Respiratory Obstruction Research Articles

Impact of temperature and humidity on airway obstruction in a cohort of elderly women

Abstract Background Temperature and relative humidity (RH) impact human health. However, little is known about the combined association between temperature and RH on respiratory health in the elderly. In this study, we evaluated the interactive associations of temperature and RH on airway obstruction in elderly German women. Methods Using data from the second follow-up (2007-2010) of the German SALIA cohort study, we assessed the short-term (Lag0-8) combined association between maximum and minimum temperature (Tmax, Tmin) and RH on airway obstruction. Airway obstruction was defined as the ratio of first second of forced expiration (FEV1) / forced vital capacity (FVC) < 0.70. Multivariable logistic regression with a distributed lag non-linear model (DLNM) was constructed for the interaction between temperature and RH and adjusted for a single pollutant, location, socioeconomic status and smoking status. Results 735 elderly women with an average (±SD) age of 73.46 (±3.09) years were included. Around 16.73% of them had airway obstruction. For non-linear antagonistic Tmax and RH interaction models, we found a U-shaped relationship from Lag 0-8, with an immediate adverse association from Lag0-1 and a significant delayed adverse association from Lag7-8. For non-linear antagonistic Tmin and RH interaction models, the relationship was U-shaped and showed an immediate adverse association from Lag0-1, while there was also a significant delayed association from Lag6-8. Conclusions Climate change increases the likelihood of exposure to adverse temperatures and weather conditions. Vulnerable populations like the elderly are more susceptible to the adverse associations of climate change. In this epidemiological study, we found that exposure to Tmax/Tmin and RH had immediate and delayed adverse associations by increasing respiratory obstruction in elderly women. Increasing public awareness of the danger of interactions between non-optimum temperature and RH on respiratory health is crucial. Key messages • Elderly women’s respiratory health is impacted by temperature and humidity interactions, requiring awareness and proactive measures. • Climate change heightens risk for vulnerable groups, emphasising the need to address environmental impacts on health.

Ultrasonic assessment of gastric solid contents in patients undergoing upper endoscope with sedation

BackgroundPerioperative reflux aspiration presents a grave concern during sedation or general anesthesia, particularly when solid gastric contents prompt acute upper respiratory obstruction, potentially resulting in fatal consequences for patients. Currently, there are limited means for promptly assessing solid gastric contents in clinical settings. Therefore, this study examined the efficacy of ultrasound assessment for solid gastric contents, offering a rapid and non-invasive approach for early detection and decision-making regarding interventions.MethodsThe study included 400 patients scheduled for upper endoscopy procedures, which encompassed both gastroscope and gastroscope combined colonoscopy examinations with sedation. Ultrasound scanning of the antrum was performed while patients were positioned semi-sitting or in the right lateral decubitus (RLD) posture. The evaluation of solid gastric contents relied on direct visual observation during endoscopy. Gastric volume measurement occurred subsequent to endoscopic suction of gastric contents. Receiver operating characteristic curves were utilized to assess the effectiveness of ultrasonography in discerning solid contents.ResultSeven patients undergoing gastroscope with sedation were found to have solid gastric contents. The sensitivity, specificity, positive predictive value, and negative predictive value of the ultrasound qualitative evaluation of solid contents were 85.7%, 99%, 60%, and 99.7%, respectively.ConclusionSolid stomach contents can be evaluated qualitatively with reasonable accuracy using ultrasonography. Additionally, in patients undergoing upper endoscopy and assessed to have solid gastric contents with ultrasound, administration of mild sedation is recommended.Trial registrationwww.chictr.org.cn (ChiCTR2100048994); registered 19/07/2021.

Technique description and outcome evaluation of Thoroughbred racehorses following soft palate thermocautery performed under standing sedation.

Palatal dysfunction (PD), which encompasses palatal instability (PI) and intermittent dorsal displacement of the soft palate, is the most common performance-limiting upper respiratory tract obstruction in young Thoroughbred racehorses. Soft palate thermocautery (SPT) performed under general anaesthesia is a routinely performed procedure for PD in some countries, but the procedure for and outcome of SPT performed under standing sedation has not been published. (1) To describe a technique for SPT performed under standing sedation; and (2) to assess post-operative performance in horses compared to controls using the Racing Post rating (RPR), British Horseracing Authority official rating (OR), Performance Index and Earnings. Retrospective case series. Medical records were reviewed for all horses that had SPT performed under standing sedation following topical and local infusion of lidocaine hydrochloride into the rostral soft palate, and that were identified to have PI by overground endoscopy. Two matched controls were identified for each case. The median RPR, OR, Performance Index and Earnings for the three pre-operative and three post-operative races were compared. No significant differences were identified between the SPT (n=23) and Control groups (n=46) for baseline characteristics or outcomes. Retrospective study design, small sample size. No significant differences in racing performance were identified between horses that had SPT performed under standing sedation and controls.

Long-term effect observation after 10 years of tonsillotomy （Histological analysis of one case of secondary operation）

Objective:To investigate the long-term effect of partial tonsillectomy in children with tonsil hypertrophy. Methods:A total of 146 children with obstructive sleep apnea（OSA） who received surgical treatment for tonsil hyperplasia from January 2010 to January 2013 were selected and divided into the observation group（n=69） and the control group（n=77）. The observation group was received tonsillotomy（TT）, and the control group was received total tonsillectomy（TE）. Parental satisfaction and OSA quality of life questionnaire for children（OSA-18） were surveyed. Residual tonsil size was measured, and polysomnography（PSG） was monitored after 10 years. HE and immunohistochemical analysis were performed on tonsil tissues of one patient who performed a second operation after TT in 2017 year. Results:The results of questionnaire survey showed that the symptoms of respiratory obstruction were significantly improved in both groups, and the satisfaction of TT group was higher than that in the TE group. No increase in the number of respiratory tract infections was observed in all patients. In the TT group, nine cases（13.04%） had tonsil hyperplasia toⅡ°, and the remaining patients had tonsil hyperplasia to Ⅰ°. In addition, one case hadtonsil suppurative infection at the 14th month after surgery, and no recurrence or reoperation was found after treatment. There were seven cases in the TT group and eight cases in the TE group with occasional snoring and mouth breathing after surgery, but the PSG examination of the patients did not meet the diagnosis of OSA. The main causes were obesity and allergic rhinitis. Compared with the first operation, the cicatricial obstruction and infection of tonsil tissue in the second operation were not significantly changed, and the immunohistochemical results also demonstrated that the expression of CD20 was not changed, and the expression of CD3 was decreased. Conclusion:Both TT and TE can effectively improve the symptoms of OSA obstruction in children. TT has less trauma, less postoperative pain, faster recovery and lower rate of hyperplasia, which can be used as one of the main methods for the treatment of tonsil hypertrophy in children.

Sedation Techniques for Drug-induced Sleep Endoscopy in Adult Patients with Sleep-disordered Breathing

Drug-induced sleep endoscopy emerged and developed as an essential alternative diagnosis tool in sleep-disordered breathing patients. Accurate identification and dynamic characteristics of upper respiratory airway obstruction are paramount in establishing an adequate therapeutic plan and selecting for particular surgical or non-surgical strategies. This article reviews the current aspects of intravenous sedation for drug-induced sleep endoscopy (DISE) in adults, emphasizing its implications for patients with sleep apnea. The ideal sedative agent for DISE should replicate natural sleep patterns while maintaining upper airway dynamics. The clinical practice exhibits a significant variability in drug selection, with midazolam and propofol often being preferred. The review presents emerging trends and advancements in DISE, emphasizing its role in optimizing surgical indications, predicting outcomes, and screening patients for alternative therapeutic strategies for OSA. Future research is needed to understand better the impact of specific sedative drugs on DISE findings, contributing to the development of standardized protocols and the evolution of new sedative drugs with improved effects and optimized techniques for delivering sedation.

FEATURES OF ANESTHESIA IN PATIENTS WITH SPECIAL NEEDS. PART 1

The non-medical use of cannabis can negatively impact the morpho-functional state of almost all organs and systems of the human body. During acute intoxication and established drug dependence, it can unevenly distort the effects of drugs for local and general anesthesia, leading to life-threatening complications. Part 1 of this review presents the results of acute and chronic cannabis use on homeostasis. Cerebral vasospasm and atherosclerosis are identified as major etiological factors for cannabis-related cerebrovascular diseases. Young to middle-aged individuals (30–50 years), male gender (male-to-female ratio 3.7:1), and chronic use (86%) are significant independent predictors of neurovascular toxicity, cerebral hypoperfusion, and stroke. Cannabis smoking causes damage to the respiratory mucosa similar to tobacco. Regular cannabis smokers can expect irritation of the upper respiratory tract, swelling, obstruction, chronic cough, bronchitis, lung emphysema, and bronchospasm. Some reports advocate the use of dexamethasone during surgery to alleviate these symptoms. The detrimental effects of chronic cannabis use on liver and kidney functions are somewhat overstated. Disturbances in immune system, thermoregulation, blood clotting, and carbohydrate metabolism in the absence of anesthetic precautions can significantly complicate the patient's condition in the perioperative period. Cannabinoids can interact with drugs from various groups. Awareness of the pathophysiological and biochemical consequences of cannabis use allows anesthesiologists to anticipate and effectively manage perioperative complications in this patient category

Pierre Robin Sequence: An Updated Evidence-Based Treatment Proposal.

The Pierre Robin sequence (PRS) is characterized by the presence of micrognathia, glossoptosis, and respiratory obstruction during the neonatal period, its prompt recognition allows to mitigate the associated morbidity and mortality. A diagnosis and treatment algorithm was previously proposed based on data from the literature to guide therapeutic efforts; therefore, it was proposed to carry out a new search for relevant evidence to update or complement it. A literature review of the subject was conducted in PubMed, Embase, and Cochrane databases, corresponding to the period between November 2016 and September 2021. Using the GRADE methodology, 38 articles from different clinical studies that discussed diagnostic tests or therapeutic approaches, directly or indirectly compared, were selected and evaluated. After evaluating and analyzing the selected articles, the new information was incorporated into an updated algorithm according to the most recent evidence found for the diagnosis and comprehensive management of patients with PRS. To date, there is no consensus in the literature on the treatment of patients with PRS nor are there multicenter studies comparing different management modalities. The indications to proceed with surgical strategies do not present changes with respect to the previous article. Nutritional monitoring is the main objective, and the study of oral feeding is essential in all scenarios.

Exploring the Complex Interplay of Obesity, Allergic Diseases, and Sleep-Disordered Breathing in Children.

This narrative review study investigates the correlations between obesity, allergies, and sleep-disordered breathing in pediatric populations. Searches for pertinent articles were conducted on the Medline PubMed Advanced Search Builder, Scopus, and Web of Science databases from unlimited to April 2024. Sleep-disordered breathing causes repeated upper airway obstructions, leading to apneas and restless sleep. Childhood obesity, which affects around 20% of children, is often associated with sleep-disordered breathing and allergies such as asthma and allergic rhinitis. It is distinguished between diet-induced obesity (resulting from excess of diet and physical inactivity) and genetic obesity (such as is seen in Down syndrome and Prader-Willi syndrome). In children with diet-induced obesity, chronic inflammation linked to weight can worsen allergies and increase the risk and severity of asthma and rhinitis. Furthermore, the nasal congestion typical of rhinitis can contribute to upper respiratory tract obstruction and obstructive sleep apnea. A vicious circle is created between asthma and sleep-disordered breathing: uncontrolled asthma and sleep-disordered breathing can worsen each other. In children with genetic obesity, despite alterations in the immune system, fewer allergies are observed compared to the broader population. The causes of this reduced allergenicity are unclear but probably involve genetic, immunological, and environmental factors. Additional research is necessary to elucidate the underlying mechanisms. The present narrative review study emphasizes the importance of jointly evaluating and managing allergies, obesity, and obstructive sleep apnea in children considering their close interconnection.

Pediatric obstructive sleep apnea: a prospective observational study of respiratory events in the immediate recovery period after adenotonsillectomy

BackgroundAdenotonsillectomy is often curative for pediatric obstructive sleep apnea, yet children remain at high risk of respiratory complications in the postoperative period. We sought to determine the incidence and risk factors for respiratory depression and airway obstruction, as well as clinically apparent respiratory events in the post-anesthesia care unit (PACU) in high-risk children after adenotonsillectomy. MethodsIn this prospective cohort study, we enrolled 60 high-risk children having adenotonsillectomy. Our primary outcome was respiratory depression and airway obstruction in the PACU measured using a noninvasive respiratory volume monitor (RVM) and defined by episodes of predicted minute ventilation less than 40% for at least 2 min. We measured clinically apparent respiratory events using continuous observation by trained study staff. ResultsThe median (range) age of our sample was 4 years (1, 16) and 27 (45%) were female. Black and Hispanic race children comprised 80% (n = 48) of our cohort. Thirty-nine (65%) had at least one episode of PACU respiratory depression or airway obstruction measured using the RVM, while only 21 (35%) had clinically apparent respiratory events. Poisson regression demonstrated the following associations with an increase in episodes of respiratory depression and airway obstruction: BMI Z-score less than −1 (estimate 3.91; [95%CI 1.49–10.23]), BMI Z-score 1–2 (estimate 2.04; [1.20–3.48]), and two or more comorbidities (estimate 1.96; [1.11–3.46]). ConclusionsRespiratory volume monitoring in the immediate postoperative period after pediatric high-risk adenotonsillectomy identifies impaired ventilation more frequently than is clinically apparent.

Maxillofacial Abscess et Causa Odontogenic Infection: A Case Report

Background: Odontogenic infection is an infection that occurs in the oral cavity caused by carious teeth and periodontal disease where the disease can spread to surrounding tissues to the face, jaw and neck. Maxillofacial abscess is a manifestation of periapical or periodontal infection. incicus, canicus or molar teeth, where periapical infection is the most frequent source of odontogenic infection compared to periodontal. Inflammation or damage to chronic dental problems can cause complications of abscesses in the surrounding area. The main complaint that causes sufferers to come to the hospital is pain in the abscess area. These complaints can also be accompanied by trismus, dysphagia, stridor caused by compression of the trachea, and even respiratory tract obstruction. Objective: To determine the progression of maxillofacial abscess so that medical management can be provided up to surgical incision and drainage. Case report: We report 2 cases of maxillofacial abscess due to odontogenic infection with management according to the progression of each case. Conclusion: The most common cause or etiology that can cause maxillofacial abscess is toothache. Management of maxillofacial abscesses begins with empirical antibiotics, which is the first step to reduce bacterial infections that produce beta lactamase. In maxillofacial abscesses, medical therapy can be given in the form of antibiotics combined with ceftriaxone with metronidazole, or meropenem with metronidazole and termination measures in the form of incision and drainage. Treatment can be chosen based on the presence or absence of warning signs and signs of complications. Incision and drainage is performed when complaints do not improve after administration of antibiotics, multiple abscesses and airway obstruction threaten the patient's life.

Health Professionals' knowledge and practice on basic life support and its predicting factors in Ethiopia: Systematic review and meta-analysis.

Basic Life Support (BLS) is a sequence of care provided to patients who are experiencing respiratory arrest, cardiac arrest, or airway obstruction. Its main purpose is to maintain the airway, breathing, and circulation through CPR. This review aimed to estimate the pooled prevalence of Health Professionals' knowledge and practice on basic life support in Ethiopia. Eligible primary studies were accessed from international database (PubMed, Google Scholar, Hinari databases) and grey literatures found in online repositories. The required data were extracted from those studies and exported to Stata 17 for analysis. A weighted inverse-variance random-effects model and Der Simonian-Laird estimation method were used to compute the overall pooled prevalence of Health Professional's knowledge, practice of basic life support and its predictors. Variations across the included studies were checked using forest plot, funnel plot, I2 statistics, and Egger's test. A total of 5,258 Health Professionals were included from 11 studies. The pooled prevalence of knowledge and practice outcomes on basic life support in Ethiopia were 47.6 (95% CI: 29.899, 65.300, I2: 99.21%) and 44.42 (95% CI: 16.42, 72.41, I2: 99.69) respectively. Educational status of the Professional's was significantly associated with knowledge outcome. Those who had degree and above were 1.9 times (AOR: 1.90 (1.24, 2.56)) more likely knowledgeable on basic life support than under degree. The overall pooled estimates of Health Professionals knowledge and practice on basic life support was considerably low. The educational status of the Health Professionals was significantly associated with knowledge outcome. The Health Professionals and responsible stakeholders should focus on the basic life support at Health Institutions. The professionals should advance their knowledge and skill on basic life support for the patients.

Respiratory emergencies in adult horses

SummaryAlthough respiratory distress is encountered infrequently in equine practice, it can be serious and potentially fatal, requiring immediate and decisive intervention. History and physical examination can often give sufficient clues to identify the cause of respiratory distress and initiate emergency treatment. Ultrasonography can also be invaluable when assessing distress caused by lower respiratory tract issues. Upper respiratory tract obstruction, tension pneumothorax and occasionally pulmonary oedema can be rapidly fatal and require immediate intervention by emergency tracheotomy, thoracocentesis and evacuation of pleural air or administration of furosemide and oxygen, if available. Acute severe asthma and substantial pleural effusion are often not an immediate threat to life but nonetheless require fast intervention including administration of bronchodilators and corticosteroids or pleurocentesis, respectively.

Oncocytic papillary cystadenoma of the larynx: a case report

BackgroundCystadenoma of the salivary glands is a rare benign clinical condition affecting both major and minor salivary glands equally. It constitutes approximately 2% of total neoplasms and 4.2–4.7% of benign formations in minor salivary glands. Typically presenting as a slow-growing, painless neoplasm, it can be distinguished from Cystadenolymphoma (Whartin’s Tumor) by the absence of lymphoid elements in histological examination. While mostly located in the oral cavity and oropharynx, it can also be found in sinonasal mucosa, and rare cases have been identified in the larynx.Case presentationA 75-year-old Caucasian woman presented to the ear, nose, and throat department with complaints of dysphonia and headaches persisting for several months. Dysphonia had developed months after an unspecified vocal cord surgery elsewhere. Flexible laryngoscopy identified a left-sided cystic swelling affecting the supraglottic space, leading to respiratory obstruction and dysphonia. Head and neck computed tomography confirmed a 1.9 × 1.7 cm bilobed cystic mass originating from the left Morgagni ventricle. Microlaryngoscopy with CO2 laser excision and biopsy revealed a histopathological diagnosis of oncocytic papillary cystadenoma. Post-surgery, the patient fully recovered from dysphonia, with no significant complications noted. Long-term clinical surveillance was advised to detect potential recurrences promptly.ConclusionEctopic minor salivary gland tumors, both benign and malignant, should be taken into consideration as potential differential diagnosis for any swelling arising within the upper digestive tract mucosa. Ears, nose, and throat clinical examination completed by videolaryngoscopy can easily point out the location of the mass. Imaging is mandatory for differential diagnosis and for surgical planning. Surgical excision can provide both diagnosis and definitive cure.

The correlation between dento-maxillary anomalies and breathing in adults. Literary review.

One of the causes of dentomaxillary anomalies (MADs) in the development of the dentomaxillary apparatus in adulthood is oral respiration with or without nasal breathing. Adults with untreated MAD complain of nasal breathing disorders such as hypopnea (snoring) or sleep apnea (loud snoring). The purpose of the study was to review the literature on the relationship between dentomaxillary anomalies and breathing in adult patients. In this respect, an electronic search in PubMed (MedLine) and Google Scholar was performed. The studies until 20.01.2023 have been analyzed. Thus, 221 sources have been identified of which 21 have been included in the literature review. The mean age of patients in the examined articles constituted 35 years ±9.5 years. The link between MAD and breathing process has been described in 17 articles. The low transverse dimension of the upper jaw leads to nasal cavity obstruction, which can lead to the impairment of the air flow to the lungs. Patients with undiagnosed MAD and upper respiratory tract obstruction may develop OSAS later in life, in those with pre-existing OSAS the condition worsens after the age of 65. The literature describes a direct relationship between hypopnea or obstructive sleep apnea syndrome (OSAS) and hypodevelopment of the lower jaw in the sagittal plane and/or the upper jaw in the transverse plane.

Tracheobronchopathia Osteochondroplastica - to Biopsy or not to Biopsy? A Relook at The Rare Disease.

Tracheobronchopathia osteochondroplastica (TPO) is a rare idiopathic disease involving the tracheobronchial tree. It is mostly an incidental finding with non-specific clinical manifestations. It has typical bronchoscopic, radiological features and biopsy is usually considered non-essential. The study aimed to determine whether biopsy makes a difference in the management of patients. All patients diagnosed with TPO in our institution over 15 years (2005 to 2020) were included in this study. Their medical records, chest computed tomography (CT), and bronchoscopy reports were retrospectively reviewed, and data were analysed. All the CT images were reviewed by a senior chest radiologist. From the 20,000 bronchoscopies and 260,000 CT thorax images obtained, 28 cases were diagnosed as TPO based on either bronchoscopy or radiology or both. Among the 19 cases diagnosed through bronchoscopy, 16 underwent a biopsy. In addition to TPO features, biopsy showed additional diagnoses in 6 cases. In 9 cases, TPO was not initially diagnosed by CT but by bronchoscopy. In 8 patients, TPO was diagnosed incidentally on CT performed for other reasons. On follow-up with the treatment of underlying/co-existing concomitant aetiologies, clinical improvement was noted in all patients. None of them progressed to respiratory failure or airway obstruction until the last follow-up. Among patients who underwent bronchoscopic biopsy of TPO lesions, 38% had biopsy results showing an alternative aetiology, which led to changes in the treatment plan for all these patients. Hence, a bronchoscopic biopsy of TPO lesions should be performed to rule out other aetiologies.

Epstein-Barr virus - uzroci, posledice, dijagnostika i lečenje Epstein-Barr virusa kod ljudi

Abstract: The Epstein-Barr virus (EBV) belongs to the family of herpesviruses, subfamily Gammaherpesvirinae, and genus Lymphocryptovirus. Despite this classification, there are two serotypes of the Epstein-Barr virus, namely type A and type B. Both types play significant roles in the development of viremia. Additionally, EBV infection can lead to lymphadenopathy, upper respiratory tract obstruction, spleen rupture, thrombocytopenia, and recently, there has been increased emphasis on the connection between this virus and certain malignant neoplasms. Diagnosing this virus can be challenging if clinicians rely solely on serological confirmation. In some cases, it is necessary to perform more specific methods, in addition to considering the clinical picture and history, to prove the presence of the virus in blood, nasopharyngeal swabs, and other tissue samples. The aim of this paper is to present the severity and consequences caused by the Epstein-Barr virus and to emphasize the importance of preventive measures in preventing the virus from coming into contact with susceptible individuals. Prevention plays a crucial role in reducing contact with the virus. Since the infection spreads via droplets, wearing masks in healthcare facilities and regular hand washing are hygiene priorities to prevent infection and further transmission.

Warfarin-induced Sublingual Swelling: A Case of Pseudo-Ludwig Angina

Pseudo-Ludwig angina is a swelling that develops generally due to a cause other than an infection and can lead to fatal conditions such as severe respiratory obstruction. Due to anticoagulant use is rarely reported in the literature. This study presented a patient whose INR value was within the normal range and who developed sublingual swelling after dental treatment (intraoral trauma). A 68-year-old female patient was admitted to the emergency department complaining of increasing intraoral swelling on examination with a sublingual 3x5 cm hematoma. Warfarin was stopped, and she was monitored for possible intubation risk in the service. The patient did not develop respiratory distress and was discharged 4 days later. The INR range within which intraoral interventions can be performed safely is still unclear. The dentist should keep in mind that such complications may develop and be prepared for bleeding complications before treatment using warfarin patients.

Nager Syndrome Co-Harboring Mutation Consistent with Stickler Syndrome: A Rare Case Report

Nager syndrome, or preaxial acrofacial dysostosis, is a rare malformation characterized by abnormalities of the craniofacial skeleton and limbs. Although most cases are sporadic and some cases have been demonstrated to have an autosomal dominant or recessive mode of inheritance, SF3B4 haploinsufficiency is the most common genetic abnormality identified in this, of which only around 100 cases have been reported so far in the literature. Classically characterized by ante-mongoloid slant, retrognathia, midface retrusion and proximal limb abnormalities like thumb aplasia or hypoplasia, arachnodactyly and radioulnar synostosis, the significant morbidity and mortality in this challenging condition is primarily due to airway abnormalities causing respiratory obstruction. We report a case of genetically confirmed Nager syndrome simultaneously harbouring a mutation consistent with Stickler syndrome type II.

Respiratory compromise in French bulldogs presented with intervertebral disc extrusion.

French bulldogs hospitalised for the management of intervertebral disc extrusion (IVDE) are frequently affected by respiratory compromise, typically brachycephalic-associated upper respiratory obstruction and/or aspiration events. We evaluated the occurrence of such respiratory compromise events in French bulldogs presented to two referral hospitals. Clinical data for French bulldogs diagnosed with IVDE were retrospectively collated, including severity of neurological deficits, neuroanatomical localisation, diagnosis, details of respiratory compromise, treatment and outcome. A total of 306 dogs diagnosed with IVDE were included. Sixty dogs (19.6%) experienced respiratory compromise, of which 31 dogs (10.1%) progressed to cyanosis, collapse or respiratory arrest. The study was limited by its retrospective nature. Furthermore, the duration of hospitalisation was not evaluated and the decision for euthanasia was often multifactorial. One in five French bulldogs presented with IVDE experienced respiratory compromise. The detrimental welfare effects of this warrant further discussion.

Bronchial Asthma, Airway Remodeling and Lung Fibrosis as Successive Steps of One Process.

Bronchial asthma is a heterogeneous disease characterized by persistent respiratory system inflammation, airway hyperreactivity, and airflow obstruction. Airway remodeling, defined as changes in airway wall structure such as extensive epithelial damage, airway smooth muscle hypertrophy, collagen deposition, and subepithelial fibrosis, is a key feature of asthma. Lung fibrosis is a common occurrence in the pathogenesis of fatal and long-term asthma, and it is associated with disease severity and resistance to therapy. It can thus be regarded as an irreversible consequence of asthma-induced airway inflammation and remodeling. Asthma heterogeneity presents several diagnostic challenges, particularly in distinguishing between chronic asthma and other pulmonary diseases characterized by disruption of normal lung architecture and functions, such as chronic obstructive pulmonary disease. The search for instruments that can predict the development of irreversible structural changes in the lungs, such as chronic components of airway remodeling and fibrosis, is particularly difficult. To overcome these challenges, significant efforts are being directed toward the discovery and investigation of molecular characteristics and biomarkers capable of distinguishing between different types of asthma as well as between asthma and other pulmonary disorders with similar structural characteristics. The main features of bronchial asthma etiology, pathogenesis, and morphological characteristics as well as asthma-associated airway remodeling and lung fibrosis as successive stages of one process will be discussed in this review. The most common murine models and biomarkers of asthma progression and post-asthmatic fibrosis will also be covered. The molecular mechanisms and key cellular players of the asthmatic process described and systematized in this review are intended to help in the search for new molecular markers and promising therapeutic targets for asthma prediction and therapy.