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Respiratory Impairment (respiratory + impairment)

Distribution by Scientific Domains

Medical Sciences	80%

Selected Abstracts

Management of scoliosis in Duchenne muscular dystrophy: a large 10-year retrospective study

DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 6 2006
M Kinali MD
Scoliosis affects 75 to 90% of patients with non-ambulant Duchenne muscular dystrophy (DMD). Spinal surgery is the treatment of choice but the indication varies among centres. Some offer surgery to all non-ambulant patients, irrespective of scoliosis severity. Early surgery has the advantage of targeting DMD when cardiorespiratory function is preserved, but not all patients develop scoliosis. We report our 10-year experience of scoliosis management in 123 patients with DMD who were at least 17 years old at the time of the study. Scoliosis was absent in 10%, and mild, non-progressive (at least 30°) in 13% of patients. Another 13% had moderate scoliosis (31,50°) and were managed conservatively. Surgery was considered in 57% (70/123) of patients with scoliosis greater than 50° and eventually performed in 35%. The remaining patients either refused surgery (9%) or were unfit because of cardiorespiratory compromise (13%). In a further 7%, scoliosis (greater than 50°), first noted after 14 years of age, was progressing slowly and surgery was not performed. At 17 years there was no difference in survival, respiratory impairment, or sitting comfort among patients managed conservatively or with surgery. One-third (44/123) of our patients were managed satisfactorily without receiving spinal surgery. We provide insight into the natural history of scoliosis in DMD that should help families and clinicians with decision-making when surgery is considered. [source]

Chronic inflammatory demyelinating polyneuropathy, phrenic nerve and respiratory symptoms

EUROPEAN JOURNAL OF NEUROLOGY, Issue 1 2005
J. Costa
Respiratory involvement in chronic inflammatory demyelinating polyneuropathy (CIDP) has been very recently described. Phrenic nerve conduction studies have been described as useful to detect respiratory impairment in these patients. This study describes two patients with CIDP, in whom neurophysiological studies of the respiratory muscles were performed. The first patient had severe respiratory insufficiency, and phrenic nerve studies disclosed no motor responses and electromyography (EMG) of the diaphragm confirmed severe loss of motor units, bilaterally. On treatment, we documented clinical and neurophysiological improvement. In the second patient, phrenic nerve studies showed abnormal results; however, EMG of the diaphragm ruled out loss of motor units. The first case represents the risk of phrenic nerve involvement in this disorder, and the potential recovery on treatment. The second case illustrates that the temporal dispersion of the motor responses can be misleading, and EMG of diaphragm should be performed to confirm the loss of motor units. [source]

Arterial blood gases in extraperitoneal laparoscopic urethrocystopexy

INTERNATIONAL JOURNAL OF UROLOGY, Issue 8 2002
Hasan Kocoglu
Abstract Background: The aim of this study was to investigate the effects of extraperitoneal laparoscopy and carbon dioxide insufflation on hemodynamic parameters, arterial blood gases and complications in urethrocystopexy operations. Methods: Twenty-five female patients who underwent extraperitoneal laparoscopic mesh urethrocystopexy operation for the correction of urinary incontinence were allocated to the study. Hemodynamic parameters were noted and blood gas analyzes were performed before the induction of anesthesia, 10 min after induction, 5 and 10 min after the beginning of carbon dioxide insufflation, at the end of carbon dioxide insufflation and 30 min after exsufflation. Results: There was no significant change in mean arterial pressure, peripheral oxygen saturation, arterial carbon dioxide pressure, and arterial oxygen saturation compared to preinsufflation and preinduction values. End-tidal carbon dioxide pressure did not increase above 45 mm/Hg during carbon dioxide insufflation. Arterial oxygen saturation and partial oxygen pressure did not decrease. Subcutaneous emphysema, pneumothorax, pneumomediastinum and pleural effusion were not noted in any patient. Conclusion: We conclude that, extraperitoneal laparoscopic urethrocystopexy is not associated with hemodynamic and respiratory impairment. [source]

Overexpression of Upf1p compensates for mitochondrial splicing deficiency independently of its role in mRNA surveillance

MOLECULAR MICROBIOLOGY, Issue 4 2004
B. De Pinto
Summary In yeast the UPF1, UPF2 and UPF3 genes encode three interacting factors involved in translation termination and nonsense-mediated mRNA decay (NMD). UPF1 plays a central role in both processes. In addition, UPF1 was originally isolated as a multicopy suppressor of mitochondrial splicing deficiency, and its deletion leads to an impairment in respiratory growth. Here, we provide evidence that inactivation of UPF2 or ,UPF3, ,like ,that ,of ,UPF1, ,leads ,to ,an ,impairment in respiratory competence, suggesting that their products, Upf1p, Upf2p and Upf3p, are equivalently involved in mitochondrial biogenesis. In addition, however, we show that only Upf1p acts as a multicopy suppressor of mitochondrial splicing deficiency, and its activity does not require either Upf2p or Upf3p. Mutations in the conserved cysteine- and histidine-rich regions and ATPase and helicase motifs of Upf1p separate the ability of Upf1p to complement the respiratory impairment of a ,upf1 strain from its ability to act as a multicopy suppressor of mitochondrial splicing deficiency, indicating that distinct pathways express these phenotypes. In addition, we show that, when overexpressed, Upf1p is not detected within mitochondria, suggesting that its role as multicopy suppressor of mitochondrial splicing deficiency is indirect. Furthermore, we provide evidence that cells overexpressing certain upf1 alleles accumulate a phosphorylated isoform of Upf1p. Altogether, these results indicate that overexpression of Upf1p compensates for mitochondrial splicing deficiency independently of its role in mRNA surveillance, which relies on Upf1p,Upf2p,Upf3p functional interplay. [source]

HsCRP levels: Measurement of airway inflammation in asthmatic children

PEDIATRICS INTERNATIONAL, Issue 1 2008
Ruth Soferman
Abstract Background: The inflammatory marker, high-sensitivity C-reactive protein (HsCRP), is known to be related to non-allergic asthma, obesity, cardiovascular disease and smoking in adults. The aim of the present study was to determine whether HsCRP is related to respiratory symptoms and pulmonary function test findings in asthmatic children. Methods: HsCRP was measured in 63 asthmatic children aged 2,12 years. The measurements were performed in 37 children during an episode of acute exacerbation and in 42 children during remission. Results: HsCRP level (14.28 ± 8.45 mg/L) during exacerbation was significantly higher than the mean level (1.92 ± 3.16 mg/L) during remission (P < 0.0001), with the decrease being more prominent in children with a low body mass index percentile (P < 0.05). A reciprocal relationship was found between forced expiratory volume in 1 s and high-sensitivity C-reactive protein values (P > 0.049). Conclusion: Elevated HsCRP levels were significantly associated with respiratory impairment in children. [source]