Difficult weaning

Massive hemoptysis is one of the fatal complications of lung cancer. There is no established standard treatment method for it, and it often causes sudden suffocation, and some cases may be difficult to save. A 63-year-old man was admitted to the hospital with dyspnea, and developed massive hemoptysis from lung cancer shortly after admission. The tumor had obstructed the right main bronchus and had invaded the right pulmonary artery. Surgery and interventional radiology were judged impossible. The patient was successfully saved by the introduction of Veno-Venous Extra Corporeal Membrane Oxygenation (V-V ECMO), and hemostasis was obtained by radiotherapy...

BACKGROUND: Mitochondrial myopathy is a group of diseases caused by abnormal mitochondrial structure or function. The mitochondrial myopathy impacts muscles of the whole body and exhibits variable symptoms. Respiratory muscle deficits deteriorate pulmonary function in patients with severe pneumonia. CASE PRESENTATION: We report the case of a male patient with severe pneumonia-induced respiratory failure. He was abnormally dependent invasive ventilator-assisted ventilation after his condition had improved...

BACKGROUND: Despite bovine viral diarrhoea virus and Chlamydia pecorum being important endemic diseases of cattle, there are limited reports of theirco-occurrence. CASE REPORT: Several 12-18-week-old, weaned Hereford calves presented with ill-thriftiness and neurological signs on a mixed cattle and sheep farm in South Australia in July 2021. Immune suppression resulting from transient infection with bovine viral diarrhoea virus (BVDV) is implicated in predisposing to infection with Chlamydia pecorum, the causative agent of sporadic bovine encephalopathy (SBE)...

BACKGROUND: More than a quarter of children who are affected by severe acute undernutrition reside in Sub-Saharan Africa. Incorrect feeding practices have a negative impact on a child's health in both the short and the long term, and the interval from conception to two years is the most critical for the development of undernutrition-related complications. These first 1000 days of life also represent an "opportunity window" for early interventions, hence, having a clear insight into dietary habits and the determinants of diet quality is fundamental to improving nutritional counseling practices...

OBJECTIVES: It is well-established that sleep quality of ICU patients is poor, with sleep being highly fragmented by multiple awakenings. These sleep disruptions are associated with poor outcomes such as prolonged weaning duration from mechanical ventilation. Polysomnography can measure sleep continuity, a parameter associated positively with outcomes in patients treated with noninvasive ventilation, but polysomnography is not routinely available in all ICUs, and simple means to assess sleep quality are needed...

BACKGROUND: Emerging data suggests a spectrum of pulmonary complications from COVID-19, ranging from dyspnea to difficult ventilator weaning and fibrotic lung damage. Prolonged hospitalization is known to significantly affect activity levels, impair muscle strength and reduce cardio-pulmonary endurance. OBJECTIVE: To assess the feasibility and safety of inpatient pulmonary rehabilitation (PR) and to explore effects on functional capacity, physical performance, fatigue levels and functional status...

Mechanical ventilation weaning within intensive care units (ICU) is a difficult process, while crucial when considering its impact on morbidity and mortality. Failed extubation and prolonged mechanical ventilation both carry a significant risk of adverse events. We aimed to determine predictive factors of extubation success using data-mining and artificial intelligence. A prospective physiological and biomedical signal data warehousing project. A 21-beds medical Intensive Care Unit of a University Hospital...

Phrenic nerve conduction studies (NCSs) and needle electromyography (EMG) can provide important information on the underlying pathophysiology in patients presenting with unexplained shortness of breath, failure to wean from the ventilator, or consideration of phrenic nerve pacemaker implantation. However, these techniques are often technically challenging, require experience, can lack sensitivity and specificity, and, in the case of diaphragm EMG, involve some degree of risk. Diagnostic high-resolution ultrasound has been introduced in recent years as an adjuvant technique readily available at the bedside that can increase the overall sensitivity and specificity of the neurophysiologic evaluation of respiratory symptoms...

The male patient was referred to the hospital at 44 days old due to dyspnea after birth and inability to wean off oxygen. His brother died three days after birth due to respiratory failure. The main symptoms observed were respiratory failure, dyspnea, and hypoxemia. A chest CT scan revealed characteristic reduced opacity in both lungs with a "crazy-paving" appearance. The bronchoalveolar lavage fluid (BALF) showed periodic acid-Schiff positive proteinaceous deposits. Genetic testing indicated a compound heterozygous mutation in the ABCA3 gene...

Post-weaning diarrhoea is a condition of increasing importance due to recent restrictions and bans on the preventive use of antimicrobials and medicinal zinc oxide. For various purposes, it is valuable to monitor the occurrence of post-weaning diarrhoea. The aim of this paper was to propose a protocol for easy and reliable assessment of the prevalence of post-weaning diarrhoea within a section of pigs as an alternative to clinical examination of a random sample of pigs. Two datasets were collected in two different observational field investigations, including more than 4000 individual clinical examinations of newly weaned pigs...

Introduction . Differentiating Crohn's disease (CD) and Behçet's disease (BD) with gastrointestinal (GI) manifestations can be clinically challenging, as current diagnostic criteria are not clear between both conditions and multiple symptoms could overlap. Case Presentation . The patient is an 8-year-old boy of Brazilian descent, who initially presented with a 1-year history of painful oral ulcers. Before presenting to the hospital, he had been treated for periodic fever, aphthous stomatitis, pharyngitis, and adenitis and placed on steroids, with relapsing symptoms on attempts to wean the doses...

BACKGROUND: Mixed autoimmune hemolytic anemia (AIHA) shows combined clinical and laboratory characteristics of warm and cold AIHA. It is relatively uncommon in children. Consequently, knowledge about mixed AIHA prevalence, clinical presentation, treatment options, and prognosis in children is limited to very few case reports. CASE PRESENTATION: We describe a six-year-old Asian girl presenting with profound anemia, blood group typing discrepancy and crossmatch incompatibility, post upper respiratory tract infection...

While anthelmintic treatment in young calves at first vaccination has not proven repeatedly effective in improving weight gain, there is evidence that treatment 90 day prior to weaning can enhance weight gain. This is difficult in most California cow/calf operations as after initial vaccination, calves are not again handled until preconditioning just prior to weaning. In an attempt to increase weight gain without the need for anthelmintic retreatment prior to preconditioning, 130 cow/calf pairs were stratified and assigned to three treatments of eprinomectin extended release injection (150 d efficacy), doramectin conventional injection, and an untreated control...

RATIONALE: Understanding the interactions between marine mammals and their environment is critical for ecological and conservation purposes. Odontocetes offer a continuous record of their life history from birth as recorded in annual increments of their tooth dentine. Because dentine is not remodeled and contains collagen, nitrogen stable isotope compositions (δ15 N) reflect nursing and weaning events, life history traits that would otherwise be impossible to retrieve in such elusive marine animals...

The decline of most caribou (Rangifer tarandus) populations underlines the need to understand the determinants of key demographic parameters. In migratory caribou, we have limited information on rates and drivers of pre-weaning mortality. We fitted 60 pregnant females of the Rivière-aux-Feuilles caribou herd with GPS camera collars to track the survival of calves from birth to weaning in 2016-2018. Over the three years, calf survival rate before weaning, i.e. to 01-Sep, approximately three months of age, was 0...

Vaccinations are one of the most impactful tools available to cow-calf producers to control within herd disease and later, in feedlots. While vaccine use has been studied across Canada, inconsistent and variable regional data makes analysis and interpretation difficult. The objective of this study was to describe vaccination protocols and factors associated with vaccine use in Canadian cow-calf herds and define associations between vaccine use and productivity outcomes. Surveys describing vaccine use in 2020 were collected from 131 cow-calf herds (40 eastern, 91 western), recruited through a national beef cattle surveillance program...

AbstractIndividual quality and environmental conditions may mask or interact with energetic trade-offs in life history evolution. Deconstructing these sources of variation is especially difficult in long-lived species that are rarely observed on timescales long enough to disentangle these effects. Here, we investigated relative support for variation in female quality and costs of reproduction as factors shaping differences in life history trajectories using a 32-year dataset of repeated reproductive measurements from 273 marked, known-age female gray seals ( Halichoerus grypus )...

BACKGROUND: During the COVID-19 pandemic, a great number of patients required Mechanical Ventilation (MV). Tracheostomy is the preferred procedure when difficult weaning is presented. Surgical techniques available for performing tracheostomy are open and percutaneous, with contradictory reports on the right choice. This paper aims to describe the clinical results after performing a tracheostomy in patients with COVID-19, regarding both surgical techniques. METHODS: An observational, analytical study of a retrospective cohort was designed...

Each suckling pig should receive ≥200 g of colostrum within the first 24 h of life, but with increased litter size this is now difficult to achieve. The aim of this study was to assess the effect of split-suckling and post-partum meloxicam provision to sows as means of ensuring adequate colostrum intake, on growth and health in pigs pre- and post-weaning. One hundred and four sows (Large White × Landrace) and their litters, averaging 16.3 piglets born alive, were assigned to one of four treatments in a two by two factorial arrangement...

INTRODUCTION: Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT) is a frequently discussed neuropsychiatric syndrome with elevated thyroid antibodies in the context of various clinical neuropsychiatric phenotypes. MRI abnormalities are usually nonspecific and treatment can be complex. CASE STUDY: We present a case of a woman in her sixties with SREAT whose psychosis kept worsening under cortisone tapering. After three years with cortisone side effects, therapy was changed to plasmapheresis and rituximab treatment with an excellent initial response, subacute unexplained deterioration with extensive leukoencephalopathy on MRI shortly after, and full recovery with regression of leukoencephalopathy afterwards...