New Frontiers in Asthma Chest Imaging.

Modern pulmonary imaging can reveal underlying pathological and pathophysiological changes in the lungs of people with asthma, with important clinical implications. A multitude of imaging modalities are now used to examine underlying structure/function relationships including computed tomography, magnetic resonance imaging, optical coherence tomography, and endobronchial ultrasound. Imaging-based biomarkers from these techniques, including airway dimensions, blood vessel volumes, mucus scores, ventilation defect extent and air trapping extent, often have increased sensitivity compared to traditional lung function measurements, and are increasingly used as endpoints in clinical trials.

A Standardized Extract Improves Knee Joint Function and Cartilage Morphology in Human Volunteers with Mild to Moderate Osteoarthritis in a Randomized Placebo-Controlled Study.

Background And Objective: Roxb. ex Colebr. (Family: Burseraceae; Genus: Boswellia) gum resin (Salai guggul) has profound therapeutic value in Ayurvedic and Unani medicines in alleviating several chronic inflammatory illnesses, including arthritis, asthma, skin and blood diseases, fever, etc.

Pediatric Emergency Care Coordinator Presence and Pediatric Care Quality Measures.

Importance: Higher pediatric readiness has been associated with improved quality and outcomes of care for children. Pediatric emergency care coordinators (PECCs) are a component of pediatric readiness, but the specific association between PECCs and quality-of-care measures is undefined.

Objective: To examine the association between PECC presence and emergency department (ED) performance as reflected by quality-of-care measures.

Vascular risk factors are associated with grey matter atrophy in secondary progressive multiple sclerosis.

Background: Comorbidities including vascular risk factors can be associated with whole and regional brain atrophy in multiple sclerosis (MS). This has been examined in mixed MS cohorts in prospective or observational studies; however, the association between vascular comorbidities (VCM) in secondary progressive MS (SPMS) and brain atrophy has been less well studied. The aim was to investigate the cross-sectional and longitudinal association between VCM, comorbidity burden and brain atrophy in SPMS.

Molecular Mechanism of Action of Endocrine-Disrupting Chemicals on the Respiratory System.

Endocrine-disrupting chemicals (EDCs) are a growing health hazard for humankind and respiratory health in particular. Such chemical compounds are present in the environment and food and may interfere with physiological processes through interference with functions of the endocrine system, making humans more susceptible to various types of diseases. This review aims to discuss the effects of EDCs on the respiratory system.

Addressing the challenges of integrating digital health technologies to measure patient-centred outcomes in clinical registries.

Longitudinal patient registries generate important evidence for advancing clinical care and the regulatory evaluation of health-care products. Most national registries rely on data collected as part of routine clinical encounters, an approach that does not capture real-world, patient-centred outcomes, such as physical activity, fatigue, ability to do daily tasks, and other indicators of quality of life. Digital health technologies that obtain such real-world data could greatly enhance patient registries but unresolved challenges have so far prevented their broad adoption.

Interleukin-38-overexpressing adenovirus infection in dendritic cell-based treatment enhances immunotherapy for allergic asthma via inducing Foxp3 regulatory T cells.

Allergic asthma is a chronic disease tied to unusual immune reactions involving type 2 T helper (Th2) cells specific to allergens. Dendritic cells (DCs) play a crucial role in guiding T-cell responses. Regulatory T (Treg) cells have the ability to suppress effector T-cell responses, and interleukin (IL)-38 is involved in Treg cell differentiation.

Ectopic Thyroid Nodule Hyperplasia: A Case Report.

BACKGROUND We present a rare case of an ectopic thyroid nodule hyperplasia, confirmed postoperatively after excision and histopathological examination of a chronic cervical mass. We discuss the different clinical and therapeutic features of this rare thyroid dysgenesis caused by a defect of migration of the gland along its normal way of descent. CASE REPORT A 48-year-old man with a history of hypertension and asthma presented with dysphagia and a progressively growing firm mass at the anterior part of his neck over the past 6 months.

Pulmonary thromboembolism masquerading as bronchial asthma in a remote medical setup at extreme high altitude.

Pulmonary thromboembolism (PTE) is a life-threatening illness. It is a great masquerader that mimics many respiratory illnesses, warranting a high index of suspicion for diagnosis. It should be suspected when respiratory illnesses do not respond to the expected course of treatment.

Possible Biological Heterogeneity of Airway Mucus Plugs in a Patient with Asthma.

Background: The presence of mucus plugs in the airway is a severe phenotype in patients with asthma; however, the mechanisms and specific treatments are not fully understood.

Purpose: To clarify the efficacy of biologics and the mechanisms for mucus plug in patients with asthma.

Patients And Methods: A 79-year-old Japanese asthmatic woman with high blood eosinophil and fractional exhaled nitric oxide (FeNO) was pointed massive mucus plugs in airway on chest CT imaging.

Run-in periods and treatment outcomes in asthma trials: A narrative review.

Background: The run-in period is an important element of randomized controlled trials, and is often used in respiratory disease trials. The design of the run-in period can greatly impact results and data interpretation, and as such should be designed carefully.

Methods: In this review, we describe the design of run-in periods across six phase 3A trials of triple therapy in asthma, and discuss how differences in run-in period design (specifically the duration, treatment, and reporting of run-in results) may have the potential to alter the interpretation of study outcomes.

Development and Implementation of a Pediatric Pulmonary-Focused Active Learning Curriculum.

Introduction: During the pediatric pulmonary rotation, trainees reported that while the clinical experience was robust, they desired more structured didactic sessions. Self-paced online modules can be an alternative but equally effective teaching tool. Multiple studies demonstrate the benefits of e-learning in medical education.

A decision tree analysis to evaluate the optimal approach to screen allergic bronchopulmonary aspergillosis in asthmatic patients.

Background: Various methods are available to screen for allergic bronchopulmonary aspergillosis (ABPA) in asthma, but their comparative performance remains uncertain.

Objectives: To identify the optimal screening algorithm for ABPA in asthmatic patients and evaluate the crude cost of various diagnostic approaches.

Methods: We performed a post hoc analysis of prospectively collected data from consecutive adult asthmatic patients evaluated for ABPA.

Pulmonary MRI in Newborns and Children.

Lung MRI is an important tool in the assessment and monitoring of pediatric and neonatal lung disorders. MRI can provide both similar and complementary image contrast to computed tomography for imaging the lung macrostructure, and beyond this, a number of techniques have been developed for imaging the key functions of the lungs, namely ventilation, perfusion, and gas exchange, through the use of free-breathing proton and hyperpolarized gas MRI. Here, we review the state-of-the-art in MRI methods that have found utility in pediatric and neonatal lung imaging, the structural and physiological information that can be gleaned from such images, and strategies that have been developed to deal with respiratory (and cardiac) motion, and other technological challenges.

A case of spontaneous pneumomediastinum in a triathlete.

Spontaneous pneumomediastinum is an infrequent condition typically secondary to smoking, illicit drug use, or asthma. The condition often follows barotrauma or bronchial hyperactivity, causing alveolar destruction and air trapping within the mediastinum. Rarely, it may present following strenuous exercise, particularly in tall, thin males, resembling the presentation of pneumothorax.

Hopkins Syndrome: An Uncommon Cause of Weakness in Intensive Care Unit.

Background: Hopkins syndrome is a rare polio-like syndrome, with an incompletely understood pathophysiology, that affects children after asthma crisis.

Methods: A 10-year-old girl was admitted to the intensive care unit following a severe asthma attack, requiring mechanical ventilation for a period of five days. After regaining consciousness, the patient exhibited development of asymmetric flaccid paraparesis.

Development of an inhalable contrast agent targeting the respiratory tract mucus layer for pulmonary ultrasonic imaging.

Impaired mucociliary transport is a distinguishing sign of cystic fibrosis, but current methods of evaluation are invasive or expose young patients to ionizing radiation. Contrast-enhanced ultrasound imaging may provide a feasible alternative. We formulated a cationic microbubble ultrasound contrast agent, to optimize adhesion to the respiratory mucus layer when inhaled.

N-cadherin antagonism is bronchoprotective in severe asthma models.

Severe asthma induces substantial mortality and chronic disability due to intractable airway obstruction, which may become resistant to currently available therapies including corticosteroids and β-adrenergic agonist bronchodilators. A key effector of these changes is exaggerated airway smooth muscle (ASM) cell contraction to spasmogens. No drugs in clinical use effectively prevent ASM hyperresponsiveness in asthma across all severities.