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https://www.readbyqxmd.com/read/28220822/pulmonary-outcomes-following-specialized-respiratory-management-for-acute-cervical-spinal-cord-injury-a-retrospective-analysis
#1
E C Zakrasek, J L Nielson, J J Kosarchuk, J D Crew, A R Ferguson, S L McKenna
STUDY DESIGN: Retrospective analysis. OBJECTIVES: To identify multivariate interactions of respiratory function that are sensitive to spinal cord injury level and pharmacological treatment to promote strategies that increase successful liberation from mechanical ventilation. SETTING: United States regional spinal cord injury (SCI) treatment center. METHODS: Retrospective chart review of patients consecutively admitted to Santa Clara Valley Medical Center between May 2013 and December 2014 for ventilator weaning with C1-C5 American Spinal Injury Association Impairment Scale (AIS) A or B SCI, <3 months from injury and who had a tracheostomy in place...
February 21, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28203417/clinical-factors-associated-with-weaning-failure-in-patients-requiring-prolonged-mechanical-ventilation
#2
Hong-Joon Shin, Jin-Sun Chang, Seong Ahn, Tae-Ok Kim, Cheol-Kyu Park, Jung-Hwan Lim, In-Jae Oh, Yu-Il Kim, Sung-Chul Lim, Young-Chul Kim, Yong-Soo Kwon
BACKGROUND: For patients requiring prolonged mechanical ventilation (PMV), weaning is difficult and mortality is very high. PMV has been defined recently, by consensus, as constituting ≥21 consecutive days of mechanical ventilation (MV) for ≥6 hours per day. This study aimed to evaluate the clinical factors predicting weaning failure in patients undergoing PMV in medical intensive care unit (ICU). METHODS: We retrospectively reviewed the clinical and laboratory characteristics of 127 patients who received MV for more than 21 days in the medical ICU at Chonnam National University Hospital in South Korea between January 2005 and December 2014...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28194751/juvenile-generalized-pustular-psoriasis-is-a-chronic-recalcitrant-disease-an-analysis-of-27-patients-seen-in-a-tertiary-hospital-in-johor-malaysia
#3
Bi-Wen Lau, Dee-Zhen Lim, Francesca Capon, Jonathan N Barker, Siew-Eng Choon
BACKGROUND: Limited information exists regarding juvenile generalized pustular psoriasis (GPP). We aim to determine the clinical profile and outcome of Malaysians with juvenile GPP. METHODS: Review of hospital case notes on patients with juvenile GPP. RESULTS: Twenty-seven patients with juvenile GPP were identified. Female to male ratio was 1.4:1. The median age at onset of GPP was 6.5 years. Ten patients had prior psoriasis with a median pre-pustular duration of 2...
February 14, 2017: International Journal of Dermatology
https://www.readbyqxmd.com/read/28188062/mechanical-ventilation-in-patients-subjected-to-extracorporeal-membrane-oxygenation-ecmo
#4
M L Sánchez
Mechanical ventilation (MV) is a crucial element in the management of acute respiratory distress syndrome (ARDS), because there is high level evidence that a low tidal volume of 6ml/kg (protective ventilation) improves survival. In these patients with refractory respiratory insufficiency, venovenous extracorporeal membrane oxygenation (ECMO) can be used. This salvage technique improves oxygenation, promotes CO2 clearance, and facilitates protective and ultraprotective MV, potentially minimizing ventilation-induced lung injury...
February 7, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28185611/retrospective-analysis-of-reproductive-performance-of-pair-bred-compared-with-trio-bred-mice
#5
Katherine Wasson
Federal guidelines provide recommendations regarding the minimum of floor space that should be allotted for breedinglaboratory rodents. Mouse mating systems used by a variety of institutions frequently deviate from these recommendations.Regulatory agencies suggest that deviations from established guidelines should be assessed on an institutional basis andrecommend periodic review by the local IACUC. Mouse breeding data, collected in a laboratory animal management softwareprogram at a single institution, were retrospectively analyzed to determine the effects of 2 breeding schemes on reproductiveperformance...
February 9, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28181942/successful-management-of-a-patient-with-possible-mast-cell-activation-syndrome-undergoing-pulmonary-embolectomy-a-case-report
#6
Ellen W Richter, Kai-Ling Hsu, Vanessa Moll
We report the successful perioperative management of a patient with presumed mastocytosis undergoing pulmonary embolectomy. Postoperatively the patient went into vasodilatory shock, which was partly attributed to mast cell mediator release. H1- and H2-antagonists, steroids, and a single dose of methylene blue were given with improvement of hemodynamics. The patient was weaned off vasoactive substances and extubated by postoperative day 2. We discuss the perioperative management of patients with mastocytosis, briefly review the literature concerning anesthetic management for cardiac surgery in patients with this disorder, and discuss our patient's alternative but related diagnosis of idiopathic mast cell activation syndrome...
February 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28173607/review-suggests-that-the-immunoregulatory-and-anti-inflammatory-properties-of-allergenic-foods-can-provoke-oral-tolerance-if-introduced-early-to-infants-diets
#7
REVIEW
Despina-Zoe T Mermiri, Theodora Lappa, Athina L Papadopoulou
: For years, the advice was to postpone introducing allergenic foods, in order to prevent food allergies. However, food allergies have escalated rather than declined and our review of the latest epidemiological, immunological and nutritional research suggests that early weaning practices may be beneficial. The most allergenic foods, such as fish, eggs and peanuts, have proved to be inherently rich in tolerogenic substances that can play a significant role in preventing allergies. CONCLUSION: We found evidence that the immunoregulatory and anti-inflammatory properties of allergenic foods can provoke oral tolerance if introduced early to both low-risk and high-risk infants...
February 7, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28168985/predicting-time-to-full-enteral-nutrition-in-children-after-significant-bowel-resection
#8
Jessica Gonzalez-Hernandez, Purvi Prajapati, Gerald Ogola, Nandini Channabasappa, Barbara Drews, Hannah G Piper
PURPOSE: Parenteral nutrition (PN) contributes to considerable morbidity in children after significant bowel resection. This study evaluates the utility of clinical variables in predicting time to independence from PN. METHODS: After IRB approval, a retrospective review (1999-2012) of 71 children who were on PN for >6weeks after intestinal resection and successfully weaned was performed. Clinical characteristics were evaluated to determine the relationship to time to full enteral nutrition...
January 29, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28168966/extracorporeal-membrane-oxygenation-for%C3%A2-acute-respiratory-distress-syndrome-after-pneumonectomy
#9
Jeremie Reeb, Anne Olland, Julien Pottecher, Xavier Delabranche, Mickael Schaeffer, Stephane Renaud, Nicola Santelmo, Romain Kessler, Gilbert Massard, Pierre-Emmanuel Falcoz
BACKGROUND: Postpneumonectomy acute respiratory distress syndrome (ppARDS) is a life-threatening condition with a disastrous prognosis. This study assessed the efficacy of venovenous extracorporeal membrane oxygenation (VV-ECMO) in adult patients with unresponsive severe ppARDS. METHODS: We retrospectively reviewed data of all patients treated with VV-ECMO for ppARDS from January 2009 to December 2015. We calculated the Sequential Organ Failure Assessment score before ECMO insertion and monitored the subsequent mechanical ventilation settings...
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28168038/echocardiography-for-patients-undergoing-extracorporeal-cardiopulmonary-resuscitation-a-primer-for-intensive-care-physicians
#10
REVIEW
Zhongheng Zhang
Echocardiography is an invaluable tool in the management of patients with extracorporeal cardiopulmonary resuscitation (ECPR) and subsequent extracorporeal membrane oxygenation (ECMO) support and weaning. At the very beginning, echocardiography can identify the etiology of cardiac arrest, such as massive pulmonary embolism and cardiac tamponade. Eliminating these culprits saves life and may avoid the initiation of extracorporeal cardiopulmonary resuscitation. If the underlying causes are not identified or intrinsic to the heart (e...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28159528/therapeutic-hypothermia-may-improve-neurological-outcomes-in-extracorporeal-life-support-for-adult-cardiac-arrest
#11
Philip Y K Pang, Gillian H L Wee, Ming Jie Huang, Anne E E Hoo, Ismail Mohamed Tahir Sheriff, See Lim Lim, Teing Ee Tan, Yee Jim Loh, Victor T T Chao, Jia Lin Soon, Ka Lee Kerk, Zakir Hussain Abdul Salam, Yoong Kong Sin, Chong Hee Lim
BACKGROUND: Limited data exists on patients receiving therapeutic hypothermia during extracorporeal life support (ECLS). We investigated outcomes and prognostic factors in these patients. METHODS: A retrospective review was conducted for 225 consecutive adult patients treated with ECLS between July 2003 and January 2016. Extracorporeal life support was initiated for refractory cardiac arrest (>10 mins) in 79 patients (35.1%). Patient demographics, ECLS-related complications, in-hospital mortality and neurological outcomes were analysed...
January 17, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28149511/the-development-and-role-of-microbial-host-interactions-in-gut-mucosal-immune-development
#12
REVIEW
C R Stokes
At birth the piglet's immune system is immature and it is dependent upon passive maternal protection until weaning. The piglet's mucosal immune system develops over the first few weeks but has not reached maturity at weaning ages which are common on commercial farms. At weaning piglets are presented with a vast and diverse range of microbial and dietary/environmental antigens. Their ability to distinguish between antigens and mount a protective response to potential pathogens and to develop tolerance to dietary antigens is critical to their survival and failure to do so is reflected in the high incidence of morbidity and mortality in the post-weaning period...
2017: Journal of Animal Science and Biotechnology
https://www.readbyqxmd.com/read/28135001/critical-illness-myopathy-cim-and-ventilator-induced-diaphragm-muscle-dysfunction-vidd-acquired-myopathies-affecting-contractile-proteins
#13
Lars Larsson, Oliver Friedrich
Critical care and intensive care units (ICUs) have undergone dramatic changes and improvements in recent years, and critical care is today one of the fastest growing hospital disciplines. Significant improvements in treatments, removal of inefficient and harmful interventions, and introduction of advanced technological support systems have improved survival among critically ill ICU patients. However, the improved survival is associated with an increased number of patients with complications related to modern critical care...
December 6, 2016: Comprehensive Physiology
https://www.readbyqxmd.com/read/28131790/-patients-experience-during-weaning-of-invasive-mechanical-ventilation-a-review-of-the-literature
#14
M E Merchán-Tahvanainen, C Romero-Belmonte, M Cundín-Laguna, P Basterra-Brun, A San Miguel-Aguirre, E Regaira-Martínez
OBJECTIVE: Weaning from invasive mechanical ventilation (IMV) is influenced by physiological and psychological factors, the latter being the least studied. The aim was to identify, through the literature, patients' experiences during weaning from IMV and report its influencing factors. METHOD: The literature search was conducted using the Pubmed, CINAHL and PsycINFO databases. The search terms were: "patient", "experience" and "ventilator weaning". The research limits were: age (>19years) and language (English, Spanish and Finnish)...
January 25, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/28118263/outcomes-of-minimally-invasive-temporary-rvad-support-for-acute-right-ventricular-failure-during-minimally-invasive-lvad-implantation
#15
Andreas Schaefer, Daniel Reichart, Alexander M Bernhardt, Mathias Kubik, Markus J Barten, Florian M Wagner, Hermann Reichenspurner, Sebastian A Philipp, Tobias Deuse
Right ventricular failure (RVF) may still occur despite the benefits of minimally-invasive left ventricular assist device (MI-LVAD) implantation. Our center strategy aims to avoid aggressive postoperative inotrope use by utilizing mechanical support to facilitate RV recovery and adaptation. We herein report first outcomes of patients with minimally-invasive temporary right ventricular assist device (MI-t-RVAD) support for RVF during MI-LVAD implantation.RVF was defined as requiring more than moderate inotopic support after weaning from cardiopulmonary bypass according to INTERMACS adverse event definitions...
January 20, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28117330/successful-tracheostomy-decannulation-after-complete-or-sensory-incomplete-cervical-spinal-cord-injury
#16
D H Kim, S W Kang, W A Choi, H J Oh
STUDY DESIGN: Retrospective study. OBJECTIVES: To report the successful tracheostomy decannulation/extubation in cervical spinal cord injury (C-SCI) patients. SETTING: Tertiary university hospital, pulmonary rehabilitation center. METHODS: Complete or sensory incomplete C-SCI patients who had received invasive acute phase respiratory management, and succeeded in decannulation/extubation became candidates of this study...
January 24, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28109052/the-use-of-methadone-to-facilitate-opioid-weaning-in-pediatric-critical-care-patients-a-systematic-review-of-the-literature-and-meta-analysis
#17
REVIEW
Leslie A Dervan, Beryl Yaghmai, Robert Scott Watson, Fredric M Wolf
BACKGROUND: Continuous opioid infusion therapy is commonly utilized in the pediatric intensive care setting to treat pain and facilitate tolerance of invasive therapies. Transitioning to methadone is one common strategy for weaning from continuous opioid infusions, but in practice this transition can be challenging, and many children still experience iatrogenic withdrawal. AIM: We reviewed the literature to evaluate the best available evidence to guide methadone therapy in this setting, and to summarize associated adverse events...
January 20, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28104501/esotropia-with-an-accommodative-component-after-surgery-for-infantile-esotropia-compared-to-primary-accommodative-esotropia
#18
Kyung-Ah Park, Sei Yeul Oh
PURPOSE: To compare the clinical outcomes of patients with an esotropia with an accommodative component after infantile esotropia surgery and patients with primary refractive accommodative esotropia. METHODS: The medical records of patients with postoperative (secondary group) and primary refractive accommodative esotropia (primary group) were reviewed retrospectively. Changes in ocular alignment, refractive error, weaning rate, decompensation rate over time, and sensory outcomes were compared...
January 16, 2017: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/28102699/tracheostomy-weaning-outcomes-in-relation-to-the-site-of-acquired-brain-injury-a-retrospective-case-series
#19
Kay Mitton, Krystyna Walton, Manoj Sivan
OBJECTIVE: To analyse whether the outcome of tracheostomy weaning is influenced by the site of injury in acquired brain injury. METHODS: A retrospective case review of all the consecutive admissions to an acute neurorehabilitation unit in a 2-year period was performed. Patients with a diagnosis of acquired brain injury and tracheostomy in situ were included in this study. RESULTS: One hundred and six patients were included in the analysis...
2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28098775/mammary-gland-involution-provides-a-unique-model-to-study-the-tgf-%C3%AE-cancer-paradox
#20
REVIEW
Qiuchen Guo, Courtney Betts, Nathan Pennock, Elizabeth Mitchell, Pepper Schedin
Transforming Growth Factor-β (TGF-β) signaling in cancer has been termed the "TGF-β paradox", acting as both a tumor suppresser and promoter. The complexity of TGF-β signaling within the tumor is context dependent, and greatly impacted by cellular crosstalk between TGF-β responsive cells in the microenvironment including adjacent epithelial, endothelial, mesenchymal, and hematopoietic cells. Here we utilize normal, weaning-induced mammary gland involution as a tissue microenvironment model to study the complexity of TGF-β function...
January 13, 2017: Journal of Clinical Medicine
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