- Respiratory syncytial virüs infections in neonates and infants. [Review]
- TPTurk Pediatri Ars 2018; 53(2):63-70
- Respiratory syncytial virus is one of the major causes of respiratory tract infections during infancy with high rates of hospitalization and mortality during the first years of life. It is the most c...
Respiratory syncytial virus is one of the major causes of respiratory tract infections during infancy with high rates of hospitalization and mortality during the first years of life. It is the most common cause of acute bronchiolitis and viral pneumonia in children below two years of age and second the most common cause of postneonatal infant mortality all around the world following malaria. In addition, the virus has been causally linked to recurrent wheezing and associated with pediatric asthma. The respiratory syncytial virus infections tend to be severe in high risk patients such as patients below six months of age, with prematurity, congenital heart diseases, neuromuscular diseases and immune deficiencies. No specific treatment is available for respiratory syncytial virus infections to date. Severe cases require supportive therapy, mainly oxygen supplementation and hydration, and less frequently, ventilatory support. Because there is no vaccine to prevent respiratory syncytial virus infections or clinically effective treatment to administer to children with respiratory syncytial virus infection, immunoprophylaxis with palivizumab is currently the only method for reducing morbidity associated with severe respiratory syncytial virus in high-risk infants.
- Hypertension and severe hypokalaemia associated with ectopic ACTH production. [Journal Article]
- BCBMJ Case Rep 2018 Aug 16; 2018
- Ectopic adrenocorticotropic hormone (ACTH) secretion represents 5%-10% of cases of Cushing's syndrome (CS), and approximately 50%-60% of these arise from neuroendocrine lung tumours, including small-...
Ectopic adrenocorticotropic hormone (ACTH) secretion represents 5%-10% of cases of Cushing's syndrome (CS), and approximately 50%-60% of these arise from neuroendocrine lung tumours, including small-cell lung cancer (SCLC). We report a 42-year-old man admitted with hypertension, metabolic alkalosis and severe hypokalaemia. On physical examination, centripetal obesity with 'moon face' and 'buffalo's hump' were identified, and wheezing on left lung was heard. A markedly elevated serum cortisol, ACTH and urine free cortisol production supported the diagnosis of CS. Chest CT showed a left hilar mass with metastasis to the liver, adrenal glands and lymph nodes. Bronchoscopy identified bronchial infiltration by SCLC. Treatment with metyrapone and chemotherapy was started. Despite initial improvement, progressive clinical deterioration occurred, culminating in death 1 year after diagnosis. Ectopic ACTH secretion is uncommon but should be suspected in patients with severe hypokalaemia, hypertension and metabolic alkalosis, especially in the context of lung cancer.
- Mixed-methods content and sentiment analysis of adolescents' voice-diaries describing daily experiences with asthma and self-management decision-making. [Journal Article]
- CEClin Exp Allergy 2018 Aug 16
- CONCLUSIONS: Teens may minimize symptoms and have greater symptom frequency and severity than is recognized by themselves or providers. Screening for specific symptoms including coughing, throat-clearing, and respiratory illness may be needed to identify those experiencing burden from asthma. This article is protected by copyright. All rights reserved.
- Serum soluble receptor for advanced glycation end-products during acute bronchiolitis in infant: Prospective study in 93 cases. [Journal Article]
- PPPediatr Pulmonol 2018 Aug 16
- CONCLUSIONS: Serum sRAGE levels are decreased in acute bronchiolitis but not correlated with disease severity. sRAGE levels should be age-adjusted in infants. Serum sRAGE levels measured in the setting of acute bronchiolitis were not predictive of recurrent wheezing.
- Mapping Progress in Reducing Cardiovascular Risk with Kidney Disease: Managing Volume Overload. [Journal Article]
- CJClin J Am Soc Nephrol 2018 Aug 15
- Co-existence of vocal cord dysfunction with pulmonary conditions other than asthma: A case series. [Journal Article]
- RMRespir Med Case Rep 2018; 25:104-108
- CONCLUSIONS: It is important to recognize that VCD can exist with pulmonary conditions other than asthma. Lack of improvement in respiratory symptoms after appropriate treatment for VCD should alert the clinician to evaluate for additional conditions.
- Tracheal sounds accurately detect apnea in patients recovering from anesthesia. [Journal Article]
- JCJ Clin Monit Comput 2018 Aug 11
- Apnea should be monitored continuously in the post anesthesia care unit (PACU) to avoid serious complications. It has been confirmed that tracheal sounds can be used to detect apnea during sedation i...
Apnea should be monitored continuously in the post anesthesia care unit (PACU) to avoid serious complications. It has been confirmed that tracheal sounds can be used to detect apnea during sedation in healthy subjects, but the performance of this acoustic method has not been evaluated in patients with frequent apnea events in the PACU. Tracheal sounds were acquired from the patients in the PACU using a microphone encased in a plastic bell. Concurrently, a processed nasal pressure signal was used as a reference standard to identify real respiratory events. The logarithm of the tracheal sound variance (log-var) was used to detect apnea, and the results were compared to the reference method. Sensitivity, specificity, positive likelihood ratios (PLR), and negative likelihood ratios (NLR) were calculated. One hundred and twenty-one patients aged 55.5 ± 13.2 years (mean ± SD) with a body mass index of 24.6 ± 3.7 kg/m2 were included in data analysis. The total monitoring time was 52.6 h. Thirty-four patients experienced 236 events of apnea lasting for a total of 122.2 min. The log-var apnea detection algorithm detected apnea with 92% sensitivity, 98% specificity, 46 PLR and 0.08 NLR. The performance of apnea detection in the PACU using the log-var tracheal sounds method proved to be reliable and accurate. Tracheal sounds could be used to minimize the potential risks from apnea in PACU patients.
- Respiratory Phenotypes during Childhood and Early Life Exposures. [Journal Article]
- AJAm J Respir Crit Care Med 2018 Aug 10
- Predictors of asthma relapse in patients who attended an emergency department. [Journal Article]
- AAAllergy Asthma Proc 2018 Jul 01; 39(4):292-298
- CONCLUSIONS: In this population, patients who had multiple ED visits in 1 year, those with uncontrolled asthma, wheezing, ≥400 blood eosinophils/μL, or who had been discharged at the first ED visit are at higher risk of relapse.
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- Predicting spirometry readings using cough sound features and regression. [Journal Article]
- PMPhysiol Meas 2018 Aug 09
- Spirometry is a commonly used method of measuring lung function. It is useful in the definitive diagnosis of diseases such as asthma and chronic obstructive pulmonary disease (COPD). However, spirome...
Spirometry is a commonly used method of measuring lung function. It is useful in the definitive diagnosis of diseases such as asthma and chronic obstructive pulmonary disease (COPD). However, spirometry requires cooperative patients, experienced staff, and repeated testing to ensure the consistency of measurements. There is discomfort associated with spirometry and some patients are not able to complete the test. In this paper, we investigate the possibility of using cough sound analysis for the prediction of spirometry measurements. Approach: Our approach is based on the premise that the mechanism of cough generation and the forced expiratory maneuver of spirometry share sufficient similarities enabling this prediction. Using an iPhone, we collected mostly voluntary cough sounds from 322 adults presenting to a respiratory function laboratory for pulmonary function testing. Subjects had the following diagnoses: obstructive, restrictive, or mixed pattern diseases, or were found to have no lung disease along with normal spirometry. The cough sounds were automatically segmented using the algorithm described in . We then represented cough sounds with various cough sound descriptors and built linear and nonlinear regression models connecting them to spirometry parameters. Augmentation of cough features with subject demographic data is also experimented with. The dataset was divided into 272 training subjects and 50 test subjects for experimentation. Main Results: The performance of the auto-segmentation algorithm was evaluated on 49 randomly selected subjects from the overall dataset with a sensitivity and PPV of 84.95% and 98.51%, respectively. Our regression models achieved a root mean square error (and correlation coefficient) for standard spirometry parameters FEV1, FVC, and FEV1/FVC of 0.593L (0.810), 0.725L (0.749), and 0.164 (0.547), respectively, on the test dataset. In addition, we could achieve sensitivity, specificity, and accuracy of 70% or higher by applying the GOLD standard for COPD diagnosis on the estimated spirometry test results. Significance: The experimental results show high positive correlation in predicting FEV1 and FVC and moderate positive correlation in predicting FEV1/FVC. The results show possibility of predicting spirometry results using cough sound analysis.