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https://www.readbyqxmd.com/read/29684374/single-center-experience-of-tracheobronchoplasty-for-tracheobronchomalacia-perioperative-outcomes
#1
Daniel H Buitrago, Adnan Majid, Daniel E Alape, Jennifer L Wilson, Mihir Parikh, Michael S Kent, Sidhu P Gangadharan
BACKGROUND: We aimed to present trends in practice as our experience has grown, and report the postoperative morbidity and its associated factors following tracheobronchoplasty. METHODS: Retrospective cohort study conducted in 161 patients who underwent tracheobronchoplasty from October 2002-September 2016. The main outcome was development of a postoperative complication within 30 days of surgery. Postoperative complication events were graded using the Clavien-Dindo system...
April 20, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29684317/portable-sleep-monitoring-for-diagnosing-sleep-apnea-in-hospitalized-patients-with-heart-failure
#2
R Nisha Aurora, Susheel P Patil, Naresh M Punjabi
BACKGROUND: Sleep apnea is an underdiagnosed condition in patients with heart failure. Efficient identification of sleep apnea is needed as treatment may improve heart failure-related outcomes. Currently, use of portable sleep monitoring in hospitalized patients and those at risk for central sleep apnea is discouraged. This study examined if portable sleep monitoring with respiratory polygraphy can accurately diagnose sleep apnea in patients hospitalized with decompensated heart failure...
April 20, 2018: Chest
https://www.readbyqxmd.com/read/29683463/a-closed-chest-model-to-induce-transverse-aortic-constriction-in-mice
#3
Lars Eichhorn, Christina Katharina Weisheit, Christopher Gestrich, Konrad Peukert, Georg Daniel Duerr, Muhammad Ajmal Ayub, Felix Erdfelder, Florian Stöckigt
Research on cardiac hypertrophy and heart failure is frequently based on pressure overload mouse models induced by TAC. The standard procedure is to perform a partial thoracotomy to visualize the transverse aortic arch. However, the surgical trauma caused by the thoracotomy in open-chest models changes the respiratory physiology as the ribs are dissected and left unattached after chest closure. To prevent this, we established a minimally invasive, closed chest approach via lateral thoracotomy. Herein we approach the aortic arch via the 2nd intercostal space without entering the chest cavities, leaving the mouse with a less traumatic injury to recover from...
April 5, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29683419/haemagglutinin-neuraminidase-from-hpiv3-mediates-human-nk-regulation-of-t-cell-proliferation-via-nkp44-and-nkp46
#4
Samantha McQuaid, Sinead Loughran, Patrick Power, Paula Maguire, Dermot Walls, Maria Grazia Cusi, Claes Orvell, Patricia Johnson
HPIV3 is a respiratory virus causing airway diseases, including pneumonia, croup, and bronchiolitis, during infancy and childhood. Currently there is no effective vaccine or anti-viral therapy for this virus. Studies have suggested that poor T cell proliferation following HPIV3 infection is responsible for impaired immunological memory associated with this virus. We have previously demonstrated that NK cells mediate regulation of T cell proliferation during HPIV3 infection. Here we add to these studies by demonstrating that the regulation of T cell proliferation during HPIV3 infection is mediated via NK receptors NKp44 and NKp46 and involves the surface glycoprotein haemagglutinin-neuraminidase but not the fusion protein of the virus...
April 23, 2018: Journal of General Virology
https://www.readbyqxmd.com/read/29683055/high-frequency-percussive-ventilation-rescue-therapy-in-morbidly-obese-patients-failing-conventional-mechanical-ventilation
#5
Anatoliy Korzhuk, Ashwad Afzal, Ivan Wong, Felix Khusid, Berhane Worku, Iosif Gulkarov
BACKGROUND: Morbidly obese patients with respiratory failure who do not improve on conventional mechanical ventilation (CMV) often undergo rescue therapy with extracorporeal membrane oxygenation (ECMO). We describe our experience with high-frequency percussive ventilation (HFPV) as a rescue modality. METHODS: In a retrospective analysis from 2009 to 2016, 12 morbidly obese patients underwent HFPV after failing to wean from CMV. Data were collected regarding demographics, cause of respiratory failure, ventilation settings, and hospital course outcomes...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29682713/-risk-factors-of-anastomotic-leakage-after-anterior-resection-for-rectal-cancer-and-the-diagnostic-value-of-computed-tomography-signs-in-anastomotic-leakage
#6
Junling Zhang, Xiaochao Guo, Jixin Zhang, Jing Liu, Tao Wu, Pengyuan Wang, Guowei Chen, Yong Jiang, Yingchao Wu, Xin Wang
OBJECTIVE: To investigate the risk factors and computed tomography (CT) diagnostic accuracy of anastomotic leakage after resection of rectal cancer (Dixon). METHODS: This retrospective study was conducted in Peking University First Hospital from January 2013 to June 2015. A cohort of 452 patients with rectal cancer was enrolled in the study. All the patients underwent anterior resection. The relationship between clinical-pathological data (including sex, age, body mass index (BMI), presence of diabetes, hypohemoglobin (Hb<90 g/L), hypoalbuminemia (Alb<35 g/L), the distance from the lower edge of the tumors to the anus, tumor diameter, tumor differentiation, tumor TNM stage, neoadjuvant therapy status, ligation of the left colonic artery(LCA), preventive colostomy, and anastomotic leakage was analyzed retrospectively...
2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29682432/an-unusually-aggressive-large-cell-carcinoma-of-the-lung-undiagnosed-until-autopsy
#7
Kartikeya Rajdev, Abdul Hasan Siddiqui, Uroosa Ibrahim, Prateek Patibandla, Tahir Khan, Dany El-Sayegh
Large cell carcinoma (LCC) of the lung has a rapid mean volume doubling time (VDT) of around 67-134 days. In some cases of LCC where the VDT is extremely rapid, clinical presentation may mimic acute lung pathologies such as pneumonia. We describe a rare presentation of an aggressive LCC of the lung with an estimated VDT of around two weeks. A 52-year-old male with a history schizophrenia presented with fever, cough, and dyspnea for three weeks duration. His medical history was significant for a recent admission six weeks before current presentation for myocardial infarction (MI) and pneumonia...
February 19, 2018: Curēus
https://www.readbyqxmd.com/read/29681814/non-gestational-choriocarcinoma-with-widespread-metastases-presenting-with-type-1-respiratory-failure-in-a-39-year-old-female-case-report-and-review-of-the-literature
#8
Louisa Stockton, Elizabeth Green, Baljeet Kaur, Emma De Winton
Introduction: Non-gestational choriocarcinoma (NGCC) is an extremely rare cancer. We report a case presenting in extremis. Case Report: A 39-year-old woman presented with type 1 respiratory failure with a 1-month history of breathlessness. Computed tomography (CT) revealed widespread metastatic disease involving the lungs, liver, pancreas, and breast. Serum β-human chorionic gonadotropin was markedly raised. Over 72 h, she deteriorated and was started on high-flow nasal cannula to facilitate discussions and for comfort...
January 2018: Case Reports in Oncology
https://www.readbyqxmd.com/read/29681203/the-immunotherapy-of-guillain-barr%C3%A3-syndrome
#9
Paula Restrepo-Jiménez, Yhojan Rodríguez, Paulina González, Christopher Chang, M Eric Gershwin, Juan-Manuel Anaya
Guillain-Barré syndrome is the most common cause of acute flaccid paralysis worldwide. Microorganisms such as Campylobacter jejuni, Cytomegalovirus, Epstein-Barr virus, Mycoplasma pneumoniae, Haemophilus influenza and Zika virus have been linked to the disease. The most common clinical variants are acute inflammatory demyelinating polyneuropathy and acute motor axonal neuropathy. Plasma exchange and intravenous immunoglobulins are the standard therapy for the disease. Areas covered: research to elucidate the pathophysiology of Guillain-Barré syndrome has led to the development of drugs directed towards new potential therapeutic targets...
April 23, 2018: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/29681105/lethal-persistent-pulmonary-hypertension-of-the-newborn-in-bohring-opitz-syndrome
#10
Masaya Kibe, Satoshi Ibara, Hidehito Inagaki, Takema Kato, Hiroki Kurahashi, Toshiro Ikeda
Bohring-Opitz syndrome (BOS) is a rare disease with a number of characteristic features, including hypertelorism, prominent metopic suture, exophthalmos, cleft palate, abnormal posture, and developmental retardation. Here, we report a BOS patient presenting with lethal persistent pulmonary hypertension of the newborn (PPHN) and inspiratory respiratory failure. The female infant was treated with nitric oxide and vasodilator, which did not improve her condition. The inspiratory respiratory failure required management with deep sedation...
May 2018: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/29680812/a-smartphone-application-for-reporting-symptoms-in-adults-with-cystic-fibrosis-protocol-of-a-randomised-controlled-trial
#11
Jamie Wood, Sue Jenkins, David Putrino, Siobhain Mulrennan, Sue Morey, Nola Cecins, Kylie Hill
INTRODUCTION: In people with cystic fibrosis (CF), exacerbations have been shown to have profound and prolonged negative effects such as reducing physical activity and health-related quality of life, increasing the rate of decline of lung function and healthcare costs, and ultimately increasing the risk of mortality. Delayed initiation of treatment following the signs of an exacerbation has been shown to be associated with failure to recover to baseline. Therefore, the late identification and treatment of an exacerbation due to delayed presentation will potentially worsen short-term and long-term outcomes...
April 21, 2018: BMJ Open
https://www.readbyqxmd.com/read/29680810/association-of-seasonal-viral-acute-respiratory-infection-with-pneumococcal-disease-a-systematic-review-of-population-based-studies
#12
You Li, Meagan E Peterson, Harry Campbell, Harish Nair
OBJECTIVE: Animal and in vitro studies suggest that viral acute respiratory infection (VARI) can predispose to pneumococcal infection. These findings suggest that the prevention of VARI can yield additional benefits for the control of pneumococcal disease (PD). In population-based studies, however, the evidence is not in accordance, possibly due to a variety of methodological challenges and problems in these studies. We aimed to summarise and critically review the methods and results from these studies in order to inform future studies...
April 21, 2018: BMJ Open
https://www.readbyqxmd.com/read/29680792/-pneumocystis-jiroveci-pneumonia-in-a-patient-taking-benepali-for-rheumatoid-arthritis
#13
Kay Frances Graham, Anne McEntegart
We present a case of a 57-year-old woman who contracted Pneumocystis jiroveci pneumonia while on Benepali, the biosimilar version of etanercept for rheumatoid arthritis. She had seropositive erosive disease. She was admitted to clinic with a 2-week history of dyspnoea, dry cough and fever. Her initial examination showed her to be hypoxic on air with saturations of 77% and left basal crackles. Her admission chest X-ray showed fine reticular shadowing, with an initial suspicion of pulmonary fibrosis. She was empirically treated for community-acquired pneumonia but continued to deteriorate with a worsening type 1 respiratory failure...
April 21, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29679597/management-of-dyspnea-in-the-terminally-ill
#14
REVIEW
Lara Pisani, Nicholas S Hill, Angela Maria Grazia Pacilli, Massimiliano Polastri, Stefano Nava
The genesis of dyspnea involves the activation of several mechanisms that are mediated and perceived depending on previous experiences, values, emotions and beliefs. Breathlessness may become unbearable, especially in terminally ill patients, whether afflicted by respiratory, cardiac or cancer-related disorders, due to a final stage of a chronic process, an acute event or both. Compared to pain, palliation of dyspnea has received relatively little attention in clinical practice and the medical literature. This is particularly true when the breathlessness is associated with acute respiratory failure since most of the studies on pharmacological and non-pharmacological treatments of respiratory distress have excluded such patients...
April 18, 2018: Chest
https://www.readbyqxmd.com/read/29679387/the-pharmacokinetics-and-pharmacodynamics-of-carfentanil-after-recreational-exposure-a-case-report
#15
Uvaraj Uddayasankar, Colin Lee, Curtis Oleschuk, Gregg Eschun, Robert E Ariano
Carfentanil and related fentanyl analogues have been linked to a number of overdose deaths from drug users in several cities across North America. Diagnosis of carfentanil exposure requires a very high index of clinical suspicion, especially because available laboratory narcotic screens do not detect this agent. We describe a 34-year-old male admitted with depressed level of consciousness and in respiratory failure after recreational exposure to a white powder later inferred to contain carfentanil. Urine and whole blood samples were obtained for conventional preliminary drug screen immunoassays for unknown exposures; in addition to utilizing high pressure liquid chromatography tandem mass spectrometry assay for quantification of carfentanil and its metabolite...
April 20, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29676798/afferent-neural-feedback-overrides-the-modulating-effects-of-arousal-hypercapnia-and-hypoxemia-on-neonatal-cardio-respiratory-control
#16
Kathleen J Lumb, Jennifer M Schneider, Thowfique Ibrahim, Anita Rigaux, Shabih U Hasan
KEY POINTS: Evidence at whole animal, organ-system, and cellular and molecular levels suggests that afferent volume feedback is critical for establishment of adequate ventilation at birth. Due to the irreversible nature of vagal ablation studies to date, it was difficult to quantify the roles of afferent volume input, arousal and changes in blood gas tensions on neonatal respiratory control. During reversible perineural vagal block, profound apneas, and hypoxemia and hypercarbia were observed necessitating termination of perineural blockade...
April 20, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29675709/acid-base-status-and-its-clinical-implications-in-critically-ill-patients-with-cirrhosis-acute-on-chronic-liver-failure-and-without-liver-disease
#17
Andreas Drolz, Thomas Horvatits, Kevin Roedl, Karoline Rutter, Richard Brunner, Christian Zauner, Peter Schellongowski, Gottfried Heinz, Georg-Christian Funk, Michael Trauner, Bruno Schneeweiss, Valentin Fuhrmann
BACKGROUND: Acid-base disturbances are frequently observed in critically ill patients at the intensive care unit. To our knowledge, the acid-base profile of patients with acute-on-chronic liver failure (ACLF) has not been evaluated and compared to critically ill patients without acute or chronic liver disease. RESULTS: One hundred and seventy-eight critically ill patients with liver cirrhosis were compared to 178 matched controls in this post hoc analysis of prospectively collected data...
April 19, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29675258/livedo-reticularis-a-cutaneous-clue-to-an-underlying-endocrine-crisis
#18
Natasha Shrikrishnapalasuriyar, Mirena Noyvirt, Philip Evans, Bethan Gibson, Elin Foden, Atul Kalhan
A 54-year-old woman was admitted to hospital with a presumed allergic reaction to a single dose of amoxicillin given for a suspected upper respiratory tract infection. She complained of chest tightness although there was no wheeze or stridor. On examination, she was pyrexial, tachycardic, hypertensive and had a diffuse mottled rash on her lower limbs. Her initial investigations showed raised inflammatory markers. She was treated in the intensive care for a presumed anaphylactic reaction with an underlying sepsis...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29674395/bilateral-tension-pneumothorax-after-acupuncture
#19
Nurashikin Mohammad
Acupuncture is an ancient complementary medicine which is currently used worldwide. Many serious adverse events have been reported which include a spectrum of mild-to-fatal complications. However, the level of awareness with regard to complications is still low both to physicians and patients. We report a 63-year-old who presented with acute shortness of breath 2 hours after having had acupuncture. On examination, there was absent breath sound heard on the left lung and slightly reduced breath sound on the right lung...
April 19, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29673610/low-exertional-inspiratory-capacity-is-not-related-to-dynamic-inspiratory-muscle-weakness-in-heart-failure
#20
Franciele Plachi, Fernanda Machado Balzan, Ricardo Gass, Rui Gustavo Dorneles, Reisi Zambiazi, Danton Pereira da Silva, Paulo R Sanches, Nadine Oliveira Clausell, Danilo C Berton
Reduction in inspiratory capacity (IC) during exercise has been reported in chronic heart failure (CHF). Since inspiratory muscle dysfunction may be present to a variable degree, the assumption that IC reduction during exercise represents an increase in end-expiratory lung volume must be made with caution. This interpretation is flawed if patients develop dynamic inspiratory muscle strength reduction, i.e., progressively lower esophageal (Pes) pressures as the IC maneuvers are repeated. Sixteen CHF patients and 9 age-matched controls performed an incremental exercise test with serial IC and respiratory pressure measurements...
April 16, 2018: Respiratory Physiology & Neurobiology
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