جستجوی مقالات مرتبط با کلیدواژه "trachea" در نشریات گروه "پزشکی"

Endotracheal intubation is a common procedure during tonsillectomy in children, and tracheal tube cuff pressure is subjected to fluctuation during this surgery due to changes in the position of the head and neck. Unusual changes in the tracheal cuff pressure can cause damage to the airway mucosa, tracheal mucosa ischemia, tracheal stenosis, and pulmonary aspiration.

The present study was conducted to investigate tracheal tube cuff pressure changes and associated factors during tonsillectomy surgery in children.

This cross-sectional study was conducted on 106 children, 3-8 years of age. In this study, the ideal tracheal tube cuff pressure was designated to be 18 cmH2O and measured at four stages phases: after tracheal intubation, after changing the position of the head and neck, 15 minutes after intubation, and before extubation. The data was analysed using SPSS statistics version 26. Frequency (percentage), and mean (standard deviation), as well as Wilcoxon, Friedman, linear regression, and Wald chi-square tests were used for data analysis.

The means (standard deviations) of the cuff pressure following after intubation, after subsequent to changing the position of the head and neck, 15 minutes after intubation, and prior to before extubation were 26.69 (6.10), 29.07 (8.39), 29.91 (5.77), and 24.12 (4.72), respectively. The baseline cuff pressure had no statistically significant relationship with age, gender, tube size, BMI, and cuff pressure changes at the 15th minute (P>0.05). The two variables of, gender and tube size, but not age and BMI (P>0.05), were significantly correlated with cuff pressure change prior to extubation compared with baseline line cuff pressure (P<0.05), but eithr age or BMI werenot significantly related to the change in cuff pressure prior to extubation compared with baseline cuff pressure (P>0.05).

Tracheal tube cuff pressure during tonsillectomy in children can increase due to the change of head and neck position, making monitoring of these changes necessary in patients undergoing tonsillectomy.

Tracheal injuries are relatively rare; however, their mortality rate is relatively high. Complete disruption of the trachea is extremely rare, and a systematic approach is required for early diagnosis and favorable outcomes. This is a case report of a 17-year-old male admitted to the emergency room after a motor vehicle accident. He was agitated and in respiratory distress with labored breathing and urgently intubated orotracheally. In the first flexible bronchoscopy, the diagnosis of the tracheal transaction was missed. Due to saturation drop and high peak ventilator pressures on the seventh day, the flexible bronchoscopy examination was performed in the operating room. This measure revealed complete tracheal transection in midportion. Neck exploration demonstrated complete tracheal transection. The area was debrided, and primary end-to-end anastomosis was performed. The patient was extubated at the end of the surgery.

Tracheal chondrosarcoma (TCS) is a rare malignancy, with only 19 cases described in the literature to date.

Herein, we presented the third-largest TCS with such an airway compromise that neither orotracheal intubation nor jet ventilation or even tracheostomy was possible. So, extracorporeal circulation was needed to excise the tumor in a one- stage procedure. The patient presented no tumor recurrences after surgery during an approximate7-years follow-up. So open surgical resection and end-to-end anastomosis probes may be applied as a safe and successful treatment. A review of the previous literature revealed no extracorporeal circulation in previous practices.

Management of tracheal chondrosarcoma is challenging due to its airway compromise during the procedure. Different treatment modalities have been advised but none of them included extracorporeal circulation as an option. We believe that this approach allows for better control of the resection and ensures better oxygenation of the patient.

Avian respiratory disease complex (RDC) is one of the most detrimental economic diseases that affected different parts of the world. Various pathogens cause the disease, but the most significant viral pathogens include avian influenza virus (AIV), infectious bronchitis virus (IBV), and Newcastle disease virus (NDV) are the most prevalent. To detect these pathogens, various methods have been discovered in the last decades. Detection and characterization of viruses by metagenomics methods have improved our knowledge about the role of virome in the avian complex respiratory disease.

This research investigates the viral pathogen populations that mostly participate in emerging these diseases using the NGS method RNA-sequencing. In surveillance of ten broiler farms from different cities with respiratory symptoms, trachea samples were collected to determine the pathogenic virome causing the disease.

In this metagenomics analysis, nine viral families were identified, comprising 72.82% of RNA viruses, 24.32% of RT viruses, and 2.86% of DNA viruses. RNA viruses had the highest contribution to the respiratory disease complex instead of disease, including paramyxoviridae, orthomyxoviridae, coronaviridae, and picornaviridae viruses. Other viruses from the RNA viruses and DNA virus families were also identified in addition to these results.

This research suggests that studies of pathogenic viromes in different diseases can help monitor different diseases and predict their future occurrence.

Caffeic acid phenethyl ester (CAPE) is one of the major components of honeybee propolis and its structure is similar to flavonoids. CAPE has been shown to possess anti-inflammatory, immunomodulatory, and antioxidant properties. Despite a wide range of biological activities of CAPE, detailed biochemical mechanisms of its action are poorly described. The aim of the present study was to investigate the in vitro effect of CAPE on isolated rat trachea.

A 20 mm long portion of rat tracheal spiral was submerged in 20 ml Krebs solution in an isolated organ bath at 37°C. Changes in tracheal contractility in response to the application of agonist agents were measured using an isometric transducer connected to a Harvard polygraph.

Acetylcholine (ACH), histamine (HIS), and CaCl2 caused the trachea to contract in a dose-dependent manner. Incubation of trachea with 10-7 M and 10-6M of CAPE induced a significant reduction in contraction induced by ACH and HIS. The degree of drug-induced tracheal contraction or relaxation was dose-dependent.

The CAPE potential to relax the trachea may antagonize cholinergic and histaminergic receptors of the trachea. The findings provide new insight into the effectiveness of CAPE in the control of asthma and the possible use of propolis for its treatment. The results highlight the anti-muscarinic, anti-histaminic, anti-inflammatory, and relaxant activities of CAPE and critically show its potential therapeutic effects.

This study was conducted to evaluate the possible mechanisms of the relaxant effects of hydroalcoholic extract of Plantago major (P. major) on tracheal smooth muscle (TSM) in rats. The effects of cumulative concentrations of P. major (5, 10, 20 and 40 mg/mL) and theophylline (0.2, 0.4, 0.6 and 0.8 mM) were evaluated on pre-contracted TSM with 10 μΜ methacholine or 60 mM KCl. To determine the possible mechanisms, the relaxant effect of the plant was also examined on incubated TSM with atropine, indomethacin, chlorpheniramine, glibenclamide, diltiazem, papaverine, and propranolol. The results indicated concentration-dependent relaxant effects for P. major in non-incubated TSM contracted by methacholine or KCl. There was no statistically significant difference in the relaxant effects of P. major between non-incubated and incubated tissues with indomethacin, papaverine, and propranolol. However, the relaxant effects of P. major in incubated tissues with atropine (p<0.01 to p<0.001), chlorpheniramine (p<0.05 to p<0.001), glibenclamide (p<0.05), or diltiazem (p<0.01) were significantly lower than non-incubated TSM. P. major indicated relatively potent relaxant effects which were lower than those of theophylline. Muscarinic and histamine (H1) receptors inhibition, as well as calcium channel blocking and potassium channel opening effects are suggested to contribute to the TSM relaxant effect of the plant.

Usually, the endotracheal tube cuff pressure is controlled by cuff pressure monitoring. However, the intermittent pilot‑manometer connection and disconnection may cause a change in the adjusted pressure. This study aimed to investigate changes in the endotracheal tube cuff pressure using both manual and intermittent controls.

A semi‑experimental within‑subject design was conducted. Fifty‑nine intubated patients in the Mazandaran Intensive Care Units (ICUs) participated through convenience sampling in 2018. In the control condition, first, the cuff pressure was adjusted in 25 cm H2O then it was measured without manometer‑pilot disconnection at 1 and 5 min intervals. In the intervention condition, cuff pressure was immediately adjusted in 25 cm H2O then it was measured with manometer‑pilot disconnection in the 1st and 5th minutes. Data analysis was performed using Independent t‑test, Chi‑square test, and Phi coefficient.

The mean and Standard Deviation (SD) change of cuff pressure after 1 minute, from 25 cm H2O, in the intervention condition was 20.22 (3.53) cm H2O. The mean (SD) of this change in the control condition was 25.22 (3.39) cm H2O. This difference was significant (t116 = 7.83, p < 0.001, d = 1.44). The mean (SD) change of cuff pressure after 5 minutes, from 25 cm H2O, in the intervention condition was 19.11 (2.98) cm H2O. The mean (SD) of this change in the control condition was 25.47 (4.53) cm H2O. This difference was significant (t116 = 9.24, p < 0.001, d = 1.70).

The tracheal tube cuff pressure has been significantly reduced during manual intermittent measuring. Therefore, it is suggested that continuous cuff pressure monitoring and regulation should be used.

Baicalein, a compound extracted from a variety of herbs, showed various pharmacological effects. This study evaluated the relaxant effects of baicalein and its underlying molecular mechanisms of action on rat’s isolated tracheal smooth muscle. Tracheal smooth muscle were contracted by 10 μM methacholine or 60 mM KCl and the effects of cumulative concentrations of baicalein (5, 10, 20 and 40 mg/ml) and theophylline (0.2, 0.4, 0.6 and 0.8 mM) were evaluated. To examine the possible mechanism(s) of the relaxant effect of baicalein, its effect was also evaluated on incubated tissues with atropine, indomethacin, diltiazem, N(G)-Nitro-L-arginine methyl ester (L-NAME), glibenclamide, propranolol and chlorpheniramine. A concentration-dependent and significant relaxant effect was seen for baicalein in non-incubated tissues contracted by KCl or methacholine (P A potent relaxant effect comparable to the effect of theophylline was shown for baicalein, which was probably mediated via inhibition of histamine (H1) receptors, stimulation of beta2-adrenergic receptors and potassium channels activation.

Dracocephalum kotschyi is a native Iranian plant with antispasmodic activities on smooth muscles such as ileum and uterus. However, so far antispasmodic effect of D. kotschyi on tracheal smooth muscle has not been reported. Therefore, the objective of this research was to investigate antispasmodic activity of D. kotschyi extract and two of its components luteolin and apigenin on rabbit tracheal contraction in vitro.

Rabbits were euthanized by carbon dioxide and the trachea was dissected and immersed in a Tyrode’s solution. Tracheal rings were prepared and mounted vertically in an organ bath at 37°C and gassed continuously with O2. The tracheal ring preparations were contracted with acetylcholine (ACh) and KCl. The isotonic tension was recorded before and after addition of aminophylline, apigenin, luteolin or flavonoids rich extract of D. kotschyi. Flavonoids rich extract were prepared from D. kotschyi using solvent-solvent fractionation technique.

Standard drug aminophylline, prevented tracheal ring preparation contracted with ACh. Cumulative addition of aminophylline also attenuated tonic contraction induced by KCl on tracheal smooth muscle. D. kotschyi extract at concentration ranges of 32-512 µg/mL in a concentration dependent manner inhibited KCl and ACh induced tracheal contraction. Apigenin and luteolin (range 16–512 µg/mL) relaxed KCl and ACh-induced contraction of tracheal smooth muscle in vitro in a concentration-dependent manner.

This study demonstrated that D. kotschyi extract is a relaxant of tracheal smooth muscle. The relaxant effect of D. kotschyi extract could be due to its flavonoids component such as apigenin and luteolin.

Crocin, a component of saffron, showed hypotensive which is perhaps due to vascular smooth muscle relaxant effect. The relaxant effects of saffron on tracheal smooth muscle also could be due to its constituent, crocin. In the present study, the relaxant effects of crocin and its possible mechanisms on rat tracheal smooth muscle were investigated. The relaxant effects of three cumulative concentrations of crocin (30, 60, and 120 μM) or theophylline (0.2, 0.4, 0.6 mM) as positive control was examined on pre-contracted tracheal smooth muscle by methacholine or KCl in non-incubated or incubated conditions with different agents including atropine, chlorpheniramine, indomethacin, diltiazem, glibenclamide and propranolol. In non-incubated tracheal smooth muscle, crocin showed significant relaxant effects on KCl induced muscle contraction (p

In this study we aimed to examine the relaxant effect of berberine, a compound extracted from a variety of herbs, on rat tracheal smooth muscle (TSM) and its possible mechanism(s). Cumulative concentrations of berberine (20, 65, 200 and 600 μg/mL) were added on pre-contracted TSM by methacholine or KCl in non-incubated or incubated tissues with atropine, chlorpheniramine, propranolol, diltiazem, glibenclamide, indomethacin, L-NG-nitro arginine methyl ester (L-NAME) and papaverine. The relaxant effects of theophylline (0.2, 0.4, 0.6 and 0.8 mM) as positive control and saline (1 mL) as negative control were also examined in non-incubated tissues. Berberine showed significant and concentration-dependent relaxant effects in non-incubated tissues contracted by KCl and methacholine (p<0.01 to p<0.001). There was no significant difference in the relaxant effects of berberine between non-incubated and incubated tissues with atropine, propranolol, diltiazem, glibenclamide, and papaverine. The relaxant effects of second concentrations of berberine in incubated tissues with L-NAME, its three lower concentration in incubated tissues with chlorpheniramine and its all concentrations in incubated tissues with indomethacin were significantly lower than non-incubated tissues (p<0.05 to p<0.001). The EC50 values of berberine in incubated tissues with chlorpheniramine was significantly higher than the non-incubated condition (p<0.05). Our findings reveal a relatively potent relaxant effect of berberine that is lower than the effect of theophylline. Proposed mechanisms for the relaxant effect of berberine are histamine (H1) receptor blockade, inhibition of cyclooxygenase pathways and/or nitric oxide formation.

Penetration injury to the neck constitutes 5–10% of all trauma cases. Penetration of a foreign body into the trachea with subsequent impaction into the tracheoesophageal party wall is extremely rare. We present a patient with an unusual penetrating injury of the neck caused by a metallic foreign body embedded into the tracheoesophageal party wall, and its management.

Case Report: A 35-year-old male presented to the emergency department with a history of accidental penetrating injury on his neck, with severe pain and bleeding from the wound entry site. On neck examination, there was an open wound, 0.5 × 0.5 cm in size, in the lower-third anterior aspect of the neck with surrounding neck swelling and tenderness. Computed tomography showed a radio-dense foreign body lodged in the tracheoesophageal party wall at the level of the second and third tracheal rings, which was removed successfully. Impacted foreign body following a penetrating wound in the neck needs considerable assessment and appropriate management.

Tissue engineering and cell-based therapies are promising therapeutic approaches in structural and functional defects of the trachea. Researchers have focused on these approaches to overcome the complications related to such diseases. Patients exposed to mustard gas suffer from massive damage to the respiratory system. Current treatment plans are only palliative and include anti-inflammatory drugs, broncholytics, long-acting β2-agonists, and inhaled corticosteroids. As mustard gas exposure leads to chronic airway inflammation, it seems that tracheobronchomalacia, because of chronic inflammation and weakness of the supporting cartilage, is an important factor in the development of chronic and refractory respiratory symptoms. The previous studies show that regenerative medicine approaches have promising potential to improve the life quality of patients suffering from tracheal defects. It seems that the engineered tracheal graft may improve the respiratory function and decrease symptoms in patients who suffer from asthma-like attacks due to mustard gas exposure. There are several successful case reports on the transplantation of stem cell-based bioartificial grafts in structural airway diseases. Therefore, we hope that the reconstruction of tracheobronchial structure can lead to a decrease in respiratory difficulties in mustard gas-exposed patients who suffer from tracheomalacia. In the present review, we summarize the main aspects of tracheal tissue engineering and cell-based therapies and the possibilities of the application of these approaches in mustard gas-exposed patients.

Tracheal bronchus is a rare congenital bronchial anomaly with a prevalence of 0.1-5.0%. The anomaly is generally asymptomatic in adults and detected incidentally bronchoscopy or radiologic examinations. Herein we report a case of tracheal bronchus in an adult male presenting with recurrent haemoptysis and cough.

The primary tracheal cancers are very rare, and squamous cell carcinoma is its most common form, especially in smokers. Due to the late presentation of symptoms, these tumors are usually diagnosed too late, and thus, they have poor survival. The gold standard protocol for these cancers is surgical excision and adjuvant radiotherapy. Primary radiotherapy is applied for the advanced and inoperable patients.
In this study, we present the case of a 78-year-old woman with a history of heavy smoking, coughing, and dyspnea for a long time. During the diagnostic evaluations, bronchoscopy was carried out and a vegetated tumor was observed about 5 cm below the vocal cords. The patient was referred to the Department of Cardiothoracic Surgery, Ghaem Hospital of Mashhad University of Medical Sciences, Iran, for surgical management. The tumor was removed with rigid bronchoscopy, and her dyspnea temporarily improved. The pathology report indicated that the patient was suffering from squamous carcinoma. Therefore, she required reoperation to excise the invaded trachea with a tumor-free margin. Ultimately, considering no marginal involvement, lymphatic metastasis, or distant metastasis, the patient was discharged and referred to receive additional oncological treatments with the recommendation of annual surveillance bronchoscopy. Seven years after the operation, the patient is still alive and healthy without any local recurrence or metastasis at the age of 82.

Ventilator-associated pneumonia (VAP) is the second most common nosocomial infection in neonates, admitted to neonatal intensive care units (NICUs). The aim of this study was to identify the main causes of bacterial colonization in endotracheal tubes and tracheal secretions of neonates hospitalized in the NICUs of our university hospitals.
This cross sectional study was conducted during 2015-2016. Thirty-nine neonates, who were under mechanical ventilation in the NICUs of Baqiyatallah and Najmiyeh hospitals of Tehran, Iran, were assessed. The patients were selected using the census sampling method. Gestational age, birth weight, duration of mechanical ventilation, length of hospital stay, tracheal discharge culture, endotracheal tube culture, blood culture, and chest radiography were evaluated.
In a total of 39 neonates (50.3% males and 49.7% females) with the mean age of 1.17±1.12 days, bacterial growth was reported in 6 (15.3%) cases. The antibiotic study of tracheal secretion and endotracheal tube cultures showed that 2.6% of patients were resistant to cephalosporins, aminoglycosides, nitrofurantoin, and carbapenem. Moreover, 12.8% were also resistant to fluoroquinolones, besides these antibiotics.
Tracheal secretion culture is a simple and proper approach for the diagnosis of VAP. Besides reducing the costs, this method can play a significant role in decreasing the incidence of infections.

The tracheal cartilage plays an important role in maintaining the mechanical stability of the trachea, as it keeps the trachea open and prevents its collapse under the negative pressures of the respiratory cycle. This study aimed to evaluate and compare the mechanical properties of cartilage specimens from the cranial and caudal regions of the human trachea and compare the results with respect to age and sex of the subjects.
After obtaining human trachea samples from braindead, organ-donating patients and storing them in appropriate conditions, the prepared cartilage samples from the cranial and caudal regions of the trachea were subjected to uniaxial tension and stress relaxation experiments to obtain the corresponding Young’s modulus and relaxation percentage values, respectively. The results were compared in terms of the position (cranial or caudal) in the trachea, and age and sex of the patients.
Based on the results, no statistically significant effect of the position in the trachea on the Young’s modulus of the human tracheal cartilage samples was observed, despite the generally stiffer behavior of cartilage samples from the cranial region compared to those from the caudal region of the trachea. For both the cranial and caudal regions, no significant effect of sex on the stiffness of the tracheal cartilage was observed; further, the cartilage samples of the human trachea (from both cranial and caudal regions) of the old subjects were significantly stiffer than those of the young subjects. Based on the stress relaxation data, no significant effect of age, sex, or position on the relaxation percentage was observed.
The tracheal cartilage samples of the old patients are significantly stiffer than those of the young patients. Sex and position in the trachea (cranial vs caudal) do not significantly influence the mechanical properties of the human tracheal cartilage samples. The results of this study can be useful in designing tracheal tissue-engineered scaffolds, which should be mechanically compatible with the native trachea.

Ibn Sina is regarded as one of the greatest physicians, thinkers and medical scholars in the history of medicine. Ibn Sina, a Persian scholar in the medieval era, wrote a famous book of medicine, the Canon of Medicine. The book was adopted as the main textbook of medicine in most Western and Persian universities. In the present critique, we analyzed the functional and anatomic descriptions of the heart, airways and the lungs as viewed by Ibn Sina in volume three of the Canon of Medicine textbook, and compared them to modern anatomy texts.