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https://www.readbyqxmd.com/read/29073778/bronchial-artery-embolization-first-line-option-for-managing-massive-hemoptysis
#1
Yutaka Miyano, Masato Kanzaki, Takamasa Onuki
Background Today, treatment for hemoptysis is not limited to surgery, and among the various options, bronchial artery embolization is regarded as an effective approach. Methods In this retrospective study, 179 of 389 patients with massive hemoptysis were treated with bronchial artery embolization, without taking into account the underlying pathological lesions responsible (bronchiectasis in 41, aspergilloma in 29, lung cancer in 25, old tuberculosis in 23, pyothorax in 19, others in 23). Results Bronchial artery embolization failed in 12 cases...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28781176/electrical-neuromodulation-of-the-respiratory-system-after-spinal-cord-injury
#2
REVIEW
Jan T Hachmann, Peter J Grahn, Jonathan S Calvert, Dina I Drubach, Kendall H Lee, Igor A Lavrov
Spinal cord injury (SCI) is a complex and devastating condition characterized by disruption of descending, ascending, and intrinsic spinal circuitry resulting in chronic neurologic deficits. In addition to limb and trunk sensorimotor deficits, SCI can impair autonomic neurocircuitry such as the motor networks that support respiration and cough. High cervical SCI can cause complete respiratory paralysis, and even lower cervical or thoracic lesions commonly result in partial respiratory impairment. Although electrophrenic respiration can restore ventilator-independent breathing in select candidates, only a small subset of affected individuals can benefit from this technology at this moment...
September 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28870357/neurostimulation-devices-for-the-treatment-of-neurologic-disorders
#3
REVIEW
Christine A Edwards, Abbas Kouzani, Kendall H Lee, Erika K Ross
Rapid advancements in neurostimulation technologies are providing relief to an unprecedented number of patients affected by debilitating neurologic and psychiatric disorders. Neurostimulation therapies include invasive and noninvasive approaches that involve the application of electrical stimulation to drive neural function within a circuit. This review focuses on established invasive electrical stimulation systems used clinically to induce therapeutic neuromodulation of dysfunctional neural circuitry. These implantable neurostimulation systems target specific deep subcortical, cortical, spinal, cranial, and peripheral nerve structures to modulate neuronal activity, providing therapeutic effects for a myriad of neuropsychiatric disorders...
September 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28901793/intravenous-fosfomycin-for-the-treatment-of-hospitalized-patients-with-serious-infections
#4
Andrew F Shorr, Jason M Pogue, John F Mohr
With the worldwide increase in the rates of antimicrobial resistance, antimicrobials with novel mechanisms of action are needed to fill a void in the antimicrobial armamentarium. Areas covered: Intravenous fosfomycin has been studied extensively in a wide variety of infections including cUTI, lower respiratory tract infection, bone and joint infections, endocarditis, meningitis, and bacteremia outside of the United States. This paper reviews the in vitro activity, pharmacokinetic properties, and clinical experience of intravenous fosfomycin in hospitalized patients with serious infections...
October 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28922285/what-where-and-why-exploring-fluorodeoxyglucose-pet-s-ability-to-localise-and-differentiate-infection-from-cancer
#5
Abby Douglas, Eddie Lau, Karin Thursky, Monica Slavin
PURPOSE OF REVIEW: To review the utility of FDG-PET imaging in detecting the cause of fever and infection in patients with cancer. RECENT FINDINGS: FDG-PET has been shown to have high sensitivity and accuracy for causes of neutropenic fever, leading to higher diagnostic certainty in this group. Recent advances in pathogen-specific labelling in PET to identify Aspergillus spp. and Yersinia spp. infections in mice, as well as differentiating between Gram-positive, Gram-negative and mycobacterial infections are promising...
December 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28922286/nocardia-infections-in-solid-organ-and-hematopoietic-stem-cell-transplant-recipients
#6
Julien Coussement, David Lebeaux, Claire Rouzaud, Olivier Lortholary
PURPOSE OF REVIEW: Nocardia spp. is a gram-positive bacteria that may cause infections in humans. Nocardiosis has been described since the early years of transplantation. This review aims to provide an overview of present knowledge regarding posttransplant nocardiosis, with a focus on recent findings. RECENT FINDINGS: Nocardiosis is not rare among transplant recipients, especially after thoracic transplantation and/or in case of intense immunosuppressive regimen or use of tacrolimus...
September 15, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28938246/the-evolving-landscape-of-new-diagnostic-tests-for-invasive-aspergillosis-in-hematology-patients-strengths-and-weaknesses
#7
Dieter Buchheidt, Mark Reinwald, Martin Hoenigl, Wolf-Karsten Hofmann, Birgit Spiess, Tobias Boch
PURPOSE OF REVIEW: The diagnosis of invasive aspergillosis in hematologic patients is a complex composite of clinical preconditions and features, imaging findings, biomarker combinations from appropriate clinical samples and microbiological and/or histological findings. RECENT FINDINGS: Recent developments in the evolving landscape of diagnostic tests for invasive aspergillosis in adult hematology patients are highlighted. SUMMARY: Novel approaches and tools are currently under development...
September 21, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28938251/critical-illness-related-corticosteroid-insufficiency-circi-a-narrative-review-from-a-multispecialty-task-force-of-the-society-of-critical-care-medicine-sccm-and-the-european-society-of-intensive-care-medicine-esicm
#8
Djillali Annane, Stephen M Pastores, Wiebke Arlt, Robert A Balk, Albertus Beishuizen, Josef Briegel, Joseph Carcillo, Mirjam Christ-Crain, Mark S Cooper, Paul E Marik, Gianfranco Umberto Meduri, Keith M Olsen, Bram Rochwerg, Sophia C Rodgers, James A Russell, Greet Van den Berghe
OBJECTIVE: To provide a narrative review of the latest concepts and understanding of the pathophysiology of critical illness-related corticosteroid insufficiency (CIRCI). PARTICIPANTS: A multi-specialty task force of international experts in critical care medicine and endocrinology and members of the Society of Critical Care Medicine and the European Society of Intensive Care Medicine. DATA SOURCES: Medline, Database of Abstracts of Reviews of Effects (DARE), Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Database of Systematic Reviews...
September 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28938253/guidelines-for-the-diagnosis-and-management-of-critical-illness-related-corticosteroid-insufficiency-circi-in-critically-ill-patients-part-i-society-of-critical-care-medicine-sccm-and-european-society-of-intensive-care-medicine-esicm-2017
#9
Djillali Annane, Stephen M Pastores, Bram Rochwerg, Wiebke Arlt, Robert A Balk, Albertus Beishuizen, Josef Briegel, Joseph Carcillo, Mirjam Christ-Crain, Mark S Cooper, Paul E Marik, Gianfranco Umberto Meduri, Keith M Olsen, Sophia C Rodgers, James A Russell, Greet Van den Berghe
OBJECTIVE: To update the 2008 consensus statements for the diagnosis and management of critical illness-related corticosteroid insufficiency (CIRCI) in adult and pediatric patients. PARTICIPANTS: A multispecialty task force of 16 international experts in critical care medicine, endocrinology, and guideline methods, all of them members of the Society of Critical Care Medicine and/or the European Society of Intensive Care Medicine. DESIGN/METHODS: The recommendations were based on the summarized evidence from the 2008 document in addition to more recent findings from an updated systematic review of relevant studies from 2008 to 2017 and were formulated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology...
September 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28866970/calprotectin-as-an-early-biomarker-of-bacterial-infections-in-critically-ill-patients-an-exploratory-cohort-assessment
#10
Niklas Jonsson, Tom Nilsen, Patrik Gille-Johnson, Max Bell, Claes-Roland Martling, Anders Larsson, Johan Mårtensson
BACKGROUND: Calprotectin is the most abundant protein in the cytosolic fraction of neutrophils, and neutrophil degranulation is a major response to bacterial infections. OBJECTIVES: To assess the value of plasma calprotectin as an early marker of bacterial infections in critically ill patients and compare it with the corresponding values for procalcitonin (PCT), C-reactive protein (CRP) and white blood cell count (WBC). METHODS: We measured daily plasma calprotectin levels in 110 intensive care unit patients using a newly developed turbidimetric assay run on clinical chemistry analysers...
September 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28935493/update-on-egfr-mutational-testing-and-the-potential-of-noninvasive-liquid-biopsy-in-non-small-cell-lung-cancer
#11
REVIEW
Edward Kim, Rebecca Feldman, Ignacio I Wistuba
Mutations in the epidermal growth factor receptor (EGFR) are important drivers of non-small-cell lung cancer (NSCLC) and have led to the emergence of EGFR-targeted therapies as critical treatment options for NSCLC. Although these agents have shown clinical activity in NSCLC patients, acquired resistance to EGFR-targeted agents is inevitable. Therefore, the ability to conveniently biopsy patient tumors is of increasing importance as new mechanisms of resistance and agents to target these resistance mutations are identified...
August 12, 2017: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28932614/acute-low-dose-hydralazine-induced-lupus-pneumonitis
#12
Sarah K Holman, Donique Parris, Sarah Meyers, Jason Ramirez
A 35-year-old female was started on hydralazine 10 mg orally three times a day for treatment of postpartum hypertension. Three months later, after multiple unsuccessful courses of prednisone and antibiotics for presumed pneumonia and asthma exacerbations, her respiratory symptoms progressed in severity and she developed resting hypoxia. Previous diagnostic work-up included spirometry with a restrictive pattern, chest CT showing bilateral basilar consolidation, negative BAL, and nonspecific findings on lung biopsy of mild inflammatory cells...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/28655186/catheter-related-right-internal-jugular-vein-thrombosis-after-chest-surgery
#13
P-T Chen, K-C Chang, K-L Hu, C-K Ting, K-H Chan, W-K Chang
Background: Central venous catheters (CVCs) are frequently used for monitoring haemodynamic status and rapidly delivering fluid therapy during the peri- and postoperative periods. Indwelling CVCs are typically used 7-14 days postoperatively for additional monitoring and treatment, but patients may develop asymptomatic catheter-related thrombosis, leading to life-threatening pulmonary embolism and death. Early detection helps to avoid such complications. Methods: This prospective observational study investigated the risk factors associated with catheter-related right internal jugular vein thrombosis in patients undergoing chest surgery...
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28882938/imatinib-dramatically-alleviates-pulmonary-tumour-thrombotic-microangiopathy-induced-by-gastric-cancer
#14
Kana Kubota, Taro Shinozaki, Yasushi Imai, Kazuomi Kario
Pulmonary tumour thrombotic microangiopathy (PTTM) is a rare complication of cancer, which can be lethal due to progressive pulmonary hypertension (PH). Several case reports have demonstrated that imatinib, a platelet-derived growth factor receptor-tyrosine kinase inhibitor, can improve severe PH in patients with PTTM.We describe the case of a 56-year-old woman. Her mean pulmonary arterial pressure (mPAP) was 47 mm Hg, and her dyspnoea worsened rapidly over several days. Although pulmonary embolism was not observed on CT, enlargement of the para-aortic lymph nodes was detected...
September 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28882120/clinical-and-radiological-characteristics-of-patients-with-late-onset-severe-restrictive-lung-defect-after-hematopoietic-stem-cell-transplantation
#15
Ho Namkoong, Makoto Ishii, Takehiko Mori, Hiroaki Sugiura, Sadatomo Tasaka, Masatoshi Sakurai, Yuya Koda, Jun Kato, Naoki Hasegawa, Shinichiro Okamoto, Tomoko Betsuyaku
BACKGROUND: Late-onset noninfectious pulmonary complications (LONIPCs), which occur more than 3 months after allogeneic hematopoietic stem cell transplantation (HSCT), are major causes of morbidity and mortality after transplantation. Among LONIPCs, we occasionally treat patients with late-onset severe restrictive lung defect after HSCT; however, its clinical features have not been fully elucidated. METHODS: A retrospective chart review of a single center on cases of late-onset severe restrictive lung defect after HSCT was performed...
September 7, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28915879/the-effect-of-sedation-and-or-analgesia-as-rescue-treatment-during-noninvasive-positive-pressure-ventilation-in-the-patients-with-interface-intolerance-after-extubation
#16
Yue-Nan Ni, Ting Wang, He Yu, Bin-Miao Liang, Zong-An Liang
BACKGROUND: Sedation and/or analgesia can relieve the patient-ventilator asynchrony. However, whether sedation and/or analgesia can benefit the clinical outcome of the patients with interface intolerance is still unclear. METHODS: A retrospective study was performed on patients with interface intolerance who received noninvasive positive pressure ventilation (NIPPV) after extubation in seven intensive care units (ICU) of West China Hospital, Sichuan University. The primary outcome was rate of NIPPV failure (defined as need for reintubation and mechanical ventilation); Secondary outcomes were hospital mortality rate and length of ICU stay after extubation...
September 15, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28233608/clinical-mimics-an-emergency-medicine-focused-review-of-asthma-mimics
#17
Kristen Kann, Brit Long, Alex Koyfman
BACKGROUND: Asthma is a common diagnosis or preexisting condition, and many patients with acute asthma exacerbation may present to the emergency department with wheezing and respiratory distress. However, many conditions may mimic this presentation. OBJECTIVES: This review provides an overview of common asthma mimics and an approach to evaluation and management. DISCUSSION: Asthma is characterized by an obstructive pulmonary disease with recurrent exacerbations...
August 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28505028/cytomegalovirus-disease-in-hematopoietic-stem-cell-transplant-patients-current-and-future-therapeutic-options
#18
Shigeo Fuji, Hermann Einsele, Markus Kapp
PURPOSE OF REVIEW: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has become one of the standard treatment for hematological diseases. Although the clinical outcome has improved significantly during the last decades, the morbidity and mortality after allo-HSCT are still obstacles to cure. Out of major morbidities, opportunistic virus infections such as cytomegalovirus (CMV) infection are important complications, in particular in patients who received human leukocyte antigen-mismatched HSCT...
August 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28548990/outbreaks-of-nontuberculous-mycobacteria
#19
Geeta Sood, Nikki Parrish
PURPOSE OF REVIEW: The purpose of this review is to summarize the emerging literature on nontuberculous mycobacteria outbreaks in healthcare settings. As our ability to identify mycobacterial species develops, we are better able to recognize epidemiologic connections and better understand the prevalence and importance of these outbreaks and pseudo-outbreaks in healthcare settings. RECENT FINDINGS: The number of outbreaks related to nontuberculous outbreaks is increasing because of heightened awareness and better diagnostic tests for species level identification of mycobacteria...
August 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28847548/cholestatic-alterations-in-the-critically-ill-some-new-light-on-an-old-problem
#20
REVIEW
Marc Jenniskens, Lies Langouche, Greet Van den Berghe
Liver dysfunction and jaundice are traditionally viewed as late features of sepsis and other critical illnesses and are associated with a complicated ICU stay. However, study results suggest that cholestatic alterations occur early in the course of critical illnesses, perceived only as minor abnormalities in routinely used biochemical liver tests. Inflammation-induced alterations in the transport of bile acids (BAs) appear to drive BAs and bilirubin toward the systemic circulation. Ongoing BA synthesis with an, at least partial, loss of feedback inhibition further contributes to elevated circulating BAs and bilirubin...
August 26, 2017: Chest
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