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https://www.readbyqxmd.com/read/28932576/outcomes-after-lung-transplantation
#1
REVIEW
Gabriel Thabut, Herve Mal
With more than 50,000 procedures having been performed worldwide, lung transplantation (LT) has become the standard of care for patients with end-stage chronic respiratory failure. LT leads to dramatic improvements in both pulmonary function and health related quality of life. Survival after LTs has steadily improved, but still lags far behind that observed after other solid organ transplantations, as evidenced by a median survival rate that currently stands at 5.8 years. Because of these disappointing results, the ability of LT to expand survival has been questioned...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28911947/albumin-prevents-infections-in-patients-with-chronic-liver-failure-in-a-single-arm-feasibility-trial
#2
Louise China, Simon S Skene, Zainib Shabir, Alexander Maini, Yvonne Sylvestre, Kate Bennett, Scott Bevan, James O'Beirne, Ewan Forrest, Jim Portal, Steve Ryder, Gavin Wright, Derek W Gilroy, Alastair O'Brien
BACKGROUND & AIMS: Infections are life threatening to patients with acute decompensation and acute-on-chronic liver failure (AD/ACLF). Patients with AD/ACLF have prostaglandin E2-mediated immune suppression, which can be reversed by administration of albumin; infusion of 20% human albumin solution (HAS) might improve outcomes of infections. We performed a feasibility study to determine optimal trial design, assess safety, and validate laboratory assessments of immune function to inform design of a phase 3 trial...
September 11, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28906399/characteristics-of-infection-and-its-impact-on-short-term-outcome-in-patients-with-acute-on-chronic-liver-failure
#3
Junjun Cai, Mengchen Zhang, Tao Han, Hui-Qing Jiang
Bacterial infections are an important cause of mortality in liver failure. However, the type of infection, predictors of infection, and their impact on outcomes in patients with acute-on-chronic liver failure (ACLF) are limited.A total of 389 patients with ACLF were admitted in this retrospective, corhort study. Once admitted, clinical data including first infection site, type (community-acquired, healthcare-associated, or nosocomial), and second infection occurrence during hospitalization were collected. The outcome was mortality within 90 days...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28893830/assessment-of-paravalvular-leakage-after-transcatheter-aortic-valve-implantation-add-clinical-signs-to-echocardiographic-data
#4
Corstiaan A den Uil, Mihai Strachinaru, Ben van der Hoven, J Han J Meeder
A 62-year old male with pulmonary fibrosis and aortic valve stenosis underwent TAVI (Corevalve Evolut XL 34 mm) in the build-up for lung transplantation (LuTx). Following post-dilation for a large annular perimeter, moderate paravalvular aortic regurgitation (AR) was observed. After 6 weeks, he was admitted to the ICU with respiratory failure(A). TTE demonstrated residual mild AR (based on a small excentric paravalvular AR jet, <10% circumferential extent, pressure half-time was not reliably measured) and together with borderline elevated NT-pro-BNP, the consultant cardiologist authorized LuTx listing...
September 11, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28838437/urgent-lung-transplantation-in-severe-acute-respiratory-failure-based-on-rapidly-progressive-interstitial-lung-disease-a-case-report
#5
I Madurka, J Elek, N Schönauer, T Bartók, K Kormosói-Tóth, É Zöllei, Á Ghimessy, G Lang, W Klepetko, F Rényi-Vámos
Lung transplantation (LUTX) became a worldwide accepted standard therapy for certain well-defined chronic end-stage lung diseases. Until recently, patients on mechanical ventilation or extracorporeal life support techniques were hardly eligible for LUTX because of the inferior short-term results. However, a paradigm shift has occurred, and now these techniques represent bridging options to LUTX for listed patients. In the current practice, transplantation from the intensive care unit (ICU) is not extraordinary in patients on the waiting list...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28836192/the-bleomycin-model-of-pulmonary-fibrosis
#6
Tianju Liu, Francina Gonzalez De Los Santos, Sem H Phan
Interstitial lung disease (ILD) comprises a large number of chronic lung disease characterized by varying degrees of inflammation and fibrosis. Mostly they are idiopathic including idiopathic pulmonary fibrosis (IPF), which is a specific disorder characterized by progressive fibrosis leading commonly to end-stage lung disease, respiratory failure, and fatal outcome. IPF and many of these fibrotic ILDs lack effective therapy despite recent approval of two drugs to slow progression in certain IPF patients. Because there are no natural models for IPF, the use of animal models that reproduce key known features of the disease is warranted...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28822818/phrenic-long-term-facilitation-following-intrapleural-ctb-sap-induced-respiratory-motor-neuron-death
#7
Nicole L Nichols, Taylor A Craig, Miles A Tanner
Amyotrophic lateral sclerosis (ALS) is a devastating disease leading to progressive motor neuron degeneration and death by ventilatory failure. In a rat model of ALS (SOD1(G93A)), phrenic long-term facilitation (pLTF) following acute intermittent hypoxia (AIH) is enhanced greater than expected at disease end-stage but the mechanism is unknown. We suggest that one trigger for this enhancement is motor neuron death itself. Intrapleural injections of cholera toxin B fragment conjugated to saporin (CTB-SAP) selectively kill respiratory motor neurons and mimic motor neuron death observed in SOD1(G93A) rats...
August 16, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28816877/fractures-in-spinal-ankylosing-disorders-a-narrative-review-of-disease-and-injury-types-treatment-techniques-and-outcomes
#8
Tarush Rustagi, Doniel Drazin, Cumhur Oner, Jonathan York, Gregory D Schroeder, Alexander R Vaccaro, Rod J Oskouian, Jens R Chapman
INTRODUCTION: Spinal ankylosing disorders encompass ankylosing spondylitis (AS), disseminated hyperostosis of the spine, and end-stage spondylosis. All these result in a stiffened and frequently deformed spinal column. This makes the spinal column highly susceptible to severe injuries that are commonly associated with unfavorable outcomes. Improved understanding of the underlying disease processes and clinical comorbidities may alter the poor injury related morbidity and mortality outcomes...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28813495/establishing-failure-predictors-for-the-planned-extubation-of-overweight-and-obese-patients
#9
Chien-Ming Chao, Chih-Cheng Lai, Ai-Chin Cheng, Shyh-Ren Chiang, Wei-Lun Liu, Chung-Han Ho, Shu-Chen Hsing, Chin-Ming Chen, Kuo-Chen Cheng
We investigated failure predictors for the planned extubation of overweight (body mass index [BMI] = 25.0-29.9) and obese (BMI ≥ 30) patients. All patients admitted to the adult intensive care unit (ICU) of a tertiary hospital in Taiwan were identified. They had all undergone endotracheal intubation for > 48 h and were candidates for extubation. During the study, 595 patients (overweight = 458 [77%]); obese = 137 [23%]) with planned extubation after weaning were included in the analysis; extubation failed in 34 patients (5...
2017: PloS One
https://www.readbyqxmd.com/read/28772036/implantation-of-a-left-ventricular-assist-device-to-provide-long-term-support-for-end-stage-duchenne-muscular-dystrophy-associated-cardiomyopathy
#10
Douglas Stoller, Faris Araj, Alpesh Amin, Catherine Fitzsimmons, Robert Morlend, Jennifer T Thibodeau, Claudio Ramaciotti, Mark H Drazner, Dan M Meyer, Pradeep P A Mammen
A young man with Duchenne muscular dystrophy presented to the UT Southwestern Neuromuscular Cardiomyopathy Clinic with advanced heart failure. Despite maximal medical therapy, his cardiac function continued to decline requiring initiation of inotrope therapy. Given the patient's clinical deterioration, a left ventricular assist device (LVAD) was implanted as destination therapy after undergoing a multidisciplinary assessment. The patient tolerated the surgical implantation of the LVAD without any significant complications, and he has had a relatively unremarkable course 38 months post-LVAD implantation...
August 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28754440/to-intubate-or-not-to-intubate-emergency-medicine-physicians-perspective-on-intubating-critically-ill-terminal-cancer-patients
#11
Kenneth Kim, Bharath Chakravarthy, Craig Anderson, Solomon Liao
CONTEXT: Emergency Physicians (EPs) often need to make a decision whether or not to intubate a terminal cancer patient. OBJECTIVE: To explore EPs' attitudes about intubating critically ill, terminal cancer patients. METHODS: Fifty EPs at three emergency departments (one university-based, one community, and one HMO) in Southern California participated in an anonymous survey that presented a hypothetical case of an end-stage lung cancer patient in pending respiratory failure...
July 25, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28736018/extracorporeal-life-support-as-a-bridge-to-lung-transplantation-in-patients-with-acute-respiratory-failure
#12
H J Yeo, S Lee, S H Yoon, S E Lee, W H Cho, D Jeon, Y S Kim, D Kim
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is being used more often as a bridge to transplantation (BTT) in patients with acutely decompensated end-stage lung disease in Korea. ECMO as a BTT may be the only rescue strategy for severe acute respiratory failure, but many centers still consider it to be a relative contraindication to lung transplantation because of its poor outcome. Because there are not enough lung donors, it is important to determine their optimal use. We reviewed and analyzed our experiences with the use of ECMO as a BTT in patients with acute respiratory failure...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28557861/heartmate-3-in-lowest-intermacs-profile-cohort-the-swiss-experience
#13
Piergiorgio Tozzi, Carlo Banfi, Kameran Ahmadov, Roger Hullin, Philippe Meyer, Raphael Giraud, Lucas Liaudet, Fabrizio Gronchi, Christophe Huber, Matthias Kirsch
New generation devices for long-term mechanical circulatory support are centrifugal pumps having fully magnetically levitated rotors to reduce blood trauma. Recently, the novel HeartMate 3 was cleared for clinical application in Switzerland. In two Swiss University Hospitals part of the "Lausanne-Geneva Transplantation Network," 10 consecutive patients in end-stage heart failure received the HeartMate 3. Device implantation criteria were persistent low output syndrome despite optimal medical treatment. The primary end-point of the study was survival or transplantation to 90 days on the device...
May 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28526246/impaired-mitophagy-facilitates-mitochondrial-damage-in-danon-disease
#14
Sherin I Hashem, Anne N Murphy, Ajit S Divakaruni, Matthew L Klos, Bradley C Nelson, Emily C Gault, Teisha J Rowland, Cynthia N Perry, Yusu Gu, Nancy D Dalton, William H Bradford, Eric J Devaney, Kirk L Peterson, Kenneth L Jones, Matthew R G Taylor, Ju Chen, Neil C Chi, Eric D Adler
RATIONALE: Lysosomal associated membrane protein type-2 (LAMP-2) is a highly conserved, ubiquitous protein that is critical for autophagic flux. Loss of function mutations in the LAMP-2 gene cause Danon disease, a rare X-linked disorder characterized by developmental delay, skeletal muscle weakness, and severe cardiomyopathy. We previously found that human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) from Danon patients exhibited significant mitochondrial oxidative stress and apoptosis...
May 16, 2017: Journal of Molecular and Cellular Cardiology
https://www.readbyqxmd.com/read/28522765/exercise-training-in-tg%C3%AE-q-44-mice-during-the-progression-of-chronic-heart-failure-cardiac-vs-peripheral-soleus-muscle-impairments-to-oxidative-metabolism
#15
Bruno Grassi, Joanna Majerczak, Eleonora Bardi, Alessia Buso, Marina Comelli, Stefan Chlopicki, Magdalena Guzik, Irene Mavelli, Zenon Nieckarz, Desy Salvadego, Urszula Tyrankiewicz, Tomasz Skorka, Roberto Bottinelli, Jerzy A Zoladz, Maria Antonietta Pellegrino
Cardiac function, skeletal (soleus) muscle oxidative metabolism and the effects of exercise training were evaluated in a transgenic murine model (Tgαq*44) of chronic heart failure (CHF) during the critical period between the occurrence of an impairment of cardiac function and the stage at which overt cardiac failure ensues (i.e. from 10 to 12 months of age). Forty-eight Tgαq*44 mice and 43 wild-type (WT) FVB controls were randomly assigned to control groups and to groups undergoing 2 months of intense exercise training (spontaneous running on a instrumented wheel)...
May 18, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28501971/electrolyte-and-acid-base-disturbances-in-end-stage-liver-disease-a-physiopathological-approach
#16
REVIEW
José Víctor Jiménez, Diego Luis Carrillo-Pérez, Rodrigo Rosado-Canto, Ignacio García-Juárez, Aldo Torre, David Kershenobich, Eduardo Carrillo-Maravilla
Electrolyte and acid-base disturbances are frequent in patients with end-stage liver disease; the underlying physiopathological mechanisms are often complex and represent a diagnostic and therapeutic challenge to the physician. Usually, these disorders do not develop in compensated cirrhotic patients, but with the onset of the classic complications of cirrhosis such as ascites, renal failure, spontaneous bacterial peritonitis and variceal bleeding, multiple electrolyte, and acid-base disturbances emerge. Hyponatremia parallels ascites formation and is a well-known trigger of hepatic encephalopathy; its management in this particular population poses a risky challenge due to the high susceptibility of cirrhotic patients to osmotic demyelination...
August 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28500219/mechanisms-of-enhanced-phrenic-long-term-facilitation-in-sod1-g93a-rats
#17
Nicole L Nichols, Irawan Satriotomo, Latoya L Allen, Ashley M Grebe, Gordon S Mitchell
Amyotrophic lateral sclerosis (ALS) is a degenerative motor neuron disease, causing muscle paralysis and death from respiratory failure. Effective means to preserve/restore ventilation are necessary to increase the quality and duration of life in ALS patients. At disease end-stage in a rat ALS model (SOD1(G93A) ), acute intermittent hypoxia (AIH) restores phrenic nerve activity to normal levels via enhanced phrenic long-term facilitation (pLTF). Mechanisms enhancing pLTF in end-stage SOD1(G93A) rats are not known...
June 14, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28459403/-evaluation-value-of-oxygenation-index-of-mechanical-ventilation-on-the-prognosis-of-patients-with-ards-a-retrospective-analysis-with-228-patients
#18
Ziyi Jia, Xiaowei Liu, Zhi Liu
OBJECTIVE: To investigate the evaluation value of oxygenation index at different times of mechanical ventilation (MV) on the prognosis of patients with acute respiratory distress syndrome (ARDS). METHODS: A retrospectively analysis was conducted. A total of 228 patients with ARDS admitted to Department of Emergency of China Medical University Affiliated First Hospital from February 2014 to June 2016 were enrolled. All patients underwent MV treatment, and recruitment maneuver (RM) was performed by pressure-controlled ventilation (PCV) 30 minutes after the implementation of the protective ventilation strategy...
January 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28442772/discriminative-and-distinct-phenotyping-by-constrained-tensor-factorization
#19
Yejin Kim, Robert El-Kareh, Jimeng Sun, Hwanjo Yu, Xiaoqian Jiang
Adoption of Electronic Health Record (EHR) systems has led to collection of massive healthcare data, which creates oppor- tunities and challenges to study them. Computational phenotyping offers a promising way to convert the sparse and complex data into meaningful concepts that are interpretable to healthcare givers to make use of them. We propose a novel su- pervised nonnegative tensor factorization methodology that derives discriminative and distinct phenotypes. We represented co-occurrence of diagnoses and prescriptions in EHRs as a third-order tensor, and decomposed it using the CP algorithm...
April 25, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28412688/clinical-research-of-treating-tuberculous-respiratory-failure-by-sequential-mechanical-ventilation
#20
Chengqun Ge, Tao Zhang, Houcui Fan
Tuberculosis is kind of common chronic infectious disease, of which the pathogenic bacterium is mainly Mycobacterium tuberculosis (MTB). One who is suffering severe tuberculosis may be ended with cardio-pulmonary function damage or cardio-pulmonary failure. This disease is of higher risks of complications or even high death rate, which is seriously challenging people's health and life. When a tuberculosis patient is accompanied with respiratory failure, which means the disease has developed into the late stage, on this occasion the optimal treatment program is to use mechanical ventilation to improve the respiratory failure condition...
November 2016: Pakistan Journal of Pharmaceutical Sciences
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