keyword
https://read.qxmd.com/read/38246033/tuning-into-mirnas-a-comprehensive-analysis-of-their-impact-on-diagnosis-and-progression-in-asthma
#21
REVIEW
Mahmoud A Elrebehy, Ahmed I Abulsoud, Walaa A El-Dakroury, Sherif S Abdel Mageed, Shereen Saeid Elshaer, Doaa Fathi, Nehal I Rizk, Yasser M Moustafa, Mohammed S Elballal, Osama A Mohammed, Mustafa Ahmed Abdel-Reheim, Mohamed Bakr Zaki, Abdulla M A Mahmoud, Ahmed A Rashad, Eman S Sawan, Tohada M Al-Noshokaty, Sameh Saber, Ahmed S Doghish
Asthma is a diverse inflammatory illness affecting the respiratory passages, leading to breathing challenges, bouts of coughing and wheezing, and, in severe instances, significant deterioration in quality of life. Epigenetic regulation, which involves the control of gene expression through processes such as post-transcriptional modulation of microRNAs (miRNAs), plays a role in the evolution of various asthma subtypes. In immune-mediated diseases, miRNAs play a regulatory role in the behavior of cells that form the airway structure and those responsible for defense mechanisms in the bronchi and lungs...
January 19, 2024: Pathology, Research and Practice
https://read.qxmd.com/read/38240536/stress-ulcer-prophylaxis-versus-placebo-a-blinded-pilot-randomized-controlled-trial-to-evaluate-the-safety-of-two-strategies-in-critically-ill-infants-with-congenital-heart-disease
#22
RANDOMIZED CONTROLLED TRIAL
Kimberly I Mills, Ben D Albert, Lori J Bechard, Stephen Chu, Christopher P Duggan, Aditya Kaza, Seth Rakoff-Nahoum, Lynn A Sleeper, Jane W Newburger, Gregory P Priebe, Nilesh M Mehta
OBJECTIVES: The routine use of stress ulcer prophylaxis (SUP) in infants with congenital heart disease (CHD) in the cardiac ICU (CICU) is controversial. We aimed to conduct a pilot study to explore the feasibility of performing a subsequent larger trial to assess the safety and efficacy of withholding SUP in this population (NCT03667703). DESIGN, SETTING, PATIENTS: Single-center, prospective, double-blinded, parallel group (SUP vs. placebo), pilot randomized controlled pilot trial (RCT) in infants with CHD admitted to the CICU and anticipated to require respiratory support for greater than 24 hours...
February 1, 2024: Pediatric Critical Care Medicine
https://read.qxmd.com/read/38215710/mechanical-ventilation-past-present-and-future
#23
JOURNAL ARTICLE
Francesca Rubulotta, Lluis Blanch Torra, Kuban D Naidoo, Hatem Soliman Aboumarie, Lufuno R Mathivha, Abdulrahman Y Asiri, Leonardo Sarlabous Uranga, Sabri Soussi
Mechanical ventilation (MV) has played a crucial role in the medical field, particularly in anesthesia and in critical care medicine (CCM) settings. MV has evolved significantly since its inception over 70 years ago and the future promises even more advanced technology. In the past, ventilation was provided manually, intermittently, and it was primarily used for resuscitation or as a last resort for patients with severe respiratory or cardiovascular failure. The earliest MV machines for prolonged ventilatory support and oxygenation were large and cumbersome...
February 1, 2024: Anesthesia and Analgesia
https://read.qxmd.com/read/38211628/acute-invasive-pulmonary-aspergillosis-clinical-presentation-and-treatment
#24
JOURNAL ARTICLE
Jannes Heylen, Yuri Vanbiervliet, Johan Maertens, Bart Rijnders, Joost Wauters
Among all clinical manifestations of pulmonary aspergillosis, invasive pulmonary aspergillosis (IPA) is the most acute presentation. IPA is caused by Aspergillus hyphae invading the pulmonary tissue, causing either tracheobronchitis and/or bronchopneumonia. The degree of fungal invasion into the respiratory tissue can be seen as a spectrum, going from colonization to deep tissue penetration with angio-invasion, and largely depends on the host's immune status. Patients with prolonged, severe neutropenia and patients with graft-versus-host disease are at particularly high risk...
January 11, 2024: Seminars in Respiratory and Critical Care Medicine
https://read.qxmd.com/read/38197931/icu-acquired-infections-in-immunocompromised-patients
#25
REVIEW
Louis Kreitmann, Julie Helms, Ignacio Martin-Loeches, Jorge Salluh, Garyphallia Poulakou, Frédéric Pène, Saad Nseir
Immunocompromised patients account for an increasing proportion of the typical intensive care unit (ICU) case-mix. Because of the increased availability of new drugs for cancer and auto-immune diseases, and improvement in the care of the most severely immunocompromised ICU patients (including those with hematologic malignancies), critically ill immunocompromised patients form a highly heterogeneous patient population. Furthermore, a large number of ICU patients with no apparent immunosuppression also harbor underlying conditions altering their immune response, or develop ICU-acquired immune deficiencies as a result of sepsis, trauma or major surgery...
January 10, 2024: Intensive Care Medicine
https://read.qxmd.com/read/38196063/antifungal-resistance-in-pulmonary-aspergillosis
#26
JOURNAL ARTICLE
Paul E Verweij, Yinggai Song, Jochem B Buil, Jianhua Zhang, Willem J G Melchers
Aspergilli may cause various pulmonary diseases in humans, including allergic bronchopulmonary aspergillosis (ABPA), chronic pulmonary aspergillosis (CPA), and acute invasive pulmonary aspergillosis (IPA). In addition, chronic colonization may occur in cystic fibrosis (CF). Aspergillus fumigatus represents the main pathogen, which may employ different morphotypes, for example, conidia, hyphal growth, and asexual sporulation, in the various Aspergillus diseases. These morphotypes determine the ease by which A...
January 9, 2024: Seminars in Respiratory and Critical Care Medicine
https://read.qxmd.com/read/38190702/serum-cell-free-dna-based-detection-of-mycobacterium-avium-complex-infection
#27
JOURNAL ARTICLE
Lin Li, Emily Henkle, Brady M Youngquist, Seungyeon Seo, Kamal Hamed, David Melnick, Christopher J Lyon, Li Jiang, Adrian M Zelazny, Tony Y Hu, Kevin L Winthrop, Bo Ning
RATIONALE: Mycobacterium avium complex (MAC) is the most common cause of nontuberculous mycobacterial pulmonary disease (NTM-PD), which exhibits increasing global incidence. Current microbiologic methods routinely used in clinical practice lack sensitivity and have long latencies, leading to delays in diagnosis and treatment initiation and evaluation. A CRISPR-based assay that measures MAC cell-free DNA (MAC-cfDNA) levels in serum could provide a rapid means to detect MAC infection and monitor response to antimicrobial treatment...
January 8, 2024: American Journal of Respiratory and Critical Care Medicine
https://read.qxmd.com/read/38166777/clinical-evolution-and-mortality-of-critically-ill-patients-with-sars-cov-2-pneumonia-treated-with-remdesivir-in-an-adult-intensive-care-unit-of-paraguay
#28
JOURNAL ARTICLE
Jessica Figueredo, Lorena Fontclara Lopez, Belinda Figueredo Leguizamon, Margarita Samudio, Marcelo Pederzani, Federico Fretes Apelt, Patricia Añazco, Ricardo Caballero, Hugo Bianco
BACKGROUND: The health crisis due to Covid-19 led to the search for therapeutics that could improve the evolution of the disease. Remdesivir, an antiviral that interferes with viral replication, was one of the first to be used for the treatment of this pathology. OBJECTIVE: To determine clinical course and mortality of patients with severe SARS-CoV-2 pneumonia treated with remdesivir, in comparison of those who didn't receive the medication. PATIENTS AND METHODS: Retrospective cohort study, with medical records review of COVID-19 patients, between August 2020 and August 2021...
January 2, 2024: BMC Infectious Diseases
https://read.qxmd.com/read/38154471/chronic-pulmonary-aspergillosis-clinical-presentation-and-management
#29
JOURNAL ARTICLE
Terry J Evans, AbdulAzeez Lawal, Chris Kosmidis, David W Denning
Chronic pulmonary aspergillosis (CPA) refers to a number of clinical syndromes resulting from the presence and local proliferation of Aspergillus organisms in the lungs of patients with chronic lung disease. CPA is more common than was realized two decades ago. Recognition remains poor, despite recent studies from many countries highlighting the high prevalence in at-risk populations. In low- and middle-income countries, CPA may be misdiagnosed and treated as tuberculosis (TB). In addition, CPA may develop following successful TB treatment...
February 2024: Seminars in Respiratory and Critical Care Medicine
https://read.qxmd.com/read/38151025/antifungal-therapies-for-aspergillus-spp-present-and-future
#30
JOURNAL ARTICLE
Gregory A Eschenauer
Currently available and recommended options for the treatment of pulmonary aspergillosis include the triazoles, echinocandins, and amphotericin B products. These therapies have significant limitations. Only the azoles are available orally, but their use is often limited by toxicities, drug-drug interactions, pharmacokinetic variability, and emerging resistance. While the echinocandins are safe agents and may have a role in combination therapy, they are unproven as monotherapy. Amphotericin B preparations are toxic and require intensive monitoring...
December 27, 2023: Seminars in Respiratory and Critical Care Medicine
https://read.qxmd.com/read/38134946/the-burden-of-bacterial-antimicrobial-resistance-in-the-who-african-region-in-2019-a-cross-country-systematic-analysis
#31
JOURNAL ARTICLE
(no author information available yet)
BACKGROUND: A critical and persistent challenge to global health and modern health care is the threat of antimicrobial resistance (AMR). Previous studies have reported a disproportionate burden of AMR in low-income and middle-income countries, but there remains an urgent need for more in-depth analyses across Africa. This study presents one of the most comprehensive sets of regional and country-level estimates of bacterial AMR burden in the WHO African region to date. METHODS: We estimated deaths and disability-adjusted life-years (DALYs) attributable to and associated with AMR for 23 bacterial pathogens and 88 pathogen-drug combinations for countries in the WHO African region in 2019...
December 19, 2023: Lancet Global Health
https://read.qxmd.com/read/38117405/cell-derived-biomimetic-nanoparticles-for-the-targeted-therapy-of-ali-ards
#32
REVIEW
Rui Gao, Peihong Lin, Zhengyu Fang, Wenjing Yang, Wenyan Gao, Fangqian Wang, Xuwang Pan, Wenying Yu
Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are common clinical critical diseases with high morbidity and mortality. Especially since the COVID-19 outbreak, the mortality rates of critically ill patients with ARDS can be as high as 60%. Therefore, this problem has become a matter of concern to respiratory critical care. To date, the main clinical measures for ALI/ARDS are mechanical ventilation and drug therapy. Although ventilation treatment reduces mortality, it increases the risk of hyperxemia, and drug treatment lacks safe and effective delivery methods...
December 20, 2023: Drug Delivery and Translational Research
https://read.qxmd.com/read/38116548/the-efficacy-of-high-dose-pulse-therapy-vs-low-dose-intravenous-methylprednisolone-on-severe-to-critical-covid-19-clinical-outcomes-a-randomized-clinical-trial
#33
JOURNAL ARTICLE
Zahra Sahraei, Parnaz Panahi, Kouroush Solhjoukhah, Maryam Mesbah, Siamak Afaghi, Mahdi Amirdosara, Jamshid Salamzadeh, Farzad Esmaeili Tarki, Ilad Alavi Darazam
BACKGROUND: It remains unclear which formulation of the corticosteroid regimen has the optimum efficacies on COVID-19 pneumonia. OBJECTIVES: The aim of this study was to compare the clinical outcomes of 2 different regimens in the treatment of acute respiratory distress syndrome (ARDS) caused by COVID-19: Methylprednisolone at a dose of 1 mg/kg every 12 hours (low-dose group) and 1000 mg/day pulse therapy for 3 days following 1 mg/kg methylprednisolone every 12 hours (high-dose group)...
2023: Iranian Journal of Pharmaceutical Research: IJPR
https://read.qxmd.com/read/38099833/antimicrobial-drug-penetration-is-enhanced-by-lung-tissue-inflammation-and-injury
#34
JOURNAL ARTICLE
Johannes Geilen, Matthias Kainz, Bernhard Zapletal, Asami Naka, Johanna Tichy, Walter Jäger, Michaela Böhmdorfer, Markus Zeitlinger, Marcus J Schultz, Tanja Stamm, Valentin Ritschl, Silvana Geleff, Edda Tschernko
RATIONALE: Pneumonia is a frequent and feared complication in intubated critically ill patients. Tissue concentrations of antimicrobial drugs need to be sufficiently high to treat the infection and also prevent development of bacterial resistance. It is uncertain whether pulmonary inflammation and injury affect antimicrobial drug penetration into lung tissue. OBJECTIVE: To determine and compare tissue and bronchoalveolar lavage fluid concentrations of ceftaroline fosamil and linezolid in a model of unilateral acute lung injury in pigs and to evaluate if dose adjustment is necessary to reach sufficient antimicrobial concentrations in injured lung tissue...
December 15, 2023: American Journal of Respiratory and Critical Care Medicine
https://read.qxmd.com/read/38087423/comparison-of-fixed-dosing-vs-train-of-four-titration-of-cisatracurium-in-covid-19-ards-patients
#35
JOURNAL ARTICLE
Oyshik Banerjee, Jessica L Elefritz, Bruce A Doepker, Sara A Atyia, Nathan E Brummel, Rachel M Smith, Demond Handley, Kari M Cape
Background: Early neuromuscular blockade with cisatracurium has been associated with improved outcomes in moderate-severe acute respiratory distress syndrome (ARDS). Previous studies have demonstrated increased drug utilization without benefits in oxygenation using fixed dose cisatracurium compared to train-of-four (TOF) titration. Objective: We sought to compare a novel, lower fixed dose cisatracurium protocol to TOF titration evaluating the impact on PaO2:FiO2 ratio (P/F). Methods: We conducted a single-center retrospective cohort study comparing fixed dose cisatracurium to TOF titration...
December 12, 2023: Journal of Pharmacy Practice
https://read.qxmd.com/read/38078286/ventilator-associated-pneumonia-in-an-academic-intensive-care-unit-in-johannesburg-south-africa
#36
JOURNAL ARTICLE
S Mazwi, S A van Blydenstein, M Mukansi
BACKGROUND: Ventilator-associated pneumonia (VAP) has an estimated incidence of 10 - 41.5 events per 1 000 ventilator days in developing countries, and carries high mortality. Little is known about the incidence and outcomes of VAP in Johannesburg, South Africa. OBJECTIVES: To describe VAP in a tertiary public hospital in Johannesburg, assess the microbiological pathogens associated with VAP (both early and late), and outline the outcomes of these patients. METHODS: The study was a retrospective record review of patients admitted to the Helen Joseph Hospital intensive care unit (ICU) between March 2013 and January 2016...
2023: African journal of thoracic and critical care medicine
https://read.qxmd.com/read/38075410/impact-of-nested-multiplex-polymerase-chain-reaction-assay-in-the-management-of-pediatric-patients-with-acute-respiratory-tract-infections-a-single-center-experience
#37
JOURNAL ARTICLE
Basma Sherif, Heba M Hamza, Hoda Ezz Elarab Abdelwahab
PURPOSE: Acute lower respiratory infection (ALRI) remains a global public health problem among children. Distinguishing the etiology of ALRI is challenging and rapid pathogen identification is critical for optimizing the diagnosis and treatment of infectious diseases. Multiplex polymerase chain reaction (PCR) is sensitive, simple, and rapid. Our objective was to evaluate the diagnostic yield and prognostic significance of the FilmArray test for identification of pathogens in pediatric patients with ALRI at a tertiary care center...
2023: Le Infezioni in Medicina
https://read.qxmd.com/read/38065297/sedation-with-propofol-remifentanil-versus-dexmedetomidine-remifentanil-for-patients-undergoing-transcatheter-aortic-valve-implant-a-retrospective-study-between-2012-and-2019
#38
JOURNAL ARTICLE
B H Vela, P J Cubillo, C B Fernández, L G Ligorit, M C Ferrer Gracía, J Antonio Diarte
BACKGROUND AND OBJECTIVES: Percutaneous implantation of an aortic valve prosthesis is a therapeutic alternative for patients with severe aortic stenosis. The procedure is traditionally performed under general anaesthesia; however, sedation is now gaining in popularity because it reduces the need for vasoactive drugs and shortens the patient's stay in the critical care unit and on the ward. The aim of this study is to evaluate the clinical efficacy, safety and potential benefits of sedation with dexmedetomidine in patients undergoing percutaneous implantation of an aortic valve prosthesis in terms of haemodynamic and respiratory complications...
December 6, 2023: Revista española de anestesiología y reanimación
https://read.qxmd.com/read/38062689/-expert-consensus-on-diagnosis-and-treatment-of-severe-covid-19-associated-with-pulmonary-aspergillus-and-mucormycosis
#39
JOURNAL ARTICLE
(no author information available yet)
The incidence and mortality of COVID-19 associated pulmonary aspergillosis (CAPA) are high in critically ill patients. Although COVID-19 associated mucormycosis (CAPM) is relatively rare, its severity and often a delayed diagnosis or misdiagnosis lead to its high mortality. The diagnosis and treatment of CAPA and CAPM in critically ill patients are challenging. Early diagnosis and a standardized therapy are the two most important factors for a good outcome. Therefore, a working group of experts from Chinese Thoracic Society and Chinese Association of Chest Physicians Critical Care Group was organized to develop this consensus based on the current medical evidence and clinical practice, in order to improve the ability of clinical treatment for critically ill patients with CAPA and CAPM...
December 8, 2023: Chinese Journal of Tuberculosis and Respiratory Diseases
https://read.qxmd.com/read/38055081/severe-infections-requiring-intensive-care-unit-admission-in-patients-receiving-ibrutinib-for-hematological-malignancies-a-groupe-de-recherche-respiratoire-en-r%C3%A3-animation-onco-h%C3%A3-matologique-grrr-oh-study
#40
JOURNAL ARTICLE
Louise Baucher, Virginie Lemiale, Adrien Joseph, Florent Wallet, Marc Pineton de Chambrun, Alexis Ferré, Romain Lombardi, Laura Platon, Adrien Contejean, Charline Fuseau, Laure Calvet, Frédéric Pène, Achille Kouatchet, Djamel Mokart, Elie Azoulay, Antoine Lafarge
BACKGROUND: In the last decade, Ibrutinib has become the standard of care in the treatment of several lymphoproliferative diseases such as chronic lymphocytic leukemia (CLL) and several non-Hodgkin lymphoma. Beyond Bruton tyrosine kinase inhibition, Ibrutinib shows broad immunomodulatory effects that may promote the occurrence of infectious complications, including opportunistic infections. The infectious burden has been shown to vary by disease status, neutropenia, and prior therapy but data focusing on severe infections requiring intensive care unit (ICU) admission remain scarce...
December 6, 2023: Annals of Intensive Care
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