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Ethiopian Journal of Health Sciences May 2023Patients with chronic obstructive pulmonary disease (COPD) experience an increased risk of perioperative pulmonary complications. The aim of this study was to evaluate... (Randomized Controlled Trial)
Randomized Controlled Trial
The Effect of Albuterol Spray on Hypoxia and Bronchospasm in Patients with Chronic Obstructive Pulmonary Disease (COPD) under General Anesthesia: A bouble-Blind Randomized Clinical Trial.
BACKGROUND
Patients with chronic obstructive pulmonary disease (COPD) experience an increased risk of perioperative pulmonary complications. The aim of this study was to evaluate the effect of albuterol spray on hypoxia and bronchospasm in patients with COPD under general anesthesia.
METHODS
This single-center, double-blind, parallel-group, randomized clinical trial was performed on 120 smoking patients with COPD who were referred to 5 Azar Educational Hospital in Gorgan, Northern Iran, in 2021. Twenty minutes before general anesthesia and also after completion of surgery and before extubation, 60 patients in the intervention group were inhaled with 2 puffs of albuterol spray. In the control group, patients were inhaled with 2 puffs of placebo spray. In perioperative period, the occurrence of wheezing, bronchospasm, coughing, hemodynamic changes, postoperative shivering, dyspnea, and nausea and vomiting were evaluated in all patients. The Consolidated Standards of Reporting Trials (CONSORT) checklist was used to report important aspects of this study.
RESULTS
The mean age of the patients was 52.34 ±8.95 years, and 115 (95.8%) of them were males while the rest were females. The difference between systolic blood pressure before induction of anesthesia (after administration of albuterol spray) between the group receiving albuterol spray and the group not receiving it was statistically significant (p=0.04). Also, the difference between the mean arterial oxygen saturation before tracheal extubation (after re-administration of albuterol spray) between the albuterol spray group and the non-albuterol group was statistically significant (p = 0.03). Wheezing and recurrent cough after induction of anesthesia and after extubation (after albuterol spray administration) was lower in the albuterol group than in the control group (p<0.05). No significant side effects were detected in the albuterol-treated group.
CONCLUSION
According to the results of this study, it seems that the prophylactic use of albuterol spray is useful in reducing the incidence of wheezing and recurrent cough before induction of anesthesia in COPD patients with smoking.
Topics: Male; Female; Humans; Adult; Middle Aged; Albuterol; Bronchial Spasm; Bronchodilator Agents; Cough; Respiratory Sounds; Pulmonary Disease, Chronic Obstructive; Anesthesia, General; Hypoxia; Double-Blind Method
PubMed: 37576161
DOI: 10.4314/ejhs.v33i3.12 -
Ecancermedicalscience 2016Patients with well-differentiated neuroendocrine tumours may develop carcinoid syndrome (CS), which is characterised by flushing, abdominal cramps, diarrhoea, and... (Review)
Review
Patients with well-differentiated neuroendocrine tumours may develop carcinoid syndrome (CS), which is characterised by flushing, abdominal cramps, diarrhoea, and bronchospasms. In this scenario, long-term secretion of vasoactive substances-serotonin, tachynins, and others, may induce fibrogenic responses in local or distant tissues, leading to complications such as carcinoid heart disease (CHD), mesenteric and/or retroperitoneal fibrosis. Rare cases of lung/pleural fibrosis and scleroderma have also been described. Despite it not being well described yet, current evidence suggests the pathogenesis of such fibrogenic complications relies on signalling through 5-HT2B and TGF-β1. Medical management is still very limited and lacks prospective and randomised studies for definitive recommendations. Surgical procedures remain the best definitive treatment option for CHD and abdominal fibrosis. Recently, cognitive impairment has also been described as a potential consequence of CS. This review critically discusses the literature concerning the epidemiology, pathogenesis, clinical features, diagnosis, and treatment options for CS-related long-term complications.
PubMed: 27594907
DOI: 10.3332/ecancer.2016.662 -
Respiratory Physiology & Neurobiology Nov 2008We review here four recent findings that have altered in a fundamental way our understanding of airways smooth muscle (ASM), its dynamic responses to physiological... (Review)
Review
We review here four recent findings that have altered in a fundamental way our understanding of airways smooth muscle (ASM), its dynamic responses to physiological loading, and their dominant mechanical role in bronchospasm. These findings highlight ASM remodeling processes that are innately out-of-equilibrium and dynamic, and bring to the forefront a striking intersection between topics in condensed matter physics and ASM cytoskeletal biology. By doing so, they place in a new light the role of enhanced ASM mass in airway hyper-responsiveness as well as in the failure of a deep inspiration to relax the asthmatic airway. These findings have established that (i) ASM length is equilibrated dynamically, not statically; (ii) ASM dynamics closely resemble physical features exhibited by so-called soft glassy materials; (iii) static force-length relationships fail to describe dynamically contracted ASM states; (iv) stretch fluidizes the ASM cytoskeleton. Taken together, these observations suggest that at the origin of the bronchodilatory effect of a deep inspiration, and its failure in asthma, may lie glassy dynamics of the ASM cell.
Topics: Animals; Bronchial Spasm; Cytoskeleton; Freezing; Humans; Muscle Contraction; Muscle, Smooth; Nonlinear Dynamics; Respiratory Mechanics; Respiratory System
PubMed: 18514592
DOI: 10.1016/j.resp.2008.04.006 -
Canadian Medical Association Journal Jan 1965
Topics: Acetylcysteine; Anti-Bacterial Agents; Bronchial Spasm; Cysteine; Drug Therapy; Epinephrine; Equipment and Supplies; Humans; Hypoxia; Isoproterenol; Mucus; Oxygen Inhalation Therapy; Phenylephrine; Propylene Glycols; Respiratory Therapy; Respiratory Tract Diseases
PubMed: 14228241
DOI: No ID Found -
American Family Physician Feb 2003Exercise-induced bronchospasm is an obstruction of transient airflow that usually occurs five to 15 minutes after physical exertion. Although this condition is highly... (Review)
Review
Exercise-induced bronchospasm is an obstruction of transient airflow that usually occurs five to 15 minutes after physical exertion. Although this condition is highly preventable, it is still underrecognized and affects aerobic fitness and quality of life. Diagnosis is based on the results of a detailed history, including assessment of asthma triggers, symptoms suggestive of exercise-induced bronchoconstriction, and a normal forced expiratory volume at one second at rest. A trial of therapy with an inhaled beta agonist may be instituted, with the subsequent addition of inhaled anti-inflammatory agents or ipratropium bromide. Nonpharmacologic measures, such as increased physical conditioning, warm-up exercises, and covering the mouth and nose, should be instituted. If symptoms persist, pulmonary function testing is warranted to rule out underlying lung disease.
Topics: Anti-Asthmatic Agents; Anti-Inflammatory Agents; Asthma, Exercise-Induced; Bronchial Spasm; Clinical Trials as Topic; Critical Pathways; Humans; Nebulizers and Vaporizers
PubMed: 12613731
DOI: No ID Found -
Cureus Sep 2022Asthma is a respiratory illness characterized by episodes of bronchial spasm that make breathing difficult. It often has an association with an allergic response or any... (Review)
Review
Asthma is a respiratory illness characterized by episodes of bronchial spasm that make breathing difficult. It often has an association with an allergic response or any hypersensitivity followed by inflammation and hypersensitivity of the airways. Asthma is a sophisticated, complicated, and diverse respiratory condition. Even while heredity is a chief hazard factor for developing asthma, environmental and inner exposures, as well as how they interact with genetic variables, also have a substantial impact on the disease's pathogenesis. In recent years, the field of asthma research has seen the emergence and deployment of high throughput omics techniques for the unbiased screening of biomarkers such as genes, transcripts, proteins, and metabolites. Better asthma risk profile has been achieved by utilizing large-scale studies that are illustrative of various population-based data and merging with clinical data. This allergic airway illness has a wide range of phenotypes and endotypes, many of which have not yet been fully defined. The diversity of phenotypes is reflected in similarly complicated etiologies, and it is thought that a number of genetic and environmental variables interrelate to promote the danger of asthma in both children and adults. In order to achieve this objective, significant efforts are necessary to describe different phenotypes, uncover fundamental mechanisms, and find associated biomarkers. It is clear that the analysis, monitoring, and treatment of asthma require a tailored strategy. The risk of developing a multifactorial ailment is characterized by the grade of genetic relationship between the individual and affected relative. Additionally, the risk is typically larger if the relative has a severe illness or was afflicted when they were young. The asthma phenotype is highly varied and expressed non-linearly in contrast to single gene illnesses. This makes it challenging to predict whether someone with a certain gene or set of genotypes would have asthma.
PubMed: 36225476
DOI: 10.7759/cureus.28768 -
Cancer Reports (Hoboken, N.J.) Jan 2023Naxitamab is a humanized GD2-binding monoclonal antibody that received accelerated approval from the U.S. Food and Drug Administration for refractory or relapsed... (Review)
Review
Outpatient administration of naxitamab in combination with granulocyte-macrophage colony-stimulating factor in patients with refractory and/or relapsed high-risk neuroblastoma: Management of adverse events.
BACKGROUND
Naxitamab is a humanized GD2-binding monoclonal antibody that received accelerated approval from the U.S. Food and Drug Administration for refractory or relapsed high-risk neuroblastoma limited to bone or bone marrow. Trial 201 (NCT03363373) is an ongoing global clinical trial to evaluate the efficacy and safety of naxitamab in combination with granulocyte-macrophage colony-stimulating factor in this population.
AIMS
Here, we review the safety profile and adverse event (AE) management associated with naxitamab administration in a pediatric population, based on Trial 201 protocol guidelines and clinical trial experience.
METHODS AND RESULTS
At least 50% of patients experienced pain, hypotension, bronchospasm, cough, vomiting, diarrhea, nausea, and tachycardia, with the following reported at grade ≥3 AEs for at least 10% of patients: pain, hypotension, urticaria, and bronchospasm. These AEs were generally manageable in the outpatient setting using premedications, supportive therapies, and appropriate monitoring post-infusion. Algorithms were established for infusion-related AEs, including hypotension and bronchospasm, to provide guidance to investigators for early recognition and timely intervention, including medication and infusion rate modification or interruption, or treatment discontinuation, based on AE severity. Educating patients and caregivers on what to expect regarding premedication at home, experience during the infusion cycle, and post-infusion monitoring helps optimize naxitamab treatment and supportive therapies and may reduce treatment burden.
CONCLUSION
This article highlights the protocol-based recommendations for the management of acute AEs associated with outpatient naxitamab treatment in Trial 201. The authors recommend close monitoring and timely implementation of measures to ensure that patients can remain on treatment and obtain maximum clinical benefit from naxitamab therapy.
Topics: United States; Humans; Child; Granulocyte-Macrophage Colony-Stimulating Factor; Outpatients; Bronchial Spasm; Neuroblastoma; Pain
PubMed: 35579862
DOI: 10.1002/cnr2.1627 -
Allergology International : Official... Dec 2006Respiratory viral infections profoundly influence the disease activity of wheezing illnesses and asthma in early childhood. Viral bronchiolitis shares many features with... (Review)
Review
Respiratory viral infections profoundly influence the disease activity of wheezing illnesses and asthma in early childhood. Viral bronchiolitis shares many features with asthma and a subset of children develop recurrent wheezing after their initial illness. Recently mechanisms for virus-induced exacerbations of childhood asthma are beginning to be focused on and defined. Viruses cause systemic immune activation and also produce local inflammation. These factors are likely to affect airway pathogenesis leading to airway narrowing, an increase in mucus production, and eventually bronchospasm, and airway obstruction. These new insights related to the pathogenesis and disease activity are likely to provide new targets for the therapy and prevention of early asthma in childhood.
Topics: Adolescent; Airway Obstruction; Asthma; Bronchial Spasm; Child; Child, Preschool; Genetic Predisposition to Disease; Humans; Infant; Inflammation; Lung; Phenotype; Recurrence; Respiratory Sounds; Respiratory Tract Infections; Risk Factors; Virus Diseases
PubMed: 17130678
DOI: 10.2332/allergolint.55.369 -
Acta Medica Iranica 2014High prevalence of asthma and bronchospasm was observed during induction of anesthesia in patients with chronic suppurative otitis mMedia (CSOM) who underwent...
High prevalence of asthma and bronchospasm was observed during induction of anesthesia in patients with chronic suppurative otitis mMedia (CSOM) who underwent tympanomastoidectomy. Although several studies have proposed association of allergic diseases with CSOM but no consensus about it has been established. Current study was designed to determine the coincidence of asthma in CSOM patients. In a cross-sectional study, authors investigated medical records of 106 CSOM patients underwent tympanomastoidectomy, aged 15 to 65 years, and 95 controls, which were matched by age and sex. Participants were admitted to Valiasr Hospital, Tehran, Iran, from April of 2011 to March of 2013. Required information, such as demographic characteristics and history of allergic rhinitis (AR) and asthma were obtained from patients' medical records. The prevalence of AR in the CSOM group was higher than controls' group (19.8% and 15.8%, respectively) (P>0.05). Asthma prevalence was significantly higher in patients with CSOM (P=0.03) (OR=7.67, 95% CI: 0.9-62.5). No significant association was found between history of AR and chronic ear infections. However, asthma was significantly more common in CSOM patients. Current study indicates that asthma and risk of bronchospasm need particular attention in patients with CSOM underwent tympanomastoidectomy before and during anesthesia.
Topics: Adolescent; Adult; Aged; Anesthesia; Asthma; Bronchial Spasm; Case-Control Studies; Chronic Disease; Cross-Sectional Studies; Female; Humans; Iran; Male; Middle Aged; Otitis Media, Suppurative; Prevalence; Rhinitis, Allergic; Risk; Young Adult
PubMed: 25530053
DOI: No ID Found -
Chest Dec 2014Bronchopulmonary C-fibers and a subset of mechanically sensitive, acid-sensitive myelinated sensory nerves play essential roles in regulating cough. These vagal sensory... (Review)
Review
Bronchopulmonary C-fibers and a subset of mechanically sensitive, acid-sensitive myelinated sensory nerves play essential roles in regulating cough. These vagal sensory nerves terminate primarily in the larynx, trachea, carina, and large intrapulmonary bronchi. Other bronchopulmonary sensory nerves, sensory nerves innervating other viscera, as well as somatosensory nerves innervating the chest wall, diaphragm, and abdominal musculature regulate cough patterning and cough sensitivity. The responsiveness and morphology of the airway vagal sensory nerve subtypes and the extrapulmonary sensory nerves that regulate coughing are described. The brainstem and higher brain control systems that process this sensory information are complex, but our current understanding of them is considerable and increasing. The relevance of these neural systems to clinical phenomena, such as urge to cough and psychologic methods for treatment of dystussia, is high, and modern imaging methods have revealed potential neural substrates for some features of cough in the human.
Topics: Bronchial Spasm; Cough; Expert Testimony; Female; Guidelines as Topic; Humans; Male; Mechanoreceptors; Nerve Fibers, Unmyelinated; Nervous System Physiological Phenomena; Reflex; Respiratory Mechanics; Respiratory Muscles; Sensitivity and Specificity; Vagus Nerve
PubMed: 25188530
DOI: 10.1378/chest.14-1481