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https://www.readbyqxmd.com/read/28819305/cardiorespiratory-pathogenesis-of-sickle-cell-disease-in-a-mouse-model
#1
Jun Ren, Xiuqing Ding, Marie Trudel, John J Greer, Joanna E MacLean
The nature and development of cardiorespiratory impairments associated with sickle cell disease are poorly understood. Given that the mechanisms of these impairments cannot be addressed adequately in clinical studies, we characterized cardiorespiratory pathophysiology from birth to maturity in the sickle cell disease SAD mouse model. We identified two critical phases of respiratory dysfunction in SAD mice; the first prior to weaning and the second in adulthood. At postnatal day 3, 43% of SAD mice showed marked apneas, anemia, and pulmonary vascular congestion typical of acute chest syndrome; none of these mice survived to maturity...
August 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28811742/respiratory-t-wave-inversion-in-a-patient-with-chest-pain
#2
Himani Sharma, Abhinav Tiwari
T-wave inversion on electrocardiogram (ECG) is always a concerning finding as it is often associated with myocardial ischemia or ventricular strain. Respiratory variation in the T-wave morphology has been reported in the literature; however, the frequency of this observation remains unknown as this is not routinely evaluated. Although the exact physiological mechanisms underlying this ECG change are unclear, it is proposed to be due to the respiratory variation of the heart position resulting in an alteration in T-wave polarity...
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/28808222/perioperative-remote-acute-lung-injury-recent-update
#3
Zhaosheng Jin, Ka Chun Suen, Daqing Ma
Perioperative acute lung injury (ALI) is a syndrome characterised by hypoxia and chest radiograph changes. It is a serious post-operative complication, associated with considerable mortality and morbidity. In addition to mechanical ventilation, remote organ insult could also trigger systemic responses which induce ALI. Currently, there are limited treatment options available beyond conservative respiratory support. However, increasing understanding of the pathophysiology of ALI and the biochemical pathways involved will aid the development of novel treatments and help to improve patient outcome as well as to reduce cost to the health service...
January 19, 2017: Journal of Biomedical Research
https://www.readbyqxmd.com/read/28805782/-blunt-chest-trauma-possibilities-to-stabilize-multiple-and-floating-ribs-fractures
#4
A S Benyan
AIM: To improve surgical treatment of patients with multiple and flotating ribs fractures. MATERIAL AND METHODS: A comparative analysis of two groups of victims with rib fractures was carried out. 148 patients of the control group underwent conservative treatment, mechanical ventilation, skeletal traction. In 167 patients of the main group we used advanced surgical tactics based on differentiated, stepwise and combined chest stabilization including osteosynthesis of ribs and thoracoscopy...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28802696/community-acquired-pneumonia-visualized-on-computed-tomography-but-not-chest-x-ray-pathogens-severity-and-clinical-outcomes
#5
Cameron P Upchurch, Carlos G Grijalva, Richard G Wunderink, Derek J Williams, Grant W Waterer, Evan J Anderson, Yuwei Zhu, Eric M Hart, Frank Carroll, Anna M Bramley, Seema Jain, Kathryn M Edwards, Wesley H Self
BACKGROUND: The clinical significance of pneumonia visualized on computed tomography (CT) in the setting of a normal chest x-ray (CXR) is uncertain. METHODS: In a multicenter prospective surveillance study of adults hospitalized with community-acquired pneumonia (CAP), we compared the presenting clinical features, pathogens, and outcomes of patients with pneumonia visualized on CT but not on concurrent CXR (CT-only pneumonia) and those with pneumonia visualized on CXR...
August 9, 2017: Chest
https://www.readbyqxmd.com/read/28801837/blunt-injuries-related-to-equestrian-sports-results-from-an-international-prospective-trauma-database-analysis
#6
Christian D Weber, Anthony R Nguyen, Rolf Lefering, Martijn Hofman, Frank Hildebrand, Hans-Christoph Pape
INTRODUCTION: The objective of this study was to investigate the nature, management, and outcome of major injuries related to equestrian sports and to define the at-risk groups for serious and life-threatening injuries. METHODS: We analyzed demographic, pre-hospital, clinical, and outcome data from an international population-based prospective trauma database (TraumaRegister DGU®). Patients with major injuries (Injury Severity Score [ISS] ≥9 points) related to equestrian sports activities were included (January 1, 1993, to December 31, 2012)...
August 11, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28800866/five-year-trends-of-critical-care-practice-and-outcomes
#7
Craig M Lilly, Sunil Swami, Xinggang Liu, Richard R Riker, Omar Badawi
BACKGROUND: Longitudinal analyses of large detailed adult critical care datasets provide insights into practice trends and generate useful outcome and process benchmarks. METHODS: Data representing 991,571 consecutive critical care visits to160 United States adult ICUs during 2009 to 2013 from the eICU Research Institute clinical practice database were used to quantitate patient characteristics, APACHE IV based acuity predictions, treatments, and outcomes. Analyses for changes over time were performed for patient characteristics, entry and discharge locations, primary admission diagnosis, treatments, adherence to consensus ICU best practices, length of stay (LOS), and inpatient mortality...
August 8, 2017: Chest
https://www.readbyqxmd.com/read/28800036/improved-outcomes-of-cardiopulmonary-resuscitation-in-rats-treated-with-vagus-nerve-stimulation-and-its-potential-mechanism
#8
Peng Sun, Jiangang Wang, Shen Zhao, Zhengfei Yang, Ziren Tang, Navami Ravindra, Jennifer Bradley, Joseph P Ornato, Mary Ann Peberdy, Wanchun Tang
Studies have demonstrated that vagus nerve stimulation (VNS) reduces ischemia/reperfusion (I/R) injury. In this study, we investigated the protective effects of VNS in a rat model of cardiopulmonary resuscitation (CPR). We further investigated whether the beneficial effects of VNS were dependent on the alpha 7 nicotinic acetylcholine receptor (α7nAChR). Forty animals were randomized into 4 groups and all underwent CPR (n = 10 each): (1) CPR alone (control); (2) VNS during CPR; (3) α7nAChR antagonist methyllycaconitine citrate (MLA) with VNS; (4) α7nAChR agonist 3-(2, 4-dimethoxybenzylidene) anabaseine (GTS-21) without VNS...
August 9, 2017: Shock
https://www.readbyqxmd.com/read/28797271/successful-long-term-extracorporeal-membrane-oxygenation-for-invasive-pulmonary-aspergillosis-a-case-report
#9
Hiroyuki Tanaka, Kei Nishiyama, Nobuaki Shime
BACKGROUND: Extracorporeal membrane oxygenation is an established life-saving procedure for severe acute respiratory failure due to various causes. In general, the duration of extracorporeal membrane oxygenation ranges from 1 to 2 weeks, with withdrawal recommended if no improvement is noted. We report a successful case of long-term extracorporeal membrane oxygenation management for respiratory failure due to invasive pulmonary Aspergillus infection. CASE PRESENTATION: A 64-year-old Asian man with no previous underlying medical conditions was transferred to our hospital for fever and dyspnea...
August 11, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28795026/rib-fractures-to-fix-or-not-to-fix-an-evidence-based-algorithm
#10
REVIEW
Michael Bemelman, M W de Kruijf, Mark van Baal, Luke Leenen
Rib fractures are a common injury resulting from blunt chest trauma. The most important complications associated with rib fractures include death, pneumonia, and the need for mechanical ventilation. The development of new osteosynthesis materials has stimulated increased interest in the surgical treatment of rib fractures. Surgical stabilisation, however, is not needed for every patient with rib fractures or for every patient with flail chest. This paper presents an easy-to-use evidence-based algorithm, developed by the authors, for the treatment of patients with flail chest and isolated rib fractures...
August 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28794965/efficacy-of-lung-volume-optimization-maneuver-monitored-by-optoelectronic-pletismography-in-the-management-of-congenital-diaphragmatic-hernia
#11
G Lista, I Bresesti, F Cavigioli, F Castoldi, E Lupo, A LoMauro, A Aliverti
Newborns affected by congenital diaphragmatic hernia (CDH) need cardio-respiratory stabilization before undergoing surgical repair. Open lung strategy is a well-established approach to optimize lung volume in preterm infants with Respiratory Distress Syndrome (RDS), using both High Frequency Oscillatory Ventilation (HFOV) and Conventional Mechanical Ventilation (CMV). We report a case of left CDH with severe lung hypoplasia, managed applying open lung strategy in HFOV (pre-surgery period) and in Assist-Control with Volume Guarantee (post-surgery period), guided by SpO2 changes, TcPO2 and TcPCO2 monitoring...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28794084/mechanically-induced-ectopy-via-stretch-activated-cation-nonselective-channels-is-caused-by-local-tissue-deformation-and-results-in-ventricular-fibrillation-if-triggered-on-the-repolarization-wave-edge-commotio-cordis
#12
T Alexander Quinn, Honghua Jin, Peter Lee, Peter Kohl
BACKGROUND: External chest impacts (commotio cordis) can cause mechanically induced premature ventricular excitation (PVEM) and, rarely, ventricular fibrillation (VF). Because block of stretch-sensitive ATP-inactivated potassium channels curtailed VF occurrence in a porcine model of commotio cordis, VF has been suggested to arise from abnormal repolarization caused by stretch activation of potassium channels. Alternatively, VF could result from abnormal excitation by PVEM, overlapping with normal repolarization-related electric heterogeneity...
August 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28780496/fifteen-minute-consultation-a-structured-approach-to-the-management-of-chronic-cough-in-a-child
#13
Cherry Alviani, Gary Ruiz, Atul Gupta
Coughing is a primary pulmonary defence mechanism that enhances clearance of secretions and particles from the airways and protects against aspiration of foreign materials. Coughing may affect 30% of children at any given time (1). Many are healthy children but some may have serious underlying disease. Childhood cough accounts for a large number of consultations and 80% of families who are referred to a paediatric respiratory clinic for chronic cough have sought medical advice five times or more (2). The majority of childhood coughs are secondary to an acute respiratory tract infection and will improve once the infection resolves, usually within 1 to 3 weeks...
August 5, 2017: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/28780253/biomechanics-of-human-parietal-pleura-in-uniaxial-extension
#14
Luis E Morales Tenorio, Kelsey J Devine, Jayme Lee, Timothy M Kowalewski, Victor H Barocas
Tension pneumothorax, a major preventable cause of battlefield death, often arises from chest trauma and is treated by needle decompression to release trapped air from the pleural cavity. Surgical simulation mannequins are often employed to train medical personnel to perform this procedure properly. Accurate reproduction of the mechanical behavior of the parietal pleura, especially in response to needle penetration, is essential to maximize the fidelity of these surgical simulators. To date, however, the design of pleura-simulating material has been largely empirical and based on subjective practitioner feel rather than on the tissue properties, which have remained unknown...
July 29, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28777459/iodixanol-vs-iopromide-in-cancer-patients-evidence-from-a-randomized-clinical-trial
#15
Irene Terrenato, Francesca Sperati, Felice Mussicco, Anna Fausta Pozzi, Annunziata di Turi, Mauro Caterino, Elisabetta de Lutio di Castelguidone, Sergio Venanzio Setola, Massimo Bellomi, Carlo Emanuele Neumaier, Laura Conti, Giovanni Cigliana, Roberta Merola, Anna Antenucci, Giulia Orlandi, Antonio Giordano, Maddalena Barba, Stefano Canitano
PURPOSE: To assess the safety profile of iso-osmolar contrast medium (CM) vs low osmolar CM in cancer patients with an estimated glomerular filtration rate (eGFR) > 60 ml/min. MATERIALS AND METHODS: In this multicentre, blind trial of patients seeking a chest-abdomen-pelvis CT with iodated CM, participants were centrally randomized to iodixanol or iopromide. Contrast induced nephropathy (CIN) at 24 and/or 72 hours were our primary outcomes. We further considered irreversible CIN, average eGFR percentage variation (%Δ), and adverse events (AEs)...
August 4, 2017: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/28776763/feasibility-symptoms-adverse-effects-and-complications-associated-with-noninvasive-assessment-of-coronary-flow-velocity-reserve-in-women-with-suspected-or-known-coronary-artery-disease
#16
Roberta Montisci, Massimo Ruscazio, Maria Francesca Marchetti, Francesca Tuveri, Cristina Cacace, Michela Congia, Norma Zedda, Luigi Meloni
BACKGROUND: Microvascular coronary impairment, defined as reduced coronary flow reserve, represents the predominant etiologic mechanism of ischemia in women with chest pain and no obstructive coronary artery disease. Transthoracic echocardiography (TTE) is a noninvasive method for assessing coronary flow velocity reserve (CFVR) in the left anterior descending coronary artery (LAD). The purpose of this investigation was to define the safety profile, feasibility, adverse events, and rate of complications of the test in women with suspected CAD...
August 3, 2017: Echocardiography
https://www.readbyqxmd.com/read/28775070/elevated-airway-liquid-volumes-at-birth-a-potential-cause-of-transient-tachypnea-of-the-newborn
#17
Erin Victoria McGillick, Katie Lee, Shigeo Yamaoka, Arjan B Te Pas, Kelly J Crossley, Megan J Wallace, Marcus John Kitchen, Robert A Lewis, Lauren T Kerr, Philip DeKoninck, Janneke Dekker, Marta Thio, Annie McDougall, Stuart B Hooper
Excessive liquid in airways and/or in distal lung tissue may underpin the respiratory morbidity associated with transient tachypnea of the newborn (TTN). However, its effects on lung aeration and respiratory function following birth are unknown. We investigated the effect of elevated airway liquid volumes on newborn respiratory function. Near term rabbit kittens (30 days gestation; term ~32 days) were delivered, had lung liquid drained and either had no liquid replaced (Control, n=7) or 30 mL/kg of liquid was re-added to the airways (liquid added; LA, n=7)...
August 3, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28770121/necrotizing-pneumonia-an-emerging-problem-in-children
#18
REVIEW
I Brent Masters, Alan F Isles, Keith Grimwood
BACKGROUND: In children, necrotizing pneumonia (NP) is an uncommon, severe complication of pneumonia. It is characterized by destruction of the underlying lung parenchyma resulting in multiple small, thin-walled cavities and is often accompanied by empyema and bronchopleural fistulae. REVIEW: NP in children was first reported in children in 1994, and since then there has been a gradual increase in cases, which is partially explained by greater physician awareness and use of contrast computed tomography (CT) scans, and by temporal changes in circulating respiratory pathogens and antibiotic prescribing...
2017: Pneumonia
https://www.readbyqxmd.com/read/28768527/bilateral-blindness-secondary-to-optic-nerve-ischemia-from-severe-amlodipine-overdose-a-case-report
#19
Raymond Kao, Yves Landry, Genevieve Chick, Andrew Leung
BACKGROUND: Calcium channel blockers are commonly prescribed medications; calcium channel blocker overdose is becoming increasingly prevalent. The typical presentation of a calcium channel blocker overdose is hypotension and decreased level of consciousness. We describe a case of a calcium channel blocker overdose that led to bilateral cortical blindness, a presentation that has not previously been reported. CASE PRESENTATION: A 49-year-old white woman with known bilateral early optic atrophy presented to our hospital with hypotension and obtundation following a known ingestion of 150 mg of amlodipine...
August 3, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28755616/endotracheal-hamartoma-case-report-two-contrasting-clinical-presentations-of-a-rare-entity
#20
Curtis Hon, Carl J O'Hara, Virginia R Litle
INTRODUCTION: The majority of tracheal tumors in adults are malignant. The finding of a benign tumor in the trachea is uncommon and endotracheal hamartomas are rare. PRESENTATION OF CASE: We report two cases presenting within six months at our institution. The first patient is a 67 year-old man who was found to have an asymptomatic endotracheal hamartoma on chest imaging for aortic valve replacement. The second patient is a 46 year-old man with an extensive continued tobacco use disorder and a known endotracheal lesion identified 8 years prior to intervention...
2017: International Journal of Surgery Case Reports
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