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https://www.readbyqxmd.com/read/29666710/acute-chest-syndrome-progressing-to-ards-in-a-patient-of-25-week-gestation
#1
Jefferson Chambers, Nichole Smith, Matthew Sehring, Subramanyam Chittivelu
Acute chest syndrome is a complication of sickle cell disease and represents the highest cause of mortality in those afflicted with the disorder. Pregnancy represents an increased risk for complications of sickle cell disease in both the mother and fetus. We present a case of a 20-year-old patient with known sickle cell disease who was at 25-week gestation and developed acute chest syndrome refractory to conventional therapies and requiring emergency cesarean section. Following delivery, the patient developed acute respiratory distress syndrome (ARDS) requiring extracorporeal membrane oxygenation (ECMO)...
2018: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29666203/efficacy-and-safety-of-pulmonary-application-of-corticosteroids-in-preterm-infants-with-respiratory-distress-syndrome-a-systematic-review-and-meta-analysis
#2
Mahin Delara, Bhupendrasinh F Chauhan, Mê-Linh Le, Ahmed M Abou-Setta, Ryan Zarychanski, Geert W 'tJong
BACKGROUND: Systemic corticosteroids as the frontline treatment of respiratory distress syndrome (RDS) in preterm infants are associated with adverse effects on growth and neurodevelopmental outcome, but the pulmonary administration of steroids may help prevent the development of bronchopulmonary dysplasia (BPD) without these side effects. OBJECTIVES: To evaluate the efficacy and safety of pulmonary application of corticosteroids in preterm infants with RDS. METHODS: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ClinicalTrials...
April 17, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29665838/fungal-infections-in-adult-patients-on-extracorporeal-life-support
#3
Yiorgos Alexandros Cavayas, Hakeem Yusuff, Richard Porter
BACKGROUND: Patients on extracorporeal membrane oxygenation (ECMO) are often among the most severely ill in the intensive care unit. They are often receiving broad-spectrum antibiotics; they have multiple entry points for pathogens; and their immune system is impaired by blood circuit interaction. These factors are thought to predispose them to fungal infections. We thus aimed to evaluate the prevalence, risk factors, and prognosis of fungal infections in adults on ECMO. METHODS: We conducted a retrospective cohort study using the Extracorporeal Life Support Organization registry, which compiles data on ECMO use from hundreds of international centers...
April 17, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29660840/the-effectiveness-of-magnesium-sulfate-for-status-asthmaticus-outside-the-intensive-care-setting
#4
Ryan L DeSanti, Nisha Agasthya, Krystal Hunter, Mohammed J Hussain
AIM: Magnesium is an adjunctive therapy used in patients with status asthmaticus who do not respond to conventional therapy. The optimal time from initiation of therapy, to determination of response and administration of magnesium has not yet been resolved. Our objective was to determine if magnesium administered in the non-intensive care setting can decrease duration of continuous albuterol and hospital length of stay. METHODS: We performed a retrospective cohort analysis of children ages 2-18 years admitted to the pediatric unit on continuous albuterol between January 2014 and December 2015 in a tertiary care children's hospital...
April 16, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29660241/copd-is-independently-associated-with-six-month-survival-in-patients-who-have-life-support-withheld-in-intensive-care
#5
A Maamar, S Chevalier, P Fillâtre, V Botoc, Y Le Tulzo, A Gacouin, J M Tadié
BACKGROUND: In-hospital outcomes following decisions of withholding or withdrawing in Intensive Care Unit (ICU) patients have been previously assessed, little is known about outcomes after ICU and hospital discharge. Our objective was to report the six-month outcomes of discharged patients who had treatment limitations in a general ICU and to identify prognostic factors of survival. METHODS: We retrospectively collected the data of patients discharged from the ICU for whom life support was withheld from 2009 to 2011...
April 16, 2018: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29659754/a-randomized-study-evaluating-the-effectiveness-of-oseltamivir-initiated-at-the-time-of-hospital-admission-in-adults-hospitalized-with-influenza-associated-lower-respiratory-tract-infections
#6
Julio Ramirez, Paula Peyrani, Timothy Wiemken, Sandra S Chaves, Alicia M Fry
Background: Influenza-associated hospitalizations result in high morbidity and mortality. We sought to determine if early empiric anti-influenza therapy improves outcomes of hospitalized patients with influenza-associated lower respiratory tract infections (I-LRTIs). Methods: This was a randomized, unblinded, trial of adult patients hospitalized with I-LRTIs in Kentucky during 2009-2012. Patients were randomized to group A (standard of care) or group B (standard of care plus oseltamivir as early as possible but within 24 hours of enrollment)...
April 11, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29658448/-clinical-features-and-prognosis-of-preterm-infants-with-varying-degrees-of-bronchopulmonary-dysplasia
#7
Wen-Li Li, Fa-Lin Xu, Ming Niu, Meng-Di Liu, Hui-Fang Dong
OBJECTIVE: To study the clinical features and prognosis of preterm infants with varying degrees of bronchopulmonary dysplasia (BPD). METHODS: The clinical data of 144 preterm infants with a gestational age of <32 weeks who were admitted to the neonatal intensive care unit from March 2014 to March 2016 and were diagnosed with BPD were collected. According to the severity of BPD, these preterm infants were divided into mild group with 81 infants and moderate/severe group with 63 infants...
April 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29656714/epidemiology-of-sepsis-in-intensive-care-units-in-turkey-a-multicenter-point-prevalence-study
#8
Nur Baykara, Halis Akalın, Mustafa Kemal Arslantaş, Volkan Hancı, Çiğdem Çağlayan, Ferda Kahveci, Kubilay Demirağ, Canan Baydemir, Necmettin Ünal
BACKGROUND: The prevalence and mortality of sepsis are largely unknown in Turkey, a country with high antibiotic resistance. A national, multicenter, point-prevalence study was conducted to determine the prevalence, causative microorganisms, and outcome of sepsis in intensive care units (ICUs) in Turkey. METHODS: A total of 132 ICUs from 94 hospitals participated. All patients (aged > 18 years) present at the participating ICUs or admitted for any duration within a 24-h period (08:00 on January 27, 2016 to 08:00 on January 28, 2016) were included...
April 16, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29656306/oral-and-sublingual-immunotherapy-for-treatment-of-ige-mediated-food-allergy
#9
REVIEW
Amy M Scurlock
Development of active therapies for IgE-mediated food allergy is a critical action step toward alleviating the adverse medical, psychosocial, and economic burdens on affected patients and families. Significant progress has been observed specifically in the application of single-allergen oral and sublingual immunotherapy for treatment of IgE-mediated food allergy, with emphasis on milk, egg, and peanut as the primary allergens. Oral immunotherapy (OIT) has demonstrated efficacy in promoting immunomodulatory effects that lead to the clinical outcome of desensitization, defined as reduced reactivity while on active OIT, in the majority of treated individuals; however, achievement of sustained unresponsiveness following cessation of therapy has been observed in a smaller subset of treated subjects...
April 14, 2018: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/29655987/overcoming-safety-challenges-in-co-therapy-extracorporeal-co-delivery-under-precise-feedback-control-of-systemic-carboxyhemoglobin-levels
#10
Jakob Wollborn, Cornelius Hermann, Ulrich Goebel, Benjamin Merget, Christian Wunder, Sven Maier, Thomas Schäfer, Dominik Heuler, Klaus Müller-Buschbaum, Hartmut Buerkle, Lorenz Meinel, Martin A Schick, Christoph Steiger
Carbon monoxide (CO) has demonstrated therapeutic potential in multiple inflammatory conditions including intensive care applications such as organ transplantation or sepsis. Approaches to translate these findings into future therapies, however, have been challenged by multiple hurdles including handling and toxicity issues associated with systemic CO delivery. Here, we describe a membrane-controlled Extracorporeal Carbon Monoxide Release System (ECCORS) for easy implementation into Extracorporeal Membrane Oxygenation (ECMO) setups, which are being used to treat cardiac and respiratory diseases in various intensive care applications...
April 12, 2018: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/29655864/comparison-of-the-severity-of-respiratory-disease-in-children-testing-positive-for-enterovirus-d68-and-human-rhinovirus
#11
Esra Caylan, Ezra Weinblatt, John Welter, Allen Dozor, Guiqing Wang, Sheila M Nolan
OBJECTIVE: To compare the characteristics and severity of respiratory disease in children testing positive for enterovirus D68 (EV-D68) and for human rhinovirus (RhV). STUDY DESIGN: A retrospective single center study of children presenting with acute respiratory symptoms and positive polymerase chain reaction for RhV/EV from September 1, 2014 through October 31, 2014 was performed. Specimens were subsequently tested specifically for EV-D68 and specimens identified as RhV were subtyped when possible into RhV-A, RhV-B, and RhV-C species...
April 11, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29652926/assessment-of-costs-associated-with-adverse-events-in-patients-with-cancer
#12
William Wong, Yeun Mi Yim, Ashley Kim, Martin Cloutier, Marjolaine Gauthier-Loiselle, Patrick Gagnon-Sanschagrin, Annie Guerin
Adverse event (AE)-related costs represent an important component of economic models for cancer care. However, since previous studies mostly focused on specific AEs, treatments, or cancer types, limited information is currently available. Therefore, this study assessed the incremental healthcare costs associated with a large number of AEs among patients diagnosed with some of the most prevalent types of cancer. Data were obtained from a large US claims database. Adult patients were included if diagnosed with and treated for one of the following cancer types: breast, digestive organs and peritoneum, genitourinary organs (including bladder and ovary and other uterine adnexa), lung, lymphatic and hematopoietic tissue, and skin...
2018: PloS One
https://www.readbyqxmd.com/read/29652913/ventilator-associated-pneumonia-in-patients-assisted-by-veno-arterial-extracorporeal-membrane-oxygenation-support-epidemiology-and-risk-factors-of-treatment-failure
#13
Adrien Bouglé, Camille Bombled, Dimitri Margetis, Guillaume Lebreton, Charles Vidal, Marine Coroir, David Hajage, Julien Amour
INTRODUCTION: Ventilator-associated pneumonia (VAP) is frequent in Intensive Care Unit (ICU) patients. In the specific case of patients treated with Veno-Arterial Extracorporeal Membrane Oxygenation Support (VA-ECMO), VAP treatment failures (VAP-TF) have been incompletely investigated. METHODS: To investigate the risk factors of treatment failure (VAP-TF) in a large cohort of ICU patients treated with VA-ECMO, we conducted a retrospective study in a Surgical ICU about patients assisted with VA-ECMO between January 1, 2013, and December 31, 2014...
2018: PloS One
https://www.readbyqxmd.com/read/29650603/top-studies-relevant-to-primary-care-practice
#14
REVIEW
Danielle Perry, Michael R Kolber, Christina Korownyk, Adrienne J Lindblad, Jamil Ramji, Joey Ton, G Michael Allan
OBJECTIVE: To summarize 10 high-quality studies from 2017 that have strong relevance to primary care practice. QUALITY OF EVIDENCE: Study selection involved routine literature surveillance by a group of primary care health professionals. This included screening abstracts of important journals and Evidence Alerts, as well as searching the American College of Physicians Journal Club. MAIN MESSAGE: Topics of the 2017 articles include whether treating subclinical hypothyroidism improves outcomes or symptoms; whether evolocumab reduces cardiovascular disease as well as low-density lipoprotein levels; whether lifestyle interventions reduce medication use in patients with diabetes; whether vitamin D prevents cardiovascular disease, cancer, or upper respiratory tract infections; whether canagliflozin reduces clinical events in patients with diabetes; how corticosteroid injections affect knee osteoarthritis; whether drained abscesses benefit from antibiotic treatment; whether patients with diabetes benefit from bariatric surgery; whether exenatide reduces clinical events in patients with diabetes; and whether tympanostomy tubes affect outcomes in recurrent acute otitis media or chronic otitis media...
April 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29648477/acute-intensive-care-unit-management-of-mustard-gas-victims-the-turkish-experience
#15
Ertugrul Kilic, Mesut Ortatatli, Sermet Sezigen, Rusen Koray Eyison, Levent Kenar
Sulfur mustard (SM) is an highly toxic and vesicant chemical weapon that was used in various military conflicts several times in the history. The severity of ocular, dermal, and pulmonary symptoms that may appear following a characteristic asymptomatic period are depending on the SM concentration and exposure duration. The aim of this study is to present the clinical features and share the intensive care unit (ICU) experiences for the medical management of mustard gas victims. Thirteen Free Syrian Army soldiers near Al-Bab region of North Syria were reportedly exposed to oily blackish smoke with garlic smell due to the explosion of a trapped bomb without causing any blast or thermal effect on 26th November 2016...
April 12, 2018: Cutaneous and Ocular Toxicology
https://www.readbyqxmd.com/read/29644297/negative-pressure-in-treatment-of-persistent-post-traumatic-subcutaneous-emphysema-with-respiratory-failure-case-report-and-literature-review
#16
Jakov Mihanović, Ivan Bačić, Nina Sulen
Subcutaneous emphysema may aggravate traumatic pneumothorax treatment, especially when mechanical ventilation is required. Expectative management usually suffices, but when respiratory function is impaired surgical treatment might be indicated. Historically relevant methods are blowhole incisions and placement of various drains, often with related wound complications. Since the first report of negative pressure wound therapy for the treatment of severe subcutaneous emphysema in 2009, only few publications on use of commercially available sets were published...
February 2018: Trauma Case Reports
https://www.readbyqxmd.com/read/29642928/diagnostic-and-management-of-life-threatening-adult-onset-still-disease-a-french-nationwide-multicenter-study-and-systematic-literature-review
#17
Antoine Néel, Anaïs Wahbi, Benoit Tessoulin, Julien Boileau, Dorothée Carpentier, Olivier Decaux, Laurence Fardet, Guillaume Geri, Pascal Godmer, Cécile Goujard, Hervé Maisonneuve, Arnaud Mari, Jacques Pouchot, Jean-Marc Ziza, Cédric Bretonnière, Mohamed Hamidou
BACKGROUND: Adult-onset Still disease (AOSD) is a rare systemic inflammatory disorder. A few patients develop organ complications that can be life-threatening. Our objectives were to describe the disease course and phenotype of life-threatening AOSD, including response to therapy and long-term outcome. METHODS: A multicenter case series of intensive care medicine (ICU) patients with life-threatening AOSD and a systematic literature review. RESULTS: Twenty patients were included...
April 11, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29627936/invasive-fungal-infections-associated-with-prior-respiratory-viral-infections-in-immunocompromised-hosts
#18
Saira Ajmal, Maryam Mahmood, Omar Abu Saleh, Jenifer Larson, M Rizwan Sohail
BACKGROUND: Increased risk of invasive pulmonary aspergillosis after influenza infection has been reported; however data are limited. PURPOSE: To describe Invasive fungal infections (IFI) associated with preceding respiratory viral infection at a large referral center. METHODS: We reviewed all IFI cases among patients with positive influenza and/or RSV nasopharyngeal/lower respiratory tract PCR from October 2015 to December 2016. Cases of pulmonary IFI were classified as possible, probable, and definite based on EORTC-MSG definitions...
April 7, 2018: Infection
https://www.readbyqxmd.com/read/29627883/platelet-transfusion-increases-risk-for-acute-respiratory-distress-syndrome-in-non-massively-transfused-blunt-trauma-patients
#19
George Kasotakis, Nichole Starr, Erek Nelson, Bedabrata Sarkar, Peter Ashley Burke, Daniel George Remick, Ronald Gary Tompkins
PURPOSE: While damage control resuscitation is known to confer a survival advantage in severely injured patients, high-ratio blood component therapy should be initiated only in carefully selected trauma patients, due to the morbidity associated with blood product use. With this project, we aim to identify the effect of platelet transfusion in non-massively transfused bluntly injured patients. METHODS: The Glue Grant database was retrospectively queried and severely injured blunt trauma patients who underwent non-massive transfusion were identified...
April 7, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29625787/tropical-diseases-in-the-icu-a-syndromic-approach-to-diagnosis-and-treatment
#20
Dilip R Karnad, Guy A Richards, Gisele Sampaio Silva, Pravin Amin
Tropical infections form 20-30% of ICU admissions in tropical countries. Diarrheal diseases, malaria, dengue, typhoid, rickettsial diseases and leptospirosis are common causes of critical illness. Overlapping clinical features makes initial diagnosis challenging. A systematic approach involving (1) history of specific continent or country of travel, (2) exposure to specific environments (forests or farms, water sports, consumption of exotic foods), (3) incubation period, and (4) pattern of organ involvement and subtle differences in manifestations help in differential diagnosis and choice of initial empiric therapy...
March 27, 2018: Journal of Critical Care
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