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    Cardiac magnetic resonance imaging-indeterminate/negative cardiac sarcoidosis revealed by (18)F-fluorodeoxyglucose-positron emission tomography: two case reports and a review of the literature.
    J Med Case Rep 2017 Oct 20;11(1):291. Epub 2017 Oct 20.
    Department of Clinical Immunology, Concord Hospital, Level 6, Hospital Rd, Concord, Sydney, NSW, 2139, Australia.
    Background: Sarcoidosis is an inflammatory disorder of immune dysregulation characterized by non-caseating granulomas that can affect any organ. Cardiac sarcoidosis is an under-recognized entity that has a heterogeneous presentation and may occur independently or with any severity of systemic disease. Diagnosing cardiac sarcoidosis remains problematic with endomyocardial biopsies associated with a high risk of complications. Read More

    Chronic Lymphocytic Leukemia: A Rare Cause of Pathological Fracture of the Femur.
    J Investig Med High Impact Case Rep 2017 Oct-Dec;5(4):2324709617735135. Epub 2017 Oct 3.
    Maimonides Medical Center, Brooklyn, NY, USA.
    The incidence rate of chronic lymphocytic leukemia (CLL) in the United States is approximately 0.005%; men are at slightly higher risk than women. Bony involvement or pathological fracture rarely occurs in CLL, and it may be the initial presentation. Read More

    Delivery and postpartum management of a patient with Pompe disease: Case report and review of the literature.
    Obstet Med 2017 Sep 14;10(3):150-151. Epub 2017 Feb 14.
    Department of Obstetrics and Gynecology, Ankara University School of Medicine, Ankara, Turkey.
    Pompe disease is an autosomal-recessive disorder caused by acid alpha-glucosidase deficiency due to mutations in the GAA gene. There are two forms of the disease: infantile-onset Pompe disease and late-onset Pompe disease. The worldwide incidence of both forms of the disease is commonly reported to be 1 in 40,000. Read More

    Evaluation of the head and neck cancer patient population and the incidence of hospitalization at an academic medical center.
    J Oncol Pharm Pract 2017 Jan 1:1078155217735688. Epub 2017 Jan 1.
    2 Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, USA.
    Purpose Patients with head and neck cancer are at risk for disease- and treatment-related toxicities that may be severe enough to require hospitalization. The risk factors associated with hospitalization in these patients are not well defined. Methods We conducted a single-center, retrospective observational study of patients with head and neck cancer receiving chemotherapy at an academic medical center infusion clinic in a one-year period. Read More

    Long-Term Quality of Life After Extracorporeal Membrane Oxygenation in ARDS Survivors: Systematic Review and Meta-Analysis.
    J Intensive Care Med 2017 Jan 1:885066617737035. Epub 2017 Jan 1.
    1 Division of Respirology, Department of Medicine, University Health Network, Toronto, Ontario, Canada.
    Purpose: Extracorporeal membrane oxygenation (ECMO) is an increasingly prevalent treatment for acute respiratory failure (ARF). To evaluate the impact of ECMO support on long-term outcomes for critically ill adults with ARF.

    Methods: We searched electronic databases 1948 through to November 30 2016; selected controlled trials or observational studies of critically ill adults with acute respiratory distress syndrome, examining long-term morbidity specifically health-related quality of life (HRQL); 2 authors independently selected studies, extracted data, and assessed methodological quality. Read More

    Predicting long-term survival after coronary artery bypass graft surgery.
    Interact Cardiovasc Thorac Surg 2017 Oct 6. Epub 2017 Oct 6.
    School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
    Objectives: To develop a model for predicting long-term survival following coronary artery bypass graft surgery.

    Methods: This study included 46 573 patients from the Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZCTS) registry, who underwent isolated coronary artery bypass graft surgery between 2001 and 2014. Data were randomly split into development (23 282) and validation (23 291) samples. Read More

    Long-term patency of on- and off-pump coronary artery bypass grafting with bilateral internal thoracic arteries: the significance of late string sign development in the off-pump technique.
    Interact Cardiovasc Thorac Surg 2017 Jul 31. Epub 2017 Jul 31.
    Department of Cardiovascular Surgery, Japanese Red Cross Nagoya First Hospital, Nakamura-ku, Nagoya, Japan.
    Objectives: This study aimed to examine the effect of off-pump coronary artery bypass grafting (CABG) in patients who underwent revascularization with bilateral internal thoracic arteries (ITAs).

    Methods: Between January 2000 and December 2014, 499 patients underwent isolated CABG with bilateral ITAs for complete revascularization of the left coronary system at our institution. On-pump CABG was performed in 137 patients, and off-pump CABG was performed in 362 patients. Read More

    Long-term Change in the Risk of Skin Cancer After Organ Transplantation: A Population-Based Nationwide Cohort Study.
    JAMA Dermatol 2017 Oct 18. Epub 2017 Oct 18.
    Department of Dermatology, Oslo University Hospital, Oslo, Norway.
    Importance: The high risk of skin cancer after organ transplantation is a major clinical challenge and well documented, but reports on temporal trends in the risk of posttransplant cutaneous squamous cell carcinoma (SCC) are few and appear contradictory.

    Objective: To study temporal trends for the risk of skin cancer, particularly SCC, after organ transplantation.

    Design, Setting, And Participants: Population-based, nationwide, prospective cohort study of 8026 patients receiving a kidney, heart, lung, or liver transplant in Norway from 1968 through 2012 using patient data linked to a national cancer registry. Read More

    High-frequency percussive ventilation in cardiac surgery patients failing mechanical conventional ventilation.
    Interact Cardiovasc Thorac Surg 2017 Jul 21. Epub 2017 Jul 21.
    Department of Cardiothoracic Surgery, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA.
    Objectives: Failure of mechanical conventional ventilation (MCV) after cardiac surgery portends a dismal prognosis, with extracorporeal membrane oxygenation frequently utilized as a salvage therapy. We describe our experience with high-frequency percussive ventilation (HFPV) as a rescue therapy for hypoxaemia refractory to MCV after cardiac surgery.

    Methods: In a 6-year retrospective analysis from 2009 to 2015, we identified 16 subjects who required HFPV after cardiac surgery. Read More

    Primary cardiac angiosarcoma: A case report.
    Medicine (Baltimore) 2017 Oct;96(42):e7352
    aDepartment of Oncology bDepartment of Thoracic Surgery cDepartment of Pathology, the 306th Hospital of PLA, Beijing, China.
    Background: Primary cardiac angiosarcoma is rare, but it is the most aggressive type of cardiac malignant tumor. When disease is confirmed it is often late in its stage resulting in a poor prognosis.

    Case Presentation: We reported a 52-year-old woman who complained of dyspnea for 2 months and dry cough for 10 days. Read More

    Valproic Acid Attenuates the Risk of Acute Respiratory Failure in Patients with Subarachnoid Hemorrhage.
    QJM 2017 Oct 18. Epub 2017 Oct 18.
    Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
    Background: To determine whether the use of valproic acid (VPA) is associated with a decreased risk of acute respiratory failure (ARF) in patients with subarachnoid hemorrhage (SAH).

    Methods: The Taiwan National Health Insurance Research Database was used to analyze all patients newly diagnosed with SAH from 2000 to 2010. The VPA users were matched for age, gender and index date in 1:2 ratios with randomly selected non-VPA users as a comparison group. Read More

    Investigating Immune Gene Signatures in Peripheral Blood from Subjects with Allergic Rhinitis Undergoing Nasal Allergen Challenge.
    J Immunol 2017 Oct 18. Epub 2017 Oct 18.
    Experimental Medicine, University of British Columbia, Vancouver, British Columbia V5Z 1M9, Canada;
    Nasal allergen challenge (NAC) is a human model of allergic rhinitis (AR) that delivers standardized allergens locally to the nasal mucosa allowing clinical symptoms and biospecimens such as peripheral blood to be collected. Although many studies have focused on local inflammatory sites, peripheral blood, an important mediator and a component of the systemic immune response, has not been well studied in the setting of AR. We sought to investigate immune gene signatures in peripheral blood collected after NAC under the setting of AR. Read More

    Higher PEEP versus Lower PEEP Strategies for Patients with Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis.
    Ann Am Thorac Soc 2017 Oct 18. Epub 2017 Oct 18.
    University of Toronto, Interdepartmental Division of Critical Care Medicine , Toronto General Hospital , 585 University Avenue , 11C-1167 , Toronto, Ontario, Canada ;
    Rationale: Higher positive end-expiratory pressure (PEEP) levels may reduce atelectrauma but increase over-distention lung injury. Whether higher PEEP improves clinical outcomes among patients with acute respiratory distress syndrome (ARDS) is unclear.

    Objective: To compare clinical outcomes of mechanical ventilation strategies using higher PEEP levels versus lower PEEP strategies in patients with ARDS. Read More

    Protective Effects of Bisoprolol against Acute Exacerbation in Moderate-to-Severe Chronic Obstructive Pulmonary Disease.
    Acta Med Okayama 2017 Oct;71(5):453-457
    Department of Allergy and Respiratory Medicine, Okayama University Hospital.
    Although recent retrospective studies suggested that the use of β-blockers appears to help improve the mortality rate and decrease the rate of exacerbation in chronic obstructive pulmonary disease (COPD) patients with heart failure, the effects of β-blockers on COPD patients without heart failure have not been established. Based on previous reports, we have launched a multicenter, prospective, single-arm phase II study to evaluate the preventive effect of the cardioselective β-blocker bisoprolol in COPD exacerbation, in Japanese individuals with moderate-to-severe COPD who do not have heart failure but do have hypertension requiring the use of medication. The primary endpoint is the rate of mild-to-severe COPD exacerbation. Read More

    Infrequent Provision of Palliative Care to Patients with Dialysis-Requiring AKI.
    Clin J Am Soc Nephrol 2017 Oct 17. Epub 2017 Oct 17.
    Division of Nephrology, Stanford University School of Medicine, Palo Alto, California; and.
    Background And Objectives: The use of palliative care in AKI is not well described. We sought to better understand palliative care practice patterns for hospitalized patients with AKI requiring dialysis in the United States.

    Design, Setting, Participants, & Measurements: Using the 2012 National Inpatient Sample, we identified patients with AKI and palliative care encounters using validated International Classification of Diseases, Ninth Revision, Clinical Modification codes. Read More

    Predictors of Death in Adults With Duchenne Muscular Dystrophy-Associated Cardiomyopathy.
    J Am Heart Assoc 2017 Oct 17;6(10). Epub 2017 Oct 17.
    Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
    Background: Duchenne muscular dystrophy (DMD) is frequently complicated by development of a cardiomyopathy. Despite significant medical advances provided to DMD patients over the past 2 decades, there remains a group of DMD patients who die prematurely. The current study sought to identify a set of prognostic factors that portend a worse outcome among adult DMD patients. Read More

    Bilateral cavitary multidrug- or extensively drug-resistant tuberculosis: role of surgery.
    Eur J Cardiothorac Surg 2017 Oct 10. Epub 2017 Oct 10.
    Department of Pulmonary TB Thoracic Surgery, St. Petersburg State Scientific and Research Institute of Phthisiopulmonology, St. Petersburg, Russia.
    Objectives: Cavitary disease and bilateral lesions are among the risk factors for poor outcome of pulmonary tuberculosis (TB). Our aim was to explore the value and limits of surgery in patients with advanced TB.

    Methods: A retrospective study of 57 consecutive patients who underwent thoracic surgery for culture-positive bilateral cavitary pulmonary TB was performed. Read More

    Failure of Isoflurane Cardiac Preconditioning in Obese Type 2 Diabetic Mice Involves Aberrant Regulation of MicroRNA-21, Endothelial Nitric-oxide Synthase, and Mitochondrial Complex I.
    Anesthesiology 2017 Oct 17. Epub 2017 Oct 17.
    From the Departments of Anesthesiology (Z.-D.G., S.Q., X.B., D.C.W., J.R.K., Z.J.B.) and Physiology (Y.L., Z.J.B., M.L.), Medical College of Wisconsin, Milwaukee, Wisconsin. Current affiliation: Department of Ophthalmology, Stanford University School of Medicine, Stanford, California (Z.-D.G.).
    Background: Diabetes impairs the cardioprotective effect of volatile anesthetics, yet the mechanisms are still murky. We examined the regulatory effect of isoflurane on microRNA-21, endothelial nitric-oxide synthase, and mitochondrial respiratory complex I in type II diabetic mice.

    Methods: Myocardial ischemia/reperfusion injury was produced in obese type 2 diabetic (db/db) and C57BL/6 control mice ex vivo in the presence or absence of isoflurane administered before ischemia. Read More

    Dilemma in management: a patient with active systemic lupus erythematosus presenting with pulmonary cavitary lesion.
    Oxf Med Case Reports 2017 Oct 10;2017(10):omx064. Epub 2017 Oct 10.
    Rheumatology, Loma Linda University Medical Center, Loma Linda, CA, USA.
    Pulmonary manifestations of systemic lupus erythematosus (SLE) include, but are not limited to, pneumonia, interstitial pneumonitis, atelectasis and pleural effusion. Cavitary lung lesions are rarely associated with SLE. We present herein the case of a female patient with SLE and lupus nephritis who presented to the hospital with respiratory failure, rash and arthralgias. Read More

    Inspiratory Muscle Training in the Intensive Care Unit: A New Perspective.
    J Clin Med Res 2017 Nov 2;9(11):929-934. Epub 2017 Oct 2.
    School of Medical Sciences, Intensive Care Unit of Clinical Hospital, Department of Surgery, State University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil.
    Background: Prolonged use of mechanical ventilation (MV) leads to weakening of the respiratory muscles, especially in patients subjected to sedation, but this effect seems to be preventable or more quickly reversible using respiratory muscle training. The aims of the study were to assess variations in respiratory and hemodinamic parameters with electronic inspiratory muscle training (EIMT) in tracheostomized patients requiring MV and to compare these variations with those in a group of patients subjected to an intermittent nebulization program (INP).

    Methods: This was a pilot, prospective, randomized study of tracheostomized patients requiring MV in one intensive care unit (ICU). Read More

    [Effects of High-frequency Jet Ventilation on Respiratory Failure after Total Arch Replacement Due to Acute Aortic Dissection with Morbid Obesity;Report of a Case].
    Kyobu Geka 2017 Oct;70(11):965-967
    Department of Cardiovascular Surgery, Hamamatsu Rosai Hospital, Hamamatsu, Japan.
    A 55-year-old morbidly obese woman [body mass index (BMI) 51.2] developed acute type A aortic dissection, and she also presented with significant hypoxemia and hypercapnia. She underwent a successful emergency total arch replacement, but severe hypoxemia persisted and Pao2/Fio2 lowered to 71. Read More

    Effect of procalcitonin-guided antibiotic treatment on mortality in acute respiratory infections: a patient level meta-analysis.
    Lancet Infect Dis 2017 Oct 13. Epub 2017 Oct 13.
    Medical University Department, Kantonsspital Aarau, Aarau, Switzerland; Faculty of Medicine, University of Basel, Basel, Switzerland.
    Background: In February, 2017, the US Food and Drug Administration approved the blood infection marker procalcitonin for guiding antibiotic therapy in patients with acute respiratory infections. This meta-analysis of patient data from 26 randomised controlled trials was designed to assess safety of procalcitonin-guided treatment in patients with acute respiratory infections from different clinical settings.

    Methods: Based on a prespecified Cochrane protocol, we did a systematic literature search on the Cochrane Central Register of Controlled Trials, MEDLINE, and Embase, and pooled individual patient data from trials in which patients with respiratory infections were randomly assigned to receive antibiotics based on procalcitonin concentrations (procalcitonin-guided group) or control. Read More

    Dietary Nitrate Supplementation Opposes the Elevated Diaphragm Blood Flow in Chronic Heart Failure during Submaximal Exercise.
    Respir Physiol Neurobiol 2017 Oct 13. Epub 2017 Oct 13.
    Department of Kinesiology, Kansas State University, Manhattan, KS 66506, USA; Department of Anatomy and Physiology, Kansas State University, Manhattan, KS 66506, USA.
    Chronic heart failure (CHF) results in a greater cost of breathing and necessitates an elevated diaphragm blood flow (BF). Dietary nitrate (NO3‾) supplementation lowers the cost of exercise. We hypothesized that dietary NO3‾ supplementation would attenuate the CHF-induced greater cost of breathing and thus the heightened diaphragm BF during exercise. Read More

    Aerobic function in mitochondria persists beyond death by heat stress in insects.
    J Therm Biol 2017 Oct 24;69:267-274. Epub 2017 Aug 24.
    Department of Ecology and Evolutionary Biology, University of California, Irvine, 321 Steinhaus Hall, Irvine, CA 92697-2525, USA.
    The critical thermal maximum (CTmax) of insects can be determined using flow-through thermolimit respirometry. It has been demonstrated that respiratory patterns cease and insects do not recover once the CTmax temperature has been reached. However, if high temperatures are maintained following the CTmax, researchers have observed a curious phenomenon whereby the insect body releases a large burst of carbon dioxide at a rate and magnitude that often exceed that of the live insect. Read More

    High-flow oxygen via nasal cannulae in patients with acute hypoxemic respiratory failure: a systematic review and meta-analysis.
    Syst Rev 2017 Oct 16;6(1):202. Epub 2017 Oct 16.
    Department of Internal Medicine, Section of Critical Care, University of Manitoba, Winnipeg, MB, Canada.
    Background: We performed a systematic review and meta-analysis to evaluate the efficacy and safety of high-flow oxygen via nasal cannulae (HFNC) compared to non-invasive ventilation (NIV) and/or standard oxygen in patients with acute, hypoxemic respiratory failure.

    Methods: We reviewed randomized controlled trials from CENTRAL, EMBASE, MEDLINE, Scopus and the International Clinical Trials Registry Platform (inception to February 2016), conference proceedings, and relevant article reference lists. Two reviewers independently screened and extracted trial-level data from trials investigating HFNC in patients with acute, hypoxemic respiratory failure. Read More

    End-of-life Characteristics and Palliative Care Provision for Patients With Motor Neuron Disease.
    Am J Hosp Palliat Care 2017 Jan 1:1049909117735832. Epub 2017 Jan 1.
    2 Palliative Home Care Team, Tuen Mun Hospital, New Territories, Hong Kong.
    Motor neuron disease (MND) is a neurodegenerative disease and manifested as progressive decline in physical, respiratory, swallowing and communication function, and ultimately death. Traditional model of care was fragmented and did not match with multifacet needs of patients and carers. Furthermore, there could be lack of integrated care at end of life for patients with MND in most lower- and middle-income countries or in places with inadequate palliative care (PC) coverage. Read More

    Hemocoagulase might not control but worsen gastrointestinal bleeding in an elderly patient with type II respiratory failure.
    Transl Gastroenterol Hepatol 2017 12;2:71. Epub 2017 Sep 12.
    Department of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang 110840, China.
    Hemocoagulase has been successfully used for the management of bleeding in patients undergoing surgery. Local spray of hemocoagulase during endoscopic therapy may be effective for the management of gastrointestinal bleeding. In China, intravenous infusion of hemocoagulase is given by some physicians for the treatment of gastrointestinal bleeding. Read More

    Antibiotic therapy, supportive treatment and management of immunomodulation-inflammation response in community acquired pneumonia: review of recommendations.
    Multidiscip Respir Med 2017 5;12:26. Epub 2017 Oct 5.
    Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Internal Medicine Department, Respiratory Unit and Regional Adult Cystic Fibrosis Center, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35 Milan, Italy.
    Community-acquired pneumonia is a common and serious disease, with high rates of morbidity and mortality. Management and treatment of community-acquired pneumonia are described in three main documents: the 2007 American Thoracic Society guidelines, the 2011 European Respiratory Society guidelines, and the 2009 British Thoracic Society guidelines, updated by the NICE in 2015. Despite the validity of current guidelines in improving prognosis and management of patients with community-acquired pneumonia, not all recommendations have high levels of evidence and there are still some controversial issues. Read More

    Efficacy of Oxycodone for Dyspnea in End-stage Heart Failure with Renal Insufficiency: A Case Report.
    Intern Med 2017 Oct 16. Epub 2017 Oct 16.
    Department of Pharmacy, Kansai Medical University Hospital, Japan.
    A 67-year-old man with dilated cardiomyopathy and renal insufficiency was admitted to our hospital with dyspnea secondary to end-stage heart failure. We introduced oxycodone for medically refractory dyspnea instead of morphine because of the patient's renal insufficiency. After the administration of oxycodone, his dyspnea was alleviated without any adverse opioid effects, such as respiratory depression. Read More

    Bilateral Tuberculous Pleurisy with Subsequent Upper Lobe Predominant Pulmonary Fibrosis Mimicking Pleuroparenchymal Fibroelastosis.
    Intern Med 2017 Oct 16. Epub 2017 Oct 16.
    Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Japan.
    Although the majority of patients with Mycobacterium tuberculosis have pulmonary involvement, some cases have pleural involvement as extra-pulmonary sites of infection. We herein report a case of upper lobe-predominant pulmonary fibrosis that developed in a 47-year-old male with a history of bilateral tuberculous pleurisy. Based on his chest radiological findings, pleuroparenchymal fibroelastosis (PPFE) was most strongly suspected, and a surgical lung biopsy (SLB) was performed to obtain a pathological diagnosis. Read More

    Clinical Features of Nontuberculous Mycobacterial Pleurisy: A Review of 12 Cases.
    Intern Med 2017 Oct 16. Epub 2017 Oct 16.
    Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Japan.
    Objective The incidence of pulmonary nontuberculous mycobacterial (NTM) infections has increased in recent decades. Nevertheless, NTM pleurisy is still a rare disease. The objective of the present study was to elucidate the clinical features and outcomes of NTM pleurisy. Read More

    Emergency Caesarean Section Saved Both an Anti-MuSK Antibody-positive Myasthenia Gravis Mother with Pregnancy-induced Hypertension and Her Premature Baby.
    Intern Med 2017 Oct 16. Epub 2017 Oct 16.
    Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Japan.
    We herein report the case of a 46-year-old pregnant woman with anti-muscle specific kinase (MuSK) antibody-positive myasthenia gravis (MG) who showed pregnancy-induced hypertension and developed respiratory failure at 30 weeks and 5 days of pregnancy, and who underwent an emergency caesarean section (CS). Her MG symptoms gradually improved in the subsequent weeks. The premature baby with positive MuSK antibodies was successfully delivered, but the male baby required temporary artificial ventilation. Read More

    Predictive factors of early postoperative respiratory complications after tonsillectomy in children with unidentified risks for this complication.
    Anaesth Crit Care Pain Med 2017 Oct 12. Epub 2017 Oct 12.
    Department of Anaesthesia, Intensive care and Pain Management, AP-HP, Robert Debré University Hospital, Paris, France; Paris Diderot University (Paris 7). Pres Paris Sorbonne Cité, Paris, France; UMR INSERM U 676.Robert Debré University Hospital, Paris, France. Electronic address:
    Introduction: Tonsillectomy is considered as a therapeutic option in obstructive sleep apnoea syndrome (OSAS). Postoperative respiratory failure is a complication that can require respiratory support. The main objective of our study is to determine risk factors of postoperative respiratory complications in children undergoing tonsillectomy. Read More

    Correlation between oxyhaemoglobin saturation by pulse oximetry and partial pressure of oxygen in patients with acute respiratory failure.
    Rev Clin Esp 2017 Oct 12. Epub 2017 Oct 12.
    Sección de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital General Universitario Reina Sofía, Murcia, España.
    Objectives: To ascertain the correlation between the partial pressure of oxygen (PaO2) and oxyhaemoglobin saturation by pulse oximetry (SpO2) in patients who were admitted to the emergency department with suspected acute respiratory failure.

    Material And Methods: A prospective, observational multicentre study was conducted in the emergency departments of 3 Spanish hospitals.

    Results: The study included 166 patients who presented mean±standard deviation PaO2, SpO2 and fraction of inspired oxygen (FiO2) values of 61. Read More

    Prevnar-13 vaccine failure in a mouse model for vitamin A deficiency.
    Vaccine 2017 Nov 9;35(46):6264-6268. Epub 2017 Oct 9.
    Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN 38105, USA; Department of Microbiology, Immunology and Biochemistry, University of Tennessee Health Science Center, Memphis, TN 38163, USA. Electronic address:
    Streptococcus pneumoniae (pneumococcus) is responsible for serious pediatric respiratory infections, and kills close to one million children under the age of five each year. Unfortunately, the Prevnar-13 vaccine (PCV-13) that is used to protect children from the serious consequences of pneumococcus infections is not always successful. Given that vitamin A deficiency (VAD) is known to affect children in both developed and developing countries, we asked if VAD could be responsible, at least in part, for PCV-13 vaccine failures. Read More

    Laparoscopic and Robotic-Assisted Hysterectomy for Uterine Leiomyomas: A Comparison of Complications and Costs.
    J Obstet Gynaecol Can 2017 Oct 11. Epub 2017 Oct 11.
    Department of Obstetrics and Gynecology, Jewish General Hospital, McGill University, Montréal, QC; Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montréal, QC. Electronic address:
    Objective: Robotic surgery is increasingly being used for treatment of malignant and benign gynaecologic diseases. The purpose of our study is to compare patient perioperative complications and costs of laparoscopic versus robotic-assisted hysterectomy for uterine leiomyomas.

    Methods: A retrospective cohort study using the Nationwide Inpatient Sample database from the United States was conducted, comparing patients who underwent robotic-assisted hysterectomy and laparoscopic hysterectomy (total laparoscopic hysterectomy and laparoscopic-assisted vaginal hysterectomy) for uterine fibroids between 2008 and 2012. Read More

    Advanced Cardiopulmonary Support for Pulmonary Embolism.
    Tech Vasc Interv Radiol 2017 Sep 5;20(3):179-184. Epub 2017 Jul 5.
    Division of Cardiothoracic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA.
    Management of high-risk pulmonary embolism (PE) requires an understanding of the pathophysiology of PE, options for rapid clot reduction, critical care interventions, and advanced cardiopulmonary support. PE can lead to rapid respiratory and hemodynamic collapse via a complex sequence of events leading to acute right ventricular failure. Importantly, reduction in pulmonary vascular resistance must be accomplished either by systemic thrombolytics, catheter directed thrombolytics, endovascular clot extraction, or surgical embolectomy. Read More

    2015-2016 Vaccine Effectiveness of Live Attenuated and Inactivated Influenza Vaccines in Children in the United States.
    Clin Infect Dis 2017 Oct 4. Epub 2017 Oct 4.
    MedImmune, Gaithersburg, Maryland.
    Background: In the 2015-2016 season, quadrivalent live attenuated influenza vaccine (LAIV) and both trivalent and quadrivalent inactivated influenza vaccine (IIV) were available in the United States.

    Methods: This study, conducted according to a test-negative case-control design, enrolled children aged 2-17 years presenting to outpatient settings with fever and respiratory symptoms for <5 days at 8 sites across the United States between November 30, 2015 and April 15, 2016. A nasal swab was obtained for reverse transcriptase-polymerase chain reaction (RT-PCR) testing for influenza, and influenza vaccination was verified in the medical record or vaccine registry. Read More

    Risk of exacerbation following pneumonia in adults with heart failure or chronic obstructive pulmonary disease.
    PLoS One 2017 13;12(10):e0184877. Epub 2017 Oct 13.
    Boston University Schools of Medicine and Public Health, Boston, MA, United States of America.
    Background: Recent evidence demonstrates increased short-term risk of cardiac complications and respiratory failure among patients with heart failure (HF) and chronic obstructive pulmonary disease (COPD), respectively, concurrent with an episode of community-acquired pneumonia (CAP). We evaluated patients with pre-existing HF or COPD, beginning 30 days after CAP diagnosis, to determine if CAP had a prolonged impact on their underlying comorbidity.

    Methods: A retrospective matched-cohort design using US healthcare claims was employed. Read More

    Report of 12 Cases with tracheobronchial mucormycosis and a review.
    Clin Respir J 2017 Oct 13. Epub 2017 Oct 13.
    Department of Respiratory Medicine, Xiangya Hospital (Key Cite of National Clinical Research Center for Respiratory Disease), Central South University, Changsha, Hunan 410008, PR China.
    Objectives: Tranchobronchial mucormycosis is a rare and invasive pulmonary mucormycosis involving the tracheobronchial tree.

    Data Source: at a 3500-bed tertiary care center.

    Study Selection: This was a retroactive study of 12 cases of tranchobronchial mucormycosis diagnosed in our hospital, and 48 cases that were previously reported in the English literature. Read More

    Oedema-fibrosis in Duchenne Muscular Dystrophy. Role of Cardiovascular Magnetic Resonance Imaging.
    Eur J Clin Invest 2017 Oct 13. Epub 2017 Oct 13.
    First Dept of Paediatrics, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece.
    Duchenne muscular dystrophy (DMD) is an X-linked muscle disorder characterized by progressive, irreversible loss of cardiac and skeletal muscular function. Muscular enlargement in DMD is attributed to oedema, due to the increased cytoplasmic Na+ concentration. The aim in this review is to present the current experience and emphasize the role of cardiovascular magnetic resonance (CMR) in the diagnosis of this condition. Read More

    Etiology and Risk Factors Determining Poor Outcome of Severe Pneumonia in Under-Five Children.
    Indian J Pediatr 2017 Oct 13. Epub 2017 Oct 13.
    Department of Pediatrics, University College of Medical Sciences & GTB Hospital, Dilshad Garden, Delhi, 110095, India.
    Objectives: To determine the etiology of severe pneumonia (pneumonia with chest indrawing) in under-five children, and to study the risk factors for poor outcomes viz., 'treatment failure', 'need for change in antibiotics', 'prolonged hospital stay', 'need for mechanical ventilation' and 'mortality.'

    Methods: Children (age 2 mo to 5 y) with pneumonia and chest drawing were enrolled prospectively from October 2012 through September 2013. Read More

    Severe Hemoptysis Associated with Bacterial Pulmonary Infection: Clinical Features, Significance of Parenchymal Necrosis, and Outcome.
    Lung 2017 Oct 12. Epub 2017 Oct 12.
    Faculté de Médecine de Créteil, Groupe de recherche clinique CARMAS, Université Paris Est Créteil, 94010, Paris, Créteil, France.
    Purpose: Severe hemoptysis (SH) associated with non-tuberculosis bacterial lower respiratory tract infection (LRTI) is poorly described, and the efficacy of the usual decision-making process is unknown. This study aimed at describing the clinical, radiological patterns, mechanism, and microbiological spectrum of SH related to bacterial LRTI, and assessing whether the severity of hemoptysis and the results of usual therapeutic strategy are influenced by the presence of parenchymal necrosis.

    Methods: A single-center analysis of patients with SH related to bacterial LRTI from a prospective registry of consecutive patients with SH admitted to the intensive care unit of a tertiary referral center between November 1996 and May 2013. Read More

    Korean Shock Society septic shock registry: a preliminary report.
    Clin Exp Emerg Med 2017 Sep 30;4(3):146-153. Epub 2017 Sep 30.
    Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea.
    Objective: To evaluate the clinical characteristics, therapeutic interventions, and outcomes of patients with septic shock admitted to the emergency department (ED).

    Methods: This study was a preliminary, descriptive analysis of a prospective, multi-center, observational registry of the EDs of 10 hospitals participating in the Korean Shock Society. Patients aged 19 years or older who had a suspected or confirmed infection and evidence of refractory hypotension or hypoperfusion were included. Read More

    Gastroparesis as the Sole Presenting Feature of Neuromyelitis Optica.
    ACG Case Rep J 2017 27;4:e109. Epub 2017 Sep 27.
    Department of Internal Medicine, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX.
    A 33-year-old African-American woman recently diagnosed with severe idiopathic gastroparesis was readmitted for hypoxic respiratory failure secondary to aspiration pneumonia. A fiber-optic endoscopic evaluation of swallow study revealed severe pharyngeal dysphagia. Brain magnetic resonance imaging showed an ill-defined lesion in the posterior aspect of the medulla concerning for a demyelinating process. Read More

    Bedside Ultrasound in the Diagnosis and Treatment of Children with Respiratory Difficulty Following Cardiac Surgery.
    J Clin Imaging Sci 2017 22;7:37. Epub 2017 Sep 22.
    King Abdulaziz Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Kingdom of Saudi Arabia.
    Many children frequently fail extubation or require a prolonged period of positive pressure ventilation support after cardiac surgery. Pediatric cardiac Intensive Care Unit (PCICU) ultrasound (US) stands as a simple, basic bedside tool that can be performed by trained intensivists for the diagnosis with immediate implication on therapeutic decisions in multiple scenarios that physicians may face in PCICU. Bedside US is widely available, convenient, and inexpensive. Read More

    Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections.
    Cochrane Database Syst Rev 2017 Oct 13;10:CD007498. Epub 2017 Oct 13.
    Medical University Department, Kantonsspital Aarau, Aarau, Switzerland.
    Background: Acute respiratory infections (ARIs) comprise of a large and heterogeneous group of infections including bacterial, viral, and other aetiologies. In recent years, procalcitonin (PCT), a blood marker for bacterial infections, has emerged as a promising tool to improve decisions about antibiotic therapy (PCT-guided antibiotic therapy). Several randomised controlled trials (RCTs) have demonstrated the feasibility of using procalcitonin for starting and stopping antibiotics in different patient populations with ARIs and different settings ranging from primary care settings to emergency departments, hospital wards, and intensive care units. Read More

    KLF2 mediates enhanced chemoreflex sensitivity, disordered breathing and autonomic dysregulation in heart failure.
    J Physiol 2017 Sep 6. Epub 2017 Sep 6.
    Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, USA.
    Key Points: Enhanced carotid body chemoreflex activity contributes to development of disordered breathing patterns, autonomic dysregulation and increases in incidence of arrhythmia in animal models of reduced ejection fraction heart failure. Chronic reductions in carotid artery blood flow are associated with increased carotid body chemoreceptor activity. Krüppel-like Factor 2 (KLF2) is a shear stress-sensitive transcription factor that regulates the expression of enzymes which have previously been shown to play a role in increased chemoreflex sensitivity. Read More

    Influenza Vaccination Rate and Reasons for Nonvaccination in Children With Cardiac Disease.
    Pediatr Infect Dis J 2017 Nov;36(11):e268-e271
    From the *Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; †Unit of Pediatric Infectious Diseases, ‡Pediatrics A, and §Institute of Pediatric Cardiology, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.
    Background: Influenza is a major cause of respiratory morbidity worldwide. It poses a risk of complications in children with cardiac disease. Influenza vaccine is considered the most effective and safe means of preventing the disease. Read More

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