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Michelle Le, Lauren Khoury, Yang Lu, Connor Prosty, Maxime Cormier, Mathew P Cheng, Robert Fowler, Srinivas Murthy, Jennifer L Y Tsang, Moshe Ben-Shoshan, Elham Rahme, Shirin Golchi, Nandini Dendukuri, Todd C Lee, Elena Netchiporouk
BACKGROUND: Omalizumab is an anti-immunoglobulin E monoclonal antibody used to treat moderate to severe chronic idiopathic urticaria, asthma, and nasal polyps. Recent research suggested that omalizumab may enhance the innate antiviral response and have anti-inflammatory properties. OBJECTIVE: We aimed to investigate the efficacy and safety of omalizumab in adults hospitalized for coronavirus disease 2019 (COVID-19) pneumonia. METHODS: This was a phase II randomized, double blind, placebo-controlled trial comparing omalizumab with placebo (in addition to standard of care) in hospitalized patients with COVID-19...
April 2024: Open Forum Infectious Diseases
#22
JOURNAL ARTICLE
Dennis D Kumi, Rohan Gajjar, Joshua T Narh, Edwin Gwira-Tamattey, Muhammad Sana, Nana Yaa Ampaw, Anna Oduro, Samuel M Odoi, Sheriff Dodoo, Setri Fugar
Background The impact of long-term systemic steroid use on electrical and mechanical complications following ST-segment elevation myocardial infarction (STEMI) has not been extensively studied. Methods In a retrospective cohort study of the National Inpatient Sample (NIS) from 2018 to 2020, adults admitted with STEMI were dichotomized based on the presence of long-term (current) systemic steroid (LTCSS) use. The primary outcome was all-cause mortality. Secondary outcomes included a composite of mechanical complications, electrical, hemodynamic, and thrombotic complications, as well as revascularization complexity, length of stay (LOS), and total charge...
February 2024: Curēus
#23
JOURNAL ARTICLE
Joseph Pergolizzi, Thomas L Miller, Jeanette Mathews, Robert B Raffa, Robert Colucci, Frank J Diana, Errol Gould
Background ENA-001 (formerly known as GAL-021) is a novel, first-in-class respiratory stimulant. Pharmacokinetic and pharmacodynamic properties, plus safety and tolerability, were assessed in a randomized, single-center study of healthy volunteers. Methodology This four-period study was designed to test continuous two-hour intravenous infusion regimens of ENA-001 at doses of 0.96, 1.44, and 1.92 mg/kg/hour versus placebo. Each participant received four infusions with a seven-day minimum washout between them: one infusion each of the three doses of ENA-001 and one placebo...
February 2024: Curēus
#24
JOURNAL ARTICLE
Jolan Malherbe, Pierre Godard, Jean-Claude Lacherade, Valentin Coirier, Laurent Argaud, Hervé Hyvernat, Francis Schneider, Julien Charpentier, Florent Wallet, Juliette Pocquet, Gaëtan Plantefeve, Jean-Pierre Quenot, Pierre Bay, Agathe Delbove, Hugues Georges, Tomas Urbina, David Schnell, Charlène Le Moal, Matthieu Stanowski, Corentin Muris, Maud Jonas, Bertrand Sauneuf, Olivier Lesieur, Amaury Lhermitte, Laure Calvet, Ines Gueguen, Damien du Cheyron
BACKGROUND: Due to aging population and increasing part of immunocompromised patients, a raise in life-threatening organ damage related to VZV can be expected. Two retrospective studies were already conducted on VZV in ICU but focused on specific organ injury. Patients with high-risk of VZV disease still must be identified. The objective of this study was to report the clinical features and outcome of all life-threatening VZV manifestations requiring intensive care unit (ICU) admission...
March 29, 2024: Annals of Intensive Care
#25
JOURNAL ARTICLE
Moritz L Schmidbauer, Sebastian Läufer, Andreas Maskos, Konstantinos Dimitriadis
INTRODUCTION: Aneurysmal subarachnoid hemorrhage (aSAH) often necessitates prolonged sedation to manage elevated intracranial pressure (ICP) and to prevent secondary brain injury. Optimal timing and biomarkers for predicting adverse events (AEs) during interruption of sedation (IS) after prolonged sedation are not well established. To guide sedation management in aSAH, we aimed to explore the frequency, risk factors, and outcomes of IS in aSAH. METHODS: In a retrospective cohort study, a total of 148 patients with aSAH from January 2015 to April 2020 were screened...
2024: Frontiers in Neurology
#26
JOURNAL ARTICLE
Suzana Margareth Lobo, Gaétan Plantefève, Girish Nair, Adilson Joaquim Cavalcante, Nara Franzin de Moraes, Estevao Nunes, Otis Barnum, Claudio Marcel Berdun Stadnik, Maria Patelli Lima, Muriel Lins, Ludhmila Abrahao Hajjar, Christopher Lipinski, Shaheen Islam, Fabiano Ramos, Tiago Simon, Jean-Benoît Martinot, Thomas Guimard, Arnaud Desclaux, Bertrand Lioger, Fernando Carvalho Neuenschwander, Bruno DeSouza Paolino, Alpesh Amin, Samuel Amil Acosta, Daniel Forde Dilling, Edgardo Cartagena, Brian Snyder, Edouard Devaud, Ana Karolina Barreto Berselli Marinho, Suzana Tanni, Patricia Medeiros Milhomem Beato, Stephan De Wit, Vani Selvan, Jeffrey Gray, Ricardo Fernandez, Valérie Pourcher, Lee Maddox, Richard Kay, Anait Azbekyan, Mounia Chabane, Cendrine Tourette, Luis Everton Esmeraldino, Pierre J Dilda, René Lafont, Jean Mariani, Serge Camelo, Sandrine Rabut, Samuel Agus, Stanislas Veillet, Waly Dioh, Rob van Maanen, Capucine Morelot-Panzini
BACKGROUND: SARS-CoV-2 binding to ACE2 is potentially associated with severe pneumonia due to COVID-19. The aim of the study was to test whether Mas-receptor activation by 20-hydroxyecdysone (BIO101) could restore the Renin-Angiotensin System equilibrium and limit the frequency of respiratory failure and mortality in adults hospitalized with severe COVID-19. METHODS: Double-blind, randomized, placebo-controlled phase 2/3 trial. Randomization: 1:1 oral BIO101 (350 mg BID) or placebo, up to 28 days or until an endpoint was reached...
February 2024: EClinicalMedicine
#27
JOURNAL ARTICLE
Frederic S Zimmerman, Chanan Shaul, Yigal Helviz, Phillip D Levin
BACKGROUND: Tracheostomy in patients who are critically ill is generally performed due to prolonged mechanical ventilation and expected extubation failure. However, tracheostomy criteria and ideal timing are poorly defined, including equivocal data from randomized controlled trials and median intubation to tracheostomy times that range from 7-21 d. However, a consistent finding is that only ∼50% of late tracheostomy groups actually undergo tracheostomy, with non-performance due to recovery or clinical deterioration...
March 27, 2024: Respiratory Care
#28
JOURNAL ARTICLE
Hye-Mee Kwon, Sa-Jin Kang, Sang-Bin Han, Jae Hwan Kim, Sung-Hoon Kim, In-Gu Jun, Jun-Gol Song, Gyu-Sam Hwang
BACKGROUND: Acute kidney injury (AKI) is one of the most common complications after living-donor liver transplantation (LDLT) that has great impact on recipient and graft outcomes. Dexmedetomidine is reported to decrease the incidence of AKI. In the current study, we investigated whether intraoperative dexmedetomidine infusion would reduce the AKI following LDLT. MATERIAL AND METHODS: In total, 205 adult patients undergoing elective LDLT were randomly assigned to the dexmedetomidine group (n=103) or the control group (n=102)...
March 28, 2024: International Journal of Surgery
#29
JOURNAL ARTICLE
Seyedmostafa Sheikhalishahi, Mathias Kaspar, Sarra Zaghdoudi, Julia Sander, Philipp Simon, Benjamin P Geisler, Dorothea Lange, Ludwig Christian Hinske
Weaning patients from mechanical ventilation (MV) is a critical and resource intensive process in the Intensive Care Unit (ICU) that impacts patient outcomes and healthcare expenses. Weaning methods vary widely among providers. Prolonged MV is associated with adverse events and higher healthcare expenses. Predicting weaning readiness is a non-trivial process in which the positive end-expiratory pressure (PEEP), a crucial component of MV, has potential to be indicative but has not yet been used as the target...
March 2024: PLOS Digit Health
#30
Hirotaka Kinoshita, Kodai Kato, Yuma Yamazaki, Eiji Hashiba, Kazuyoshi Hirota
Clazosentan, a potent selective endothelin receptor subtype A antagonist, has been demonstrated to be effective in preventing cerebral vasospasms after subarachnoid hemorrhage. We report the successful management of respiratory failure due to pulmonary edema associated with clazosentan, with a hemodynamic monitoring system. A 49-year-old Japanese man underwent emergency clipping for a right internal carotid-posterior communicating artery aneurysm. The surgery and general anesthesia for the rupture proceeded with no complications...
February 2024: Curēus
#31
JOURNAL ARTICLE
Randeep S Heer, Faye L Selby, Amit K J Mandal, Vadir Baktash, Piotr Szawarski, Sirtaaj Mattoo, Hasan Mohiaddin, Kanchani K Makuloluwa, Hussein Chreif, Fouad R Amin, Constantinos G Missouris
BACKGROUND: QRS fragmentation (fQRS) is a depolarization disorder that can be detected on routine electrocardiography (ECG). Current evidence suggests that fQRS is a prognosticator of adverse cardiovascular events. This study aimed to assess the relationship between fQRS and all-cause mortality in critically unwell coronavirus disease 2019 (COVID-19) patients and to investigate the significance of associated abnormalities on echocardiography. METHODS: A retrospective cohort study of COVID-19 patients in a critical care setting was performed...
March 26, 2024: Anatolian Journal of Cardiology
#32
JOURNAL ARTICLE
Tori Kinamon, Ursula Waack, Mark Needles, Daniel Rubin, Deborah Collyar, Sarah B Doernberg, Scott R Evans, Toshimitsu Hamasaki, Thomas L Holland, Jessica Howard-Anderson, Henry Chambers, Vance G Fowler, Sumati Nambiar, Peter Kim, Helen W Boucher, Ramya Gopinath
BACKGROUND: Desirability of outcome ranking (DOOR) is an innovative approach to clinical trial design and analysis that uses an ordinal ranking system to incorporate the overall risks and benefits of a therapeutic intervention into a single measurement. Here, we derived and evaluated a disease-specific DOOR endpoint for registrational trials for hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia (HABP/VABP). METHODS: Through comprehensive examination of data from nearly 4,000 participants enrolled in six registrational trials for HABP/VABP submitted to the FDA between 2005-2022, we derived and applied a HABP/VABP specific endpoint...
March 25, 2024: Clinical Infectious Diseases
#33
REVIEW
Ryotaro Yoneoka, Kenichiro Takeda, Hajime Kasai, Toshihiko Sugiura, Kohei Shikano, Mitsuhiro Abe, Takuji Suzuki
BACKGROUND Hemoptysis due to airway hemorrhage is treated with hemostatic agents, bronchial artery embolization (BAE), or surgical resection. We present the case of a 65-year-old man with refractory hemoptysis associated with chronic progressive pulmonary aspergillosis (CPPA) who failed to respond to combined endobronchial occlusion (EBO) with endobronchial Watanabe spigot (EWS) and BAE. CASE REPORT A 63-year-old man was diagnosed with CPPA in the right upper lung and presented to our hospital 2 years later for hemoptysis at age 65...
March 13, 2024: American Journal of Case Reports
#34
JOURNAL ARTICLE
Deepak Talwar, Deepak Prajapat, Surbhi Talwar, Dhruv Talwar
INTRODUCTION: Colistin is used to treat hospital-acquired pneumonia and ventilator-associated pneumonia. However, direct drug deposition at the site of infection may improve its efficacy and reduce systemic exposure. The aim of this study was to assess the safety and tolerability of nebulized colistin among Indian patients diagnosed with pneumonia caused by multidrug-resistant gram-negative bacilli in real-world settings. METHODOLOGY: We retrospectively reviewed the medical records of patients treated with nebulized colistin for pneumonia...
February 2024: Curēus
#35
JOURNAL ARTICLE
Meseret Gebre, Kassa Haile, Trevor Duke, Md Tanveer Faruk, Mehnaz Kamal, Md Farhad Kabir, Md Fakhar Uddin, Muluye Shimelis, Tigist Beyene, Bethelhem Solomon, Meles Solomon, Abebe Genetu Bayih, Alemseged Abdissa, Taye Tolera Balcha, Rahel Argaw, Asrat Demtse, Abate Yeshidinber Weldetsadik, Abayneh Girma, Bitseat W Haile, Abu Sadat Mohammad Sayeem Bin Shahid, Tahmeed Ahmed, John D Clemens, Mohammod Jobayer Chisti
BACKGROUND: The safety and efficacy of bubble continuous positive airway pressure (bCPAP) for treatment of childhood severe pneumonia outside tertiary care hospitals is uncertain. We did a cluster-randomised effectiveness trial of locally made bCPAP compared with WHO-recommended low-flow oxygen therapy in children with severe pneumonia and hypoxaemia in general hospitals in Ethiopia. METHODS: This open, cluster-randomised trial was done in 12 general (secondary) hospitals in Ethiopia...
March 21, 2024: Lancet Global Health
#36
JOURNAL ARTICLE
Yang-Han Lin, Ting-Chia Chang, Chung-Feng Liu, Chih-Cheng Lai, Chin-Ming Chen, Willy Chou
Patients admitted to intensive care units (ICU) and receiving mechanical ventilation (MV) may experience ventilator-associated adverse events and have prolonged ICU length of stay (LOS). We conducted a survey on adult patients in the medical ICU requiring MV. Utilizing big data and artificial intelligence (AI)/machine learning, we developed a predictive model to determine the optimal timing for weaning success, defined as no reintubation within 48 hours. An interdisciplinary team integrated AI into our MV weaning protocol...
March 22, 2024: Medicine (Baltimore)
#37
JOURNAL ARTICLE
Qingxian Fan, Yan Zhao, Jianrong Zhang, Yu'e Wu, Qingping Huang, Ying Gao, Jingqin Wang, Changqiong Guo, Shuqing Zhang
Dysphagia is often a long-term problem after ischemic stroke, which are often accompanied by complications and results in poor outcome. This study aimed to investigate the influencing factors associated with the prognosis of dysphagia after senile ischemic stroke and evaluate the diagnostic performance of crucial factors. A total of 192 elderly ischemic stroke patients (96 patients without dysphagia with average age of 69.81 ± 4.61 years and 96 patients with dysphagia with average of 70...
March 22, 2024: Journal of Molecular Neuroscience: MN
#38
JOURNAL ARTICLE
Dhammika Leshan Wannigama, Cameron Hurst, Phatthranit Phattharapornjaroen, Parichart Hongsing, Natchalaikorn Sirichumroonwit, Kanokpoj Chanpiwat, Ali Hosseini Rad S M, Robin James Storer, Puey Ounjai, Phitsanuruk Kanthawee, Natharin Ngamwongsatit, Rosalyn Kupwiwat, Chaisit Kupwiwat, James Michael Brimson, Naveen Kumar Devanga Ragupathi, Somrat Charuluxananan, Asada Leelahavanichkul, Talerngsak Kanjanabuch, Paul G Higgins, Vishnu Nayak Badavath, Mohan Amarasiri, Valerie Verhasselt, Anthony Kicic, Tanittha Chatsuwan, Kashif Pirzada, Farid Jalali, Angela M Reiersen, Shuichi Abe, Hitoshi Ishikawa
BACKGROUND: Repurposed drugs with host-directed antiviral and immunomodulatory properties have shown promise in the treatment of COVID-19, but few trials have studied combinations of these agents. The aim of this trial was to assess the effectiveness of affordable, widely available, repurposed drugs used in combination for treatment of COVID-19, which may be particularly relevant to low-resource countries. METHODS: We conducted an open-label, randomized, outpatient, controlled trial in Thailand from October 1, 2021, to June 21, 2022, to assess whether early treatment within 48-h of symptoms onset with combinations of fluvoxamine, bromhexine, cyproheptadine, and niclosamide, given to adults with confirmed mild SARS-CoV-2 infection, can prevent 28-day clinical deterioration compared to standard care...
April 2024: EClinicalMedicine
#39
JOURNAL ARTICLE
Michelle Paton, Sarah Chan, Ary Serpa Neto, Claire J Tipping, Anne Stratton, Rebecca Lane, Lorena Romero, Tessa Broadley, Carol L Hodgson
BACKGROUND: Mobilisation during critical illness is now included in multiple clinical practice guidelines. However, a large, randomised trial and systematic review have recently identified an increased probability of adverse events and mortality in patients who received early active mobilisation in the intensive care unit (ICU). We aimed to determine the effects of mobilisation compared with usual care on adverse events and mortality in an acute ICU setting. In subgroup analyses, we specifically aimed to investigate possible sources of harm, including the timing and duration of mobilisation achieved, ventilation status, and admission diagnosis...
March 18, 2024: Lancet Respiratory Medicine
#40
JOURNAL ARTICLE
Yolanda Peña-López, María Slocker-Barrio, Juan-Carlos de-Carlos-Vicente, Marta Serrano-Megías, Iolanda Jordán-García, Jordi Rello
OBJECTIVES: An objective categorization of respiratory infections based on outcomes is an unmet clinical need. Ventilator-associated pneumonia and tracheobronchitis remain used in clinical practice, whereas ventilator-associated events (VAE) are limited to surveillance purposes. RESEARCH METHODOLOGY/DESIGN: This was a secondary analysis from a multicentre observational prospective cohort study. VAE were defined as a sustained increase in minimum Oxygen inspired fraction (FiO2) and/or Positive end-expiratory pressures (PEEP) of ≥ 0...
March 19, 2024: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
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