- [Use of noninvasive ventilation in critically ill patients]. [Journal Article]
- OHOrv Hetil 2018; 159(45):1831-1837
- CONCLUSIONS: Noninvasive ventilation is a widely used, effective treatment mode which can improve the outcome in certain diseases compared to invasive ventilation. Noninvasive ventilation in incorrect indications could, however, lead to increased failure rates and mortality. Orv Hetil. 2018; 159(45): 1831-1837.
- Rutosides for treatment of post-thrombotic syndrome. [Review]
- CDCochrane Database Syst Rev 2018 Nov 08; 11:CD005625
- Post-thrombotic syndrome (PTS) is a long-term complication of deep venous thrombosis (DVT) that is characterised by pain, swelling, and skin changes in the affected limb. One in three patients with D...
Post-thrombotic syndrome (PTS) is a long-term complication of deep venous thrombosis (DVT) that is characterised by pain, swelling, and skin changes in the affected limb. One in three patients with DVT will develop post-thrombotic sequelae within five years. Rutosides are a group of compounds derived from horse chestnut (Aesculus hippocastanum), a traditional herbal remedy for treating oedema formation in chronic venous insufficiency (CVI). However, it is not known whether rutosides are effective and safe in the treatment of PTS. This is the second update of the review first published in 2013.
- Carcinogenesis-related changes in iron metabolism in chronic obstructive pulmonary disease subjects with lung cancer. [Journal Article]
- OLOncol Lett 2018; 16(5):6831-6837
- Chronic obstructive pulmonary disease (COPD) is often accompanied by lung cancer. In our previous work, it was observed that matrix metalloproteinase-3 and haptoglobin (HP) polymorphisms were potenti...
Chronic obstructive pulmonary disease (COPD) is often accompanied by lung cancer. In our previous work, it was observed that matrix metalloproteinase-3 and haptoglobin (HP) polymorphisms were potential markers of enhanced susceptibility to lung cancer development among male COPD subjects. Here, results are reported on blood serum levels of several proteins involved in iron metabolism, inflammation and the oxidative stress response compared between the same groups of subjects. The blood serum levels of tumor necrosis factor α (TNFα), transferrin, hepcidin, ferritin, soluble transferrin receptor and 8-oxo-2'-deoxyguanosine were compared, as well as total iron-binding capacity (TIBC) and ceruloplasmin ferroxidase activity in two groups of subjects: Male COPD patients (54 subjects) and male COPD patients diagnosed with lung cancer (53 subjects). Statistically significant differences were identified between the two groups in transferrin and TNFα levels, as well as in TIBC; all three parameters were lower in the group consisting of COPD patients diagnosed with lung cancer (P<0.01). It was also revealed that HP genotype 1/2 was concomitant with low transferrin blood level in subjects with COPD; this apparent dependence was absent in the COPD + cancer subjects. The results indicate a role of iron metabolism in the susceptibility to lung cancer in COPD-affected subjects. They also emphasize the importance of individual capacity for an effective response to oxidative stress during the pathogenic process as HP is a plasma protein that binds free hemoglobin and its polymorphism results in proteins with altered hemoglobin-binding capacity and different antioxidant and iron-recycling functions.
- A case of bleomycin-induced lung toxicity. [Journal Article]
- MAMonaldi Arch Chest Dis 2018 Nov 06; 88(3):981
- A 64-year-old female was admitted for dry cough, dyspnea, fever, loss of appetite, and weight loss. Past medical history revealed scoliosis, cholecystectomy, and Hodgkin lymphoma. ABG values were: pH...
A 64-year-old female was admitted for dry cough, dyspnea, fever, loss of appetite, and weight loss. Past medical history revealed scoliosis, cholecystectomy, and Hodgkin lymphoma. ABG values were: pH: 7.42, pCO2: 40.2 mm Hg, pO2: 61.4 mm Hg. Chest CT showed cystic lesions, emphysema, ground glass, and reticular opacities. ABG values worsened under 8L/min nasal oxygen. The patient underwent bilevel positive airway pressure (BiPAP) and methylprednisolone 60 mg/day bid was commenced. The final diagnosis was respiratory insufficiency due to bleomycin toxicity. The patient deceased on the sixth day after transfer to the intensive care unit. Bleomycin is an effective chemotherapeutic agent used for Hodgkin lymphoma treatment. It causes significant lung toxicity in half of the patients. Clinicians should always remember that bleomycin toxicity may lead to fatal complications in patients with comorbid conditions. We present this case to remark the possible consequences of bleomycin toxicity and the precautions taken to preclude bleomycin-induced pulmonary complications are discussed.
- Amish nemaline myopathy and dilated cardiomyopathy caused by a homozygous contiguous gene deletion of TNNT1 and TNNI3 in a Mennonite child. [Journal Article]
- EJEur J Med Genet 2018 Nov 02
- Amish nemaline myopathy (ANM) is a severe congenital form of NM, known to be fatal in early childhood due to pulmonary insufficiency. Homozygous mutations in TNNT1 were originally ascertained in an O...
Amish nemaline myopathy (ANM) is a severe congenital form of NM, known to be fatal in early childhood due to pulmonary insufficiency. Homozygous mutations in TNNT1 were originally ascertained in an Older Amish community in 2000. To date, only five reports with six pathogenic variants in TNNT1 have been described in both Amish and non-Amish consanguineous families. Here, we describe a 16-month old female from a small Mennonite community from Mexico, presenting with congenital hypotonia and dilated cardiomyopathy, with a novel homozygous deletion of 19q13.42 of about 11 kb in size, encompassing TNNT1 and TNNI3. Cardiomyopathy has not been observed in association with ANM in previous reports and systolic function is usually normal in children in this form of NM. Conversely, homozygous mutations in TNNI3 have been associated with dilated cardiomyopathy. Our report underscores the consideration of contiguous gene deletion in children with ANM who present with congenital hypotonia and cardiomyopathy. The report also expands the known spectrum of non-Amish related ANM mutations to include homozygous multi-exonic TNNT1 deletion.
- Predictors for treatment outcomes among patients with drug-susceptible tuberculosis in the Netherlands: a retrospective cohort study. [Journal Article]
- CMClin Microbiol Infect 2018 Oct 22
- CONCLUSIONS: Native- and foreign-born patients exhibited similar TB treatment outcomes. To further reduce disease transmission and inhibit drug resistance, special attention should be given to high-risk patients.
- Respiratory failure, non-invasive ventilation and symptom burden: an observational study. [Journal Article]
- JPJ Pain Symptom Manage 2018 Oct 30
- CONCLUSIONS: This study describes the patient-reported symptoms occurring during an episode of acute respiratory failure. Understanding the symptom profile of patients in this setting may allow clinicians to target symptom relief while simultaneously managing respiratory failure, enhancing care.
- Noninvasive ventilation in acute hypoxemic respiratory failure: A systematic review and meta-analysis. [Review]
- JCJ Crit Care 2018 Oct 19; 49:84-91
- CONCLUSIONS: NIV showed a significant protective effect for intubation in immunosuppressed patients (cancer and transplants) and in patients with APE/CAP. However, the benefits of NIV for other etiologies are not clear and more trials are needed to prove these effects.
- Melody valve in mitral position: Complete fracture causing acute mitral stenosis in a child. [Case Reports]
- CCCatheter Cardiovasc Interv 2018 Oct 31
- We present a case of a 7-year-old boy with a history of multiple mitral valve interventions and subsequent Melody valve placement in the mitral position, who presented with acute mitral stenosis due ...
We present a case of a 7-year-old boy with a history of multiple mitral valve interventions and subsequent Melody valve placement in the mitral position, who presented with acute mitral stenosis due to complete fracture of the Melody stent. He was born early with severe mitral and tricuspid insufficiency due to valvular dysplasia, and ended up with 4 sternotomies before the age of 2 due to mitral valve dysfunction and recurrent prosthetic valve thrombosis. He then developed mixed stenosis and regurgitation at age 6, and to avoid another sternotomy, valve-in-valve therapy with off-label use of a 20-mm Melody valve was done with hybrid procedure via trans-apical approach. Eight months later he presented with acutely worsened mitral stenosis (mean gradient 20 mm Hg), due to fracture of the proximal stent. While the safety and efficacy of the Melody valve has been well established especially in the pulmonary position, stent fracture is a known and potentially serious complication. As with any novel valve therapy, close follow-up and frequent imaging may be warranted to watch for loss of stent integrity, particularly if clinical symptoms of valve dysfunction occur.
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- Increasing Immunization Rates in Infants with Severe Chronic Lung Disease: A Quality Improvement Initiative. [Journal Article]
- HPHosp Pediatr 2018; 8(11):693-698
- CONCLUSIONS: The implementation of (1) an in-hospital immunization record review, (2) an e-mail reminder, (3) a weekly multidisciplinary eligibility discussion, and (4) an updated rounding tool was successful in increasing and sustaining immunization rates in this population of infants with CLD. The multidisciplinary CLD meeting was a novel opportunity to discuss immunization eligibility and safety monitoring.