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https://www.readbyqxmd.com/read/28224446/current-care-and-investigational-therapies-in-achondroplasia
#1
REVIEW
Sheila Unger, Luisa Bonafé, Elvire Gouze
PURPOSE OF REVIEW: The goal of this review is to evaluate the management options for achondroplasia, the most common non-lethal skeletal dysplasia. This disease is characterized by short stature and a variety of complications, some of which can be quite severe. RECENT FINDINGS: Despite several attempts to standardize care, there is still no widely accepted consensus. This is in part due to absence of concrete data on the incidence of sudden unexplained death in infants with achondroplasia and the best investigation for ascertaining which individuals could benefit from foramen magnum decompression surgery...
February 21, 2017: Current Osteoporosis Reports
https://www.readbyqxmd.com/read/28224110/comparison-of-inhaled-milrinone-nitric-oxide-and-prostacyclin-in-acute-respiratory-distress-syndrome
#2
Martin Albert, Daniel Corsilli, David R Williamson, Marc Brosseau, Patrick Bellemare, Stéphane Delisle, Anne Qn Nguyen, France Varin
AIM: To evaluate the safety and efficacy of inhaled milrinone in acute respiratory distress syndrome (ARDS). METHODS: Open-label prospective cross-over pilot study where fifteen adult patients with hypoxemic failure meeting standard ARDS criteria and monitored with a pulmonary artery catheter were recruited in an academic 24-bed medico-surgical intensive care unit. Random sequential administration of iNO (20 ppm) or nebulized epoprostenol (10 μg/mL) was done in all patients...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28223463/impact-of-a-respiratory-therapy-assess-and-treat-protocol-on-adult-cardiothoracic-icu-readmissions
#3
Robert T Dailey, Thomas Malinowski, Mitchel Baugher, Daniel D Rowley
BACKGROUND: The purpose of this retrospective medical record review was to report on recidivism to the ICU among adult postoperative cardiac and thoracic patients managed with a respiratory therapy assess-and-treat (RTAT) protocol. Our primary null hypothesis was that there would be no difference in all-cause unexpected readmissions and escalations between the RTAT group and the physician-ordered respiratory care group. Our secondary null hypothesis was that there would be no difference in primary respiratory-related readmissions, ICU length of stay, or hospital length of stay...
February 21, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28222699/suspicion-of-respiratory-tract-infection-with-multidrug-resistant-enterobacteriaceae-epidemiology-and-risk-factors-from-a-paediatric-intensive-care-unit
#4
Hanna Renk, Lenja Stoll, Felix Neunhoeffer, Florian Hölzl, Matthias Kumpf, Michael Hofbeck, Dominik Hartl
BACKGROUND: Multidrug-resistant (MDR) infections are a serious concern for children admitted to the Paediatric Intensive Care Unit (PICU). Tracheal colonization with MDR Enterobacteriaceae predisposes to respiratory infection, but underlying risk factors are poorly understood. This study aims to determine the incidence of children with suspected infection during mechanical ventilation and analyses risk factors for the finding of MDR Enterobacteriaceae in tracheal aspirates. METHODS: A retrospective single-centre analysis of Enterobacteriaceae isolates from the lower respiratory tract of ventilated PICU patients from 2005 to 2014 was performed...
February 21, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28222476/-positionpaper-on-telemonitoring-in-sleep-related-breathing-disorders
#5
W Randerath, M Bögel, C Franke, A Hellmann, B Jany, G Nilius, T Penzel, T Voshaar, A Wiater
The use of telemonitoring in the care of patients with Sleep-related Breathing Disorders (SBD) can enhance medical support significantly. Telemonitoring aims at helping physicians to detect therapy problems early and thus improve patients' therapy adherence. Diagnostics and therapy decisions in the telemonitoring process nevertheless remain the responsibility of sleep specialists. The selection of data monitored, their evaluation and resulting consequences fall to the physician, who makes decisions and prescribes therapy in consultation with the patient...
February 2017: Pneumologie
https://www.readbyqxmd.com/read/28220227/prediction-of-pediatric-sepsis-mortality-within-1%C3%A2-h-of-intensive-care-admission
#6
Luregn J Schlapbach, Graeme MacLaren, Marino Festa, Janet Alexander, Simon Erickson, John Beca, Anthony Slater, Andreas Schibler, David Pilcher, Johnny Millar, Lahn Straney
PURPOSE: The definitions of sepsis and septic shock have recently been revised in adults, but contemporary data are needed to inform similar approaches in children. METHODS: Multicenter cohort study including children <16 years admitted with sepsis or septic shock to ICUs in Australia and New Zealand in the period 2012-2015. We assessed septic shock criteria at ICU admission to define sepsis severity, using 30-day mortality as outcome. Through multivariable logistic regression, a pediatric sepsis score was derived using variables available within 60 min of ICU admission...
February 20, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28219826/hot-topics-in-reactive-oxygen-therapy-antimicrobial-and-immunological-mechanisms-safety-and-clinical-applications
#7
REVIEW
Matthew Dryden, Jonathan Cooke, Rami Salib, Rebecca Holding, Sylvia Pender, Jill Brooks
Reactive oxygen species (ROS), when combined with various delivery mechanisms, has the potential to become a powerful novel therapeutic agent against difficult-to-treat infections, especially those involving biofilm. It is important in the context of the global antibiotic resistance crisis. ROS is rapidly active in vitro against all Gram-positive and Gram-negative bacteria tested. ROS also has antifungal and antiviral properties. ROS prevents the formation of biofilms caused by a range of bacterial species in wounds and respiratory epithelium...
February 17, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28217064/a-simple-technique-to-achieve-vascular-access-for-continuous-venous-venous-ultrafiltration-in-a-toddler
#8
Joseph Drew Tobias
Acute renal failure is associated with increased mortality in the Pediatric Intensive Care Unit. When anuric or oliguric renal failure occurs, the associated fluid overload may compromise respiratory function and has been shown to be associated with worse outcomes. Renal replacement therapy using continuous venous-venous hemofiltration (CVVH) allows for fluid, solute, and nitrogenous waste removal. However, large bore vascular access with placement of a double-lumen dialysis catheter is necessary to ensure effective flow rates to allow for CVVH...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28216104/high-flow-nasal-cannula-therapy-versus-non-invasive-ventilation-in-children-with-severe-acute-asthma-exacerbation-an-observational-cohort-study
#9
J Pilar, V Modesto I Alapont, Y M Lopez-Fernandez, O Lopez-Macias, D Garcia-Urabayen, I Amores-Hernandez
INTRODUCTION: The present study describes our experience with the high-flow humidified nasal cannula (HFNC) versus non-invasive ventilation (NIV) in children with severe acute asthma exacerbation (SA). METHODS: An observational study of a retrospective cohort of 42 children with SA admitted to a Pediatric Intensive Care Unit (PICU) for non-invasive respiratory support was made. The primary outcome measure was failure of initial respiratory support (need to escalate from HFNC to NIV or from NIV to invasive ventilation)...
February 16, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28214457/operative-fixation-of-rib-fractures-indications-techniques-and-outcomes
#10
David Galos, Benjamin Taylor, Toni McLaurin
Rib fractures are extremely common injuries and vary in there severity from single nondisplaced fractures to multiple segmental fractures resulting in flail chest and respiratory compromise. Historically, rib fractures have been treated conservatively with pain control and respiratory therapy. However this method may not be the best treatment modality in all situations. Operative fixation of select rib fractures has been increasing in popularity especially in patients with flail chest and respiratory compromise...
January 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28213266/noninvasivepositive-pressure-ventilation-vsinvasive-mechanical-ventilation-as-first-line-therapy-for-acute-hypoxemic-respiratory-failure-in-cancer-patients
#11
Nisha K Rathi, Sajid A Haque, Ron Nates, Alyssa Kosturakis, Hao Wang, Wenli Dong, Lei Feng, Rose J Erfe, Christina Guajardo, Laura Withers, Clarence Finch, Kristen J Price, Joseph L Nates
PURPOSE: The objective was to describe the characteristics and outcomes of critically ill cancer patients who received noninvasive positive pressure ventilation (NIPPV) vs invasive mechanical ventilation as first-line therapy for acute hypoxemic respiratory failure. MATERIAL AND METHODS: A retrospective cohort study of consecutive adult intensive care unit (ICU) cancer patients who received either conventional invasive mechanical ventilation or NIPPV as first-line therapy for hypoxemic respiratory failure...
January 20, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28212992/nivolumab-induced-interstitial-lung-disease-analysis-of-two-phase-ii-studies-patients-with-recurrent-or-advanced-non-small-cell-lung-cancer
#12
Terufumi Kato, Noriyuki Masuda, Yoichi Nakanishi, Masashi Takahashi, Toyoaki Hida, Hiroshi Sakai, Shinji Atagi, Shiro Fujita, Hiroshi Tanaka, Koji Takeda, Miyako Satouchi, Yoshinobu Namba, Tomohide Tamura
OBJECTIVES: Drug-induced interstitial lung disease (ILD) is often associated with high mortality; however it is difficult to predict and manage. we examined the clinical findings and imaging characteristics of nivolumab induced ILD reported in the two phase II studies patients with recurrent or advanced non-small-cell lung cancer. MATERIALS AND METHODS: We examined the clinical findings and imaging characteristics of all cases of ILD reported in two phase II trials of nivolumab, an anti-programmed death-1 antibody, in Japanese patients with recurrent or advanced non-small-cell lung cancer...
February 2017: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
https://www.readbyqxmd.com/read/28208022/protein-requirements-for-critically-ill-patients-with-renal-and-liver-failure
#13
Jayshil J Patel, Craig J McClain, Menaka Sarav, Jill Hamilton-Reeves, Ryan T Hurt
Diseases leading to critical illness induce proteolysis resulting in muscle wasting and negative nitrogen balance. Muscle wasting has been associated with poor intensive care unit (ICU)-related outcomes, including an increased risk for mortality. Acute kidney injury (AKI) represents a common organ dysfunction associated with ICU-related disorders, such as sepsis, trauma, and respiratory failure. AKI and renal replacement therapy lead to amino acid loss. Decompensated liver cirrhosis (DLC) and acute liver failure (ALF) represent more severe forms of liver dysfunction leading to ICU admission...
February 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28203337/comparison-of-the-efficacy-of-three-natural-surfactants-curosurf-survanta-and-alveofact-in-the-treatment-of-respiratory-distress-syndrome-among-neonates-a-randomized-controlled-trial
#14
Mirhadi Mussavi, Keyvan Mirnia, Khairollah Asadollahi
BACKGROUND: Although several different types of natural surfactants are available, including Alveofact, Curosurf, and Survanta, the preferred type and the magnitude of their effects are unknown. OBJECTIVES: This study was designed to compare the effects of these three surfactants on the gas exchange and clinical outcomes of neonates with respiratory distress syndrome (RDS). METHODS: This triple-blind randomized clinical trial studied all preterm neonates ≤ 37 weeks with RDS who were admitted to the neonatal intensive care unit (NICU) of Taleghani hospital (Tabriz, Iran) between 2012 and 2013...
October 2016: Iranian Journal of Pediatrics
https://www.readbyqxmd.com/read/28196469/extracorporeal-membrane-oxygenation-for-avian-influenza-a-h7n9-patient-with-acute-respiratory-distress-syndrome-a-case-report-and-short-literature-review
#15
Qi Nie, Ding-Yu Zhang, Wen-Juan Wu, Chao-Lin Huang, Zheng-Yi Ni
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is performed as an acceptable life-saving bridging procedure in patients with severe acute respiratory distress syndrome (ARDS).To patients with avian influenza A (H7N9)-associated ARDS, ECMO could be adopted as a feasible therapeutic solution. We present our successful experience with ECMO utilized in a respiratory failure patient with H7N9 infection. CASE PRESENTATION: A 44 years-old female with H7N9-induced ARDS was admitted to intensive care unit (ICU) and was treated with veno-venous ECMO for six days, antiviral therapy, prolonged corticosteroid infusion and other therapies...
February 14, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28195507/predicting-risk-factors-for-radiation-pneumonitis-after-stereotactic-body-radiation-therapy-for-primary-or-metastatic-lung-tumors
#16
Mitsuru Okubo, Tomohiro Itonaga, Tatsuhiko Saito, Sachika Shiraishi, Ryuji Mikami, Hidetugu Nakayama, Akira Sakurada, Shinji Sugahara, Kiyoshi Koizumi, Koichi Tokuuye
OBJECTIVES: To investigate risk factors for radiation-induced pneumonitis (RP) after hypofractionated stereotactic body radiotherapy (SBRT) in patients with lung tumors. METHODS: From May 2004 to January 2016, 66 patients with 71 primary or metastatic lung tumors were treated with SBRT; these 71 cases were retrospectively analyzed for RP. To explore the risk factors for RP, the following factors were investigated: age, sex, performance status, operability, number of treatments, respiratory gating, pulmonary emphysema, tumor location, and subclinical interstitial lung disease (ILD)...
February 14, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28188718/-hematopoietic-stem-cells-transplant-in-patients-with-common-variable-immunodeficiency-is-a-therapeutic-option
#17
Julio César Cambray-Gutiérrez, Diana Andrea Herrera-Sánchez, Patricia López-Pérez, Aurora Chávez-García, Marco Antonio Yamazaki-Nakashimada
BACKGROUND: Patients with common variable immunodeficiency show higher incidence of sinopulmonary and gastrointestinal infections, as well as lymphoproliferative and autoimmune diseases. The treatment of choice is replacement therapy with human gamma-globulin. Hematopoietic stem cell transplantation is a non-conventional therapeutic modality. CASE REPORT: Twenty-six-year old woman with no family or hereditary history of primary immune deficiencies or consanguinity, with repeated episodes of otitis, sinusitis, gastroenteritis and bronchitis since childhood...
January 2017: Revista Alergia Mexico: Organo Oficial de la Sociedad Mexicana de Alergia e Inmunología, A.C
https://www.readbyqxmd.com/read/28187115/clinical-course-of-enterovirus-d68-in-hospitalized-children
#18
Jennifer E Schuster, Rangaraj Selvarangan, Ferdaus Hassan, Kayla B Briggs, Lindsay Hays, Jenna O Miller, Barbara Pahud, Henry T Puls, Mary Ann Queen, Marita T Thompson, Gina Weddle, Mary Anne Jackson
BACKGROUND: Enterovirus D68 (EV-D68) has been sporadically reported as a cause of respiratory tract infections. In 2014, an international outbreak of EV-D68 occurred and caused severe respiratory disease in the pediatric population. METHODS: A retrospective chart review was performed of children admitted to Children's Mercy Hospital from August 1, 2014, to September 15, 2014, with positive multiplex polymerase chain reaction testing for EV/rhinovirus (RV). Specimens were subsequently tested for EV-D68, and clinical data were obtained from the medical records...
March 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28187065/clinical-course-of-enterovirus-d68-in-hospitalized-children
#19
Jennifer E Schuster, Rangaraj Selvarangan, Ferdaus Hassan, Kayla B Briggs, Lindsay Hays, Jenna O Miller, Barbara Pahud, Henry T Puls, Mary Ann Queen, Marita T Thompson, Gina Weddle, Mary Anne Jackson
BACKGROUND: Enterovirus D68 (EV-D68) has been sporadically reported as a cause of respiratory tract infections. In 2014, an international outbreak of EV-D68 occurred and caused severe respiratory disease in the pediatric population. METHODS: A retrospective chart review was performed of children admitted to Children's Mercy Hospital from August 1-September 15, 2014 with positive multiplex PCR testing for enterovirus/rhinovirus (EV/RV). Specimens were subsequently tested for EV-D68, and clinical data were obtained from the medical records...
December 13, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28186850/the-use-of-dexmedetomidine-in-pediatric-palliative-care-a-preliminary-study
#20
Jamie Burns, Kevin Jackson, Kathy A Sheehy, Julia C Finkel, Zenaide M Quezado
OBJECTIVE: To evaluate the effect of dexmedetomidine infusions in patients with advanced malignancies, advanced heart disease, or after stem cell transplantation (SCT), who during end-of-life care had pain and/or agitation unresponsive to conventional therapies. BACKGROUND: Pediatric patients with intractable advanced malignancies, end-stage congenital heart diseases, or after SCT can suffer a great deal during end of life. Pain, drowsiness, fatigue, irritability, and worrying are experienced frequently, considered distressing, and are strongly associated with reductions in health-related quality-of-life scores...
February 10, 2017: Journal of Palliative Medicine
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