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https://www.readbyqxmd.com/read/28346081/pneumocystis-jiroveci-pneumonia-pjp-in-non-hiv-immunocompromised-individuals
#1
Kathleen Schoovaerts, Luc Dirix, Annemie Rutten, Jef Van Schaeren, Bruno Van Herendael, Sofie Van Grieken, Luc Heytens
OBJECTIVES: PJP is a major cause of morbidity and mortality in immunocompromised individuals. Diagnosing PJP is often difficult because respiratory signs might be minimal or absent and the sensitivity of a chest X-ray (CXR) is low. We studied the clinical risk factors in order to increase awareness and facilitate the diagnosis. METHODS: We studied a prospective case series over a one year period (from 1 January 2015 to 1 January 2016) and did a retrospective analysis (from 2013 to 2016) of all PJP positive bronchoalveolar lavage (BAL) analysis...
March 27, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28339789/early-treatment-gains-for-antibiotic-administration-and-within-human-host-time-series-data
#2
Todd R Young, Erik M Boczko
As technological improvements continue to infiltrate and impact medical practice, it has become possible to non-invasively collect dense physiological time series data from individual patients in real time. These advances continue to improve physicians' ability to detect and to treat infections early. One important benefit of early detection and treatment of nascent infections is that it leads to earlier resolution. In response to current and anticipated advances in data capture, we introduce the Early Treatment Gain (ETG) as a measure to quantify this benefit...
February 18, 2017: Mathematical Medicine and Biology: a Journal of the IMA
https://www.readbyqxmd.com/read/28339309/the-use-of-non-invasive-ventilation-during-exercise-training-in-copd-patients
#3
Nicolino Ambrosino, Lixin Xie
Non-invasive ventilation (NIV) is increasingly used in addition to exercise training in patients with chronic obstructive pulmonary disease with the purpose to allow them to train at higher intensities. Different modalities of assisted ventilation have been used with benefits for relief of dyspnoea and increase in exercise capacity. Nevertheless there are some potential problems with the use of NIV in pulmonary rehabilitation programmes. Despite promising results, a generalised use of NIV during exercise training programmes is unlikely to have a role in routine settings...
March 24, 2017: COPD
https://www.readbyqxmd.com/read/28337439/a-brief-review-of-non-invasive-monitoring-of-respiratory-condition-for-extubated-patients-with-or-at-risk-for-obstructive-sleep-apnea-after-surgery
#4
REVIEW
Xuezheng Zhang, Mahmoud Attia Mohamed Kassem, Ying Zhou, Muhammad Shabsigh, Quanguang Wang, Xuzhong Xu
Obstructive sleep apnea (OSA) is one of the important risk factors contributing to postoperative airway complications. OSA alters the respiratory physiology and increases the sensitivity of muscle tone of the upper airway after surgery to residual anesthetic medication. In addition, the prevalence of OSA was reported to be much higher among surgical patients than the general population. Therefore, appropriate monitoring to detect early respiratory impairment in postoperative extubated patients with possible OSA is challenging...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28330686/imaging-of-acute-and-chronic-thromboembolic-disease-state-of-the-art
#5
REVIEW
A Ruggiero, N J Screaton
Acute pulmonary embolism (PE) is a life-threatening condition that requires prompt diagnosis and treatment. Recent advances in imaging allow acute and rapid recognition even by the non-specialist radiologist. Most acute emboli resolve on anticoagulation without sequelae; however, some emboli fail to fully resolve becoming endothelialised with the development of chronic thromboembolic disease (CTED). Increased pulmonary vascular resistance arising from CTED may lead to chronic thromboembolic pulmonary hypertension (CTEPH) a debilitating disease affecting up to 5% of survivors of acute PE...
March 19, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28330506/clonidine-for-sedation-in-the-critically-ill-a-systematic-review-and-meta-analysis
#6
Jing Gennie Wang, Emilie Belley-Coté, Lisa Burry, Mark Duffett, Timothy Karachi, Dan Perri, Waleed Alhazzani, Frederick D'Aragon, Hannah Wunsch, Bram Rochwerg
BACKGROUND: This systematic review and meta-analysis investigates the efficacy and safety of clonidine as a sedative in critically ill patients requiring invasive mechanical ventilation. METHODS: We performed a comprehensive search of MEDLINE, EMBASE, CINAHL and the Cochrane trial registry. We identified RCTs that compared clonidine to any non-clonidine regimen in critically ill patients, excluding neonates, requiring mechanical ventilation. The GRADE method was used to assess certainty of evidence...
February 25, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28329427/what-drives-perceived-work-intensity-in-neonatal-intensive-care-units-empirical-evidence-from-a-longitudinal-study
#7
Sandra Sülz, Kristina Langhammer, Michael Becker-Peth, Bernhard Roth
AIM: To investigate the drivers of perceived work intensity among neonatal intensive care unit nurses. BACKGROUND: The consequences of high work intensity have been studied extensively, yet setting-specific drivers have received less attention. DESIGN: Prospective, longitudinal and monocentric study design. METHODS: The study combined data from standardized diary surveys and passive observations of study nurses. Data were collected over a period of six months in 2015...
March 22, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28329277/resting-right-ventricular-function-is-associated-with-exercise-performance-in-pah-but-not-in-cteph
#8
Michaela Beatrice Rehman, Luke S Howard, Luc P Christiaens, Dipender Gill, J Simon R Gibbs, Petros Nihoyannopoulos
Aims: To assess whether resting right ventricular (RV) function assessed by Global RV longitudinal strain (RVLS) and RV fractional area change (FAC) is associated with exercise performance in pulmonary arterial hypertension (PAH) and in chronic thromboembolic pulmonary hypertension (CTEPH). Methods and results: We prospectively recruited 46 consecutive patients with PAH and 42 patients with CTEPH who were referred for cardio-pulmonary exercise testing (CPET) and transthoracic echocardiography...
February 27, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28328654/outcomes-for-children-receiving-noninvasive-ventilation-as-the-first-line-mode-of-mechanical-ventilation-at-intensive-care-admission-a-propensity-score-matched-cohort-study
#9
Jenny V Morris, Padmanabhan Ramnarayan, Roger C Parslow, Sarah J Fleming
OBJECTIVES: To compare outcomes of children receiving noninvasive ventilation with those receiving invasive ventilation as first-line mode of mechanical ventilation following unplanned intensive care admission. DESIGN: Propensity score-matched cohort study analyzing data prospectively collected by the Pediatric Intensive Care Audit Network over 8 years (2007-2014). SETTING: Thirty-one PICUs in the United Kingdom and Ireland; twenty-one of whom submitted Pediatric Critical Care Minimum Dataset data for the entire study period...
March 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28315940/a-multi-faceted-strategy-to-reduce-ventilation-associated-mortality-in-brain-injured-patients-the-bi-vili-project-a-nationwide-quality-improvement-project
#10
Karim Asehnoune, Ségolène Mrozek, Pierre François Perrigault, Philippe Seguin, Claire Dahyot-Fizelier, Sigismond Lasocki, Anne Pujol, Mathieu Martin, Russel Chabanne, Laurent Muller, Jean Luc Hanouz, Emmanuelle Hammad, Bertrand Rozec, Thomas Kerforne, Carole Ichai, Raphael Cinotti, Thomas Geeraerts, Djillali Elaroussi, Paolo Pelosi, Samir Jaber, Marie Dalichampt, Fanny Feuillet, Véronique Sebille, Antoine Roquilly
PURPOSE: We assessed outcomes in brain-injured patients after implementation of a multi-faceted approach to reduce respiratory complications in intensive care units. METHODS: Prospective nationwide before-after trial. Consecutive adults with acute brain injury requiring mechanical ventilation for ≥24 h in 20 French intensive care units (ICUs) were included. The management of invasive ventilation in brain-injured patients admitted between 1 July 2013 and 31 October 2013 (4 months) was monitored and analysed...
March 18, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28301327/high-resolution-respiratory-inductive-plethysmography-in-rats-validation-in-anesthetized-conditions
#11
Timothe Flenet, Julie Fontecave-Jallon, Pierre-Yves Gumery, Charles Eynard, Francois Boucher, Pierre Baconnier, Stephane Tanguy
Respiratory monitoring is often required in experimental physiological and pharmacological studies in rodents. Currently, the mostly used techniques are direct measurement of airflow on intubated animals and whole body plethysmography. Although the reliability of these methods has been broadly demonstrated, they also have several drawbacks such as invasiveness, high cost of use or confinement of the animals. Respiratory Inductive Plethysmography (RIP) is a non-invasive technique already used in medium-sized mammals that has not yet been evaluated in small rodents...
March 16, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28294083/tensor-veli-palatini-electromyography-for-monitoring-eustachian-tube-rehabilitation-in-otitis-media
#12
P M Picciotti, G Della Marca, L D'Alatri, D Lucidi, M Rigante, E Scarano
BACKGROUND: The pathogenesis of otitis media is related to Eustachian tube dysfunction. The tensor veli palatini muscle actively opens the Eustachian tube and promotes middle-ear ventilation. This study describes a technique for paratubal electromyography that uses a surface, non-invasive electrode able to record tensor veli palatini muscle activity during swallowing. METHODS: Twenty otitis media patients and 10 healthy patients underwent tensor veli palatini electromyography...
March 15, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28288605/switch-of-noninvasive-ventilation-niv-to-continuous-positive-airway-pressure-cpap-in-patients-with-obesity-hypoventilation-syndrome-a-pilot-study
#13
Sarah Orfanos, Dany Jaffuel, Christophe Perrin, Nicolas Molinari, Pascal Chanez, Alain Palot
BACKGROUND: Obesity is a major worldwide public health issue. The main respiratory complication stemming from obesity is obesity hypoventilation syndrome (OHS). Most of the OHS patients diagnosed during an exacerbation are treated with non invasive ventilation (NIV). Up to date, no prospective study has demonstrated in real life conditions the feasibility of a systematic protocoled switch of NIV to continuous positive airway pressure (CPAP), once stability is achieved. METHODS: In this prospective study, we included stable patients with OHS, with moderate to severe concomitant obstructive sleep apnea (OSA) and without obstructive pulmonary disease, who had been undergoing NIV for more than 2 months...
March 14, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28288233/-dress-syndrome-in-paediatrics-clinical-case
#14
Marcos Silva-Feistner, Elena Ortiz, María Jesús Rojas-Lechuga, Daniel Muñoz
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare, potentially life-threatening, drug-induced hypersensitivity reaction that includes skin eruption, haematological abnormalities, lymphadenopathy, and internal organ involvement. OBJECTIVE: Presenting a rare condition in children, to facilitate a rapid diagnostic suspicion and recognition by doctors. CASE REPORT: An 9 months old infant admitted due to a severe viral pneumonia, managed with non-invasive ventilation and ceftriaxone...
February 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28287810/evaluation-of-initial-respiratory-support-strategies-in-vlbw-neonates-with-rds
#15
Seyyed Abolfazl Afjeh, Mohammad Kazem Sabzehei, Maryam Khoshnood Shariati, Ahmad Reza Shamshiri, Fatemeh Esmaili
BACKGROUND: Non-invasive ventilation (NIV) has brought about a significant change in care and treatment of respiratory distress syndrome (RDS) in very low birth weight (VLBW) neonates. The present study was designed and conducted to evaluate different strategies of initial respiratory support (IRS) in VLBW neonates hospitalized in the neonatal intensive care unit (NICU). METHODS: This prospective study was conducted over three years (March 21, 2011 to March 20, 2014)...
March 2017: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/28286784/the-influence-of-metabolic-imbalances-and-oxidative-stress-on-the-outcome-of-critically-ill-polytrauma-patients-a-review
#16
REVIEW
Alexandru Florin Rogobete, Dorel Sandesc, Marius Papurica, Emil Robert Stoicescu, Sonia Elena Popovici, Lavinia Melania Bratu, Corina Vernic, Adriana Mariana Sas, Adrian Tudor Stan, Ovidiu Horea Bedreag
The critically ill polytrauma patient presents with a series of associated pathophysiologies secondary to the traumatic injuries. The most important include systemic inflammatory response syndrome (SIRS), sepsis, oxidative stress (OS), metabolic disorders, and finally multiple organ dysfunction syndrome (MODS) and death. The poor outcome of these patients is related to the association of the aforementioned pathologies. The nutrition of the critically ill polytrauma patient is a distinct challenge because of the rapid changes in terms of energetic needs associated with hypermetabolism, sepsis, SIRS, and OS...
2017: Burns and trauma
https://www.readbyqxmd.com/read/28283771/non-invasive-ventilation-for-acute-hypercapnic-respiratory-failure-in-older-patients
#17
Fatma Çiftci, Aydın Çiledağ, Serhat Erol, Akın Kaya
BACKGROUND: This trial was conducted to carry out an age and etiology-based analysis of the clinical efficacy of non-invasive ventilation (NIV) in acute hypercapnic respiratory failure (AHRF). METHODS: This single center, prospective, cohort study included patients aged ≥65 years with chronic obstructive pulmonary disease (COPD), acute cardiogenic pulmonary edema (ACPE), community-acquired pneumonia (CAP), bronchiectasis, and kyphoscoliosis, who were treated with NIV for AHRF in the intensive care unit within a 4-year period...
March 10, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28277990/preventing-facial-pressure-ulcers-in-patients-under-non-invasive-mechanical-ventilation-a-randomised-control-trial
#18
D Peña Otero, D Vazquez Domínguez, L Hernanz Fernández, A Santano Magariño, V Jimenez González, J V García Klepzing, J V Beneit Montesinos
OBJECTIVE: To comparatively assess the efficacy of four different therapeutic strategies to prevent the development of facial pressure ulcers (FPUs) related to the use of non-invasive mechanical ventilation (NIV) with oro-nasal masks in critically ill hospitalised patients. METHOD: This randomised control trial was performed at the high dependency unit in the University General Hospital Gregorio Marañón in Madrid, Spain. Overall, 152 patients with acute respiratory failure were recruited...
March 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28273700/-ventilator-associated-pneumonia-among-premature-infants-34-weeks-gestational-age-in-neonatal-intensive-care-unit-in-china-a-multicenter-study
#19
S J Li, S Y Yan, Y Zhou, K L E E Han, W L Guo, Q Xia, S P Vibhuti, J Z Wang, S W Ji, S H A H Yang, S N Yang, C Shan, C Y Liu, Z Z Yi, R B Liu, L Lin, B Wang, J Q He, Z L Li, Y Pan, L Guo, M X Chen, X N Liu, Y Zhou, L Li, C Q Xiong, Q Qi, X Y Hei, J Cao, Y J Jiang, M Y Zhang, Y Shoo
Objective: To investigate the incidence and pathogen distribution of ventilator-associated pneumonia (VAP) among preterm infants admitted to level Ⅲ neonatal intensive care units (NICU) in China. Method: A prospective study was conducted in 25 level Ⅲ NICU, enrolling all preterm infants <34 weeks gestational age admitted to the participating NICU within the first 7 days of life from May 2015 to April 2016. Chi-square test, t test and Mann-Whitney U test were used for statistical analysis. Result: A total of 7 918 patients were enrolled, within whom 4 623(58...
March 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28260695/non-invasive-breath-monitoring-with-enose-does-not-improve-glucose-diagnostics-in-critically-ill-patients-in-comparison-to-continuous-glucose-monitoring-in-blood
#20
Jan Hendrik Leopold, Lieuwe Bos, Camilla Colombo, Peter Sterk, Marcus Schultz, Ameen Abu-Hanna
INTRODUCTION: Continuous glucose monitoring (CGM) can be beneficiary in critically ill patients. Current CGM devices rely on subcutaneous or blood plasma glucose measurements and consequently there is an increased risk of infections and the possibility of loss of blood with each measurement. A potential method to continuously and non-invasively measure blood glucose levels is using exhaled breath. A correlation between blood glucose levels and volatile organic compounds (VOCs) in the exhaled breath was already reported...
March 6, 2017: Journal of Breath Research
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