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Yesterday, 18 Ιουλίου 2016, 8:26:18 πμ
A New Way to See a Bronchopleural Fistula
Σάββατο, 16 Ιουλίου 2016, 7:00:07 μμ | Elaine Soon
American Journal of Respiratory and Critical Care Medicine, Volume 194, Issue 2, Page 239-240, July 15, 2016.
The Lung Microbiome in HIV. Getting to the HAART of the Host–Microbe Interface
Σάββατο, 16 Ιουλίου 2016, 7:00:07 μμ | Leopoldo N. Segal
American Journal of Respiratory and Critical Care Medicine, Volume 194, Issue 2, Page 136-137, July 15, 2016.
Tracheostomy in Adults
Σάββατο, 16 Ιουλίου 2016, 7:00:07 μμ
American Journal of Respiratory and Critical Care Medicine, Volume 194, Issue 2, Page P3-P4, July 15, 2016.
Understanding the Influence of Genes, Diet, and Occupation on Respiratory Health
Σάββατο, 16 Ιουλίου 2016, 7:00:07 μμ | André F. S. Amaral
American Journal of Respiratory and Critical Care Medicine, Volume 194, Issue 2, Page 236-238, July 15, 2016.
Allergen-induced Changes in Bone Marrow and Airway Dendritic Cells in Subjects with Asthma
Σάββατο, 16 Ιουλίου 2016, 7:00:07 μμ | Amani El-Gammal
American Journal of Respiratory and Critical Care Medicine, Volume 194, Issue 2, Page 169-177, July 15, 2016.
Reply: Why Pregnant Women Should Avoid Any Form of Nicotine during Pregnancy: An Elastin-based Perspective
Σάββατο, 16 Ιουλίου 2016, 7:00:07 μμ | Eliot R. Spindel
American Journal of Respiratory and Critical Care Medicine, Volume 194, Issue 2, Page 247-248, July 15, 2016.
Opening the Debate on the New Sepsis Definition. ; Medicare’s Sepsis Reporting Program: Two Steps Forward, One Step Back
Σάββατο, 16 Ιουλίου 2016, 7:00:07 μμ | Ian J. Barbash
American Journal of Respiratory and Critical Care Medicine, Volume 194, Issue 2, Page 139-141, July 15, 2016.
Effect of Advanced HIV Infection on the Respiratory Microbiome
Σάββατο, 16 Ιουλίου 2016, 7:00:07 μμ | Homer L. Twigg
American Journal of Respiratory and Critical Care Medicine, Volume 194, Issue 2, Page 226-235, July 15, 2016.
Accuracy and Reliability of Internet Resources for Information on Idiopathic Pulmonary Fibrosis
Σάββατο, 16 Ιουλίου 2016, 7:00:07 μμ | Jolene H. Fisher
American Journal of Respiratory and Critical Care Medicine, Volume 194, Issue 2, Page 218-225, July 15, 2016.
Long-Term Outcomes after Critical Illness. The Best Predictor of the Future Is the Past
Σάββατο, 16 Ιουλίου 2016, 7:00:07 μμ | Brian H. Cuthbertson
American Journal of Respiratory and Critical Care Medicine, Volume 194, Issue 2, Page 132-134, July 15, 2016.
Long-Term Mortality and Major Adverse Cardiovascular Events in Sepsis Survivors. A Nationwide Population-based Study
Σάββατο, 16 Ιουλίου 2016, 7:00:07 μμ | Shuo-Ming Ou
American Journal of Respiratory and Critical Care Medicine, Volume 194, Issue 2, Page 209-217, July 15, 2016.
Reply: The Methodology of Assessing Long-Term Mortality and Cardiovascular Risks in Survivors of Sepsis
Σάββατο, 16 Ιουλίου 2016, 7:00:07 μμ | Shuo-Ming Ou
American Journal of Respiratory and Critical Care Medicine, Volume 194, Issue 2, Page 246-246, July 15, 2016.
Update in Tuberculosis/Pulmonary Infections 2015
Σάββατο, 16 Ιουλίου 2016, 7:00:07 μμ | Serena P. Koenig
American Journal of Respiratory and Critical Care Medicine, Volume 194, Issue 2, Page 142-146, July 15, 2016.
Spontaneous Cavitation and Progressive Accumulation of Air in a Metastatic Mediastinal Lymph Node
Σάββατο, 16 Ιουλίου 2016, 7:00:07 μμ | Madhu Pendurthi
American Journal of Respiratory and Critical Care Medicine, Volume 194, Issue 2, Page e1-e1, July 15, 2016.
A Chronic Obstructive Pulmonary Disease Susceptibility Gene, FAM13A, Regulates Protein Stability of β-Catenin
Σάββατο, 16 Ιουλίου 2016, 7:00:07 μμ | Zhiqiang Jiang
American Journal of Respiratory and Critical Care Medicine, Volume 194, Issue 2, Page 185-197, July 15, 2016.
Diffuse Idiopathic Skeletal Hyperostosis Is Associated with Lower Lung Volumes in Current and Former Smokers
Σάββατο, 16 Ιουλίου 2016, 7:00:07 μμ | Sytse F. Oudkerk
American Journal of Respiratory and Critical Care Medicine, Volume 194, Issue 2, Page 241-242, July 15, 2016.
Idiopathic Pulmonary Fibrosis on the Internet. Let’s Calm the Sea of (Mis)information
Σάββατο, 16 Ιουλίου 2016, 7:00:07 μμ | David J. Lederer
American Journal of Respiratory and Critical Care Medicine, Volume 194, Issue 2, Page 134-136, July 15, 2016.
Airway Basal Cell Expansion Takes Cues from Keratinocytes
Σάββατο, 16 Ιουλίου 2016, 7:00:07 μμ | Hans-Willem Snoeck
American Journal of Respiratory and Critical Care Medicine, Volume 194, Issue 2, Page 127-128, July 15, 2016.
Abnormal foreign body in the esophagus: a rare presentation
Σάββατο, 16 Ιουλίου 2016, 1:55:50 μμ
Abstract
Foreign body ingestion and impaction in the esophagus can happen at any age, although occurring more frequent in children (<10 years) and adults (>50 years). This problem can happen in both sexes with equal frequency. The risk factors in favor of the esophagus foreign body impaction include impaired vision, poor dentations, psychotic patients, body packers, prisoners, and patients with previous esophageal abrasion. The aim of this article is to study the etiology, clinical presentation, surgical treatment, and complications of foreign body ingestion at the same time as presenting a rare remarkable case.Intermittent distal perfusion shortens hypothermic circulatory arrest time in aortic arch replacement surgery
Σάββατο, 16 Ιουλίου 2016, 8:04:09 πμ
Abstract
The procedure and efficacy of the intermittent distal perfusion during hypothermic circulatory arrest in total arch replacement was described. During hypothermic circulatory arrest, elephant trunk was fixed inside the descending aorta. Then, the AP Grid Catheter was inserted through the elephant trunk, and blood perfusion at a flow rate of 500 ml/min for 5 min was installed. After the perfusion, distal anastomosis was completed. Clinical results of 23 patients (Group I) with this technique were compared with these of 21 patients without the procedure (Group II). Continuous hypothermic circulatory arrest time was significantly shorter (32.7 vs. 72.7 min; p < 0.05) and postoperative serum creatinine level was significantly lower (1.29 vs. 1.68; p < 0.05) in Group I than Group II. The incidence of abdominal complication was also fewer in Group I. Intermittent distal perfusion shortens hypothermic circulatory arrest time and is protective for the lower body including kidneys.Right ventricular infarction caused by tricuspid ring annuloplasty
Πέμπτη, 14 Ιουλίου 2016, 10:07:00 μμ
Abstract
Injury to the right coronary artery (RCA) is a rare complication of tricuspid annuloplasty. We report a patient who developed right ventricular (RV) infarction, because of tricuspid annuloplasty, and review management options.Point: Is escalation of the inhaled corticosteroid dose appropriate for acute loss of asthma control in an attempt to reduce need for oral corticosteroids in children? Yes
Πέμπτη, 14 Ιουλίου 2016, 5:55:49 μμ | Farber HJ.
Counterpoint: Is escalation of the inhaled corticosteroid dose appropriate for acute loss of asthma control in an attempt to reduce need for oral corticosteroids in children? No
Πέμπτη, 14 Ιουλίου 2016, 5:55:49 μμ | Weinberger M.
The Inaccuracy of Patient Recall for COPD Exacerbation Rate Estimation and its Implications: Results from Central Adjudication
Πέμπτη, 14 Ιουλίου 2016, 5:55:49 μμ | Frei A, Siebeling L, Wolters C, et al.
Background
COPD exacerbation incidence rates are often ascertained retrospectively, through patient recall and self-reports. We compared exacerbation ascertainment through patient self-reports and single physician chart review to central adjudication by a committee and explored determinants and consequences of misclassification.
Methods
Self-reported exacerbations (event-based definition) in 409 primary care COPD patients participating in the ICE COLD ERIC cohort were ascertained 6-monthly over 3 years. Exacerbations were adjudicated by single experienced physicians and an adjudication committee who had information from patient charts. We assessed the accuracy (sensitivities and specificities) of self-reports and single physician chart review against a central adjudication committee (reference standard). We used multinomial logistic regression and bootstrap stability analyses to explore determinants of misclassifications.
Results
The adjudication committee identified 648 exacerbations, corresponding with an incidence rate of 0.60±0.83 exacerbations/patient-year and a cumulative incidence proportion of 58.9%. Patients self-reported 841 exacerbations (incidence rate 0.75±1·01, incidence proportion 59.7%). Sensitivity/specificity of self-reports were 84%/76%, those of single physician chart review between 89-96% and 87-99%. The multinomial regression model and bootstrap selection showed that having experienced more exacerbations was the only factor consistently associated with under- and over-reporting of exacerbations (under-reporters: relative risk ratio 2.16, 95% CI 1.76-2.65; over-reporters: relative risk ratio 1.67, 95% CI 1.39-2.00).
Conclusions
Patient 6-month recall of exacerbation events are inaccurate. This may lead to inaccurate estimates of incidence measures and underestimation of treatment effects. The use of multiple data sources combined with event adjudication could substantially reduce sample size requirements and possibly cost of studies.Lung clearance index in adults and children with cystic fibrosis
Πέμπτη, 14 Ιουλίου 2016, 5:55:49 μμ | O’Neill K, Tunney MM, Johnston E, et al.
Background
Lung clearance index (LCI) has good clinimetric properties and an acceptable feasibility profile as a surrogate endpoint in Cystic Fibrosis (CF). Although most studies to date have been in children, increasing numbers of adults with CF also have normal spirometry. Further study of LCI as an endpoint in CF adults is required. Therefore, the purpose of this study was to determine the clinimetric properties of LCI over the complete age range of people with CF.
Methods
Clinically stable adults and children with CF and age matched healthy controls were recruited.
Results
LCI and spirometry data for 110 CF subjects and 61 controls were collected at a stable visit. CF Questionnaire-Revised (CFQ-R) was completed by 80/110 CF subjects. Fifty-six CF subjects completed a second stable visit. The LCI CV% was 4.1% in adults and 6.3% in children with CF. The coefficient of repeatability of LCI was 1.2 in adults and 1.3 in children. In both adults and children, LCI (AUCROC=0.93 and 0.84) had greater combined sensitivity and specificity to discriminate between people with CF and controls compared to FEV1 (AUCROC=0.88 and 0.60) and FEF25-75 (AUCROC=0.87 and 0.68). LCI correlated significantly with the CFQ-R treatment burden in adults (r=-0.37; pConclusionsProtracted Bacterial Bronchitis in Children: Natural History and Risk Factors for Bronchiectasis
Πέμπτη, 14 Ιουλίου 2016, 5:55:49 μμ | Wurzel DF, Marchant JM, Yerkovich ST, et al.
Background
Protracted bacterial bronchitis (PBB) and bronchiectasis are distinct diagnostic entities that share common clinical and laboratory features. It is postulated, but remains unproven, that PBB precedes a diagnosis of bronchiectasis in a subgroup of children. In a cohort of children with PBB, our objectives were to: (a) determine the medium-term risk of bronchiectasis and (b) identify risk factors for bronchiectasis and recurrent episodes of PBB.
Methods
161 children with PBB and 25 controls were prospectively recruited to this cohort study. A subset of 106 children was followed for 2 years. Flexible bronchoscopy, BAL and basic immune function tests were performed. CT chest was undertaken if clinical features were suggestive of bronchiectasis.
Results
Of 161 children with PBB (66% male), 13 (8.1%) were diagnosed with bronchiectasis over the study period. Almost half (43.5%) with PBB had recurrent episodes (>3/year). Major risk factors for bronchiectasis included: H. influenzae lower airway infection (in BAL) (p=0.013) and recurrent episodes of PBB (p=0.003). H. influenzae infection conferred >7 times higher risk of bronchiectasis [HR 7.55 (95%CI 1.66 - 34.28), p=0.009] compared to absence of H. influenzae. The majority of isolates (82%) were nontypeable H. influenzae. No risk factors for recurrent PBB were identified.
Conclusions
PBB is associated with a future diagnosis of bronchiectasis in a subgroup of children. H. influenzae lower airway infection and recurrent PBB are significant predictors. Clinicians should be cognisant of the relationship between PBB and bronchiectasis and appropriate follow-up measures should be taken in those with risk factors.Treatment of Acute Respiratory Distress Syndrome with Prone Positioning
Πέμπτη, 14 Ιουλίου 2016, 5:55:49 μμ | Scholten EL, Beitler JR, Prisk G, et al.
Prone positioning was first proposed in the 1970s as a method to improve gas exchange in the acute respiratory distress syndrome (ARDS). Subsequent observations of dramatic improvement in oxygenation with simple patient rotation motivated the next several decades of research. This work elucidated the physiology mechanisms underlying changes in gas exchange and respiratory mechanics with prone ventilation. However, translating physiological improvements into a clinical benefit has proven challenging; several contemporary trials showed no major clinical benefits with proning. By optimizing patient selection and treatment protocols, the most recent Proning Severe ARDS Patients (PROSEVA) trial demonstrated a significant mortality benefit with prone ventilation. This trial, and subsequent meta-analyses, support the role of prone positioning as an effective therapy to reduce mortality in severe ARDS, particularly when applied early with other lung-protective strategies. This review discusses the physiological principles, clinical evidence, and practical application of prone ventilation in ARDS.
Obesity: systemic and pulmonary complications, biochemical abnormalities, and impairment of lung function
Τρίτη, 12 Ιουλίου 2016, 7:17:07 μμ
Abstract
Obesity is currently one of the major epidemics of this millennium and affects individuals throughout the world. It causes multiple systemic complications, some of which result in severe impairment of organs and tissues. These complications involve mechanical changes caused by the accumulation of adipose tissue and the numerous cytokines produced by adipocytes. Obesity also significantly interferes with respiratory function by decreasing lung volume, particularly the expiratory reserve volume and functional residual capacity. Because of the ineffectiveness of the respiratory muscles, strength and resistance may be reduced. All these factors lead to inspiratory overload, which increases respiratory effort, oxygen consumption, and respiratory energy expenditure. It is noteworthy that patterns of body fat distribution significantly influence the function of the respiratory system, likely via the direct mechanical effect of fat accumulation in the chest and abdominal regions. Weight loss caused by various types of treatment, including low-calorie diet, intragastric balloon, and bariatric surgery, significantly improves lung function and metabolic syndrome and reduces body mass index. Despite advances in the knowledge of pulmonary and systemic complications associated with obesity, longitudinal randomized studies are needed to assess the impact of weight loss on metabolic syndrome and lung function.Obesity: systemic and pulmonary complications, biochemical abnormalities, and impairment of lung function
Τρίτη, 12 Ιουλίου 2016, 11:52:30 πμ | Thiago Thomaz Mafort, Rogério Rufino, Cláudia Henrique Costa and Agnaldo José Lopes
Obesity is currently one of the major epidemics of this millennium and affects individuals throughout the world. It causes multiple systemic complications, some of which result in severe impairment of organs a...
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