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Developmental Changes in the Respiratory System of the Neonate-Child
Published in Susmita Chowdhuri, M Safwan Badr, James A Rowley, Control of Breathing during Sleep, 2022
Ahuva Brown, Liran Tamir Hostovsky, Estelle B Gauda
Bronchial and pulmonary C-fiber receptors are unmyelinated vagal fibers that are found throughout the airway from the nose to the alveoli. The bronchial C-fibers are activated by stimuli in the bronchial circulation, while pulmonary C-fibers are activated by stimuli in the pulmonary circulation. Both are identified via their activation by capsaicin, found in hot peppers. They are both responsive to and activated by inflammatory mediators (52). The reflex response to C-fiber activation can include cough, apnea, broncho- and laryngospasm, rapid shallow breathing, and hypotension. Lung edema activates C fibers called Juxtacapillary receptors in the alveolar wall, which causes rapid shallow breathing (53). However, in infants, prolonged expiratory apnea is the most common response to C-fiber activation. Apnea is often an early sign of inflammation in infants that can be induced by C-fiber activation (54) and viral infections (55). Of interest, C-fibers can be sensitized by prenatal exposure to nicotine (56), explaining the association between increased incidence of SIDS in infants with upper airway infection who have also been exposed prenatally to cigarette smoke (reviewed in (57)).
Sudden Unexpected Death and Epilepsy
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
Seizure type has not been fully evaluated in relation to SUD. Generalized tonic-clonic seizures are the most frequent seizure type suffered by patients who suddenly die (11–13). It is unclear whether these seizures are primarily or secondarily generalized. Partial seizures are frequently associated with autonomic changes (32,33). Expiratory apnea, inhibited respirations, tachycardia, bradycardia, and increased blood pressure are all examples of these changes. Cardiac dysfunction has been seen with seizures (3337). Atrial fibrillation, palpitations, angina, syncope, and cardiac arrest have been described. The location of the seizure focus may have an effect on the frequency of SUD. Lesions in different areas of the nervous system cause varying cardiorespiratory changes (38,39). For example, subarachnoid hemorrhage or intracerebral blood can lead to fatal cardiac dysrhythmias.
Nonobstructive Sleep Patterns in Children
Published in Mark A. Richardson, Norman R. Friedman, Clinician’s Guide to Pediatric Sleep Disorders, 2016
Chiari malformation Type II (CM-II) is usually diagnosed shortly after birth, as it is always associated with a myelomeningocele. In CM-II, there is caudal displacement of the cerebellar vermis and brainstem. Hydrocephalus is common and must be treated. The increased intracranial pressure from untreated hydrocephalus may worsen the cerebellar and brainstem herniation of the CM-II lesion. Respiratory complications are common and potentially fatal. Inspiratory stridor requires prompt evaluation for vocal paralysis and manifests as obstructive apnea. Babies with CM-II demonstrate a unique and dramatic form of apnea associated with painful or startling experiences in which the child has a complete cessation of respiratory movements resulting in cyanosis (24). This prolonged expiratory apnea with cyanosis (PEAC) can lead to bradycardia and death. Nonfatal events can be mistaken for prolonged breath-holding spells. Though less common, older children with CM-II present with symptoms similar to CM-I and similar to CM-I can develop syringomyelia.
Effects of hypopressive exercises on post-partum abdominal diastasis, trunk circumference, and mechanical properties of abdominopelvic tissues: a case series
Published in Physiotherapy Theory and Practice, 2023
Miriam Ramírez-Jiménez, Francisco Alburquerque-Sendín, Juan Luis Garrido-Castro, Daiana Rodrigues-de-Souza
Five postures were selected from the basic protocol, three of which were performed in standing, one in sitting and one in supine. In each position, after the application of the previously described technical and postural indications, three hypopressive maneuvers were performed, consisting of: 1) Three slow, deep diaphragmatic breaths; 2) At the end of the third expiration, the participant had to exhale the air to the reserve volume; 3) Expiratory apnea for 10 seconds (during the first sessions) to 25 seconds (maximal duration at the end of the intervention), during which the participant focused on expanding the chest by moving the ribs in an upward and outward direction during which no exchange of air occurred; and 4) The expiratory apnea should lead to a superior displacement of the tendinous center of the diaphragm, in an attempt to move the abdominal wall toward the lumbar spine. Thus, each exercise was repeated three times (i.e. three apneas separated by three diaphragmatic breaths each). The five positions selected for this study are further described and illustrated in Supplemental Material 1.
Novel imaging modalities in detection of cardiovascular involvement in ankylosing spondylitis
Published in Scandinavian Cardiovascular Journal, 2018
Demet Ozkaramanli Gur, Derya Necmiye Ozaltun, Savas Guzel, Banu Sarifakioglu, Aydin Akyuz, Seref Alpsoy, Ozge Aycicek, Derya Baykiz
Three consecutive cardiac cycles were recorded at end expiratory apnea for subsequent offline analysis of LV deformation. Syngo Siemens software package which utilizes velocity vector imaging (VVI) was used for the evaluation of layer specific LV strain and strain rates. The methods of image acquisition and post processing for LV strain were carried out as described previously [15]. Layer-specific longitudinal strain (LS), circumferential strain (CS), radial strain (RS) and strain rate (SR) parameters were calculated from appropriate windows as described in the literature [15]. Only absolute values of the strain parameters are reported. Deformation imaging of the aorta was performed from parasternal long axis view. Since the dedicated software does not have aortic wall strain; we used apical two chambers view of LV to evaluate aortic deformation. Biesevicience et al [16] used a similar method to evaluate biomechanics of dilative aortas. The inner contour of the proximal aortic wall was traced during systole, and the region of interest was corrected manually by adjusting the diameter. The apical segments of the LV analysis in standard apical two chambers view were omitted and six segments were reduced to four, dividing aortic wall into two anterior and two posterior segments. Anterior and posterior aortic wall strain parameters were evaluated separately (Figure 1).
Diaphragm ultrasonography in adults with sickle cell anemia: evaluation of morphological and functional aspects
Published in Hematology, 2020
Rachel Zeitoune, Roberto Mogami, Ana Celia Baptista Koifman, Agnaldo Jose Lopes, Andrea Ribeiro Soares, Rosangela Aparecida Gomes Martins, Maria Christina Paixão Maioli
Muscle thickness was measured using a frozen image, from one hyperechoic line to the other, with the cursors positioned in the center of the muscle (Figure 1). Three thickness measurements were performed for each hemidiaphragm, expressed in centimeters, during inspiratory apnea (total lung capacity – TLC), and 3 measurements were performed during expiratory apnea (functional residual capacity – FRC) by calculating the average of the measurements for each manoeuvre [31]. Furthermore, the diaphragm thickening fraction (DTF) (thickness in inspiratory apnea – expiratory apnea/thickness in expiratory apnea × 100%), which quantifies the degree of muscle thickening from FRC to TLC, was calculated.