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https://www.readbyqxmd.com/read/28637064/safety-and-efficacy-of-glycopyrrolate-as-a-premedication-for-endoscopic-submucosal-dissection-a-randomized-double-blind-placebo-controlled-study
#1
Eui Joo Kim, Min Young Um, Kyoung Oh Kim, Jung Ho Kim, Su Young Kim, Dong Kyun Park, Kwang An Kwon, Jun Won Chung, Yoon Jae Kim
Background and study aims Anticholinergic premedication has not been validated for endoscopic submucosal dissection (ESD). In this randomized, double-blind, placebo-controlled trial, we investigated the efficacy and safety of glycopyrrolate as a premedication for ESD. Methods A total of 196 patients undergoing ESD at a single tertiary medical center between December 2014 and February 2016 were randomly allocated to receive one of the following two premedications: glycopyrrolate (0.004 mg/kg intramuscularly [IM]) or placebo (2...
June 21, 2017: Endoscopy
https://www.readbyqxmd.com/read/28627352/-acute-cor-pulmonale-in-acute-respiratory-distress-syndrome
#2
Feng Zhang, Quan Cao, Xiangrong Zuo
Acute respiratory distress syndrome (ARDS) is a severe respiratory condition that is characterized by rapidly progressive hypoxemia with noncardiogenic pulmonary edema. Despite the improvement of therapeutic methods, the mortality of ARDS is in the range of 40%-50% all over the world. Some studies have shown that a significant number of patients with ARDS had acute cor pulmonale (ACP), and ACP is independently associated with the mortality of patients with ARDS, which has attracted wide attention in recent years...
March 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28621297/endoscopic-ultrasound-with-or-without-fine-needle-aspiration-has-a-meaningful-impact-on-clinical-care-in-the-pediatric-population
#3
Amit Raina, Maire A Conrad, Benjamin Sahn, Alireza Sedarat, Gregory G Ginsberg, Nuzhat A Ahmad, Vinay Chandrasekhara, Petar Mamula, Michael L Kochman
BACKGROUND AND OBJECTIVES: The safety and utility of endoscopic ultrasound (EUS) for the evaluation and management of gastrointestinal (GI) tract disorders among adults has been established. The literature on safety and efficacy in a pediatric referral population (under 21 years of age) is limited. We hypothesized that EUS is safe and useful in the pediatric population. We reviewed the pediatric EUS experience at a single tertiary-care system. We describe the indications, findings, safety, technical success rate, and impact on clinical outcomes...
May 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28620066/mitochondrial-complex-iv-subunit-4-isoform-2-is-essential-for-acute-pulmonary-oxygen-sensing
#4
Natascha Sommer, Maik Huttemann, Oleg Pak, Susan Scheibe, Fenja Knöpp, Christopher Sinkler, Monika Malczyk, Mareike Gierhardt, Azadeh Esfandiary, Simone Kraut, Felix T Jonas, Christine Veith, Siddhesh Aras, Akylbek Sydykov, Nasim Alebrahimdehkordi, Klaudia Giehl, Matthias Hecker, Ralf P Brandes, Werner Seeger, Friedrich Grimminger, Hossein A Ghofrani, Ralph T Schermuly, Lawrence I Grossman, Norbert Weissmann
Rationale: Acute pulmonary oxygen sensing is essential to avoid life-threatening hypoxemia via hypoxic pulmonary vasoconstriction (HPV) which matches perfusion to ventilation. Hypoxia-induced mitochondrial superoxide release has been suggested as critical step in the signaling pathway underlying HPV. However, the identity of the primary oxygen sensor and mechanism of superoxide release in acute hypoxia, as well as its relevance for chronic pulmonary oxygen sensing remains unresolved. Objective: To investigate the role of the pulmonary specific isoform 2 of subunit 4 of mitochondrial complex IV (Cox4i2) and the subsequent mediators superoxide and hydrogen peroxide for pulmonary oxygen sensing and signaling...
June 15, 2017: Circulation Research
https://www.readbyqxmd.com/read/28616377/blue-after-splenectomy
#5
Taaran Cariappa Ballachanda Subbaiah, Jeremy P Feldman
INTRODUCTION: We present a 51 year old, African American, female who presented with persistent hypoxemia. She had been taking dapsone for many years for prophylaxis against Pneumocystic Jiroveci with no symptoms but eventually developed methemoglobinemia only after a splenectomy. From our literature review there are no documented cases that have demonstrated this relationship between dapsone, splenic function and methemoglobin and we hope to share our perplexing case and shed light on the interaction...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28613912/molecular-and-immune-biomarkers-in-acute-respiratory-distress-syndrome-a-perspective-from-members-of-the-pulmonary-pathology-society
#6
Vera Luiza Capelozzi, Timothy Craig Allen, Mary Beth Beasley, Philip T Cagle, Don Guinee, Lida P Hariri, Aliya N Husain, Deepali Jain, Sylvie Lantuejoul, Brandon T Larsen, Ross Miller, Mari Mino-Kenudson, Mehrad Mitra, Kirtee Raparia, Anja Roden, Frank Schneider, Lynette M Sholl, Maxwell Lawrence Smith
Acute respiratory distress syndrome (ARDS) is a multifactorial syndrome with high morbidity and mortality rates, characterized by deficiency in gas exchange and lung mechanics that lead to hypoxemia, dyspnea, and respiratory failure. Histologically, ARDS is characterized by an acute, exudative phase, combining diffuse alveolar damage and noncardiogenic edema, followed by a later fibroproliferative phase. Despite an enhanced understanding of ARDS pathogenesis, the capacity to predict the development of ARDS and to risk-stratify patients with the disease remains limited...
June 14, 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28611257/isolated-intrapulmonary-vascular-dilatations-and-the-risk-of-developing-hepatopulmonary-syndrome-in-liver-transplant-candidates
#7
Manuel Mendizabal, David Goldberg, Federico Piñero, Diego Arufe, María José de la Fuente, Pablo Testa, Matías Coronel, Sergio Baratta, Luis Podestá, Michael Fallon, Marcelo Silva
BACKGROUND: The natural history of intrapulmonary vascular dilations (IPVD) and their impact on patient outcomes in the setting of portal hypertension has only been described in small series. AIMS: To assess the development of hepatopulmonary síndrome (HPS) in patients with isolated IPVD and to evaluate outcomes of IPVD and HPS among patients evaluated for liver transplantation (LT). MATERIAL AND METHODS: Data from a prospective cohort of patients evaluated for LT with standardized screening for HPS were analyzed...
August 1, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28595341/obstructive-sleep-apnea-dynamically-increases-nocturnal-plasma-free-fatty-acids-glucose-and-cortisol-during-sleep
#8
Swati Chopra, Aman Rathore, Haris Younas, Luu V Pham, Chenjuan Gu, Aleksandra Beselman, Il-Young Kim, Robert R Wolfe, Jamie Perin, Vsevolod Y Polotsky, Jonathan C Jun
Context: Obstructive sleep apnea (OSA) is associated with diabetes and cardiovascular disease. This association may be related to metabolic changes that transpire during sleep in OSA. Objective: To examine the impact of OSA, elicited by cessation of continuous positive airway pressure (CPAP), on frequently sampled nocturnal metabolic markers including plasma free fatty acids (FFA), glucose, insulin, triglycerides, cortisol, and lactate; as well as glucose production, oral glucose tolerance, blood pressure, endothelial function, cholesterol, and high sensitivity C-reactive protein (hsCRP)...
June 8, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28591973/-the-application-of-internal-iliac-artery-balloon-occlusion-in-pernicious-placenta-previa
#9
Xiao-Rong Qi, Xing-Hui Liu, Yong You, Xiao-Dong Wang, Rong Zhou, Ai-Yun Xing, Li Zhang, Gang Ning, Fu-Min Zhao, Kai-Ming Li
OBJECTIVES: To evaluate the clinical application value of internal iliac artery balloon occlusion in pernicious placenta previa. METHODS: We retrospectively reviewed the medical records of the patients of pernicious placenta previa in a single center from Jan, 2010 to Jan, 2015. The patients were divided into two groups, internal iliac artery balloon occlusion group and the control group without endovascular intervention. Blood loss in operation, volume of transfused blood products, caesarean hysterectomy, operating time, hospital days after operation and postoperative morbidity were compared between the two groups...
July 2016: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/28589462/discharge-or-admit-emergency-department-management-of-incidental-pulmonary-embolism-in-patients-with-cancer-a-retrospective-study
#10
Srinivas R Banala, Sai-Ching Jim Yeung, Terry W Rice, Cielito C Reyes-Gibby, Carol C Wu, Knox H Todd, W Frank Peacock, Kumar Alagappan
BACKGROUND: Hospitalization and early anticoagulation therapy remain standard care for patients who present to the emergency department (ED) with pulmonary embolism (PE). For PEs discovered incidentally, however, optimal therapeutic strategies are less clear-and all the more so when the patient has cancer, which is associated with a hypercoagulable state that exacerbates the threat of PE. METHODS: We conducted a retrospective review of a historical cohort of patients with cancer and incidental PE who were referred for assessment to the ED in an institution whose standard of care is outpatient treatment of selected patients and use of low-molecular-weight heparin for anticoagulation...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28587528/a-prospective-observational-cohort-study-of-exposure-to-womb-like-sounds-to-stabilize-breathing-and-cardiovascular-patterns-in-preterm-neonates
#11
Joanna J Parga, Ravi R Bhatt, Kalpashri Kesavan, Myung-Shin Sim, Harvey N Karp, Ronald M Harper, Lonnie Zeltzer
PURPOSE: We exposed premature infants to womb-like sounds to evaluate such exposure on breathing and cardiovascular patterns. We hypothesized that these sounds would reduce apnea and intermittent hypoxemia, enhance parasympathetic outflow, and improve cardiovascular patterns. METHODS: A total of 20 cases and 5 control infants at ≤ 32-36 weeks corrected gestational age participated in a prospective observational cohort study. Twenty-four hours of continuous ECG, respiratory and oxygen saturation data were collected in all infants...
June 7, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28584437/severe-pediatric-acute-respiratory-distress-syndrome-due-to-scrub-typhus-successful-ventilation-with-airway-pressure-release-ventilation-mode-after-becoming-refractory-to-protective-ventilation
#12
Sudha Chandelia, Sarika Jain
Scrub typhus can affect lungs from mild illness like pneumonitis to a severe illness like acute respiratory distress syndrome (ARDS). Such patients may be very challenging to treat when their hypoxemia becomes severe and refractory to treatment. Main treatment is supportive in terms of mechanical ventilation. In adult ARDS, low tidal volume (TV) ventilation has been recommended, but there is no consensus on most effective ventilation mode in children. We present a case of a 12-year-old girl who developed severe ARDS (PO2/FiO2 ratio - 58), refractory to low TV ventilation...
May 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28583135/outcomes-and-prognostic-factors-of-non-hiv-patients-with-pneumocystis-jirovecii-pneumonia-and-pulmonary-cmv-co-infection-a-retrospective-cohort-study
#13
Qing Yu, Peng Jia, Li Su, Hong Zhao, Chengli Que
BACKGROUND: Pneumocystis jirovecii pneumonia (PJP) and pulmonary cytomegalovirus (CMV) infection are common opportunistic infections among immunocompromised patients. However, few studies have evaluated their co-infection, especially among non-HIV patients. Therefore, we aimed to evaluate the outcomes and prognostic factors among non-HIV patients with PJP according to their CMV infection status. METHODS: This retrospective study evaluated non-HIV patients who were diagnosed with PJP between January 2009 and January2016...
June 5, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28578633/early-pulmonary-compliance-increase-during-cardiac-surgery-predicted-post-operative-lung-dysfunction
#14
Yann Sacuto, Thierry Sacuto
INTRODUCTION: Lung dysfunction following cardiac surgery is currently viewed as the consequence of atelectasis and lung injury. While the mechanism of atelectasis has been largely detailed, the pathogenesis of lung injury after cardiopulmonary bypass is still unclear. Based upon clinical and experimental studies, we hypothesized that lungs could be injured through a mechanical phenomenon. METHODS: We recorded pulmonary compliance at six key moments of a heart operation in 62 adult patients undergoing elective cardiac surgery...
June 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28578113/safety-of-percutaneous-dilatational-tracheostomy-in-patients-with-acute-brain-injury-and-a-reduced-pao2-fio2-ratio-a-retrospective-analysis-of-54-patients
#15
Claudia Ditz, Jann F Wojak, Emma Smith, Abdulkareem Abusamha, Volker M Tronnier, Jan Gliemroth, Jan N Kuechler
OBJECTIVE: Percutaneous Dilatational Tracheostomy (PDT) is a commonly performed method in neurocritical care, whose safety has been proven in numerous studies. Nevertheless, there are poor data regarding the application in patients with acute brain injury and poor respiratory function. The purpose of this study was to evaluate the incidence of hypoxemia and hypercapnia during PDT in those patients. METHODS: In a retrospective analysis, we acquired data from 54 patients with an acute brain injury (ABI) and a reduced PaO2/FiO2 ratio (PaO2/FiO2<300mmHg)...
May 31, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28575361/chest-radiograph-findings-in-childhood-pneumonia-cases-from-the-multisite-perch-study
#16
Nicholas Fancourt, Maria Deloria Knoll, Henry C Baggett, W Abdullah Brooks, Daniel R Feikin, Laura L Hammitt, Stephen R C Howie, Karen L Kotloff, Orin S Levine, Shabir A Madhi, David R Murdoch, J Anthony G Scott, Donald M Thea, Juliet O Awori, Breanna Barger-Kamate, James Chipeta, Andrea N DeLuca, Mahamadou Diallo, Amanda J Driscoll, Bernard E Ebruke, Melissa M Higdon, Yasmin Jahan, Ruth A Karron, Nasreen Mahomed, David P Moore, Kamrun Nahar, Sathapana Naorat, Micah Silaba Ominde, Daniel E Park, Christine Prosperi, Somwe Wa Somwe, Somsak Thamthitiwat, Syed M A Zaman, Scott L Zeger, Katherine L O'Brien
Background.: Chest radiographs (CXRs) are frequently used to assess pneumonia cases. Variations in CXR appearances between epidemiological settings and their correlation with clinical signs are not well documented. Methods.: The Pneumonia Etiology Research for Child Health project enrolled 4232 cases of hospitalized World Health Organization (WHO)-defined severe and very severe pneumonia from 9 sites in 7 countries (Bangladesh, the Gambia, Kenya, Mali, South Africa, Thailand, and Zambia)...
June 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28561960/acute-respiratory-distress-syndrome-and-septic-shock-in-a-cat-with-disseminated-toxoplasmosis
#17
Natashia A Evans, Julie M Walker, Alison C Manchester, Jonathan F Bach
OBJECTIVE: To describe acute respiratory distress syndrome (ARDS) and septic shock in a cat with disseminated toxoplasmosis. CASE SUMMARY: A 2-year-old neutered male domestic shorthair cat was presented for acute respiratory distress. At the time of presentation it had been receiving cyclosporine for treatment of eosinophilic dermatitis. Thoracic radiographs revealed severe mixed nodular interstitial and alveolar patterns. An endotracheal wash was performed, which confirmed a diagnosis of pulmonary toxoplasmosis...
May 31, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28559468/severity-of-hypoxemia-and-other-factors-that-influence-the-response-to-aerosolized-prostacyclin-in-ards
#18
Richard H Kallet, Gregory Burns, Hanjing Zhuo, Kelly Ho, Justin S Phillips, Lance P Pangilinan, Vivian Yip, Antonio Gomez, Michael S Lipnick
BACKGROUND: ARDS is characterized by decreased functional residual capacity (FRC), heterogeneous lung injury, and severe hypoxemia. Tidal ventilation is preferentially distributed to ventilated alveoli. Aerosolized prostaglandin I2 exploits this pathophysiology by inducing local vasodilation, thereby increasing ventilation-perfusion matching and reducing hypoxemia. Therefore, aerosolized prostaglandin I2 efficacy may depend upon FRC. Both PaO2 /FIO2 and compliance of the respiratory system (CRS) are indirect signifiers of FRC and thus may partly determine the response to aerosolized prostaglandin I2...
May 30, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28548310/diagnostic-and-prognostic-values-of-club-cell-protein-16-cc16-in-critical-care-patients-with-acute-respiratory-distress-syndrome
#19
Jinle Lin, Wenwu Zhang, Lijun Wang, Fang Tian
BACKGROUND: Acute respiratory distress syndrome (ARDS) is a critical condition characterized by bilateral pulmonary infiltrates and severe hypoxemia. This study aimed to evaluate the diagnostic and prognostic values of Club cell protein 16 (CC16) in critical care patients with ARDS. METHODS: In this retrospective observational study, 83 patients with ARDS and 129 non-ARDS patients on ICU admission were enrolled. The differences in serum CC16 and other laboratory indicators between two groups were analyzed...
May 26, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28546370/pediatric-oxygen-therapy-a-review-and-update
#20
Brian K Walsh, Craig D Smallwood
Oxygen is a colorless, odorless, tasteless gas that is utilized by the body for respiration. Oxygen has played a major role in respiratory care. Oxygen therapy is useful in treating hypoxemia but is often thought of as a benign therapy. After many years of study, we have learned a great deal of the benefits and potential risk of this powerful drug. Today oxygen gas is cheap, widely available, and easy to administer. Oxygen delivery devices vary in cost from a few cents for a simple nasal cannula to $25-$50 for some humidified systems...
June 2017: Respiratory Care
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