory symptoms, along with concerns that refluxed gastric contents into the esophagus may micro-aspirate into the lungs causing injury and potentially accelerate disease progression, have resulted in high usage of empirical anti-reflux treatments. However, empirical treatment of reflux (medical or mechanical) is frequently ineffective without obvious explanation for the lack of respiratory improvement. This review provides novel and updated understanding of the pathophysiological mechanisms that link upper gut dysfunction, reflux (both distal and proximal), lung structure, lung mechanics and breathing patterns, including the potential role of the vagally mediated esophageal-bronchial reflex and the bi-directional nature of these interactions in individual respiratory diseases. We also highlight the need for a consensus between gastrointestinal and respiratory communities and propose a framework for diagnosing and managing GERD in respiratory disease.

We explored pharmacotherapeutic response patterns of lipopolysaccharides (LPS)-induced pneumonia and sepsis as direct and indirect acute lung injury (ALI), and efficacy of a combined surfactant (S) and inhaled nitric oxide (iNO), simulating critical care, in rabbits of post-neonatal infancy. Anaesthetized 7-day-old healthy rabbits were injected intratracheally (IT) or intravenously (IV) with LPS (15-20-25 mg/kg, L) or saline as a control (C), and subjected to initial 2-hour mechanical ventilation (MV) with standardized tidal volume to induce ALI. They were then treated with S (200 mg/kg) and iNO (10 ppm, N), or not, thereby allocating to 6 groups (ITC, ITL, ITLSN, IVC, IVL, IVLSN) for another 8 h. Survival time/rate (ST), and variables as biomarkers in lung physiology, histopathology, biochemistry, and pathophysiology were measured. The survival was LPS-route, but not dosing, dependent. Compared to the IVL, ITL had relatively higher ST, lung injury score (LIS), lower intrapulmonary phospholipid pools, mRNA expressions in surfactant proteins (SPs) and pulmonary vascular endothelial cell injury (VEI)-related variables. ITLSN had higher phospholipid pools but no improvement in ST, lung mechanics, LIS or mRNA expression of SPs, proinflammatory mediators and VEI-related variables. IVLSN had improved lung mechanics, LIS, phospholipid pools, and SP-A mRNA expression, but worse ST, metabolic acidosis, higher interleukin mRNA expression in the lungs, liver and kidney, suspected as sepsis-associated multiorgan involvement. Using the infant rabbit LPS-ALI model, we characterized the survival as LPS-route dependent, the lung impairment and response pattern in surfactant and iNO treatment ineffectiveness/failure, as pharmacotherapeutic response patterns, with causal implication pertinent to the underlying pathophysiology of experimental pediatric ARDS.

People often physically cling to others when afraid and doing so can downregulate negative emotional experiences (e.g., Coan et al., 2006). However, in some situations, physical touch may fail to downregulate emotional experiences-such as when an individual being touched is physiologically aroused themselves. To test this hypothesis, we built plush robots with motorized plastic ribcages that were manipulated to contract and expand to simulate human breathing patterns. Participants held these robots while we measured their heart rate before, during, and after watching a fear-eliciting stimulus. Consistent with our hypothesis, participants who interacted with robots that exhibited accelerated-breathing patterns experienced a pronounced increase in their own heart rate, compared to participants who held stable-breathing and nonbreathing robots. These results indicate that holding or clinging to others engaged in accelerated breathing may be ineffective or detrimental for downregulating one's own physiological arousal. (PsycInfo Database Record (c) 2026 APA, all rights reserved).