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Chronic Respiratory Failure

Cheryl L Maier, Phillip J Gross, Christina L Dean, Satheesh Chonat, Andrew Ip, Morgan McLemore, Fuad El Rassi, Sean R Stowell, Cassandra D Josephson, Ross M Fasano
BACKGROUND: Fever accompanying vaso-occlusive crisis is a common presentation in patients with sickle cell disease (SCD) and carries a broad differential diagnosis. Here, we report a case of transfusion-transmitted malaria in a patient with SCD presenting with acute vaso-occlusive crisis and rapidly decompensating to multisystem organ failure (MSOF). CASE REPORT: An 18-year-old African American male with SCD was admitted after multiple days of fever and severe generalized body pain...
March 9, 2018: Transfusion
S Ben Saad, B Melki, L Douik El Gharbi, F Soraya, N Chaouch, H Aouina, J Cherif, A Hamzaoui, A Merghli, H Daghfous, F Tritar
BACKGROUND: Pneumothorax is a serious complication of cavitary pulmonary tuberculosis. The aim of this study was to describe clinical futures, to highlight challenges of its management. METHODS: A retrospective multicentric and descriptive study including 65 patients treated for PT (1999-2015) was conducted to figure out clinical futures and its work-up. RESULTS: The mean age was 37.8 years. The sex ratio was 3.6. Smoking history and incarceration were noted respectively in 67...
March 6, 2018: Revue de Pneumologie Clinique
Douglas W Jones, Philip P Goodney, Jens Eldrup-Jorgensen, Marc L Schermerhorn, Jeffrey J Siracuse, Jeanwan Kang, Jesse A Columbo, Bjoern D Suckow, David H Stone
OBJECTIVE: Performing lower extremity bypass (LEB) in actively smoking claudicants remains controversial. Whereas some surgeons advocate a strict nonoperative approach to active smokers, citing perceived inferior outcomes, others will proceed with surgical bypass if the patient is anatomically suited and medical management has failed. The purpose of this study was to determine the impact of active smoking on LEB outcomes among claudicants. METHODS: All patients undergoing infrainguinal LEB for claudication in the Vascular Study Group of New England from 2003 to 2016 were analyzed...
March 6, 2018: Journal of Vascular Surgery
Whittney A Warren, Domingo Franco-Palacios, Christopher S King, Oksana A Shlobin, Steven D Nathan, Shalika B Katugaha, Haresh Mani, A Whitney Brown
A 24-year-old woman with ΔF508/Y1092X cystic fibrosis (CF) complicated by severe obstructive lung disease (FEV1 of 30% predicted) was admitted for IV antibiotics for planned sinus surgery resulting from severe chronic sinusitis causing frequent exacerbations and declining lung function. She had persistent airway infection with multidrug-resistant Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, and growth of a fungus presumed to be an airway colonizer, identified as Stephanoascus ciferrii 1 year before presentation...
March 2018: Chest
Ourania Preventza, Matt D Price, Hiruni S Amarasekara, Adam Tullos, Peter Chen, Michael R Reidy, Gregory Pattakos, Kim I de la Cruz, Qianzi Zhang, Joseph S Coselli
OBJECTIVES: To compare short-term outcomes, long-term survival and reinterventions in patients requiring surgery after chronic Type I and chronic primary Type III aortic dissections. METHODS: Over an 11-year period, 466 patients underwent thoraco-abdominal aortic aneurysm repair for chronic Type III (n = 239) and Type I (n = 227) aortic dissections. Short-term outcomes and reinterventions were evaluated by multivariable regression analysis for the entire group; propensity matching produced 169 pairs...
March 2, 2018: European Journal of Cardio-thoracic Surgery
Takayasu Ito, Masahide Oki, Hideo Saka, Yasuhiro Kondoh, Tomoki Kimura, Kensuke Kataoka
A 71-year-old man, who had received long-term oxygen therapy for respiratory failure caused by chronic obstructive pulmonary disease, had an enlarged mediastinal lymph node for one year. As his lung function was poor, we tried performing endobronchial ultrasound-guided transbronchial needle aspiration under non-invasive positive pressure ventilation for diagnosis but could not obtain sufficient specimens. Later, we performed an endoscopic ultrasound with bronchoscope-guided fine-needle aspiration (EUS-B-FNA) using a transesophageal approach...
May 2018: Respirology Case Reports
Brittany N Burton, Swapnil Khoche, Alison M A'Court, Ulrich H Schmidt, Rodney A Gabriel
OBJECTIVE: Postoperative respiratory failure requiring reintubation is associated with a significant increase in mortality. However, perioperative risk factors and their effects on unplanned 30-day reintubation and postoperative outcomes after unplanned reintubation following lung resection are not described well. The aim of this study was to determine whether certain comorbidities, demographic factors, and postoperative outcomes are associated with 30-day reintubation after thoracic surgery...
January 31, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Laura Rosella, Kathy Kornas, Anjie Huang, Catherine Bornbaum, David Henry, Walter P Wodchis
With falling mortality rates for several diseases, patients are living longer with complex multimorbidities. We explored the burden of multimorbidity at the time of death, how it varies by socioeconomic status, and trends over time in Ontario, Canada. We calculated the proportions of decedents with varying degrees of multimorbidity and types of conditions at death, and we analyzed the trend from 1994 to 2013 in the number of conditions at the time of death. The prevalence of multimorbidity at death increased from 79...
March 2018: Health Affairs
Kevin J Li, Ronald J Gurrera, Lynn E Delisi
Clozapine has been shown to be the most efficacious therapy for treatment resistant schizophrenia, estimated at one third of all schizophrenia cases. There is significant morbidity and mortality associated with clozapine including risk of agranulocytosis, aspiration pneumonia, bowel ischemia, myocarditis, seizures, and weight gain. Here we present a case of a 62-year-old man with chronic paranoid schizophrenia refractory to numerous antipsychotics who was started on clozapine therapy during an acute inpatient psychiatric admission...
March 1, 2018: Schizophrenia Research
Quoc Tran, Ryo Mizumoto, Daniel Mehanna
INTRODUCTION: Subcutaneous emphysema (SE) is a frequent and often self-limiting complication of tube thoracostomy or other cardiothoracic procedures. On rare occasions, severe and extensive surgical emphysema marked by palpable cutaneous tension, dysphagia, dysphonia, palpebral closure or associated with pneumoperitoneum, airway compromise, "tension phenomenon" and respiratory failure require treatment. PRESENTATION OF CASE: A 67 year old lady presented with a large spontaneous pneumothorax on the background of end-stage chronic obstructive pulmonary disease (COPD) and newly diagnosed lung cancer, developed extensive surgical emphysema following insertion of a chest drain...
February 9, 2018: International Journal of Surgery Case Reports
Michael E Wilson, Abdul M Majzoub, Claudia C Dobler, J Randall Curtis, Tarek Nayfeh, Bjorg Thorsteinsdottir, Amelia K Barwise, Jon C Tilburt, Ognjen Gajic, Victor M Montori, M Hassan Murad
OBJECTIVES: To assess the effectiveness of noninvasive ventilation in patients with acute respiratory failure and do-not-intubate or comfort-measures-only orders. DATA SOURCES: MEDLINE, EMBASE, CINAHL, Scopus, and Web of Science from inception to January 1, 2017. STUDY SELECTION: Studies of all design types that enrolled patients in the ICU or hospital ward who received noninvasive ventilation and had preset do-not-intubate or comfort-measures-only orders...
March 1, 2018: Critical Care Medicine
Nousheen Akhter, Nadeem Ahmed Rizvi
Objective: To evaluate the effectiveness and safety of using BiPAP through endotracheal tube in comatose Chronic Obstructive Pulmonary Disease (COPD) patients with hypercapnic respiratory failure. Methods: This is a prospective study done at Department of Chest Medicine, Jinnah Postgraduate Medical Centre, Karachi, during March to June 2017. It included all comatose COPD patients with hypercapnic respiratory failure who had a poor functional status prior to the illness and who did not meet the criteria to be kept on mechanical ventilator...
November 2017: Pakistan Journal of Medical Sciences Quarterly
Nishamali Jayatilleke, Richard D Hayes, Chin-Kuo Chang, Robert Stewart
BACKGROUND: Serious mental illness (SMI, including schizophrenia, schizoaffective disorder, and bipolar disorder) is associated with worse general health. However, admissions to general hospitals have received little investigation. We sought to delineate frequencies of and causes for non-psychiatric hospital admissions in SMI and compare with the general population in the same area. METHODS: Records of 18 380 individuals with SMI aged ⩾20 years in southeast London were linked to hospitalisation data...
February 28, 2018: Psychological Medicine
Carmen Fontela, Jesús Castilla, Regina Juanbeltz, Iván Martínez-Baz, María Rivero, Aisling O'Leary, Natalia Larrea, Ramón San Miguel
OBJECTIVES: The increased survival of HIV-infected individuals has resulted in a premature aging of this population, with the consequent development of premature age-related comorbidities and risk factors. We aimed to describe the prevalence of age-related comorbidities and cardiovascular risk factors in older adults with HIV infection on antiretroviral therapy (ART). METHODS: A retrospective cross-sectional study was undertaken in a cohort of HIV patients aged ≥50 years on ART in September 2016 in Spain...
February 28, 2018: Postgraduate Medicine
Josephine Kam Tai Dermawan, Subha Ghosh, M Kelly Keating, K V Gopalakrishna, Sanjay Mukhopadhyay
BACKGROUND: Candida is frequently isolated from the respiratory tract and usually reflects airway colonization. True Candida pneumonia is rare. Our aim is to document a case of Candida pneumonia confirmed by cultures, molecular techniques, and surgical lung biopsy, and to highlight a previously unreported pathologic manifestation of this infection. CASE SUMMARY: A 59-year-old man with a history of chronic obstructive pulmonary disease (COPD) presented with dry cough, low-grade fever, and progressive dyspnea...
January 2018: Medicine (Baltimore)
Christos Chouaid, Jean Baptiste Assié, Pascal Andujar, Cecile Blein, Charlène Tournier, Alexandre Vainchtock, Arnaud Scherpereel, Isabelle Monnet, Jean Claude Pairon
This study was undertaken to determine the healthcare burden of malignant pleural mesothelioma (MPM) in France and to analyze its associations with socioeconomic deprivation, population density, and management outcomes. A national hospital database was used to extract incident MPM patients in years 2011 and 2012. Cox models were used to analyze 1- and 2-year survival according to sex, age, co-morbidities, management, population-density index, and social deprivation index. The analysis included 1,890 patients (76% men; age: 73...
February 26, 2018: Cancer Medicine
Serdal Korkmaz
Hyperleukocytosis is defined as a white blood cell count greater than 100.000/μL in patients affected by acute or chronic leukemias. Hyperleukocytosis is more common in acute leukemias than in chronic leukemias. Risk factors include younger age, acute myeloid leukemia, the microgranular variant of acute promyelocytic leukemia, acute lymphoblastic leukemia and some cytogenetic abnormalities. Although it can affect any organ system, symptoms usually arise from involvement of the cerebral, pulmonary and renal microvasculature...
February 20, 2018: Transfusion and Apheresis Science
Jens M Hohlfeld, Jens Vogel-Claussen, Heike Biller, Dominik Berliner, Korbinian Berschneider, Hanns-Christian Tillmann, Simone Hiltl, Johann Bauersachs, Tobias Welte
BACKGROUND: Pulmonary hyperinflation in chronic obstructive pulmonary disease (COPD) is associated with reduced biventricular end-diastolic volumes and increased morbidity and mortality. The combination of a long-acting β agonist (LABA) and a muscarinic antagonist (LAMA) is more effective in reducing hyperinflation than LABA-inhaled corticosteroid combination therapy but whether dual bronchodilation improves cardiac function is unknown. METHODS: We did a double-blind, randomised, two-period crossover, placebo-controlled, single-centre study (CLAIM) at the Fraunhofer Institute of Toxicology and Experimental Medicine (Hannover, Germany), a specialty clinic...
February 21, 2018: Lancet Respiratory Medicine
Wan-Ling Chen, Chin-Ming Chen, Shu-Chen Kung, Ching-Min Wang, Chih-Cheng Lai, Chien-Ming Chao
This retrospective cohort study investigated the outcomes and prognostic factors in nonagenarians (patients 90 years old or older) with acute respiratory failure. Between 2006 and 2016, all nonagenarians with acute respiratory failure requiring invasive mechanical ventilation (MV) were enrolled. Outcomes including in-hospital mortality and ventilator dependency were measured. A total of 173 nonagenarians with acute respiratory failure were admitted to the intensive care unit (ICU). A total of 56 patients died during the hospital stay and the rate of in-hospital mortality was 32...
January 23, 2018: Oncotarget
Alexandre Debelmas, Déborah Benchetrit, Damien Galanaud, Roman H Khonsari
History A 21-year-old man with a history of abuse of multiple drugs and mild cognitive impairment who initially underwent treatment for excited delirium developed respiratory arrest shortly after admission and was successfully resuscitated. Unenhanced computed tomography (CT) of the head and neck and contrast material-enhanced CT of the chest, abdomen, pelvis, and complete spine were performed shortly after the initial treatment. Head and neck magnetic resonance (MR) imaging was performed 24 hours after admission...
March 2018: Radiology
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