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Protective lung strategy

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https://www.readbyqxmd.com/read/28430689/perioperative-outcomes-of-robotic-assisted-hysterectomy-compared-with-open-hysterectomy
#1
Bhargavi Gali, Jamie N Bakkum-Gamez, David J Plevak, Darrell Schroeder, Timothy O Wilson, Christopher J Jankowski
BACKGROUND: Increasing numbers of robotic hysterectomies (RH) are being performed. To provide ventilation (with pneumoperitoneum and steep Trendelenburg position) for these procedures, utilization of lung protective strategies with limiting airway pressures and tidal volumes is difficult. Little is known about the effects of intraoperative mechanical ventilation and high peak airway pressures on perioperative complications. We performed a retrospective review to determine whether patients undergoing RH had increased pulmonary complications compared to total abdominal hysterectomy (TAH)...
April 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28429624/impact-of-high-dose-oleuropein-on-cisplatin-induced-oxidative-stress-genotoxicity-and-pathological-changes-in-rat-stomach-and-lung
#2
Fatime Geyikoglu, Hatice Isikgoz, Hakan Onalan, Suat Colak, Salim Cerig, Murat Bakir, Mirkhalil Hosseinigouzdagani, Kubra Koc, Huseyin Serkan Erol, Yavuz Selim Saglam, Serkan Yildirim
The current systemic treatments of the various solid tumors involve Cisplatin (CIS)-based chemotherapy. Due to its cytotoxicity, this approach is limited. Moreover, the safety of CIS is only discussed especially in breast and stomach cancers. Therefore, we, for the first time, explored the restorative efficacy of oleuropein (OLE), in stomach and lung injuries induced by CIS. Sprague-Dawley rats were divided into eight groups: control CIS, OLE and CIS + OLE. Single dose of (7 mg/kg) CIS was administered intraperitoneally to CIS and CIS + OLE groups...
April 21, 2017: Journal of Asian Natural Products Research
https://www.readbyqxmd.com/read/28428174/klotho-an-anti-aging-molecule-attenuates-oxidant-induced-alveolar-epithelial-cell-mtdna-damage-and-apoptosis
#3
Seok-Jo Kim, Paul Cheresh, Mesut Eren, Renea P Jablonski, Anjana Yeldandi, Karen M Ridge, Gr Scott Budinger, Dong-Hyun Kim, Myles S Wolf, Douglas Vaughan, David W Kamp
Alveolar epithelial cell (AEC) apoptosis and inadequate repair resulting from 'exaggerated' lung aging and mitochondrial dysfunction are critical determinants promoting lung fibrosis. α-Klotho, which is an anti-aging molecule that is expressed predominantly in the kidney and secreted in the blood, can protect lung epithelial cells against hyperoxia-induced apoptosis. We reasoned that Klotho protects AEC exposed to oxidative stress in part by maintaining mitochondrial DNA (mtDNA) integrity and mitigating apoptosis...
April 20, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/28425132/early-post-operative-management-after-lung-transplantation-results-of-an-international-survey
#4
Christopher S King, Vincent Valentine, Ashok Cattamanchi, Domingo Franco-Palacios, Oksana A Shlobin, A Whitney Brown, Ramesh Singh, Linda Bogar, Steven D Nathan
INTRODUCTION: Little data exists regarding optimal therapeutic strategies post-operatively after lung transplant (LTx). Current practice patterns rely on expert opinion and institutional experience resulting in non-uniform post-operative care. To better define current practice patterns, an international survey of LTx clinicians was conducted. METHODS: A 30-question survey was sent to transplant clinicians via email to the ISHLT open forum mailing list and directly to the chief transplant surgeon and pulmonologist of all LTx centers in the United States...
April 20, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28424682/interactions-between-type-1-interferons-and-the-th17-response-in-tuberculosis-lessons-learned-from-autoimmune-diseases
#5
REVIEW
Bas C Mourik, Erik Lubberts, Jurriaan E M de Steenwinkel, Tom H M Ottenhoff, Pieter J M Leenen
The classical paradigm of tuberculosis (TB) immunity, with a central protective role for Th1 responses and IFN-γ-stimulated cellular responses, has been challenged by unsatisfactory results of vaccine strategies aimed at enhancing Th1 immunity. Moreover, preclinical TB models have shown that increasing IFN-γ responses in the lungs is more damaging to the host than to the pathogen. Type 1 interferon signaling and altered Th17 responses have also been associated with active TB, but their functional roles in TB pathogenesis remain to be established...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28418771/persistence-in-temporary-lung-niches-a-survival-strategy-of-lung-resident-memory-cd8-t-cells
#6
Shiki Takamura
Respiratory virus infections, such as those mediated by influenza virus, parainfluenza virus, respiratory syncytial virus (RSV), severe acute respiratory syndrome coronavirus (SARS-CoV), rhinovirus, and adenovirus, are responsible for substantial morbidity and mortality, especially in children and older adults. Furthermore, the potential emergence of highly pathogenic strains of influenza virus poses a significant public health threat. Thus, the development of vaccines capable of eliciting long-lasting protective immunity to those pathogens is a major public health priority...
April 18, 2017: Viral Immunology
https://www.readbyqxmd.com/read/28418758/inhaled-heparin-therapeutic-efficacy-and-recent-formulations
#7
Ayca Yildiz-Pekoz, Yildiz Ozsoy
Heparin is well known for its anticoagulant and anti-inflammatory properties. Inhaled heparin regimens are increasingly being used to manage lung disease. It has been used to treat cystic fibrosis, thromboembolism, and pulmonary fibrosis, as well as bronchial asthma and asthma-induced airway hypersensitivity. Several preclinical studies attained some useful effects of heparin-administered, parenterally and through inhalation, treatment of lung disease. Besides, recent clinical trials suggest that inhaled heparin for lung diseases is beneficial and safe, but such data remain to be limited...
April 18, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28405016/influenza-induced-lung-trm-not-all-memories-last-forever
#8
REVIEW
Natalija Van Braeckel-Budimir, John T Harty
In the light of new findings that lung tissue resident memory CD8+ T cells (Trm) represent major mediators of heterosubtypic immunity against influenza virus, it is of utmost importance to understand the basic biological mechanisms behind induction, formation and maintenance of this cell population. Addressing these important knowledge gaps will potentially inform development of superior, broadly-protective influenza vaccines and new immunization strategies.Immunology and Cell Biology accepted article preview online, 13 April 2017...
April 13, 2017: Immunology and Cell Biology
https://www.readbyqxmd.com/read/28403395/individual-patient-data-analysis-of-tidal-volumes-used-in-three-large-randomized-control-trials-involving-patients-with-acute-respiratory-distress-syndrome
#9
J Poole, C McDowell, R Lall, G Perkins, D McAuley, F Gao, D Young
Background.: The acute respiratory distress syndrome (ARDS) is a condition with a high mortality and morbidity. Mechanical ventilation prevents immediate mortality but may further damage patients' lungs. Low tidal volume lung-protective strategies have been shown to increase survival by reducing this iatrogenic damage. Current guidelines recommend tidal volumes of 6-8 ml kg -1 of predicted body weight. We used data from three large randomized controlled trials of treatments for ARDS to determine compliance with these recommendations...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28387927/multimodal-lung-cancer-screening-using-the-italung-biomarker-panel-and-low-dose-computed-tomography-results-of-the-italung-biomarker-study
#10
Francesca Maria Carozzi, Simonetta Bisanzi, Laura Carrozzi, Fabio Falaschi, Andrea Lopes Pegna, Mario Mascalchi, Giulia Picozzi, Marco Peluso, Cristina Sani, Luana Greco, Cristina Ocello, Eugenio Paci
Asymptomatic high-risk subjects, randomized in the intervention arm of the ITALUNG trial (1406 screened for lung cancer), were enrolled for the ITALUNG biomarker study (n = 1356), in which samples of blood and sputum were analysed for plasma DNA quantification (cut off 5ng/ml), loss of heterozygosity and microsatellite instability. The ITALUNG biomarker panel (IBP) was considered positive if at least one of the two biomarkers included in the panel was positive. Subjects with and without lung cancer diagnosis at the end of the screening cycle with LDCT (n = 517) were evaluated...
April 7, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28385915/physiology-in-medicine-understanding-dynamic-alveolar-physiology-to-minimize-ventilator-induced-lung-injury-vili
#11
Gary F Nieman, Joshua Satalin, Michaela Kollisch-Singule, Penny L Andrews, Hani Aiash, Nader M Habashi, Louis A Gatto
The acute respiratory distress syndrome (ARDS) remains a serious clinical problem with the main treatment being supportive in the form of mechanical ventilation. However, mechanical ventilation can be a double edge sword, if set improperly can exacerbate the tissue damage caused by ARDS and is known as ventilator induced lung injury (VILI). In order to minimize VILI we must understand the pathophysiologic mechanisms of tissue damage at the alveolar level. In this Physiology in Medicine paper the dynamic physiology of alveolar inflation and deflation during mechanical ventilation will be reviewed...
April 6, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28375554/inflammatory-responses-to-influenza-vaccination-at-the-extremes-of-age
#12
Jacqueline U McDonald, Ziyun Zhong, Helen T Groves, John S Tregoning
Age affects the immune response to vaccination, with individuals at the extremes of age responding poorly. The initial inflammatory response to antigenic materials shapes the subsequent adaptive response and so understanding is required about the effect of age on the profile of acute inflammatory mediators. In this study we measured the local and systemic inflammatory response after influenza vaccination or infection in neonatal, young adult and aged mice. Mice were immunised intramuscularly with inactivated influenza vaccine with and without the adjuvant MF59 and then challenged with H1N1 influenza...
April 4, 2017: Immunology
https://www.readbyqxmd.com/read/28370521/efficacy-comparison-of-adjuvants-in-pcrv-vaccine-against-pseudomonas-aeruginosa-pneumonia
#13
COMPARATIVE STUDY
Saeko Hamaoka, Yoshifumi Naito, Hideya Katoh, Masaru Shimizu, Mao Kinoshita, Koichi Akiyama, Atsushi Kainuma, Kiyoshi Moriyama, Ken J Ishii, Teiji Sawa
Vaccination against the type III secretion system of P. aeruginosa is a potential prophylactic strategy for reducing the incidence and improving the poor prognosis of P. aeruginosa pneumonia. In this study, the efficacies of three different adjuvants, Freund's adjuvant (FA), aluminum hydroxide (alum) and CpG oligodeoxynucleotide (ODN), were examined from the viewpoint of inducing PcrV-specific immunity against virulent P. aeruginosa. Mice that had been immunized intraperitoneally with recombinant PcrV formulated with one of the above adjuvants were challenged intratracheally with a lethal dose of P...
February 2017: Microbiology and Immunology
https://www.readbyqxmd.com/read/28363030/integrated-stress-response-mediates-epithelial-injury-in-mechanical-ventilation
#14
Tamas Dolinay, Blanca E Himes, Maya Shumyatcher, Gladys Gray Lawrence, Susan S Margulies
RATIONALE: Ventilator-induced lung injury (VILI) is a severe complication of mechanical ventilation that can lead to acute respiratory distress syndrome (ARDS). VILI is characterized by damage to the epithelial barrier with subsequent pulmonary edema and profound hypoxia. Available lung protective ventilator strategies offer only modest benefit in preventing VILI because they cannot impede alveolar overdistension and concomitant epithelial barrier dysfunction in the inflamed lung regions...
March 31, 2017: American Journal of Respiratory Cell and Molecular Biology
https://www.readbyqxmd.com/read/28348947/legionella-pneumonia-associated-with-severe-acute-respiratory-distress-syndrome-and-diffuse-alveolar-hemorrhage-a-rare-association
#15
Muhammad Kashif, Ravi Patel, Bharat Bajantri, Gilda Diaz-Fuentes
Legionella pneumophila is a common, usually underreported and undiagnosed cause of community acquired pneumonia which can lead to significant morbidity and mortality. Diffuse alveolar hemorrhage rarely have been associated with legionella infection. We present a 61-year-old man with hypertension, diabetes mellitus and obesity admitted with severe acute respiratory distress syndrome. He was found to have Legionella pneumonia with associated diffuse alveolar hemorrhage diagnosed with bronchoscopic sequential bronchoalveolar lavage...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28344805/utilization-of-cholera-toxin-b-as-a-mucosal-adjuvant-elicits-antibody-mediated-protection-against-s-pneumoniae-infection-in-mice
#16
Kari Wiedinger, Daniel Pinho, Constantine Bitsaktsis
BACKGOUND: The introduction of the pneumococcal conjugate and polysaccharide vaccines have been valuable tools for combating invasive pneumococcal infection in children and healthy adults. Despite the available vaccination strategies, pneumococcal pneumonia and associated diseases continue to cause substantial morbidity and mortality, particularly in individuals with chronic disease and ageing populations. Next-generation pneumococcal vaccines will need to be highly immunogenic across patient populations providing both mucosal and systemic protective immunity...
February 2017: Therapeutic Advances in Vaccines
https://www.readbyqxmd.com/read/28342639/sendai-virus-mucosal-vaccination-establishes-lung-resident-memory-cd8%C3%A2-t-cell-immunity-and-boosts-bcg-primed-protection-against-tb-in-mice
#17
Zhidong Hu, Ka-Wing Wong, Hui-Min Zhao, Han-Li Wen, Ping Ji, Hui Ma, Kang Wu, Shui-Hua Lu, Feng Li, Zhong-Ming Li, Tsugumine Shu, Jian-Qing Xu, Douglas B Lowrie, Xiao-Yong Fan
Accumulating evidence has shown the protective role of CD8(+) T cells in vaccine-induced immunity against Mycobacterium tuberculosis (Mtb) despite controversy over their role in natural immunity. However, the current vaccine BCG is unable to induce sufficient CD8(+) T cell responses, especially in the lung. Sendai virus, a respiratory RNA virus, is here engineered firstly as a novel recombinant anti-TB vaccine (SeV85AB) that encodes Mtb immuno-dominant antigens, Ag85A and Ag85B. A single mucosal vaccination elicited potent antigen-specific T cell responses and a degree of protection against Mtb challenge similar to the effect of BCG in mice...
March 22, 2017: Molecular Therapy: the Journal of the American Society of Gene Therapy
https://www.readbyqxmd.com/read/28342045/effects-of-an-alveolar-recruitment-maneuver-on-subdural-pressure-brain-swelling-and-mean-arterial-pressure-in-patients-undergoing-supratentorial-tumour-resection-a-randomized-crossover-study
#18
Alana M Flexman, Peter A Gooderham, Donald E Griesdale, Ruth Argue, Brian Toyota
PURPOSE: Although recruitment maneuvers have been advocated as part of a lung protective ventilation strategy, their effects on cerebral physiology during elective neurosurgery are unknown. Our objectives were to determine the effects of an alveolar recruitment maneuver on subdural pressure (SDP), brain relaxation score (BRS), and cerebral perfusion pressure among patients undergoing supratentorial tumour resection. METHODS: In this prospective crossover study, patients scheduled for resection of a supratentorial brain tumour were randomized to undergo either a recruitment maneuver (30 cm of water for 30 sec) or a "sham" maneuver (5 cm of water for 30 sec), followed by the alternative intervention after a 90-sec equilibration period...
March 24, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28341777/respiratory-compromise-as-a-new-paradigm-for-the-care-of-vulnerable-hospitalized-patients
#19
Timothy A Morris, Peter C Gay, Neil R MacIntyre, Dean R Hess, Sandra K Hanneman, James P Lamberti, Dennis E Doherty, Lydia Chang, Maureen A Seckel
Acute respiratory compromise describes a deterioration in respiratory function with a high likelihood of rapid progression to respiratory failure and death. Identifying patients at risk for respiratory compromise coupled with monitoring of patients who have developed respiratory compromise might allow earlier interventions to prevent or mitigate further decompensation. The National Association for the Medical Direction of Respiratory Care (NAMDRC) organized a workshop meeting with representation from many national societies to address the unmet needs of respiratory compromise from a clinical practice perspective...
April 2017: Respiratory Care
https://www.readbyqxmd.com/read/28339394/global-and-regional-assessment-of-sustained-inflation-pressure-volume-curves-in-patients-with-acute-respiratory-distress-syndrome
#20
Tobias Becher, Philipp Rostalski, Matthias Kott, Andy Adler, Dirk Schadler, Norbert Weiler, Inez Frerichs
Static or quasi-static pressure-volume (P-V) curves can be used to determine the lung mechanical properties of patients suffering from acute respiratory distress syndrome (ARDS). According to the traditional interpretation, lung recruitment occurs mainly below the lower point of maximum curvature (LPMC) of the inflation P-V curve. Although some studies have questioned this assumption, setting of positive end-expiratory pressure 2 cmH2O above the LPMC was part of a "lung-protective" ventilation strategy successfully applied in several clinical trials...
March 24, 2017: Physiological Measurement
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