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Journal of Perinatology : Official... Oct 2023Meconium aspiration syndrome (MAS) is a complex respiratory disease that continues to be associated with significant morbidities and mortality. The pathophysiological... (Review)
Review
Meconium aspiration syndrome (MAS) is a complex respiratory disease that continues to be associated with significant morbidities and mortality. The pathophysiological mechanisms of MAS include airway obstruction, local and systemic inflammation, surfactant inactivation and persistent pulmonary hypertension of the newborn (PPHN). Supplemental oxygen and non-invasive respiratory support are the main therapies for many patients. The management of the patients requiring invasive mechanical ventilation could be challenging because of the combination of atelectasis and air trapping. While studies have explored various ventilatory modalities, evidence to date does not clearly support any singular modality as superior. Patient's pathophysiology, symptom severity, and clinician/unit expertise should guide the respiratory management. Early identification and concomitant management of PPHN is critically important as it contributes significantly to mortality and morbidities.
Topics: Female; Humans; Infant, Newborn; Meconium Aspiration Syndrome; Respiration, Artificial; Persistent Fetal Circulation Syndrome; Pulmonary Surfactants; Morbidity
PubMed: 37543651
DOI: 10.1038/s41372-023-01708-2 -
Journal of Wound Care Jul 2023Intertrigo is a common inflammatory skin disorder caused by skin-on-skin friction in skin folds, due to moisture becoming trapped because of poor air circulation. This... (Review)
Review
Intertrigo is a common inflammatory skin disorder caused by skin-on-skin friction in skin folds, due to moisture becoming trapped because of poor air circulation. This can occur in any area of the body where two skin surfaces are in close contact with each other. The aim of this scoping review was to systematically map, review and synthesise evidence on intertrigo in adults. We identified a wide range of evidence and performed a narrative integration of this related to the diagnosis, management and prevention of intertrigo. A literature search was conducted within the following databases: Cochrane Library, MEDLINE, CINAHL, PubMed and EMBASE. After reviewing articles for duplicates and relevance, 55 articles were included. The incorporation of intertrigo in the ICD-11 provides a clear definition and should improve the accuracy of estimates. With regards to the diagnosis, prevention and management of intertrigo, the literature demonstrates consensus among health professionals in approach and this forms the basis for the recommendations of this review: identify predisposing factors and educate patient in reducing these; educate patients in skin fold management and adopt structured skin care routine; treat secondary infection with appropriate topical agent; consider using moisture-wicking textiles within skin folds to reduce skin-on-skin friction, wick away moisture and reduce secondary infection. Overall, the quality of evidence on which to determine the strength of any recommendations for practice remains low. There remains the need for well-designed studies to test proposed interventions and build a robust evidence base.
Topics: Humans; Adult; Coinfection; Intertrigo; Skin Diseases; Skin; Skin Care
PubMed: 37405940
DOI: 10.12968/jowc.2023.32.7.411 -
Clinical Imaging Jul 2023The American Thoracic Society provides guidelines for the confident radiographic diagnosis of UIP. In addition, the guidelines identify findings on CT scans that should...
The American Thoracic Society provides guidelines for the confident radiographic diagnosis of UIP. In addition, the guidelines identify findings on CT scans that should suggest an alternative diagnosis to UIP. These findings include consolidation, air trapping, nodules, ground glass opacities, cysts, and upper lung and bronchovascular distribution. We present a mnemonic to help the reader remember the list of findings that are inconsistent with UIP and provide imaging examples for completeness. The mnemonic is "CANNOT B" UIP.
Topics: Humans; Lung Diseases, Interstitial; Lung; Tomography, X-Ray Computed; Radiography; Cysts
PubMed: 37031524
DOI: 10.1016/j.clinimag.2023.02.015 -
Chest Sep 2023Pressure-dependent pneumothorax is a common clinical event, often occurring after pleural drainage in patients with visceral pleural restriction, partial lung resection,... (Review)
Review
Pressure-dependent pneumothorax is a common clinical event, often occurring after pleural drainage in patients with visceral pleural restriction, partial lung resection, or lobar atelectasis from bronchoscopic lung volume reduction or an endobronchial obstruction. This type of pneumothorax and air leak is clinically inconsequential. Failure to appreciate the benign nature of such air leaks may result in unnecessary pleural procedures or prolonged hospital stay. This review suggests that identification of pressure-dependent pneumothorax is clinically important because the air leak that results is not related to a lung injury that requires repair but rather to a physiological consequence of a pressure gradient. A pressure-dependent pneumothorax occurs during pleural drainage in patients with lung-thoracic cavity shape/size mismatch. It is caused by an air leak related to a pressure gradient between the subpleural lung parenchyma and the pleural space. Pressure-dependent pneumothorax and air leak do not need any further pleural interventions.
Topics: Humans; Pneumothorax; Pneumonectomy; Pleural Cavity; Thoracic Surgical Procedures; Pleura
PubMed: 37187435
DOI: 10.1016/j.chest.2023.04.049