Horse choanae are directionally asymmetric / Las coanas de los caballos son direccionalmente asimétricas

SUMMARY: Studies related to the upper respiratory pathway asymmetries are still scarce in the veterinary literature. We present here a study of choanae asymmetries of a pure horses belonging to "Cavall Pirinenc Català" (Pyrenean Horse Breed). For this goal, the palates of 23 dry skulls with no apparent pathologies were photographed and evaluated using geometric morphometrics. On each photo, we identified and digitized a total of 26 points (subset of 2 mid-sagittal, 4 paired landmarks (discrete homologous points) and 10 semilandmarks (points on an outline determined by extrinsic criteria) per side on the choana. Both fluctuating and directional asymmetries appeared statistically significant, the latter accounting more than half of the total variation. The lateral bend observed in horse choanae may be due to the asymmetrically positioned nasal passages. So detected equine choana asymmetry must rather be considered functional, with no clinical implication and presents an important consideration when equine choanae shape.

RESUMEN: Los estudios relacionados con las asimetrías de las vías respiratorias superiores aún son escasos en la literatura veterinaria. Presentamos un estudio de coanas asimetrías de un caballo puro perteneciente al "Cavall Pirinenc Català" (Raza del Caballo de los Pirineos). Para ello, se fotografiaron y evaluaron los paladares de 23 cráneos secos sin patologías aparentes mediante morfometría geométrica. En cada foto, identificamos y digitalizamos un total de 26 puntos (subconjunto de 2 puntos medio sagitales, 4 puntos de referencia emparejados (puntos homólogos discretos) y 10 puntos semillanos (puntos en un contorno determinado por criterios extrínsecos) por lado de la coana. Ambos fluctúan Las asimetrías direccionales aparecieron estadísticamente significativas, representando estas últimas más de la mitad de la variación total. La curvatura lateral observada en las coanas de caballo puede deberse a los conductos nasales asimétricamente posicionados. Por lo tanto, la asimetría de coanas equinas detectada debería considerarse funcional, sin implicación clínica y presenta una importante consideración cuando se forman coanas equinas.

Frequency and effect of type 1 hypersensitivity in patients from India with chronic obstructive pulmonary disease and associated upper airways symptoms

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is now recognized as a systemic disorder with many comorbidities. Atopy in patients with COPD and upper airways symptoms has not been characterized. OBJECTIVE: We investigated the occurrence and impact of aeroallergen sensitisation in patients with COPD and upper airways symptoms.

Progress of biomechanical research on obstructive sleep apnea hypopnea syndrome / 医用生物力学

Obstructive sleep apnea hypopnea syndrome (OSAHS) is a kind of disease characterized by repetitive pharyngeal collapse during sleep, and its pathogenesis involves multiple aspects. In this paper, from the aspect of biomechanics, various factors that might induce sleep apnea were studied based on anatomic and physiological characteristics of human upper respiratory system, and biomechanical models of OSAHS reported in recent years as well as potential mechanical pathogenesis of OSAHS were then analyzed. Finally, the prospects of future researches on OSAHS biomechanics were discussed. Establishing the biomechanical model of upper airways is an effective method not only important for studying pathogenesis of OSAHS, but also helpful for preoperative assessment and postoperative predictions for OSAHS treatment in clinic.

Chronic cough in subjects with upper airway diseases

Cough is the commonest respiratory symptom leading to a medical consultation. Although acute cough which is usually associated with respiratory viral infection is not a problem to manage, chronic cough is frequently a diagnostic and therapeutic challenge as it does not respond to usual treatments. Specific group of chronic coughers are considered to have upper airway diseases, lately categorized as having upper airway cough syndrome. There is an increasing pool of evidence that upper airway diseases have significant involvements in the regulation of cough reflex, indicating that they must be taken into considerations as major triggers of coughing in the patients. Here we summarize current literature and experiences on the pathogenesis of upper airway cough syndrome, and discuss further clinical applications.

Upper airway collapsibility evaluated by a negative expiratory pressure test in severe obstructive sleep apnea

OBJECTIVES: To investigate the usefulness of measuring upper airway collapsibility with a negative expiratory pressure application as a screening test for severe obstructive sleep apnea (OSA). INTRODUCTION: OSA is a risk factor for cardiovascular disease, and it may have serious consequences. Its recognition may have important implications during the perioperative period. Increased upper airway collapsibility is one of the main determinants of OSA, and its evaluation could be useful for identifying this condition. METHODS: Severe OSA and normal subjects (24 in each group) were matched by body mass index and referred to our sleep laboratory. The subjects were enrolled in an overnight sleep study, and a diurnal negative expiratory pressure test was performed. Flow drop (DV) and expiratory volume were measured in the first 0.2 s (V02) of the negative expiratory pressure test. RESULTS: DV ( percent) and V02 ( percent) values were statistically different between normal and OSA subjects. OSA patients showed a greater decrease in flow than normal subjects. In addition, severely OSA patients exhaled during the first 0.2 s of the negative expiratory pressure application was an average of only 11.2 percent of the inspired volume compared to 34.2 percent for the normal subjects. Analysis of the receiver operating characteristics showed that V02 ( percent) and DV ( percent) could accurately identify severe OSA in subjects with sensitivities of 95.8 percent and 91.7 percent, respectively, and specificities of 95.8 percent and 91.7 percent, respectively. CONCLUSIONS: V02 ( percent) and DV ( percent) are highly accurate parameters for detecting severe OSA. The pharyngeal collapsibility measurement, which uses negative expiratory pressure during wakefulness, is predictive of collapsibility during sleep.

A negative expiratory pressure test during wakefulness for evaluating the risk of obstructive sleep apnea in patients referred for sleep studies

OBJECTIVE: Obstructive sleep apnea is characterized by increased upper airway collapsibility during sleep. The present study investigated the use of the negative expiratory pressure test as a method to rule out obstructive sleep apnea. METHODS: Flow limitation was evaluated in 155 subjects. All subjects underwent a diurnal negative expiratory pressure test and a nocturnal sleep study. The severity of sleep apnea was determined based on the apneahypopnea index. Flow limitation was assessed by computing the exhaled volume at 0.2, 0.5, and 1.0 s (V0.2, V0.5, and V1.0, respectively) during the application of a negative expiratory pressure and expressed as a percentage of the previous exhaled volume. Receiver-operating characteristic curves were constructed to identify the optimal threshold volume at 0.2, 0.5, and 1.0 s for obstructive sleep apnea detection. RESULTS: Mean expiratory volumes at 0.2 and 0.5 s were statistically higher (p <0.01) in healthy subjects than in all obstructive sleep apneic groups. Increasing disease severity was associated with lower expiratory volumes. The V0.2 ( percent) predictive parameters for the detection of sleep apnea were sensitivity (81.1 percent), specificity (93.1 percent), PPV (98.1 percent), and NPV (52.9 percent). Sensitivity and NPV were 96.9 percent and 93.2 percent, respectively, for moderate-to-severe obstructive sleep apnea, and both were 100 percent for severe obstructive sleep apnea. CONCLUSION: Flow limitation measurement by V 0.2 ( percent) during wakefulness may be a very reliable method to identify obstructive sleep apnea when the test is positive and could reliably exclude moderate and severe obstructive sleep apnea when the test is negative. The negative expiratory pressure test appears to be a useful screening test for suspected obstructive sleep apnea.