#Journal of Pulmonary & Respiratory

[juniperpublishersijoprs-blog]

Happy Easter

[covid-safer-hotties]

Almost 10% of US lung transplants go to COVID-19 patients. Researchers are learning why - Published Aug 21, 2024

Researchers from Michigan State University and Corewell Health, in collaboration with the Cleveland Clinic, have made a significant breakthrough in understanding post-COVID-19 lung complications.

The study, by Xiaopeng Li of MSU, Reda Girgis of Corewell Health and Kun Li of Cleveland Clinic's Florida Research and Innovation Center, was published in the American Journal of Respiratory Cell and Molecular Biology and highlights the role of a gene called ATP12A in promoting lung damage and excessive mucus production following COVID-19 infection.

COVID-19 infection activates this gene in the lungs, initiating progressive lung scarring that can eventually require a lung transplant. The collaboration investigated the biology behind climbing lung transplant rates among patients with post-COVID pulmonary fibrosis. Almost 10% of all lung transplants in the United States now go to COVID-19 patients, according to data from the United Network for Organ Sharing, or UNOS.

"Understanding how and why some individuals develop severe lifelong complications is critical to developing more effective post-COVID lung damage treatment," said Xiaopeng Li, associate professor in the MSU College of Human Medicine's Department of Pediatrics and Human Development.

Collaborating with Kun Li, Xiaopeng Li investigated ATP12A expression in lung samples from individuals undergoing lung transplantation. Clinical samples provided by Reda Girgis, medical director of Corewell Health's lung transplant program and a professor at MSU, confirmed elevated ATP12A levels in individuals with post-COVID-19 pulmonary fibrosis, akin to fibrosis unrelated to COVID-19.

"At Cleveland Clinic, we confirmed COVID-19 infection directly caused ATP12A levels to increase and contributed to pulmonary fibrosis," noted Kun Li.

This discovery lays the groundwork for potential therapeutic interventions, aiming to benefit all pulmonary fibrosis patients, irrespective of their condition's origin. The next step for the researchers is to unravel how infection elevates ATP12A levels and its contribution to pulmonary fibrosis, paving the way for improved treatments in the future.

Find the (paywalled) study at either link!

[darkmaga-returns]

By Nicolas Hulscher, MPH

Last week, the study titled Effects of Microplastic Exposure on Human Digestive, Reproductive, and Respiratory Health: A Rapid Systematic Review by Chartres et al was published in the journal Environmental Science and Technology:

Microplastics are ubiquitous environmental contaminants for which there are documented human exposures, but there is a paucity of research evaluating their impacts on human health. We conducted a rapid systematic review using the “Navigation Guide” systematic review method. We searched four databases in July 2022 and April 2024 with no restriction on the date. We included studies using predefined eligibility criteria that quantitatively examined the association of microplastic exposure with any health outcomes. We amended the eligibility criteria after screening studies and prioritized digestive, reproductive, and respiratory outcomes for further evaluation. We included three human observational studies examining reproductive (n= 2) and respiratory (n = 1) outcomes and 28 animal studies examining reproductive (n = 11), respiratory (n = 7), and digestive (n = 10) outcomes. For reproductive outcomes (sperm quality) and digestive outcomes (immunosuppresion) we rated overall body evidence as “high” quality and concluded microplastic exposure is “suspected” to adversely impact them. For reproductive outcomes (female follicles and reproductive hormones), digestive outcomes (gross or microanatomic colon/small intestine effects, alters cell proliferation and cell death, and chronic inflammation), and respiratory outcomes (pulmonary function, lung injury, chronic inflammation, and oxidative stress) we rated the overall body of evidence as “moderate” quality and concluded microplastic exposure is “suspected” to adversely impact them. We concluded that exposure to microplastics is “unclassifiable” for birth outcomes and gestational age in humans on the basis of the “low” and “very low” quality of the evidence. We concluded that microplastics are “suspected” to harm human reproductive, digestive, and respiratory health, with a suggested link to colon and lung cancer. Future research on microplastics should investigate additional health outcomes impacted by microplastic exposure and identify strategies to reduce exposure.

[killed-by-choice]

“Marjorie Roe” 32 (USA ~1972)

“Marjorie” was a 32-year-old white woman admitted to a hospital to have her gallbladder out. Other than the fairly recent issues that led to doctors deciding to remove it, she had “no previous significant illnesses except for two abortions” that she had traveled to another state to undergo. (These legal induced abortions had, interestingly, been noted by doctors under the “significant illness” category.) The second abortion had been only a few weeks before Marjorie came to the hospital.

When the hospital performed a pre-op examination, Marjorie appeared to be healthy enough to undergo surgery. What the doctors didn’t realize was how strongly her recent abortion would affect her post-operative outcome.

The gallbladder (and to a lesser extent, the appendix) were confirmed to have been diseased upon removal. Marjorie began to recover and it seemed that she would be fine, but then a latent side effect of the recent abortion began to manifest. When she tried to walk, she went into respiratory distress and quickly became unresponsive. CPR failed and she died two days after what should have been a fairly uneventful surgery.

Marjorie’s autopsy, performed two hours after her death, finally revealed what was happening even before being admitted to the hospital. Her left thigh was mottled and unusually enlarged. A branched, firm clot impacted in her pulmonary conus had distended the right atrium and ventricle of her heart. The clot was analyzed and found to be a thromboembolus. She had been killed by a post-abortion pulmonary embolism. It was concluded that an occult venous thrombus had been formed before the gallbladder removal (with her recent abortion as a significant contributing factor and likely cause), which was then dislodged from her left leg and blocked the pulmonary conus.

In addition to the embolism itself, Marjorie had slight serosanguineous peritoneal effusions, congestion of the lungs and pulmonary edema. Her left ovary contained a hemorrhagic corpus luteum.

The doctors who submitted Marjorie’s case to a medical journal wrote that “The current increase in abortions necessitates specifie inquiry and careful examination in young women and probably should indicate delay of all except emergency surgery for a period of at least six months.”

[bluecoolr]

Cheryl Eddington

A/N: I got lazy and decided to just dump all the info I have on baby girl.

Birth name: Cheryl Catacutan

Cheryl from French “cherie”, meaning “beloved”

Catacutan, Hispanicized from Filipino “katakutan”, meaning “fear (verb)”.

Adoptive surname Eddington, inspired by British astrophysicist Arthur Eddington, who posited the concept of the arrow of time. Eddington proposed that entropy - the state of disorder, randomness, and uncertainty - increased with time.

Nicknames: Silver Cheryl, Butcher of Blythe

Birthday: November 1st (Age 17)

Residence:

[Formerly] Port Allenham

US Territory

Burnt lime/Quicklime District - people hauled limestone from the bay and crushed them up for calcium oxide production

Majority of the city burnt down after a series of large scale lime kilns exploded.

Cheryl suffered severe respiratory trauma from the fire and calcium oxide in the atmosphere. She got a pulmonary edema that had to be drained. Ever since, she's had chronic respiratory problems and periodically uses a nebulizer.

Her parents died in the fire.

Blythe, New York

Carthage School, Connecticut

Former all-boys private preparatory school, slowly transitioning into a co-ed setup.

Elias Cross Reform School, New York

Detention center for juvenile violators of federal law, serves mostly as a holding point until they're old enough to be transferred to prison.

Physical Appearance

Height: 5 feet 7 in

Weight: 58 kg

Hair color: Dark brown

Eye color: Dark brown

Skin color: Fair

Distinguishing characteristics: large, wide nose, choppy hair

Hobbies & Interests

Journaling

Research and experimentation

Equestrian sports

Horror games

Likes:

Checklists

Checking items off lists

Start of term

Writing essays

Explosives

Industrial chemistry

Dislikes:

Skirts

Crowded communal showers

Boring hunter courses

Her adoptive parents

Ambitions:

USMC Sabotage and Demolition Expert

Petroleum Engineer on an offshore oil rig

Trivia:

Really doesn’t like animals that much. Is okay with her horse, Agamemnon, because she treats him like a person.

Social smoker.

Literally only adopted to fill in the spot of her deceased cousin. Esentially lives two lives. One as the shining multi-talented heiress and just plain old Cheryl, who lives in a dusty garrett room.

[jcsmicasereports]

Successful Jatene procedure for great arteries transposition correction in newborn with SARSCoV-2 infection by Guillermo Careaga-Reyna MD in Journal of Clinical Case Reports Medical Images and Health Sciences

Abstract

Pandemic of COVID-19 represents a challenge for treatment of patients with congenital herat disease. We present a newborn with great vessels transposition and positive SARS-CoV-2 PCR test. The patient was submitted to a successful surgical treatment with corrective Jatene procedure, requiring opened chest wall during 72 h of postoperative period and 43 days of total in-hospital lenght of stay.

KEY-WORDS: COVID-19, SARS-CoV-2, great vessel transposition, Jatene procedure, congenital heart disease.

Introduction

Coronaviruses are single stranded ribonucleic acid viruses with a diameter of 60–140 nm and a high rate of genetic mutations and recombinations, rendering them capable of escaping from the immune system and causing novel infections (1). In less than six months, the coronavirus disease 2019 (COVID-19) pandemic has swiftly spread from one city in China to over 190 countries worldwide (2-4). Neonatal infections with SARS-CoV-2 have been described although robust data on vertical transmission are lacking. In most instances where neonatal infection has been reported, close contact with infected mother or caregiver is postulated to have occurred (4).

In newborns, the case is regarded as positive for infection if any of the following conditions occurs, (1): positive PCR for SARS-CoV-2 in respiratory tract or blood samples, high homology of viral gene sequences of the samples from the respiratory tract or blood to the COVID-19 sequence.

We present a case of a newborn with great vessel transposition and SARS-CoV-2 infection.

Case Report

We present a new born with great arteries transposition associated to aquired SARS-COV-2 infection.

The patient was refrerred to our hospital, with a positive SARS-CoV-2 test, with mechanical ventilatory support in order to confirm a complex congenital heart disease.

The diagnosis was established via echocardiographic evaluation which showed normal venous return, concordance atrio-ventricular and ventriculo-arterial discordance. It was concluded: great arteries transposition, patent ductus arteriosus and permeability of foramen oval.

The patient was recovered from a septic shock with no evidence of systemic inflammatory response requires inotropic support and after stabilization in neonatal intensive care unit, at 10 day in-hospital stay,  was submitted to an open heart surgery consisted in anatomic correction with Jatene procedure. The aortic cross-clamping time was 119 min, with cardiopulmonary bypass (CPB) of 181 min. It was decided to maintain in postoperative period opened chest wall, and after 72 the chest wall closure was succesfully realized with favorable posoperative evolution. After 32 days of postoperative, the patient was discharged from hospital. Actually, two years after surgery, the patient is doing well, only with mild pulmonary stenosis without hemodinamic or clinical repercusion.

Discussion

For infants born to COVID positive mothers should be reasonable to separate him from the mother if will need cardiac surgery to try avoid post-natal infection.

In fact, there is minimal evidence of placental vertical transmisión. In this case, the patient has a positive test for SARS-CoV-2 infection and evolved with septic shock in the preoperative period.

It may also be reasonable to do serial testing on the infant, but there is no consensus on the correct timing surgery should be scheduled with advice from a multidisciplinary team of experts including cardiac medical, cardiac surgical, and infectious diseases as indicated. After evaluation of the clinical conditions for a heart team in our hospital, it was decided to realize the surgical procedure in order to avoid progression of heart damage and irreversible heart failure.

However we must remember that, if prudent, surgery should be delayed until the patient’s symptoms have improved and/or testing has been repeated (often after 14 days) and is negative (5).

On the other side, in older patients the inflammatory response due to SARS-CoV-2 infection has been a frequent complication.

In our patient, probably due to the age, it was no presented even with the septic shock o posteriorly associated to the use of CPB during the surgical procedure

It was concluded taht COVID-19 may affect all age patients. However with cautious evaluation and treatment of associated disease as in our case, the patient improves survival, despite severity of viral illness, and during this pandemic period, patients with active COVID-19, at neonatal period we have no treated any other.

[109moons]

Here are my days.

5:30am: Lab comes to take blood. All of my bird veins are black, blue, mustard, indigo. If I am still sedated enough, I cry without realizing tears are rolling down my face. The exhaustion is too much to bother acknowledging crying.

7am: Shift change. My night nurse updates daytime of how low my oxygen is and to be careful with my blood pressure. She reminds them that I need plasma at an incredibly specific time to try to influence my INR numbers for the day. Adriana says goodbye for the morning and says she hopes she doesn’t see me later, but we both know I will still be here.

7:30am: Meds. Magnesium drip. Platelets. Potassium. Steroids. Anxiety medication. Muscle relaxers. Blood pressure medication. Nausea medication for the blood pressure medication. Iodine up the nose. Propanol shot down the hatch.

8:30am-ish: Breakfast. Eggs taste like plastic and I cannot have salt. My eyes are dry from my oxygen cannula blowing up in my face.

8:35am then every 15 minutes: Random person from respiratory pops their head in and encourages me to take deep breaths. I contemplate creative forms of murder. My liver hurts. I force myself to pee in a bed pan and act like my kidneys are not shriveled and my back feels like a vacuum trying to strain to urinate.

8:40am: I really do not want dialysis.

9am: Rounds. Pulmonary wants a chest tube. Respiratory wants me to “just breathe”. Hepatology is here and avoiding giving answers about my transplant. My Mom is crying. I am stoic. Nephrology gives themselves more gray hairs and stresses out over my kidneys. Cardiology says things about “shunts” and bubble tests.

I just think about inhaling and exhaling and how badly it hurts with one lung.

10am-ish: Internal medicine comes by and apologizes profusely for the disagreement between teams and why I have not been given a chest tube yet. I usually cry again here. This is the definition of being in between a rock and a hard place, but I’m circling the drain between these places.

11am: Probably lunch. Probably also gross. Probably fighting with my Mom and regretting asking for her support. I would rather be alone.

Twilight zone: This is usually the hours between doctors where I let my respiration get really low and rest. I sip on my protein shake. I nest with my squishmallows and blankets. I journal. I think about the man I truly loved and how when I die, if I die, I have to be sure to not take it to my grave how I feel. The bed feels warmer, pretending he’s here under my fall blankets and surrounded with flowers and creature comforts.

People visit after this usually. I laugh until I can’t because it hurts too badly. I feel self conscious in my pajamas with my dirty hair. I feel like I have to entertain, even though I don’t. I insist it does not make me tired, but it does - but it makes me happy.

5pm: Labs. Time to find another vein to stab. Usually a chest X-ray here too. It feels great laying on a hard board for an X-ray everyday on a ribcage that has been punctured five times in ten days. But please, I know your ribs hurt so bad. Meds. More diuretics. Have to pee every ten minutes. Hope visitors are not here, because I feel less than human peeing in a bed pan with friends here.

Somewhere through the rest of the night, my Mother will decide to remind me that I deserve to be dying. That I am ungrateful, or unappreciative, or I removed the joy from her life. I am humbled and reminded of how small I am. My nurse usually kicks her out then and brings me a cup of vanilla and chocolate ice cream, because who wants to pick?

I’ll slowly chew up my grisly dinner, take my sleeping medication, and get ready for my oxygen to plummet overnight. The bed is exploding with comforts and I know if I go in my sleep, I will be as soft as I was coming in to this world.

Then it will be September 25th, 2023, and I’ll do it all again.

[abhishekhospital]

Are You Breathing Right? How an Asthma Specialist in Jaipur Can Improve Your Quality of Life

Introduction

Most people consider it quite normal to breathe. On the other hand, asthmatics have to struggle to breathe just to carry out basic movements like walking upstairs or simply going outside. If you are asthmatic, then you should not continue to suffer from asthma. Consulting an experienced asthma specialist in Jaipur can help you manage your symptoms and greatly enhance your quality of life. Let us look at how asthma specialists and Abhishek Hospital will assist you in breathing easily again.

Things you must know about asthma

Asthma is a disorder occurring out of inflammation of the airways, leading to heat contraction and overproduction of mucus. Symptoms include wheezing, coughing, a feeling of tightness in the chest, and breathlessness. While asthma cannot be cured, with a suitable treatment plan one can maintain an asthma-free life. 

Common Triggers Of Asthma

Asthma triggers vary from one patient to another. The most common among them are:

Allergens (dust mites, pollen, pet dander).

Pollution and smoke

Respiratory infections

Stress and exercise

Weather changes

An asthma specialist in Jaipur can guide you in identifying and avoiding these triggers.

Why You Need An Asthma Specialist

Medical Diagnosis And Care Of High Quality

Jaipur-based asthma specialists will ensure an authentic diagnosis and tailor-made treatment plan addressing your needs, and pulmonary functions will probably be one of the modern tools to assess what level the condition is.

Personalized Treatment Plans

Asthma cannot be diagnosed by merely providing a static form for the assessment, where the doctor fills in the context. The specialist ensures that your treatment plan has taken all the personal factors into account: what triggers you, the lifestyle you lead, and your medical history. 

Preventive Care

Besides relieving your symptoms, this treatment will teach you how to avoid these triggers, along with what to do during an attack. 

How an Asthma Specialist in Jaipur Can Help You

1. Correct Diagnosis

Since asthma is often confused with other respiratory disorders, this thus results in improper treatment. An asthma specialist in Jaipur conducts thorough evaluations to confirm your diagnosis and rule out other conditions.

2. Medication Management

Asthma medications fall into two basic groups: 

Relievers: Used for quick relief during an asthma attack.

Controllers: These reduce inflammation that can lead to further flare-ups.

The asthma specialist assures you that you are on the optimum combination of medications to provide better control.

3. Allergy Testing

The specialist may recommend you undergo allergy testing if allergies trigger your asthma. Identifying and managing your triggers could considerably reduce symptoms.

4. Breathing Techniques and Rehabilitation

An asthma specialist typically teaches breathing techniques to rehabilitate the chest and work on overall respiratory health.

5. Emergency Action Plans

An individually tailored action plan gives you the edge to recognize early warning signs of an impending asthma attack and acts as a manual on what steps to take to handle it correctly.

Why Choose Jaipur for Asthma Treatment?

Jaipur has some of the best assistance in the country: world-class facilities and patient-centric care now that the city has become a hotspot for respiratory treatment. Abhishek Hospital is leading the way in this regard, with a team of qualified specialists and full-fledged asthma care. 

Tips for Managing Asthma

1. Identify Your Triggers

Keep a journal to document what the causes of your symptoms are and avoid them whenever possible.

2. Use Your Inhaler Correctly

Despite being a facility most users are very aware of, many patients who have this condition do not use their inhalers correctly, rendering them ineffective. An asthma specialist in Jaipur can guide you on the correct technique.

3. Staying Active

While it is true that exercise-induced asthma is commonplace, staying active can actually improve lung strength. Speak with your specialist about safe activities.

4. Keep Your Environment Clean

A clean environment helps to minimize exposure to dust mites and mould and also reduces the concentration of different types of allergens.

5. Pay Attention to Your Symptoms

You should really watch for those signs and symptoms of asthma to execute some preemptive action if an attack is likely to strike.

Benefits of Consulting An Asthma Specialist

Quality of Life: The possible best treatment may allow you to lead a more active, fun life.

Number of Attacks: Specialists help reduce the incidence and severity of flare-ups.

Reduced Need for ER Visits: Asthma care means fewer trips to the hospital for emergency treatment.

Uninterrupted Sleep: Say goodbye to sleepless nights by breathing free.

When to See an Asthma Specialist

Consulting an asthma specialist in Jaipur becomes due when

The severity of your symptoms increases despite taking medication.

You awaken at night due to asthma.

Your asthma attacks take place more than twice a week.

Your activities of daily living are disrupted.

Conclusion

Breathing is essential to life, and no one should struggle for it. By consulting an experienced asthma specialist in Jaipur, you can take charge of your condition and lead a healthier, more active life. Abhishek Hospital has very well-trained and conscious staff, totally assured in their care and support for you every step of the way. Schedule a consultation today and get back that freer smile. 

[myrawjcsmicasereports]

 Kussmaul’s Sign- In a patient with Severe PAH by Javaid Ahmad Dar in  Journal of Clinical Case Reports Medical Images and Health Sciences

Case Report

The patient is a 33 years old male who had a history of acute pulmonary embolism three and a half years back. He had received thrombolysis with alteplase and was subsequently on oral anticoagulants. After one year of the index episode, the patient started to experience progressive worsening of breathlessness. Further evaluation led to the diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH). Patient was offered pulmonary endarterectomy which he declined and preferred medical management. He did not show clinical improvement and eventually developed refractory heart failure. And patient presented to Emergency department (ED) with worsening of breathlessness. On presentation to the ED, patient was in distress with pulse of 110/min, BP of 100/60 with no evidence of pulsus paradoxus, Respiratory rate of 22/min and chest was revealing bilateral basal crepts and CVS examination revealed pansystolic mummer at left parasternal edge. JVP was elevated and showed only one prominent outward crest, which is a prominent CV wave and one dominant downward trough, a prominent Y descent, and there was a paradoxical rise in the JVP on inspiration (video 1) which is an important clinical sign in heart failure commonly known by the eponym Kussmaul’s sign. The prominent CV wave in this paitent reflected sever Tricuspid regurigitation (TR). On echo, patient had severe RV dysfunction with severe TR with Pulmonary hypertension. Patient was treated with intravenous diuretics, and pulmonary vasodilators and improved symptomatically and was referred for work up for heart-lung transplantation.

Discussion

Kussmaul’s sign is characterized by paradoxical increase in right atrial pressure on inspiration due to decrease in RV compliance as in pericardial diseases like chronic constrictive pericarditis, cardiac tamponade, advanced heart failure and pulmonary hypertension. In this patient’s JVP, only prominent upstroke and downstroke is against the constrictive pericarditis which is the most common condition in which Kussmaul’s sign is  seen. Constrictive Pericarditis has prominent X and Y descends in contrast to only prominent Y descend here. In this patient with a history of previous history of CTEPH, Kussmaul’s sign reflects advance disease with severe RV dysfunction. In patients with pulmonary hypertension, Kussmaul’s sign is thought to result due to decreased RV compliance, however in a study in patients with severe PAH, Kussmaul’s sign was shown to reflect severe pulmonary vascular physiology and correlated independently as a poor prognostic factor.1 In a meta-analysis in patients presenting with acute myocardial infarction, Kussmaul’s sign has been found to be very specific for RV involvement and portends an increased preload requirement with intravenous fluids.2 Correctly identifying these clinical signs in a patient presenting to ED, adds in the appropriate management of the patient. This would be most appropriate in patients presenting with inferior wall MI’s where Kussmaul’s sign identifies a subset of patients with RV involvement who have a much sinister prognosis. And in heart failure population, Kussmaul’s sign is common in patients referred for heart transplantation and is associated with adverse cardiopulmonary hemodynamics.3

[swldx]

RNZ Pacific 1309 28 Nov 2024

7390Khz 1259 28 NOV 2024- RNZ PACIFIC (NEW ZEALAND) in ENGLISH from RANGITAIKI. SINPO = 54333. English, s/on w/bellbird int. until pips and news @1300z anchored by Lydia Lewis. § A new study on plastic consumption warns that business as usual will result in nearly double the amount of plastic pollution. World leaders, including the Pacific, are currently meeting in South Korea to try agree on a new international treaty to fight plastic pollution. Neil Nathan, one of the authors of the study, Pathways to reduce global plastic waste mismanagement and greenhouse gas emissions by 2050, which was published in the journal Science, said business as usual means plastic waste will continue to grow exponentially. § Tongan Prime Minister Hu'akavameliku Siaosi Sovaleni is facing a second vote of no confidence next week. The prime minister has pointed out that this is happening just 11 months before the next election, which would leave a new government little time to do anything before parliament is dissolved ahead of the poll. The vote was instigated by 'Aisake Eke, who also initiated a similar motion last year. Hu'akavameliku easily defeated the previous vote. § The son of Fiji's former prime minister Frank Bainimarama has been sentenced to 28 months in jail after violently attacking an ex-girlfriend in Sydney, leaving her with a ruptured ear drum. § In Fiji, funding for baiting of homes from the infestation of termites will be made available to families with income less than $30,000 after Cabinet endorsed the expansion of the termite baiting programme. § A "huge" police presence is in the small Bay of Plenty community of Matapihi as Mongrel Mob gang members gather for the tangi of one of their own. According to local reporter for Aukaha News, Ripeka Timutimu, the community has responded to the influx of police with mixed views - but the majority are angry, and say there was not enough consultation about how big the operation was going to be. The tangi comes just a week after a new law was introduced, banning gang members from wearing patches and gang insignia in public. § US President-elect Donald Trump's vow to impose tariffs on China and Mexico unless they stem the flow of fentanyl and migrants across the US border could impel deeper cooperation from those governments on drug policing, experts said. § A new clinical trial has unveiled a promising way to treat severe asthma and chronic obstructive pulmonary disease (COPD) attacks. The study, published in The Lancet Respiratory Medicine journal, indicates that an injection of benralizumab could work better than the current steroid tablet treatment. Researchers have hailed this development as the first significant breakthrough in managing these chronic lung conditions in over 50 years. § Sports. @1308z "Pacific Waves" anchored by female announcer. QRM=slight heterodyne. Backyard fence antenna, JRC NRD-535D. 100kW, beamAz 35°, bearing 240°. Received at Plymouth, MN, United States, 12912KM from transmitter at Rangitaiki. Local time: 0659.

[snehalblog]

Plethysmograph Market: Exploring Key Trends, Competitive Landscape, and Future Opportunities in Healthcare Monitoring - UnivDatos

According to a new report by UnivDatos Market Insights, The Plethysmograph Market was valued at USD 101.2 Million in 2022 and is expected to grow a CAGR of 4.5% during the forecast period (2023-2030). A plethysmograph is a medical tool that detects volume changes within an organ or body part. It's commonly utilized in respiratory studies to measure alterations in lung air volume. This device plays a crucial role in diagnosing respiratory ailments and evaluating lung function. Several factors are contributing to the growth of such diagnostics including the increased consumption of alcohol and tobacco, the surge in awareness programs regarding respiratory disorders, and rising investments in diagnostic departments are driving the growth of the healthcare sector. Apart from these factors, rising strategic collaborations are leading the market of medical devices in this forecast period. For instance, the incidence of bradycardia was reported to be approximately 1 in 600 individuals worldwide in September 2020 according to the American Journal of Cardiology.

Access sample report (including graphs, charts, and figures): https://univdatos.com/get-a-free-sample-form-php/?product_id=54390&utm_source=LinkSJ&utm_medium=Snehal&utm_campaign=Snehal&utm_id=snehal

The report suggests that the Rising Expenditure on the Healthcare Sector is one of the major factors driving the growth of the medical device market during the forthcoming years. Money is essential for gaining prominence in the market, and the medical device industry is gaining much of it. This expenditure is driving the market for the development of new technological advancements in the field of diagnostics. In recent years, there has been an increasing number of company and government collaborations focused on plethysmographs. For instance, in November 2023, the Association of Indian Medical Device Industry (AIMED) and the Centre for the Development of Russia Strategic Partnership (DRISP) signed a Memorandum of Understanding (MoU) to promote bilateral trade between both nations. It also provides hope for patients to get better care and support through plethysmography, also it can serve as a doorway to opportunities for offering better diagnostic options in the future.

Body Plethysmographs Gaining Maximum Traction in the Market:

Body plethysmographs continue to be significant tools in respiratory physiology and pulmonary function testing. These devices play a crucial role in assessing lung function by accurately measuring lung volumes and capacities. Body plethysmographs are considered a standard tool in pulmonary function testing laboratories and respiratory clinics. They provide precise measurements of lung volumes, aiding in diagnosing and monitoring various respiratory conditions such as asthma, COPD, restrictive lung diseases, and other pulmonary disorders. In the plethysmograph market, while advancements in technology have led to the development of other techniques and devices for assessing lung function, body plethysmographs maintain their importance due to their accuracy and reliability in measuring lung volumes. Companies involved in the production and development of pulmonary function testing equipment often include body plethysmographs in their product portfolios, emphasizing their role in comprehensive respiratory diagnostics.

North America has shown its potential in several arenas, and plethysmographs are one of them. A plethysmograph is a medical instrument used to track volume variations in organs or body parts. Primarily applied in respiratory analysis, it measures changes in lung air volume. This device aids in diagnosing respiratory conditions and assessing lung functionality. There have been significant collaborations between pharmaceutical organizations to facilitate the exchange of resources and knowledge to provide enhanced pulmonary care to patients in the nation. For instance, in November 2023, the Association of Indian Medical Device Industry (AIMED) and the Centre for the Development of Russia Strategic Partnership (DRISP) signed a Memorandum of Understanding (MoU) to promote bilateral trade between both nations.

One of the pivotal areas of growth in the U.S. plethysmograph market is advancements in diagnostics. These technologies, along with advancements in bioinformatics and data analysis, contribute significantly to identifying, characterizing, and utilizing plethysmographs for diagnosis, prognosis, and personalized treatment strategies. Traditionally, the U.S. has chased up accessibility and affordability issues concerning lung diagnostic services, but the presence of a diagnostic system that will more efficiently prevent metastatic cells from progressing is still a challenging factor. The U.S. pharmaceutical sector is known for its significant contribution to innovative healthcare services globally and is slowly stepping into the arena of innovative diagnostic procedures through multiple ongoing clinical trials to provide appropriate therapeutics. For instance, in March 2023, the Mayo Clinic started a clinical trial to evaluate whether undergoing gender-affirming care will impact the way the lung function using plethysmography. Also, in September 2023, the University of Pittsburgh started a clinical trial to study coronary artery disease in patients with Friedreich's ataxia using plethysmography.

Click here to view the Report Description & TOC : https://univdatos.com/get-a-free-sample-form-php/?product_id=54390&utm_source=LinkSJ&utm_medium=Snehal&utm_campaign=Snehal&utm_id=snehal

Conclusion

The global plethysmograph market is a rapidly growing field, with advancements in technology leading to improved outcomes for patients with the initial stage of the disease. The global plethysmograph market is expected to continue to grow in the coming years, as new technologies are developed. Overall, the global plethysmograph market represents a significant opportunity for medical device industries, which are making strategic alliances to design effective diagnostics for respiratory disorders. With continued research and development, even more effective and personalized treatments will likely become available in the future, leading to improved outcomes for patients and doctors through plethysmography.

[adityarana1687-blog]

Snus Market Size To Reach $4.10 Billion By 2030

The global snus market is expected to reach USD 4.10 billion by 2030, registering a CAGR of 4.7% from 2024 to 2030, according to a new report by Grand View Research, Inc. The major growth driver includes the high adoption of snus to encourage the use of less harmful tobacco products and due to the ease of application of snus. The increasing consumer interest in natural and holistic wellness solutions. With a growing emphasis on health-conscious living, consumers are seeking alternatives to traditional tobacco products that offer potential health benefits without the harmful effects associated with smoking. CBD-infused snus presents a promising option for individuals looking to incorporate wellness-enhancing ingredients into their daily routine while still enjoying the convenience and familiarity of snus. Snus is safer than smoking combustible tobacco products for nicotine inhalation. According to a paper published in the Harm Reduction Journal, consumption of snus was not found to be linked with a higher risk of pancreatic cancer. This is due to the lower nitrosamine levels in the snus compared to tobacco smoke. This factor is predicted to augment market growth during the forecast period.

Another trend in the market is the growing adoption of tobacco-free snus. Industry players are focusing on producing tobacco-free alternatives to maintain the product’s prevalence in the market as tobacco consumption is declining globally. The product is beneficial for those trying to reduce or stop using tobacco. There are numerous flavors and brands available, and they all contain a mixture of herbs and flavors that together produce an experience resembling that of traditional snus. The shift in consumer preference toward smokeless tobacco products, such as snus, as a safer substitute for numerous other tobacco-based products, such as cigars, cigarettes, and smoke pipes, can be attributed to rising health awareness among consumers. The tobacco steam is pasteurized rather than fermented When making snus, which lowers the incidence of pancreatic pulmonary, oral, and respiratory cancer and slows the growth of microbes that produce nitrosamines found in tobacco.

Snus is primarily exported from Sweden, and due to convenience, the Swedish people consume the most pouched snus. As per a report published by the European Network for Smoking Prevention, the average snus user consumes about 19 g daily, with Swedish men being more likely to follow this trend. According to Swedish consumers, snus performs the social functions of smoking better than cigarettes, which is the main factor for current and new users who prefer it over all other products. Furthermore, the market is ripe for innovation, presenting opportunities for companies to differentiate their products and capture market share. There is a rising demand for novel flavors, nicotine strengths, and packaging formats, providing room for creativity and experimentation. Companies can leverage this opportunity by introducing innovative product offerings that cater to diverse consumer preferences and stand out in a competitive landscape.

Request a free sample copy or view report summary: Snus Market Report

Snus Market Report Highlights

The portion segment led the product segment with the highest revenue share owing to its rising popularity due to convenience of usage unlike loose snus or other tobacco products

Fruit flavors are expected to be the fastest-growing segment during the forecast period. This growth is attributable to the younger population preferring sweet-tasting and more appealing tobacco products

Middle East & Africa is expected to grow significantly over the projected timeframe owing to lenient government regulations regarding tobacco sales in the region

Snus Market Segmentation

Grand View Research has segmented the global snus market based on product, flavor, distribution channel, and region:

Snus Product Outlook (Revenue, USD Million, 2018 - 2030)

Loose

Portion

Snus Flavor Outlook (Revenue, USD Million, 2018 - 2030)

Original/Unflavored

Flavored

Mint

Whiskey

Fruit

Others

Snus Distribution Channel Outlook (Revenue, USD Million, 2018 - 2030)

Tobacco Stores

Convenience Stores

Online

Others

Snus Regional Outlook (Revenue, USD Million, 2018 - 2030)

North America

U.S.

Canada

Mexico

Europe

UK

Sweden

Norway

Asia Pacific

China

India

Japan

Indonesia

Bangladesh

Central & South America

Brazil

Argentina

Middle East & Africa (MEA)

South Africa

List of Key Players of the Snus Market

Swedish Match AB

British American Tobacco

Imperial Brands

US Smokeless Tobacco Co., Inc.

Philip Morris International

Swisher

Mac Baren Tobacco Company A/S

Nordic Snus

Ministry of Snus

Northerner Scandinavia Inc.

[lungplusclinic]

Discover Top Strategies for Respiratory Health from the Leading Chest Specialist in Varanasi

Maintaining optimal respiratory health is crucial for overall well-being and quality of life. With air quality issues and increasing respiratory conditions, it's more important than ever to pay attention to our lungs. Dr. Vikas Jaiswal, a renowned chest specialist in Varanasi, provides invaluable insights into maintaining and improving respiratory health. Here are some top strategies to ensure your lungs stay healthy and function optimally.

1. Regular Check-Ups

One of the most effective ways to maintain respiratory health is through regular medical check-ups. Dr. Vikas Jaiswal emphasizes the importance of visiting a chest specialist for routine evaluations, especially if you have a history of respiratory issues. Early detection of conditions like asthma, chronic obstructive pulmonary disease (COPD), or interstitial lung disease can lead to more effective management and better outcomes. Regular check-ups can also help monitor existing conditions and adjust treatment plans as needed.

2. Healthy Lifestyle Choices

A balanced lifestyle plays a significant role in respiratory health. Dr. Vikas Jaiswal recommends incorporating the following lifestyle changes:

Diet: A nutritious diet rich in fruits, vegetables, lean proteins, and whole grains can support overall health and strengthen the immune system. Foods high in antioxidants, such as berries and leafy greens, help reduce inflammation and oxidative stress, which can benefit lung function.

Exercise: Regular physical activity is crucial for maintaining lung health. Cardiovascular exercises like walking, jogging, and swimming can improve lung capacity and efficiency. Dr. Vikas Jaiswal suggests engaging in at least 150 minutes of moderate-intensity exercise per week. Additionally, breathing exercises such as diaphragmatic breathing can enhance lung function and reduce respiratory symptoms.

Hydration: Staying well-hydrated helps keep the mucous membranes in the respiratory tract moist, which can aid in the prevention of infections and ease the clearance of mucus from the lungs. Aim to drink at least 8 glasses of water a day, and adjust based on activity level and climate.

3. Avoiding Smoking and Pollutants

Smoking is a leading cause of respiratory diseases, including lung cancer, COPD, and chronic bronchitis. Dr. Vikas Jaiswal strongly advises against smoking and encourages smokers to seek help to quit. Avoiding secondhand smoke is equally important, as it can also cause harm to the lungs.

In addition to smoking, exposure to environmental pollutants and allergens can negatively impact respiratory health. Dr. Vikas Jaiswal suggests minimizing exposure to air pollutants by staying indoors on days with high pollution levels and using air purifiers in your home. For individuals with allergies, identifying and avoiding triggers such as dust, pollen, and mold can help prevent respiratory issues.

4. Managing Respiratory Conditions

For individuals with pre-existing respiratory conditions, proper management is essential. Dr. Jaiswal provides the following tips:

Medication Adherence: Following prescribed medication regimens is crucial for managing chronic respiratory conditions. Inhalers, steroids, and other medications should be used as directed to control symptoms and prevent exacerbations.

Monitoring Symptoms: Keeping track of symptoms and their triggers can help manage respiratory conditions more effectively. Maintain a journal to record changes in symptoms, medication usage, and potential environmental triggers. This information can be valuable during consultations with your chest specialist.

Allergy Management: For those with allergic asthma, managing allergies is a key component of respiratory health. Dr. Jaiswal recommends allergy testing to identify specific allergens and utilizing medications or allergy shots as needed.

5. Breathing Exercises and Techniques

Breathing exercises can significantly benefit respiratory health by improving lung capacity and efficiency. Dr. Vikas Jaiswal suggests incorporating the following techniques into your routine:

Diaphragmatic Breathing: Also known as abdominal breathing, this technique involves engaging the diaphragm to take deep, slow breaths. It can help reduce stress and improve oxygenation.

Pursed-Lip Breathing: This technique involves inhaling through the nose and exhaling slowly through pursed lips. It can help individuals with COPD and other respiratory conditions control their breathing and reduce shortness of breath.

Deep Breathing Exercises: Deep breathing exercises, such as those practiced in yoga or meditation, can help enhance lung function and promote relaxation.

6. Maintaining a Healthy Weight

Obesity can negatively impact respiratory health by putting additional strain on the lungs and leading to conditions such as sleep apnea. Dr. Vikas Jaiswal advises maintaining a healthy weight through a combination of a balanced diet and regular exercise. Weight management can improve lung function and overall health.

7. Vaccinations

Vaccinations play a crucial role in preventing respiratory infections that can compromise lung health. Dr. Vikas Jaiswal recommends staying up-to-date with vaccinations such as the flu vaccine, pneumococcal vaccine, and COVID-19 vaccine. These vaccines can help protect against infections that may exacerbate existing respiratory conditions or lead to serious complications.

8. Healthy Sleep Habits

Quality sleep is essential for overall health, including respiratory function. Poor sleep can worsen respiratory conditions and lead to complications. Dr. Jaiswal suggests establishing a regular sleep routine, creating a comfortable sleep environment, and addressing any sleep disorders, such as sleep apnea, with your healthcare provider.

9. Stress Management

Chronic stress can negatively impact respiratory health by triggering or exacerbating symptoms of conditions like asthma. Dr. Vikas Jaiswal recommends incorporating stress management techniques such as mindfulness, meditation, and relaxation exercises into your daily routine. Managing stress can improve overall well-being and respiratory function.

10. Regular Follow-Ups

For those with chronic respiratory conditions, regular follow-up appointments with a chest specialist are essential. Dr. Jaiswal emphasizes the importance of ongoing monitoring and adjustments to treatment plans as needed. Regular follow-ups ensure that any changes in symptoms or health status are promptly addressed, leading to better management and improved quality of life.

In conclusion, maintaining optimal respiratory health involves a multifaceted approach that includes regular check-ups, healthy lifestyle choices, and effective management of existing conditions. Dr. Vikas Jaiswal, the leading chest specialist in Varanasi, provides valuable guidance to help individuals achieve and sustain excellent lung health. By following these strategies, you can enhance your respiratory well-being and enjoy a better quality of life.

[killed-by-choice]

“Dottie Roe,” 30 (USA 1965)

“Dottie” was a New Yorker seeking medical attention because she had started bleeding in the second trimester. She had suffered two miscarriages in the past and likely feared that she might lose this baby too. Unfortunately, the doctor’s dubious course of action would end her baby’s life and her own.

The medical journal that recorded Dottie’s case does not specify what the diagnosis was, but the doctor decided to put Dottie through a hysterotomy abortion and a tubal ligation. This was a questionable course of action considering that hysterotomy abortion is associated with a very high maternal mortality rate. But since it qualified under the health exemption (“life of the mother” exception), it was completely legal.

The report of Dottie’s death raises questions. She was under general anesthesia for the abortion and tubal ligation, but would never wake up. The journal states that “Cardiac arrest ensued during the procedure, and the patient expired following completion of a tubal ligation, never having regained consciousness.”

Later research found that the risk of hysterotomy abortion concurrent with surgical sterilization was unjustified even in someone perfectly healthy. Today, medical knowledge has advanced beyond the antiquated approach of abortion for pregnancy complications— the recommendation that failed Dottie and her child.

Other pre-Roe legal abortions that were meant as “life/health of the mother” exceptions and killed the patient instead include:

“Carolyn” and “Caroline Roe”: Both died in North Carolina in 1970 or 1971 after abortions for “health indications”

“Bonnie Roe”: Put through an abortion because her heart condition, then died because of drugs for the abortion that were contraindicated in heart patients

“Molly Roe”: Her killers were rebuked by a maternal health committee for a saline abortion that was more dangerous to the young lupus patient than her pregnancy

“Rita Roe”: A cardiac patient who died from multiple pulmonary emboli after an abortion at 12 weeks pregnant

Caro Lena Grasso: An Italian immigrant with a chronic respiratory illness who died of infection caused by the abortion meant to stabilize her

Erika Charlotte Wullschleger: At 28, she was in a tank respirator at Scripps Memorial Hospital. She was just starting to get better before dying from the abortion that her husband, not she, signed the consent forms to.

Barbara Riley: After a doctor told her to have an abortion instead of giving birth again, she reluctantly underwent the highly dangerous saline abortion that took both lives.

(Sources below)

New York State Medical Journal, January 1974

[rahulp3]

Bronchodilator Market Outlook from 2024 to 2034

The global Bronchodilator Market, medications that help ease breathing in people with respiratory conditions, is poised for significant growth. According to projections, the market is expected to reach a substantial USD 67.8 billion by 2034. This translates to a steady Compound Annual Growth Rate (CAGR) of approximately 5.9% from 2024 to 2034. With a current market size estimated at USD 38.2 billion in 2024, the increasing demand for bronchodilators signifies a growing focus on managing respiratory health.

Several factors are anticipated to spur growth in the bronchodilator industry. These include the rising prevalence of respiratory diseases such as asthma and COPD, the growing geriatric population, and increasing government initiatives and programs.

The rising geriatric population globally is emerging as a key factor driving demand for bronchodilators. As age increases, people become more susceptible to lung problems. According to the journal Clinical Interventions in Ageing, the aging population is significantly impacted by pulmonary illness.

Request a Sample of this Report Now! https://www.futuremarketinsights.com/reports/bronchodilator-market

[jcsmicasereports]

Granulomatosis with Polyangiitis (Wegener’s granulomatosis) manifesting with Cranial Nerve Palsies and Pachymeningitis: A Case report by Christian Matta in Journal of Clinical Case Reports Medical Images and Health Sciences

Abstract

We present a case of a 78-year-old male patient diagnosed with pachymeningitis secondary to Wegener's granulomatosis (WG), also known as granulomatosis with polyangiitis (GPA), associated with p-ANCA positivity. This case report aims to highlight the clinical presentation and diagnosis, of pachymeningitis in WG and provide a review of the literature on this manifestation.

Introduction: Wegener's granulomatosis (WG) is a systemic small-vessel vasculitis characterized by necrotizing granulomatous inflammation, primarily affecting the upper and lower respiratory tracts and kidneys. (1) Central nervous system (CNS) involvement is uncommon, occurring in approximately 2-8% of cases, with the most common manifestation being peripheral neuropathy. However, pachymeningitis is a rare manifestation of GPA, characterized by thickening of the dura mater. (2,3) We present a case of pachymeningitis due to GPA, providing simultaneously a literature review.

Case Presentation: In February 2020, a 78-year-old male patient presented with binocular diplopia, bitemporal headache and a progressive vision loss in the left eye accompanied by a bilateral serous otitis media. A brain computed tomography (CT) was performed, however no significant findings were found.  After a progressive degradation of his visual field, a brain MRI with gadolinium enhancement was performed in 2021 and demonstrated a subdural hematoma of the left convexity with a diffuse, thick dural enhancement suggestive of pachymeningitis. A set of laboratory tests was performed to including autoimmune antibodies: anti-nuclear antibodies, antibodies against extractable nuclear antigens, anti-double- and singlestranded DNA; anti-neutrophil cytoplasmic antibodies, anticyclic citrullinated peptide antibodies, anti-MOG, and antiaquaporin-4 (AQP4), all proved negative. The blood levels of vitamin B12, B9, thyroid-stimulating hormone, and the angiotensin-converting enzyme (ACE) were normal. Lumbar puncture revealed an opening pressure of 20 cmH2o, elevated protein of 1.3g/L, normal glucose levels and normal WCC in the cerebrospinal fluid (CSF), with a sterile culture. In March 2022, the patient presents a progressive onset of visual loss in the right eye. Ophthalmic examination showed a visual acuity at 2/10 without papillitis. A brain MRI found pachymeningitis with atrophy of the left optic nerve (Figure 2). A CT scan of the chest showed the presence of a nodular shadow with some cavitation involving the middle lobe of the left lung in favor of vascular malformation. Salivary gland biopsy showed sialadenitis. A blood patch for suspicion of CSF hypotension was performed as a therapeutic test but without clinical benefit. In May 2022, a brain and whole-body FDG-PET was performed and showed the presence of moderately hypermetabolic bilateral hilar lymph nodes, and the progression of left frontal pachymeningitis associated with moderate hypermetabolism affecting bilateral internal temporal regions. The patient was started on intravenous methylprednisolone (1 g/day) for 3 days, without ocular improvement and with poor tolerance of his diabetes The patient was re-hospitalized for a follow-up evaluation in January 2023. A whole-body Positron emission tomography (PET) imaging with F-18-labelled 2-fluoro 2-deoxy-D glucose (F18 FDG) showed a hypermetabolic nodule of the walls of the trachea, the right main bronchus, the subcarinal, the pulmonary hiles, and the nasal septum. A cerebral F-18 FDG PET showed intense hypermetabolism of the right optic nerve, associated with marked encephalic hypermetabolism, predominantly in the temporal and supratentorial regions (Figure 3 and 4). Laboratory test showed Erythrocyte sedimentation rate (ESR) of 65 mm/h (normal range: 0-20 mm/h), C-reactive protein (CRP) of 45 mg/L (normal range: <10 mg/L), and a white blood cell count of 14,000 cells/µL (normal range: 4,000-11,000 cells/µL) with neutrophil predominance. Lumbar puncture revealed an elevated opening pressure, elevated protein, and normal glucose levels in the cerebrospinal fluid (CSF), with a sterile culture. Autoimmune and infectious tests were re-performed, and all proved negative including the Anti-neutrophil cytoplasmic antibodies directed to proteinase3 (c-ANCA) but not the Perinuclear anti-neutrophil cytoplasmic antibodies (P-ANCA) which was positive. So, the patient was diagnosed with granulomatosis with angiitis.

Discussion: Previously known as Wegener’s Granulomatosis, this systemic necrotising vasculitis is associated with cANCA PR3. Predominantly afflicting small vessels, the multisystem disease is classically recognized to affect the renal system alongside upper and lower respiratory tracts. (4) Pachymeningitis, a rare manifestation of granulomatosis with polyangiitis (GPA). It can present with various neurological symptoms and is associated with ANCA (antineutrophil cytoplasmic antibody) positivity. It was reported by Nagashima et al. (2000). Where they presented a case study of a patient with P ANCA Wegeners granulomatosis who had pachymeningitis and multiple cranial neuropathies. (5) This case report discussed the association of pachymeningitis with P-ANCA-positive Wegener's granulomatosis, associated with the imaging pattern of WG on 18-FDG PET Scan. It emphasizes the diagnostic challenge and the need for timely management. These findings underscore the significance of recognizing pachymeningitis in the context of GPA and its association with p ANCA positivity for appropriate diagnosis and management. It highlights the importance of retesting for ANCA when symptoms and imaging are highly suggestive of the diagnosis.

Conclusion: In conclusion, pachymeningitis is a rare and challenging manifestation of WG. A high index of suspicion, along with a combination of clinical, laboratory, and radiological findings, is essential for accurate diagnosis and prompt initiation of appropriate treatment.