Singultation: What to Do?

Canadian Health and Care Mall defines singultation as a nonspecific violation of function of external respiration, which occurs as a result of a series of convulsive trembling contractions of the diaphragm and is subjectively manifested in unpleasant short and intense respiratory movements. It sometimes appears in healthy people for no apparent reason and, as a rule, is a harmless, rapidly stopping phenomenon.

Singultation can occur in the following circumstances:

  • general cooling (especially in young children), especially at alcoholic intoxication.
  • overstretching of the stomach (overfilling it with food). According to experts, such involuntary muscle contractions can come from esophagus. Disturbances of swallowing and stuck food in esophagus provoke spasms in the place where esophagus passes into stomach.
  • when diaphragmatic nerve is irritated. The so-called «ordinary» singultation is manifestation of a nervous tic. This occurs under the influence of diaphragmatic nerve, which for unknown reasons transmits excitation to the muscles of diaphragm. As a result, uncontrolled spasms occur.

Hiccups may also be a symptom of certain diseases, for example, in the case of diaphragm irritation at inflammatory process in abdominal cavity. Sometimes it becomes long and painful. Hiccups occur at certain diseases of brain and spinal cord, and can also occur at myocardial infarction, infectious diseases and mental agitation.

In cases of prolonged, persistent singultation, it is necessary to consult a doctor who will determine its cause and prescribe treatment. With development of renal insufficiency, there may also be constant or periodic singultation. It can be the result of development of abscess or tumor in the chest, diaphragm or esophagus. Some people have singultation due to psychological reasons, it resembles reactions at transient paralysis in soldiers who are afraid of fighting. In such cases, singultation is unconscious and reflect desire to avoid very unpleasant events. Some people suffer singultation in postoperative period, which can be a reaction to pain medications.


Symptoms of singultation:

  • sharp contractions of diaphragm, accompanied by brief inhalations and simultaneous protrusion of abdomen;
  • singultation are accompanied by compressed sounds, which are associated with sharp passage of air through closed vocal chink.

Forms of Singultation

Singultation can be physiological (not caused by any diseases) and pathological (abnormal).

Physiological singultation occurs in healthy people. It lasts for a short time (5 — 15 minutes) and does not bring discomfort, it usually disappears by itself.

Pathological singultation may be long- (lasting several hours and even days) and short-term (several minutes). The cause of its occurrence is most often pathological conditions.

According to origin of singultation there are several types:

  • «central» — develops at the defeat of brain and spinal cord, craniocerebral trauma, hysteria (mental illness), certain mental disorders (depression, manic-depressive syndrome), diseases of nervous system (brain and spinal cord tumors);
  • «peripheral» — is observed at lesion of diaphragmatic (originating from spinal cord at the level of cervical vertebrae and controlling diaphragm) and vagus nerves (originating from lower parts of brain and partially controlling esophagus, stomach, intestines and heart);
  • «toxic» — occurs on the background of various poisoning (poisonous mushrooms, stale products, medicines, etc.);
  • «reflected» — is observed at intestinal diseases — enteritis (inflammation of small intestine), enterocolitis (inflammation of large intestine), parasitic diseases (ascarids, pinworms).

What is the reason for this phenomenon? Despite significant achievements of medicine for many years of its existence, there is still no reliable treatment for these minor spasms that cause a person to produce indecent sounds. But do not worry, there are several ways to solve this problem.

To get rid of singultation, you need to stop the spasms of diaphragm and esophagus. This can be done either by distraction or by breathing techniques. Usually this is enough.

When singultation does not stop, you make great efforts to make it disappear. You focus on your chest and deliberately strain diaphragm. But, straining and trying to suppress the next attack of singultation, you only complicate the situation.

Canadian Health and Care Mall recommends to undergo examination in the following cases:

  • if singultation lasts more than an hour;
  • if attacks of singultation occur several times a day or several days a week;
  • if, in addition to hiccups, you have chest pain, heartburn or swallowing disorders.

If you often have singultation or its attacks last for a long time, your doctor may prescribe X-ray examination after taking barium mixture to identify any obstruction in esophagus. To eliminate singultation that is permanent and not associated with any mechanical obstruction in esophagus, the doctor may prescribe certain medications, depending on what your disorders are related to.


Regulatory T Cells in Allergy and Asthma: Targets for Intervention

Targets for InterventionBased on the studies reported here, it is clear that targeting of a number of cell-surface molecules and soluble mediators may be beneficial in asthma. DCs activated with TSLP are involved in the generation of Tr1s in the thymus, but Th2 cells in the periphery. Improved understanding of the signals that drive this divergent pathway may identify novel molecules as targets for intervention either alone, or in combination with TSLP. Signaling of tolerogenic DCs to naive T cells can lead to the development of IL-10-secreting Tr1-like regulatory cells. TGF-P is crucial in the development of CD4 + CD25+ Treg and induces expression of the master regulatory transcription factor Fox p3. While TGF-P has profibrotic characteristics that may compromise its use as a therapeutic, a combination of TGF-P and IL-10 may enhance regulatory function while reducing associated fibrosis. IL-6 is an archetypal proinflammatory cytokine that is able to enhance allergic airway disease and suppress the generation of Treg. Blockade of the IL-6 pathway has already been achieved in other clinical disorders and may prompt studies to evaluate this form of intervention in asthma.44 TSLP induces expression of the Th2 chemokines TARC and MDC, which drive recruitment of Th2 T cells to sites of allergic inflammation. Inhibitors of CC che-mokine receptor 4, the receptor for these molecules, are already being developed for the treatment of asthma.

Continue reading “Regulatory T Cells in Allergy and Asthma: Targets for Intervention”

Canadian Health&Care Mall Observes Defective Regulation in Allergic Diseases and Asthma

autoantigens Compromised regulation may provide an explanation for hyperreactivity to allergens and autoantigens. A number of studies have investigated the possibility that allergen-specific Treg function is defective in individuals with allergic diseases about which you may learn more on Canadian Health&Care Mall via (Fig 2). CD4+CD25+ T cells from grass pollen-allergic individuals were less able to suppress proliferative responses and IL-5 production by CD4+CD25-negative T cells. Moreover, suppression by CD4+CD25+ T cells was further compromised during the pollen season, suggesting that increased allergen dose in vivo may provide a strong enough stimulus to override Treg-mediated suppression.

Other similar studies have also found evidence of defective regulation but with some caveats. For example, CD4+CD25+ T-cell function from birch pollen-allergic subjects and nonallergic control subjects was compared in and out of season. While both groups had equivalent suppression of allergen-induced proliferation and similar suppression of IFN-7, suppression of Th2 responses appeared to be compromised in allergic subjects, as both CD4+CD25+ and CD4+CD25-negative T cells made IL-5 and IL-13 to birch pollen. The findings are consistent with the observation40 that Th2 thymocyte clones were more resistant to regulation by either CD4+CD25+ or CD8+CD25+ regulatory human thymocytes than were Th1 thymocyte clones.

Continue reading “Canadian Health&Care Mall Observes Defective Regulation in Allergic Diseases and Asthma”

Regulatory T Cells in Allergy and Asthma: Allergen-Specific Responses in Nonallergic Individuals

airway hyperresponsivenessCytokine production by allergen-specific T cells is crucial in establishing and maintaining the tolerant or inflammatory context of allergen recognition, Production of Th2 cytokines is associated with allergic diseases including asthma. The nonallergic phenotype has historically been associated either with a failure to recognize the allergen (immunologic ignorance) or the expression of a “protective” Th1 cytokine profile. Indeed, Th1 cytokine profiles have been reported in nonallergic individuals in response to allergen. However, Th1 responses to allergens would be expected to give rise to inflammatory responses such as delayed-type hypersensitivity reactions, which is not generally the case. Thus, allergic individuals respond to allergen with an inflammatory Th2 response, whereas nonallergic individuals appear to make an immune response that is associated with Th1 cytokines but is noninflammatory.

Studies suggest that active regulation is an essential element in maintaining noninflammatory peripheral tolerance to allergens in healthy individuals. Blood T cells were stimulated with aeroallergens and/or food allergens and subsequently selected on the basis of allergen-induced cytokine production. The profile of allergen-specific interferon (IFN)-^ (Th1 marker), IL-4 (Th2 marker), and IL-10 (antiinflammatory cytokine and marker [Tr1] of a population of regulatory T cells [Treg]) production differed between allergic and nonallergic subjects, with the ratio of cell numbers secreting these three cytokines determining the development of a healthy or allergic immune response. Thus, lowTr1 numbers and high Th2 cell numbers resulted in an allergic response, whereas in nonallergic individuals a mixed Th1/Th2 response was associated with a strong IL-10 response.14 Similarly, T-cell clones derived from children persistently allergic to cow milk produced Th2 cytokines (IL-4, IL-13), whereas allergic control subjects without cow milk allergy (but allergic to another food) produced a mixed Th1/Th2 response associated with markedly elevated IL-10 levels. Continue reading “Regulatory T Cells in Allergy and Asthma: Allergen-Specific Responses in Nonallergic Individuals”

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