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https://www.readbyqxmd.com/read/28445312/early-progression-of-brain-atrophy-in-patients-with-anti-n-methyl-d-aspartate-receptor-encephalitis-case-reports
#1
Hiroshi Kataoka, Nobuhiro Sawa, Yasuyo Tonomura, Satoshi Ueno
BACKGROUND: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis responds to immunnotherapy, and approximately 80% of patients with this disorder fully recover or have only minor sequelae. Brain magnetic resonance imaging (MRI) does not show a specific abnormality, but some patients have progressive cerebral atrophy. The cerebral atrophy can become reversible after clinical improvement. METHODS: We describe 3 patients with diffuse cerebral atrophy (DCA) on serial brain MRI...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28444078/expiratory-rib-cage-compression-in-mechanically-ventilated-adults-systematic-review-with-meta-analysis
#2
Lúcia Faria Borges, Mateus Sasso Saraiva, Marcos Ariel Sasso Saraiva, Fabrício Edler Macagnan, Adriana Kessler
Objective: To review the literature on the effects of expiratory rib cage compression on ventilatory mechanics, airway clearance, and oxygen and hemodynamic indices in mechanically ventilated adults. Methods: Systematic review with meta-analysis of randomized clinical trials in the databases MEDLINE (via PubMed), EMBASE, Cochrane CENTRAL, PEDro, and LILACS. Studies on adult patients hospitalized in intensive care units and under mechanical ventilation that analyzed the effects of expiratory rib cage compression with respect to a control group (without expiratory rib cage compression) and evaluated the outcomes static and dynamic compliance, sputum volume, systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, peripheral oxygen saturation, and ratio of arterial oxygen partial pressure to fraction of inspired oxygen were included...
January 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28441913/the-masquerading-presentation-of-a-systemic-anaplastic-large-cell-lymphoma-alk-positive-a-case-report-and-review-of-the-literature
#3
Selma Al-Ahmad, Vincent Maertens, Christophe Libeer, Vera Schelfhout, Filip Vanhoenacker, Nancy Boeckx, Marleen Vandevenne
We report an unusual case of systemic anaplastic large cell lymphoma (ALCL), ALK positive with leukemic involvement in a 57-year-old woman. The patient presented with a fulminant respiratory infection unresponsive to treatment requiring intensive care and ventilatory support. The CT scan demonstrated mediastinal and bilateral lymphadenopathy. On peripheral smear a few atypical lymphocytes were visualized. Based on the increasing number of atypical lymphocytes in the daily peripheral bloodsmears, the diagnosis ALCL was suggested...
April 25, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28435743/effects-of-overground-locomotor-training-on-the-ventilatory-response-to-volitional-treadmill-walking-in-individuals-with-incomplete-spinal-cord-injury-a-pilot-study
#4
Gino S Panza, Andrew A Guccione, Lisa M Chin, Jared M Gollie, Jeffery E Herrick, John P Collins
INTRODUCTION: Although there has been substantial emphasis on the neuromuscular and cardiovascular adaptations following rehabilitation, pulmonary adaptations in individuals with incomplete SCI (iSCI) in response to locomotor training have been less frequently studied. In healthy individuals, effective transition from rest to work is accomplished by a hyperpneic response, which exhibits an exponential curve with three phases. However, the degree to which our current understanding of exercise hyperpnea can be applied to individuals with iSCI is unknown...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28433581/therapeutic-burst-suppression-coma-in-pediatric-febrile-refractory-status-epilepticus
#5
Jainn-Jim Lin, Cheng-Che Chou, Shih-Yun Lan, Hsiang-Ju Hsiao, Yu Wang, Oi-Wa Chan, Shao-Hsuan Hsia, Huei-Shyong Wang, Kuang-Lin Lin
BACKGROUND: Evidence for the beneficial effect of therapeutic burst-suppression coma in pediatric patients with febrile refractory status epilepticus is limited, and the clinical outcomes of this treatment strategy are largely unknown. Therefore, the aim of this study was to explore the outcomes of therapeutic burst-suppression coma in a series of children with febrile refractory status epilepticus. METHODS: We retrospectively reviewed consecutive pediatric patients with febrile refractory status epilepticus admitted to our pediatric intensive care unit between January 2000 and December 2013...
April 19, 2017: Brain & Development
https://www.readbyqxmd.com/read/28417671/the-use-of-noninvasive-positive-pressure-ventilation-following-pediatric-tonsillectomy
#6
Adva Buzi, Orly M Coblens, Michael MacGillivray, Lisa Elden
Objective To determine the risks of bleeding and other complications in pediatric patients who require noninvasive positive pressure ventilation (PPV) in the immediate posttonsillectomy period. Study Design Case series with chart review. Setting Single tertiary pediatric hospital. Subjects and Methods Sixty-nine patients who had undergone tonsillectomy from July 2007 through December 2013 and required postoperative PPV were reviewed. Data collected included age, sex, medical history, preoperative polysomnogram parameters, length of use and type of noninvasive ventilatory support, and postoperative complications...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28410251/association-of-need-for-tracheotomy-with-decreasing-mechanical-in-exsufflation-flows-in-amyotrophic-lateral-sclerosis
#7
John R Bach, Neelam Upadhyaya
Although patients with lower motor neuron and myopathic disorders can prolong their lives by depending on continuous noninvasive ventilatory support, most patients with amyotrophic lateral sclerosis (ALS) cannot and must use tracheostomy mechanical ventilation to prolong survival. This case demonstrates that this occurs because amyotrophic lateral sclerosis patients' upper motor neuron reflex laryngeal closure and stridor cause upper airway collapse that renders mechanical insufflation-exsufflation (MIE) ineffective in expulsing airway secretions as well as for permitting continuous noninvasive ventilatory support...
April 13, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28404729/wings-as-impellers-honey-bees-co-opt-flight-system-to-induce-nest-ventilation-and-disperse-pheromones
#8
Jacob M Peters, Nick Gravish, Stacey A Combes
Honey bees (Apis mellifera) are remarkable fliers that regularly carry heavy loads of nectar and pollen, supported by a flight system - the wings, thorax and flight muscles - that one might assume is optimized for aerial locomotion. However, honey bees also use this system to perform other crucial tasks that are unrelated to flight. When ventilating the nest, bees grip the surface of the comb or nest entrance and fan their wings to drive airflow through the nest, and a similar wing-fanning behavior is used to disperse volatile pheromones from the Nasonov gland...
April 12, 2017: Journal of Experimental Biology
https://www.readbyqxmd.com/read/28399118/feasibility-and-physiological-effects-of-non-invasive-neurally-adjusted-ventilatory-assist-niv-nava-in-preterm-infants
#9
Christopher Gibu, Phillip Cheng, Raymond J Ward, Benjamin Castro, Gregory P Heldt
BACKGROUND: Non-invasive Neurally Adjusted Ventilator Assist (NIV-NAVA) was introduced to our clinical practice via a pilot and a randomized observational study to assess its safety, feasibility, and short term physiological effects. METHODS: The pilot protocol applied NIV-NAVA to 11 infants on nasal CPAP, high-flow nasal cannula (HFNC), or nasal IMV (NIMV), in multiple 2-4 h periods of NIV-NAVA for comparison. This provided the necessary data to design a randomized, controlled observational cross-over study in 8 additional infants to compare the physiological effects of NIV-NAVA to NIMV during 2-hour steady state conditions...
April 11, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28393785/modifying-risks-to-improve-outcome-in-cardiac-surgery-an-anesthesiologist-s-perspective
#10
REVIEW
Murali Chakravarthy
Challenging times are here for cardiac surgical and anesthesia team. The interventional cardiologist seem to have closed the flow of 'good cases' coming up for any of the surgery,; successful percutaneous interventions seem to be offering reasonable results in these patients, who therefore do not knock on the doors of the surgeons any more . It is a common experience among the cardiac anesthesiologists and surgeons that the type of the cases that come by now are high risk. That may be presence of comorbidities, ongoing medical therapies, unstable angina, uncontrolled heart failure and rhythm disturbances; and in patients with ischemic heart disease, the target coronaries are far from ideal...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28390638/treatment-of-idiopathic-diaphragm-flutter-a-case-study
#11
Michael Chiou, María Victoria Herrero, John R Bach, Jeffrey L Cole, Enrique Luis Gonzales
Diaphragm flutter is a rare disorder defined by dyspnea and often thoracoabdominal pain associated with rapid rhythmic involuntary contractions of the diaphragm with no effective treatment. A 35-year-old woman's flutter was triggered by increasing the depth of breathing and by (electrical) stimulation of the diaphragm. Medical therapy, phrenic nerve crush, and diaphragm pacer stimulation were ineffective. Since increasing diaphragm activity was a trigger, resting the diaphragm was tried. A manual resuscitator and, subsequently, mouthpiece and nasal noninvasive ventilatory support (NVS) instantaneously halted the flutter for 3 months and almost instantaneously for another 6 months...
April 2017: Chest
https://www.readbyqxmd.com/read/28388225/effects-of-pressure-support-ventilation-may-be-lost-at-high-exercise-intensities-in-people-with-copd
#12
David Anekwe, Michel de Marchie, Jadranka Spahija
Pressure support ventilation (PSV) may be used for exercise training in chronic obstructive pulmonary disease (COPD), but its acute effect on maximum exercise capacity is not fully known. The objective of this study was to evaluate the effect of 10 cm H2O PSV and a fixed PSV level titrated to patient comfort at rest on maximum exercise workload (WLmax), breathing pattern and metabolic parameters during a symptom-limited incremental bicycle test in individuals with COPD. Eleven individuals with COPD (forced expiratory volume in one second: 49 ± 16%; age: 64 ± 7 years) performed three exercise tests: without a ventilator, with 10 cm H2O of PSV and with a fixed level titrated to comfort at rest, using a SERVO-i ventilator...
April 7, 2017: COPD
https://www.readbyqxmd.com/read/28378600/addition-of-non-invasive-ventilatory-support-to-combined-aerobic-and-resistance-training-improves-dyspnea-and-quality-of-life-in-heart-failure-patients-a-randomized-controlled-trial
#13
Hugo Souza Bittencourt, Cristiano Gonçalves Cruz, Bruno Costa David, Erenaldo Rodrigues, Camille Magalhães Abade, Roque Aras Junior, Vitor Oliveira Carvalho, Francisco Borges Faria Dos Reis, Mansueto Gomes Neto
OBJECTIVE: To test the hypothesis that combined aerobic and resistance training and non-invasive ventilatory support result in additional benefits compared with combined aerobic and resistance training alone in heart failure patients. DESIGN: A randomized, single-blind, controlled study. SETTING: Cardiac rehabilitation center. PARTICIPANTS: A total of 46 patients with New York Heart Association class II/III heart failure were randomly assigned to a 10-week program of combined aerobic and resistance training, plus non-invasive ventilatory support ( n = 23) or combined aerobic and resistance training alone ( n = 23)...
April 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28371221/prediction-of-right-ventricular-failure-after-ventricular-assist-device-implant-systematic-review-and-meta-analysis-of-observational-studies
#14
REVIEW
Diego Bellavia, Attilio Iacovoni, Cesare Scardulla, Lorenzo Moja, Michele Pilato, Sudhir S Kushwaha, Michele Senni, Francesco Clemenza, Valentina Agnese, Calogero Falletta, Giuseppe Romano, Joseph Maalouf, Michael Dandel
Right ventricular failure (RVF) after left ventricular assist device (LVAD) implantation is associated with increased morbidity and mortality, but the identification of LVAD candidates at risk for RVF remains challenging. We undertook a systematic review and meta-analysis of observational studies of risk factors associated with RVF after LVAD implant. Thirty-six studies published between 1 January 1995 and 30 April 2015, comprising 995 RVF patients out of a pooled final population of 4428 patients, were identified...
March 31, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28370024/prefrontal-oxygenation-and-the-acoustic-startle-eyeblink-response-during-exercise-a-test-of-the-dual-mode-model
#15
Gavin D Tempest, Gaynor Parfitt
The interplay between the prefrontal cortex and amygdala is proposed to explain the regulation of affective responses (pleasure/displeasure) during exercise as outlined in the dual-mode model. However, due to methodological limitations the dual-mode model has not been fully tested. In this study, prefrontal oxygenation (using near-infrared spectroscopy) and amygdala activity (reflected by eyeblink amplitude using acoustic startle methodology) were recorded during exercise standardized to metabolic processes: 80% of ventilatory threshold (below VT), at the VT, and at the respiratory compensation point (RCP)...
March 30, 2017: Psychophysiology
https://www.readbyqxmd.com/read/28365109/pushing-the-boundaries-of-ecls-outcomes-in-34-week-ega-neonates
#16
Joseph T Church, Anne C Kim, Kimberly M Erickson, Ankur Rana, Robert Drongowski, Ronald B Hirschl, Robert H Bartlett, George B Mychaliska
PURPOSE: Extracorporeal life support (ECLS) is usually reserved for infants ≥34weeks estimated gestational age (EGA) owing to concerns about increased mortality and incidence of intracranial hemorrhage (ICH). We sought to characterize survival, rates of ICH, and complications in <34week EGA neonates placed on ECLS. METHODS: 752 neonates of EGA 29-34weeks were identified in the Extracorporeal Life Support Organization (ELSO) Registry (1976-2008). Data analyzed included birthweight, survival, pre-ECLS conditions, ventilatory parameters and complications (including ICH and other neurological outcomes)...
March 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28338483/prevalence-and-impact-on-weaning-of-pleural-effusion-at-the-time-of-liberation-from-mechanical-ventilation-a-multicenter-prospective-observational-study
#17
Martin Dres, Damien Roux, Tài Pham, Alexandra Beurton, Jean-Damien Ricard, Muriel Fartoukh, Alexandre Demoule
BACKGROUND: Pleural effusion is frequent in intensive care unit patients, but its impact on the outcome of weaning remains unknown. METHODS: In a prospective study performed in three intensive care units, pleural ultrasound was performed at the first spontaneous breathing trial to detect and quantify pleural effusion (small, moderate, and large). Weaning failure was defined by a failed spontaneous breathing trial and/or extubation requiring any form of ventilatory support within 48 h...
March 24, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28338349/clinical-features-of-children-and-adults-with-a-muscular-dystrophy-using-powered-indoor-outdoor-wheelchairs-disease-features-comorbidities-and-complications-of-disability
#18
Andrew Oliver Frank, Lorraine H De Souza
PURPOSE: To describe the clinical features of electric powered indoor/outdoor wheelchair users with a muscular dystrophy, likely to influence optimal prescription; reflecting features of muscular dystrophies, conditions secondary to disability, and comorbidities impacting on equipment provision. METHODS: Cross-sectional retrospective case note review of recipients of electric powered indoor/outdoor wheelchairs provided by a specialist regional wheelchair service...
February 25, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28332298/impact-of-maternal-obesity-on-very-preterm-infants
#19
Rubia Khalak, Asha Rijhsinghani, Sarah E McCallum
OBJECTIVE: Infants born at less than  34 weeks' gestational age are at higher risk for morbidity and mortality. Data are limited on the impact of maternal obesity on the very preterm infant. This study reviewed whether maternal obesity further increases the intensive care needs of very preterm infants of less than 34 weeks' gestation. METHODS: Maternal and neonatal data for live-born singleton births of 23 0/7 to 33 6/7 weeks' gestation delivering in upstate New York were reviewed...
March 22, 2017: Obesity
https://www.readbyqxmd.com/read/28320035/srage-is-elevated-in-the-lungs-of-premature-infants-receiving-mechanical-ventilation
#20
Henry J Rozycki, Jennifer Bradley, Simon Karam
Background Soluble receptor for advanced glycation end-products (sRAGE), a soluble isoform of the RAGE receptor, is elevated in lungs from patients with acute conditions such as acute respiratory distress syndrome and bronchiolitis. This study investigated whether sRAGE is present in ventilated infants. Methods Tracheal aspirates from the first week or the fifth week of life were obtained from intubated very low birth weight subjects and analyzed by Western blot. Immunohistochemistry analysis for sRAGE was performed on paraffin-embedded lung autopsy slides from 19 other infants...
March 20, 2017: American Journal of Perinatology
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