Articles: function.
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Semin Respir Crit Care Med · Dec 2022
Chronic Obstructive Pulmonary Disease and Small Airways Diseases.
The small airways are a common target of injury within the lungs and may be affected by a wide variety of inhaled, systemic, and other disorders. Imaging is critical in the detection and diagnosis of small airways disease since significant injury may occur prior to pulmonary function tests showing abnormalities. The goal of this article is to describe the typical imaging findings and patterns of small airways diseases. An approach which divides the imaging appearances into four categories (tree-in-bud opacities, poorly defined centrilobular nodules, mosaic attenuation, and emphysema) will provide a framework in which to formulate appropriate and focused differential diagnoses.
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Case Reports
Co2 Rebreathing Observed While Using a Bag-Mask Resuscitator With Integrated Manometer: A Case Report.
Bag-mask resuscitators with integrated manometry help reduce the risk of pulmonary injury during manual ventilation. All such devices must function as intended while preventing carbon dioxide rebreathing, as unintended hypercapnia can be harmful in critically ill patients. We describe a case of carbon dioxide rebreathing in a patient suspected of having a brain injury after blunt trauma who was manually ventilated with a widely available bag-mask resuscitator with integrated manometry after emergent intubation. This case highlights the importance of vigilant monitoring of end-tidal carbon dioxide and appropriate troubleshooting and investigation of unexplained findings to mitigate and prevent adverse patient outcomes.
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Perera D, Clayton T, O'Kane PD, et al. Percutaneous revascularization for ischemic left ventricular dysfunction. N Engl J Med. 2022;387:1351-60. 36027563.
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Increased expression of alpha-synuclein (ASYN) and decreased expression of Nurr1 are associated with Parkinson's disease (PD) pathogenesis. These two proteins interact functionally and ASYN overexpression suppresses Nurr1 levels. ASYN pan-neuronal overexpression coupled with Nurr1 hemizygosity followed by Nurr1 repression in aging mice results in the manifestation of a typical PD-related phenotype and pathology. ⋯ However, they displayed increased energy expenditure, reduced striatal dopamine (DA) and prolonged hyperactivity to a novel environment indicating impaired habituation. This DA-ergic dysfunction was observed in young adult '2-hit-DA' mice, persisted throughout life and it was associated with ASYN and Nurr1 synergistic alterations of DAT levels and function. Our experiments indicate that the expression levels of ASYN and Nurr1 are critical in the dysregulation of the nigrostriatal DA system and may be involved in neuropsychiatric aspects of PD.