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Lung Failure

Doron Aronson, Varda Shalev, Rachel Katz, Gabriel Chodick, Diab Mutlak
PURPOSE:  We used a large real-world data from community settings to develop and validate a 10-year risk score for new-onset atrial fibrillation (AF) and calculate its net benefit performance. METHODS:  Multivariable Cox proportional hazards model was used to estimate effects of risk factors in the derivation cohort ( n  = 96,778) and to derive a risk equation. Measures of calibration and discrimination were calculated in the validation cohort ( n  = 48,404)...
August 13, 2018: Thrombosis and Haemostasis
Erik H Van Iterson, Joshua R Smith, Thomas P Olson
BACKGROUND: Peak exercise V̇O2 is a primary marker of prognosis in heart failure (HF). The pathophysiology of impaired peak V̇O2 is unclear in patients. To what extent alveolar airway function impacts V̇O2 during cardiopulmonary exercise testing (CPET) has not been fully elucidated. This study aimed to phenotype how changes in alveolar ventilation (V̇A ), volume (VA ), and related parameters couple with exercise V̇O2 in HF. METHODS: N=35 HF (LVEF=20±6%; ages, 53±7 years) participated in CPET with breath-to-breath measurements of ventilation and gas-exchange...
August 10, 2018: Journal of Cardiac Failure
Olivia J Kelada, Roy H Decker, Sameer K Nath, Kimberly L Johung, Ming-Qiang Zheng, Yiyun Huang, Jean-Dominique Gallezot, Chi Liu, Richard E Carson, Uwe Oelfke, David J Carlson
PURPOSE: Tumor hypoxia correlates with treatment failure in patients undergoing conventional radiation therapy. However, no published studies have investigated tumor hypoxia in patients undergoing stereotactic body radiation therapy (SBRT). We aimed to noninvasively quantify the tumor hypoxic volume (HV) in non-small cell lung cancer (NSCLC) tumors to elucidate the potential role of tumor vascular response and reoxygenation at high single doses. METHODS AND MATERIALS: Six SBRT-eligible patients with NSCLC tumors >1 cm were prospectively enrolled in an institutional review board-approved study...
September 1, 2018: International Journal of Radiation Oncology, Biology, Physics
Masamitsu Ubukata, Atsushi Mitsuhashi, Yuki Nishizawa, Teruhiro Fujii, Masaki Hara, Akihito Ohta, Kosaku Nitta
A 70-year-old man with prior Raynaud's phenomena developed hypertension and renal insufficiency. Raynaud's phenomena, finger skin thickening, interstitial lung disease, and positive anticentromere antibody findings indicated systemic sclerosis (SSc). Based on the presence of SSc, severe hypertension with rapidly progressive renal failure, and proliferative and obliterative arteriolar vasculopathy, scleroderma renal crisis (SRC) was diagnosed. Despite good blood pressure control with antihypertensive drugs, hemodialysis was initiated and could not be withdrawn owing to unimproved renal dysfunction...
August 10, 2018: Internal Medicine
Aurélien Belot, Helen Fowler, Edmund Njeru Njagi, Miguel-Angel Luque-Fernandez, Camille Maringe, Winnie Magadi, Aimilia Exarchakou, Manuela Quaresma, Adrian Turculet, Michael D Peake, Neal Navani, Bernard Rachet
INTRODUCTION: We investigated socioeconomic disparities and the role of the main prognostic factors in receiving major surgical treatment in patients with lung cancer in England. METHODS: Our study comprised 31 351 patients diagnosed with non-small cell lung cancer in England in 2012. Data from the national population-based cancer registry were linked to Hospital Episode Statistics and National Lung Cancer Audit data to obtain information on stage, performance status and comorbidities, and to identify patients receiving major surgical treatment...
August 12, 2018: Thorax
Andrei M Beliaev, Peter M Alison, Denise Reddy, Mark O'Carroll, Christopher Lewis, Tanya J McWilliams
BACKGROUND: Important risk factors for long-term survival of lung transplant (LT) recipients are infection, acute graft rejection (AR) and chronic lung allograft dysfunction (CLAD). Socioeconomic deprivation (SED) is associated with increased graft failure rate after heart and kidney transplantation, but has not been investigated in LT recipients. The aim of this study was to evaluate an association between LT recipients' SED status and development of AR, CLAD, and long-term survival...
October 2018: Journal of Surgical Research
Jamie Sy Ho, Edwin R Chilvers, Muhunthan Thillai
Sarcoidosis is a multisystem granulomatous disease predominantly affecting the lungs, with increased risk of cardiovascular disease, pulmonary hypertension and cardiac sarcoidosis (CS), the latter due to direct granuloma infiltration. Sarcoidosis is often managed by chest physicians who need to understand the diagnostic pathways and initial management plans for patients with cardiac involvement. Areas covered: The most serious consequence of CS is sudden cardiac death due to ventricular tachyarrhythmias or complete atrioventricular block...
August 13, 2018: Expert Review of Respiratory Medicine
Kyung Hwa Lee, Jae Myoung Noh, Yong Chan Ahn, Dongryul Oh, Jhingook Kim, Young Mog Shim, Jung-Ho Han
PURPOSE: To report failure pattern in Masaoka-Koga stage II-IV type C thymic epithelial tumor (TET) following postoperative radiation therapy (PORT) and to evaluate suitability of PORT target volume confined to "tumor bed only with margin". METHODS AND MATERIALS: Retrospective review of 53 patients with stage II-IV type C TET was done. The clinical outcomes, failure pattern in relation to PORT target volume, and prognostic factors were analyzed. RESULTS: During the median follow-up of 69 months, 14 deaths and 25 recurrences were observed...
August 9, 2018: International Journal of Radiation Oncology, Biology, Physics
Christian Grønhøj, Kathrine Kronberg Jakobsen, David H Jensen, Jacob Rasmussen, Elo Andersen, Jeppe Friborg, Christian von Buchwald
OBJECTIVES: The incidence of human papillomavirus (HPV) positive oropharyngeal squamous cell carcinoma (OPSCC) is increasing. Currently, data is sparse on the pattern and timing of recurrence. This long-term study concerning both HPV- and p16-status aimed to report predictive factors, pattern, timing of loco-regional recurrence (LRR) and distant recurrence (DR), and survival following recurrence in patients diagnosed with OPSCC. MATERIAL AND METHODS: We included patients diagnosed with OPSCC from 2000 to 2014 in Eastern Denmark, who were treated with curative intent...
August 2018: Oral Oncology
Samuel P Wiles, Charles R Lane, Ali Ataya, Mourad H Senussi, Madhu Sasidhar, Xiaofeng Wang, Tarik Hanane
PURPOSE: The purpose of this study is to evaluate outcomes in MICU lung transplant recipients with acute respiratory failure treated with non-invasive positive pressure ventilation (NPPV) and identify factors associated with NPPV failure (need for intubation). METHODS: Retrospective chart review of all lung transplant recipients who were admitted with acute respiratory failure to the MICU from January 2009-August 2016 was completed. Logistic regression analysis was performed to determine which factors were independently associated with NPPV failure...
August 1, 2018: Journal of Critical Care
Ketul R Chaudhary, Yupu Deng, Colin M Suen, Mohamad Taha, Thomas H Petersen, Shirley H J Mei, Duncan J Stewart
BACKGROUND AND PURPOSE: Pulmonary arterial hypertension (PAH) is a life-threatening disease that leads to progressive pulmonary hypertension, right heart failure and death. Parenteral prostaglandins, including treprostinil, a prostacyclin analogue, represent the most effective medical treatment for severe PAH. We investigated the effect of treprostinil on established severe PAH and underlying mechanisms using the rat SU5416 (SU, a vascular endothelial growth factor receptor-2 inhibitor)-chronic hypoxia (Hx) model of PAH...
August 11, 2018: British Journal of Pharmacology
R Blaizot, E Ouattara, A Fauconneau, M Beylot-Barry, A Pham-Ledard
BACKGROUND: Infections are one of the major causes of death in patients with advanced stage mycosis fungoides (MF) or with Sézary Syndrome (SS). However, few recent data are available on the characteristics and risk factors of these infectious events. OBJECTIVES: To describe infectious events occurring in a cohort of patients with MF/SS, and to identify clinical and biologic associated risk factors. METHODS: A retrospective cohort study was used to investigate infectious events and associated factorsin patients diagnosed with MF (stage IB and beyond) or SSfollowed from May 2011 to May 2016at the University Hospital of Bordeaux, France RESULTS: Seventy-one patients with completed follow-up were included...
August 11, 2018: British Journal of Dermatology
Solange Peters, Alessandra Curioni-Fontecedro, Hovav Nechushtan, Jin-Yuan Shih, Wei-Yu Liao, Oliver Gautschi, Vito Spataro, Mojca Unk, James Chih-Hsin Yang, Robert M Lorence, Philippe Carrière, Agnieszka Cseh, Gee-Chen Chang
INTRODUCTION: Approximately 1-4% of non-small-cell lung cancer (NSCLC) tumors harbor a human epidermal growth factor receptor 2 (HER2) mutation; there is no approved targeted treatment for this subgroup. METHODS: Patients with stage IV NSCLC that progressed after clinical benefit on erlotinib/gefitinib and/or had activating epidermal growth factor receptor (EGFR) or HER2 mutations, had exhausted other treatments, and were ineligible for afatinib trials, were enrolled in a named patient use (NPU) program, receiving afatinib 30-50 mg/day on a compassionate basis within routine clinical practice...
August 7, 2018: Journal of Thoracic Oncology
Mary K Dahmer, Michael W Quasney, Anil Sapru, Ginny Gildengorin, Martha A Q Curley, Michael A Matthay, Heidi Flori
OBJECTIVES: To test whether plasma interleukin-1 receptor antagonist or variants within the gene encoding for interleukin-1ra (IL1RN), or proteins involved in regulating interleukin-1β levels or interleukin-1β response, are associated with pediatric acute respiratory distress syndrome or outcomes in mechanically ventilated children with parenchymal lung disease. DESIGN: Prospective cohort study. SETTING: Twenty-two PICUs participating in the multisite clinical trial, Randomized Evaluation of Sedation Titration for Respiratory Failure (U01 HL086622)...
August 7, 2018: Pediatric Critical Care Medicine
Michael Kleiner Shochat, Marat Fudim, Avraham Shotan, David S Blondheim, Mark Kazatsker, Iris Dahan, Aya Asif, Yoseph Rozenman, Ilia Kleiner, Jean Marc Weinstein, Gurusher Panjrath, Paul A Sobotka, Simcha R Meisel
AIMS: Readmissions for heart failure (HF) are a major burden. We aimed to assess whether the extent of improvement in pulmonary fluid content (ΔPC) during HF hospitalization evaluated by lung impedance (LI), or indirectly by other clinical and laboratory parameters, predicts readmissions. METHODS AND RESULTS: The present study is based on pre-defined secondary analysis of the IMPEDANCE-HF extended trial comprising 266 HF patients at New York Heart Association Class II-IV and left ventricular ejection fraction ≤ 35% randomized to LI-guided or conventional therapy during long-term follow-up...
August 10, 2018: ESC Heart Failure
Christopher John Joyce, Kiran Shekar, David Andrew Cook
BACKGROUND: Venovenous extracorporeal membrane oxygenation (vv-ECMO) is an effective treatment for severe respiratory failure. The interaction between the cardiorespiratory system and the oxygenator can be explored with mathematical models. Understanding the physiology will help the clinician optimise therapy. As others have examined O2 exchange, the main focus of this study was on CO2 exchange. METHODS: A model of the cardiorespiratory system during vv-ECMO was developed, incorporating O2 , CO2 and N2 exchange in both the lung and the oxygenator...
August 9, 2018: Intensive Care Medicine Experimental
Jennifer A Ogren, Raghav Tripathi, Paul M Macey, Rajesh Kumar, John M Stern, Dawn S Eliashiv, Luke A Allen, Beate Diehl, Jerome Engel, M R Sandhya Rani, Samden D Lhatoo, Ronald M Harper
Objective: Generalized tonic-clonic seizures are accompanied by cardiovascular and respiratory sequelae that threaten survival. The frequency of these seizures is a major risk factor for sudden unexpected death in epilepsy (SUDEP), a leading cause of untimely death in epilepsy. The circumstances accompanying such fatal events suggest a cardiovascular or respiratory failure induced by unknown neural processes rather than an inherent cardiac or lung deficiency. Certain cortical regions, especially the insular, cingulate, and orbitofrontal cortices, are key structures that integrate sensory input and influence diencephalic and brainstem regions regulating blood pressure, cardiac rhythm, and respiration; output from those cortical regions compromised by epilepsy-associated injury may lead to cardiorespiratory dysregulation...
2018: NeuroImage: Clinical
Sanja Cicko, Thomas Christian Köhler, Cemil Korcan Ayata, Tobias Müller, Nicolas Ehrat, Anja Meyer, Madelon Hossfeld, Andreas Zech, Francesco Di Virgilio, Marco Idzko
Acute respiratory distress syndrome (ARDS) is a life-threating lung condition resulting from a direct and indirect injury to the lungs [1, 2]. Pathophysiologically it is characterized by an acute alveolar damage, an increased permeability of the microvascular-barrier, leading to protein-rich pulmonary edema and subsequent impairment of arterial oxygenation and respiratory failure [1]. This study examined the role of extracellular ATP in recruiting inflammatory cells to the lung after induction of acute lung injury with lipopolysaccharide (LPS)...
July 17, 2018: Oncotarget
Luca Mezzetto, Lorenzo Scorsone, Michele Sacco, Albino Eccher, Luca Idolazzi, Gian Franco Veraldi
Vasculitis are an heterogeneous group of syndromes, which shares inflammation of blood vessels wall as main feature. Anti-neutrophil cytoplasmatic antibody (ANCA)-associated vasculitis (AAV) is a necrotizing vasculitis, with few or no immune deposits, predominantly affecting small vessels (i.e., capillaries, venules, arterioles, and small arteries), associated with ANCAs specific for myeloperoxidase (MPO-ANCA) or proteinase 3 (PR3-ANCA). Clinical manifestations may be heterogeneous but an involvement of lungs and kidneys frequently occurs...
August 6, 2018: Annals of Vascular Surgery
Tomoya Hara, Satoshi Nishimura, Toshihiro Yamamoto, Yumiko Kajimoto, Keiji Kusumoto, Ray Kanagawa, Shota Ikeda, Tomoyuki Nishimoto
The renin-angiotensin system (RAS), which plays an important role in the progression of heart failure, is efficiently blocked by the inhibition of renin, the rate-limiting enzyme in the RAS cascade. In the present study, we investigated the cardioprotective effects of TAK-272 (SCO-272, imarikiren), a novel, orally effective direct renin inhibitor (DRI), and compared its efficacy with that of aliskiren, a DRI that is already available in the market. TAK-272 was administered to calsequestrin transgenic (CSQ-tg) heart failure mouse model that show severe symptoms and high mortality...
2018: PloS One
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