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Trials 2021 Apr 12;22(1):268. Epub 2021 Apr 12.

Department of Physical and Rehabilitation Medicine - Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal.

Objectives: The primary objective of the presented study is to analyze the respiratory and functional effects of a rehabilitation program in patients affected by hospitalization in Intensive Care Unit (ICU) due to COVID-19, in comparison with the group treated with standard of care, at discharge endpoint. The secondary objectives of the presented study are to evaluate different outcomes of the rehabilitation program in comparison to standard of care regarding: functional performance at 4-week and 12-week post- discharge mark; health-related quality of life, the impact on the health services (namely days of hospitalization), the cost-effectiveness of the intervention proposed.

Trial Design: This is a randomized, controlled, double-blind, double-arm clinical trial of treatment, with an allocation ratio 1:1 and framework of superiority. Read More

Am Heart J 2021 Apr 9. Epub 2021 Apr 9.

Hospital Clínico San Carlos. Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC). Madrid, Spain.

Background: The use of Renin-Angiotensin system inhibitors (RASi) in patients with coronavirus disease 2019 (COVID-19) has been questioned because both share a target receptor site.

Methods: HOPE-COVID-19 (NCT04334291) is an international investigator-initiated registry. Patients are eligible when discharged after an in-hospital stay with COVID-19, dead or alive. Read More

Rev Med Chil 2020 Oct;148(10):1467-1474

Hospital Clínico Universidad de Chile, Santiago, Chile.

Coronavirus disease 19 is characterized by an intense inflammatory response and a high incidence of thrombotic events. Autopsy studies show severe endothelial injury associated with thrombosis of the alveolar capillaries of the lungs and other organs. In the pathophysiology of this disease endothelial injury and dysfunction, inflammation and thrombosis are key factors for the development of severe phenotypes. Read More

Biochem Biophys Res Commun 2021 Apr 8;556:134-141. Epub 2021 Apr 8.

Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan.

Oxidative stress is a deteriorating factor for pancreatic β-cells under chronic hyperglycemia in diabetes. However, the molecular mechanism underlying the increase in oxidative stress in β-cells under diabetic conditions remains unclear. We demonstrated previously that the selective alleviation of glucotoxicity ameliorated the downregulation of several β-cell factors, including Cox6a2. Read More

J Integr Neurosci 2021 Mar;20(1):143-151

Running Gene Inc.,100083 Beijing, P. R. China.

Infantile hypertonic myofibrillar myopathy is characterized by the rapid development of rigid muscles and respiratory insufficiency soon after birth, with very high mortality. It is extremely rare, and only a few cases having been reported until now. Here we report four Chinese infants with fatal neuromuscular disorders characterized by abdominal and trunk skeletal muscle stiffness and rapid respiratory insufficiency progression. Read More

Ann Thorac Surg 2021 Apr 5. Epub 2021 Apr 5.

Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, ITALY. Electronic address:

Background: Clinical significance of multifocal pulmonary neuroendocrine proliferation (MNEP), including tumorlets and pulmonary neuroendocrine cell hyperplasia, in association with Typical Carcinoid (TC), is still debated.

Methods: A retrospective series of TC with long-term follow-up data prospectively collected from two institutions was evaluated, and the outcome comparison between TC alone and MNEP+TC was investigated. Several baseline covariates were imbalanced between the MNEP+TC and TC groups, therefore, we have conducted 1:1 propensity score matching and inverse probability of treatment weighting (IPTW) in the full sample. Read More

Mymensingh Med J 2021 Apr;30(2):292-300

Dr Habiba Sultana, MD (Radiology & Imaging) Final Part Student, Department of Radiology & Imaging, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:

This study is aimed to find out various clinical, radio-graphical and echocardiographic variables to predict mitral valvular disease and their correlation with Echocardiography. This cross-sectional observational study was conducted in the Department of Radiology and Imaging, in collaboration with Department of Cardiology, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from January 2017 to December 2018. Total 50 consecutive cases enrolled in this study who was the patients of mitral valvular disease. Read More

N Engl J Med 2021 04;384(14):1361-1363

From the Medical Research Institute of New Zealand and the Intensive Care Unit, Wellington Hospital - both in Wellington, New Zealand.

Ann Vasc Surg 2021 Apr 3. Epub 2021 Apr 3.

Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.

Introduction: Cardiovascular involvement in SARS-CoV-2 infection has emerged as one of viral major clinical features during actual pandemic; limb arterial ischemic events, venous thrombosis, acute myocardial infection and stroke have occurred in patients. Acute aortic conditions have also been described, followed by interesting observations on cases, hypothesis, raised since the emergence of the pandemics.

Methods: a review of cases in literature of aortic pathology in patients with clinically suspected/microbiologically confirmed COVID-19 infection has been carried out to analyze anagraphic data, clinical presentation, treatment options and outcome. Read More

Minerva Pediatr (Torino) 2021 Apr 2. Epub 2021 Apr 2.

Neurophysiology Unit, Neurology Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Encephalopathy of different etiologies in infants is often the reason for central respiratory insufficiency which eventually leads patients to the paediatric intensive care unit. Magnetic resonance imaging (MRI) and brainstem auditory evoked potentials (BAEPs) may be useful to identify brainstem alterations among patients with respiratory insufficiency of central origin. MRI is a compulsory technique to identify brain abnormalities, but may fail to detect brainstem lesions of small dimensions. Read More

J Pak Med Assoc 2021 02;71(2(A)):446-448

Department of Neurology, King Edward Medical University (KEMU), Lahore, Pakistan.

Objective: To assess sensory symptoms on presentation as a predictor of respiratory insufficiency in patients of Guillain-Barre Syndrome.

Methods: The descriptive cross-sectional study was conducted from November 2018 to March 2019 at the Neurology Department of King Edward Medical University, Lahore, Pakistan, and comprised patients aged 18-60 years suffering from Guillain-Barre Syndrome as per Brighton criteria. All patients were monitored for respiratory insufficiency by single breath count and arterial blood gases. Read More

Cardiol Young 2021 Apr 5:1-7. Epub 2021 Apr 5.

Pediatric Cardiology, Children's National Hospital, George Washington University, Washington, DC, USA.

Background: Children with CHD carry an additional burden of pulmonary insufficiency, often necessitating prolonged ventilatory support, especially in the peri-operative phase. There has been an increase in the utilisation of non-invasive ventilatory support for these children. The objective of this study was to evaluate the utilisation, safety, and outcomes of RAM cannula as a tool for escalation and de-escalation of respiratory support in paediatric cardiac patients less than one year of age. Read More

Respir Med Case Rep 2021 19;33:101391. Epub 2021 Mar 19.

Kurihara Central Hospital, Department of Respiratory Medicine, Miyano Cyuo 3-11, Tsukidate, Kurihara, Miyagi, 987-2205, Japan.

The etiology of Sjögren's syndrome (SS) remains unclear and is associated with many other autoimmune diseases. In particular, symptoms of SS are not apparent when steroids are already being administered for other autoimmune diseases. This report documents a case of autoimmune hepatitis with SS, which was diagnosed on the basis of the worsening of unilateral pleural effusion after the discontinuation of steroids as well as the manifestation of symptoms, such as dry mouth. Read More

Int J Chron Obstruct Pulmon Dis 2021 26;16:771-781. Epub 2021 Mar 26.

Cologne Merheim Hospital, Department of Pneumology, Kliniken der Stadt Köln gGmbH, Witten/Herdecke University, Cologne, Germany.

Purpose: The impact of oronasal and nasal masks on the quality of nocturnal non-invasive ventilation (NIV) needs to be clarified. This trial was designed to compare the impact of oronasal and nasal masks on the objective quality and subjective acceptance of nocturnal NIV in COPD-patients.

Patients And Methods: In a randomized crossover trial, 30 COPD-patients with well-established high-intensity NIV (mean inspiratory/expiratory positive airway pressure 26±3/5±1 cmHO, mean respiratory back-up rate 17±1/min) were ventilated for two consecutive nights on oronasal and nasal masks, respectively. Read More

Am J Transplant 2021 Apr 3. Epub 2021 Apr 3.

Department of Surgery, Division of Abdominal Transplant Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA.

Cystic fibrosis (CF) is an inherited autosomal recessive disorder. Despite optimized therapy, the majority of affected individuals ultimately die of respiratory failure. Lung transplantation is the only available therapy that deals definitively with the end-stage pulmonary disease and has become the treatment of choice for some of these patients. Read More

Medicina (Kaunas) 2021 Mar 24;57(4). Epub 2021 Mar 24.

Department of Head and Neck Surgery and Otorhinolaryngology, University Clinical Hospital of Railway Company, Iuliu Hatieganu University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania.

: Establishing the diagnosis of COVID-19 and pulmonary coinfection is difficult due to clinical and radiological similarities that exist between the two disorders. For the moment, fungal coinfections are underestimated in COVID-19 patients. : We report the case of a 52-year-old male patient, who presented to the emergency department for severe dyspnea and died 17 h later. Read More

Front Endocrinol (Lausanne) 2021 16;12:642131. Epub 2021 Mar 16.

Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wrocław, Poland.

Introduction: In acromegaly, chronic exposure to impaired GH and IGF-I levels leads to the development of typical acromegaly symptoms, and multiple systemic complications as cardiovascular, metabolic, respiratory, endocrine, and bone disorders. Acromegaly comorbidities contribute to decreased life quality and premature mortality. The aim of our study was to assess the frequency of acromegaly complications and to evaluate diagnostic methods performed toward recognition of them. Read More

Front Endocrinol (Lausanne) 2021 16;12:596654. Epub 2021 Mar 16.

Section of Paediatrics, Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona, Italy.

In early 2020, a novel coronavirus leading to potentially death was discovered. Since then, the 2019 coronavirus disease (COVID-19) has spread to become a worldwide pandemic. Beyond the risks strictly related to the infection, concerns have been expressed for the endocrinological impact that COVID-19 may have, especially in vulnerable individuals with pre-existing endocrinological health conditions. Read More

Saudi Med J 2021 Apr;42(4):391-398

From the Department of Pediatrics (Alnajjar, Dohain, Abdelmohsen, Alahmadi, Zaher, Abdelgalil), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; and from the Department of Pediatrics (Dohain, Abdelmohsen, Abdelgalil), Cairo University, Cairo, Egypt.

Objectives: To determine the demographic and clinical characteristics, underlying comorbidities, and outcomes of children with coronavirus disease 2019 (COVID-19) infection.

Methods: In this retrospective study, we reported 62 pediatric patients (age <14 years) with confirmed COVID-19 between March 2 and July 1, 2020, at King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

Results: Comorbid conditions, including cardiac, neurological, respiratory, and malignant disorders, were reported in 9 patients (14. Read More

Ann Am Thorac Soc 2021 04;18(4):573-581

Department of Pulmonary, Allergy and Critical Care Medicine, Respiratory Institute, and.

Dyspnea in low-preload states is an underrecognized but growing diagnosis in patients with unexplained dyspnea. Patients can often experience debilitating symptoms at rest and with exertion, as low measured preload often leads to decreased cardiac output and ultimately dyspnea. In the present article, we performed a review of the literature and a multidisciplinary evaluation to understand the pathophysiology, diagnosis, and treatment of dyspnea in low-preload states. Read More

Amyotroph Lateral Scler Frontotemporal Degener 2021 Apr 1:1-9. Epub 2021 Apr 1.

St. Joseph's Hospital and Medical Cente, Barrow Neurological Institute, Phoenix, AZ, USA.

To evaluate the prescribing practices of noninvasive ventilation (NIV) and patient compliance during VITALITY-ALS. VITALITY-ALS enrolled patients with a slow vital capacity (SVC) ≥70% of predicted who were not using NIV at screening. Physicians prescribed NIV without restriction following randomization. Read More

BMC Health Serv Res 2021 Mar 31;21(1):290. Epub 2021 Mar 31.

The Prehospital Research Unit, Region of Southern Denmark, Odense University Hospital, Odense, Denmark.

Introduction: Crowding of the emergency departments is an increasing problem. Many patients with an exacerbation of chronic obstructive pulmonary disease (COPD) are often treated in the emergency departments for a very short period before discharged to their homes. It is possible that this treatment could take place in the patients' homes with sufficient diagnostics supporting the treatment. Read More

Adv Exp Med Biol 2021 ;1303:129-138

Division of Pulmonary and Critical Care Medicine, Albany Medical College, Albany, NY, USA.

Dysfunction of locomotor muscles is frequent in chronic pulmonary diseases and strongly associated with worse outcomes including higher mortality. Although these associations have been corroborated over the last decades, there is poor mechanistic understanding of the process, in part due to the lack of adequate animal models to investigate this process. Most of the mechanistic research has so far been accomplished using relevant individual stimuli such as low oxygen or high CO delivered to otherwise healthy animals as surrogates of the phenomena occurring in the clinical setting. Read More

Crit Care 2021 03 29;25(1):124. Epub 2021 Mar 29.

CHU Lille, Service de Chirurgie Cardiaque, F-59000, Lille, France.

J Intensive Care Med 2021 Mar 29:8850666211005422. Epub 2021 Mar 29.

Division of Pulmonary, Critical Care, and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

Background: Acute Respiratory Distress Syndrome (ARDS) is a frequent cause of respiratory failure in intensive care unit (ICU) patients and results in significant morbidity and mortality. ARDS often develops as a result of a local or systemic inflammatory insult. Cancer can lead to systemic inflammation but whether cancer is an independent risk factor for developing ARDS is unknown. Read More