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https://www.readbyqxmd.com/read/27933693/heart-transplantation-in-children-with-intellectual-disability-an-analysis-of-the-unos-database
#1
Alexander N Goel, Amit Iyengar, Kenneth Schowengerdt, Andrew C Fiore, Charles B Huddleston
Heart transplantation in children with intellectual disability (ID) is an issue of debate due to the shortage of available donor organs. We sought to perform the first large-scale retrospective cohort study describing the prevalence and outcomes of heart transplantation in this population. The United Network of Organ Sharing database was queried from 2008 to 2015 for pediatric patients (age <19 years) receiving first, isolated heart transplant. Recipients were divided into three subgroups: definite ID, probable ID, and no ID...
December 9, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27932672/a-led-based-phosphorimeter-for-measurement-of-microcirculatory-oxygen-pressure
#2
Philippe Guerci, Yasin Ince, Paul Heeman, Dirk J Faber, Bulent Ergin, Can Ince
Quantitative measurements of microcirculatory and tissue oxygenation are of prime importance in experimental research. Non-invasive time-resolved quenching of phosphorescence has given further insight into the fundamental mechanisms of oxygen transport to healthy tissues and in models of disease. Phosphorimeters are devices dedicated to the study of phosphorescence quenching. The experimental applications of phosphorimeters range from measuring a specific oxygen partial pressure (PO2) in cellular organelles such as mitochondria, finding values of PO2 distributed over an organ or capillaries, to measuring microcirculatory PO2 changes simultaneously in several organ systems...
December 8, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/27932671/coupling-of-eit-with-computational-lung-modeling-for-predicting-patient-specific-ventilatory-responses
#3
Christian J Roth, Tobias Becher, Inez Frerichs, Norbert Weiler, Wolfgang A Wall
Providing personalised optimal mechanical ventilation for patients with acute or chronic respiratory failure is still a challenge within a clinical setting for each case anew. In this article, we integrate electrical impedance tomography (EIT) monitoring into a powerful patient-specific computational lung model to create an approach for personalising protective ventilatory treatment. The underlying computational lung model is able to predict global quantities e.g., tracheal flow and tidal volume, as well as local tissue aeration and strains for any ventilation manoeuvre...
December 8, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/27932031/number-of-rib-fractures-thresholds-independently-predict-worse-outcomes-in-older-patients-with-blunt-trauma
#4
Nikita O Shulzhenko, Tiffany J Zens, Megan V Beems, Hee Soo Jung, Ann P O'Rourke, Amy E Liepert, John E Scarborough, Suresh K Agarwal
BACKGROUND: There have been conflicting reports regarding whether the number of rib fractures sustained in blunt trauma is associated independently with worse patient outcomes. We sought to investigate this risk-adjusted relationship among the lesser-studied population of older adults. METHODS: A retrospective review of the National Trauma Data Bank was performed for patients with blunt trauma who were ≥65 years old and had rib fractures between 2009 and 2012 (N = 67,695)...
December 5, 2016: Surgery
https://www.readbyqxmd.com/read/27931317/influence-of-rack-design-and-disease-prevalence-on-detection-of-rodent-pathogens-in-exhaust-debris-samples-from-individually-ventilated-caging-systems
#5
Beth A Bauer, Cynthia Besch-Williford, Robert S Livingston, Marcus J Crim, Lela K Riley, Matthew H Myles
Sampling of bedding debris within the exhaust systems of ventilated racks may be a mechanism for detecting murine pathogens in colony animals. This study examined the effectiveness of detecting pathogens by PCR analysis of exhaust debris samples collected from ventilated racks of 2 different rack designs, one with unfiltered air flow from within the cage to the air-exhaust pathway, and the other had a filter between the cage and the air-exhaust pathway. For 12 wk, racks were populated with either 1 or 5 cages of mice (3 mice per cage) infected with one of the following pathogens: mouse norovirus (MNV), mouse parvovirus (MPV), mouse hepatitis virus (MHV), Helicobacter spp...
November 2016: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/27931033/low-positive-airway-pressure-without-positive-end-expiratory-pressure-decreases-blood-loss-during-hepatectomy-in-living-liver-donors
#6
Tomohiro Iguchi, Toru Ikegami, Tetsuhiro Fujiyoshi, Tomoharu Yoshizumi, Ken Shirabe, Yoshihiko Maehara
BACKGROUND/AIMS: Despite the development of strategies to minimize blood loss during hepatectomy challenges remain. Our aim was to determine whether low positive airway pressure (PAP) without positive end-expiratory pressure (PEEP) could minimize blood loss during hepatectomy. METHODS: Forty-one living liver donors who underwent extended left lobectomy or right lobectomy between December 2012 and November 2013 were retrospectively analyzed. In the standard PAP group (n = 18), tidal volume was 8-10 ml/kg, respiratory rate was 10-12/min and PEEP was maintained at 5 cm H2O...
December 9, 2016: Digestive Surgery
https://www.readbyqxmd.com/read/27930572/acute-onset-chronic-inflammatory-demyelinating-polyneuropathy-in-hantavirus-and-hepatitis-b-virus-coinfection-a-case-report
#7
Jong Youb Lim, Young-Ho Lim, Eun-Hi Choi
INTRODUCTION: Chronic inflammatory demyelinating polyneuropathy (CIDP) is an acquired autoimmune disorder with progressive weakness. Acute-onset CIDP resembles Guillain-Barre syndrome (GBS), a rapidly progressive disorder, and follows a chronic course. To our knowledge, no case of acute-onset CIDP in hantavirus and hepatitis B virus (HBV) coinfection has been reported previously. CLINICAL FINDINGS: We report a case of acute-onset CIDP that was initially diagnosed as GBS...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27930361/determining-the-appropriate-model-complexity-for-patient-specific-advice-on-mechanical-ventilation
#8
Stephen E Rees, Dan S Karbing
Mathematical physiological models can be applied in medical decision support systems. To do so requires consideration of the necessary model complexity. Models that simulate changes in the individual patient are required, meaning that models should have a complexity where parameters can be uniquely identified at the bedside from clinical data and where the models adequately represent the individual patient's (patho)physiology. This paper describes the models included in a system for providing decision support for mechanical ventilation...
December 8, 2016: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/27928595/-left-ventricular-unloading-in-cardiogenic-shock
#9
A Schäfer, J Bauersachs
Cardiogenic shock is an acute life-threatening condition, which results in impaired end-organ perfusion and oxygenation. Invasive ventilation and medicinal treatment with inotropes or vasopressors are necessary in most cases; however, they are also associated with reduced long-term prognosis. Frequently, medical treatment is not even sufficient to stabilize the patient; therefore, dedicated mechanical circulatory support devices that actively reduce the load on the left ventricle were developed to allow myocardial recovery or to gain time until definitive treatment...
December 7, 2016: Herz
https://www.readbyqxmd.com/read/27927871/severity-of-respiratory-syncytial-virus-lower-respiratory-tract-infection-with-viral-coinfection-in-hiv-uninfected-children
#10
Natalie I Mazur, Louis Bont, Adam L Cohen, Cheryl Cohen, Anne von Gottberg, Michelle J Groome, Orienka Hellferscee, Kerstin Klipstein-Grobusch, Omphile Tschegofatso Mekgoe, Fathima Naby, Jocelyn Moyes, Stefano Tempia, Florette K Treurnicht, Marietje Venter, Sibongile Walaza, Nicole Wolter, Shabir A Madhi
BACKGROUND: Molecular diagnostics enable sensitive detection of respiratory viruses but their clinical significance remains unclear in pediatric lower respiratory tract infections (LRTI). We aimed to determine whether viral coinfections increased life-threatening disease in a large cohort. METHODS: Molecular testing was performed for respiratory viruses in nasopharyngeal aspirates collected from children aged <5 years within 24 hours of hospital admission during sentinel surveillance for Severe Acute Respiratory Illness (SARI) hospitalisation conducted in South Africa during February 2009-December 2013...
December 7, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27927814/non-invasive-ventilation-in-acute-respiratory-failure-a-meta-analysis
#11
Yu-Jing Liu, Jing Zhao, Hui Tang
Non-invasive positive-pressure ventilation (NPPV) has assumed an important role in the management of respiratory failure because it provides ventilatory support without the need for an invasive airway. However, its effectiveness remains unclear. We performed this meta-analysis to investigate the utility of NPPV intervention in patients with acute respiratory failure (ARF). A comprehensive literature search identified 12 studies enrolling a total of 963 patients from Medline, PubMed, Cochrane and EMBASE databases that assessed the effectiveness of NPPV versus conventional mechanical ventilation and/or non-ventilation therapy in patients with ARF, irrespective of the underlying aetiology, as well as mortality rate and the length of intensive care unit (ICU) or hospital stay...
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27927755/characteristics-and-outcomes-of-patients-with-myocarditis-listed-for-heart-transplantation
#12
Chantal A ElAmm, Sadeer G Al-Kindi, Guilherme H Oliveira
BACKGROUND: Myocarditis can cause dilated cardiomyopathy resulting in end-stage heart failure requiring advanced therapies. There is little contemporary information on the clinical progression, need for mechanical circulatory support, and outcomes of orthotopic heart transplantation of these patients. METHODS AND RESULTS: We queried the UNOS database (United Network for Organ Sharing) for all adults listed for orthotopic heart transplantation (2000-2015) with a listed diagnosis of myocarditis...
December 2016: Circulation. Heart Failure
https://www.readbyqxmd.com/read/27927604/factors-predicting-failure-of-noninvasive-ventilation-assist-for-preventing-reintubation-among-medical-critically-ill-patients
#13
Preecha Thomrongpairoj, Surat Tongyoo, Withaya Tragulmongkol, Chairat Permpikul
PURPOSE: Reintubation after failed extubation is associated with high mortality. Noninvasive ventilation (NIV) has been used to prevent reintubation, but the results have been inconclusive. We investigated the factors predicting failure of NIV-assisted extubation among medical critically ill patients. MATERIALS AND METHODS: This retrospective cohort study enrolled patients who were admitted to medical intensive care units at Siriraj Hospital between March 2012 and August 2015 who required more than 48 hours of mechanical ventilation and who received NIV after endotracheal extubation...
November 30, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27925855/costs-associated-with-influenza-related-hospitalization-in-the-elderly
#14
Núria Torner, Encarna Navas, Núria Soldevila, Diana Toledo, Gemma Navarro, Aurea Morillo, Maria José Pérez, Angela Domínguez
Seasonal influenza epidemics remain a considerable burden in adults, especially in those at higher risk of complications. The aim of this study was to determine the costs associated with influenza-related hospitalization in patients aged ≥65 years admitted to 20 hospitals from seven Spanish regions during the 2013-14 and 2014-15 influenza seasons. Bivariate analysis was used to compare costs in vaccinated and unvaccinated cases. Costs were calculated according to the Spanish National Health System diagnosis-related group tables for influenza and other respiratory system conditions (GRD 89 and GRD 101)...
December 7, 2016: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/27925446/the-declined-levels-of-inflammatory-cytokines-related-with-weaning-rate-during-period-of-septic-patients-using-ventilators
#15
Jung-Lung Hsiao, Chao-Huei Yang, Mei-Hua Lu, Hui-Ming Chang, Wang-Sheng Ko, Ya-Ling Chiou
INTRODUCTION: Approximately 50% of patients with sepsis-induced acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) require mechanical ventilation. Patients with extended mechanical ventilator use routinely develop re-infections, which increases hospital stay, mortality, and health care cost. Some studies have pointed out inflammatory factors concentrations can affect ventilator weaning, but do not indicate changed inflammatory factors related to ventilator weaning during using ventilators...
December 7, 2016: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/27925393/intensive-care-unit-icu-readmission-after-major-lung-resection-prevalence-patterns-and-mortality
#16
Jae Jun Jung, Jong Ho Cho, Tae Hee Hong, Hong Kwan Kim, Yong Soo Choi, Jhingook Kim, Young Mog Shim, Jae Ill Zo
BACKGROUND: The aim of this study was to identify risk factors associated with mortality in patients re-admitted to an intensive care unit (ICU) after initial recovery from major lung resection. METHODS: We retrospectively reviewed the case records of all patients who underwent major lung resection between February 2011 and May 2013. A total of 1916 patients underwent major resection surgery for various lung diseases, 63 (3.3%) of which required ICU admission after initial recovery...
December 7, 2016: Thoracic Cancer
https://www.readbyqxmd.com/read/27925235/quantification-of-operational-learning-in-minimal-invasive-extracorporeal-circulation
#17
Kyriakos Anastasiadis, Polychronis Antonitsis, Christos Asteriou, Helena Argiriadou, Apostolos Deliopoulos, Dimitrios Konstantinou, Vassilios Grosomanidis, Paschalis Tossios
Minimal invasive extracorporeal circulation (MiECC) has initiated important new efforts within science and technology towards a more physiologic perfusion. In this study, we aim to investigate the learning curve of our center regarding MiECC. We studied a series of 150 consecutive patients who underwent elective coronary artery bypass grafting by the same surgical team during the initial phase of MiECC application. Patients were randomly assigned into two groups. Group A (n = 75) included patients operated on MiECC, while group B (n = 75) included patients operated with conventional cardiopulmonary bypass (cCPB)...
December 7, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27925055/lung-protection-an-intervention-for-tidal-volume-reduction-in-a-teaching-intensive-care-unit
#18
Arturo Briva, Cristina Gaiero
Objective: To determine the effect of feedback and education regarding the use of predicted body weight to adjust tidal volume in a lung-protective mechanical ventilation strategy. Methods: The study was performed from October 2014 to November 2015 (12 months) in a single university polyvalent intensive care unit. We developed a combined intervention (education and feedback), placing particular attention on the importance of adjusting tidal volumes to predicted body weight bedside...
December 1, 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/27925054/prone-position-in-patients-with-acute-respiratory-distress-syndrome
#19
Mariano Setten, Gustavo Adrián Plotnikow, Matías Accoce
Acute respiratory distress syndrome occupies a great deal of attention in intensive care units. Despite ample knowledge of the physiopathology of this syndrome, the focus in intensive care units consists mostly of life-supporting treatment and avoidance of the side effects of invasive treatments. Although great advances in mechanical ventilation have occurred in the past 20 years, with a significant impact on mortality, the incidence continues to be high. Patients with acute respiratory distress syndrome, especially the most severe cases, often present with refractory hypoxemia due to shunt, which can require additional treatments beyond mechanical ventilation, among which is mechanical ventilation in the prone position...
December 1, 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/27924171/predictors-of-transition-to-hospice-care-among-hospitalized-older-adults-with-a-diagnosis-of-dementia-in-texas-a-population-based-study
#20
Lavi Oud
BACKGROUND: Decedent older adults with dementia are increasingly less likely to die in a hospital, though escalation of care to a hospital setting, often including critical care, remains common. Although hospice is increasingly reported as the site of death in these patients, the factors associated with transition to hospice care during end-of-life (EOL) hospitalizations of older adults with dementia and the extent of preceding escalation of care to an intensive care unit (ICU) setting among those discharged to hospice have not been examined...
January 2017: Journal of Clinical Medicine Research
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