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Biomedical subjects

Ruth Soferman

Publications and source records attributed to Ruth Soferman.

6 recordsLinked to original sources
PubMed2006

Diagnosis of laryngomalacia by fiberoptic endoscopy: awake compared with anesthesia-aided technique.

RATIONALE: Fiberoptic flexible laryngoscopy (FFL) is the diagnostic procedure of choice in patients with laryngomalacia. Two techniques can be applied, either when the infant is awake or using anesthesia/sedation. The choice of technique may effect the diagnosis. STUDY OBJECTIVES: To compare the two techniques for diagnosing laryngomalacia. PATIENTS AND INTERVENTIONS: A total of 42 infants who underwent awake fiberoptic laryngoscopy for congenital stridor, in whom either laryngomalacia was diagnosed or no cause for stridor was found, underwent a repeat laryngoscopy using anesthesia/sedation. The 84 video recordings of the supraglottic portions were copied onto a videotape along with 25 recordings of normal upper airways without stridor and 31 duplicate cases with stridor. A total of 140 recordings was mixed at random on a videotape. Sound was not included. MEASUREMENTS: Three investigators (Y.S., J.B.A., and A.D.) independently scored each recording using a laryngomalacia scoring system (scoring range, 0 to 8). RESULTS: A threshold score of 2 was the optimal cutoff point for discriminating laryngomalacia from normal condition. The awake technique (WT) missed three cases of laryngomalacia and overdiagnosed one healthy control subject. The anesthesia technique was superior with a sensitivity of 100%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 100% compared with 93%, 92%, 97%, and 79%, respectively, for the WT. CONCLUSIONS: The diagnosis of laryngomalacia with FFL is more accurate using anesthesia/sedation. The WT may be appropriate for screening or for patients with mild cases having a characteristic presentation.

Anesthesia↗
PubMed2006

Immunopathophysiologic mechanisms of cystic fibrosis lung disease.

Cystic fibrosis is a life-threatening autosomal recessive disorder with a highly variable clinical presentation. The pathophysiology is related to the mutant transmembrane conductance regulator (CFTR), a chloride channel that is encoded by the CF single gene located on chromosome 7. The variability of the clinical presentations, even among patients carrying the same mutation, is extensive enough to justify the hypothesis that other pathophysiologic mechanisms participate in the evolution of the disease phenotype. Presented here are recent lines of research on the contributing factors to respiratory tract morbidity, as well as the innate defense mechanisms in the CF lungs, the cytokines and chemokines that influence the inflammatory processes, the antioxidative system, and the composition of the airways surface fluid. These studies concluded that the clinical presentation is determined by pathology of the CFTR as well as by other mechanisms, some of which are related to the CFTR functions and others to the products of modifier genes as well as the influence of the environment.

Cystic Fibrosis↗
PubMed2004

Soluble CD14 as a predictor of subsequent development of recurrent wheezing in hospitalized young children with respiratory syncytial virus-induced bronchiolitis.

BACKGROUND: Respiratory syncytial virus (RSV) infection in infancy that causes severe bronchiolitis had been implicated as potentially responsible for the subsequent development of asthma. The CD14 receptor responds to the microbial burden in the environment and modulates the development of the allergic phenotype. OBJECTIVE: To investigate the relationship between the serum level of soluble CD14 (sCD14) in children hospitalized because of RSV-induced bronchiolitis and the subsequent development of recurrent wheezing. METHODS: Serum levels of sCD14 were measured in 21 children younger than 14 months who were hospitalized because of RSV-induced bronchiolitis. The diagnosis of significant wheezing was evaluated by recurrent episodes of coughing, wheezing, and respiratory distress, which were relieved by inhalation of beta-agonists and corticosteroids. RESULTS: Of the 21 children, 19 were followed up for 12 months. The mean sCD14 serum level of 14,521 +/- 1,773 pg/mL in the group of 6 children who did not exhibit recurrent wheezing was significantly higher than the level of 11,243 +/- 3,264 pg/mL in the group of 13 children who exhibited significant recurrent wheezing (P < .05). The subsequent development of recurrent wheezing was not influenced by positive family history of asthma, number of siblings, sex, or breast-feeding. CONCLUSION: A follow-up period of 12 months in this small pilot group showed that high serum levels of sCD14 modulate the influence of RSV on subsequent recurrent episodes of wheezing.

Bronchiolitis, Viral↗