Author(s) Wong ; Viyasar, Thevarajah; Layton, Benjamin; Lauder, Joshua
Source British Journal of Hospital Medicine (17508460); Nov 2022; vol. 82 (no. 11); p. 369-376
Publication Date Nov 2022
Nitrous oxide, also known as 'laughing gas', is one of the most widely used recreational drugs among teenagers in the UK. Copious inhalation of nitrous oxide may increase intra-alveolar pressure, resulting in barotrauma secondary to alveolar rupture. Pneumomediastinum and subcutaneous emphysema are common clinical findings in nitrous oxide-associated barotrauma. Prolonged nitrous oxide misuse may inactivate vitamin B12 through the alteration of its metabolism, causing demyelination of the central and peripheral nervous system. A spectrum of neurological manifestations has been reported, including peripheral neuropathy, myelopathy and subacute combined degeneration of the spinal cord. Medical therapies and psychosocial interventions aiming at nitrous oxide cessation are important treatment steps to achieve partial or complete recovery from the adverse effects associated with inhalation of nitrous oxide.
Combination fixed-dose beta agonist and steroid inhaler as required for adults or children with mild asthma: A Cochrane systematic review
Author(s) Crossingham I.; Turner S.; Richardson R.; Webb P.; Ramakrishnan S. et al.
Source BMJ Evidence-Based Medicine; 2021
Background: In people with mild asthma poor adherence to regular therapy is common and increases the risk of exacerbations, morbidity and mortality. The use of fixed-dose combination inhalers containing an inhaled corticosteroid (ICS) and a fast-acting beta2-agonist (FABA) is established in moderate asthma, but they may also have potential utility in mild asthma. Objective(s): To evaluate the efficacy and safety of single combined FABA/ICS inhaler only used as needed in people with mild asthma. Design and setting: Cochrane meta-analysis of available trial data. Participant(s): Children aged 12+ and adults with mild asthma.
Author(s) Donovan T.; Milan S.J.; Adatia A.; Solkar Z.; Stovold E. et al.
Source Cochrane Database of Systematic Reviews; Jul 2021; vol. 2021 (no. 7)
Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. To evaluate the effects of subcutaneous omalizumab versus placebo for asthma in adults and children.Copyright © 2021 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Histogram analysis for bedside respiratory monitoring in not critically ill preterm neonates: a proposal for a new way to look at the monitoring data
Author(s) Sur A.; Paria A.
Source European Journal of Pediatrics; 2020
Publication Date 2020
Despite robust evidence in favour of maintaining optimal oxygen saturation targets in the preterm infants, the titration of oxygen is largely dependent on manual observations and transcription. Similarly, notwithstanding the gaining popularity of non-invasive modalities like high-flow nasal therapy, the practices of weaning and escalating support are largely individualized and based on point of care observations. These are often erroneous and lack objectivity. Histogram analysis from patient monitors is an easy and objective way of quantifying vital parameters and their trends. We review the technology and evidence available behind this practice. .
Author(s) Donovan T.; Milan S.J.; Wang R.; Banchoff E.; Bradley P. et al.
Source The Cochrane database of systematic reviews; Dec 2020; vol. 12
Publication Date Dec 2020
BACKGROUND: Exacerbations of chronic obstructive pulmonary disease (COPD) are a major cause of hospital admissions, disease-related morbidity and mortality. COPD is a heterogeneous disease with distinct inflammatory phenotypes, including eosinophilia, which may drive acute exacerbations in a subgroup of patients. Monoclonal antibodies targeting interleukin 5 (IL-5) or its receptor (IL-5R) have a role in the care of people with severe eosinophilic asthma, and may similarly provide therapeutic benefit for people with COPD of eosinophilic phenotype.
Spirometry performed as part of the Manchester community-based lung cancer screening programme detects a high prevalence of airflow obstruction in individuals without a prior diagnosis of COPD
Author(s) Balata H.; Harvey J.; Barber P.V.; Duerden R.; Evison M. et al.
Source Thorax; May 2020
BACKGROUND: COPD is a major cause of morbidity and mortality in populations eligible for lung cancer screening. We investigated the role of spirometry in a community-based lung cancer screening programme.
Intra-pleural fibrinolytic therapy versus placebo, or a different fibrinolytic agent, in the treatment of adult parapneumonic effusions and empyema
Author(s) Altmann E.S.; Crossingham I.; Wilson S.; Davies H.R.
Source Cochrane Database of Systematic Reviews; Oct 2019; vol. 2019 (no. 10)
Background Pleural infection, including parapneumonic effusions and thoracic empyema, may complicate lower respiratory tract infections. Standard treatment of these collections in adults involves antibiotic therapy, effective drainage of infected fluid and surgical intervention if conservative management fails. Intrapleural fibrinolytic agents such as streptokinase and alteplase have been hypothesised to improve fluid drainage in complicated parapneumonic effusions and empyema and therefore improve treatment outcomes and prevent the need for thoracic surgical intervention. Intrapleural fibrinolytic agents have been used in combination with DNase, but this is beyond the scope of this review.
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