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https://www.readbyqxmd.com/read/29776982/variable-effectiveness-of-stepwise-implementation-of-nudge-type-interventions-to-improve-provider-compliance-with-intraoperative-low-tidal-volume-ventilation
#1
Vikas N O'Reilly-Shah, George S Easton, Craig S Jabaley, Grant C Lynde
BACKGROUND: Identifying mechanisms to improve provider compliance with quality metrics is a common goal across medical disciplines. Nudge interventions are minimally invasive strategies that can influence behavioural changes and are increasingly used within healthcare settings. We hypothesised that nudge interventions may improve provider compliance with lung-protective ventilation (LPV) strategies during general anaesthesia. METHODS: We developed an audit and feedback dashboard that included information on both provider-level and department-level compliance with LPV strategies in two academic hospitals, two non-academic hospitals and two academic surgery centres affiliated with a single healthcare system...
May 18, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29762231/surfactant-administration-during-pediatric-cardiac-extracorporeal-membrane-oxygenation
#2
Constantinos Chrysostomou, Timothy Maul, Filip Istvanic, Peter Wearden
We investigated the safety and efficacy of surfactant during extracorporeal membrane oxygenation (ECMO) in children with cardiac disease. ECMO patients administered surfactant (surfactant group) were compared with patients who did not receive (control). Criteria to administer surfactant were based on a decreased lung compliance of <0.5 ml/kg/cm H2O. Efficacy was determined on pulmonary compliance change and the radiography-based respiratory distress severity (RDS) score. For the surfactant group, lung compliance measurements and RDS scores were obtained just before the first surfactant administration (T0), 24 hours after the last dose of surfactant (T1), and 24 hours after ECMO decannulation (T2)...
May 11, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29758177/the-efficacy-of-antenatal-steroid-therapy-is-dependent-on-the-duration-of-low-concentration-fetal-exposure-evidence-from-a-sheep-model-of-pregnancy
#3
Matthew W Kemp, Masatoshi Saito, Haruo Usuda, Shimpei Watanabe, Shinichi Sato, Takushi Hanita, Yusaku Kumagai, Timothy J Molloy, Michael Clarke, Peter J Eddershaw, Gabrielle C Musk, Augusto Schmidt, Demelza Ireland, Lucy Furfaro, Matthew S Payne, John P Newnham, Alan H Jobe
OBJECTIVE: Antenatal corticosteroids (ANS) are among the most important and widely used interventions to improve outcomes for preterm infants. ANS dosing regimens remain un-optimized and without maternal weight-adjusted dosing. We, and others, have hypothesised that once a low concentration of materno-fetal steroid exposure is achieved and maintained, the duration of the steroid exposure determines treatment efficacy. Using a sheep model of pregnancy, we tested the relationship between steroid dose, and duration of exposure, and treatment efficacy...
May 9, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29755102/-multimodality-therapy-for-lung-cancer-with-chest-wall-invasion
#4
Koji Kawaguchi, Kohei Yokoi
The standard therapy for patients with T3N0-1M0 non-small cell lung cancer (NSCLC) involving the chest wall is considered initial resection and adjuvant chemotherapy. However, the compliance of adjuvant therapy is relatively low, and the prognosis for those patients has not been satisfactory. We therefore advocated a new strategy of induction chemoradiotherapy followed by surgery and conducted a prospective, multi-institutional phaseⅡ trial with the aim of improving the survival. The mature results of this trial showed the treatment strategy to be safe and effective with a high rate of pathologic response...
April 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29752580/loss-of-hox5-function-results-in-myofibroblast-mislocalization-and-distal-lung-matrix-defects-during-postnatal-development
#5
Steven M Hrycaj, Leilani Marty-Santos, Andrew J Rasky, Nicholas W Lukacs, Deneen M Wellik
Alveologenesis is the final stage of lung development and is responsible for the formation of the principle gas exchange units called alveoli. The lung mesenchyme, in particular the alveolar myofibroblasts, are drivers of alveolar development, however, few key regulators that govern the proper distribution and behavior of these cells in the distal lung during alveologenesis have been identified. While Hox5 triple mutants (Hox5 aabbcc) exhibit neonatal lethality, four-allele, compound mutant mice (Hox5 AabbCc) are born in Mendelian ratios and are phenotypically normal at birth...
April 27, 2018: Science China. Life Sciences
https://www.readbyqxmd.com/read/29750030/validation-of-exhaled-volatile-organic-compounds-analysis-using-electronic-nose-as-index-of-copd-severity
#6
Panaiotis Finamore, Claudio Pedone, Simone Scarlata, Alessandra Di Paolo, Simone Grasso, Marco Santonico, Giorgio Pennazza, Raffaele Antonelli Incalzi
Aim: Six-minute walking test distance (6MWD) and body mass index, obstruction, dyspnea and exercise (BODE) index are measures of functional status in COPD patients, but require space, time and patient's compliance. Exhaled volatile organic compounds (VOCs) analysis via electronic nose is a quick and easy method that has already been used to discriminate COPD phenotypes. The aim of this study is to evaluate whether VOCs analysis can predict functional status and its variation over time in COPD patients...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29747634/regulation-of-fibroblast-fas-expression-by-soluble-and-mechanical-pro-fibrotic-stimuli
#7
Amos E Dodi, Iyabode O Ajayi, Christine Chang, Meghan Beard, Shanna L Ashley, Steven K Huang, Victor J Thannickal, Daniel J Tschumperlin, Thomas H Sisson, Jeffrey C Horowitz
BACKGROUND: Fibroblast apoptosis is a critical component of normal repair and the acquisition of an apoptosis-resistant phenotype contributes to the pathogenesis of fibrotic repair. Fibroblasts from fibrotic lungs of humans and mice demonstrate resistance to apoptosis induced by Fas-ligand and prior studies have shown that susceptibility to apoptosis is enhanced when Fas (CD95) expression is increased in these cells. Moreover, prior work shows that Fas expression in fibrotic lung fibroblasts is reduced by epigenetic silencing of the Fas promoter...
May 10, 2018: Respiratory Research
https://www.readbyqxmd.com/read/29745251/amd3100-ameliorates-cigarette-smoke-induced-emphysema-like-manifestations-in-mice
#8
Daria Barwinska, Houssam Oueini, Christophe Poirier, Marjorie E Albrecht, Natalia V Bogatcheva, Matthew J Justice, Jacob Saliba, Kelly S Schweitzer, Hal E Broxmeyer, Keith L March, Irina Petrache
We have shown that cigarette smoke (CS)-induced pulmonary emphysema-like manifestations are preceded by marked suppression of the number and function of bone marrow hematopoietic progenitor cells (HPC). To investigate if a limited availability of HPC may contribute to CS-induced lung injury, we used an FDA-approved antagonist of the interactions of SDF-1 with its receptor CXCR4 to promote intermittent HPC mobilization and tested its ability to limit emphysema-like injury following chronic CS. We administered AMD3100 (5mg/kg) to mice during a chronic CS exposure protocol of up to 24 weeks...
May 10, 2018: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/29743094/feasibility-and-safety-of-low-flow-extracorporeal-co-2-removal-managed-with-a-renal-replacement-platform-to-enhance-lung-protective-ventilation-of-patients-with-mild-to-moderate-ards
#9
Matthieu Schmidt, Samir Jaber, Elie Zogheib, Thomas Godet, Gilles Capellier, Alain Combes
BACKGROUND: Extracorporeal carbon-dioxide removal (ECCO2 R) might allow ultraprotective mechanical ventilation with lower tidal volume (VT) (< 6 ml/kg predicted body weight), plateau pressure (Pplat ) (< 30 cmH2 O), and driving pressure to limit ventilator-induced lung injury. This study was undertaken to assess the feasibility and safety of ECCO2 R managed with a renal replacement therapy (RRT) platform to enable very low tidal volume ventilation of patients with mild-to-moderate acute respiratory distress syndrome (ARDS)...
May 10, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29741919/efficacy-of-acupuncture-treatment-for-improving-the-respiratory-status-in-patients-receiving-prolonged-mechanical-ventilation-in-intensive-care-units-a-retrospective-observational-study
#10
Jun Matsumoto-Miyazaki, Hiroaki Ushikoshi, Kodai Suzuki, Nagisa Miyazaki, Takahide Nawa, Hideshi Okada, Shozo Yoshida, Ichijiro Murata, Shinji Ogura, Shinya Minatoguchi
BACKGROUND AND OBJECTIVE: Patients in critical care settings often require prolonged mechanical ventilation (MV) therapy and, occasionally, they cannot be weaned from MV. The authors evaluated the efficacy of acupuncture treatment for improving the respiratory status and promoting successful weaning from prolonged MV in patients at intensive care units (ICUs). DESIGN: Retrospective observational study. SETTING: Gifu University Hospital, Gifu, Japan...
May 9, 2018: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/29739231/evaluating-the-time-to-palliative-care-referrals-in-patients-with-small-cell-lung-cancer-a-single-centre-retrospective-review
#11
Geoffrey Alan Watson, Jean Saunders, Linda Coate
INTRODUCTION: Lung cancer is a leading cause of morbidity and mortality worldwide. Patients with lung cancer may experience a plethora of symptoms, which can be debilitating and affect their quality of life. Palliative care input to manage their physical and psychological well-being is a crucial component of their oncological care. The benefit of early palliative care input has been shown in patients with non-small cell lung cancer; however, data pertaining to patients with small-cell lung cancer are scarce...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29731780/lung-mesenchymal-stem-cells-ameliorate-elastase-induced-damage-in-an-animal-model-of-emphysema
#12
Donato Cappetta, Antonella De Angelis, Giuseppe Spaziano, Gioia Tartaglione, Elena Piegari, Grazia Esposito, Loreta Pia Ciuffreda, Angela Liparulo, Manuela Sgambato, Teresa Palmira Russo, Francesco Rossi, Liberato Berrino, Konrad Urbanek, Bruno D'Agostino
Pulmonary emphysema is a respiratory condition characterized by alveolar destruction that leads to airflow limitation and reduced lung function. Although with extensive research, the pathophysiology of emphysema is poorly understood and effective treatments are still missing. Evidence suggests that mesenchymal stem cells (MSCs) possess the ability to engraft the injured tissues and induce repair via a paracrine effect. Thus, the aim of this study was to test the effects of the intratracheal administration of lung-derived mouse MSCs in a model of elastase-induced emphysema...
2018: Stem Cells International
https://www.readbyqxmd.com/read/29731655/immune-regulating-effects-of-exercise-on-cigarette-smoke-induced-inflammation
#13
REVIEW
Ashkan Madani, Katharina Alack, Manuel Jonas Richter, Karsten Krüger
Long-term cigarette smoking (LTCS) represents an important risk factor for cardiac infarction and stroke and the central risk factor for the development of a bronchial carcinoma, smoking-associated interstitial lung fibrosis, and chronic obstructive pulmonary disease. The pathophysiologic development of these diseases is suggested to be promoted by chronic and progressive inflammation. Cigarette smoking induces repetitive inflammatory insults followed by a chronic and progressive activation of the immune system...
2018: Journal of Inflammation Research
https://www.readbyqxmd.com/read/29730892/activation-of-p70s6-kinase-1-in-mesenchymal-stem-cells-is-essential-to-lung-tissue-repair
#14
Katsuyuki Takeda, Fangkun Ning, Joanne Domenico, Masakazu Okamoto, Shigeru Ashino, Sang-Ha Kim, Yi Yeong Jeong, Yoshiki Shiraishi, Naohiro Terada, Everett Rand Sutherland, Erwin W Gelfand
All-trans retinoic acid (ATRA) or mesenchymal stem cells (MSCs) have been shown to promote lung tissue regeneration in animal models of emphysema. However, the reparative effects of the combination of the two and the role of p70S6 kinase-1 (p70S6k1) activation in the repair process have not been defined. Twenty-one days after intratracheal instillation of porcine pancreatic elastase (PPE), MSC and/or 10 days of ATRA treatment was initiated. Thirty-two days later, static lung compliance (Cst), mean linear intercepts (MLIs), and alveolar surface area (S) were measured...
May 5, 2018: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/29728414/t-piece-resuscitators-how-do-they-compare
#15
Murray Hinder, Alistair McEwan, Thomas Drevhammer, Snorri Donaldson, Mark Brian Tracy
BACKGROUND: The T-piece resuscitator (TPR) has seen increased use as a primary resuscitation device with newborns. Traditional TPR design uses a high resistance expiratory valve to produce positive end expiratory pressure (PEEP) or continuous positive airway pressure (CPAP) at resuscitation. A new TPR device that uses a dual flow ratio valve (fluidic flip) to produce PEEP/CPAP is now available (rPAP). We aimed to compare the measured ventilation performance of different TPR devices in a controlled bench test study...
May 4, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29725972/congruence-between-pulmonary-function-and-computed-tomography-imaging-assessment-of-cystic-fibrosis-severity
#16
Anna Rybacka, Joanna Goździk-Spychalska, Adam Rybacki, Tomasz Piorunek, Halina Batura-Gabryel, Katarzyna Karmelita-Katulska
In cystic fibrosis, pulmonary function tests (PFTs) and computed tomography are used to assess lung function and structure, respectively. Although both techniques of assessment are congruent there are lingering doubts about which PFTs variables show the best congruence with computed tomography scoring. In this study we addressed the issue by reinvestigating the association between PFTs variables and the score of changes seen in computed tomography scans in patients with cystic fibrosis with and without pulmonary exacerbation...
May 4, 2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29722490/-ct-scan-in-early-detection-of-lung-cancer-in-patients-with-chronic-obstructive-pulmonary-disease-a-retrospective-monocentric-study
#17
S Takkal, A Van Muylem, P A Gevenois
OBJECTIVE: To explore the possible benefit of detecting lung cancer in COPD patients and to assess the pulmonologist's compliance with the Fleischner Society guidelines for management of pulmonary nodules. METHODS: This monocentric retrospective study was approved by the institutional ethical Committee. Patients with COPD undergoing a CT scan between January 2010 and March 2017 were included. Depending on CT indication (respectively screening or other indications), patients were divided into Group 1 and 2...
2018: Revue Médicale de Bruxelles
https://www.readbyqxmd.com/read/29721820/hypothermic-total-liquid-ventilation-after-experimental-aspiration-associated-acute-respiratory-distress-syndrome
#18
Jérôme Rambaud, Fanny Lidouren, Michaël Sage, Matthias Kohlhauer, Mathieu Nadeau, Étienne Fortin-Pellerin, Philippe Micheau, Luca Zilberstein, Nicolas Mongardon, Jean-Damien Ricard, Megumi Terada, Patrick Bruneval, Alain Berdeaux, Bijan Ghaleh, Hervé Walti, Renaud Tissier
BACKGROUND: Ultrafast cooling by total liquid ventilation (TLV) provides potent cardio- and neuroprotection after experimental cardiac arrest. However, this was evaluated in animals with no initial lung injury, whereas out-of-hospital cardiac arrest is frequently associated with early-onset pneumonia, which may lead to acute respiratory distress syndrome (ARDS). Here, our objective was to determine whether hypothermic TLV could be safe or even beneficial in an aspiration-associated ARDS animal model...
May 2, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29721013/changes-in-hepatic-blood-flow-and-liver-function-during-closed-abdominal-hyperthermic-intraperitoneal-chemotherapy-following-cytoreduction-surgery
#19
Stéphanie Dupont, Eduardo R C Schiffer, Marion J White, John R A Diaper, Marc-Joseph Licker, Philippe C Masouyé
Background: The increase in intra-abdominal pressure (IAP) during closed abdominal hyperthermic intraperitoneal chemotherapy (HIPEC) leads to major haemodynamic changes and potential organ dysfunction. We investigated these effects on hepatic blood flow (HBF) and liver function in patients undergoing HIPEC following cytoreductive surgery and fluid management guided by dynamic preload indices. Methods: In this prospective observational clinical study including 15 consecutive patients, we evaluated HBF by transesophageal echocardiography and liver function by determination of the indocyanine green plasma disappearance rate (ICG-PDR)...
2018: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/29716881/mini-review-chronic-obstructive-pulmonary-disease-its-new-drug-treatments-and-strategies-a-review
#20
Muhammad Hanif, Junaid Qureshi, Hira Ijaz, Muhammad Iqbal Mustafa, Akhtar Rasul, Naeem Amir, Basma Aftab, Ahad Fayyaz
COPD is a complicated disease. Current available treatments are just for symptomatic relief and they cannot reverse the damages to lungs tissues due to alveolar destruction in COPD. Research is being conducted to evaluate new treatments and strategies to find specific treatments to minimize the symptoms of COPD. A new mixture of herbal medicine i.e AKL1 has emerged and thought to cure COPD symptoms especially cough related quality of life of COPD patients. Although, the results have showed no significant difference as compared to placebo but researchers recommend further evaluation in a large population (COPD Patients) group...
May 2018: Pakistan Journal of Pharmaceutical Sciences
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