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https://www.readbyqxmd.com/read/29750814/one-year-mortality-after-recovery-from-critical-illness-a-retrospective-cohort-study
#1
Sharukh Lokhandwala, Ned McCague, Abdullah Chahin, Braiam Escobar, Mengling Feng, Mohammad M Ghassemi, David J Stone, Leo Anthony Celi
RATIONALE: Factors associated with one-year mortality after recovery from critical illness are not well understood. Clinicians generally lack information regarding post-hospital discharge outcomes of patients from the intensive care unit, which may be important when counseling patients and families. OBJECTIVE: We sought to determine which factors among patients who survived for at least 30 days post-ICU admission are associated with one-year mortality. METHODS: Single-center, longitudinal retrospective cohort study of all ICU patients admitted to a tertiary-care academic medical center from 2001-2012 who survived ≥30 days from ICU admission...
2018: PloS One
https://www.readbyqxmd.com/read/29738754/closure-of-a-post-transplant-bronchial-dehiscence-with-endobronchial-fibrin-sealant
#2
Branden W Luna, Luca Paoletti, Chadrick E Denlinger, Nicholas J Pastis, Timothy P Whelan
Airway complications following lung transplantation are well described and can lead to significant morbidity and mortality. Treatment options for anastomotic dehiscence include expectant management, placement of endobronchial stents, or surgical repair. The use of fibrin sealant instilled via bronchoscopy to seal a dehiscence has not been well described. Our patient is a 57 year old male who underwent orthotropic bilateral lung transplantation for end stage COPD. He was found to have a partial bronchial anastomosis dehiscence and subsequently treated with endobronchial fibrin sealant glue instillation...
May 5, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29668346/medication-discontinuation-at-the-end-of-life-a-questionnaire-study-on-physicians-experiences-and-opinions
#3
Eric C T Geijteman, Bregje A A Huisman, Marianne K Dees, Roberto S G M Perez, Carin C D van der Rijt, Lia van Zuylen, Agnes van der Heide
BACKGROUND: Many patients who are in the last phase of life use multiple medications that are continued until shortly before they ultimately die. Little is known about physicians' opinions and experiences regarding medication discontinuation at the end of patients' lives. OBJECTIVE: To explore physicians' opinions and experiences regarding medication discontinuation during the last phase of life, and to identify factors influencing the continuation of potentially inappropriate medications...
April 18, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29629995/single-vs-bilateral-lung-transplantation-when-and-why
#4
Shambhu Aryal, Steven D Nathan
PURPOSE OF REVIEW: Lung transplantation is a life-saving treatment for several end stage lung diseases. Over the last two decades, the number of lung transplantation performed worldwide has steadily increased but several thousand people still die every year waiting for lung transplantation. However, the optimal procedure for lung transplantation in non-septic lung conditions remains debatable. RECENT FINDINGS: In pulmonary fibrosis and COPD, many recent studies suggest superiority of bilateral lung transplantation over single lung transplantation when long-term survival is evaluated; consequently, bilateral lung transplantation has been favored by many lung transplantation centers...
April 7, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29576405/a-propensity-matched-comparison-of-fenestrated-endovascular-aneurysm-repair-and-open-surgical-repair-of-pararenal-and-paravisceral-aortic-aneurysms
#5
Giovanni Tinelli, Maria Antonietta Crea, Chiara de Waure, Gian Luca Di Tanna, Jean-Pierre Becquemin, Jonathan Sobocinski, Francesco Snider, Stéphan Haulon
OBJECTIVE: This study investigated the outcomes of a current series of patients treated with fenestrated and branched endovascular aneurysm repair (F-BEVAR) or open surgical repair (OSR) for pararenal abdominal aortic aneurysms (pr-AAAs), including juxtarenal, suprarenal, and type IV thoracoabdominal aneurysms. This study compares the outcomes of these procedures from two high-volume centers without the bias induced by a learning curve. METHODS: All patients with pr-AAAs undergoing repair at two centers between January 2010 and June 2016 were included in a prospective database...
March 22, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29558226/management-of-copd-in-end-of-life-care-by-spanish-pulmonologists
#6
Patricia Sobradillo Ecenarro, Marta Inchausti Iguiñiz, Sandra Pedrero Tejada, Nuria Marina Malanda, María Alfonso Imizcoz, Laura Ansola Marlasca, Bernardino Alcázar Navarrete
Chronic obstructive pulmonary disease is progressive and in its advanced stage is associated with major disability. Previous studies suggest that patients with this disease receive little palliative care, even in very advanced stages. Given this, our objectives were to describe the clinical practice of Spanish pulmonologists in the care of patients with end-stage chronic obstructive pulmonary disease, to identify potential barriers to implementing palliative care in these patients and to correlate these responses with doctor's years of experience...
March 20, 2018: COPD
https://www.readbyqxmd.com/read/29545277/aberrant-epithelial-differentiation-by-cigarette-smoke-dysregulates-respiratory-host-defence
#7
Gimano D Amatngalim, Jasmijn A Schrumpf, Fernanda Dishchekenian, Tinne C J Mertens, Dennis K Ninaber, Abraham C van der Linden, Charles Pilette, Christian Taube, Pieter S Hiemstra, Anne M van der Does
It is currently unknown how cigarette smoke-induced airway remodelling affects highly expressed respiratory epithelial defence proteins and thereby mucosal host defence.Localisation of a selected set of highly expressed respiratory epithelial host defence proteins was assessed in well-differentiated primary bronchial epithelial cell (PBEC) cultures. Next, PBEC were cultured at the air-liquid interface, and during differentiation for 2-3 weeks exposed daily to whole cigarette smoke. Gene expression, protein levels and epithelial cell markers were subsequently assessed...
April 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29538541/soluble-urokinase-type-plasminogen-activator-receptor-as-a-measure-of-treatment-response-in-acute-exacerbation-of-copd
#8
Gehan Hassan AboEl-Magd, Maaly Mohamed Mabrouk
OBJECTIVE: To evaluate the value of soluble urokinase-type plasminogen activator receptor (suPAR) in the diagnosis of acute exacerbation of COPD (AECOPD) and in monitoring treatment response, analyzing the relationship between suPAR and fibrinogen in AECOPD. AECOPD leads to increased airway inflammation, contributing to an exaggerated release of inflammatory mediators. METHODS: We recruited 45 patients with AECOPD and 20 healthy control subjects. Medical histories were taken, and all subjects underwent clinical examination, chest X-ray, pulmonary function tests, and blood gas analysis...
January 2018: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/29524398/functional-electrical-stimulation-a-new-therapeutic-approach-to-enhance-exercise-intensity-in-chronic-obstructive-pulmonary-disease-patients-a-randomized-controlled-crossover-trial
#9
Clément Medrinal, Guillaume Prieur, Yann Combret, Aurora Robledo Quesada, David Debeaumont, Tristan Bonnevie, Francis Edouard Gravier, Elise Dupuis Lozeron, Jean Quieffin, Olivier Contal, Bouchra Lamia
OBJECTIVE: To evaluate the effect of quadriceps functional electrical stimulation (FES)-cycling on exertional oxygen uptake (V˙o2 ) compared with placebo FES-cycling in patients with chronic obstructive pulmonary disease (COPD). DESIGN: A randomized, single-blind, placebo-controlled crossover trial. SETTING: Pulmonary rehabilitation department. PARTICIPANTS: Consecutive patients (N=23) with COPD Global Initiative for Chronic Obstructive Lung Disease stage 2, 3, or 4 (mean forced expiratory volume during the first second, 1...
March 7, 2018: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29522553/association-between-chronic-pancreatitis-and-urolithiasis-a-population-based-cohort-study
#10
Chien-Hua Chen, Cheng-Li Lin, Long-Bin Jeng
PURPOSE: Chronic pancreatitis (CP) can cause fat or bile acid malabsorption due to exocrine insufficiency. Fat or bile acid malabsorption has been reported to increase the risk of urolithiasis through increased intestinal oxalate absorption. However, no studies have reported an association between CP and urolithiasis. METHODS: We identified 15,848 patients (age: ≥20 years) diagnosed as having CP between 2000 and 2010 from the National Health Insurance Research Database as the study cohort...
2018: PloS One
https://www.readbyqxmd.com/read/29507945/hemoglobin-a1c-targets-for-glycemic-control-with-pharmacologic-therapy-for-nonpregnant-adults-with-type-2-diabetes-mellitus-a-guidance-statement-update-from-the-american-college-of-physicians
#11
Amir Qaseem, Timothy J Wilt, Devan Kansagara, Carrie Horwitch, Michael J Barry, Mary Ann Forciea
Description: The American College of Physicians developed this guidance statement to guide clinicians in selecting targets for pharmacologic treatment of type 2 diabetes. Methods: The National Guideline Clearinghouse and the Guidelines International Network library were searched (May 2017) for national guidelines, published in English, that addressed hemoglobin A1c (HbA1c) targets for treating type 2 diabetes in nonpregnant outpatient adults. The authors identified guidelines from the National Institute for Health and Care Excellence and the Institute for Clinical Systems Improvement...
April 17, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29501846/quantitative-proteomic-characterization-of-the-lung-extracellular-matrix-in-chronic-obstructive-pulmonary-disease-and-idiopathic-pulmonary-fibrosis
#12
Emma Åhrman, Oskar Hallgren, Lars Malmström, Ulf Hedström, Anders Malmström, Leif Bjermer, Xiao-Hong Zhou, Gunilla Westergren-Thorsson, Johan Malmström
Remodeling of the extracellular matrix (ECM) is a common feature in lung diseases such as chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF). Here, we applied a sequential tissue extraction strategy to describe disease-specific remodeling of human lung tissue in disease, using end-stages of COPD and IPF. Our strategy was based on quantitative comparison of the disease proteomes, with specific focus on the matrisome, using data-independent acquisition and targeted data analysis (SWATH-MS)...
March 1, 2018: Journal of Proteomics
https://www.readbyqxmd.com/read/29501016/management-of-extensive-surgical-emphysema-with-subcutaneous-drain-a-case-report
#13
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...
2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29482196/unrecognized-cardiovascular-emergencies-among-medicare-patients
#14
Daniel A Waxman, Hemal K Kanzaria, David L Schriger
Importance: The Institute of Medicine described diagnostic error as the next frontier in patient safety and highlighted a critical need for better measurement tools. Objectives: To estimate the proportions of emergency department (ED) visits attributable to symptoms of imminent ruptured abdominal aortic aneurysm (AAA), acute myocardial infarction (AMI), stroke, aortic dissection, and subarachnoid hemorrhage (SAH) that end in discharge without diagnosis; to evaluate longitudinal trends; and to identify patient characteristics independently associated with missed diagnostic opportunities...
April 1, 2018: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29462335/five-year-experience-using-the-lung-allocation-score-the-munich-lung-transplant-group
#15
Barbara Schuba, Miriam Scheklinski, Vera von Dossow, Christian Schneider, Gerhard Preissler, Nikolaus Kneidinger, Claus Neurohr, Sebastian Michel, Christian Hagl, Rene Schramm
OBJECTIVES: The Lung Allocation Score (LAS) was implemented in Germany on 10 December 2011 after demonstrating favourable outcomes in the USA since its introduction in 2005. There are only limited and short-term data on the effect of the LAS on lung transplantation programmes in Germany. The purpose of this study was to analyse our 5-year single-centre experience with the LAS within the influential area of the Eurotransplant Foundation (ET). METHODS: After implementation of the LAS until December 2016, 294 patients underwent a single-lung transplantation or a bilateral sequential lung transplantation for end-stage lung disease at our centre...
February 15, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29444912/analysis-of-airway-pathology-in-copd-using-a-combination-of-computed-tomography-micro-computed-tomography-and-histology
#16
Naoya Tanabe, Dragoş M Vasilescu, Miranda Kirby, Harvey O Coxson, Stijn E Verleden, Bart M Vanaudenaerde, Daisuke Kinose, Yasutaka Nakano, Peter D Paré, James C Hogg
The small conducting airways are the major site of obstruction in chronic obstructive pulmonary disease (COPD). This study examined small airway pathology using a novel combination of multidetector row computed tomography (MDCT), micro-computed tomography (microCT) and histology.Airway branches visible on specimen MDCT were counted and the dimensions of the third- to fifth-generation airways were computed, while the terminal bronchioles (designated TB), preterminal bronchioles (TB-1) and pre-preterminal bronchioles (TB-2) were examined with microCT and histology in eight explanted lungs with end-stage COPD and seven unused donor lungs that served as controls...
February 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29409767/association-of-hyperglycemic-crisis-with-an-increased-risk-of-end-stage-renal-disease-a-nationwide-population-based-cohort-study
#17
Yuan Kao, I-Jung Feng, Chien-Chin Hsu, Jhi-Joung Wang, Hung-Jung Lin, Chien-Cheng Huang
BACKGROUND: A hyperglycemic crisis episode (HCE) is associated with poor management of diabetes, which is a risk factor for end-stage renal disease (ESRD); however, the association between an HCE and ESRD has not been clarified. We conducted a nationwide population-based cohort study with the purpose of delineating this issue. METHODS: We identified 9208 diabetic patients with an HCE and an identical number of diabetic patients with matched age, sex, and index date without an HCE between 2000 and 2002...
April 2018: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29386887/russian-guidelines-for-the-management-of-copd-algorithm-of-pharmacologic-treatment
#18
Zaurbek Aisanov, Sergey Avdeev, Vladimir Arkhipov, Andrey Belevskiy, Alexander Chuchalin, Igor Leshchenko, Svetlana Ovcharenko, Evgeny Shmelev, Marc Miravitlles
The high prevalence of COPD together with its high level of misdiagnosis and late diagnosis dictate the necessity for the development and implementation of clinical practice guidelines (CPGs) in order to improve the management of this disease. High-quality, evidence-based international CPGs need to be adapted to the particular situation of each country or region. A new version of the Russian Respiratory Society guidelines released at the end of 2016 was based on the proposal by Global Initiative for Obstructive Lung Disease but adapted to the characteristics of the Russian health system and included an algorithm of pharmacologic treatment of COPD...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29386076/outbreak-of-legionnaires-disease-associated-with-cooling-towers-at-a-california-state-prison-2015
#19
K D Lucas, C Wheeler, P McLendon, B N Leistikow, J C Mohle-Boetani
A large outbreak of Legionnaires' disease occurred at a California state prison in August 2015. We conducted environmental and epidemiological investigations to identify the most likely source of exposure and characterise morbidity. Sixty-four inmates had probable Legionnaires' disease; 14 had laboratory-confirmed legionellosis. Thirteen (17%) inmates were hospitalised; there were no deaths. Ill inmates were more likely to be ⩾65 years old (P < 0.01), have the chronic obstructive pulmonary disease (P < 0...
February 2018: Epidemiology and Infection
https://www.readbyqxmd.com/read/29287828/effectiveness-of-a-respiratory-rehabilitation-programme-in-patients-with-chronic-obstructive-pulmonary-disease
#20
María Jesús Prunera-Pardell, Susana Padín-López, Adolfo Domenech-Del Rio, Ana Godoy-Ramírez
OBJECTIVE: To evaluate the effectiveness of the multidisciplinary respiratory rehabilitation (RR) programme in patients with severe or very severe chronic obstructive pulmonary disease pre the RR programme, at the end of the programme and one year after the RR, measuring changes in ability to exercise (walking test), effort tolerance(forced expiratory volume (FEV1)) and health-related quality of life. METHOD: Quasi-experimental single group design. We included patients diagnosed with severe or very severe chronic obstructive pulmonary disease (stages III and IV of the GOLD classification) who entered the rehabilitation programme for the years 2011 and 2012...
January 2018: Enfermería Clínica
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