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https://www.readbyqxmd.com/read/28324091/association-between-dabigatran-vs-warfarin-and-risk-of-osteoporotic-fractures-among-patients-with-nonvalvular-atrial-fibrillation
#1
Wallis C Y Lau, Esther W Chan, Ching-Lung Cheung, Chor Wing Sing, Kenneth K C Man, Gregory Y H Lip, Chung-Wah Siu, Joanne K Y Lam, Alan C H Lee, Ian C K Wong
Importance: The risk of osteoporotic fracture with dabigatran use in patients with nonvalvular atrial fibrillation (NVAF) is unknown. Objective: To investigate the risk of osteoporotic fracture with dabigatran vs warfarin in patients with NVAF. Design, Setting, and Participants: Retrospective cohort study using a population-wide database managed by the Hong Kong Hospital Authority. Patients newly diagnosed with NVAF from 2010 through 2014 and prescribed dabigatran or warfarin were matched by propensity score at a 1:2 ratio with follow-up until July 31, 2016...
March 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28316302/high-frequency-oscillatory-ventilation-hfov-as-primary-ventilator-strategy-in-the-management-of-severe-acute-respiratory-distress-syndrome-ards-with-pneumothorax-in-the-setting-of-trauma
#2
Kartik Prabhakaran, Daniel Hagler, Dominick Vitale, Alejandro Betancourt, Patrizio Petrone, Corrado P Marini
No abstract text is available yet for this article.
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28306515/decentralized-safety-concept-for-closed-loop-controlled-intensive-care
#3
Jan Kühn, Christian Brendle, André Stollenwerk, Martin Schweigler, Stefan Kowalewski, Thorsten Janisch, Rolf Rossaint, Steffen Leonhardt, Marian Walter, Rüdger Kopp
This paper presents a decentralized safety concept for networked intensive care setups, for which a decentralized network of sensors and actuators is realized by embedded microcontroller nodes. It is evaluated for up to eleven medical devices in a setup for automated acute respiratory distress syndrome (ARDS) therapy. In this contribution we highlight a blood pump supervision as exemplary safety measure, which allows a reliable bubble detection in an extracorporeal blood circulation. The approach is validated with data of animal experiments including 35 bubbles with a size between 0...
March 17, 2017: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/28306336/fifty-years-of-research-in-ards-cell-based-therapy-for-ards-biology-and-potential-therapeutic-value
#4
John G Laffey, Michael A Matthay
Based on several pre-clinical studies, cell-based therapy has emerged as a potential new therapeutic for ARDS. Of the various cell-based therapy options, mesenchymal stromal cells (MSCs) from bone marrow, adipose tissue and umbilical cord have the most experimental data to support their potential efficacy for lung injury from both infectious and non-infectious causes. Mechanistically, MSCs exert their beneficial effects by release of paracrine factors, microvesicles, and transfer of mitochondria, all of which have anti-inflammatory and pro-resolving effects on injured lung endothelium and alveolar epithelium, including enhancing the resolution of pulmonary edema by upregulating sodium-dependent alveolar fluid clearance...
March 17, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28306327/fifty-years-of-research-in-ards-respiratory-mechanics-in-acute-respiratory-distress-syndrome
#5
William R Henderson, Lu Chen, Marcelo B P Amato, Laurent J Brochard
Acute respiratory distress syndrome is a multifactorial lung injury that continues to be associated with high levels of morbidity and mortality. Mechanical ventilation, while lifesaving, is associated with new iatrogenic injury. Current best practice involves the use of small tidal volumes, low plateau and driving pressures, and high levels of positive end expiratory pressure. Collectively, these interventions are termed "lung protective ventilation". Recent investigations suggest that individualized measurements of pulmonary mechanical variables rather than population based ventilation prescriptions may be used to set the ventilator with the potential to improve outcomes beyond those achieved with standard lung protective ventilation...
March 17, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28304180/nanomedicine-for-the-treatment-of-acute-respiratory-distress-syndrome-the-2016-ats-bear-cage-award-winning-proposal
#6
Jacob S Brenner
After dozens of clinical trials, there are still no FDA-approved drugs which improve mortality in acute respiratory distress syndrome (ARDS). These poor results may in part be caused by three unique pharmacological challenges presented by ARDS: 1) ARDS patients are fragile due to concomitant multiple organ dysfunction, so do not tolerate off-target side effects of drugs; 2) inhaled drug delivery is impeded by the column of proteinaceous fluid covering the injured alveoli; 3) ARDS is heterogeneous in its underlying pathophysiology, so targeting one pathway is unlikely to improve most patients...
March 17, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28302938/effect-of-acetate-ringer-ssolution-with-or-without-5-dextrose-administered-intravenously-to-diarrheic-calves
#7
Kenji Tsukano, Satoko Kato, Shinya Sarashina, Izumi Abe, Tadaharu Ajito, Hiromichi Ohtsuka, Kazuyuki Suzuki
The objectives of this study were to evaluate the effects of intravenous acetate Ringer's solution, with or without dextrose, on diarrheic calves with either experimentally induced or spontaneous diarrhea. In the experimental model, diarrhea was induced in nine healthy calves by administering cold milk (below 4°C) twice a day for 2 days. The calves were randomly assigned to the isotonic saline (ISS), acetated Ringer's (AR), or acetated Ringer's with 5% dextrose (ARD) groups, with three calves assigned to each group...
March 12, 2017: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/28302253/determinants-of-quality-of-life-and-return-to-work-following-acute-respiratory-distress-syndrome
#8
Frank Dodoo-Schittko, Susanne Brandstetter, Sebastian Blecha, Kathrin Thomann-Hackner, Magdalena Brandl, Helge Knüttel, Thomas Bein, Christian Apfelbacher
BACKGROUND: Acute respiratory distress syndrome (ARDS) in adults is a consequence of lung damage caused by either pulmonary or extrapulmonary disease. Survivors often suffer from an impaired health-related quality of life (HRQoL), mental and physical impairments, and persistent inability to work. METHODS: In this systematic review of the literature, we consider the determinants of HRQoL and return to work (RtW). 24 observational studies showing a statistical association between one or more determinants and HRQoL or RtW were included...
February 17, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28301393/potential-contribution-of-mitochondrial-mt-dna-damage-associated-molecular-patterns-damps-in-transfusion-products-to-the-development-of-acute-respiratory-distress-syndrome-ards-after-multiple-transfusions
#9
Jon D Simmons, Yann-Leei L Lee, Viktor M Pastukh, Gina Capley, Cherry A Muscat, David C Muscat, Michael L Marshall, Sidney B Brevard, Mark N Gillespie
INTRODUCTION: Massive transfusions are accompanied by an increased incidence of a particularly aggressive and lethal form of acute lung injury (delayed TRALI) which occurs >24 hours after transfusions. In light of recent reports showing that mtDNA DAMPs are potent pro-inflammatory mediators, and that their abundance in the sera of severely injured or septic patients is predictive of clinical outcomes, we explored the idea that mtDNA DAMPs are present in transfusion products and are associated with the occurrence of delayed TRALI...
March 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28287530/open-tracheostomy-gastric-acid-aspiration-murine-model-of-acute-lung-injury-results-in-maximal-acute-nonlethal-lung-injury
#10
Ravi Alluri, Hilliard L Kutscher, Barbara A Mullan, Bruce A Davidson, Paul R Knight
Acid pneumonitis is a major cause of sterile acute lung injury (ALI) in humans. Acid pneumonitis spans the clinical spectrum from asymptomatic to acute respiratory distress syndrome (ARDS), characterized by neutrophilic alveolitis, and injury to both alveolar epithelium and vascular endothelium. Clinically, ARDS is defined by acute onset of hypoxemia, bilateral patchy pulmonary infiltrates and non-cardiogenic pulmonary edema. Human studies have provided us with valuable information about the physiological and inflammatory changes in the lung caused by ARDS, which has led to various hypotheses about the underling mechanisms...
February 26, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28284294/optimal-strategies-for-severe-acute-respiratory-distress-syndrome
#11
REVIEW
Jeremy W Cannon, Jacob T Gutsche, Daniel Brodie
Acute respiratory distress syndrome (ARDS) occurs in more than 10% of intensive care unit admissions and in nearly 25% of ventilated patients. Mortality remains high at 40%, and, for patients who survive, recovery continues for months or even years. Early recognition and minimizing further lung injury remain essential to successful management of severe ARDS. Advanced treatment strategies, which complement lung protective ventilation, include short-term neuromuscular blockade, prone positioning, and extracorporeal membrane oxygenation...
April 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28283699/opening-pressures-and-atelectrauma-in-acute-respiratory-distress-syndrome
#12
Massimo Cressoni, Davide Chiumello, Ilaria Algieri, Matteo Brioni, Chiara Chiurazzi, Andrea Colombo, Angelo Colombo, Francesco Crimella, Mariateresa Guanziroli, Ivan Tomic, Tommaso Tonetti, Giordano Luca Vergani, Eleonora Carlesso, Vladimir Gasparovic, Luciano Gattinoni
PURPOSE: Open lung strategy during ARDS aims to decrease the ventilator-induced lung injury by minimizing the atelectrauma and stress/strain maldistribution. We aim to assess how much of the lung is opened and kept open within the limits of mechanical ventilation considered safe (i.e., plateau pressure 30 cmH2O, PEEP 15 cmH2O). METHODS: Prospective study from two university hospitals. Thirty-three ARDS patients (5 mild, 10 moderate, 9 severe without extracorporeal support, ECMO, and 9 severe with it) underwent two low-dose end-expiratory CT scans at PEEP 5 and 15 cmH2O and four end-inspiratory CT scans (from 19 to 40 cmH2O)...
March 10, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28277743/obesity-induced-endoplasmic-reticulum-stress-causes-lung-endothelial-dysfunction-and-promotes-acute-lung-injury
#13
Dilip Shah, Freddy Romero, Zhi Guo, Jianxin Sun, Jonathan Li, Caleb B Kallen, Ulhas P Naik, Ross Summer
Obesity is a significant risk factor for the acute respiratory distress syndrome (ARDS). The mechanisms underlying this association are unknown. We recently showed that diet-induced obese (DIO) mice exhibit pulmonary vascular endothelial dysfunction which is associated with enhanced susceptibility to lipopolysaccharide (LPS)-induced lung injury. Here, we demonstrate that lung endothelial dysfunction in DIO mice coincides with increased endoplasmic reticulum (ER) stress. Specifically, we observed enhanced expression of the major sensors of misfolded proteins including PERK, IREα and ATF6, in whole lung and in lung endothelial cells isolated from DIO mice...
March 9, 2017: American Journal of Respiratory Cell and Molecular Biology
https://www.readbyqxmd.com/read/28277329/sevoflurane-compared-with-isoflurane-minimizes-lung-damage-in-pulmonary-but-not-in-extrapulmonary-acute-respiratory-distress-syndrome-in-rats
#14
Mariana N Araújo, Cíntia L Santos, Cynthia S Samary, Luciana B B Heil, Vinicius C M Cavalcanti, Fernanda F Cruz, Nathane S Felix, Johnatas D Silva, Marcelo M Morales, Paolo Pelosi, Fatima C Fernandes, Nivaldo R Villela, Pedro L Silva, Patricia R M Rocco
BACKGROUND: Volatile anesthetics modulate inflammation in acute respiratory distress syndrome (ARDS). However, it is unclear whether they act differently depending on ARDS etiology. We hypothesized that the in vivo and in vitro effects of sevoflurane and isoflurane on lung damage would not differ in pulmonary (p) and extrapulmonary (exp) ARDS. METHODS: Twenty-four Wistar rats were randomized to undergo general anesthesia (1-2 minutes) with sevoflurane and isoflurane...
March 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28275770/reactivity-of-4-fe-co-n-0-2-o2-oxidation-of-co-by-o2-at-an-isolated-metal-atom
#15
Shaun G Ard, Oscar Martinez, Steven A Brown, Jordan C Sawyer, P B Armentrout, Albert A Viggiano, Nicholas S Shuman
The kinetics of (4)Fe(+)(CO)n=0-2 + O2 are measured under thermal conditions from 300-600 K using a selected-ion flow tube apparatus. Both the bare metal and n = 2 cations are inert to reaction over this temperature range, but (4)Fe(+)(CO) reacts rapidly (k = 3.2 ± 0.8 × 10(-10) cm(3) s(-1) at 300 K, 52% of the collisional rate coefficient) to form FeO(+) + CO2. This is an example of the oxidation of CO by O2 occurring entirely on a single non-noble metal atom. The reaction of the bare metal reaction is known to be endothermic, such that this result is expected; however, the n = 2 reaction has highly exothermic product channels available, such that the lack of reaction is surprising in light of the n = 1 reactivity...
March 9, 2017: Physical Chemistry Chemical Physics: PCCP
https://www.readbyqxmd.com/read/28275497/extracorporeal-membrane-oxygenation-as-a-rescue-therapy-for-acute-respiratory-failure-during-chemotherapy-in-a-patient-with-acute-myeloid-leukemia
#16
Sang Won Lee, Youn Seup Kim, Goohyeon Hong
Acute respiratory distress syndrome (ARDS) caused by pneumonia in patients with hematologic malignancies can be life-threatening. Extracorporeal membrane oxygenation (ECMO) is the only temporary treatment for patients with ARDS who are refractory to conventional treatment. However, the immunosuppression and coagulopathies in hematological malignancies such as lymphoma and acute leukemia are relative contraindications for ECMO, due to high risks of infection and bleeding. Here, we report a 22-year-old man with acute myeloid leukemia (AML) who developed pneumonia and ARDS during induction chemotherapy; he was treated with ECMO...
February 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28275225/low-flow-veno-venous-extracorporeal-co2-removal-for-acute-hypercapnic-respiratory-failure
#17
Matthias P Hilty, Thomas Riva, Silvia R Cottini, Eva-Maria Kleinert, Alessandra Maggiorini, Marco Maggiorini
BACKGROUND: Ventilation with low tidal volume and airway pressure results in a survival benefit in ARDS patients. Previous research suggests that avoiding mechanical ventilation altogether may be beneficial in some cases of respiratory failure. Our hypothesis was that low flow veno-venous extracorporeal CO2 removal (ECCO2R) enables maintenance of a lung protective ventilation strategy or awake spontaneous ventilation despite severe hypercapnic respiratory failure (HRF). METHODS: Twenty patients with HRF were investigated while mechanically ventilated (n=14) or breathing spontaneously close to respiratory exhaustion (n=6)...
March 8, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28268884/creating-virtual-ards-patients
#18
Anup Das, Mainul Haque, Marc Chikhani, Wenfei Wang, Jonathan G Hardman, Declan G Bates
This paper presents the methodology used in patient-specific calibration of a novel highly integrated model of the cardiovascular and pulmonary pathophysiology associated with Acute Respiratory Distress Syndrome (ARDS). We focus on data from previously published clinical trials on the static and dynamic cardio-pulmonary responses of three ARDS patients to changes in ventilator settings. From this data, the parameters of the integrated model were identified using an optimization-based methodology in multiple stages...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28260175/involvement-of-the-bufadienolides-in-the-detection-and-therapy-of-the-acute-respiratory-distress-syndrome
#19
Mir M K Abbas, B Patel, Q Chen, W Jiang, B Moorthy, R Barrios, J B Puschett
PURPOSE: The acute respiratory distress syndrome (ARDS) represents a major challenge for clinicians as well as basic scientists. The mortality rate for ARDS has been maintained within the range of 40-52%. The authors have examined the involvement of the "cardiotonic steroids" in the pathogenesis and therapy of ARDS. We have studied the possible role of the bufadienolide, marinobufagenin (MBG), in the pathogenesis of ARDS in both a rat model of ARDS and in patients afflicted with that disorder...
March 4, 2017: Lung
https://www.readbyqxmd.com/read/28259747/exosome-based-immunomodulation-during-aging-a-nano-perspective-on-inflamm-aging
#20
REVIEW
Francesco Prattichizzo, Luigina Micolucci, Monica Cricca, Sabrina De Carolis, Emanuela Mensà, Antonio Ceriello, Antonio Domenico Procopio, Massimiliano Bonafè, Fabiola Olivieri
Exosomes are nanovesicles formed by inward budding of endosomal membranes. They exert complex immunomodulatory effects on target cells, acting both as antigen-presenting vesicles and as shuttles for packets of information like proteins, coding and non-coding RNA, and nuclear and mitochondrial DNA fragments. Albeit different, all such functions seem to be encompassed in the adaptive mechanism mediating the complex interactions of the organism with a variety of stressors, providing both for defense and for the evolution of symbiotic relationships with others organisms (gut microbiota, bacteria, and viruses)...
March 1, 2017: Mechanisms of Ageing and Development
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