Asthma, obesity and targeted interventions: an update

Purpose of review Obese asthma is now widely recognized as a phenotype of difficult asthma that is common and less responsive to traditional asthma treatments, so identifying specific treatments is increasingly important. Recent findings Obesity can lead to asthma through a complex relationship of causes including mechanical, inflammatory, metabolic and genetic factors. Exercise programmes including pulmonary rehabilitation, weight loss via dietary restriction, exercise and bariatric surgery, or combinations of all of these can improve quality of life, symptoms, and exercise capacity, with reductions in medication use and exacerbations, and represent tailored treatment for this phenotype of severe difficult to treat asthmatic patients. Summary Exercise programmes and pulmonary rehabilitation, weight loss programmes targeting 5–10% weight loss and bariatric surgery are effective treatments for the obese asthma phenotype. Correspondence to Douglas C. Cowan, Room 17, 4th Floor Walton Building, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, UK. Tel: +1 412115451; e-mails: Douglas.cowan@ggc.scot.nhs.uk Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Influence of Immunological Maturity on Respiratory Syncytial Virus-Induced Morbidity in Young Children

Viral Immunology, Ahead of Print.


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Association of Single Nucleotide Polymorphisms in TNFA and IL10 Genes with Disease Severity in Influenza A/H1N1pdm09 Virus Infections: A Study from Western India

Viral Immunology, Ahead of Print.


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Clinical Significance of B7-H3 Expression During the Progression of Hepatitis B Virus Infection

Viral Immunology, Ahead of Print.


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Contribution of Vaccination to Human Health

Viral Immunology, Ahead of Print.


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Anti-Bovine Podoplanin Monoclonal Antibody PMab-44 Detects Goat Podoplanin in Immunohistochemistry

Monoclonal Antibodies in Immunodiagnosis and Immunotherapy, Ahead of Print.


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Russell-Silver syndrome with cleft palate: a case report

Abstract

Background

Russell-Silver syndrome (RSS) is characterized by intrauterine growth retardation, short stature without postnatal catch-up growth, and an inverted triangular face with relative macrocephaly. There have been few case reports of RSS with cleft palate, in which perioperative problems such as difficult intubation due to trismus and impossibility to wear a mouth gag due to growth failure of the mandible were described. The case of a female RSS patient with cleft palate who underwent palatoplasty is reported.

Case presentation

Although her weight was particularly low (5920 g), palatoplasty was performed under general anesthesia at 3 years and 6 months of age. Despite limited mouth opening, intubation was relatively easy. Although her mandibular alveolar width was narrow, a Dingman mouth gag could be tightly fastened around her mouth. Postoperatively, the patient was transferred to the intensive care unit without extubation due to pharyngeal edema. On the following day, since the pharyngeal edema had improved, the endotracheal tube was extubated, and her respiratory status was subsequently stable.

Conclusions

In RSS patients with cleft palate, there have been a few reports of pharyngeal edema. Thus, the risk of pharyngeal edema must be considered in such patients.

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