Endoscopic treatment of persistent alveolar-pleural air leaks with a unidirectional endobronchial valve

The persistent air leaks due to alveolopleural fistula are not an uncommon complication of pneumothorax, particularly secondary ones. Unidirectional flow endobronchial valves designed for lung volume reduction are the latest incorporation to the therapeutic armamentarium. We present the case of a patient with chronic obstructive pulmonary disease (COPD) with persistent pneumothorax in spite of treatment with three pleurodesis which was able to be resolved with the placement of two IBV? valves.     

Noninvasive ventilation through a helmet in postextubation hypoxemic patients: physiologic comparison between neurally adjusted ventilatory assist and pressure support ventilation

Purpose  

Neurally adjusted ventilatory assist (NAVA) has been shown to improve patient–ventilator interaction and reduce asynchronies in intubated patients, as opposed to pressure support ventilation (PSV). This is a short-term head-to-head physiologic comparison between PSV and NAVA in delivering noninvasive ventilation through a helmet (h-NIV), in patients with postextubation hypoxemic acute respiratory failure.     

Idiopathic hypersomnia: a report of three adolescent-onset cases in a two-generation family

Idiopathic hypersomnia is an uncommon sleep disorder characterized by prolonged sleep time and excessive daytime sleepiness without cataplexy. This study concerned a case of familial occurrence. The proband expressed an idiopathic hypersomnia with long sleep time at the age of 12 years. Clinical interview and ad libitum polysomnographic study did not reveal any symptoms of narcolepsy or other sleep disorders. Family history revealed that a 20-year-old sister had experienced symptoms of hypersomnia from the age of 16 and their mother had been diagnosed with idiopathic hypersomnia previously. The diagnosis of idiopathic hypersomnia with long sleep time was confirmed in the sister by clinical interview and ad libitum polysomnography. Human leukocyte antigen (HLA) did not reveal the DQB1-0602 phenotype in the proband and relatives. This report confirms the hypothesis of a genetic predisposition in idiopathic hypersomnia.