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https://www.readbyqxmd.com/read/27766377/-diaphragm-dysfunction-facts-for-clinicians
#1
REVIEW
C S Bruells, G Marx
Diaphragm function is crucial for patient outcome in the ICU setting and during the treatment period. The occurrence of an insufficiency of the respiratory pump, which is predominantly formed by the diaphragm, may result in intubation after failure of noninvasive ventilation. Especially patients suffering from chronic obstructive pulmonary disease are in danger of hypercapnic respiratory failure. Changes in biomechanical properties and fiber texture of the diaphragm are further cofactors directly leading to a need for intubation and mechanical ventilation...
October 20, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/27756436/acute-presentation-of-a-giant-intrathyroidal-parathyroid-adenoma-a-case-report
#2
Stephanie Rutledge, Michele Harrison, Martin O'Connell, Tadhg O'Dwyer, Maria M Byrne
BACKGROUND: We report the case of a giant intrathyroidal parathyroid adenoma weighing 59 g in a young woman presenting acutely with severe hypercalcemia requiring correction and adequate preoperative management prior to surgery. Parathyroid adenomas account for 85 % of cases of primary hyperparathyroidism. Those weighing more than 3.5g are classified as giant parathyroid adenomas. There are only 25 cases of parathyroid adenomas weighing over 30g reported in the literature. With the wide availability of biochemical screening tests in Western countries, mildly elevated calcium levels are often discovered incidentally...
October 19, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27682813/diaphragmatic-dysfunction-is-characterized-by-increased-duration-of-mechanical-ventilation-in-subjects-with-prolonged-weaning
#3
Zhihua Lu, Qiuping Xu, Yuehua Yuan, Ge Zhang, Feng Guo, Huiqing Ge
BACKGROUND: Diaphragmatic dysfunction is often underdiagnosed and is among the risk factors for failed weaning. The purpose of this study was to determine the prevalence of diaphragmatic dysfunction diagnosed by B-mode ultrasonography and to determine whether prolonged weaning subjects with diaphragmatic dysfunction have increased duration of mechanical ventilation compared with those without diaphragmatic dysfunction. METHODS: This was a prospective observational study in mechanically ventilated subjects who failed ≥3 spontaneous breathing trials or required >7 d of weaning after the first spontaneous breathing trial...
October 2016: Respiratory Care
https://www.readbyqxmd.com/read/27647376/ultrasonographic-diaphragmatic-excursion-is-inaccurate-and-not-better-than-the-mrc-score-for-predicting-weaning-failure-in-mechanically-ventilated-patients
#4
Cédric Carrie, Chloé Gisbert-Mora, Eline Bonnardel, Bernard Gauche, Matthieu Biais, Frédéric Vargas, Gilles Hilbert
PURPOSE: To assess the ability of diaphragmatic ultrasound (US) to predict weaning failure in mechanically ventilated patients undergoing a first spontaneous breathing trial (SBT). METHODS: During a 4-month period, 67 consecutive patients eligible for a first SBT underwent US measurements of maximal diaphragmatic excursion (MDE) by a right anterior subcostal approach. Weaning failure was defined as either the failure of SBT or the need for resumption of ventilatory support for acute respiratory failure or death within 48h following successful extubation...
September 16, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27620292/assessment-of-diaphragmatic-dysfunction-in-the-critically-ill-patient-with-ultrasound-a-systematic-review
#5
Massimo Zambon, Massimiliano Greco, Speranza Bocchino, Luca Cabrini, Paolo Federico Beccaria, Alberto Zangrillo
PURPOSE: Diaphragmatic dysfunction (DD) has a high incidence in critically ill patients and is an under-recognized cause of respiratory failure and prolonged weaning from mechanical ventilation. Among different methods to assess diaphragmatic function, diaphragm ultrasonography (DU) is noninvasive, rapid, and easy to perform at the bedside. We systematically reviewed the current literature assessing the usefulness and accuracy of DU in intensive care unit (ICU) patients. METHODS: Pubmed, Cochrane Database of Systematic Reviews, Embase, Scopus, and Google Scholar Databases were searched for pertinent studies...
September 12, 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27512490/adrenal-cushing-s-syndrome-in-pregnancy-clinical-and-molecular-characterisation-of-a-case
#6
Anne Trinh, Irene Chan, Maria Alexiadis, Medina Pell, Beena Kumar, Peter J Fuller
BACKGROUND: Cushing's syndrome is rare during pregnancy and more commonly due to adrenal pathology, in contrast to the non-pregnant population. Increased levels of cortisol-binding globulin and placental production of corticotropin-releasing hormone and adrenocorticotropic hormone complicate the diagnostic strategies usually employed. CASE: A 32-year-old G1P0 at 15/40 gestation presented with severe peripheral oedema and excessive weight gain. Examination revealed pitting oedema to the abdominal wall, wide violaceous striae, moon facies and acne...
March 2016: Obstetric Medicine
https://www.readbyqxmd.com/read/27500981/mitigation-of-ventilator-induced-diaphragm-atrophy-by-transvenous-phrenic-nerve-stimulation
#7
Steven C Reynolds, Ramasamy Meyyappan, Viral Thakkar, Bao D Tran, Marc-André Nolette, Gautam Sadarangani, Rodrigo A Sandoval, Laura Bruulsema, Brett Hannigan, Jason W Li, Elizabeth Rohrs, Jason Zurba, Joaquín Andrés Hoffer
Rationale Ventilator-induced Diaphragm Dysfunction is a significant contributor to weaning difficulty in ventilated critically ill patients. It has been hypothesized that electrically pacing the diaphragm during mechanical ventilation could reduce diaphragm dysfunction. Objectives We tested a novel, central line catheter-based, transvenous phrenic nerve pacing therapy for protecting the diaphragm in sedated and ventilated pigs. Methods Eighteen Yorkshire pigs were studied. Six pigs were sedated and mechanically ventilated for 2...
August 8, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27468680/ultrasound-guided-laryngeal-air-column-width-difference-and-the-cuff-leak-volume-in-predicting-the-effectiveness-of-steroid-therapy-on-postextubation-stridor-in-adult-are-they-useful
#8
Ghada F El-Baradey, Nagat S El-Shmaa, Fatma Elsharawy
OBJECTIVE: To evaluate the effectiveness of steroids therapy on postextubation stridor (PES) depending on the clinical response, the ultrasound guided laryngeal air column width difference (LACWD) and the cuff leak volume (CLV). DESIGN: Prospective, observer-blinded study. SETTING: Carried out in intensive care unit in Tanta university hospital. PATIENTS: 432 patients of both sexes received mechanical ventilation for more than 24 hours and met defined criteria for a weaning trial...
December 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27422706/change-in-diaphragmatic-thickness-during-the-respiratory-cycle-predicts-extubation-success-at-various-levels-of-pressure-support-ventilation
#9
Scott Blumhof, David Wheeler, Kendol Thomas, F Dennis McCool, Jorge Mora
PURPOSE: Ultrasonographic assessment of diaphragm function with patients on low levels of pressure support (PS) predicts extubation outcomes, but similar information regarding extubation success under other conditions is lacking. The purpose of this study was to determine whether ultrasound (US) measurements of the diaphragm made on various levels of PS can predict time until successful extubation. METHODS: Fifty-six intubated patients underwent ultrasound of the right hemidiaphragm during a PS wean at varying levels of pressure support (PS 5/5 cm of H2O, 10/5 cm of H2O, and 15/5 cm of H2O)...
August 2016: Lung
https://www.readbyqxmd.com/read/27397793/human-chorionic-gonadotrophin-in-early-gestation-induces-growth-of-estrogenic-ovarian-follicles-and-improves-primiparous-sow-fertility-during-summer
#10
Jemma Seyfang, P Langendijk, T Y Chen, E Bouwman, R N Kirkwood
Reduced summer farrowing rates may be due to inadequate corpora luteal (CL) support. Porcine CL become dependent on LH from 12 d of pregnancy and the embryonic estrogen signal for maternal recognition of pregnancy (MRP) is initiated at about 11-12 d after insemination. We hypothesised that injection of the LH analogue human chorionic gonadotropin (hCG) would induce growth of estrogenic follicles and, by mimicking the signal for MRP and stimulating progesterone secretion, increase primiparous sow fertility. In Experiment 1, during a 28 d lactation 53 mixed parity sows were full-fed either throughout lactation (n=16) or until 18 d and then feed restricted during the last 10 d of lactation (n=36)...
September 2016: Animal Reproduction Science
https://www.readbyqxmd.com/read/27351423/treatments-for-breast-engorgement-during-lactation
#11
REVIEW
Lindeka Mangesi, Irena Zakarija-Grkovic
BACKGROUND: Breast engorgement is a painful condition affecting large numbers of women in the early postpartum period. It may lead to premature weaning, cracked nipples, mastitis and breast abscess. Various forms of treatment for engorgement have been studied but so far little evidence has been found on an effective intervention. OBJECTIVES: This is an update of a systematic review first published by Snowden et al. in 2001 and subsequently published in 2010. The objective of this update is to seek new information on the best forms of treatment for breast engorgement in lactating women...
2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27335184/-quantitative-evaluation-proposal-of-a-ultrasonographic-protocol-for-weaning-from-mechanichal-ventilation
#12
Ángel Augusto Pérez-Calatayud, Raúl Carrillo-Esper, Emilio Arch-Tirado
INTRODUCTION: Mechanical ventilation is a therapy for vital support used in a significant proportion of critically ill patients. The right time to successfully discontinue this therapy is a challenge for the intensive care specialist. For this reason it is still a subject for research. The echocardiographic evaluation of the diastolic dysfunction, the diaphragm, and the lung have become an invaluable tool for weaning from mechanical ventilation protocols, especially in patients with difficult or prolonged weaning from mechanical ventilation...
May 2016: Gaceta Médica de México
https://www.readbyqxmd.com/read/27316915/french-intensive-care-society-international-congress-r%C3%A3-animation-2016
#13
(no author information available yet)
No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27289856/lung-ultrasound-to-predict-mechanical-ventilation-weaning-failure
#14
L Y Delgado Ayala, O Torres, A Sanchez-Calzada, J L Navarro, A Torres, R Gastelum, P Romano Albornoz, M Arcos, E E Monares, J Aguirre, J Franco
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27236329/minimal-invasive-treatment-of-life-threatening-bleeding-caused-by-cardiopulmonary-resuscitation-associated-liver-injury-a-case-report
#15
Pål Aksel Næss, Kristian Engeseth, Ole Grøtta, Geir Øystein Andersen, Christine Gaarder
BACKGROUND: Life-threatening bleeding caused by liver injury due to chest compressions is a rare complication in otherwise successful cardiopulmonary resuscitation. Surgical intervention has been suggested to achieve bleeding control; however, reported mortality is high. In this report, we present a brief literature review and a case report in which use of a less invasive strategy was followed by an uneventful recovery. CASE PRESENTATION: A 37-year-old white woman was admitted after out-of-hospital cardiac arrest...
2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27199381/tracheal-rupture-after-intubation-and-placement-of-an-endotracheal-balloon-catheter-a-view%C3%A2-in-cardiac-surgery
#16
Simone T Timman, Jo M Mourisse, Stefan M van der Heide, Ad F Verhagen
The endotracheal balloon catheter (A-view®) is a device developed to locate atherosclerotic plaques of the ascending aorta (AA) in cardiac surgery to prevent stroke. The saline-filled balloon is located in the trachea and combines the advantages of transoesophageal echocardiography (e.g. used before performing the sternotomy) and intraoperative epiaortic ultrasound scanning (e.g. complete view of the AA). We report the first severe complication after the use of A-view®. This is a case of a 66-year old woman who underwent elective myocardial revascularization complicated by an intraoperative iatrogenic tracheal rupture of 6 cm, after uncomplicated intubation and the use of an endotracheal balloon catheter (A-view®), which required direct surgical repair with a posterolateral thoracotomy after the myocardial revascularization was completed, weaning from bypass and closure of the median sternotomy...
September 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27161831/ultrasound-for-diaphragmatic-dysfunction-in-postoperative-cardiac-children
#17
Hussam K Hamadah, Mohamed S Kabbani, Mahmoud Elbarbary, Omar Hijazi, Ghassan Shaath, Sameh Ismail, Ammar M H Qadi, Hayan AlTaweel, Abdulraouf Jijeh
: Introduction The use of ultrasound for assessing diaphragmatic dysfunction after paediatric cardiac surgery may be under-utilised. This study aimed to evaluate the role of bedside ultrasound performed by an intensivist to diagnose diaphragmatic dysfunction and the need for plication after paediatric cardiac surgery. METHODS: We carried out a retrospective cohort study on prospectively collected data of postoperative children admitted to the paediatric cardiac ICU during 2013...
May 10, 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/27157392/single-fixed-time-artificial-insemination-in-gilts-and-weaned-sows-using-plh-at-estrus-onset-administered-through-vulvar-submucosal-route
#18
R R Ulguim, D L Fontana, M L Bernardi, I Wentz, F P Bortolozzo
This study evaluated the use of a single fixed-time artificial insemination (FTAI) in gilts and weaned sows using 2.5 mg of porcine luteinizing hormone (pLH) administered through vulvar submucosal route, at the onset of estrus. In experiment 1 (Exp.1), 318 pubertal gilts were assigned to two groups: control-G-no hormonal application and artificial inseminations (AIs) at 12, 36, and 60 hours after the onset of estrus if they were still in standing estrus; and FTAI-G-use of pLH at the onset of estrus and a single FTAI 12 hours later...
September 1, 2016: Theriogenology
https://www.readbyqxmd.com/read/27136003/genetic-and-phenotypic-variance-and-covariance-components-for-methane-emission-and-postweaning-traits-in-angus-cattle
#19
K A Donoghue, T Bird-Gardiner, P F Arthur, R M Herd, R F Hegarty
Ruminants contribute 80% of the global livestock greenhouse gas (GHG) emissions mainly through the production of methane, a byproduct of enteric microbial fermentation primarily in the rumen. Hence, reducing enteric methane production is essential in any GHG emissions reduction strategy in livestock. Data on 1,046 young bulls and heifers from 2 performance-recording research herds of Angus cattle were analyzed to provide genetic and phenotypic variance and covariance estimates for methane emissions and production traits and to examine the interrelationships among these traits...
April 2016: Journal of Animal Science
https://www.readbyqxmd.com/read/27112953/diaphragm-ultrasound-as-a-new-method-to-predict-extubation-outcome-in-mechanically-ventilated-patients
#20
Shereen Farghaly, Ali A Hasan
AIM: To evaluate role of diaphragmatic thickening and excursion, assessed ultrasonographically, in predicting extubation outcome. METHODS: Fifty-four patients who successfully passed spontaneous breathing trial (SBT) were enrolled. They were assessed by ultrasound during SBT evaluating diaphragmatic excursion, diaphragmatic thickness (Tdi) at end inspiration, at end expiration and diaphragmatic thickness fraction (DTF%). Simultaneously traditional weaning parameters were recorded...
April 21, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
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