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BMJ Case Rep 2022 Jun 27;15(6). Epub 2022 Jun 27.

Internal Medicine, RG Kar Medical College and Hospital, Kolkata, West Bengal, India.

Acute-onset quadriparesis is not only debilitating and a grave concern for the patient but also perturbs the clinician as it demands early diagnosis and prompt management to prevent catastrophic outcome due to respiratory failure. Guillain-Barré syndrome (GBS) and hypokalaemia are notorious causes of acute-onset lower motor neuron (LMN) quadriparesis and warrant a rapid evaluation to necessitate early management. However, coexistence of these two entities is extremely rare and may pose a diagnostic and therapeutic challenge and mandates exclusion of either condition to avoid a poor outcome. Read More

Nat Med 2022 Jun 27. Epub 2022 Jun 27.

KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.

Three lineages (BA.1, BA.2 and BA. Read More

Clin Respir J 2022 Jun 27. Epub 2022 Jun 27.

The NEMO (NEuroMuscular Omniservice) Clinical Center, Milan, Italy.

Introduction: Respiratory insufficiency is one of the main causes of death in myotonic dystrophy type 1 (DM1). Although there is general consensus these patients have a restrictive ventilatory pattern, hypoventilation, chronic hypercapnia and sleep disturbances, the prevalence of respiratory disease and indication for and effects of non-invasive ventilation (NIV) need to be further explored.

Objectives: We aim to describe the respiratory function and the need for NIV at baseline and over time in a cohort of adult patients with DM1. Read More

Int J Pediatr Otorhinolaryngol 2022 Jun 23;159:111214. Epub 2022 Jun 23.

Department of Otolaryngology, Meyer Children Hospital, Florence, Italy.

The management of tracheal wall lacerations is debated. Current treatments are mainly derived by the experience on adults and include conservative or surgical treatments depending on the clinical condition of the patient. We report our preliminary data with removable tracheal stents in 3 children with tracheal tears and respiratory failure. Read More

Rev Med Inst Mex Seguro Soc 2022 May 2;60(3):249-257. Epub 2022 May 2.

Instituto Mexicano del Seguro Social, Hospital General Regional No. 66, Servicio de Urgencias. Ciudad Juárez, Chihuahua, México.

Background: The COVID-19 pandemic caused hospital reconversion throughout Mexico and it was scarce information about its development in second-level intensive care units (ICU).

Objective: To determine the clinical characteristics related to COVID-19 mortality in a second-level ICU.

Material And Methods: Observational, cohort, retrospective, and analytical study. Read More

Biol Res Nurs 2022 Jun 27:10998004221109925. Epub 2022 Jun 27.

Division of Pulmonary, Critical Care and Sleep Medicine, 205280University of Washington, Seattle, WA, USA.

: Survivors of acute respiratory failure (ARF) experience long-term cognitive impairment and circadian rhythm disturbance after hospital discharge. Although prior studies in aging and neurodegenerative diseases indicate actigraphy-estimated rest-activity circadian rhythm disturbances are risk factors for cognitive impairment, it is unclear if this applies to ARF survivors. This study explored the relationships of actigraphy-estimated rest-activity circadian rhythms with cognitive functioning in ARF survivors at 3 months after discharge. Read More

Egypt J Immunol 2022 Jul;29(3):90-98

Department of Medical Microbiology and Immunology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Severity of symptoms in COVID-19 has been shown to result from a cytokine storm. Interleukin (IL)-17 is one of these various cytokines, which results in a proinflammatory response, systemic inflammatory symptoms, inflammatory cell infiltration of lung tissue and thus leads to the massive lung pathology and multiorgan failure. Gene polymorphisms in the regulatory regions of cytokine-encoding genes affect the amounts of cytokines produced and possess a fundamental role in infectious diseases. Read More

J Zoo Wildl Med 2022 Jun;53(2):363-372

Veterinary Specialty Center, Buffalo Grove, IL 60089, USA.

Elasmobranch cardiac anatomy and physiology has been well described; however, there is a dearth of information regarding cardiac disease. In support of a clinical case of suspected congestive heart failure in a 22-yr-old male sand tiger shark (), a study was undertaken to identify feasible echocardiographic imaging planes and preliminary indices for this species. Eleven echocardiograms were performed on six apparently healthy sand tiger sharks. Read More

Medicine (Baltimore) 2022 Jun 24;101(25):e29551. Epub 2022 Jun 24.

Department of Internal Medicine, Research Center for Pulmonary Disorders, Jeonbuk National University Medical School, Jeonju, South Korea.

Abstract: Bronchiolitis generally refers to inflammation and/or fibrosis of the non-cartilaginous small airways located approximately from the 8th airway generation down to the terminal and respiratory bronchioles. In contrast to young children, the frequency of small airway infection in adult bronchiolitis appears less frequent and a number of other pathophysiological conditions have been implicated in adult bronchiolitis. However, little information is available on the exact medical burden of bronchiolitis such as its prevalence and comorbidities in the adult population. Read More

Curr Opin Crit Care 2022 Jun 28. Epub 2022 Jun 28.

Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut.

Purpose Of Review: The modern cardiac intensive care unit (CICU) has evolved into a high-intensity unit that cares for critically ill patients. Despite this transformation, changes to the staffing model and organizational structure in these specialized units have only recently begun to meet these challenges. We describe the most recent evidence which will inform future CICU staffing models. Read More

Int Rev Immunol 2022 Jun 25:1-20. Epub 2022 Jun 25.

Department of Biochemistry, All India Institute of Medical Sciences, Bhopal, India.

Coronavirus disease-19 (COVID-19), a pandemic caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), is a primarily respiratory tract disease. Suitable animal models for COVID-19 are required to study various aspects of pathogenesis, drug discovery, effective and safe vaccine development. Several laboratory animals including, non-human primates, hamsters, ferrets, transgenic mice, and zebrafish, have been used and proven their significance experimentally. Read More

Oxid Med Cell Longev 2022 17;2022:2782429. Epub 2022 Jun 17.

Key Laboratory of Targeted Intervention of Cardiovascular Disease, Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, and Department of Physiology, Nanjing Medical University, Nanjing, China.

Background: Pulmonary arterial hypertension (PAH) is a complex pulmonary vasculature disease characterized by progressive obliteration of small pulmonary arteries and persistent increase in pulmonary vascular resistance, resulting in right heart failure and death if left untreated. Artemisinin (ARS) and its derivatives, which are common antimalarial drugs, have been found to possess a broad range of biological effects. Here, we sought to determine the therapeutic benefit and mechanism of ARS and its derivatives treatment in experimental pulmonary hypertension (PH) models. Read More

Front Neurol 2022 9;13:905477. Epub 2022 Jun 9.

Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, China.

Background: Brainstem hemorrhage has a rapid onset with high mortality and disability rates. In recent years, an increasing number of studies have reported on the surgical treatment of brainstem hemorrhage. The introduction of stereotaxic instruments and navigation systems has improved the accuracy of surgical treatment; however, the popularity of these devices in the primary hospitals is not high. Read More

Indian J Clin Biochem 2022 Jun 18:1-11. Epub 2022 Jun 18.

Department of Biochemistry, All India Institute of Medical Sciences, Patna, 801507 India.

COVID-19, a global pandemic that led to increased morbidity and mortality worldwide since its outcome at the end of the year 2019. A newly discovered variant of severe acute respiratory distress syndrome coronavirus-2 (SARS-CoV-2) was the arbitrator for spreading the syndrome by droplet transmission causing multi-organ failure in many occasions. A post-infection-pro-diabetic disposition was found evident in this study with the persistence of hepato-pancreatic aberrations in respect of reference range of tissue specific bio-markers in hospital admitted COVID-19 cases. Read More

Front Oncol 2022 9;12:875793. Epub 2022 Jun 9.

Graduate School, Dalian Medical University, Dalian, China.

Background: Primary osteosarcoma of the breast (POB) is an extremely aggressive and heterogeneous neoplasm that originates from nonepithelial elements of the mammary gland and accounts for fewer than 1% of breast cancers and fewer than 5% of all sarcomas.

Case Presentation: An 83-year-old Chinese woman went to our hospital because of a palpable mass she had had for 8 months in the left breast accompanied by persistent dull pain for 10 days. This mass was initially misdiagnosed as a degenerating fibroadenoma and was graded as probably benign (BI-RADS category 3) by ultrasonography (US) and computed tomography (CT) plain scan and contrast enhancement of chest. Read More

Ochsner J 2022 ;22(2):169-175

Department of Neurocritical Care, Ochsner Clinic Foundation, New Orleans, LA.

Mucormycosis is a serious angioinvasive fungal infection. Immunocompromised patients are more likely to be susceptible to mucormycosis than immunocompetent individuals. Cerebral mucormycosis has been reported, but cases have primarily been unilateral. Read More

J Oncol 2022 15;2022:4711935. Epub 2022 Jun 15.

Department of Geriatric Intensive Care Unit Nursing, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 610072, China.

NIV (noninvasive ventilation) is becoming more popular as a first-line treatment for older patients with lung cancer who are experiencing acute respiratory failure. In the ICU, older age is linked to worse results with mechanical breathing. When dealing with severely sick patients, noninvasive ventilation is beneficial. Read More

Front Microbiol 2022 9;13:919501. Epub 2022 Jun 9.

Veterinary Medical Research Institute, Budapest, Hungary.

Secondary fungal infections may complicate the clinical course of patients affected by viral respiratory diseases, especially those admitted to intensive care unit. Hospitalized COVID-19 patients are at increased risk of fungal co-infections exacerbating the prognosis of disease due to misdiagnosis that often result in treatment failure and high mortality rate. COVID-19-associated fungal infections caused by predominantly and species, and fungi of the order have been reported from several countries to become significant challenge for healthcare system. Read More

Sleep Sci 2022 Apr-Jun;15(2):250-258

University of British Columbia, Anesthesiology, Pharmacology and Therapeutics - Vancouver - BC - Canada.

Cardiovascular diseases (CVDs) are the leading causes of mortality worldwide, accounting for nearly 18 million deaths per year. Among other considerations, treating CVDs requires better understanding their risk factors. Sleep-disordered breathing, especially obstructive sleep apnea (OSA), is a likely contributor to several CVDs. Read More

Med Clin (Engl Ed) 2022 Jun 18;158(11):509-518. Epub 2022 Jun 18.

Infectious Diseases Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain.

Background: Modulation of the immune system to prevent lung injury is being widely used against the new coronavirus disease (COVID-19). The primary endpoint was mortality at 7 days after tocilizumab administration. Secondary endpoints were admission to the intensive care unit, development of ARDS and respiratory insufficiency among others. Read More

Front Med (Lausanne) 2022 9;9:823067. Epub 2022 Jun 9.

Department of Clinical Nursing, School of Nursing, Nanjing Medical University, Nanjing, China.

Background: A prolonged stay in the intensive care unit (ICU) is associated with gastrointestinal failure, which may have a destructive effect on functional status within 1 year after hospital discharge. The aim was to investigate the effects of a daily exercise session, using a bedside cycle ergometer, on gastrointestinal functions, such as diarrhea, gastric retention, and vomiting, in patients with severe pneumonia who received mechanical ventilation (MV).

Methods: The study was a randomized controlled trial, and its setting was the ICU of a tertiary hospital in Eastern China. Read More

Proc (Bayl Univ Med Cent) 2022 24;35(4):410-414. Epub 2022 Mar 24.

College of Medicine, Central Michigan University, Saginaw, Michigan.

Ventilator-associated pneumonia (VAP) is a major cause of healthcare-associated mortality and morbidity in critically ill patients who are mechanically ventilated. The purpose of this study was to describe the various primary discharge diagnoses of hospitalizations with VAP, to identify their demographic characteristics, and to identify risk factors for mortality in hospitalizations with VAP. Hospitalizations with a diagnosis of VAP with mechanical ventilation for over 24 hours were selected from the National Inpatient Sample in 2016 and 2017. Read More

Cureus 2022 Jun 22;14(6):e26200. Epub 2022 Jun 22.

Internal Medicine, Trinity Medical Center West, Steubenville, USA.

E-vape and e-cigarettes-associated lung injury (EVALI) is a diagnostic dilemma and even more obscure during the coronavirus disease 2019 (COVID-19) pandemic. A rise was seen in EVALI cases at the beginning of the COVID-19 pandemic. Still, the non-specific presentation, or the overlapping symptoms of COVID-19 and EVALI, can negate the possible diagnosis of EVALI because of a clinician's predisposition toward infectious etiologies, and it becomes even more challenging during a viral pandemic. Read More

J Neuromuscul Dis 2022 Jun 20. Epub 2022 Jun 20.

Department of Neurogenetics, Royal Perth Hospital, Perth, WA, Australia.

A 38-year-old pregnant woman presented at 30 weeks gestation in respiratory distress with pre-eclampsia. This was on the background of slowly progressive dyspnoea over six years, with generalised weakness and previous surgery for ptosis and prognathia. After successful caesarean delivery at 31 weeks, the patient was found to have a homozygous likely pathogenic variant in the MYOD1 gene. Read More

J Clin Lab Anal 2022 Jun 26:e24569. Epub 2022 Jun 26.

Department of Pharmacology, Cangzhou Medical College, Cangzhou, China.

Background: Long noncoding RNA (lncRNA) cancer susceptibility candidate gene 2 (CASC2) inhibits inflammation and multi-organ dysfunction in various ways. The present study was intended to explore the potency of blood lncRNA CASC2 as a biomarker for sepsis management.

Methods: Totally, 184 sepsis patients and 30 healthy controls were enrolled. Read More

Intern Emerg Med 2022 Jun 26. Epub 2022 Jun 26.

Unit of Internal Medicine and Metabolic Diseases, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Despite vaccination programs, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains a public health problem. Identifying key prognostic determinants of severity of the disease may help better focus health resources. The negative prognostic role for metabolic and hepatic alterations is established; however, the interplay among different metabolic comorbidities and their interconnections with the liver have never been explored. Read More

Respir Res 2022 Jun 26;23(1):171. Epub 2022 Jun 26.

Department of Anaesthesia and Intensive Care Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Sforza, 35, 20122, Milan, Lombardia, Italy.

Background: Few data exist on high flow nasal cannula (HFNC) use in patients with acute respiratory failure (ARF) admitted to general wards.

Rationale And Objectives: To retrospectively evaluate feasibility and safety of HFNC in general wards under the intensivist-supervision and after specific training.

Methods: Patients with ARF (dyspnea, respiratory rate-RR > 25/min, 150 < PaO/FiO < 300 mmHg during oxygen therapy) admitted to nine wards of an academic hospital were included. Read More

Respir Investig 2022 Jun 23. Epub 2022 Jun 23.

Department of Anesthesiology, Osaka Women's and Children's Hospital, Osaka, Japan.

Background: The joint committee of the Japanese Society of Intensive Care Medicine/Japanese Respiratory Society/Japanese Society of Respiratory Care Medicine on ARDS Clinical Practice Guideline has created and released the ARDS Clinical Practice Guideline 2021.

Methods: The 2016 edition of the Clinical Practice Guideline covered clinical questions (CQs) that targeted only adults, but the present guideline includes 15 CQs for children in addition to 46 CQs for adults. As with the previous edition, we used a systematic review method with the Grading of Recommendations Assessment Development and Evaluation (GRADE) system as well as a degree of recommendation determination method. Read More

J Cardiothorac Vasc Anesth 2022 May 22. Epub 2022 May 22.

Division of Cardiac Thoracic and Vascular Anesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria.

Objective: Postoperative myasthenic crisis with respiratory failure is a potentially lethal complication, warranting careful perioperative planning and extended postoperative surveillance of patients. Data on the incidence of postoperative respiratory failure and optimal management of patients after robotic-assisted thymectomy are limited. The objective of this study was to evaluate the incidence of respiratory complications and the need for intensive care unit (ICU) capacities after robotic-assisted thymectomy in patients with myasthenia gravis. Read More

Zhong Nan Da Xue Xue Bao Yi Xue Ban 2022 May;47(5):535-545

Department of Nephrology, Second Xiangya Hospital, Central South University, Changsha 410011.

Objectives: Acute kidney injury (AKI) is one of the common complications in critically ill septic patients, which is associated with increased risks of death, cardiovascular events, and chronic renal dysfunction. The duration of AKI and the renal function recovery status after AKI onset can affect the patient prognosis. Nevertheless, it remains controversial whether early recovery status after AKI is closely related to the prognosis in patients with sepsis-associated AKI (SA-AKI). Read More