A framework for understanding shared substrates of airway protection

Deficits of airway protection can have deleterious effects to health and quality of life. Effective airway protection requires a continuum of behaviors including swallowing and cough. Swallowing prevents material from entering the airway and coughing ejects endogenous material from the airway. There is significant overlap between the control mechanisms for swallowing and cough. In this review we will present the existing literature to support a novel framework for understanding shared substrates of airway protection. This framework was originally adapted from Eccles' model of cough28 (2009) by Hegland, et al.42 (2012). It will serve to provide a basis from which to develop future studies and test specific hypotheses that advance our field and ultimately improve outcomes for people with airway protective deficits

Acne Conglobata Associated with Hidradenitis Suppurativa, Disorders of Follicular Occlusion (Case Report)

The author is presenting the case of a 23-year-old female patient with a severe form of acne conglobata, with the first symptoms of the disease occurring as far back as the prepubertal age. In the past year the disease has combined with hidradenitis suppurativa (to be referred to henceforth as “HS”), Hurley stage I, in the axillae and both sides of the inguinal region, with a family history of acne conglobata (both her mother and brother were affected). Further examinations ruled out inflammatory bowel disease because of a lack of further associated symptoms, except for sideropenic anaemia (lesser form) and lower serum values of vitamin D. Up until now the disease has been resistant to treatment, including the long-term treatment of methylprednisolone in combination with isotretinoid as well as dapsone and antibiotics

Methods of Objectifying Cough

Cough is one of the most common symptoms encountered by clinicians. Attempts to measure cough date back to early 1950s and since then, significant progress has been made in understanding cough and many methods have been developed. Methods for cough measurement can be divided into subjective and objective methods and further according to the aspect of cough they assess. Subjective methods for cough assessment provide us with information about patient’s personal experiences of cough and about psychosocial aspect of cough. Most widely used subjective methods include cough severity visual analogue scale, cough severity diaries, and various quality of life questionnaires. Objective methods for cough assessment focus mainly on cough frequency and on cough reflex sensitivity. Most widely used methods from this group include cough monitors and cough inhalation challenges. This review focuses on the most widely used cough measurement methods and points out their advantages and limitations for use in research and clinical practice. The ability to measure cough in clinical and research conditions could be used to determine treatment outcomes, to test new therapies, and to further study pathophysiology and physiology of cough

Severe Recurrent Epistaxis - The Main Symptom of Hereditary Haemorrhagic Teleangiectasia

Hereditary haemorrhagic telangiectasia (HHT), also known as Rendu-Osler-Weber syndrome, is of dominant autosomal inheritance. Pathologic changes of vascular walls cause recurrent episodes of bleeding from many organ systems. Recurrent epistaxis is the first and the most frequent symptom of HHT. The causal therapy is not known but there are many therapeutic procedures improving the overall condition