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https://www.readbyqxmd.com/read/28735156/adaptive-periodic-paralysis-allows-weaning-deep-sedation-overcoming-the-drowning-syndrome-in-ecmo-patients-bridged-for-lung-transplantation-a-case-series
#1
Irina Timofte, Michael Terrin, Erik Barr, June Kim, Joseph Rinaldi, Nicholas Ladikos, Jay Menaker, Ali Tabatabai, Zachary Kon, Bartley Griffith, Richard Pierson, Si Pham, Aldo Iacono, Daniel Herr
PURPOSE: Sedation in extracorporeal membrane oxygenation (ECMO) is challenging. Patients require deep sedation because of extremely high respiratory rates and increased work of breathing ("Drowning Syndrome") resulting in altered intra-thoracic pressure and reduced pump flow associated with hemodynamic compromise and decreased oxygenation. However, deep sedation impedes essential active rehabilitation with physical therapy. METHODS: We reviewed data on 3 ECMO patients for whom we used a novel approach to replace continuous drips with periodic sedation/paralysis...
July 17, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28734692/respiratory-arrest-at-the-onset-of-idiopathic-childhood-occipital-epilepsy-of-gastaut
#2
Keiko Funata, Tatsuhiko Shike, Toshiki Takenouchi, Yukio Yamashita, Takao Takahashi
Occipital lobe epilepsy of childhood includes two entities: Panayiotopoulos syndrome in pre-school children, and idiopathic childhood occipital epilepsy of Gastaut (ICOEG) in school-age children. The typical initial manifestation of the former is vomiting, and that of the latter is visual hallucinations. Ictal cardiopulmonary arrest at initial presentation has been reported for Panayiotopoulos syndrome, but not for ICOEG. We document a 7-year-old previously healthy girl who experienced an acute elemental visual hallucination of seeing insects, followed by a new-onset generalized seizure...
July 19, 2017: Brain & Development
https://www.readbyqxmd.com/read/28727104/a-major-gene-for-host-response-to-porcine-reproductive-and-respiratory-syndrome-is-not-unfavorably-associated-with-overall-performance-under-nonchallenging-conditions-in-commercial-pig-lines
#3
J R Dunkelberger, P K Mathur, M S Lopes, E F Knol, J C M Dekkers
A QTL for host response to porcine reproductive and respiratory syndrome (PRRS) was identified in a previous study. The SNP WUR10000125 (WUR) is used as a tag SNP for this QTL. The favorable (B) allele at this SNP is in low frequency in commercial populations, possibly because this allele is unfavorably associated with an important trait under nonchallenging conditions and, therefore, may have been selected against. Therefore, objectives of this study were to estimate the effect of WUR on traits under selection in commercial lines under nonchallenging conditions and to estimate the effect of WUR genotype of parents on performance of crossbred progeny in a commercial-like environment...
July 2017: Journal of Animal Science
https://www.readbyqxmd.com/read/28721327/two-catastrophes-in-one-patient-drug-reaction-with-eosinophilia-and-systemic-symptoms-and-toxic-shock-syndrome
#4
Moayed Ibrahim, Diana L Nunley
A 70-year-old, immunocompromised patient presented to the emergency room (ER) five weeks after she was started on clopidogrel. She complained of skin eruption, mouth ulcers, fatigue, and myalgia over the past two weeks. Labs showed severe hyponatremia, acute kidney injury, rhabdomyolysis, hyperkalemia, and elevated liver enzymes. She was treated with steroids and discharged after her condition improved. However, a month later, she returned to the ER, complaining of nausea, vomiting, diarrhea, dizziness, chills, and shortness of breath over the past two days...
June 15, 2017: Curēus
https://www.readbyqxmd.com/read/28719515/anaesthetic-management-of-patients-with-myopathies
#5
Mark Schieren, Jerome Defosse, Andreas Böhmer, Frank Wappler, Mark U Gerbershagen
: The anaesthetic management of patients with myopathies is challenging. Considering the low incidence and heterogeneity of these disorders, most anaesthetists are unfamiliar with key symptoms, associated co-morbidities and implications for anaesthesia. The pre-anaesthetic assessment aims at the detection of potentially undiagnosed myopathic patients and, in case of known or suspected muscular disease, on the quantification of disease progression. Ancillary testing (e.g. echocardiography, ECG, lung function testing etc...
July 15, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28717172/evolution-of-the-pseudomonas-aeruginosa-mutational-resistome-in-an-international-cystic-fibrosis-clone
#6
Carla López-Causapé, Lea Mette Sommer, Gabriel Cabot, Rosa Rubio, Alain A Ocampo-Sosa, Helle Krogh Johansen, Joan Figuerola, Rafael Cantón, Timothy J Kidd, Soeren Molin, Antonio Oliver
Emergence of epidemic clones and antibiotic resistance development compromises the management of Pseudomonas aeruginosa cystic fibrosis (CF) chronic respiratory infections. Whole genome sequencing (WGS) was used to decipher the phylogeny, interpatient dissemination, WGS mutator genotypes (mutome) and resistome of a widespread clone (CC274), in isolates from two highly-distant countries, Australia and Spain, covering an 18-year period. The coexistence of two divergent CC274 clonal lineages was revealed, but without evident geographical barrier; phylogenetic reconstructions and mutational resistome demonstrated the interpatient transmission of mutators...
July 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28710132/autophagy-deficiency-compromises-alternative-pathways-of-respiration-following-energy-deprivation
#7
Jessica As Barros, João Henrique F Cavalcanti, David B Medeiros, Adriano Nunes-Nesi, Tamar Avin-Wittenberg, Alisdair R Fernie, Wagner Araujo
Under heterotrophic conditions carbohydrate oxidation inside the mitochondria is the primary energy source for cellular metabolism. However, during energy-limited conditions, alternative substrates are required to support respiration. Amino acid oxidation in plant cells plays a key role in this by generating electrons that can be transferred to the mitochondrial electron transport chain via the electron transfer flavoprotein/ubiquinone oxidoreductase system. Autophagy, a catabolic mechanism for macromolecule and protein recycling, allows the maintenance of amino acid pools and nutrient remobilization...
July 14, 2017: Plant Physiology
https://www.readbyqxmd.com/read/28699890/changes-of-mitochondrial-ultrastructure-and-function-during-ageing-in-mice-and-drosophila
#8
Tobias Brandt, Arnaud Mourier, Luke S Tain, Linda Partridge, Nils-Göran Larsson, Werner Kühlbrandt
Ageing is a progressive decline of intrinsic physiological functions. We examined the impact of ageing on the ultrastructure and function of mitochondria in mouse and fruit flies (Drosophila melanogaster) by electron cryo-tomography and respirometry and discovered distinct age-related changes in both model organisms. Mitochondrial function and ultrastructure are maintained in mouse heart, whereas subpopulations of mitochondria from mouse liver show age-related changes in membrane morphology. Subpopulations of mitochondria from young and old mouse kidney resemble those described for apoptosis...
July 12, 2017: ELife
https://www.readbyqxmd.com/read/28696044/practice-patterns-of-palliative-radiation-therapy-in-pediatric-oncology-patients-in-an-international-pediatric-research-consortium
#9
Avani Dholakia Rao, Qinyu Chen, Ralph P Ermoian, Sara R Alcorn, Maria Luisa S Figueiredo, Michael J Chen, Karin Dieckmann, Shannon M MacDonald, Matthew M Ladra, Daria Kobyzeva, Alexey V Nechesnyuk, Kristina Nilsson, Eric C Ford, Brian A Winey, Rosangela C Villar, Stephanie A Terezakis
BACKGROUND/OBJECTIVES: The practice of palliative radiation therapy (RT) is based on extrapolation from adult literature. We evaluated patterns of pediatric palliative RT to describe regimens used to identify opportunity for future pediatric-specific clinical trials. DESIGN/METHODS: Six international institutions with pediatric expertise completed a 122-item survey evaluating patterns of palliative RT for patients ≤21 years old from 2010 to 2015. Two institutions use proton RT...
July 11, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28688573/comparison-between-selective-and-routine-intensive-care-unit-admission-post-supraglottoplasty
#10
Timothy Cooper, Bree Harris, Ahmed Mourad, Daniel Garros, Hamdy El-Hakim
OBJECTIVE: To compare major post-operative respiratory complications, post-operative disposition and duration of hospital admission before and after adopting a selective intensive care unit (ICU) admission care plan following supraglottoplasty (SGP). METHODS: Retrospective case series set in a tertiary pediatric referral center. Eligible patients undergoing SGP between October 2003 and July 2015 were identified through a prospectively kept surgical database. Historical cohorts with routine admission to ICU and selective admission to ICU were identified based on a shift in surgeon practice...
August 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28682836/a-technique-of-awake-bronchoscopic-endotracheal-intubation-for-respiratory-failure-in-patients-with-right-heart-failure-and-pulmonary-hypertension
#11
Jimmy Johannes, David A Berlin, Parimal Patel, Edward J Schenck, Frances Mae West, Rajan Saggar, Igor Z Barjaktarevic
OBJECTIVE: Patients with pulmonary hypertension and right heart failure have a high risk of clinical deterioration and death during or soon after endotracheal intubation. The effects of sedation, hypoxia, hypoventilation, and changes in intrathoracic pressure can lead to severe hemodynamic instability. In search for safer approach to endotracheal intubation in this cohort of patients, we evaluate the safety and feasibility of an alternative intubation technique. DATA SOURCES: Retrospective data analysis...
July 4, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28679347/serotonin-calcitonin-and-calcitonin-gene-related-peptide-in-acute-pancreatitis
#12
Kirsten Lykke Wahlstrøm, Srdan Novovic, Annette Kjær Ersbøll, Philip Hasbak, Lars Nannestad Jørgensen, Mark Berner Hansen
OBJECTIVE: The aim of this study was to investigate plasma levels of serotonin, calcitonin and calcitonin gene-related peptide (CGRP) in the course of acute pancreatitis (AP) taking organ failure, etiology and severity into consideration. MATERIAL AND METHODS: Sixty consecutive patients with alcohol- or gallstone-induced AP were included over a 15-month period. Patients were treated according to a standardized algorithm and monitored for organ specific morbidity and mortality...
July 5, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28673074/pediatric-pleural-empyema-one-of-the-management-challenges-in-children-of-democratic-republic-of-congo
#13
Kibwe Alphonse Simbi, Valentin Kazadi, Louis-Marie Aissi, François Mbahewaka Katsuva, Numbi Oscar Luboya, Léon Tshilolo, Vincenzo Zanardo
Empyema is a serious complication characterized by purulent exudate and bacteria in the pleural space, which may progress to necrosis, cavitations or fistulas in the thoracic cavity. It remains a major challenge throughout low-income countries. Objectives were to emphasize the role of basic medical and radiologic approach and to resolve a severe lung complication when facilities are inadequate. A five-year-old female was referred with distress respiratory to the Emergency Unit of Monkole, a large public-private missionary hospital in Kinshasa, Congo...
June 23, 2017: La Pediatria Medica e Chirurgica: Medical and Surgical Pediatrics
https://www.readbyqxmd.com/read/28667196/patient-safety-during-procedural-sedation-using-capnography-monitoring-a-systematic-review-and-meta-analysis
#14
Rhodri Saunders, Michel M R F Struys, Richard F Pollock, Michael Mestek, Jenifer R Lightdale
OBJECTIVE: To evaluate the effect of capnography monitoring on sedation-related adverse events during procedural sedation and analgesia (PSA) administered for ambulatory surgery relative to visual assessment and pulse oximetry alone. DESIGN AND SETTING: Systematic literature review and random effects meta-analysis of randomised controlled trials (RCTs) reporting sedation-related adverse event incidence when adding capnography to visual assessment and pulse oximetry in patients undergoing PSA during ambulatory surgery in the hospital setting...
June 30, 2017: BMJ Open
https://www.readbyqxmd.com/read/28667068/role-of-the-nrf2-ho-1-axis-in-bronchopulmonary-dysplasia-and-hyperoxic-lung-injuries
#15
REVIEW
Emanuele Amata, Valeria Pittalà, Agostino Marrazzo, Carmela Parenti, Orazio Prezzavento, Emanuela Arena, Seyed Mohammad Nabavi, Loredana Salerno
Bronchopulmonary dysplasia (BPD) is a chronic illness that usually originates in preterm newborns. Generally, BPD is a consequence of respiratory distress syndrome (RDS) which, in turn, comes from the early arrest of lung development and the lack of pulmonary surfactant. The need of oxygen therapy to overcome premature newborns' compromised respiratory function generates an increasing amount of reactive oxygen species (ROS), the onset of sustained oxidative stress (OS) status, and inflammation in the pulmonary alveoli deputies to respiratory exchanges...
July 15, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28665787/effects-of-procalcitonin-testing-on-antibiotic-use-and-clinical-outcomes-in-patients-with-upper-respiratory-tract-infections-an-individual-patient-data-meta-analysis
#16
Jonas Odermatt, Natalie Friedli, Alexander Kutz, Matthias Briel, Heiner C Bucher, Mirjam Christ-Crain, Olaf Burkhardt, Tobias Welte, Beat Mueller, Philipp Schuetz
BACKGROUND: Several trials found procalcitonin (PCT) helpful for guiding antibiotic treatment in patients with lower respiratory tract infections and sepsis. We aimed to perform an individual patient data meta-analysis on the effects of PCT guided antibiotic therapy in upper respiratory tract infections (URTI). METHODS: A comprehensive search of the literature was conducted using PubMed (MEDLINE) and Cochrane Library to identify relevant studies published until September 2016...
June 29, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28665409/structural-basis-for-human-respiratory-syncytial-virus-ns1-mediated-modulation-of-host-responses
#17
Srirupa Chatterjee, Priya Luthra, Ekaterina Esaulova, Eugene Agapov, Benjamin C Yen, Dominika M Borek, Megan R Edwards, Anuradha Mittal, David S Jordan, Parameshwar Ramanan, Martin L Moore, Rohit V Pappu, Michael J Holtzman, Maxim N Artyomov, Christopher F Basler, Gaya K Amarasinghe, Daisy W Leung
Human respiratory syncytial virus (hRSV) is a major cause of morbidity and mortality in the paediatric, elderly and immune-compromised populations(1,2). A gap in our understanding of hRSV disease pathology is the interplay between virally encoded immune antagonists and host components that limit hRSV replication. hRSV encodes for non-structural (NS) proteins that are important immune antagonists(3-6); however, the role of these proteins in viral pathogenesis is incompletely understood. Here, we report the crystal structure of hRSV NS1 protein, which suggests that NS1 is a structural paralogue of hRSV matrix (M) protein...
June 30, 2017: Nature Microbiology
https://www.readbyqxmd.com/read/28662821/the-role-of-matrix-metalloproteinases-in-development-repair-and-destruction-of-the-lungs
#18
Amanda Y Hendrix, Farrah Kheradmand
Normal gas exchange after birth requires functional lung alveolar units that are lined with epithelial cells, parts of which are intricately fused with microvascular capillaries. A significant phase of alveolar lung development occurs in the perinatal period, continues throughout early stages in life, and requires activation of matrix-remodeling enzymes. Failure to achieve an optimum number of alveoli during lung maturation can cause several untoward medical consequences including disabling obstructive and/or restrictive lung diseases that limit physiological endurance and increase mortality...
2017: Progress in Molecular Biology and Translational Science
https://www.readbyqxmd.com/read/28660138/emergent-reintubation-following-elective-cervical-surgery-a-case-series
#19
Joshua Schroeder, Stephan N Salzmann, Alexander P Hughes, James D Beckman, Jennifer Shue, Federico P Girardi
AIM: To review cases of emergent reintubation after cervical surgery. METHODS: Patients who were emergently intubated in the post-operative period following cervical surgery were identified. The patients' prospectively documented demographic parameters, medical history and clinical symptoms were ascertained. Pre-operative radiographs were examined for the extent of their pathology. The details of the operative procedure were discerned. RESULTS: Eight hundred and eighty patients received anterior- or combined anterior-posterior cervical surgery from 2008-2013...
June 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28654841/exposure-to-particulate-matter-2-5-pm2-5-induced-macrophage-dependent-inflammation-characterized-by-increased-th1-th17-cytokine-secretion-and-cytotoxicity
#20
Qin-Yun Ma, Da-Yu Huang, Hui-Jun Zhang, Shaohua Wang, Xiao-Feng Chen
Particulate matter PM2.5 is a class of airborne particles and droplets with sustained high levels in many developing countries. Epidemiological studies have shown the association between sustained high level of PM2.5 and the risk of many diseases in the respiratory system, including lung cancer. However, the precise mechanisms through which PM2.5 induces respiratory diseases are still unclear. In this study, we demonstrated that CD4(+) and CD8(+) T cells following PM2.5 treatment demonstrated significantly elevated mRNA and protein levels of interferon (IFN)-γ, interleukin (IL)-10, IL-17, and IL-21 production...
June 24, 2017: International Immunopharmacology
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