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https://www.readbyqxmd.com/read/29765591/a-case-of-periorbital-necrotizing-fasciitis-rapidly-progressing-to-severe-multiorgan-failure
#1
Paola Eiben, Sancho Rodriguez-Villar
Periorbital necrotizing fasciitis (PNF) is a severe suppurative infection of the subcutaneous tissue and underlying fascia of the periorbital region. Typically, the course of PNF is milder and has a better prognosis than that of necrotizing fasciitis in other parts of the body. As such, this disease is thought to be associated with a significantly smaller risk of morbidity and mortality. Nevertheless, it is a rare and devastating condition that can lead to disfigurement, blindness and death. Early recognition is critical to improved patient outcomes...
April 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29764969/cardiovascular-phenotype-and-prognosis-of-patients-with-heart-failure-induced-by-cancer-therapy
#2
Wilson Nadruz, Erin West, Morten Sengeløv, Gabriela L Grove, Mário Santos, John D Groarke, Daniel E Forman, Brian Claggett, Hicham Skali, Anju Nohria, Amil M Shah
OBJECTIVE: This study compared the clinical features, cardiac structure and function evaluated by echocardiography, cardiopulmonary response to exercise and long-term clinical outcomes between patients with heart failure (HF) induced by cancer therapy (CTHF) and heart failure not induced by cancer therapy (NCTHF). METHODS: We evaluated 75 patients with CTHF and 894 with NCTHF who underwent clinically indicated cardiopulmonary exercise testing, and followed these individuals for a median of 4...
May 15, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29764401/management-of-acute-respiratory-failure-in-interstitial-lung-diseases-overview-and-clinical-insights
#3
REVIEW
Paola Faverio, Federica De Giacomi, Luca Sardella, Giuseppe Fiorentino, Mauro Carone, Francesco Salerno, Jousel Ora, Paola Rogliani, Giulia Pellegrino, Giuseppe Francesco Sferrazza Papa, Francesco Bini, Bruno Dino Bodini, Grazia Messinesi, Alberto Pesci, Antonio Esquinas
BACKGROUND: Interstitial lung diseases (ILDs) are a heterogeneous group of diseases characterized by widespread fibrotic and inflammatory abnormalities of the lung. Respiratory failure is a common complication in advanced stages or following acute worsening of the underlying disease. Aim of this review is to evaluate the current evidence in determining the best management of acute respiratory failure (ARF) in ILDs. METHODS: A literature search was performed in the Medline/PubMed and EMBASE databases to identify studies that investigated the management of ARF in ILDs (the last search was conducted on November 2017)...
May 15, 2018: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29732178/femoro-jugular-cannulation-in-veno-venous-extracorporeal-membrane-oxygenation-pro-con
#4
REVIEW
Martina Crivellari, Federico Pappalardo
Veno-venous (VV) extracorporeal membrane oxygenation (ECMO) is the most efficient technique for respiratory support. It is based on a patient adequate circulation and cardiac function and it is indicated for isolated lung failure after optimization of the ventilatory support and the medical treatment. We describe PRO and CONs of the Femoro-jugular (F>J) approach, as an ideal setting for patients which require high flow (>5 L/min), such as those with extreme hypoxemia and/or septic shock. This technique can be accomplished very quickly at the bedside also in an unstable patient...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29729860/is-ventilatory-therapy-combined-with-exercise-training-effective-in-patients-with-heart-failure-and-sleep-disordered-breathing-results-of-a-randomized-trial-during-a-cardiac-rehabilitation-programme-satelit-hf
#5
Marie-Christine Iliou, Sonia Corone, Barnabas Gellen, Thierry Denolle, Frederic Roche, Anaïs Charles Nelson, Christian Darné
BACKGROUND: Sleep-related disordered breathing is common in patients with chronic heart failure. AIM: To assess the efficacy of short-term nocturnal ventilatory therapy combined with exercise training (V+ET) compared with exercise training alone (ET) in patients with chronic heart failure with sleep-disordered breathing. METHODS: Patients in New York Heart Association functional class II-IIIb, with an apnoea-hypopnoea index (AHI)>15/h, and enrolled in a cardiac rehabilitation programme, were centrally randomized to V+ET or ET...
May 2, 2018: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29721319/successful-ventilator-weaning-following-vascular-bypass-in-patient-with-vascular-tracheobronchial-compression
#6
Kei Sonehara, Toshitaka Shomura, Masanori Yasuo, Atsuhito Ushiki, Hiroshi Yamamoto, Masayuki Hanaoka
A 74-year-old man, who had undergone thoracoplasty for tuberculous sequelae 54 years earlier, was referred to our hospital with a chief complaint of dyspnea. He had recently received mechanical ventilation due to pneumonia. However, although the pneumonia had improved, extubation was prevented by the presence of hypercapnic respiratory failure with tracheal stenosis due to compression of the right aortic arch and the left common carotid artery. Bypass surgery was performed, during which the left subclavian artery was placed over the left common carotid artery...
July 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29689105/cerebral-desaturation-in-heart-failure-potential-prognostic-value-and-physiologic-basis
#7
Yu-Jen Chen, Jong-Shyan Wang, Chih-Chin Hsu, Pyng-Jing Lin, Feng-Chun Tsai, Ming-Shien Wen, Chi-Tai Kuo, Shu-Chun Huang
Cerebral tissue oxygen saturation (SctO2) reflects cerebral perfusion and tissue oxygen consumption, which decline in some patients with heart failure with reduced ejection fraction (HFrEF) or stroke, especially during exercise. Its physiologic basis and clinical significance remain unclear. We aimed to investigate the association of SctO2 with oxygen transport physiology and known prognostic factors during both rest and exercise in patients with HFrEF or stroke. Thirty-four HFrEF patients, 26 stroke patients, and 17 healthy controls performed an incremental cardiopulmonary exercise test using a bicycle ergometer...
2018: PloS One
https://www.readbyqxmd.com/read/29679387/the-pharmacokinetics-and-pharmacodynamics-of-carfentanil-after-recreational-exposure-a-case-report
#8
Uvaraj Uddayasankar, Colin Lee, Curtis Oleschuk, Gregg Eschun, Robert E Ariano
Carfentanil and related fentanyl analogues have been linked to a number of overdose deaths from drug users in several cities across North America. Diagnosis of carfentanil exposure requires a very high index of clinical suspicion, especially because available laboratory narcotic screens do not detect this agent. We describe a 34-year-old male admitted with depressed level of consciousness and in respiratory failure after recreational exposure to a white powder later inferred to contain carfentanil. Urine and whole blood samples were obtained for conventional preliminary drug screen immunoassays for unknown exposures; in addition to utilizing high pressure liquid chromatography tandem mass spectrometry assay for quantification of carfentanil and its metabolite...
April 20, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29678727/assessment-of-thoracic-blood-volume-by-computed-tomography-in-patients-with-heart-failure-and-periodic-breathing
#9
Caitlin C Fermoyle, Steven C Chase, Lyle J Olson, Bruce D Johnson
BACKGROUND: Periodic breathing (PB) is often observed in patients with HF at rest, with sleep and during exercise. However, mechanisms underlying abnormal ventilatory control are not entirely established. METHODS: Eleven subjects with HF (10M, age=69±12yr) and 12 age-matched controls (8M, age=65±9yr) participated in the study. PB was defined as a peak in the 0.003-0.04Hz frequency range of the flow signal during 6-minutes of awake resting breathing. Thoracic blood volumes (Vt , thorax; Vh , heart; Vp , pulmonary), mean transit times (MTT) and extravascular lung water (EVLW) were quantified using computed tomography...
April 17, 2018: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/29663436/early-effects-of-empagliflozin-on-exercise-tolerance-in-patients-with-heart-failure-a-pilot-study
#10
Julio Núñez, Patricia Palau, Eloy Domínguez, Anna Mollar, Eduardo Núñez, Jose María Ramón, Gema Miñana, Enrique Santas, Lorenzo Fácila, Jose Luis Górriz, Juan Sanchis, Antoni Bayés-Genís
BACKGROUND: Sodium-glucose linked transporter 2 inhibition recently emerged as a promising therapy for reducing the risk of heart failure (HF) in patients with type 2 diabetes mellitus (T2DM). However, there is a lack of data endorsing its role in symptomatic HF patients. We sought to evaluate the short-term effects of empagliflozin on maximal exercise capacity in these patients. HYPOTHESIS: We postulate tretament with empagliflozin may improve functional capacity in patients with T2DM and established HF...
April 17, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29628475/prognostic-improvement-of-acute-necrotizing-eosinophilic-myocarditis-anem-through-a-rapid-pathological-diagnosis-and-appropriate-therapy
#11
Akihiko Yonenaga, Eriko Hasumi, Katsuhito Fujiu, Aya Ushiku, Masaru Hatano, Jiro Ando, Hiroyuki Morita, Masafumi Watanabe, Issei Komuro
We present the case of a patient with acute necrotizing eosinophilic myocarditis (ANEM) who rapidly recovered after receiving high-dose corticosteroid therapy. A previously healthy 29-year-old woman presented to our hospital with abdominal pain, nausea, and fever that had lasted for two days. Her clinical condition progressively declined and she ultimately presented with cardiogenic shock due to fulminant heart failure and atrioventricular dissociation due to sinus bradycardia, which required inotropic and ventilatory support...
April 6, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29623546/exercise-rehabilitation-in-ventricular-assist-device-recipients-a-meta-analysis-of-effects-on-physiological-and-clinical-outcomes
#12
REVIEW
Liza Grosman-Rimon, Spencer D Lalonde, Nina Sieh, Maureen Pakosh, Vivek Rao, Paul Oh, Sherry L Grace
Exercise rehabilitation in heart failure patients has been shown to improve quality of life (QoL) and survival. It is also recommended in clinical practice guidelines for ventricular assist device (VAD) recipients. However, there have only been two meta-analyses on the effects of exercise rehabilitation in VAD patients, on only two outcomes. The objective of the review was to quantitatively evaluate the effect of exercise rehabilitation in VAD recipients on functional capacity, exercise physiology parameters, chronotropic responses, inflammatory biomarkers and neurohormones, heart structure and function, and clinical outcomes...
April 6, 2018: Heart Failure Reviews
https://www.readbyqxmd.com/read/29607174/effect-of-a-passive-exhalation-port-on-tracheostomy-ventilation-in-amyotrophic-lateral-sclerosis-patients-a-randomized-controlled-trial
#13
Andrea Vianello, Giovanna Arcaro, Beatrice Molena, Silvia Iovino, Federico Gallan, Cristian Turato, Rosario Marchese-Ragona
Background: Amyotrophic lateral sclerosis (ALS) patients often require long-term tracheostomy ventilation (LT-TV) because of progressive ventilatory failure. Although widely used for non-invasive ventilation (NIV), passive exhalation port systems have not been gaining popularity for TV because of the possibility of carbon dioxide (CO2 ) rebreathing. The current study set out to investigate the effect of a Whisper Swivel connector in comparison to an active exhalation valve on gas exchange and symptoms in ALS patients requiring LT-TV...
February 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29602482/-neurofibromatosis-as-a-cause-of-breathlessness
#14
A Palot, C Ferrandez, K Alagha, A Ilstad-Minnihan, C Tummino, M Gouitaa, D Charpin, P Chanez
INTRODUCTION: Type 1 neurofibromatosis, also called "Recklinghausen's disease" is among the most frequent autosomal dominant genetic disorders, with an incidence of 1:3500 births. It mainly affects the skin and peripheral nervous system. However, in its less frequent manifestations, are tumors such as meningocele and skeletal dysplasias leading to severe clinical presentation. CASE REPORT: We report the case of a 55-year-old patient with type 1 neurofibromatosis and dyspnea due to a large left thoracic meningocele combined with a significant kyphoscoliosis, causing a severe restrictive ventilatory defect, complicated by chronic respiratory failure and pulmonary hypertension...
March 27, 2018: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/29593914/rituximab-induced-pulmonary-edema-managed-with-extracorporeal-life-support
#15
Jacob R Miller, Warren Isakow, Muhammad F Masood, Patrick Aguilar, Kristen M Sanfilippo, Keki R Balsara, Akinobu Itoh
Though rare, rituximab has been reported to induce severe pulmonary edema. We describe the first report of ECLS utilization for this indication. A 31-year-old female with severe thrombotic thrombocytopenic purpura developed florid pulmonary edema after rituximab infusion. Despite advanced ventilatory settings, she developed severe respiratory acidosis and remained hypoxemic with a significant vasopressor requirement. Since her pulmonary insult was likely transient, ECLS was considered. Due to combined cardiorespiratory failure, she received support with peripheral venoarterial ECLS...
2018: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29588313/reliability-and-physiological-interpretation-of-pulmonary-gas-exchange-by-circulatory-equivalents-in-chronic-heart-failure
#16
Chunting Tan, Harry B Rossiter, Janos Porszasz, T Scott Bowen, Klaus K Witte, William W Stringer, Richard Casaburi, James E Hansen
BACKGROUND: Peak ratios of pulmonary gas-exchange to ventilation during exercise (V˙O2/V˙E and V˙CO2/V˙E, termed "circulatory equivalents") are sensitive to heart failure (HF) severity, likely reflecting low and/or poorly distributed pulmonary perfusion. We tested whether peak V˙O2/V˙E and V˙CO2/V˙E would: (1) distinguish HF patients from controls; (2) be independent of incremental exercise protocol; and (3) correlate with lactate threshold (LT) and ventilatory compensation point (VCP), respectively...
March 27, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29576198/tracheal-leiomyosarcoma-urgent-bronchoscopic-treatment-of-an-acute-ventilatory-failure
#17
Micaela Raices, Agustín Dietrich, Rodrigo S Castro, David Smith
No abstract text is available yet for this article.
March 22, 2018: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/29575588/exercise-on-transition-uncoupling-of-ventilatory-gas-exchange-and-cardiac-hemodynamic-kinetics-accompany-pulmonary-oxygen-stores-depletion-to-impact-exercise-intolerance-in-human-heart-failure
#18
Erik H Van Iterson, Joshua R Smith, Thomas P Olson
AIM: In contrast to knowledge that heart failure (HF) demonstrate peak exercise uncoupling across ventilation, gas-exchange, and cardiac hemodynamics, whether this dyssynchrony follows that at the exercise on-transition is unclear. This study tested whether exercise on-transition temporal lag for ventilation relative to gas-exchange and oxygen pulse (O2 pulse) couples with effects from abnormal pulmonary gaseous oxygen store (O2store ) contributions to V̇O2 to interdependently precipitate persistently elevated ventilatory demand and low oxidative metabolic capacity in HF...
March 25, 2018: Acta Physiologica
https://www.readbyqxmd.com/read/29571133/lc-ms-based-serum-fingerprinting-reveals-significant-dysregulation-of-phospholipids-in-chronic-heart-failure
#19
M Marcinkiewicz-Siemion, M Ciborowski, K Ptaszynska-Kopczynska, A Szpakowicz, A Lisowska, M Jasiewicz, E Waszkiewicz, A Kretowski, W J Musial, K A Kaminski
Cardiac and extracardiac lipid metabolism is known to be significantly altered in the course of the heart failure with reduced ejection fraction (HF-REF), however the precise mechanisms are not fully elucidated. The aim of the study was to use of untargeted metabolomics to identify and validate changes in the blood metabolites profile, occurring as a result of HF-REF development. The analyses were performed first in the derivation set (36 chronic HF-REF patients and 19 controls without the disease) and repeated in validation cohort (31 chronic HF-REF patients and 20 controls)...
March 15, 2018: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/29564726/potentially-modifiable-respiratory-variables-contributing-to-outcome-in-icu-patients-without-ards-a-secondary-analysis-of-provent
#20
Fabienne D Simonis, Carmen S V Barbas, Antonio Artigas-Raventós, Jaume Canet, Rogier M Determann, James Anstey, Goran Hedenstierna, Sabrine N T Hemmes, Greet Hermans, Michael Hiesmayr, Markus W Hollmann, Samir Jaber, Ignacio Martin-Loeches, Gary H Mills, Rupert M Pearse, Christian Putensen, Werner Schmid, Paolo Severgnini, Roger Smith, Tanja A Treschan, Edda M Tschernko, Marcos F Vidal Melo, Hermann Wrigge, Marcelo Gama de Abreu, Paolo Pelosi, Marcus J Schultz, Ary Serpa Neto
BACKGROUND: The majority of critically ill patients do not suffer from acute respiratory distress syndrome (ARDS). To improve the treatment of these patients, we aimed to identify potentially modifiable factors associated with outcome of these patients. METHODS: The PRoVENT was an international, multicenter, prospective cohort study of consecutive patients under invasive mechanical ventilatory support. A predefined secondary analysis was to examine factors associated with mortality...
March 21, 2018: Annals of Intensive Care
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