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https://www.readbyqxmd.com/read/29040482/strategies-to-reduce-pulmonary-complications-after-transhiatal-esophagectomy
#1
A M Gillinov, R F Heitmiller
Background: By eliminating a thoracotomy, transhiatal esophagectomy (THE) is purported to reduce postoperative pulmonary complications. However, data from many early series do not support this contention, documenting pulmonary complications in up to 50% of patients and pneumonia in 5%-20%. Since 1990, we have implemented a management strategy designed to maximize airway protection in the postoperative period. The purpose of this study was to determine the current incidence of pulmonary complications after transhiatal esophagectomy without thoracotomy...
November 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29034524/carotid-chemoreceptor-control-of-muscle-sympathetic-nerve-activity-in-hypobaric-hypoxia
#2
James P Fisher, Daniela Flück, Matthias P Hilty, Carsten Lundby
High altitude hypoxia causes pronounced sympathoexcitation but the underlying mechanisms remain unclear. We tested the hypothesis that intravenous infusion of dopamine to attenuate carotid chemoreceptor responsiveness would reduce muscle sympathetic nerve activity (MSNA) at high altitude. Nine healthy individuals (mean [SD]; 26 [4] yr) were studied at sea level (SL, Zurich) and at high altitude (ALT, 3454 m, 15-17 days after arrival), both while breathing the ambient air and during an acute incremental hypoxia test (8 × 3 min stages, PET O2 90-45 mmHg)...
October 15, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/29032896/risk-factors-of-icu-or-high-dependency-requirements-amongst-hospitalized-pediatric-pertussis-cases-a-10-year-retrospective-series-singapore
#3
Chia-Yin Chong, Chee-Fu Yung, Natalie Woon-Hui Tan, Sanchalika Acharyya, Koh-Cheng Thoon
INTRODUCTION: Pertussis causes the highest complication rates and deaths in the infant group. Our study explored risk factors for ICU/high dependency (HD) admissions and intubation/non-invasive ventilation (NIV). METHODS: A retrospective review of pertussis admissions over 10 years from 2007 to 2016 was done at KK Women's and Children's Hospital, Singapore. To understand risk factors for severe pertussis infection, we compared cases requiring ICU/HD care with controls admitted to the general ward...
October 9, 2017: Vaccine
https://www.readbyqxmd.com/read/29032602/muscle-specific-differences-in-expression-and-phosphorylation-of-the-janus-kinase-2-signal-transducer-and-activator-of-transcription-3-following-long-term-mechanical-ventilation-and-immobilization-in-rats
#4
Heba Salah, Wen Fury, Jesper Gromada, Yu Bai, Tamar Tchkonia, James L Kirkland, Lars Larsson
AIM: Muscle wasting is one of the factors most strongly predicting mortality and morbidity in critically ill intensive care unit (ICU). This muscle wasting affects both limb and respiratory muscles but the understanding of underlying mechanisms and muscle-specific differences remains incomplete. This study aims at investigating the temporal expression and phosphorylation of the Janus kinase / signal transducer and activator of transcription (JAK/STAT) pathway in muscle wasting associated with the ICU condition in order to characterize the JAK/STAT proteins and the related changes leading or responding to their activation during exposure to the ICU condition...
October 15, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/29029284/the-influence-of-co2-on-genioglossus-muscle-after-discharge-following-arousal-from-sleep-hypocapnia-and-genioglossus-muscle-after-discharge
#5
Jennifer M Cori, Peter D Rochford, Fergal J O'Donoghue, John Trinder, Amy S Jordan
Objectives: Ventilatory after-discharge (sustained elevation of ventilation following stimulus removal), occurs during sleep but not when hypocapnia is present. Genioglossus after-discharge also occurs during sleep, but CO2 effects have not been assessed. The relevance is that post-arousal after-discharge may protect against upper airway collapse. This study aimed to determine whether arousal elicits genioglossus after-discharge that persists into sleep, and whether it is influenced by CO2...
October 6, 2017: Sleep
https://www.readbyqxmd.com/read/29027126/etiology-and-risk-factors-determining-poor-outcome-of-severe-pneumonia-in-under-five-children
#6
Suresh Kumar Jakhar, Mukul Pandey, Dheeraj Shah, V G Ramachandran, Rumpa Saha, Natasha Gupta, Piyush Gupta
OBJECTIVES: To determine the etiology of severe pneumonia (pneumonia with chest indrawing) in under-five children, and to study the risk factors for poor outcomes viz., 'treatment failure', 'need for change in antibiotics', 'prolonged hospital stay', 'need for mechanical ventilation' and 'mortality.' METHODS: Children (age 2 mo to 5 y) with pneumonia and chest drawing were enrolled prospectively from October 2012 through September 2013. Clinical history was recorded, and examination, anthropometry and investigations (including chest X-ray, blood culture and nasopharyngeal swab culture) were performed...
October 13, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29024364/healthcare-utilization-after-liver-transplantation-is-highly-variable-both-among-centers-and-recipients
#7
T Bittermann, R A Hubbard, M Serper, J D Lewis, S F Hohmann, L B VanWagner, D S Goldberg
The relationship between healthcare utilization before and after liver transplantation (LT) and its association with center characteristics is incompletely understood. This was a retrospective cohort study of 34,402 adult LTs between 2002-2013 using Vizient inpatient claims data linked to the United Network for Organ Sharing database. Multivariable mixed-effects linear regression models evaluated the association between hospitalization 90 days pre-LT and the number of days alive and out of the hospital (DAOH) 1 year post-LT...
October 11, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29023898/impact-of-ketamine-use-on-adjunctive-analgesic-and-sedative-medications-in-critically-ill-trauma-patients
#8
Kaitlin A Pruskowski, Kelly Harbourt, Mehrnaz Pajoumand, Sai-Ho Jason Chui, H Neal Reynolds
BACKGROUND: Ketamine may be used to manage pain and agitation that is refractory to "traditional" agents such as fentanyl, propofol, benzodiazepines, and dexmedetomidine; however, literature describing the use of ketamine continuous infusions for this purpose in critically ill trauma patients is limited. OBJECTIVES: The primary objective of this study was to determine the impact of the initiation of a ketamine continuous infusion on sedative and analgesic use in critically ill trauma patients...
October 10, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29022274/midazolam-prevents-motor-neuronal-death-from-oxidative-stress-attack-mediated-by-jnk-erk-pathway
#9
Guo-Zheng Li, Hong-Lei Tao, Cheng Zhou, Dong-Dong Wang, Cong-Bin Peng
Midazolam is a sedative used by patients with mechanical ventilation. However, the potential clinical value is not fully explored. In this report, we made use of a neuroblastoma-spinal cord hybrid motor neuron-like cell line NSC34, and elucidated the potential role of Midazolam on these cells under the insult of oxidative stress. We found the protective effect of Midazolam on motor neurons against cytotoxicity induced by the combination of oligomycin A and rotenone (O/R) or phenylarsine oxide. The characteristics of apoptosis, such as the ratio of TUNEL+ cells or the expression level of cleaved Caspase-3, was decreased by 22 or 45% in the presence of Midazolam...
October 11, 2017: Human Cell
https://www.readbyqxmd.com/read/29021759/effects-of-gladiolus-dalenii-on-the-stress-induced-behavioral-neurochemical-and-reproductive-changes-in-rats
#10
David Fotsing, Gwladys T Ngoupaye, Agnes C Ouafo, Stephanie K J Njapdounke, Yongabi A Kenneth, Elisabeth Ngo Bum
Gladiolus dalenii is a plant commonly used in many regions of Cameroon as a cure for various diseases like headaches, epilepsy, schizophrenia, and mood disorders. Recent studies have revealed that the aqueous extract of G. dalenii (AEGD) exhibited antidepressant-like properties in rats. Therefore, we hypothesized that the AEGD could protect from the stress-induced behavioral, neurochemical, and reproductive changes in rats. The objective of the present study was to elucidate the effect of the AEGD on behavioral, neurochemical, and reproductive characteristics, using female rats subjected to chronic immobilization stress...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29019893/rescue-therapeutic-strategy-combining-ultra-protective-mechanical-ventilation-with-extracorporeal-co2-removal-membrane-in-near-fatal-asthma-with-severe-pulmonary-barotraumas-a-case-report
#11
Arthur Pavot, Jihad Mallat, Nicolas Vangrunderbeeck, Didier Thevenin, Malcolm Lemyze
RATIONALE: Mechanical ventilation of severe acute asthma is still considered a challenging issue, mainly because of the gas trapping phenomenon with the potential for life-threatening barotraumatic pulmonary complications. PATIENT CONCERNS: Herein, we describe 2 consecutive cases of near-fatal asthma for whom the recommended protective mechanical ventilation approach using low tidal volume of 6 mL/kg and small levels of PEEP was rapidly compromised by giant pneumomediastinum with extensive subcutaneousemphysema...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28993571/job-safety-analysis-and-hazard-identification-for-work-accident-prevention-in-para-rubber-wood-sawmills-in-southern-thailand
#12
Phayong Thepaksorn, Supawan Thongjerm, Salee Incharoen, Wattasit Siriwong, Kouji Harada, Akio Koizumi
OBJECTIVE: We utilized job safety analysis (JSA) and hazard identification for work accident prevention in Para rubber wood sawmills, which aimed to investigate occupational health risk exposures and assess the health hazards at sawmills in the Trang Province, located in southern Thailand. METHODS: We conducted a cross-sectional study which included a walk-through survey, JSA, occupational risk assessment, and environmental samplings from March through September 2015 at four Para rubber wood sawmills...
October 7, 2017: Journal of Occupational Health
https://www.readbyqxmd.com/read/28992926/the-real-welfare-scheme-identification-of-risk-and-protective-factors-for-welfare-outcomes-in-commercial-pig-farms-in-the-uk
#13
F Pandolfi, I Kyriazakis, K Stoddart, N Wainwright, S A Edwards
From 2013-2016, animal-based measures were collected as part of the "Real Welfare" protocol adopted by the Red Tractor Pigs Assurance Scheme to assess the welfare in finisher pig herds in the UK. Trained veterinarians from 89 veterinary practices assessed 112,241 pens (hospital pens excluded) from 1928 farms using a multistage sampling protocol, and collected data about pig welfare, management and farm environment. Multivariable analyses were conducted for five main welfare outcomes: lameness, pigs requiring hospitalization, severe tail lesions, severe body marks and enrichment use ratio (number of active pigs interacting with the enrichment/total number of active pigs)...
October 1, 2017: Preventive Veterinary Medicine
https://www.readbyqxmd.com/read/28990225/feasibility-of-diaphragm-pacing-in-patients-after-bilateral-lung-transplantation
#14
Dries Testelmans, Philippe Nafteux, Sophie Van Cromphaut, Bart Vrijsen, Robin Vos, Paul De Leyn, Herbert Decaluwé, Dirk Van Raemdonck, Geert M Verleden, Bertien Buyse
Recent animal studies and intra-operative studies in humans suggested that phrenic nerve stimulation could attenuate ventilator-induced diaphragm dysfunction. The purpose of the present study is to examine the safety and feasibility of diaphragm pacing during the weaning process after bilateral lung transplantation. Four patients, suffering from chronic pulmonary disease, were included, and diaphragm pacing was evaluated after lung transplantation. Implantation of electrodes at the end of the lung transplant procedure was possible in three of the four patients...
October 9, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28986821/endothelial-glycocalyx-degradation-is-more-severe-in-patients-with-non-pulmonary-sepsis-compared-to-pulmonary-sepsis-and-associates-with-risk-of-ards-and-other-organ-dysfunction
#15
Laura S Murphy, Nancy Wickersham, J Brennan McNeil, Ciara M Shaver, Addison K May, Julie A Bastarache, Lorraine B Ware
BACKGROUND: Disruption of the endothelial glycocalyx contributes to acute lung injury in experimental sepsis but has not been well studied in humans. To study glycocalyx degradation in sepsis-induced ARDS, we measured plasma levels of syndecan-1, a marker for glycocalyx degradation. METHODS: The present study is a retrospective observational study of 262 ventilated medical ICU patients at risk of ARDS due to severe sepsis and APACHE II ≥ 25. Plasma syndecan-1 was measured at study enrollment...
October 6, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28984091/repeated-alveolar-recruitment-maneuvers-with-and-without-positive-end-expiratory-pressure-during-bariatric-surgery-a-randomized-trial
#16
Ke Wei, Su Min, Jun Cao, Xuechao Hao, Jie Deng
BACKGROUND: Positive end-expiratory pressure (PEEP) is considered essential in protective ventilation, while may lead to hemodynamic impairment. In the present study, we investigated the effect of repeated alveolar recruitment maneuvers (ARMs) with or without additional PEEP on the arterial oxygenation of obese patients who were undergoing bariatric surgery. METHODS: Thirty-six obese adult patients with body mass index (BMI) >40 kg/m2 who were scheduled for laparoscopic sleeve gastrectomy were randomly allocated into three groups: (1) control group, no intraoperative ARMs; (2) ARM+ZEEP group, repeated ARMs every 30 minutes without extra PEEP; or (3) ARM+PEEP group, ARMs followed by 8 cm H2O of PEEP from the onset of pneumoperitoneum...
October 4, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28983961/developing-a-predictive-model-for-fine-particulate-matter-concentrations-in-low-socio-economic-households-in-durban-south-africa
#17
Busisiwe Shezi, Nkosana Jafta, Benn Sartorius, Rajen N Naidoo
BACKGROUND: In low resource settings there is a need to develop models that can address contributions of household and outdoor sources to population exposures. The aim of the study was to model indoor PM2.5 using household characteristics, activities and outdoor sources. METHODS: Households belonging to participants in the Mother and Child in the Environment (MACE) birth cohort, in Durban, South Africa, were randomly selected. A structured walkthrough identified variables likely to generate PM2...
October 6, 2017: Indoor Air
https://www.readbyqxmd.com/read/28983937/factors-associated-with-change-in-health-related-quality-of-life-among-individuals-treated-with-long-term-mechanical-ventilation-a-six-year-follow-up-study
#18
Heidi Markussen, Sverre Lehmann, Roy M Nilsen, Gerd K Natvig
AIMS: To examine changes and explanatory variables for changes in health-related quality of life in patients treated with long-term mechanical ventilation over a six-year period. BACKGROUND: Long-term mechanical ventilation is a treatment for individuals with chronic hypercapnic respiratory failure, primarily caused by neuromuscular diseases, obesity hypoventilation syndrome, chronic obstructive pulmonary and restrictive thoracic diseases. Studies on long-term outcome on health-related quality of life and factors influencing it are lacking...
October 6, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28981603/high-mobility-group-box-1-protein-is-involved-in-the-protective-effect-of-saquinavir-on-ventilation-induced-lung-injury-in-mice
#19
Xin Wang, Renlingzi Zhang, Yao Tong, Xibing Ding, Shuqing Jin, Xiang Zhao, Jiaying Zong, Zhixia Chen, Timothy R Billiar, Quan Li
Saquinavir (SQV) is the first FDA approved HIV protease inhibitor. Previous studies showed that SQV can limit Toll-like receptor-4 (TLR4)-mediated inflammatory pathway and nuclear factor-κB (NF-κB) activation, thereby playing a protective role in many kinds of diseases. High-mobility group box 1 (HMGB1) has been identified as an inflammatory mediator and it might express its toxicity in a short period of time in ventilator-induced lung injury (VILI). In this study, C57BL/6 mice were randomly divided into four groups (n = 10): control group and control with SQV group (Con + SQV) were spontaneous breath...
October 1, 2017: Acta Biochimica et Biophysica Sinica
https://www.readbyqxmd.com/read/28979565/protective-ventilation-with-veno-venous-lung-assist-in-respiratory-failure-a-protocol-for-a-multicentre-randomised-controlled-trial-of-extracorporeal-carbon-dioxide-removal-in-patients-with-acute-hypoxaemic-respiratory-failure
#20
J J McNamee, M A Gillies, N A Barrett, A M Agus, R Beale, A Bentley, A Bodenham, S J Brett, D Brodie, S J Finney, A J Gordon, M Griffiths, D Harrison, C Jackson, C McDowell, C McNally, G D Perkins, W Tunnicliffe, A Vuylsteke, T S Walsh, M P Wise, D Young, D F McAuley
One of the few interventions to demonstrate improved outcomes for acute hypoxaemic respiratory failure is reducing tidal volumes when using mechanical ventilation, often termed lung protective ventilation. Veno-venous extracorporeal carbon dioxide removal (vv-ECCO2R) can facilitate reducing tidal volumes. pRotective vEntilation with veno-venouS lung assisT (REST) is a randomised, allocation concealed, controlled, open, multicentre pragmatic trial to determine the clinical and cost-effectiveness of lower tidal volume mechanical ventilation facilitated by vv-ECCO2R in patients with acute hypoxaemic respiratory failure...
May 2017: J Intensive Care Soc
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