A Novel Pharyngeal Clearance Maneuver for Initial Tracheostomy Tube Cuff Deflation in High Cervical Tetraplegia

This report presents a novel technique termed the pharyngeal clearance maneuver, which uses a modified application of the mechanical insufflation-exsufflation device to mobilize “secretion burden” at the portion of the trachea above the tracheostomy cuff during cuff deflation. Utilization of this strategy may reduce the risk of aspiration, infection, and respiratory compromise for patients with high cervical spinal cord injury in the acute rehabilitation setting. It is of particular benefit for those whose cuffs are being deflated for the first time and who may have large secretion volumes above the cuff. It can be further used as needed before speaking trials and swallow therapies. We anticipate that the pharyngeal clearance maneuver may be used in other populations with impaired cough and need for invasive ventilator support because of ventilator pump failure (eg, spinal muscular atrophy, congenital myopathies, obesity hypoventilation, amyotrophic lateral sclerosis, muscular dystrophy, and acute inflammatory demyelinating polyneuropathy).
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Brief Reports Source Type: research

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ConclusionsEDA aggravates steatosis by striking balance between lipid deposition and elimination. It was a potential biomarker of NAFLD.
Source: Clinica Chimica Acta - Category: Laboratory Medicine Source Type: research
CONCLUSIONS: Results of this study provide evidence that obesity affects the expression of the subset of genes related to immune response in the blood and that development of insulin resistance in obese adolescents is associated with strong down-regulation of the expressions of HLA-DRA, HLA-DRB1, HLA-F, and HLA-G genes, which may be contribute to the development of obesity complications. It is possible that transcription factor NFX1 and miR-190b participate in downregulation of HLA-DRA gene expression in the blood of obese adolescents with insulin resistance. PMID: 31517622 [PubMed - in process]
Source: Endocrine Regulations - Category: Endocrinology Tags: Endocr Regul Source Type: research
CONCLUSIONS: Results of this investigation provide evidence that insulin resistance in obese adolescents is associated with gene specific changes in the expression of IGF1, IGF2, IGFBP2, IGFBP5, IGFBP7, and HTRA1 genes and these changes possibly contribute to the development of glucose intolerance and insulin resistance. PMID: 31517621 [PubMed - in process]
Source: Endocrine Regulations - Category: Endocrinology Tags: Endocr Regul Source Type: research
Conclusions: Irisin levels do not differ after the onset of puberty thereafter with the progressing pubertal maturation. This may have important implications when using this adipomyokine in the future for diagnosis or treatment of obesity-related diseases. PMID: 31514491 [PubMed - as supplied by publisher]
Source: JCRPE Journal of Clinical Research in Pediatric Endocrinology - Category: Endocrinology Tags: J Clin Res Pediatr Endocrinol Source Type: research
Publication date: Available online 13 September 2019Source: The Veterinary JournalAuthor(s): K.H. Barnes, K.S. Aulakh, C. LiuAbstractManagement of urinary retention after spinal cord injury in dogs is often needed and can include use of medications to relax the urethral sphincter. This was a retrospective study evaluating two such medications, prazosin and diazepam, and whether dogs treated with these medications had different lengths of hospitalization, urinary continence levels, or development of bacteriuria compared to dogs not receiving these medications after thoracolumbar hemilaminectomy for intervertebral disc herni...
Source: The Veterinary Journal - Category: Veterinary Research Source Type: research
This study aimed to determine the role of the endocardial endothelium (EE) in the cardiac β-adrenergic (β-AR) remodeling at the early phase of endotoxemic shock.Main methodsRats received either lipopolysaccharide (LPS) or saline (control) intravenously. Three hours later, β-AR cardiac contractility was evaluated on papillary muscles with or without a functional EE.Key findingsIsoproterenol-induced contractility was strongly increased in papillary muscles from LPS rats. A similar increase was observed with a β1-AR stimulation, whereas β2-AR and β3-AR produced similar contractility in control an...
Source: Life Sciences - Category: Biology Source Type: research
Publication date: Available online 13 September 2019Source: BiologicalsAuthor(s): Alexandra Douglas-Bardsley, Catpagavalli Asokanathan, Sharon Tierney, Jason Hockley, Kevin MarkeyAbstractPertussis toxin (PT) in its detoxified form is one of the major protective antigens in vaccines against Bordetella pertussis (whooping cough). Reference preparations of native PT are required for the quality control of pertussis vaccines. Stocks of the first WHO International Standard (IS) for PT (JNIH-5) were low and a replacement was required. One candidate material was donated by a vaccine manufacturer to NIBSC. It was formulated, lyoph...
Source: Biologicals - Category: Biology Source Type: research
Authors: Shackleton C, Evans R, Shamley D, West S, Albertus Y Abstract OBJECTIVES: To evaluate the effectiveness of over-ground robotic locomotor training in individuals with spinal cord injuries with regard to walking performance, cardiovascular demands, secondary health complications and user-satisfaction. DATA SOURCES: PubMed, Cochrane, Web of Science, Scopus, EBSCOhost and Engineering Village. STUDY SELECTION: Trials in which robotic locomotor training was used for a minimum of 3 participants with spinal cord injury. DATA EXTRACTION: Independent extraction of data by 2 reviewers using a pre-establis...
Source: Journal of Rehabilitation Medicine - Category: Rehabilitation Tags: J Rehabil Med Source Type: research
In this study we investigated these questions using eye-tracking and a two alternative forced food-choice task after measuring subjective values (attitude extremity) and their accompanying accessibility, certainty, and stability. Understanding this basic decision-making process is key if we are to gain insight on how to combat societal problems like obesity and other issues related to diet. We found that participants allocated more attention to items with lower attitude accessibility, but tended to choose items with higher attitude accessibility. Higher attitude certainty and stability had no effects on attention, but led ...
Source: Journal of Experimental Social Psychology - Category: Psychiatry & Psychology Source Type: research
CONCLUSIONS: Our results support the consensus that the R47H variant is significantly associated with AD. However, we did not find evidence for association of the R47H variant with other neurodegenerative diseases. PMID: 31513029 [PubMed - as supplied by publisher]
Source: Alzheimer Disease and Associated Disorders - Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research
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