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https://www.readbyqxmd.com/read/27923248/timing-of-multiorgan-dysfunction-among-hospitalized-infants-with-fatal-fulminant-sepsis
#1
James L Wynn, Matthew S Kelly, Daniel K Benjamin, Reese H Clark, Rachel Greenberg, Daniel K Benjamin, P Brian Smith
Objective Identify the progression of specific signs of multiorgan dysfunction among infants with fatal sepsis. Study Design Cohort study of 679 infants who died within 3 days of the start of a late-onset sepsis (LOS) episode in neonatal intensive care units from 1997 to 2012. We extracted clinical and laboratory data on the day of death (day 0) and the preceding 5 days (days -5 to -1). Results Median (25th percentile-75th percentile) gestational age was 25 (24-28) weeks. Compared with day -1, day 0 was characterized by an increased requirement for mechanical ventilation and higher mean fraction of inspired oxygen...
December 6, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27922912/the-current-overuse-and-misuse-of-meta-analyses-on-sublingual-immunotherapy-the-case-of-grass-pollen-allergy
#2
Erminia Ridolo, Cristoforo Incorvaia, Bruna Luciana Gritti, Giovanni Passalacqua
PURPOSE OF REVIEW: Meta-analysis provides the highest level of evidence-based efficacy of a medical treatment or intervention. Allergen immunotherapy in its two forms of subcutaneous immunotherapy and sublingual immunotherapy (SLIT) is an effective treatment of respiratory allergy as shown by meta-analyses, but in recent years there has been an overflow of meta-analyses on SLIT, with contrasting results that may generate confusion among physicians. RECENT FINDINGS: It can be observed that flaws are often present in meta-analyses including: incorrect selection of trials, inappropriate use of evaluation parameters for the analysis, and unsuitable analyses...
December 5, 2016: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27922906/patient-outcomes-after-early-versus-late-tracheostomy-in-the-puerto-rico-trauma-hospital
#3
Ana M Romero Vázquez, Omar García Rodríguez, Ediel Ramos Meléndez, Pablo Rodríguez Ortiz
OBJECTIVE: This study aimed to evaluate the impact of early tracheostomy (ET, ≤7 days) versus that of late tracheostomy (LT, >7 days) on outcomes such as hospital length of stay (LOS), intensive care unit (ICU) days, mechanical ventilation (MV) days, and mortality ratio. METHODS: A historical cohort study was undertaken using charts of patients admitted to the Puerto Rico Trauma Hospital who required MV and underwent tracheostomies, from 2000 to 2013. A logistic regression was performed to evaluate the association between timing of tracheostomy and complications and mortality...
December 5, 2016: Journal of Patient Safety
https://www.readbyqxmd.com/read/27922887/regional-cerebral-abnormalities-measured-by-frequency-domain-near-infrared-spectroscopy-in-pediatric-patients-during-extracorporeal-membrane-oxygenation
#4
Fenghua Tian, Christopher Jenks, Donald Potter, Darryl Miles, Lakshmi Raman
Extracorporeal membrane oxygenation (ECMO) is a form of advanced cardio-respiratory support provided to critically ill patients with severe respiratory and/or cardiovascular failure. While children undergoing ECMO therapy have significant risk for neurological morbidity, currently there is a lack of reliable bedside tool to detect the neurologic events for patients on ECMO. This study assessed the feasibility of frequency-domain near-infrared spectroscopy (NIRS) for detection of intracranial complications during ECMO therapy...
December 2, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27922884/extracorporeal-membrane-oxygenation-in-dengue-malaria-and-acute-chagas-disease
#5
Cornelis M Schreuder, Jhonathan A Eslava, Leonardo A Salazar, Adriana S Murcia, Mario J Forero, Mauricio A Orozco, Luis E Echeverría, Antonio Figueredo
Extracorporeal Membrane Oxygenation (ECMO) is widely used in Acute Respiratory Distress Syndrome (ARDS) and myocarditis. Severe vector-mediated diseases may be complicated by ARDS or myocarditis, which are both associated with a high mortality rate. We present six cases of severe dengue, malaria, and acute Chagas disease that were treated with ECMO from September 2007 to September 2015. Patients included two pediatric and four adults (ages 12 to 48). Survival to decannulation was 83% and to discharge was 66%...
December 2, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27922881/safety-and-outcomes-of-mobile-ecmo-using-a-bicaval-dual-stage-venous-catheter
#6
Hussein D Kanji, Alexandra Chouldechova, Chris Harvey, Ephraim O'dea, Gail Faulkner, Giles Peek
There is little published data on the safety and effectiveness of mobile (inter-hospital) extra-corporeal membrane oxygenation (ECMO) in adults, particularly focusing on the cannulation strategy. We sought to study the outcomes of patients cannulated with a bicaval dual lumen catheter needing mobile compared to conventional ECMO. Specifically, we evaluated the safety of using this cannulation strategy during initiation, in transport and overall performance. Multivariate adjustment was performed to report on adjusted 6-month survival as well as complications and performance from cannulation and the ECMO run...
December 2, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27922846/acute-respiratory-distress-syndrome-in-another-50-years-historical-footnote-or-persistent-malady
#7
Boyd Taylor Thompson
No abstract text is available yet for this article.
December 5, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27922845/continued-under-recognition-of-acute-respiratory-distress-syndrome-after-the-berlin-definition-what-is-the-solution
#8
John G Laffey, Tài Pham, Giacomo Bellani
PURPOSE OF REVIEW: Timely recognition of acute respiratory distress syndrome (ARDS) may allow for more prompt management and less exacerbation of lung injury. However, the absence of a diagnostic test for ARDS means that the diagnosis of ARDS requires clinician recognition in what is usually a complicated and evolving illness. We review data concerning the extent of recognition of ARDS in the era of the Berlin definition of ARDS. RECENT FINDINGS: ARDS continues to be under-recognized - even in the era of the more recent 'Berlin' definition, and significant delay in its recognition is common...
December 5, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27922742/the-diaphragm-acts-as-a-brake-during-expiration-to-prevent-lung-collapse
#9
Mariangela Pellegrini, Göran Hedenstierna, Agneta Roneus, Monica Segelsjö, Anders Larsson, Gaetano Perchiazzi
RATIONALE: The diaphragm is the major inspiratory muscle and is assumed to relax during expiration. However, electrical post-inspiratory activity has been observed. Whether or not there is an expiratory diaphragmatic contraction that preserves lung patency has yet to be explored. OBJECTIVE: We hypothesized the occurrence of an expiratory diaphragmatic contraction directed at stabilizing peripheral airways and preventing or reducing cyclic expiratory lung collapse...
December 6, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27922699/adhesion-and-invasion-of-streptococcus-pneumoniae-to-primary-and-secondary-respiratory-epithelial-cells
#10
Sara Novick, Marilous Shagan, Karin Blau, Sarit Lifshitz, Noga Givon-Lavi, Nili Grossman, Lipa Bodner, Ron Dagan, Yaffa Mizrachi Nebenzahl
The interaction between Streptococcus pneumoniae (S. pneumoniae) and the mucosal epithelial cells of its host is a prerequisite for pneumococcal disease development, yet the specificity of this interaction between different respiratory cells is not fully understood. In the present study, three areas were examined: i) The capability of the encapsulated S. pneumoniae serotype 3 strain (WU2) to adhere to and invade primary nasal‑derived epithelial cells in comparison to primary oral‑derived epithelial cells, A549 adenocarcinoma cells and BEAS‑2B viral transformed bronchial cells; ii) the capability of the unencapsulated 3...
December 6, 2016: Molecular Medicine Reports
https://www.readbyqxmd.com/read/27922570/developing-a-simulation-based-training-program-for-the-prehospital-professionals-and-students-on-the-management-of-middle-east-respiratory-syndrome
#11
Melih Elcin, Arif Onan, Orhan Odabasi, Melahat Saylam, Handan Ilhan, Pinar Daylan Kockaya, Ilker Gurcuoglu, Yavuz Uckuyu, Duygu Cengiz, Osman Arikan Nacar
INTRODUCTION: Middle East Respiratory Syndrome (MERS) is a major global health threat. Prehospital professionals face the risk of infection as they work to save lives. They should be made aware of the disease and be prepared to handle such cases. The aims of our study are to develop a training program about the prehospital management of a MERS case using standardized patient (SP) scenarios, to evaluate the awareness and preparedness of the participants about MERS, and to evaluate the effectiveness of this training...
December 2016: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/27922539/effect-of-tomographic-operator-inaccuracies-and-respiratory-motion-on-pet-ct-lung-nodule-images-smearing
#12
Joël Daouk, Pascal Bailly, Roger Bouzerar, Marc-Étienne Meyer
BACKGROUND: In thoracic PET/computed tomography (CT) imaging, uptake foci usually appear smeared because of postreconstruction smoothing and respiratory motion. OBJECTIVE: The aim of the present study was to assess the respective contributions of the reconstruction process and respiratory motion on PET/CT images. MATERIALS AND METHODS: Thirty-one pulmonary lesions were studied. Free-breathing PET/CT acquisitions were followed by a 10-min respiratory-gated PET/CT acquisition...
December 2, 2016: Nuclear Medicine Communications
https://www.readbyqxmd.com/read/27922535/association-between-short-term-exposure-to-ultrafine-particles-and-mortality-in-eight-european-urban-areas
#13
Massimo Stafoggia, Alexandra Schneider, Josef Cyrys, Evangelia Samoli, Zorana Jovanovic Andersen, Getahun Bero Bedada, Tom Bellander, Giorgio Cattani, Konstantinos Eleftheriadis, Annunziata Faustini, Barbara Hoffmann, Bénédicte Jacquemin, Klea Katsouyanni, Andreas Massling, Juha Pekkanen, Noemi Perez, Annette Peters, Ulrich Quass, Tarja Yli-Tuomi, Francesco Forastiere
BACKGROUND: Epidemiologic evidence on the association between short-term exposure to ultrafine particles and mortality is weak, due to the lack of routine measurements of these particles and standardized multi-center studies. We investigated the relationship between ultrafine particles and particulate matter (PM) and daily mortality in eight European urban areas. METHODS: We collected daily data on non-accidental and cardio-respiratory mortality, particle number concentrations (as proxy for ultrafine particle number concentration), fine and coarse PM, gases and meteorologic parameters in eight urban areas of Finland, Sweden, Denmark, Germany, Italy, Spain, and Greece, between 1999 and 2013...
November 29, 2016: Epidemiology
https://www.readbyqxmd.com/read/27922501/an-overview-of-congenital-myopathies
#14
Jean K Mah, Jeffrey T Joseph
PURPOSE OF REVIEW: This article uses a case-based approach to highlight the clinical features as well as recent advances in molecular genetics, muscle imaging, and pathophysiology of the congenital myopathies. RECENT FINDINGS: Congenital myopathies refer to a heterogeneous group of genetic neuromuscular disorders characterized by early-onset muscle weakness, hypotonia, and developmental delay. Congenital myopathies are further classified into core myopathies, centronuclear myopathies, nemaline myopathies, and congenital fiber-type disproportion based on the key pathologic features found in muscle biopsies...
December 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27922496/metabolic-myopathies
#15
Mark A Tarnopolsky
PURPOSE OF REVIEW: Metabolic myopathies are genetic disorders that impair intermediary metabolism in skeletal muscle. Impairments in glycolysis/glycogenolysis (glycogen-storage disease), fatty acid transport and oxidation (fatty acid oxidation defects), and the mitochondrial respiratory chain (mitochondrial myopathies) represent the majority of known defects. The purpose of this review is to develop a diagnostic and treatment algorithm for the metabolic myopathies. RECENT FINDINGS: The metabolic myopathies can present in the neonatal and infant period as part of more systemic involvement with hypotonia, hypoglycemia, and encephalopathy; however, most cases present in childhood or in adulthood with exercise intolerance (often with rhabdomyolysis) and weakness...
December 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27922256/statins-in-critical-care-to-give-or-not-to-give
#16
Amr S Omar, Samy Hanoura, Haifa M Aljanubi, Ahmed Mahfouz
Owing to statin's immune modulatory, anti-inflammatory, antioxidant, antithrombotic and endothelial function actions, they are widely used in the critical care settings in diverse disease scenarios. We aim to explore the evidence to globalize the utilization of statins in the intensive care practice for different indications. We carried out a search of the PubMed, Cochrane and EMBASE databases up to January 2016. We included review articles, meta-analyses, and original trials on the effects of statin therapy in the intensive care unit (ICU) combining the following MESH terms: 'satins', 'intensive care, 'cardiac surgery', 'sepsis', 'acute respiratory distress syndrome' 'pneumonia', subarachnoid hemorrhage', traumatic brain injury and 'critical illness'...
December 6, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27922241/an-unusual-case-of-neuroblastoma-a-17-year-old-adolescent-presented-with-bilateral-diffuse-lung-metastasis-at-initial-diagnosis
#17
Çağlar Ödek, Tanıl Kendirli, Esra Pekpak, Ayhan Yaman, Başak Adaklı-Aksoy, Handan Dinçaslan, Nurdan Taçyıldız, Emel Ünal, Erdal İnce, Gülsan Yavuz
Neuroblastoma (NB) is the most frequently diagnosed neoplasm during infancy and its incidence declines within the first 3-5 years of life. It can be rarely diagnosed in adolescents and young adults. Adolescents have advanced stage of disease, higher frequency of uncommon metastatic sites such as lungs, and worse outcomes. Herein, we describe an unusual case of NB in a 17-year-old adolescent presented with lung metastasis at diagnosis. The patient was diagnosed with stage IV NB. Thorax high-resolution computed tomography (HRCT) scan revealed irregular septal thickening with ground glass opacity consistent with pulmonary parenchymal metastases...
2016: Turkish Journal of Pediatrics
https://www.readbyqxmd.com/read/27922210/comparison-between-thoracic-radiographic-findings-and-postmortem-diagnosis-of-thoracic-diseases-in-dyspneic-companion-rats-rattus-norvegicus
#18
Virginie Fouriez-Lablée, Claire Vergneau-Grosset, Philip H Kass, Allison L Zwingenberger
Companion rats are often presented to veterinarians for respiratory difficulties. Dyspnea in rats is most commonly due to infectious pneumonia, and thoracic neoplasia can go undiagnosed ante mortem due to a mistaken interpretation of pneumonia. In domestic carnivores, pulmonary nodular patterns have been shown to correlate with lung neoplastic diseases and infectious diseases. The main objective of this retrospective case series study was to determine whether certain radiographic criteria could be correlated with the presence of thoracic infectious disease and neoplastic disease in companion rats...
December 6, 2016: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/27922116/risk-assessment-of-recent-egyptian-h5n1-influenza-viruses
#19
A-S Arafa, S Yamada, M Imai, T Watanabe, S Yamayoshi, K Iwatsuki-Horimoto, M Kiso, Y Sakai-Tagawa, M Ito, T Imamura, N Nakajima, K Takahashi, D Zhao, K Oishi, A Yasuhara, C A Macken, G Zhong, A P Hanson, S Fan, J Ping, M Hatta, T J S Lopes, Y Suzuki, M El-Husseiny, A Selim, N Hagag, M Soliman, G Neumann, H Hasegawa, Y Kawaoka
Highly pathogenic avian influenza (HPAI) viruses of the H5N1 subtype are enzootic in poultry populations in different parts of the world, and have caused numerous human infections in recent years, particularly in Egypt. However, no sustained human-to-human transmission of these viruses has yet been reported. We tested nine naturally occurring Egyptian H5N1 viruses (isolated in 2014-2015) in ferrets and found that three of them transmitted via respiratory droplets, causing a fatal infection in one of the exposed animals...
December 6, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27922084/the-impact-of-cold-spells-on-mortality-and-effect-modification-by-cold-spell-characteristics
#20
Lijun Wang, Tao Liu, Mengjue Hu, Weilin Zeng, Yonghui Zhang, Shannon Rutherford, Hualiang Lin, Jianpeng Xiao, Peng Yin, Jiangmei Liu, Cordia Chu, Shilu Tong, Wenjun Ma, Maigeng Zhou
In China, the health impact of cold weather has received little attention, which limits our understanding of the health impacts of climate change. We collected daily mortality and meteorological data in 66 communities across China from 2006 to 2011. Within each community, we estimated the effect of cold spell exposure on mortality using a Distributed Lag Nonlinear Model (DLNM). We also examined the modification effect of cold spell characteristics (intensity, duration, and timing) and individual-specific factors (causes of death, age, gender and education)...
December 6, 2016: Scientific Reports
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