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https://www.readbyqxmd.com/read/28537970/neuraxial-and-combined-neuraxial-general-anesthesia-compared-to-general-anesthesia-for-major-truncal-and-lower-limb-surgery-a-systematic-review-and-meta-analysis
#1
Lauren M Smith, Crispiana Cozowicz, Yoshiaki Uda, Stavros G Memtsoudis, Michael J Barrington
Neuraxial anesthesia may improve perioperative outcomes when compared to general anesthesia; however, this is controversial. We performed a systematic review and meta-analysis using randomized controlled trials and population-based observational studies identified in MEDLINE, PubMed, and EMBASE from 2010 to May 31, 2016. Studies were included for adult patients undergoing major surgery of the trunk and lower extremity that reported: 30-day mortality (primary outcome), cardiopulmonary morbidity, surgical site infection, thromboembolic events, blood transfusion, and resource use...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28530671/cardiopulmonary-assessment-of-patients-with-systemic-sclerosis-for-hematopoietic-stem-cell-transplantation-recommendations-from-the-european-society-for-blood-and-marrow-transplantation-autoimmune-diseases-working-party-and-collaborating-partners
#2
REVIEW
D Farge, R K Burt, M-C Oliveira, E Mousseaux, M Rovira, Z Marjanovic, J de Vries-Bouwstra, N Del Papa, R Saccardi, S J Shah, D C Lee, C Denton, T Alexander, D G Kiely, J A Snowden
Systemic sclerosis (SSc) is a rare disabling autoimmune disease with a similar mortality to many cancers. Two randomized controlled trials of autologous hematopoietic stem cell transplantation (AHSCT) for SSc have shown significant improvement in organ function, quality of life and long-term survival compared to standard therapy. However, transplant-related mortality (TRM) ranged from 3-10% in patients undergoing HSCT. In SSc, the main cause of non-transplant and TRM is cardiac related. We therefore updated the previously published guidelines for cardiac evaluation, which should be performed in dedicated centers with expertize in HSCT for SSc...
May 22, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28526671/telehealth-interventions-to-support-self-management-of-long-term-conditions-a-systematic-metareview-of-diabetes-heart-failure-asthma-chronic-obstructive-pulmonary-disease-and-cancer
#3
REVIEW
Peter Hanlon, Luke Daines, Christine Campbell, Brian McKinstry, David Weller, Hilary Pinnock
BACKGROUND: Self-management support is one mechanism by which telehealth interventions have been proposed to facilitate management of long-term conditions. OBJECTIVE: The objectives of this metareview were to (1) assess the impact of telehealth interventions to support self-management on disease control and health care utilization, and (2) identify components of telehealth support and their impact on disease control and the process of self-management. Our goal was to synthesise evidence for telehealth-supported self-management of diabetes (types 1 and 2), heart failure, asthma, chronic obstructive pulmonary disease (COPD) and cancer to identify components of effective self-management support...
May 17, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28524025/-effect-of-esmolol-on-hemodynamics-and-clinical-outcomes-in-patients-with-septic-shock
#4
Shupeng Wang, Min Li, Jun Duan, Li Yi, Xu Huang, Desheng Chen, Gang Li
OBJECTIVE: To evaluate the effect of heart rate control with esmolol on hemodynamics, inflammatory cytokines and clinical outcomes in patients with septic shock. METHODS: A prospective randomized controlled trial was conducted. The patients with septic shock admitted to Department of Critical Care Medicine of China-Japan Friendship Hospital from August 2014 to October 2016 were enrolled. After 24 hours of resuscitation and other therapy, they were randomly divided into two groups by sealed envelope...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28523476/impact-of-a-patient-navigator-program-on-hospital-based-and-outpatient-utilization-over-180%C3%A2-days-in-a-safety-net-health-system
#5
Richard B Balaban, Fang Zhang, Catherine E Vialle-Valentin, Alison A Galbraith, Marguerite E Burns, Marc R Larochelle, Dennis Ross-Degnan
BACKGROUND: With emerging global payment structures, medical systems need to understand longer-term impacts of care transition strategies. OBJECTIVE: To determine the effect of a care transition program using patient navigators (PNs) on health service utilization among high-risk safety-net patients over a 180-day period. DESIGN: Randomized controlled trial conducted October 2011 through April 2013. PARTICIPANTS: Patients admitted to the general medicine service with ≥1 readmission risk factor: (1) age ≥ 60; (2) in-network inpatient admission within prior 6 months; (3) index length of stay ≥ 3 days; or (4) admission diagnosis of heart failure or (5) chronic obstructive pulmonary disease...
May 18, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28520962/systematic-short-term-pulmonary-rehabilitation-before-lung-cancer-lobectomy-a-randomized-trial
#6
Yutian Lai, Jianhua Su, Peiyuan Qiu, Mingming Wang, Kun Zhou, Yuxin Tang, Guowei Che
OBJECTIVES: The goal of this study was to assess the impact of a preoperative 1-week, systematic, high-intensity inpatient exercise regimen on patients with lung cancer who had risk factors for postoperative pulmonary complications (PPCs). METHODS: We conducted a randomized controlled trial with 101 subjects of a preoperative, 7-day systematic, integrated, high-intensity pulmonary exercise regimen. The control group received standard preoperative care. We analysed the occurrence of PPCs in both groups as the primary outcome; other outcomes included changes in blood gas, quality of life, peak expiratory flow rate, the 6-min walk distance and others...
May 17, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28516071/levamisole-as-an-adjuvant-to-short-course-therapy-in-newly-diagnosed-pulmonary-tuberculosis-patients
#7
Chetna Ashok Shamkuwar, Sushant Hiraman Meshram, Sunil M Mahakalkar
BACKGROUND: The estimated incidence and prevalence of tuberculosis in India are 2.1 and 2.6 million cases respectively. Immunotherapy may shorten tuberculosis treatments and improve the immunity of individuals as well. Hence we study the efficacy of levamisole (LVM) (immunomodulator) as an adjuvant to chemotherapy of pulmonary tuberculosis patients. MATERIALS AND METHODS: A randomized, double-blind, placebo-controlled clinical trial was conducted for 21 months in newly diagnosed sputum positive pulmonary tuberculosis patients...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28515936/pulse-dose-steroids-in-severe-pulmonary-arterial-hypertension-secondary-to-systemic-lupus-erythematosus
#8
Cody Lee, Jean Elwing
OBJECTIVE: The pulmonary vascular targeted treatment for systemic lupus erythematosus-associated pulmonary arterial hypertension is similar to other connective tissue disease-associated pulmonary arterial hypertension. In addition, there also appears to be a role for immunosuppression in the overall management. However, the optimal immunosuppressive regimen and what patients will respond to treatments are currently not clearly elucidated given the lack of randomized controlled trials on the subject...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28508087/the-vitamin-d-for-enhancing-the-immune-system-in-cystic-fibrosis-disc-trial-rationale-and-design-of-a-multi-center-double-blind-placebo-controlled-trial-of-high-dose-bolus-administration-of-vitamin-d3-during-acute-pulmonary-exacerbation-of-cystic-fibrosis
#9
Vin Tangpricha, Ellen M Smith, Jose Binongo, Suzanne E Judd, Thomas R Ziegler, Seth Walker, Rabindra Tirouvanziam, Susu M Zughaier, Moon Jeong Lee, Supavit Chesdachai, Wendy A Hermes, James F Chmiel, Amit Gaggar, Ruth E Grossmann, Patricia M Joseph, Jessica A Alvarez
Vitamin D deficiency is highly prevalent in children and adults with cystic fibrosis (CF). Recent studies have found an association between vitamin D status and risk of pulmonary exacerbations in children and adults with CF. The ongoing Vitamin D for enhancing the Immune System in Cystic fibrosis (DISC) study is a multi-center, double-blind, randomized, placebo-controlled trial that will test the hypothesis of whether high dose vitamin D given as a single oral bolus of 250,000 IU to adults with CF during a pulmonary exacerbation followed by a maintenance dose of vitamin D will improve time to next pulmonary exacerbation and re-hospitalization, improve survival and lung function compared to placebo and reduce the rates of pulmonary exacerbation,...
June 2017: Contemporary Clinical Trials Communications
https://www.readbyqxmd.com/read/28506729/-the-role-of-extracorporeal-removal-of-co2-ecco2r-in-the-management-of-respiratory-diseases
#10
J L Diehl, J Boisramé-Helms, A Chardon-Couteau, M Commereuc, J-L Augy, A Sokoloff, N Rivet, P Gaussem, D M Smadja, N Aissaoui
INTRODUCTION: The aim of extracorporeal removal of CO2 (ECCO2R) is to ensure the removal of CO2 without any significant effect on oxygenation. ECCO2R makes use of low to moderate extracorporeal blood flow rates, whereas extracorporeal membrane oxygenation (ECMO) requires high blood flows. STATE OF THE ART: For each ECCO2R device it is important to consider not only performance in terms of CO2 removal, but also cost and safety, including the incidence of hemolysis and of hemorrhagic and thrombotic complications...
May 12, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28504995/remote-ischemic-preconditioning-decreases-oxidative-lung-damage-after-pulmonary-lobectomy-a-single-center-randomized-double-blind-controlled-trial
#11
José García-de-la-Asunción, Laura Bruno, Jaume Perez-Griera, Genaro Galan, Alfonso Morcillo, Richard Wins, Eva García-Del-Olmo, Ricardo Guijarro, Benjamín Sarriá, Francisco Martí, Marina Soro, Francisco Javier Belda
BACKGROUND: During lobectomy in patients with lung cancer, the operated lung is often -collapsed and hypoperfused. Ischemia/reperfusion injury may then occur when the lung is -re-expanded. We hypothesized that remote ischemic preconditioning (RIPC) would decrease oxidative lung damage and improve gas exchange in the postoperative period. METHODS: We conducted a single-center, randomized, double-blind trial in patients with nonsmall cell lung cancer undergoing elective lung lobectomy...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28502521/-extracorporeal-life-support-in-thoracic-surgery-what-are-the-indications-and-the-pertinence
#12
REVIEW
J Reeb, A Olland, S Renaud, O Collange, X Delabranche, N Santelmo, F Meziani, P-M Mertes, G Massard, P-E Falcoz
INTRODUCTION: In thoracic surgery, extracorporeal life support (ECLS) technologies are used in cases of severe and refractory respiratory failure or as intraoperative cardiorespiratory support. The objectives of this review are to describe the rationale of ECLS techniques, to review the pulmonary diseases potentially treated by ECLS, and finally to demonstrate the efficacy of ECLS, using recently published data from the literature, in order to practice evidence based medicine. STATE OF THE ART: ECLS technologies should only be undertaken in expert centers...
May 12, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28496549/phosphodiesterase-5-inhibitors-improve-clinical-outcomes-exercise-capacity-and-pulmonary-hemodynamics-in-patients-with-heart-failure-with-reduced-left-ventricular-ejection-fraction-a-meta-analysis
#13
Renato De Vecchis, Arturo Cesaro, Carmelina Ariano, Anna Giasi, Carmela Cioppa
BACKGROUND: Several studies have compared the use of phosphodiesterase-5 (PDE5) inhibitors sildenafil or udenafil with the placebo in patients suffering from pulmonary hypertension (PH) due to left chronic heart failure (CHF), corresponding to group 2 (PH due to left heart disease) of the PH classification (according to 2015 ESC/ERS guidelines for the diagnosis and treatment of PH). The results of the use of PDE5 inhibitors in the PH due to left heart disease were inconsistent and heterogeneous...
June 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28496314/treatment-of-lung-disease-in-alpha-1-antitrypsin-deficiency-a-systematic-review
#14
REVIEW
Ross G Edgar, Mitesh Patel, Susan Bayliss, Diana Crossley, Elizabeth Sapey, Alice M Turner
BACKGROUND: Alpha-1 antitrypsin deficiency (AATD) is a rare genetic condition predisposing individuals to chronic obstructive pulmonary disease (COPD). The treatment is generally extrapolated from COPD unrelated to AATD; however, most COPD trials exclude AATD patients; thus, this study sought to systematically review AATD-specific literature to assist evidence-based patient management. METHODS: Standard review methodology was used with meta-analysis and narrative synthesis (PROSPERO-CRD42015019354)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28495620/vitamin-c-to-decrease-the-effects-of-smoking-in-pregnancy-on-infant-lung-function-vcsip-rationale-design-and-methods-of-a-randomized-controlled-trial-of-vitamin-c-supplementation-in-pregnancy-for-the-primary-prevention-of-effects-of-in-utero-tobacco-smoke-exposure
#15
Cindy T McEvoy, Kristin F Milner, Ashley J Scherman, Diane G Schilling, Christina J Tiller, Brittany Vuylsteke, Lyndsey E Shorey-Kendrick, Eliot R Spindel, Robert Schuff, Julie Mitchell, Dawn Peters, Jill Metz, David Haas, Keith Jackson, Robert S Tepper, Cynthia D Morris
Despite strong anti-smoking efforts, at least 12% of American women cannot quit smoking when pregnant resulting in >450,000 smoke-exposed infants born yearly. Smoking during pregnancy is the largest preventable cause of childhood respiratory illness including wheezing and asthma. Recent studies have shown a protective effect of vitamin C supplementation on the lung function of offspring exposed to in utero smoke in a non-human primate model and an initial human trial. Vitamin C to Decrease the Effects of Smoking in Pregnancy on Infant Lung Function (VCSIP) is a randomized, double-blind, placebo-controlled trial to evaluate pulmonary function at 3months of age in infants delivered to pregnant smokers randomized to 500mg/day of vitamin C versus placebo during pregnancy...
May 8, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28494170/why-high-intensity-nppv-is-favourable-to-low-intensity-nppv-clinical-and-physiological-reasons
#16
S B Schwarz, F S Magnet, W Windisch
High-intensity non-invasive positive pressure ventilation (NPPV) was originally described for chronic hypercapnic chronic obstructive pulmonary disease (COPD) patients in 2009, and refers to a specific ventilatory approach whereby NPPV settings are aimed at achieving the lowest arterial partial pressure of carbon dioxide (PaCO2) values possible. Thus, high-intensity NPPV requires ventilator settings to be increased in a stepwise approach to either an individually tolerated maximum, or to the levels necessary to achieve normocapnia...
May 11, 2017: COPD
https://www.readbyqxmd.com/read/28492586/-risk-of-pneumonia-during-long-term-regular-treatment-of-stable-copd-with-inhaled-glucocorticoids-a-systematic-review
#17
Fabio Arpinelli, Gaetano Caramori, Maria Sandra Magnoni
Inhaled glucocorticoids are anti-inflammatory drugs used in combination with long acting bronchodilators beta2-agonists for the treatment of stable chronic obstructive pulmonary disease (COPD), to improve lung function and symptoms and to reduce the future risk COPD exacerbations. However, has been also associated to an increased risk of pneumonia. The objective of this systematic review was therefore to analyze all randomized controlled trials to identify the risk of pneumonia during the regular treatment with long-term inhaled glucocorticosteroids compared to treatment with placebo in patients with stable COPD...
April 2017: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/28490871/home-noninvasive-positive-pressure-ventilation-with-built-in-software-in-stable-hypercapnic-copd-a-short-term-prospective-multicenter-randomized-controlled-trial
#18
Luqian Zhou, Xiaoying Li, Lili Guan, Jianhua Chen, Bingpeng Guo, Weiliang Wu, Yating Huo, Ziqing Zhou, Zhenyu Liang, Yuqi Zhou, Jie Tan, Xin Chen, Yuanlin Song, Rongchang Chen
BACKGROUND: The benefits of noninvasive positive pressure ventilation (NPPV) in patients with hypercapnic COPD are controversial. It is presumed that methodology and appropriate use of NIV ventilator might be crucial for the outcomes. With the new built-in software, the performance of NIV can be monitored at home, which can guarantee the compliance and appropriate use. This study investigated effects of home use of NIV in hypercapnia in COPD patients using the NIV ventilator with built-in software for monitoring...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28490869/pulmonary-infection-control-window-as-a-switching-point-for-sequential-ventilation-in-the-treatment-of-copd-patients-a-meta-analysis
#19
Yingying Lv, Qiurong Lv, Quanchao Lv, Tianwen Lai
PURPOSE: Choosing the appropriate time to switch to noninvasive positive-pressure ventilation (NPPV) plays a crucial role in promoting successful weaning. However, optimal timing for transitioning and weaning patients from mechanical ventilation (MV) to NPPV has not been clearly established. In China, the pulmonary infection control (PIC) window as a switching point for weaning from MV has been performed for many years, without definitive evidence of clinical benefit. This study aimed to summarize the evidence for NPPV at the PIC window for patients with respiratory failure from COPD...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28490555/telehealthcare-for-patients-suffering-from-chronic-obstructive-pulmonary-disease-effects-on-health-related-quality-of-life-results-from-the-danish-telecare-north-cluster-randomised-trial
#20
Pernille Heyckendorff Lilholt, Flemming Witt Udsen, Lars Ehlers, Ole K Hejlesen
OBJECTIVE: To assess the effect of telehealthcare compared with usual practice in patients with chronic obstructive pulmonary disease (COPD). DESIGN: A cluster-randomised trial with 26 municipal districts that were randomly assigned either to an intervention group whose members received telehealthcare in addition to usual practice or to a control group whose members received usual practice only (13 districts in each arm). SETTING: Twenty-six municipal districts in the North Denmark Region of Denmark...
May 9, 2017: BMJ Open
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