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https://www.readbyqxmd.com/read/28651419/-significance-of-evaluating-the-severity-of-patients-with-extremely-severe-burn-by-platelet-count-recovery-in-the-early-stage-post-burn
#1
Y Wu, Q Zhang, J Liu, J J Tang, J X Zheng, M Liu
Objective: To retrospectively analyze the prognostic value of platelet count recovery in the early stage post burn for patients with extremely severe burn, so as to evaluate their severity. Methods: A study involving 244 adult patients with extremely severe burn admitted to our hospital from January 2006 to December 2015, conforming to the inclusion criteria, was conducted. Data of their demography, injury, transmission, disease change in hospital, and platelet count from post injury day (PID) 1 to 10 were collected...
May 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28651166/air-quality-inside-subway-metro-indoor-environment-worldwide-a-review
#2
REVIEW
Bin Xu, Jinliang Hao
The air quality in the subway metro indoor microenvironment has been of particular public concern. With specific reference to the growing demand of green transportation and sustainable development, subway metro systems have been rapidly developed worldwide in last decades. The number of metro commuters has continuously increased over recent years in metropolitan cities. In some cities, metro system has become the primary public transportation mode. Although commuters typically spend only 30-40min in metros, the air pollutants emitted from various interior components of metro system as well as air pollutants carried by ventilation supply air are significant sources of harmful air pollutants that could lead to unhealthy human exposure...
June 23, 2017: Environment International
https://www.readbyqxmd.com/read/28650926/hypercapnia-induced-amelioration-of-the-intestinal-microvascular-oxygenation-in-sepsis-is-independent-of-the-endogenous-sympathetic-nervous-system
#3
Jan Schulz, Sabrina Schöneborn, Christian Vollmer, Richard Truse, Anna Herminghaus, Inge Bauer, Christopher Beck, Olaf Picker
INTRODUCTION: Insufficient microvascular oxygenation (μHBO2) of the intestinal mucosa worsens outcome of septic patients. Hypercapnia ameliorates μHBO2, mediated via endogenous vasopressin release. Under physiological conditions, blockade of the endogenous sympathetic nervous system abolishes this protective effect of hypercapnia. The aim of our study was therefore to evaluate the role of the endogenous sympathetic nervous system during hypercapnia on intestinal μHBO2 under septic conditions...
June 23, 2017: Shock
https://www.readbyqxmd.com/read/28650903/thigh-ultrasound-monitoring-identifies-decreases-in-quadriceps-femoris-thickness-as-a-frequent-observation-in-critically-ill-children
#4
Frederic V Valla, David K Young, Muriel Rabilloud, Uvaraj Periasami, Manoj John, Florent Baudin, Carole Vuillerot, Aurélie Portefaix, Deborah White, Jenna A Ridout, Rosan Meyer, Bénédicte Gaillard Le Roux, Etienne Javouhey, Nazima Pathan
OBJECTIVES: Significant muscle wasting develops in critically ill adults, with subsequent worse outcomes. In the pediatric setting, occurrence and effects of muscle wasting are undescribed; this is in part due to a lack of validated, objective methods for assessing muscle wasting. A single measurement of quadriceps femoris thickness has failed to show consistent reproducibility. We hypothesized that averaging repeated measurements could afford good reproducibility to allow for quadriceps femoris thickness decline detection and monitoring...
June 23, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28650727/models-for-nearly-every-occasion-part-iv-two-box-decreasing-emission-models
#5
Gary H Ganser, Paul Hewett
New two box "well-mixed room" decreasing emission (DE) models are introduced for scenarios that involve local controls, such as some form of local exhaust or local exhaust with filtered return. In addition, these models allow for the recirculation of a filtered (or cleaned) portion of the general room ventilation. For each control device scenario, a steady state and transient near and far field model is presented. The transient equations predict the concentration at time t after the application of the substance...
June 26, 2017: Journal of Occupational and Environmental Hygiene
https://www.readbyqxmd.com/read/28650714/models-for-nearly-every-occasion-part-iii-one-box-decreasing-emission-models
#6
Paul Hewett, Gary H Ganser
New one box "well-mixed room" decreasing emission (DE) models are introduced that allow for local exhaust or local exhaust with filtered return, as well the recirculation of a filtered (or cleaned) portion of the general room ventilation. For each control device scenario, a steady state and transient model is presented. The transient equations predict the concentration at any time t after the application of a known mass of a volatile substance to a surface, and can be used to predict the task exposure profile, the average task exposure, as well as peak and short-term exposures...
June 26, 2017: Journal of Occupational and Environmental Hygiene
https://www.readbyqxmd.com/read/28650562/the-economic-value-of-hybrid-single-photon-emission-computed-tomography-with-computed-tomography-imaging-in-pulmonary-embolism-diagnosis
#7
Lauren K Toney, Richard D Kim, Swetha R Palli
OBJECTIVE: To quantify the potential economic value of single-photon emission computed tomography (SPECT) with computed tomography (CT; SPECT/CT) versus CT pulmonary angiography (CTPA), ventilation-perfusion (V/Q) planar scintigraphy and V/Q SPECT imaging modalities for diagnosing suspected pulmonary embolism (PE) patients in an emergency setting. METHODS: An Excel-based simulation model was developed to compare SPECT/CT versus the alternate scanning technologies from a payer's perspective...
June 26, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28650415/videolaryngoscopy-versus-fiber-optic-intubation-through-a-supraglottic-airway-in-children-with-a-difficult-airway-an-analysis-from-the-multicenter-pediatric-difficult-intubation-registry
#8
Nicholas E Burjek, Akira Nishisaki, John E Fiadjoe, H Daniel Adams, Kenneth N Peeples, Vidya T Raman, Patrick N Olomu, Pete G Kovatsis, Narasimhan Jagannathan, Agnes Hunyady, Adrian Bosenberg, See Tham, Daniel Low, Paul Hopkins, Chris Glover, Olutoyin Olutoye, Peter Szmuk, John McCloskey, Nicholas Dalesio, Rahul Koka, Robert Greenberg, Scott Watkins, Vikram Patel, Paul Reynolds, Maria Matuszczak, Ranu Jain, Samia Khalil, David Polaner, Jennifer Zieg, Judit Szolnoki, Kumar Sathyamoorthy, Brad Taicher, N Ricardo Riveros Perez, Solmaletha Bhattacharya, Tarun Bhalla, Paul Stricker, Justin Lockman, Jorge Galvez, Mohamed Rehman, Britta Von Ungern-Sternberg, David Sommerfield, Codruta Soneru, Franklin Chiao, Martina Richtsfeld, Kumar Belani, Lina Sarmiento, Sam Mireles, Guelay Bilen Rosas, Raymond Park, James Peyton
BACKGROUND: The success rates and related complications of various techniques for intubation in children with difficult airways remain unknown. The primary aim of this study is to compare the success rates of fiber-optic intubation via supraglottic airway to videolaryngoscopy in children with difficult airways. Our secondary aim is to compare the complication rates of these techniques. METHODS: Observational data were collected from 14 sites after management of difficult pediatric airways...
June 23, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28650414/combined-thoracic-ultrasound-assessment-during-a-successful-weaning-trial-predicts-postextubation-distress
#9
Stein Silva, Dalinda Ait Aissa, Pierre Cocquet, Lucille Hoarau, Jean Ruiz, Fabrice Ferre, David Rousset, Michel Mora, Arnaud Mari, Olivier Fourcade, Béatrice Riu, Samir Jaber, Bénoît Bataille
BACKGROUND: Recent studies suggest that isolated sonographic assessment of the respiratory, cardiac, or neuromuscular functions in mechanically ventilated patients may assist in identifying patients at risk of postextubation distress. The aim of the present study was to prospectively investigate the value of an integrated thoracic ultrasound evaluation, encompassing bedside respiratory, cardiac, and diaphragm sonographic data in predicting postextubation distress. METHODS: Longitudinal ultrasound data from 136 patients who were extubated after passing a trial of pressure support ventilation were measured immediately after the start and at the end of this trial...
June 23, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28650070/the-human-ventilatory-response-to-stress-rate-or-depth
#10
Michael J Tipton, Abbi Harper, Julian F R Paton, Joseph T Costello
Many stressors cause an increase in ventilation in humans. This is predominantly reported as an increase in minute ventilation (V̇E ). But, the same V̇E can be achieved by a wide variety of changes in the depth (tidal volume, VT ) and number of breaths (respiratory frequency, ƒR). This review investigates the impact of stressors including: cold, heat, hypoxia, pain and panic on the contributions of ƒR and VT to V̇E to see if they differ with different stressors. Where possible we also consider the potential mechanisms that underpin the responses identified, and propose mechanisms by which differences in ƒR and VT are mediated...
June 26, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28649575/ecmo-in-major-burn-patients-feasibility-and-considerations-when-multiple-modes-of-mechanical-ventilation-fail
#11
Jason D Kennedy, Wesley Thayer, Reuben Beuno, Kelly Kohorst, Avinash B Kumar
BACKGROUND: We report two cases of acute respiratory distress syndrome in burn patients who were successfully managed with good outcomes with extra corporeal membrane oxygenation (ECMO) after failing multiple conventional modes of ventilation, and review the relevant literature. CASE PRESENTATION: The two patients were a 39-year-old male and 53-year-old male with modified Baux Scores of 79 and 78, respectively, with no known inhalation injury. After the initial modified Parkland-based fluid resuscitation and partial escharotomy, both patients developed worsening hypoxemia and acute respiratory distress syndrome...
2017: Burns and trauma
https://www.readbyqxmd.com/read/28649388/systemic-sclerosis-due-to-crystalline-silica-exposure-among-jewelry-workers-in-korea-two-case-reports
#12
Jae Yoon Kim, Sang Yoon Do, Young Hoon Moon, Chul Gab Lee, Yun Sung Kim, Byung Soon Choi, Eun-A Kim, Han Soo Song
BACKGROUND: Occupational exposure to crystalline silica is a potential risk factor for various systemic autoimmune diseases including systemic sclerosis. The etiology of systemic sclerosis is not conclusively known, but there are epidemiological studies that show the relationship between exposure to crystalline silica and risk of systemic sclerosis. Here we report, for the first time, two cases of crystalline silica-related systemic sclerosis in patients who worked in crystal processing in the jewelry-manufacturing field...
2017: Annals of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28649385/the-practice-of-tracheostomy-decannulation-a-systematic-review
#13
REVIEW
Ratender Kumar Singh, Sai Saran, Arvind K Baronia
Decannulation is an essential step towards liberating tracheostomized patients from mechanical ventilation. However, despite its perceived importance, there is no universally accepted protocol for this vital transition. Presence of an intact sensorium coordinated swallowing and protective coughing are often the minimum requirements for a successful decannulation. Objective criteria for each of these may help better the clinical judgement of decannulation. In this systematic review on decannulation, we focus attention to this important aspect of tracheostomy care...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28649372/the-use-of-high-frequency-ventilation-during-general-anaesthesia-an-update
#14
REVIEW
Karolina Galmén, Piotr Harbut, Jacob Freedman, Jan G Jakobsson
Various forms of high-frequency ventilation (HFV) have been described. HFV is broadly defined as artificial ventilation of the lungs with sub-deadspace tidal volumes delivered using supra-physiological frequencies. HFV has been used in anaesthesia and intensive care for special procedures and conditions since the 1960s. Clinical interest in the use and the technical evolution of HFV has developed over time. There is a renewed interest in HFV for avoiding parenchymal movement during stereotactic tumour ablation...
2017: F1000Research
https://www.readbyqxmd.com/read/28648859/ceftriaxone-versus-ceftriaxone-plus-a-macrolide-for-community-acquired-pneumonia-in-hospitalized-patients-with-hiv-aids-a-randomized-controlled-trial
#15
Claudia Figueiredo-Mello, Pontus Naucler, Marinella D Negra, Anna S Levin
OBJECTIVES: Evaluate if treatment with ceftriaxone and a macrolide, improved patient outcome when compared with monotherapy with ceftriaxone, in hospitalized patients with HIV/AIDS with community-acquired pneumonia (CAP). METHODS: Adult patients with HIV hospitalized due to suspected CAP were randomized to receive one of two regimens, ceftriaxone plus macrolide or ceftriaxone plus placebo, at a 1:1 proportion (Brazilian Clinical Trials Registry: RBR-8wtq2b). The primary outcome was in-hospital mortality and the secondary outcomes were mortality within 14 days, need for vasoactive drugs, need for mechanical ventilation, time to clinical stability and length of hospitalization...
June 22, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28648671/late-complications-of-percutaneous-tracheostomy-using-the-balloon-dilation-technique
#16
J B Araujo, J M Añón, A García de Lorenzo, A M García-Fernandez, M Esparcia, J Adán, S Relanzon, D Quiles, V de Paz, A Molina
OBJECTIVE: The purpose of this study was to determine the late complications in critically ill patients requiring percutaneous tracheostomy (PT) using the balloon dilation technique. DESIGN: A prospective, observational cohort study was carried out. SCOPE: Two medical-surgical intensive care units (ICU). PATIENTS: All mechanically ventilated adult patients consecutively admitted to the ICU with an indication of tracheostomy...
June 22, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28648664/high-dose-ivig-successfully-reduces-high-rhgaa-igg-antibody-titers-in-a-crim-negative-infantile-pompe-disease-patient
#17
Mugdha Rairikar, Zoheb B Kazi, Ankit Desai, Crista Walters, Amy Rosenberg, Priya S Kishnani
Alglucosidase alfa (rhGAA) has altered the course of an otherwise fatal outcome in classic infantile Pompe disease (IPD), which presents with cardiomyopathy and severe musculoskeletal involvement. However, the response to therapy is determined by several factors including the development of high and sustained antibody titers (HSAT) to rhGAA. Cross-reactive immunologic material (CRIM) negative patients are at the highest risk for development of HSAT. Immune tolerance induction (ITI) with methotrexate, rituximab, and intravenous immunoglobulin (IVIG) has been largely successful in preventing the immune response and in achieving tolerance when done in conjunction with enzyme replacement therapy (ERT) initiation...
May 18, 2017: Molecular Genetics and Metabolism
https://www.readbyqxmd.com/read/28648663/effect-of-enzyme-replacement-therapy-with-alglucosidase-alfa-myozyme%C3%A2-in-12-patients-with-advanced-late-onset-pompe-disease
#18
Constantinos Papadopoulos, David Orlikowski, Hélène Prigent, Arnaud Lacour, Céline Tard, Alain Furby, Julien Praline, Guilhem Solé, Jean-Yves Hogrel, Marie De Antonio, Claudio Semplicini, Joelle Deibener-Kaminsky, Pierre Kaminsky, Bruno Eymard, Nadjib Taouagh, Barbara Perniconi, Dalil Hamroun, Pascal Laforêt
BACKGROUND: The efficacy of enzyme replacement therapy (ERT) in patients at an advanced stage of Pompe disease has only been addressed in a few studies. Our objective was to assess the long term effects of ERT in a cohort of patients with severe Pompe disease. METHODS: We identified patients from the French Pompe Registry with severe respiratory failure and permanent wheelchair use (assisted walk for a few meters was allowed) when starting ERT. Patients' medical records were collected and reviewed and respiratory and motor functions, before ERT initiation and upon last evaluation were compared...
June 20, 2017: Molecular Genetics and Metabolism
https://www.readbyqxmd.com/read/28648535/technical-performance-score-predictor-of-outcomes-in-complete-atrioventricular-septal-defect-repair
#19
Rinske IJsselhof, Kim Gauvreau, Pedro Del Nido, Meena Nathan
BACKGROUND: Technical performance score (TPS) has been associated with both early and late outcomes across a wide range of congenital cardiac procedures. We sought to validate TPS as predictor of outcomes for complete atrioventricular septal defect (CAVSD) repair. METHODS: This was a single-center retrospective review of patients after balanced CAVSD repair between January 1, 2000, and March 1, 2016. We assigned TPS (class 1, no residua; class 2, minor residua; class 3, major residua or reintervention before discharge for residua) based on summation of subcomponent scores from discharge echocardiograms...
June 22, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28648309/economic-burden-of-community-acquired-pneumonia-among-pediatric-patients-aged-3-months-to-19-years-in-the-philippines
#20
Bernadette A Tumanan-Mendoza, Victor L Mendoza, Melchor Victor G Frias, Dolores D Bonzon
OBJECTIVE: 1) To determine the hospitalization, follow-up and total costs, and the economic burden of community-acquired pneumonia among pediatric patients aged 3 months to <19 years of age; 2) To compare the estimated cost of hospitalization to the pneumonia case rate payments of the Philippine Health Insurance Corporation (PhilHealth). METHODS: Using the societal perspective, both healthcare and non-healthcare costs were estimated. This was done through two tertiary private hospitals in the Philippines...
May 2017: Value in Health Regional Issues
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