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https://www.readbyqxmd.com/read/27906009/current-trends-and-intricacies-in-the-management-of-hiv-associated-pulmonary-tuberculosis
#1
REVIEW
Narendran Gopalan, Padmapriyadarsini Chandrasekaran, Soumya Swaminathan, Srikanth Tripathy
Human immunodeficiency virus (HIV) epidemic has undoubtedly increased the incidence of tuberculosis (TB) globally, posing a formidable global health challenge affecting 1.2 million cases. Pulmonary TB assumes utmost significance in the programmatic perspective as it is readily transmissible as well as easily diagnosable. HIV complicates every aspect of pulmonary tuberculosis from diagnosis to treatment, demanding a different approach to effectively tackle both the diseases. In order to control these converging epidemics, it is important to diagnose early, initiate appropriate therapy for both infections, prevent transmission and administer preventive therapy...
September 26, 2016: AIDS Research and Therapy
https://www.readbyqxmd.com/read/27902675/infected-congenital-epicardial-cyst-presenting-as-acute-abdomen
#2
Timothy Dribin, Matthew D Files, Erin R Rudzinski, Ron Kaplan, Kimberly P Stone
A previously healthy 3-year-old boy presented to the emergency department with abdominal pain, fever, and emesis. Laboratory and radiologic evaluation for causes of acute abdomen were negative; however, review of the abdominal x-ray demonstrated cardiomegaly with the subsequent diagnosis of pericardial cyst by echocardiogram and computed tomography. The patient underwent surgical decompression and attempted removal of the cystic structure revealing that the cyst originated from the epicardium. His abdominal pain and fever resolved postoperatively and he completed a 3-week course of ceftriaxone for treatment of Propionibacterium acnes infected congenital epicardial cyst...
December 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27902340/viral-bacterial-interactions-in-the-respiratory-tract
#3
Carla Bellinghausen, Gernot Gu Rohde, Paul Hm Savelkoul, Emiel Fm Wouters, Frank Rm Stassen
In the respiratory tract, viruses and bacteria can interact on multiple levels. It is well known that respiratory viruses, particularly influenza viruses, increase the susceptibility to secondary bacterial infections. Numerous mechanisms, including compromised physical and immunological barriers, and changes in the microenvironment have hereby been shown to contribute to the development of secondary bacterial infections. In contrast, our understanding of how bacteria shape a response to subsequent viral infection is still limited...
October 18, 2016: Journal of General Virology
https://www.readbyqxmd.com/read/27902157/pulmonary-oedema
#4
Monica Thompson
What was the nature of the CPD activity and/or practice-related feedback and/or event or experience in your practice? The CPD article discussed acute pulmonary oedema, which is the build-up of excess fluid in the lungs. It is a life-threatening illness that should be treated as a medical emergency.
November 30, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27895451/non-cardiogenic-pulmonary-edema-rhabdomyolysis-and-myocardial-injury-following-heroin-inhalation-a-case-report
#5
G Bazoukis, A Spiliopoulou, K Mourouzis, P Grigoropoulou, A Yalouris
BACKGROUND: Heroin use by non-injecting routes of administration (snorting, swallowing, "chasing the dragon") is considered to be safer but is not risk-free for fatal overdose or serious side effects. We report the case of an adolescent who was transferred unconscious to the emergency department after heroin inhalation. Description of the case: A 17-year-old male was transferred to the emergency department unconscious (Glasgow coma scale: 6/15) after heroin inhalation. He was treated with non-rebreather mask and intravenous infusion of naloxone with gradual improvement of consciousness and arterial blood gasses...
January 2016: Hippokratia
https://www.readbyqxmd.com/read/27893645/preperitoneal-pelvic-packing-reduces-mortality-in-patients-with-life-threatening-hemorrhage-due-to-unstable-pelvic-fractures
#6
Clay Cothren Burlew, Ernest E Moore, Philip F Stahel, Andrea E Geddes, Amy E Wagenaar, Fredric M Pieracci, Charles J Fox, Eric M Campion, Jeffrey L Johnson, Cyril Mauffrey
BACKGROUND: A 2015 AAST trial reported a 32% mortality for pelvic fracture patients in shock. Angioembolization (AE) is the most common intervention; the Maryland group revealed time to AE averaged 5 hours. The goal of this study was to evaluate the time to intervention and outcomes of an alternative approach for pelvic hemorrhage. We hypothesized preperitoneal pelvic packing (PPP) results in a shorter time to intervention and lower mortality. METHODS: In 2004 we initiated a PPP protocol for pelvic fracture hemorrhage...
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27892925/a-mouse-model-for-mers-coronavirus-induced-acute-respiratory-distress-syndrome
#7
Adam S Cockrell, Boyd L Yount, Trevor Scobey, Kara Jensen, Madeline Douglas, Anne Beall, Xian-Chun Tang, Wayne A Marasco, Mark T Heise, Ralph S Baric
Middle East respiratory syndrome coronavirus (MERS-CoV) is a novel virus that emerged in 2012, causing acute respiratory distress syndrome (ARDS), severe pneumonia-like symptoms and multi-organ failure, with a case fatality rate of ∼36%. Limited clinical studies indicate that humans infected with MERS-CoV exhibit pathology consistent with the late stages of ARDS, which is reminiscent of the disease observed in patients infected with severe acute respiratory syndrome coronavirus. Models of MERS-CoV-induced severe respiratory disease have been difficult to achieve, and small-animal models traditionally used to investigate viral pathogenesis (mouse, hamster, guinea-pig and ferret) are naturally resistant to MERS-CoV...
November 28, 2016: Nature Microbiology
https://www.readbyqxmd.com/read/27891026/anaesthesia-management-in-craniovertebral-junctional-anomalies
#8
REVIEW
Oswald Mascarenhas
Craniovertebral Junctional (CVJ) anomalies are developmental disorders that affect the skeleton and enclosed neuraxis at the junction of cranium and cervical spine. The high prevalence of airway obstruction and restrictive pulmonary disease in combination with cardiovascular manifestations poses a high anaesthetic risk to these patients. This article provides a discussion of management of anaesthesia in patients with craniovertebral anomalies, the evaluation of risk factors in these patients and their management, including emergency airway issues...
October 2016: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/27890713/allogeneic-human-mesenchymal-stem-cells-in-patients-with-idiopathic-pulmonary-fibrosis-via-intravenous-delivery-aether-a-phase-i-safety-clinical-trial
#9
Marilyn K Glassberg, Julia Minkiewicz, Rebecca L Toonkel, Emmanuelle S Simonet, Gustavo A Rubio, Darcy Difede, Shirin Shafazand, Aisha Khan, Marietsy V Pujol, Vincent F LaRussa, Lisa H Lancaster, Glenn D Rosen, Joel Fishman, Yolanda N Mageto, Adam Mendizabal, Joshua M Hare
BACKGROUND: Despite recent FDA approval of two new drugs for idiopathic pulmonary fibrosis (IPF), curative therapies remain elusive and mortality remains high. Pre-clinical and clinical data support the safety of human mesenchymal stem cells as a potential novel therapy for this fatal condition. The AETHER trial was the first study designed to evaluate the safety of a single infusion of bone marrow-derived mesenchymal stem cells in patients with idiopathic pulmonary fibrosis. METHODS: Nine patients with mild to moderate IPF were sequentially assigned to one of three cohorts and dosed with a single intravenous infusion of 20, 100, or 200 x 10(6) human bone marrow-derived mesenchymal stem cells per infusion from young, unrelated, male donors...
November 24, 2016: Chest
https://www.readbyqxmd.com/read/27890689/developmental-toxicity-of-nicotine-a-transdisciplinary-synthesis-and-implications-for-emerging-tobacco-products
#10
REVIEW
Lucinda J England, Kjersti Aagaard, Michele Bloch, Kevin Conway, Kelly Cosgrove, Rachel Grana, Thomas J Gould, Dorothy Hatsukami, Frances Jensen, Denise Kandel, Bruce Lanphear, Frances Leslie, James R Pauly, Jenae Neiderhiser, Mark Rubinstein, Theodore A Slotkin, Eliot Spindel, Laura Stroud, Lauren Wakschlag
While the health risks associated with adult cigarette smoking have been well described, effects of nicotine exposure during periods of developmental vulnerability are often overlooked. Using MEDLINE and PubMed literature searches, books, reports and expert opinion, a transdisciplinary group of scientists reviewed human and animal research on the health effects of exposure to nicotine during pregnancy and adolescence. A synthesis of this research supports that nicotine contributes critically to adverse effects of gestational tobacco exposure, including reduced pulmonary function, auditory processing defects, impaired infant cardiorespiratory function, and may contribute to cognitive and behavioral deficits in later life...
November 24, 2016: Neuroscience and Biobehavioral Reviews
https://www.readbyqxmd.com/read/27888446/cesarean-section-in-the-setting-of-severe-pulmonary-hypertension-requiring-extracorporeal-life-support
#11
Ryosuke Hara, Shuhei Hara, Chin Siang Ong, Gary Schwartz, Christopher Sciortino, Narutoshi Hibino
We describe the use of veno-arterial extracorporeal membrane oxygenation (ECMO) in a 35-year-old female with severe fixed pulmonary hypertension who went into cardiogenic shock during a Cesarean section. Pregnancy in the presence of severe pulmonary hypertension is typically contraindicated due to high maternal mortality rates. This patient visited our hospital at 37 weeks of gestation after experiencing dyspnea and chest pain. Clinical evaluation revealed severe fixed pulmonary hypertension. At the time of the planned delivery, femoral lines were placed; in case of emergency, ECMO became necessary during the delivery...
November 25, 2016: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27886851/the-role-of-necroptosis-in-pulmonary-diseases
#12
REVIEW
Kenji Mizumura, Shuichiro Maruoka, Yasuhiro Gon, Augustine M K Choi, Shu Hashimoto
By regulating the cell number and eliminating harmful cells, programmed cell death plays a critical role in development, homeostasis, and disease. While apoptosis is a recognized form of programmed cell death, necrosis was considered a type of uncontrolled cell death induced by extreme physical or chemical stress. However, recent studies have revealed the existence of a genetically programmed and regulated form of necrosis, termed necroptosis. Necroptosis is defined as necrotic cell death that is dependent on receptor-interacting protein kinase 3 (RIPK3)...
November 2016: Respiratory Investigation
https://www.readbyqxmd.com/read/27884776/inverted-orientation-improves-decellularization-of-whole-porcine-hearts
#13
Po-Feng Lee, Eric Chau, Rafael Cabello, Alvin T Yeh, Luiz C Sampaio, Andrea S Gobin, Doris A Taylor
In structurally heterogeneous organs, such as heart, it is challenging to retain extracellular matrix integrity in the thinnest regions (eg, valves) during perfusion decellularization and completely remove cellular debris from thicker areas. The high inflow rates necessary to maintain physiologic pressure can distend or damage thin tissues, but lower pressures prolong the process and increase the likelihood of contamination. We examined two novel retrograde decellularization methods for porcine hearts: inverting the heart or venting the apex to decrease inflow rate...
November 21, 2016: Acta Biomaterialia
https://www.readbyqxmd.com/read/27882775/association-between-availability-of-care-providers-and-healthcare-utilizations-among-adults-with-asthma
#14
Minchul Kim, Carl V Asche, William Tillis, Jinma Ren
BACKGROUND: Limited accessibility to providers may delay appropriate control of asthma exacerbations. The objective of our study is to estimate the contributors to the hospital/emergency department (ED) visits among adults with asthma focusing on the availability of healthcare providers. METHODS: We conducted a pooled cross-sectional analysis using the 2011-2013 Asthma Call-Back Survey linked with 2012-2016 Area Health Resource Files. We employed multivariable logistic regression with dichotomous outcomes of hospitalization and ED visits...
December 2, 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27879182/-acute-respiratory-failure-caused-by-minocycline
#15
B Kok, M J T van de Ven, H J van Leeuwen
BACKGROUND: In the case of pneumonia an infectious cause is always considered first. However, toxic agents and medicines can also be the cause of pneumonia. CASE DESCRIPTION: A 54-year-old woman was referred to the emergency department because of progressive dyspnoea, a non-productive cough, headache, and fever. She was admitted with the diagnosis community acquired pneumonia. Despite treatment with antibiotics and oxygen she developed hypoxic respiratory failure, which necessitated invasive mechanical ventilation...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27878782/trajectory-of-cause-of-death-among-brought-dead-neonates-in-tertiary-care-public-facilities-of-pakistan-a-multicenter-study
#16
Muhammad Ayaz Mustufa, Munir Ahmed Sheikh, Ijaz-Ul-Haque Taseer, Syed Jamal Raza, Muhammad Sohail Arshad, Tasleem Akhter, Ghazala Mohyuddin Arain, Sultana Habibullah, Sohail Safdar, Rukhsana Firdous, Muhammad Adnan
BACKGROUND: Considering the fact that Pakistan is amongst the countries with very high neonatal mortality rates, we conducted a research study to determine the possible causes and characteristics of neonates presenting dead to the emergency department of tertiary public health care facilities of Pakistan using verbal autopsies. METHODS: A descriptive case series study was conducted in emergency department/pediatrics ward/neonatal ward/nursery unit of ten tertiary care public health facilities, situated in seven major cities of Pakistan from November, 2011 to June, 2013...
November 23, 2016: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/27877032/pulmonary-complications-after-abdominal-surgery-in-patients-with-mild-to-moderate-chronic-obstructive-pulmonary-disease
#17
Tae Hoon Kim, Jae Seung Lee, Sei Won Lee, Yeon-Mok Oh
Postoperative pulmonary complications (PPCs) are one of the most important causes of postoperative morbidity and mortality after abdominal surgery. Although chronic obstructive pulmonary disease (COPD) has been considered a risk factor for PPCs, it remains unclear whether mild-to-moderate COPD is a risk factor. This retrospective cohort study included 387 subjects who underwent abdominal surgery with general anesthesia in a tertiary referral hospital. PPCs included pneumonia, pulmonary edema, pulmonary thromboembolism, atelectasis, and acute exacerbation of COPD...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27876247/effect-of-pirfenidone-on-mortality-pooled-analyses-and-meta-analyses-of-clinical-trials-in-idiopathic-pulmonary-fibrosis
#18
Steven D Nathan, Carlo Albera, Williamson Z Bradford, Ulrich Costabel, Ian Glaspole, Marilyn K Glassberg, David R Kardatzke, Monica Daigl, Klaus-Uwe Kirchgaessler, Lisa H Lancaster, David J Lederer, Carlos A Pereira, Jeffrey J Swigris, Dominique Valeyre, Paul W Noble
BACKGROUND: In clinical trials of idiopathic pulmonary fibrosis, rates of all-cause mortality are low. Thus prospective mortality trials are logistically very challenging, justifying the use of pooled analyses or meta-analyses. We did pooled analyses and meta-analyses of clinical trials of pirfenidone versus placebo to determine the effect of pirfenidone on mortality outcomes over 120 weeks. METHODS: We did a pooled analysis of the combined patient populations of the three global randomised phase 3 trials of pirfenidone versus placebo-Clinical Studies Assessing Pirfenidone in Idiopathic Pulmonary Fibrosis: Research of Efficacy and Safety Outcomes (CAPACITY 004 and 006; trial durations 72-120 weeks) and Assessment of Pirfenidone to Confirm Efficacy and Safety in Idiopathic Pulmonary Fibrosis (ASCEND 016; 52 weeks)-for all-cause mortality, treatment-emergent all-cause mortality, idiopathic-pulmonary-fibrosis-related mortality, and treatment-emergent idiopathic-pulmonary-fibrosis-related mortality at weeks 52, 72, and 120...
November 19, 2016: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/27876029/home-telemonitoring-for-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-a-randomized-controlled-trial
#19
Andrea Vianello, Massimo Fusello, Lorenzo Gubian, Claudia Rinaldo, Claudio Dario, Alessandra Concas, Claudio Saccavini, Laura Battistella, Giulia Pellizzon, Giuseppe Zanardi, Silvia Mancin
BACKGROUND: Although a number of studies have suggested that the use of Telemonitoring (TM) in patients with Chronic Obstructive Pulmonary Disease (COPD) can be useful and efficacious, its real utility in detecting Acute Exacerbation (AE) signaling the need for prompt treatment is not entirely clear. The current study aimed to investigate the benefits of a TM system in managing AE in advanced-stage COPD patients to improve their Health-Related Quality of Life (HRQL) and to reduce utilization of healthcare services...
November 22, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27875733/relationship-between-ambient-temperature-and-frequency-and-severity-of-cardiovascular-emergencies-a-prospective-observational-study-based-on-out-of-hospital-care-data
#20
Mario Hensel, Markus Stuhr, Daniel Geppert, Jan F Kersten, Jürgen Lorenz, Thoralf Kerner
OBJECTIVE: To test the hypothesis that more cardiovascular emergencies occur at low rather than at high temperatures under moderate climatic conditions. METHODS: This was a prospective observational study performed in a prehospital setting. Data from the Emergency Medical Service in Hamburg (Germany) and from the local weather station were evaluated over a 5-year period. Temperature data were matched with the associated rescue mission data. Lowess-Regression analysis was performed to assess the relationship between the temperature and the frequency of individual cardiovascular emergencies...
November 8, 2016: International Journal of Cardiology
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