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https://www.readbyqxmd.com/read/29668131/-severe-hypoxemic-respiratory-failure-caused-by-pneumocystis-jirovecii-in-a-late-kidney-transplant-recipient
#1
John Fredy Nieto-Ríos, Mónica Zuluaga-Quintero, Arbey Aristizábal-Alzate, Catalina Ocampo-Kohn, Lina María Serna-Higuita, Isabel Cristina Ramírez-Sánchez, Gustavo Adolfo Zuluaga-Valencia
Pneumonia caused by Pneumocystis jirovecii is an uncommon infection in kidney transplant patients that can have an acute and rapid progression to respiratory failure and death. The period of greatest risk occurs in the first six months after the transplant, and it relates to the high doses of immunosuppression drugs required by patients. However, it may occur late, associated with the suspension of prophylaxis with trimethoprim-sulfamethoxazole.We present two cases of renal transplant patients who had severe hypoxemic respiratory failure due to P...
March 15, 2018: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/29666726/-nocardia-spp-pneumonia-in-a-solid-organ-recipient-role-of-linezolid
#2
George Mwandia, Hari Polenakovik
We describe a rare infection with Nocardia spp. ( N. pseudobrasiliensis species identification based on high-performance liquid chromatography analysis) in a 68-year-old renal transplant recipient. He presented with pneumonia complicated by hypoxic respiratory failure. He was allergic to sulphonamides. He was initially successfully treated with linezolid. However, he suffered severe sensory neuropathy after 4 months of therapy, necessitating linezolid cessation and completion of treatment with azithromycin...
2018: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/29664460/a-novel-variant-in-atm-gene-causes-ataxia-telangiectasia-revealed-by-whole-exome-sequencing
#3
Noufa A Alonazi, Khalid J Hundallah, Amal M Al Hashem, Sarar Mohamed
Ataxia-Telangiectasia (A-T) is an autosomal recessive disorder caused by variants in ATM gene and characterized by progressive neurologic impairment, cerebellar ataxia, and oculo-cutaneous telangiectasia. Immunodeficiency with a recurrent sinopulmonary infections are observed in patients with A-T. Here, we report a novel stop codon variant, c.5944 C>T (p.Gln1982*), revealed by whole-exome sequencing in a 9-year old boy. He presented with recurrent upper respiratory tract infections, failure to thrive, developmental delay, ataxic gait, and bulbar telangiectasia...
April 2018: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
https://www.readbyqxmd.com/read/29664034/incidence-prognosis-of-acute-kidney-injury-in-individuals-of-snakebite-in-a-tertiary-care-hospital-in-india
#4
Ramulu Pulimaddi, Amruth Rao Parveda, Balkishan Brahmanpally, Paul Marx Kalakanda, K Ramakrishna, Venkata Ramana Devi Chinnapaka
Background & objectives: The snakebites are considered to be an occupational hazard in agriculture workers and the snake handlers, resulting in a considerable morbidity, mortality and economical implications. This study was conducted to determine the incidence, clinical presentation, renal injury and clinical outcome in snakebite victims who developed acute kidney injury (AKI). Methods: This hospital-based prospective, observational study was done on 100 cases who were admitted for the management of snakebite and found to develop AKI in a tertiary care hospital at Hyderabad, India...
December 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/29662744/postoperative-complications-associated-with-rhbmp2-use-in-posterior-posterolateral-lumbar-fusion
#5
Nabil Esmail, Zorica Buser, Jeremiah R Cohen, Darrel S Brodke, Hans-Joerg Meisel, Jong-Beom Park, Jim A Youssef, Jeffrey C Wang, S Tim Yoon
Study Design: Retrospective database review. Objective: Posterior/posterolateral lumbar fusion (PLF) is an effective treatment for a variety of spinal disorders; however, variations in surgical technique have different complication profiles. The aim of our study was to quantify the frequency of various complications in patients undergoing PLF with and without human recombinant bone morphogenetic protein 2 (rhBMP2). Methods: We queried the orthopedic subset of the Medicare database (PearlDiver) between 2005 and 2011 for patients undergoing PLF procedures with and without rhBMP2...
April 2018: Global Spine Journal
https://www.readbyqxmd.com/read/29661625/unusual-presentation-of-middle-east-respiratory-syndrome-coronavirus-leading-to-a-large-outbreak-in-riyadh-during-2017
#6
Hala Amer, Abdulrahman S Alqahtani, Hind Alzoman, Nawfal Aljerian, Ziad A Memish
BACKGROUND: The hallmark of Middle East respiratory syndrome coronavirus (MERS-CoV) disease is the ability to cause major health care-associated nosocomial outbreaks with superspreading events leading to massive numbers of cases and excessive morbidity and mortality. In this report, we describe a patient who presented with acute renal failure requiring hemodialysis and became a MERS-CoV superspreader, igniting a recent multihospital outbreak in Riyadh. MATERIAL AND RESULTS: Between May 31 and June 15, 2017, 44 cases of MERS-CoV infection were reported from 3 simultaneous clusters from 3 health care facilities in Riyadh, Saudi Arabia, including 11 fatal cases...
April 13, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29661446/multivisceral-transplantation-rehabilitation-program-case-report
#7
T M Loschi, M P R G Cinacchi, M D T A Baccan, F Marques, P T Pedroso, S P Meira Filho, T Scacchetti, D N Pavão
Multivisceral transplantation is the treatment for multiple abdominal organ failure. The patient experiences reduced food intake and absorption of nutrients, contributing to weight loss and decreased muscle mass, reducing functional capacity. A physical and nutritional rehabilitation program based on adequate caloric intake associated with supervised physical exercise seems to support a gain of muscle mass, re-establishing its capacity and functional independence. A rehabilitation program was carried out, consisting of low-intensity aerobic exercise on treadmill, exercises of global strengthening (50% of 1 maximum repetition [1RM], with progressive increase), and nutritional monitoring (oral hypercaloric diet, hyperproteic supplementation daily and after exercise)...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29661384/a-systematic-review-and-consensus-definitions-for-standardised-end-points-in-perioperative-medicine-pulmonary-complications
#8
REVIEW
T E F Abbott, A J Fowler, P Pelosi, M Gama de Abreu, A M Møller, J Canet, B Creagh-Brown, M Mythen, T Gin, M M Lalu, E Futier, M P Grocott, M J Schultz, R M Pearse
BACKGROUND: There is a need for robust, clearly defined, patient-relevant outcome measures for use in randomised trials in perioperative medicine. Our objective was to establish standard outcome measures for postoperative pulmonary complications research. METHODS: A systematic literature search was conducted using MEDLINE, Web of Science, SciELO, and the Korean Journal Database. Definitions were extracted from included manuscripts. We then conducted a three-stage Delphi consensus process to select the optimal outcome measures in terms of methodological quality and overall suitability for perioperative trials...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661379/isoflurane-disrupts-excitatory-neurotransmitter-dynamics-via-inhibition-of-mitochondrial-complex-i
#9
P I Zimin, C B Woods, E B Kayser, J M Ramirez, P G Morgan, M M Sedensky
BACKGROUND: The mechanisms of action of volatile anaesthetics are unclear. Volatile anaesthetics selectively inhibit complex I in the mitochondrial respiratory chain. Mice in which the mitochondrial complex I subunit NDUFS4 is knocked out [Ndufs4(KO)] either globally or in glutamatergic neurons are hypersensitive to volatile anaesthetics. The volatile anaesthetic isoflurane selectively decreases the frequency of spontaneous excitatory events in hippocampal slices from Ndufs4(KO) mice...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29660669/the-systemic-inflammatory-response-syndrome-criteria-and-their-differential-association-with-mortality
#10
Kirsi-Maija Kaukonen, Michael Bailey, David Pilcher, D James Cooper, Rinaldo Bellomo
PURPOSE: Despite the recent Sepsis-3 consensus, the Systemic Inflammatory Response Syndrome (SIRS) criteria continue to be assessed and recommended. Such use implies equivalence and interchangeability of criteria. Thus, we aimed to test whether such criteria are indeed equivalent and interchangeable. MATERIALS AND METHODS: From 2000 to 2015, we identified patients with infection, organ failure, and at least one SIRS criterion in 179 Intensive Care Units in Australia and New...
April 7, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29660241/copd-is-independently-associated-with-six-month-survival-in-patients-who-have-life-support-withheld-in-intensive-care
#11
A Maamar, S Chevalier, P Fillâtre, V Botoc, Y Le Tulzo, A Gacouin, J M Tadié
BACKGROUND: In-hospital outcomes following decisions of withholding or withdrawing in Intensive Care Unit (ICU) patients have been previously assessed, little is known about outcomes after ICU and hospital discharge. Our objective was to report the six-month outcomes of discharged patients who had treatment limitations in a general ICU and to identify prognostic factors of survival. METHODS: We retrospectively collected the data of patients discharged from the ICU for whom life support was withheld from 2009 to 2011...
April 16, 2018: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29659754/a-randomized-study-evaluating-the-effectiveness-of-oseltamivir-initiated-at-the-time-of-hospital-admission-in-adults-hospitalized-with-influenza-associated-lower-respiratory-tract-infections
#12
Julio Ramirez, Paula Peyrani, Timothy Wiemken, Sandra S Chaves, Alicia M Fry
Background: Influenza-associated hospitalizations result in high morbidity and mortality. We sought to determine if early empiric anti-influenza therapy improves outcomes of hospitalized patients with influenza-associated lower respiratory tract infections (I-LRTIs). Methods: This was a randomized, unblinded, trial of adult patients hospitalized with I-LRTIs in Kentucky during 2009-2012. Patients were randomized to group A (standard of care) or group B (standard of care plus oseltamivir as early as possible but within 24 hours of enrollment)...
April 11, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29659630/body-mass-index-of-92-027-patients-acutely-admitted-to-general-hospitals-in-denmark-associated-clinical-characteristics-and-30-day-mortality
#13
Sigrid Bjerge Gribsholt, Lars Pedersen, Bjørn Richelsen, Olaf Dekkers, Reimar Wernich Thomsen
BACKGROUND: Data are sparse on the range of BMI among patients acutely admitted to general hospitals. We investigated BMI values and associated patient characteristics, reasons for hospital admission, and mortality in Denmark. METHODS: We identified all persons with an acute inpatient admission 2011-2014 in Central Denmark Region and assessed BMI measurements recorded in the Clinical Information System. We used cross-sectional and cohort analyses to examine the BMI distribution and its association with demographic characteristics, comorbidities, medication use, tobacco smoking, reasons for admission, and 30-day mortality...
2018: PloS One
https://www.readbyqxmd.com/read/29658839/comparison-of-emergency-cholecystectomy-with-delayed-cholecystectomy-after-percutaneous-transhepatic-gallbladder-drainage-in-patients-with-moderate-acute-cholecystitis
#14
Chang-Wei Ke, Shuo-Dong Wu
INTRODUCTION: Patients with moderate (grade II) acute cholecystitis patients, as defined by the 2013 Tokyo Guidelines, were retrospectively compared with respect to emergency cholecystectomy (EC) and delayed cholecystectomy (DC) after percutaneous transhepatic gallbladder drainage (PTGBD) to determine the better treatment strategy. METHODS: Forty-nine of 103 patients with PTGBD and 47 of 54 patients with EC were assessed for eligibility from January 2013 to January 2017...
April 16, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29658403/endobronchial-stenting-on-vv-ecmo-in-a-6-month-old-girl-with-right-lung-agenesis-and-severe-stenosis-of-the-left-main-bronchus
#15
Vaclav Vobruba, Jiri Votruba, Jan Bělohlávek, Tomas Grus, Pavel Leden, Tomas Zaoral, Jan Hřídel
INTRODUCTION: Lung agenesis is a rare disorder with a variable, but potentially very bad clinical course. It necessitates complex clinical management, especially in life-threatening situations. CASE REPORT: We describe a case of a 6-month-old girl with right lung agenesis who required venovenous extracorporeal membrane oxygenation (VV-ECMO) due to pneumonia complicated by exacerbated previously diagnosed left main bronchus stenosis. The stenosis was resolved by endobronchial intervention and X-ray-guided stent insertion, which enabled weaning from ECMO and was aimed at preventing such a life-threatening respiratory failure in the future...
April 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29657947/modifiable-risk-factors-for-early-mortality-in-low-risk-penn-class-aa-acute-type-a-aortic-dissection-patients-a-descriptive-study
#16
Christian Olsson
Background: Acute Type A aortic dissection (ATAAD) without end-organ or generalized ischemia is Penn class Aa and considered low-risk. Nevertheless, surgical mortality can be considerable in this subgroup and may be related to modifiable factors. The objective of this study was to analyze 30-day mortality among ATAAD Penn class Aa patients with special reference to modifiable perioperative factors. Methods: Among all patients operated for ATAAD from 1990 to 2010, all Penn class Aa patients dying within 30 days were included in a retrospective descriptive study...
August 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/29657718/endotracheal-tube-clamping-and-extracorporeal-membrane-oxygenation-to-resuscitate-massive-pulmonary-haemorrhage
#17
Chien-Feng Lee, Chun-Ta Huang, Sheng-Yuan Ruan
Massive pulmonary haemorrhage is a life-threatening and difficult-to-manage condition. In certain circumstances, traditional approaches for haemoptysis may not be effective. Here, we report a 64-year-old man presenting with dyspnoea and leg oedema. He was diagnosed with microscopic polyangiitis due to positive perinuclear anti-neutrophil cytoplasmic antibody and other supportive evidence. His hospital course was complicated with massive pulmonary haemorrhage, which led to hypoxic respiratory failure, shock, and pulseless electrical activity...
July 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29657373/severe-varicella-pneumonia-in-adults-seven-years-single-center-experience-from-india
#18
Akashdeep Singh, Siddharth Parkash, Sunil K Gupta, R K Soni
Context: Varicella pneumonia is a rare but a serious complication of chickenpox in adults. There is paucity of data on varicella pneumonia from India. Aims: The aim of this study is to describe the clinical manifestations, hospital course, treatment, and outcome of adult patients with severe varicella pneumonia. Settings and Design: This was a retrospective, observational study of patients with severe varicella pneumonia attending a tertiary care teaching hospital...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29656714/epidemiology-of-sepsis-in-intensive-care-units-in-turkey-a-multicenter-point-prevalence-study
#19
Nur Baykara, Halis Akalın, Mustafa Kemal Arslantaş, Volkan Hancı, Çiğdem Çağlayan, Ferda Kahveci, Kubilay Demirağ, Canan Baydemir, Necmettin Ünal
BACKGROUND: The prevalence and mortality of sepsis are largely unknown in Turkey, a country with high antibiotic resistance. A national, multicenter, point-prevalence study was conducted to determine the prevalence, causative microorganisms, and outcome of sepsis in intensive care units (ICUs) in Turkey. METHODS: A total of 132 ICUs from 94 hospitals participated. All patients (aged > 18 years) present at the participating ICUs or admitted for any duration within a 24-h period (08:00 on January 27, 2016 to 08:00 on January 28, 2016) were included...
April 16, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29652913/ventilator-associated-pneumonia-in-patients-assisted-by-veno-arterial-extracorporeal-membrane-oxygenation-support-epidemiology-and-risk-factors-of-treatment-failure
#20
Adrien Bouglé, Camille Bombled, Dimitri Margetis, Guillaume Lebreton, Charles Vidal, Marine Coroir, David Hajage, Julien Amour
INTRODUCTION: Ventilator-associated pneumonia (VAP) is frequent in Intensive Care Unit (ICU) patients. In the specific case of patients treated with Veno-Arterial Extracorporeal Membrane Oxygenation Support (VA-ECMO), VAP treatment failures (VAP-TF) have been incompletely investigated. METHODS: To investigate the risk factors of treatment failure (VAP-TF) in a large cohort of ICU patients treated with VA-ECMO, we conducted a retrospective study in a Surgical ICU about patients assisted with VA-ECMO between January 1, 2013, and December 31, 2014...
2018: PloS One
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