Chest
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The therapeutic value of transcutaneous electrical stimulation of the genioglossus muscle in patients with obstructive sleep apnea (OSA) to reduce sleep-disordered breathing is unclear. ⋯ Continuous transcutaneous electrical stimulation of the genioglossus contracts the genioglossus muscle and reduces ventilatory load and neural respiratory drive in patients with OSA.
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Review Meta Analysis
Diagnosis of pneumothorax by radiography and ultrasonography: a meta-analysis.
This study compares, by meta-analysis, the use of anterior-posterior chest radiography (CR) with transthoracic ultrasonography for the diagnosis of pneumothorax. ⋯ The meta-analysis indicated that bedside ultrasonography performed by clinicians had higher sensitivity and similar specificity compared with CR in the diagnosis of pneumothorax, but the accuracy of ultrasonography in the diagnosis of pneumothorax depended on the skill of the operators.
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Comparative Study
Overnight rostral fluid shift in obstructive sleep apnea: does it affect the severity of sleep-disordered breathing?
Obstructive sleep apnea (OSA) is a common disorder with multifactorial pathogenesis. It has been proposed that rostral fluid displacement contributes to the pathogenesis of OSA. We hypothesized that if fluid shift is an important factor in OSA, then it would be more severe during the second one-half of the night when there is maximally displaced fluid rostrally. ⋯ There is a significant fluid shift rostrally to the neck overnight in patients with and without OSA. However, this fluid shift is not associated with worsening of OSA, thus making it unlikely that fluid displacement is a contributing factor in the pathogenesis or severity of OSA.
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Cough is a common symptom of diseases such as asthma and COPD and also presents as a disease in its own right. Treatment options are limited; a recent meta-analysis concluded that over-the-counter remedies are ineffective, and there is increasing concern about their use in children. Transient receptor potential cation channel, subfamily A, member 1 (TRPA1) channels are nonselective cation channels that are activated by a range of natural products (eg, allyl isothiocyanate), a multitude of environmental irritants (eg, acrolein, which is present in air pollution, vehicle exhaust, and cigarette smoke), and inflammatory mediators (eg, cyclopentenone prostaglandins). ⋯ Inhalational exposure to irritating gases, fumes, dusts, vapors, chemicals, and endogenous mediators can lead to the development of cough. The respiratory tract is innervated by primary sensory afferent nerves, which are activated by mechanical and chemical stimuli. Recent data suggest that activation of TRPA1 on these vagal sensory afferents by these irritant substances could lead to central reflexes, including dyspnea, changes in breathing pattern, and cough, which contribute to the symptoms and pathophysiology of respiratory diseases.